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系統識別號 U0007-1704200714522659
論文名稱(中文) 發展台灣版簡明疲憊量表(BFI-Taiwan Form)與台灣版安德森症狀量表(MDASI-Taiwan Form)及信效度檢測
論文名稱(英文) Development and Validation of the Brief Fatigue Inventory-Taiwan Form and M. D. Anderson Symptom Inventory-Taiwan Form
校院名稱 臺北醫學大學
系所名稱(中) 護理學研究所
系所名稱(英) Graduate Institute of Nursing
學年度 91
學期 2
出版年 92
研究生(中文) 張愛萍
研究生(英文) Ai-Pin Chang
學號 G005089007
學位類別 碩士
語文別 中文
口試日期
論文頁數 180頁
口試委員 指導教授-林佳靜
中文關鍵字 癌症  疲憊  症狀困擾  日常生活活動功能干擾  台灣版簡明疲憊量表  台灣版安德森症狀量表 
英文關鍵字 cancer  fatigue  symptom distress  interference with usual functioning  BFI-Taiwan Form  MDASI-Taiwan Form 
學科別分類
中文摘要 與癌症有關的疲憊,是癌症患者一個最困擾、最盛行、也最容易被忽視的共同症狀。癌症症狀困擾是主觀的經驗,會嚴重干擾癌症患者的日常生活活動功能,更影響到癌症患者的生活品質。使用簡單的、有效的、可信賴的、靈敏的、由癌症患者自我評估的測量工具,才能確實的評估出癌症患者的疲憊及癌症症狀困擾與日常生活活動功能干擾的嚴重程度。 故本研究的目的在發展台灣版簡明疲憊量表(BFI-Taiwan Form)與台灣版安德森症狀量表(MDASI-Taiwan Form),並檢測其信效度;及了解癌症患者的疲憊、症狀困擾及對日常生活活動功能干擾的嚴重程度與相關性。本研究為描述性相關性研究,採結構式問卷訪談調查,以方便取樣方式於南部區域醫院以上腫瘤科住院及門診患者為對象,共收集200位個案資料。研究工具有:台灣版簡明疲憊量表、台灣版安德森症狀量表、簡式情緒狀態量表、台灣版SF-36健康評估量表、Karnofsky功能狀況量表。台灣版簡明疲憊量表與台灣版安德森症狀量表信度檢定採內在一致性Cronbach’s α及再測信度,效度檢定採建構效度、鑑別效度及效標效度,並以接受化學治療癌症患者重複測量的差異來檢定量表的敏感度。 結果顯示,台灣版簡明疲憊量表疲憊強度與生活干擾強度Cronbach’s α為 .89與 .91,再測信度r = .80與 .97。台灣版安德森症狀量表症狀強度與生活干擾強度Cronbach’s α為 .85與 .93,再測信度r= .97與 .96。並皆有良好之建構效度、鑑別效度及效標效度、與敏感度。大多數的癌症患者會經歷到中至重度嚴重程度的疲憊、各種癌症症狀困擾與對日常生活活動功能的干擾,與癌症有關的疲憊及癌症症狀困擾會干擾癌症患者的日常生活活動功能,疲憊及癌症症狀嚴重程度越高,日常生活活動的干擾嚴重程度也越高。本研究發展的台灣版簡明疲憊量表(BFI-Taiwan Form)與台灣版安德森症狀量表(MDASI-Taiwan Form)能提供癌症照護專業人員快速、確實的評估出癌症患者的疲憊及癌症症狀困擾與日常生活活動功能干擾的嚴重程度,迅速提供適當的照護措施,提昇癌症患者的生活品質。
英文摘要 Fatigue is the most distressing, prevalent, and ignorant common symptoms in cancer patients. Cancer symptom distress is subjective sense and experience of cancer patients, that seriously interfere with usual functioning and affect quality of life. It requires a simple, available, reliable, sensitive and self-reported instrument, to assess accurate severity levels of fatigue and interference with usual functioning of cancer patients. The purposes of this study was to (1) Development and Validation of the Brief Fatigue Inventory-Taiwan Form and M. D. Anderson Symptom Inventory-Taiwan Form. (2) Explore the severity levels of fatigue, cancer symptom distress, and interference with usual functioning of cancer patients, and correlation between them. A cross-sectional descriptive correlational design was adopt for the study and the structured questionnaire interview was used. Two hundred eligible subjects were recruited by convenience sampling from the oncology inpatients and outpatients in Southern Taiwan. The instruments included BFI-Taiwan Form, MDASI-Taiwan Form, Short Form -POMS, SF-36-Taiwan Form, and KPS. The validation were establishing reliability by internal consistency (Cronbach’s α) and test-retest reliability, and validity by construct, discriminant and criterion validity. The sensitivity was presented by comparing the repeated measure scores of received chemotherapy patients. The study results revealed that fatigue and interference intensity of the BFI-Taiwan Form Cronbach’s αwere .89 and .91, test-retest reliability r were .80 and .97. Symptom distress and interference intensity of the MDASI-Taiwan Form Cronbach’s αwere .85 and .93, test-retest reliability r were .97 and .96. Both instruments have good construct, discriminant criterion validity, and sensitivity. Most of the cancer patients experienced moderate to severe severity levels of fatigue, symptom distress and interference. Cancer-related fatigue and symptom distress were interfere with usual functioning of cancer patients. Severity levels of fatigue and symptom distress were high, the levels of interference were higher. BFI-Taiwan Form and MDASI-Taiwan Form provide rapidly and accurate assessment of the severity levels of fatigue, symptom distress and interference with usual functioning in cancer patients to professionals. Namely provides proper nursing intervention and improve the quality of life in cancer patients.
論文目次 目 錄 頁 數 致 謝……………………………………………………………… Ⅰ 中文摘要……………………………………………………………… Ⅲ 英文摘要……………………………………………………………… Ⅴ 目 錄……………………………………………………………… Ⅶ 圖表目次……………………………………………………………… ⅩⅠ 第一章 緒論 第一節 研究動機……………………….……………………..…1 第二節 研究重要性……………………….…………………..…4 第三節 研究目的………………………….…….…….………....7 第二章 文獻查證 第一節 癌症疲憊症狀與相關因素………………….………..…8 第二節 癌症疲憊症狀評估量表……………………..……….…15 第三節 癌症症狀困擾與相關因素…………………………...…25 第四節 癌症症狀困擾評估量表…………………………..….…32 第三章 研究問題 第一節 研究問題……………………………………..……….…41 第二節 名詞解釋……………………………………………...…42 第四章 研究方法 第一節 研究設計…………………………………………..….…45 第二節 研究場所………………………………………………..45 第三節 研究對象………………………………………….….…46 第四節 研究工具………………………………………….…….47 第五節 資料收集過程…………………………………………..65 第六節 資料分析…………………………………………….….67 第七節 研究對象保護權益……………………………….….…71 第五章 研究結果 第一節 簡式情緒狀態量表(Short Form -POMS)之分布………74 第二節 台灣版SF-36健康評估量表(SF-36-Taiwan Form) 之分布…………………………………………….…….77 第三節 Karnofsky功能評估量表(KPS)之分布………………..81 第四節 癌症患者人口學特性分析……………………….….…83 第五節 台灣版簡明疲憊量表(BFI-Taiwan Form)之分布……...90 第六節 台灣版安德森症狀量表(MDASI-Taiwan Form)之分布 分布……………………………………………………..106 第六章 討論 第一節 台灣版簡明疲憊量表(BFI-Taiwan Form)之信度、 效度與敏感度……………………………………….….121 第二節 台灣版安德森症狀量表(MDASI-Taiwan Form)之 信度、效度與敏感度………………………..……...….127 第三節 癌症患者之疲憊嚴重程度與疲憊干擾日常生活 活動功能嚴重程度及相關性…………………………..132 第四節 癌症患者之癌症症狀困擾嚴重程度與癌症症狀 干擾日常生活活動功能嚴重程度及相關性…………..138 第七章 結論與建議 第一節 結論……………………………………………………..145 第二節 護理上的應用…………………………………………..148 第三節 研究限制與建議………………………………………..151 參考資料 中文部分….………………………………….……..……………..154 英文部分….……………………………………..…….…………..156 附錄 附錄一 研究同意書……………………………………………..168 附錄二 個案基本資料…………………………………………..169 附錄三 台灣版簡明疲憊量表…………………………………..170 附錄四 台灣版安德森症狀量表………………………………..171 附錄五 簡式情緒狀態量表……………………………………..173 附錄六 台灣版SF-36健康評估量表…………………………..175 附錄七 Karnofsky功能評估量表……………………………….180 圖表目次 表一 前驅研究台灣版簡明疲憊量表(BFI- Taiwan Form) 與台灣版安德森症狀量表(MDASI- Taiwan Form) 之信、效度檢定………………………………………..63 表二 前驅研究與正式研究簡式情緒狀態量表(Short Form-POMS)、台灣版SF-36健康評估量表 (SF-36-Taiwan Form)與Karnofsky功能評估 量表(KPS)之信度檢定…………………………………64 表三 台灣版簡明疲憊量表(BFI-Taiwan Form)與台灣 版安德森症狀量表(MDASI-Taiwan Form)信、效 度檢定方法………………………………………….….69 表四 資料統計分析方法……………………………………..70 表五 簡式情緒狀態量表(Short Form -POMS)分數 之描述統計……………………………………………..76 表六 台灣版SF-36健康評估量表(SF-36-Taiwan Form) 分數之描述統計..... ... ... ... .……………………….…..80 表七 Karnofsky功能評估量表(KPS)分數之描述統計……..82 表八 人口學特性分布………………………………………..87 表九 以台灣版簡明疲憊量表(BFI-Taiwan Form)評估 過去24小時疲憊最嚴重程度之描述統計……………92 表十 台灣版簡明疲憊量表(BFI-Taiwan Form)嚴重程度 之分布…………………………………………………..93 表十一 台灣版簡明疲憊量表(BFI-Taiwan Form)疲憊強度 及台灣版安德森症狀量表(MDASI-Taiwan Form) 症狀強度與生活干擾強度之相關……….….…….……95 表十二 台灣版簡明疲憊量表(BFI-Taiwan Form)與人口學 特性之差異與相關……………………………………..97 表十三 正式研究台灣版簡明疲憊量表(BFI-Taiwan Form) 與台灣版安德森症狀量表(MDASI-Taiwan Form) 之信度檢定……………………………………………..99 表十四 台灣版簡明疲憊量表(BFI-Taiwan Form)各子項目 與總分之相關…………………………………………..100 表十五 台灣版簡明疲憊量表(BFI-Taiwan Form)之效度 檢定…………………………..……………..…..………103 表十六 台灣版簡明疲憊量表(BFI-Taiwan Form)與台灣 版安德森症狀評估量表(MDASI-Taiwan Form) 之敏感度檢定…………………………………………..105 表十七 以台灣版安德森症狀量表(MDASI-Taiwan Form) 評估過去24小時症狀最嚴重程度之描述統計………108 表十八 台灣版安德森症狀量表(MDASI-Taiwan Form) 嚴重程度之分布………………………………………..110 表十九 台灣版安德森症狀量表(MDASI-Taiwan Form) 與人口學特性之差異與相關…………………………..114 表二十 台灣版安德森症狀量表(MDASI-Taiwan Form) 各子項目與總分之相關………………………..………116 表二十一 台灣版安德森症狀量表(MDASI-Taiwan Form) 之效度檢定……………………………………...……...119
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