觸控式電腦問卷與手寫問卷之可行性與相等性評估-以EORTC QLQ-C30及EORTC QLQ-PR25測量攝護腺癌患者生活品質為例

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题名:	觸控式電腦問卷與手寫問卷之可行性與相等性評估-以EORTC QLQ-C30及EORTC QLQ-PR25測量攝護腺癌患者生活品質為例 Measurement Feasibility and Equivalence of Paper and Touch-screen Versions of the EORTC QLQ-C30 and the EORTC QLQ-PR25 Questionnaires in Prostate Cancer Patients
作者:	彭巧伶;Chiao-Ling Peng
贡献者:	公共衛生學院環境醫學研究所碩士班
关键词:	健康相關生活品質;攝護腺癌;問卷;歐洲癌症治療與研究組織生活品質核心問卷;歐洲癌症治療與研究組織攝護腺癌生活品質問卷;交叉設計;觸控式電腦問卷;紙本問卷;可行性;相等性;health-related quality of life;prostate cancer;EORTC QLQ-C30;EORTC QLQ-PR25;questionnaire;feasibility;equivalence;cross-over design;touch-screen;computer;paper-and-pencil
日期:	2010
上传时间:	2010-09-29 12:03:13 (UTC+8)
摘要:	目的：歐洲癌症治療與研究組織生活品質核心問卷與攝護腺癌生活品質問卷已被廣泛用來評估攝護腺癌患者的生活品質。隨著電子化的進步，已發現電子化問卷可彌補傳統上測量生活品質常面臨的問題：以紙筆形式填寫所得結果無法即時分析並運用於臨床治療等。本研究將利用傳統及現代測量的分析比較觸控式電腦問卷與手寫問卷兩種方式在評估攝護腺癌患者之生活品質是否具有相等性及可行性，作為觸控式電腦問卷取代紙本問卷之依據，並且進行觸控式電腦問卷執行的喜好度評估。材料與方法：本研究採用隨機交叉設計研究法，樣本為來自中國醫藥大學附設醫院之泌尿科門診，共計收案99位攝護腺癌患者，每位患者以歐洲癌症治療與研究組織攝護腺癌生活品質問卷評量其生活品質，分別在不同時間點利用紙本問卷與觸控式電腦問卷施測。分析方法以交叉設計模式、相等性分析、組內相關係數分析、Rasch模式之試題差別功能分析，比較各範疇及題目的相等性。此外亦記錄施測時間，且以自行發展的問卷來評估患者對以觸控式電腦施測的喜好度，並以描述性統計、t檢定及卡方檢進行分析。結果：交叉設計模式分析的結果整體來說並無發現模式效應。相等性分析的結果顯示觸控式電腦問卷與手寫問卷皆拒絕虛無假說，代表兩者具有相等性。兩份問卷中除了EORTC QLQ-PR25'與治療相關的症狀'組內相關係數=0.47之外，在各範疇中組內相關係數範圍為0.61~0.84。Rasch分析的結果發現並無試題差別功能產生。在喜好度方面，約92％的患者表明他們喜歡使用觸控式電腦問卷來完成問卷；約97％的患者認為觸控式電腦問卷容易使用。結論：觸控式電腦問卷與手寫問卷兩種方式在評估攝護腺癌患者之生活品質具有相等性及可行性。大多數的攝護腺癌患者偏好使用電腦問卷，而且年齡越輕的喜好度越高。臨床診斷資訊電腦化幫助醫師診斷及開立處方時能夠掌握最新最完整的資訊，而且對癌症病人來說大大的增加了他們與醫師之間的互動與溝通。 The EORTC QLQ-C30（a 30-item European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire） and the EORTC QLQ-PR25（a 25-item questionnaire designed for use among patients with localized and metastatic prostate cancer） are widely used instruments for evaluating the health related quality of life (HRQL) of prostate cancer patients. Over the past two decades, researchers have measured HRQL using paper-and-pencil questionnaires. With the emergence of computer technology, electronic questionnaires are increasingly being used for data collection, particularly in medical practice. Nevertheless, the equivalence and feasibility of touch-screen version and paper-and-pencil version of two questionnaires measuring prostate cancer patients have not been clearly established. Therefore, this study compared data obtained using touch-screen versions of two questionnaires with those obtained using the equivalent paper-and-pencil versions for assessing quality of life. A crossover design study was used to investigate the equivalence and acceptance of the questionnaires in 99 prostate cancer patients enrolled from China Medical University Hospital’s Department of Urology out-patient clinic. Equivalence test, and a cross-over model analysis were applied to examine the equity of health-related quality of life scores between the two modes, using Rasch analysis to assess differential item functioning (DIF) between touch-screen and paper versions. Results of this study showed the equivalence of the paper version and the touch-screen version of two quality of life questionnaires. Intraclass correlation coefficient (ICC) ranged from 0.48~0.83 of the two modes in the EORTC QLQ-C30 and EORTC QLQ-PR25, which indicated moderate to good reliability. There was no DIF of the EORTC QLQ-PR25 using Rasch analysis to assess for prostate cancer patients. About 92% of patients had indicated that they liked to use the touch-screen to complete the questionnaire. About 97% of patients thought the touch-screen interface was user-friendly. In conclusion, information collected using the touch-screen version of EORTC QLQ-C30 and EORTC QLQ-PR25 questionnaires is equivalent to that collected using the paper-and-pencil version. The touch-screen version is well accepted for assessing prostate cancer patients’ quality of life. Feasibility of touch-screen mode is acceptable for most patients, and preferred in younger prostate cancer patients. The e-data can be easily integrated with other clinical data to provide real time diagnostic information in clinic. It may not only improve medical care quality, but also promote the relationship between physician and patient.
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