Department of Health Promotion and Health Education, National Taiwan Normal University, No, 162, He-ping East Road, Section 1, Taipei 10610, Taiwan.
Harm Reduct J. 2013 Dec 10;10:37. doi: 10.1186/1477-7517-10-37.
Quality of life (QOL) is an important outcome measure in the treatment of heroin addiction. The Taiwan version of the World Health Organization Quality of Life assessment (WHOQOL-BREF [TW]) has been developed and studied in various groups, but not specifically in a population of injection drug users. The aim of this study was to analyze the psychometric properties of the WHOQOL-BREF (TW) in a sample of injection drug users undergoing methadone maintenance treatment.
A total of 553 participants were interviewed and completed the instrument. Item-response distributions, internal consistency, corrected item-domain correlation, criterion-related validity, and construct validity through confirmatory factor analysis were evaluated.
The frequency distribution of the 4 domains of the WHOQOL-BREF (TW) showed no floor or ceiling effects. The instrument demonstrated adequate internal consistency (Cronbach's alpha coefficients were higher than 0.7 across the 4 domains) and all items had acceptable correlation with the corresponding domain scores (r = 0.32-0.73). Correlations (p < 0.01) of the 4 domains with the 2 benchmark items assessing overall QOL and general health were supportive of criterion-related validity. Confirmatory factor analysis yielded marginal goodness-of-fit between the 4-domain model and the sample data.
The hypothesized WHOQOL-BREF measurement model was appropriate for the injection drug users after some adjustments. Despite different patterns found in the confirmatory factor analysis, the findings overall suggest that the WHOQOL-BREF (TW) is a reliable and valid measure of QOL among injection drug users and can be utilized in future treatment outcome studies. The factor structure provided by the study also helps to understand the QOL characteristics of the injection drug users in Taiwan. However, more research is needed to examine its test-retest reliability and sensitivity to changes due to treatment.
生活质量（QOL）是治疗海洛因成瘾的重要结果衡量标准。世界卫生组织生活质量评估量表（WHOQOL-BREF [TW]）的台湾版本已在不同群体中开发和研究，但并未专门针对注射吸毒者群体。本研究旨在分析接受美沙酮维持治疗的注射吸毒者样本中 WHOQOL-BREF（TW）的心理测量特性。
共对 553 名参与者进行访谈并完成了该工具。评估了项目反应分布、内部一致性、校正项目-领域相关性、效标关联效度和通过验证性因素分析的结构效度。
WHOQOL-BREF（TW）的 4 个领域的频率分布没有出现地板或天花板效应。该工具表现出足够的内部一致性（4 个领域的克朗巴赫α系数均高于 0.7），并且所有项目与相应领域的得分均具有可接受的相关性（r=0.32-0.73）。4 个领域与评估总体生活质量和总体健康的 2 个基准项目的相关性（p<0.01）支持效标关联效度。验证性因素分析显示，4 个领域模型与样本数据之间的拟合度尚可。
在进行一些调整后，假设的 WHOQOL-BREF 测量模型适用于注射吸毒者。尽管在验证性因素分析中发现了不同的模式，但总体结果表明，WHOQOL-BREF（TW）是一种可靠且有效的注射吸毒者生活质量测量工具，可用于未来的治疗结果研究。研究提供的因子结构也有助于了解台湾注射吸毒者的生活质量特征。但是，还需要更多的研究来检验其重测信度和对治疗引起的变化的敏感性。
