中文版西雅圖心絞痛問卷之信度與效度

Reliability and Validity of a Chinese Version of Seatle Angina Questionnaire

本研究的目的在於翻譯西雅圖心絞痛問卷(seatle Angina Questionnaire; SAQ)之中文版，並探討此中文版問卷的信度及效度。將原英文版之西雅圖心絞痛問卷翻譯為中文版，經由專家評估及心臟病人試用意見修正，再反譯回英文並參酌原版作者意見後而定。自心臟內科運動心電圖檢查中選取60位冠狀動脈疾病患者為本研究對象，先完成第1次之中文版西雅圖心絞痛問卷（SAQ中文版）及Short Form-36 (SF-36)台灣版的填答，平均相隔4週後再以郵寄方式完成第2次之SAQ中文版問卷測量，回覆者計有44位（73.3%）。SAQ中文版問卷的再測信度，經比較其中33位穩定性心絞痛的病人2次問卷分數間沒有顯著地差異，5個面向之二次測量的組內相關係數(ICC)介於0.44至0.79。問卷之各面向的內在一致性 Cronbach's α係數則介於0.43至0.84。在對照現有的測量工具的效標關聯效度，發現SAQ中文版問卷之體能活動功能分數與運動測試時間、與SF-36台灣版之身體生理功能面向分數、及與身體功能標準化計分的相關係數分別為0.44、0.84 、及0.59。疾病感受度分數則與SF-36台灣版之一般健康面向分數的相關係數為0.51。另外，追蹤期間有病情變化患者（惡化組）之心絞痛穩定度的得分較穩定心絞痛患者（穩定組）為低(p<0.01)。比較2組間各面向分數前後變化的差異，顯示惡化組在心絞痛穩定度及疾病感受度2個面向分數有較多明顯地減少(p<0.05)，可以反應出病情之相關變化。總結而言，本研究驗證了中文版西椎圖心絞痛問卷的信度及效度良好，適用於中文語系之心臟病人，增添臨床上研究健康相關生活品質之可資測量的工具。

The aim of this study was to validate a translated version of the Seatle Angina Questionnaire (SAQ) in Chinese speaking populations. The SAQ was translated into Chinese from its English version and its wording and meaning were modified based on the recommendations of five experts and 11 patients. Before its use in patients, the Chinese version was translated back into English by an independent translator in order to recheck whether equivalent to the original English version. Sixty patients who were diagnosed with coronary artery disease and completed stress exercise test were recruited at out patient department. Both Chinese version SAQ and Taiwan version Short Form-36 (SF-36) were administrated to them in the first visit time. About 4 weeks later, the Chinese SAQ were administrated again by mail. The responsive rate was 73.3% (44/60). In validation study, the physical function scales of Chinese version SAQ were correlated moderately to highly with the duration of stress exercise test (r=0.44), physical function scales (r=0.84) and standardized physical component scales (r=0.59) of Taiwan version SF-36. The disease perception scales were also correlated with the general health perception scales of Taiwan version SF-36 (r=0.51). The Cronbach’s alpha were 0.43 to 0.84 in assessing internal consistency of each Chinese SAQ’s domain. Test-retest reliability was assessed by comparing serial responses of 33 patients with stable angina over a 4-weeks interval. No significant differences of 2-times responses were found in all domain scales and their intraclass correlation coefficients ranged from 0.44 to 0.79. The Chinese SAQ was sensitive to subtle clinical change of cardiac patients, especially in angina stability scale and disease perception scale. In summary, The Chinese version of Seatle Angina Questionnaire is a reliable and valid instrument for evaluating the health-related quality of life of the individuals with coronary artery disease in Chinese speaking population.