腦部傷害病患生活品質問卷中文版信度 , 效度與感應度之評估
腦部傷害病患生活品質問卷中文版信度，效度與感應度之評估
摘要
創傷性腦部傷害是許多事故傷害致死及失能的主要原因，這些病患的預後通常承受了生理、認知、
行為、情緒和社會適應等問題。腦部傷害病患的預後結果通常是以測量殘疾、失能和社交障礙為主
，而他們的健康相關生活品質在國內則是較少被評估，尤其是很少經由病患本身的直接評估。雖然 近年來有許多工具用來測量生活品質，但這些量表為一般性問卷之用，並非針對創傷性腦部傷害而 設計。特定疾病生活品質問卷是否適合測量健康相關生活品質，是一個值得探討的問題。本研究目 的在評估翻譯後中文版「腦部傷害病患生活品質問卷」 (Quality of Life of Brain Injured ，簡稱 QO LBI ) ，其包含生理 (4 題 ) 、智能 (7 題 ) 、心理 (5 題 ) 、功能 (3 題 ) 、社會 (9 題 ) 和個人 (9 題 ) 等 六大範疇的特定疾病生活品質問卷的信度、效度與感應度等心理計量特性。研究對象是台北地區 2 2 家醫院因創傷性腦部傷害而就醫年齡 18 歲以上的病患，共有 100 位病患接受電話訪談。內部一致 性信度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 (Int raclass correlation coefficients) 值皆大於 0.45 。 收斂效度與世界衛生組織生活品質簡明版問卷 (WH OQOL-BREF) ，在生理、心理、社會、個人範疇的皮爾森相關係數 (Pearson’s correlation) 大於 0.4 。 在區辨效度方面可以看出有工作者其生活品質分數較無工作者高 ; 感應度 (responsiveness) 分析發現 有工作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 0.56; 六個範疇的效 應值從 0.17 - 0.56 ，顯示有中度理想問卷感應度。腦部傷害病患生活品質問卷經過驗證，為具有良 好的信效度與感應度的量表，是適用於測量國內腦部傷害病患健康相關生活品質的有用工具。
關鍵詞 : 創傷性腦部傷害，生活品質，信度，效度，感應度
Reliability, Validity, and Responsiveness of the Taiwanese Version of QOLBI Questionnaire
Reliability, Validity, and Responsiveness of the Taiwanese Version of QOLBI Questionnaire
Abstract
In modern industrial countries traumatic brain injury is a common sequel after different kinds of accidents.
It is also the major cause associated with significant morbidity and mortality of the accident. The late outco me of patients with traumatic brain injury has been investigated by measuring deficits, disability and social handicap, but their health related quality of life has been less evaluated, and not by a direct analysis of the s ubjective patient quality of life. Although many instruments has been developed for assessment of quality of life, but most of the instruments are generic not disease-specific, especially not for the patients who suff ered from traumatic brain injury. The purpose of this study was to investigate the suitability of the Taiwane se version of Quality of Life of Brain Injured questionnaire (QOLBI). The present investigation examined t he psychometric properties of the QOLBI when used in the study of traumatic brain injury (TBI). The Taiw anese version of the 37-item QOLBI is categorized into six domains: physical (4 items), intellectual(7item s),psychological (5 items), functional (3 items), social (9 items), personal (9 items). This study examines th e practicality, reliability, validity, and responsiveness of the QOLBI in traumatic brain injury. Cronbach’s α coefficients for internal consistence ranged from 0.74 to 0.97. The interclass correlation coefficients rang ed from 0.73 to 0.99 for intra-observer variation, and from 0.48 to 0.70 for inter-observer variation. The co nvergent validity analysis showed Pearson’s correlation coefficients higher than 0.4 in four relating domain s: physical, psychological, social, and personal. The scores of the six domains were higher in people who h ad return to work than in those out of employment.. We used return to work as an external indicator to mea sure the responsiveness of each QOLBI domain, and the effect sizes of the six domains ranged from 0.17 to 0.56. From this study we conclud that the use of the QOLBI is suitable for the traumatic brain injury.
Keywords: traumatic brain injury (TBI), quality of life (QOL), reliability, validity, responsiveness
