| 摘要: | 背景：台灣自1984年發現第一起由美國境外移入之愛滋病患後，感染HIV之個案數呈現逐年增加的趨勢，且因2003年於矯正機關全面實施HIV之檢驗，造成急速上升的現象。感染HIV之注射藥癮者大部份來自矯正機關之篩檢結果，這群愛滋收容人所屬環境本就與一般人口族群有所差異，且此族群未來必將回歸社會，故由公共衛生的角度來看，對此族群有更多的了解實為重要。
目的：本研究之目的為評估於測量台灣愛滋收容人之生活品質時，WHOQOL-BREF生活品質問卷使用於該族群之信效度。
方法：愛滋收容人選自中部地區矯正機關之醫療機構，研究對象共261人，平均年齡為34歲，且男性佔了75%，以世界衛生組織健康相關生活品質問卷(WHOQOL-BREF)探討其使用於此族群其信效度，並藉由分析內部一致性、再測信度、已知群組效度、建構效度及反應性效度來進行評估，此外，內容效度的評估則透過一系列額外的題目，藉此了解此族群認為重要的生活品質項目。
結果：WHOQOL-BREF生活品質問卷使用於愛滋收容人之信效度結果顯示評估內部一致性之Cronbach’s α值介於0.7至0.83；相等性檢定(Equivalence test)呈現近八成之題目，其前後測(2週)平均得分差異於0.5分以內，即具有良好的再測信度；於內容效度部分，除了性生活之外(3.2分)，其餘所有題目皆被評為重要的(於五點量尺中各題平均得分皆高於3.7分)；已知群組效度的部分，發現於性別、年齡、體內免疫球蛋白(CD4)數目、每日毒品花費及被判刑期上是呈現顯著差異的，其餘相關特質則未見具有差異；在反應性效度的部分，可發現生理範疇的分數在經過了一年之後都是下降的，但其餘範疇則未見其差異，此現象與治療與否有關；探索性因素分析萃取出兩因子：因子一主要包含了生理與心理範疇之題目，因子二則主要包含了環境與社會範疇之題目，兩因子共可解釋84.2%之變異；經些微調整之後，驗證性因素分析顯示WHOQOL-BREF之原始架構模式呈現良好之配適度，即具有良好的建構效度。
結論：本研究結果顯示WHOQOL-BREF生活品質問卷用於台灣愛滋收容人具有良好之信效度。
Background: The first case of HIV/AIDS in Taiwan, which was contracted in the United States, was found in 1984. The number of new cases of HIV infection in Taiwan has continued to rise. In 2003, HIV testing in correctional facilities was fully implemented resulting in a sharp rise in new cases. Most of these cases were drug addicts who had become infected through intravenous injection. The environment of HIV/AIDS inmates is clearly different from that of HIV/AIDS patients in the general population. HIV/AIDS inmates will return to society so from a public health perspective it is important to gain a better understanding of this population.
Objective: The aim of this study was to assess the reliability and validity of the WHOQOL-BREF quality of life questionnaire for measuring quality of life among Taiwanese inmates with HIV/AIDS.
Methods: The HIV/AIDS inmates were selected from a medical facility at a correctional institution in central Taiwan. A total of 261 subjects, with an average age of 34 years and comprising 75% males, were included in the study. The World Health Organization’s health-related quality of life questionnaire (WHOQOL-BREF) was administered to the inmates in order to explore its reliability and validity. The reliability and validity were assessed by analyzing the internal consistency, test-retest reliability, known-group validity, construct validity and responsiveness. Furthermore, the content validity was assessed by an additional series of items to measure what the inmates’ consider to be important in their quality of life.
Results: The results of the reliability and validity analyses of the WHOQOL-BREF for HIV/AIDS inmates showed the Cronbach's α for internal consistency ranged from 0.7 to 0.83. The equivalence test showed good test-retest reliability, with nearly 80% of items measured before and after (2 weeks) showing a mean difference score of 0.5 points or less. For content validity, on average, all items were rated as being important (>3.7 on 5-point Likert scale), except for sexual life (3.2). Also, known-group validity showed significant differences in gender, age, CD4 counts, daily cost of drug habit prior to jail, and length of prison sentence. In the validity of responsiveness, we found the scores of physical domain declined after a year, but scores in the other domains were unchanged, as expected. The results were similar for patients receiving or not receiving AIDS treatment. Exploratory factor analysis showed two factors: the first factor included physical and psychological domains, and the second factor included the environment and social domain. The two factors explained 84.2% of the total variance. After a slight adjustment, confirmatory factor analysis showed good fitness in the original model of the WHOQOL-BREF, indicating good construct validity.
Conclusion: The WHOQOL-BREF for Taiwanese HIV/AIDS inmates had good reliability and validity. |
