国人生活质量普适量表的编制与评价

武阳丰; 谢高强; 李莹; 周北凡; 张普洪; 史平; 任福秀; 马兰艳

Abstract

武阳丰,谢高强,李莹,周北凡,张普洪,史平,任福秀,马兰艳.国人生活质量普适量表的编制与评价[J].Chinese journal of Epidemiology,2005,26(10):751-756

国人生活质量普适量表的编制与评价

The development and assessment on the general quality of life instrument for Chinese people

Received:February 10, 2005

DOI：

KeyWord: 生活质量一般人群测量工具

English Key Word: Quality of life General population Instrument evaluation

FundProject:国家“十五”科技攻关基金资助项目(2001BA703B01)

Author Name	Affiliation
WU Yang-feng	Department of Epidemiology, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
XIE Gao-qiang	Department of Epidemiology, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
LI Ying	Department of Epidemiology, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
ZHOU Bei-fan	Department of Epidemiology, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
ZHANG Pu-hong	Department of Epidemiology, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
SHI Ping	北京市石景山区疾病预防控制中心
REN Fu-xiu	北京市石景山区疾病预防控制中心
MA Lan-yan	北京市石景山区疾病预防控制中心

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Abstract:

目的编制适合中国一般人群的生活质量普适量表并评价该量表的信度和效度。方法参照世界卫生组织生活质量量表(WHO－100)和美国医学结局健康状况调查问卷(SF－36)，并结合中国人群社会文化特点编制生活质量普适量表(QOL－35)，包括35个条目，分别属于总体健康和生活质量、生理功能、独立生活能力、心理功能、社会功能、生活条件6个领域和1个反应生活质量变化的条目。对127名社区成人的生活质量进行间隔24－72 h的重复调查，评价量表的重测信度。对135名门诊或社区人群同时应用WHO－100、SF－36和QOL－35，比较QOL－35与国外标准量表的内部一致性信度和结构效度。在1356名社区人群中评价QOL－35的稳定性和适用性。结果 (1)重测信度： QOL－35量表各条目2次测量之间权重一致性(Kappa值)范围为0．86～1．00，各领域和整个量表在2 次测量之间的组内相关系数范围为0．68～0．94。(2)内部一致性信度：QOL－35、WHO－100和SF－36量表的克隆巴赫α分别为0．93、0．97和0．89。(3)结构效度：三个量表经因子分析选出的前7个因子方差累计贡献率分别为66．5％、50．3％和65．3％。(4)标准效度：QOL－35总分与WHO－100总分和SF－36 的总分Spearman相关系数分别为0．805和0．745。(5)判别效度：各种慢性病总患病率在QOL－35总分第一到第四分位人群中分别为53．1％、33．1％、26．4％和25．1％(P＜0．05)。(6)QOL－35在1356名一般人群的初步应用显示出近似的克隆巴赫α。结论 QOL－35具有较好的重测信度，与WHO－100和SF－36相比以较少的条目获得较好的结构效度、内部一致性和判别效度，在较大人群的初步应用显示出较为稳定的测量特性，QOL－35是评价中国一般人群生活质量较理想的工具。

English Abstract:

Objective To develop a general quality of life (QOL)instrument for Chinese in accordance with theChinese culture and to assess its reliablility, validity and sensitivity. Methods A 35-item QOL questionnaire (QOL-35O was developed with reference to the World Health Organization QOL questionnaire(WHO-100) and the 36-item medical outcomes study on short-form health status(SF-36). Thirty five items were divided into six domains(general, physical, independent, psychological, social, environment) and one item on QOL transition. The reliability of QOL-35, WHO-100 and SF-36. The adaptability was assessed by application to 1356 community-based samples in Beijing. Results (1)Test-retest reliability of QOL-35: weighted Kappa indexes for items ere from 0.86 to 1.00. Intraclass correlation coefficients were from 0.68 to 0.94 for domains, and 0.94 for total score. (2)On internal consistency: Cronbach＇s Alphas were 0.93,0.97 and 0.89 for QOL-35, WHO-100 and SF-36.(3)On construct validity. The accumulated proportions of variances of the preceding seven factors were 66.5%,50.3% and 65.3% for QOL-35, WHO-100 and SF-36. (4) On criterion validity. Spearman correlation coefficients of tatal QOL score of QOL-35 with those of WHO-100 and SF-36 were 0.805 and 0.745.(5)The rates of chronic diseases were 51.3%,33.1%,26.4% and 25.1% from first to fourth quantile of the total QOL scores of QOL-35(P<0.05).(6)Cronbach＇s Alpha was from 0.68 to 0.93 in 135 subjects, and from 0.71 to 0.91 in 1356 individuals of natural population. Conclusion The QOL-35 instrument satisfied test-retest reliability and was highly correlated with WHO-100 and SF-36,having fewer items but better construcion validity, betterinternal consistency. and better discrimination ability. We suggested that QOL-35 be used as a replicable tool to assess quality of life in the Chinese general population.

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