台灣版孕期噁心嘔吐健康相關生活品質量表之信效度測試

Testing the Reliability and Validity of the Taiwan Health-Related Quality of Life for Nausea and Vomiting During Pregnancy Scale

背景：孕期噁心嘔吐的症狀困擾衝擊著孕婦的生活品質，但具信效度且已被測試的評估工具很少。目的：檢測台灣版孕期噁心嘔吐健康相關生活品質量表之信效度。方法 橫斷性研究設計，採方便取樣，2011年11月15日至2013年6月15日於南部某醫學中心及區域教學醫院產檢門診，收集416位第一、二孕期懷孕婦女之資料，並以卡方檢定、項目分析及主軸分析檢測量表之建構效度，再以皮爾森積差相關鑑定此量表與世界衛生組織生活品質問卷台灣簡明版〔World Health Organization Quality of Life-BREF in Taiwan, WHOQOL- BREF（TW）〕的同時效標效度。結果 原量表因素分析萃取4個因素，分別為「限制」（10題）、「生理症狀與惡化因素」（9題）、「情緒」（6 題）、「疲憊」（4題），可解釋總變異量為67.45％。分量表與總量表的聚斂效度良好（r = .78– .85, p < .01），各分量表之間的區辨性效度佳（r = .48– .68, p < .01）；總量表與WHOQOL-BREF（TW）有良好的效標關聯效度（r = -.37, p < .01）。量表的內在一致性良好，總量表的信度Cronbach’s α值為.95，各分量表的Cronbach’s α值皆達.70以上，總量表兩週再測信度佳、組內相關係數（intraclass correlation coefficient, ICC）值為.92（n = 37, p < .001）。結論／ 實務應用：本量表可做為日後研究和臨床孕期噁心嘔吐生活品質的評估工具，以協助適時提供孕婦合宜的護理措施、增進其生活品質。

Background: Symptom distress related to pregnancy-related nausea and vomiting is known to impact quality of life in pregnant women. However, few reliable and valid assessment tools are available for research use. Purpose: To test the reliability and validity of the Taiwan health-related quality of life for nausea and vomiting during pregnancy (NVPQOL) scale. Method: A cross-sectional study design was conducted. A convenience sample of 416 pregnant women in their first and second trimesters were recruited from the prenatal clinics of one medical center and one regional teaching hospital in southern Taiwan. Chi-square tests, item analysis, and principal axis factor analysis were used to examine construct validity. Pearson’s correlation coefficient was then conducted to compare the concurrent validity of the scale against the Chinese-language version of the World Health Organization Quality of Life Assessment [WHOQOL-BREF (TW)]. Results: Four factors were extracted using factor analysis: “limitations” (10 items), “physical symptoms/aggravating factors” (9 items), “emotions” (6 items), and “fatigue” (4 items), which together accounted for 67.45% of the total variance. The NVPQOL showed good convergent (r = .78 ~ .85, p < .01), discriminate (r = .48 ~ .68, p < .01), and concurrent validities, with a -0.37 correlation coefficient between the WHOQOL-BREF (TW) and the NVPQOL (p < .01). The Cronbach’s α of the NVPQOL was .95. The intraclass correlation coefficient for test-retest reliability of two weeks was .92 (n = 37, p < .001). Conclusions/Implications for Practice: The NVPQOL may be used in future research and clinical assessment to measure quality of life in women who experience nausea and vomiting during pregnancy in order to provide appropriate nursing interventions in a timely manner to improve quality of life.