| Summary: | 博士 === 國立臺灣大學 === 護理學研究所 === 92 === Abstract
【Background and purpose】
Quality of life (QOL) is the paramount goal of end-of-
life care. However, there is no Chinese language instrument
for measuring QOL has been shown to have adequate
psychometric properties for Taiwanese patients with terminal
cancer. The purposes of this study were to investigate the
constructs and to establish the conceptual framework of QOL
in terminal cancer patients and to examine the psychometric
properties of a Chinese language version of the McGill
Quality of Life Questionnaire and further develop an MQOL-
Taiwan version based on Taiwanese culture.
【Subjects and methods】
Low structured interview guide and MQOL questionnaire
were used for data collection in the palliative care unit,
oncology wards and outpatient clinics of family medicine.
The fifteen highly heterogeneous patients were selected by
purposive sampling. The qualitative data were coding and
categorizing by content analysis. The MQOL questionnaire was
administered to 113 Taiwanese patients with terminal cancer
and 122 chronic disease patients for psychometric testing.
Data were analysed by SPSS version 11 and EQS 5.7b.
Statistical analysis was conducted using Pearson’s product
moment correlation, Mann-Whitney test, Kruskal-Wallis test,
exploratory and confirmatory factor analysis, and multiple
regression analysis.
【Results】
The results can be summarized as followed:
1.The QOL in Taiwanese terminal cancer patients can be
composed of four categories and eight themes. Each theme
has both positive and negative aspects. The first
category is “internal-external physical harmony and well-
being” which include internal physiological functions
and external physical activities. The second category is
“psychological-affective harmony and well-being” which
include subjective affection and cognitive evaluation of
well-being. The third category is “family-social harmony
and well-being” which indicates the relationships with
family, and the integration with environments. The fourth
category is ”spiritual-existential harmony and well-
being” which represents one person harmonizing with
self, others, higher being and nature. The ultimate goal
of achieving QOL is to reach the dynamic harmony of
physical、psychological、spiritual and social aspects,
which is a state of “unity of nature and human being”.
2.The 16-items MQOL-Taiwan version, including a native item
of “Family concerns”, was found to be acceptable,
validated and reliable. Good content validity (CVI=0.98),
construct validity and reliability (Cronbach’s α= 0.74
to 0.87) can be recognized, confirming that QOL does have
cross culturally robust constructs. The four domains of
physical, psychological, spiritual-existential well-
being, and social support are applicable in Taiwanese cul
ture and can be explained 64% of total variance.
3.Although the domain of physical symptoms has the lowest
score in 4 domains of QOL, the spiritual-existential
domain is the most important domain in predicting the
score of overall QOL.
4.The relatively important variables to decline overall
MQOL score were numbers and severity of symptoms
including restless, anorexia and fever..
【Conclusions】
The study results indicate the MQOL-Taiwan version
questionnaire will be suitable for the use of clinical care
and research, and able to provide the end of life care with
more cultural sensitivity in Taiwan.
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