臺灣博碩士論文加值系統

由於人類壽命的延長，人們從重視生存與健康轉變為重視健康相關生活品質（health-related quality of life），但多數用來測量健康相關生活品質的問卷，並無充足的證據顯示問卷是否適用在老人族群。故此研究目的，是在探討「世界衛生組織生活品質問卷台灣簡明版」在老人族群的適用性。研究對象是來自台中縣新社鄉中的六個村，其中六十五歲以上的老人共有2072位，完成第一次訪視的共有1200位；一年後完成第二次測量的共有798位。資料的收集是由經過標準化訓練的訪員至老人家中做訪視。健康相關生活品質的測量是使用「世界衛生組織生活品質問卷台灣簡明版」，此問卷架構包括有：整體生活品質及整體健康2題，及生理（共7題）、心理（共6題）、社會關係（共4題）及環境（共9題）四個範疇，總共有28題。問卷是否適用則是從可行性分析、信度分析、效度分析及感應度分析四部分來做探討。可行性分析結果顯示，「工作能力」及「性生活」這兩題，使用在老人族群時，會產生較多的遺漏值，分別為2.5%及16.5%其他則是從0.08% 至0.83%。內部一致性的數值在各範疇中高巴氏α（Cronbach’s α）值皆大於0.7；再測信度中，內在等級相關係數（Intraclass correlation coefficients）值大多數題目大於0.7。區辨效度可以看出發生跌倒者其生活品質分數較沒發生跌倒者低；而患有慢性疾病者其生活品質分數也較沒有慢性疾病者低。收斂效度是以探索性因素分析來做，結果與原本的四個範疇不同。感應度（responsiveness）分析發現跌倒對生活品質所產生的變化以生理範疇最明顯，其效應值（effect size）為-0.34；社會關係範疇最不明顯，其效應值為-0.09。整體而言，雖然問卷中仍有兩題需做更進一步的修正，但此問卷可以適用在老人族群中。

The purpose of this study was to investigate the suitability of the brief Taiwan-version of the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF) among 1,200 elderly subjects in of Taichung County, Taiwan. The Taiwan version of the 28-item WHOQOL-BREF is categorized into four domains: physical (7 items), psychological (6 items), social (4 items), and environmental (9 items). This study examines the practicality, reliability, validity, and responsiveness of the WHOQOL-BREF for older people. Results of the practicality were satisfactory because the percentages of the missing values in four domains ranged from 0.1 to 16.5. Cronbach’s α coefficients for internal consistence ranged from 0.73 to 0.79. In addition, intraclass correlation coefficients ranged from 0.59 to 0.94 for intra-observer variation, and from 0.39 to 0.97 for inter-observer variation. The scores of the four WHOQOL-BREF domains were lower in people who had a fall or a chronic disease than in those without a fall or a chronic disease. In the exploratory factor analysis, the items in the WHOQOL-BREF converged on 4 common factors. We used fall status as an external indicator to measure the responsiveness of each WHOQOL-BREF domain, and the effect sizes of the four domains ranged from -0.09 to -0.45. This study concluded that the use of the WHOQOL-BREF is suitable for the elderly.

致謝-----------------------------------------------------------------------------------I
中文摘要----------------------------------------------------------------------------II
英文摘要---------------------------------------------------------------------------IV
第一章 緒 論-------------------------------------------------------------------1
第一節 研究背景及動機-------------------------------------------------1
第二節 研究目的----------------------------------------------------------4
第三節 文獻回顧----------------------------------------------------------4
第二章 研究方法及步驟-------------------------------------------------------6
第一節 研究對象----------------------------------------------------------6
第二節 實施步驟----------------------------------------------------------7
第三節 研究工具----------------------------------------------------------8
第四節 資料分析---------------------------------------------------------10
第三章 結果---------------------------------------------------------------------14
第四章 討論---------------------------------------------------------------------17
第五章 結論與建議------------------------------------------------------------21
參考文獻---------------------------------------------------------------------------22
圖一 研究流程圖---------------------------------------------------------------26
表一 可行性分析---------------------------------------------------------------27
表二 內部一致性---------------------------------------------------------------28
表三 再測信度------------------------------------------------------------------29
表四 區辨效度------------------------------------------------------------------30
表五 收斂效度------------------------------------------------------------------31
表六 感應度分析---------------------------------------------------------------32
附錄 台灣簡明版世界衛生組織生活品質問卷---------------------------33

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