世界衛生組織生活品質問卷應用於台灣老年人之心理計量研究

Abstract

近年來台灣老年人口的不斷的攀升，據經建會估計，2018年老年人口將超過總人口的14%，正式步入高齡社會。越來越多人開始關注老年人的生活，老年生活品質測量也因此變得更為重要。世界衛生組織所發展的生活品質問卷(WHOQOL)，除了測量常見的生活品質範疇(WHOQOL-100、WHOQOL-BREF)外，亦針對老年族群編製了外加模組(WHOQOL-OLD)，希望能完整捕捉老年生活品質的面貌。在台灣，世界衛生組織問卷使用非常廣泛，但是有關該問卷應用於老年人的心理計量研究卻不為多見，因此本研究希望能針對WHOQOL問卷於台灣老年人的應用狀況進行探討，以提供未來老年相關研究有效的生活品質測量工具。研究一欲驗證不同的WHOQOL問卷版本於台灣老年人的信度與效度。發現台灣簡明版WHOQOL-BREF於台灣老年人使用上效度略差，但是其短版EUROHIS-8則有良好的信效度表現；WHOQOL-OLD與其短版中的第三版則具有良好的心理計量特性。研究二，依據不同的居住情境，將社區、機構老年人分群，確立問卷於兩群人的心理計量特性並進行WHOQOL問卷的生活品質分數比較。結果指出在台灣簡明版WHOQOL-BREF的社會範疇、WHOQOL-OLD的感官能力、社會參與、死亡觀、親密感層面分數上，兩群人差異達顯著。研究三，企圖建立應用於台灣老年人，心理計量特性表現更好的WHOQOL短版，然而目前尚未發現信度與效度表現皆優於過去的版本，故仍建議使用國外現有的短版。

In recent years, Taiwan's aged population are consistently getting growth. According to the reports of CEPD that the aged population will exceed 14% of the total population in 2018, the Taiwan will become the aged society. As a result, studies on the issue of elders’ life are increasingly received attention, especially for developing appropriate measurements of elders' quality of life (QOL). The World Health Organization had developed a questionnaire to measure QOL, called WHOQOL. Attempting to capture the entire QOL of elders, the WHOQOL contains not only common domains of QOL but also an add-on module (WHOQOL-OLD) for elders. Although the WHOQOL is widely used in Taiwan, its applicability for the elders in Taiwan is rarely investigated. The objectives of this study are to examine the psychometric properties of the WHOQOL and to provide a useful instrument which can appropriately measure QOL for elders in Taiwan. In study1, the reliability and validity in different versions of WHOQOL were examined. The results showed that the reliability and validity of the short version, EUROHIS, have a good performance relative to the WHOQOL-BREF (Taiwan’s version). The psychometric properties of the WHOQOL-OLD and its short version (V3) were also acceptable, with high reliability and validity. Study 2 compared the scores of the WHOQOL between community-dwelling and nursing home resident. Social domain of the WHOQOL-BREF (Taiwan version) as well as the majority of the facets of the WHOQOL-OLD including sensory ability, death and dying, social participation, intimacy facets achieved statistically significant differences. In study 3, this study attempted to establish more suitable short version for Taiwan’s elders, yet the psychometric properties of this new version performed worse than the previous version.