生活品質研究與醫藥衛生成本效性評估─子計畫一：特定疾病版生活品質問卷的發展與結構分析(3/3)
Date Issued
2003
Date
2003
Author(s)
DOI
912320B002083M56
Abstract
The WHOQOL-BREF questionnaire that contains 26 items and forms 4 QOL
domains (i.e., physical, psychological, social, and environment) is the simplified
version of the WHOQOL-100. The culturally adapted version of the
WHOQOL-BREF includes 2 more national items for Taiwanese. The two national
items are categorized into “being respected/accepted (Guanxi/Mientze)” and
“eating/food” facets respectively. We administered this questionnaire-Taiwan version
to 214 health subjects and 854 unhealthy patients with diverse diseases from 17
hospitals over Taiwan and to 181 patients with coronary artery bypass grating
（CABG）from two hospitals in Taipei. The purpose of this study is to
quantitatively compare the latent QOL factor structures among these subjects.
Subjects are classified into groups differently according to disease types and sample
sizes. To obtain enough sample size in a group for statistical purpose, we may
combine patients such as the patients with different cancers to form a disease group
(e.g., “tumor/cancer group”). Only the disease groups with larger sample size are
studied. Both exploratory factor analysis (EFA) and confirmatory factor analysis
(CFA) on a four –factor model are conducted for each group. To compare the EFA
factor structures among groups, factor congruence coefficient (FCC) which measures
the degree of similarity between two factor structures from two independent samples
is calculated for each pair of factors. To compare the CFA factor structures among
groups, multi-sample analyses are conducted to confirm the comparability of factor
structures among groups.
Both EFA and CFA results suggest that subjects with different diseases have different
perceptions on their QOL.
In the past, quality of life（QOL）researchers usually sum the scores from several
dimensions/sub-dimensions/items with equal weights to obtain individual’s overall
QOL score. However, this approach has been inquired. One of the arguments is that
QOL dimensions/sub-dimensions/items may have different meanings to individuals in
terms of importance. Equal weighting approach may underestimate the QOL
dimensions/items with more importance and overestimate the QOL dimensions/items
with less importance to individuals. As a result, individual’s true QOL level cannot be
estimated appropriately. To examine this issue in a more clear way, several
questions should be raised. One is “Can we sum scores from different
dimensions/items?” The answer may be yes and may be not because this depends on
how people define the “overall QOL score”. Under certain conditions, we may sum
scores from different dimensions/items to form an overall QOL score. If the answer is
YES, we may continue to ask the second question “Who should give the weights?”
Should it be the health professionals, the health services users (i.e., patients), the
health policy-makers, or the public? We will discuss the advantages and the
disadvantages of each type of persons who give weights. Moreover, we would further
ask “How to give weights and sum the scores?” The purpose of this exploratory
study is to find the appropriate ways to weigh the dimensions of QOL measures so
that the assessment of QOL can describe subject’ true QOL level better and the overall QOL score is much more meaningful.
Subjects
quality of life
factor structure
EFA
CFA
weighting methods
SDGs
Publisher
臺北市：國立臺灣大學心理學系暨研究所
Type
report
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