Xia Ping, Li Ning-Xiu, Liu Chao-Jie, Lü Yu-Bo, Zhang Qiang, Ou Ai-Hua
Department of Social Medicine, West China School of Public Health, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2010 Jul;41(4):678-83.
To investigate the impact of cultural factors on quality of life (QOL) and to identify appropriate ways of dividing sub-populations for population norm-based quality of life assessment.
The WHOQOL-BREF was used as a QOL instrument. Another questionnaire was developed to assess cultural values. A cross-sectional survey was undertaken in 1090 Guangzhou residents, which included 635 respondents from communities and 455 patients who visited outpatient departments of hospitals. Cronbach's a coefficients and item-domain correlation coefficients were calculated to test the reliability and validity of the WHOQOL-BREF, respectively. Student t test, ANOVA and stepwise multiple linear regression analysis were performed to identify the variables that might have an impact on the QOL. Two regression models with and without including cultural variables were constructed, and the extent of impact exerted by the cultural factors was assessed through a comparison of the change of adjusted R square values.
A total of 1052 (96%) valid questionnaire were returned. The Cronbach's alpha coefficients of the WHOQOL-BREF ranged from 0.67 to 0.78. Age, education, occupation and family income were correlated with all of the domains of the WHOQOL-BREF. Chronic condition was correlated with physical, psychological, and social relationship domains of the WHOQOL-BREF. Gender was correlated with physical and psychological domains of the WHOQOL-BREF. The multiple regression analysis showed that social and demographic factors contributed to 6.3%, 13.6%, 10.4% and 8.7% of the predicted variances for the physical, psychological, social relationship, and environment domains, respectively. Social support, horizontal collectivism, vertical individualism, escape acceptance, fear of death, health value, supernatural belief had a significant impact on QOL. However, social support was the only one factor that had an impact on all of the four QOL domains.
It is necessary to divide sub-cultural populations for population norm-based QOL assessment. Further research is needed to develop a practical approach to the sub-cultural population division.
探讨文化因素对生活质量（QOL）的影响，并确定基于人群常模的生活质量评估中划分亚人群的合适方法。
采用世界卫生组织生活质量简表（WHOQOL-BREF）作为生活质量评估工具。另编制一份问卷以评估文化价值观。对1090名广州居民进行横断面调查，其中包括635名社区受访者和455名到医院门诊就诊的患者。分别计算克朗巴哈系数（Cronbach's α）和项目-领域相关系数，以检验WHOQOL-BREF的信度和效度。进行学生t检验、方差分析和逐步多元线性回归分析，以确定可能对生活质量有影响的变量。构建包含和不包含文化变量的两个回归模型，并通过比较调整后R平方值的变化来评估文化因素的影响程度。
共回收有效问卷1052份（96%）。WHOQOL-BREF的克朗巴哈α系数在0.67至0.78之间。年龄、教育程度、职业和家庭收入与WHOQOL-BREF的所有领域均相关。慢性病与WHOQOL-BREF的生理、心理和社会关系领域相关。性别与WHOQOL-BREF的生理和心理领域相关。多元回归分析表明，社会人口学因素分别占生理、心理、社会关系和环境领域预测方差的6.3%、13.6%、10.4%和8.7%。社会支持、水平集体主义、垂直个人主义、逃避接受、对死亡的恐惧、健康价值观、超自然信仰对生活质量有显著影响。然而，社会支持是唯一对所有四个生活质量领域都有影响的因素。
有必要为基于人群常模的生活质量评估划分亚文化人群。需要进一步研究以开发一种实用的亚文化人群划分方法。
