Flanagan生活品質質量表應用於台北地區脊髓損傷患者之探討

Implementing the Adapted Flanagan Quality of Life Scale in Persons with Spinal Cord Injury Living in Taipei: A Psychometric Study

目的：本研究目的在探討修改後之Flanagan生活品質量表應用於臺灣脊髓損傷患者時量表之信、效度。方法：研究設計是屬非實驗、psychometrc評量。研究分兩部份，第一部份在經由量表之翻譯、反翻譯循環後得到中文版之Flanagan生活品質量表，並透過59位會中英文之普通個案填寫中英文版之Flanagan生活品質量表以檢視其內有一致個度、皮爾森相關係數及建構效度。第二部份則是利用訪談住在臺北縣市的脊髓損傷出院患者，收集其對生活品質之感受、想法，並將資料分析後與Flanagan生活品質量表之各項目做比較，以印證其內容效度。 結果：研究結果顯示皮爾森相關係數在中、英文版各項目是0.84至0.98。內在一致信度在兩種版本均是0.88。內容效度則經由郵寄及親自訪談共39位髓損傷者三個開放式問題如：（1）對您而言生活品質是什麼？（2）什麼載情對您的生活品質而言是重要的？（3）在過去的一年裡，您的生活品質有什麼樣的變化？資料分析結果顯示大部份在Flanagan生活品質量表中定義的生活品質項目，均有在興脊髓損傷患者的訪談中被提到，除了第8是：「參與組織社團，公共事務」這一項。在分析訪談資料中，另外還有四個新的項目相關於脊髓損傷患者之生活品質： （1）無障礙環境、便利的設施與交通；（2）心理的調適；（3）沒有因脊髓損傷而相關的合併症；（4）與照顧者之間有良好的關係（尤以四肢癱瘓的頸髓損傷者為主）。另外，Cronbach alpha值於第一、二次測試分別為0.85及0.83，經2-3週間隔後再測信度為0.83。研究結果顯示Flanagan生活品質量表中文版是一信效度均不錯的生活品質量表，但若應用於脊髓損傷患者則建議添加上面提到的四個新項目。Purpose: The purpose of this study was to gather knowledge about implementing the adapted Flanagan Quality of Life Scale (QOLS, 1987), in spinal cord injured (SCI) outpatients in Taiwan.Methods: The study was a non-experimental psychometric assessment design. In the preliminary stage, a number of translations and back-translations were carried out to ensure a refined and accurate Chinese-language version QOLS. Fifty-nine bilingual persons examined the reliability and concurrent validity of the Chinese version. In the main study, content analysis was used to analyze the qualitative data in order to assure the content validity.Results: Pearson's correlation coefficients between the English and Chinese (E&C) versions were 0.84 to 0.98. The internal consistency reliability in the E&C versions both was 0.88. The content validity of the QOLS was confirmed with 39 SCI outpatients by asking three open-ended questions about quality of life (QOL). All the major components of the QOL identified in the QOLS were also identified by SCI outpatients as components of their QOL except item #8' participating in organization or public affairs'. The additional four domains identified by the SCI outpatients were as follows: (1)freedom from environment barriers, convenient equipment and transportation, (2)psychological adaptation, (3)freedom from complications and (4)good relationships with caregivers. In addititon, Cronbach's alpha was 0.85 on the first testing and 0.83 on the second testing. The test-retest correlation with a two-to-three week interval was 0.83.Conclusions: Overall, the reliability and validity of the Chinese version of adapted Flanagan QOLS were high. The additional four domains may be added to the adapted Flanagan QOLS when implemented with the SCI outpatients.