Yang Shu-Chang, Kuo Pei-Wen, Wang Jung-Der, Lin Ming-I, Su Syi
Institutes of Health Care Organization Administration and Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan, ROC.
Am J Kidney Dis. 2005 Oct;46(4):635-41. doi: 10.1053/j.ajkd.2005.06.015.
In 1991, the World Health Organization (WHO) initiated a cross-cultural project to develop a quality-of-life (QOL) questionnaire (WHOQOL); soon after this, the clinically applicable short form was developed and named WHOQOL-BREF, followed by a Taiwanese version (WHOQOL-BREF[TW]).
We first administered the WHOQOL-BREF(TW) and symptom/problem scale to 376 patients with end-stage renal disease on regular hemodialysis therapy in Taiwan. Analysis with multiple stepwise regressions was conducted to study determinants of QOL domains and items.
The WHOQOL-BREF(TW) was reliable and valid from various validation studies. The 4 domains (physical, psychological, social relations, and environment) and global items (overall quality of life and general health) of the WHOQOL-BREF(TW) each differentiated symptoms/problems of hemodialysis patients from age-, sex-, and education-matched healthy referents. The 4 domains, except for environment and global items of the WHOQOL-BREF(TW), each differentiated erythropoietin dosage from age-, sex-, and education-matched healthy referents. After adjusting for age, sex, marriage, and education, the prominent associated factors of various QOL domains and items were age, area (Taipei or Keelung), hemoglobin level, normalized protein catabolic rate, and symptom/problem scale.
The WHOQOL-BREF(TW) is reliable and valid for long-term study of hemodialysis patients, and hemodialysis had negative impacts on QOL, especially in patients with more severe disease with greater symptom/problem scores, lower hemoglobin levels, and lower normalized protein catabolic rates.
1991年，世界卫生组织（WHO）启动了一项跨文化项目，以开发一份生活质量（QOL）问卷（WHOQOL）；此后不久，又开发出了临床适用的简表，并将其命名为WHOQOL-BREF，随后出现了台湾版本（WHOQOL-BREF[TW]）。
我们首先对台湾376例接受定期血液透析治疗的终末期肾病患者进行了WHOQOL-BREF（TW）和症状/问题量表的施测。采用多元逐步回归分析来研究生活质量领域和项目的决定因素。
来自各种效度研究表明，WHOQOL-BREF（TW）可靠且有效。WHOQOL-BREF（TW）的4个领域（生理、心理、社会关系和环境）以及总体项目（总体生活质量和一般健康状况），均能将血液透析患者的症状/问题与年龄、性别和教育程度相匹配的健康对照者区分开来。WHOQOL-BREF（TW）的4个领域，除了环境领域和总体项目外，均能将促红细胞生成素剂量与年龄、性别和教育程度相匹配的健康对照者区分开来。在对年龄、性别、婚姻状况和教育程度进行调整后，各种生活质量领域和项目的主要相关因素为年龄、地区（台北或基隆）、血红蛋白水平、标准化蛋白分解代谢率和症状/问题量表。
WHOQOL-BREF（TW）对于血液透析患者的长期研究是可靠且有效的，血液透析对生活质量有负面影响，尤其是对于病情更严重、症状/问题得分更高、血红蛋白水平更低以及标准化蛋白分解代谢率更低的患者。
