题名

Construct Validity of the Quality of Life for Patients with Schizophrenia

并列篇名

精神分裂症病人生活品質量表之建構效度

作者

李淑君(Shu-Chun Lee);林金定(Jin-Ding Lin);邱恩琦(En-Chi Chiu);龍佛衛(For-Wey Lung)

关键词

健康相關生活品質 ; 精神疾患 ; 建構效度 ; 結構方程式模式 ; health-related quality of life ; severe and persistent mental illness ; construct validity ; structural equation modeling

期刊名称

台灣精神醫學

卷期/出版年月

28卷1期(2014 / 03 / 01)

页次

ii+16 - 26

内容语文

英文

中文摘要

Objective: Health-related quality of life (HRQoL) has become one of the most valuable indicators of treatment in patients with schizophrenia. The purpose of this study was to establish the construct validity of eight domains in a HRQoL scale. Methods: From four psychiatric rehabilitation centers, 237 patients were chosen for participation in the study. Inclusion criteria were a DSM-IV-R diagnosis of schizophrenia. Quality of life was measured using the Quality of Life for Mental Disorders (QoLMD) scale. Structural equation modeling (SEM) was chosen to investigate the construct of the QoLMD. Results: This model of HRQoL for patients with schizophrenia was acceptable (Chi-square=1004.484 (df=789), p=0.192, GFI=0.852, RMSEA=0.034, TLI=0.940). The relationship between eight domains of the QoLMD can be interpretive into three parts: (A) under family support, patients with schizophrenia had significantly directly related to mental and physical health (β=0.849 and 0.738) and significantly indirectly related to HRQoL (i.e., life satisfaction, autonomy, health maintenance); (B) under physical health, schizophrenia patients had significantly directly related to HRQoL (β=0.745-0.921) (p<0.001); and (C) under mental health had significantly directly related to physical health (β=0.217) (p<0.05). Conclusion: The SEM revealed that HRQoL was interpreted by the pathways between eight domains of QoLMD, and therefore it made clinical therapists understood clearly about the correlation and mutual-influential pathway between HRQoL and QoLMD.

英文摘要

Objective: Health-related quality of life (HRQoL) has become one of the most valuable indicators of treatment in patients with schizophrenia. The purpose of this study was to establish the construct validity of eight domains in a HRQoL scale. Methods: From four psychiatric rehabilitation centers, 237 patients were chosen for participation in the study. Inclusion criteria were a DSM-IV-R diagnosis of schizophrenia. Quality of life was measured using the Quality of Life for Mental Disorders (QoLMD) scale. Structural equation modeling (SEM) was chosen to investigate the construct of the QoLMD. Results: This model of HRQoL for patients with schizophrenia was acceptable (Chi-square=1004.484 (df=789), p=0.192, GFI=0.852, RMSEA=0.034, TLI=0.940). The relationship between eight domains of the QoLMD can be interpretive into three parts: (A) under family support, patients with schizophrenia had significantly directly related to mental and physical health (β=0.849 and 0.738) and significantly indirectly related to HRQoL (i.e., life satisfaction, autonomy, health maintenance); (B) under physical health, schizophrenia patients had significantly directly related to HRQoL (β=0.745-0.921) (p<0.001); and (C) under mental health had significantly directly related to physical health (β=0.217) (p<0.05). Conclusion: The SEM revealed that HRQoL was interpreted by the pathways between eight domains of QoLMD, and therefore it made clinical therapists understood clearly about the correlation and mutual-influential pathway between HRQoL and QoLMD.

主题分类 醫藥衛生 > 社會醫學
参考文献
  1. Cheng, JJ,Ouyang, WC,Lee, FSC(2006).The development and reliability of quality of life scale for psychiatric patients.Taiwanese Journal of Psychiatry,20,19-31.
    連結:
  2. Lu, HF、Tseng, HM、Tsai, YJ(2003)。Assessment of health-related quality of life in Taiwan (I): development and psychometric testing of SF-36 Taiwan version。Taiwan Journal of Public Health,22,501-11。
    連結:
  3. Albert, U,Maina, G.,Bogetto, F,Chiarle, A(2010).Clinical predictors of health-related quality of life in obsessive-compulsive disorder.Compr Psychiatry,51,193-200.
  4. Barnes, AL,Murphy, ME,Fowler, CA,Rempfer, MV(2012).Health-related quality of life and overall life satisfaction in people with serious mental illness.Schizophr Res Treatment,2012
  5. Barnes, ALB,Murphy, MEM,Fowler, CA,Rempfer, MV(2012).Health-related quality of life and overall life satisfaction in people with serious mental illness.Schizophr Res Treatment,2012,245103.
  6. Barret, P(2007).Structural equation modelling: adjudging model fit.Pers Individ Dif,42,815-24.
  7. Bollen, KA(1989).Structural Equations with Latent Variables.New York:Wiley.
  8. Bollen, KA(ed.),Long, JS(ed.)(1993).Testing Structural Equation Models.Newsbury Park, California USA:Sage.
  9. Byrne, BM(1994).Structural Equation Modeling with EQS and EQS/Windows.Thousand Oaks, California, USA:Sage Publications.
  10. Chang, JT,Hays, RD,Shekelle, PG(2006).Patients' global ratings of their health care are not associated with the technical quality of their care.Ann Intern Med,144,665-72.
  11. Cohen, J(1988).Statistical Power Analysis for the Behavioral Sciences.Hillsdale, New Jersey, USA:Lawrence Earlbaum Associates.
  12. Cramer, JA,Rosenheck, R,Xu, W,Thomas, J,Henderson, W,Charney, DS(2000).Quality of life in schizophrenia: a comparison of instruments. Department of Veterans Affairs Cooperative Study Group on Clozapine in Refractory Schizophrenia.Schizophr Bull,26,659-66.
  13. Eack, SM,Newhill, CE(2007).Psychiatric symptoms and quality of life in schizophrenia: a meta-analysis.Schizophr Bull,33,1225-37.
  14. Eack, SM,Newhill, CE(2007).Psychiatric symptoms and quality of life in schizophrenia: a meta-analysis.Schizophr Bull,3,1225-37.
  15. Falloon, IRH,Pederson, J(1985).Family management in the prevention of morbidity of schizophrenia: The adjustment family unit.Br J Psychiatry,147,156-63.
  16. Folsom, DP,Depp, C,Palmer, BW(2009).Physical and mental health-related quality of life among older people with schizophrenia.Schizophr Res,108,207-13.
  17. Galuppi, A,Turola, MC,Nanni, MG,Mazzoni, P,Grassi, L(2010).Schizophrenia and quality of life: how important are symptoms and functioning?.Int J Ment Health Syst,4,31.
  18. Grewal, R,Joseph, AC,Baumgartner, H(2004).Multicollinearity and measurement error in structural equation models: implications for theory testing.Marketing Sci,23,519-29.
  19. Heinrichs, DW,Hanlon, TE,Carppenter, WT(1984).The Quality of Life Scale: An instrument for rating the schizophrenic deficit syndrome.Schizophr Bull,10,388-98.
  20. Ho, WW,Chiu, MY,Lo, WT,Yiu, MG(2010).Recovery components as determinants of the health-related quality of life among patients with schizophrenia: structural equation modelling analysis.Aust N Z J Psychiatry,44,71-84.
  21. Holcomb, WR,Morgan, P,Adams, NA,Ponder, H,Farrel, M(1993).Development of a structured interview scale for measuring quality of life of the several mentally ill.J Clin Psychol,49,830-40.
  22. Hou, SY,Ke, CL,Su, YC,Lung, FW,Huang, CJ(2008).Exploring the burden of the primary family caregivers of schizophrenia patients in Taiwan.Psychiatry Clin Neurosci,62,508-14.
  23. Hoyle, RH(ed.)(1999).Structural Equation Modeling: Concepts, Issues, and Applications.Thousand Oaks, California, USA:Sage.
  24. Jinnett, K,Alexander, JA,Ullman, E(2001).Case management and quality of life: assessing treatment and out-comes for clients with chronic and persistent mental illness.Health Serv Res,36,61-90.
  25. Joreskog, KG,Sorbom, D(1989).LISREL 7: A Guide to the Program and Applications.Chicago:Statistical Package for Scoial Science.
  26. Kamphuis, M,Ottenkamp, J,Vliegen, HW(2002).Health related quality of life and health status in adult survivors with previously operated complex congenital heart disease.Heart,87,356-62.
  27. Katakura, N,Matsuzawa, K,Ishizawa, K,Takayanagi, C(2013).Psychological and physical self-management of people with schizophrenia in community psychiatric rehabilitation settings: a qualitative study.Int J Nurs Pract,19(Suppl 2),24-33.
  28. Kilbourne, AM,Perron, BE,Mezuk, B,Welsh, D,Ilgen, M,Bauer, MS(2009).Co-occurring conditions and health-related quality of life in patients with bipolar disorder.Psychosom Med,8,894-900.
  29. Kline, RB(1998).Principles and Practice of Structural Equation Modeling.New York:Guilford Press.
  30. Lin, FJ(2008).Solving multicollinearity in the process of fit-ting regression model using the nested estimate procedure.Qual Quant,42,417-26.
  31. Maat, A,Fett, AK,Derks, E,Group investigators(2012).Social cognition and quality of life in schizophrenia.Schizophr Res,137,212-8.
  32. Malhotra, NK,Peterson, M,Kleiser, SB(1999).Marketing research: a state-of-the-art review and directions for the twenty-first century.Acad Market Sci,27,160-83.
  33. Malm, U,May, PRA,Dencker, SJ(1981).Evaluation of the quality of life of the schizophrenic outpatient: A checklist.Schizophr Bull,7,477-87.
  34. Martens, L,Addington, J(2001).The psychological well-being of family members of individuals with schizophrenia.Soc Psychiatry Psychiatr Epidemiol,36,128-33.
  35. Mason, CH,Perreault, WD, Jr(1991).Collinearity, power and interpretation of multiple regression analysis.J Mark Res,28,268-80.
  36. Moerbeek, M,van Breukelen, GJ,Berger, MP(2003).A comparison between traditional methods and multilevel regression for the analysis of multicenter intervention studies.J Clin Epidemiol,56,341-50.
  37. National Institute of Mental Health(1987).Towards a Model for a Comprehensive Community-based Mental Health System.Washington, DC:NIMH.
  38. Prince, M,Patel, V,Saxena, S(2007).No health without mental health.Lancet,370,859-77.
  39. Rigbi, A,Shalev-Mevorach, L,Taller, A,Taller, Y,Lerer, B(2003).Relationship of clinical and demographic characteristics of schizophrenia patients to rehabilitation status/discussion.Isr J Psychiatry Relat Sci,40,258-67.
  40. Ritsner, MS,Lisker, A,Arbitman, M(2012).Ten-year quality of life outcomes among patients with schizophrenia and schizoaffective disorders: I. Predictive value of disorder-related factors.Qual Life Res,21,837-47.
  41. Schinnar, AP,Rothbard, AB,Kanter, R,Jung, YS(1990).An empirical literature review of definitions of severe and persistent mental illness.Am J Psychiatry,147,1602-8.
  42. Sim, K,Mahendran, R,Siow, AC(2005).Health-related quality of life and psychiatric comorbidity in first episode psychosis.Compr Psychiatry,46,278-83.
  43. Siskind, D,Harris, M,Pirkis, J,Whiteford, H(2012).Personalised support delivered by support workers for people with severe and persistent mental illness: A systematic review of patient outcomes.Epidemiol Psychiatr Sci,21,97-110.
  44. Tabachnick, BG(ed.),Fidell, LS(ed.)(2001).Using Multivariate Statistics.Needham Heights, Massachusetts, USA:Allyn & Bacon.
  45. Taylor, TL,Killaspy, H,Wright, C(2009).A systematic review of the international published literature relating to quality of institutional care for people with longer term mental health problems.BMC Psychiatry,9,55.
  46. THE WHOQOL GROUP(1998).Development of the World Health Organization WHOQOL-BREF Quality of Life Assessment.Psychol Med,28,551-58.
  47. Tucker, LR,Lewis, C(1973).A reliability coefficient for maximum likelihood factor analysis.Psychometrika,38,1-10.
  48. Verbeke, W,Bagozzi, RP(2000).Sales call anxiety: Exploring what it means when fear rules a sales encounter.Market,64,88-101.
  49. Westland, JC(2010).Lower bounds on sample size in structural equation modeling.Electron Commer Res Appl,9,476-87.
  50. Yu, WY,Cheng, HL,Lung, FW,Chen, MZ,Lin, CH(1995).The development of quality of Life instrument for schizophrenia.Pub Health,22,29-40.
  51. Zubritsky, C,Abbott, KM,Hirschman, KB,Bowles, KH,Foust, JB,Naylor, MD(2013).Health-related quality of life: expanding a conceptual framework to include older adults who receive long-term services and supports.Gerontologist,53,205-10.
被引用次数
  1. LEE, Shu-Chun,CHIU, En-Chi(2018).Factor Structure of the Quality of Life Scale for Mental Disorders in Patients With Schizophrenia.The Journalof Nursing Research,26(3),185-190.