摘要：
背景：服務精神分裂症病患的領域中，個案的健康相關生活品質（Health-Related Quality of Life）常是各專業了解復健成效的指標，因此健康相關生活品質量表若能具有良好的再測信度心理計量，將能提供研究者和臨床工作者有效的分析結果。
目的：本研究深入探討四種常用於精神分裂病患的健康相關生活品質量表心理計量中的再測信度，包括：World Health Organization Quality of Life-BREF (WHOQOL-BREF)、Short From 36(SF-36)、Taiwan Lancashire Quality of Life Profile (T-LQOLP)及Schizophrenia Quality of Life Scale-Revision4(SQLS-R4)。期能藉由瞭解量表的再測信度及最小改變量，更精準地測量精神分裂症病患的健康相關生活品質的變化。
方法：樣本為南部某一醫療機構的慢性住院精神分裂症病患，收案條件如下：根據DSM-IV診斷為精神分裂症病患，再經BPRS及MMSE篩選，確定病情穩定、有足夠認知能力以進行評估者，人數100名。每一健康相關生活品質量表間隔兩週分別進行前後測。利用組內相關係數(ICC)、Bland and Altman Analysis、測量標準誤差(SEM)，及最小真實改變量(SRD)進行統計分析，以獲得各評估量表的再測信度及感應度。
結果：相對指標：四種量表總分的組內相關係數，範圍由0.87—0.94，均大於0.75，顯示具極佳的信度；絕對指標：(1)總分的測量標準誤差(測量標準誤差百分比)分別為：WHOQOL-BREF=3.25(5.67%)、SF-36=6.21(5.70%)、T-LQOLP=6.74(5.89%)，及SQLS R4=6.54(15.73%)，前三者的測量標準誤差百分比均少於10%，屬於可接受範圍。(2)最小真實改變量(最小真實改變量百分比)分別是：WHOQOL-BREF=9.01(15.72%)、SF-36=17.20(15.79%)、T-LQOLP=18.69(16.34%)及SQLS- R4=18.12(43.60%)，前三者的最小真實改變量百分比均少於30%，表示其測量標準誤落屬於可接受範圍。(3)Bland and Altman分析，均顯示沒有系統誤差。
結論：本研究顯示在精神分裂症病患族群中，四種健康相關生活品質量表的再測信度，都具有良好至極佳的程度；在感應度方面，WHOQOL-BREF（廣用性）較及SF-36（廣用性），T-LQOLP（特定性）及SQLS-R4（特定性）容易偵測出真正變化，可以幫助臨床專業依據測量標準誤差、最小真實改變量，來判斷精神分裂症患者健康相關生活品質的真正變化。

關鍵字：再測信度、精神分裂症、健康相關生活品質量表、感應度

Abstract：
Background:
In the realm of dealing with patients of schizophrenia, the “Health-related quality of life” is often the index of effectiveness of the profession. In this sense, if the Scale of “health-related quality of life” contains effective psychometric of the test-retest reliability, it will provide researchers and clinical professionals valid results.

Purpose:
In this research, the test-retest reliabilities of four Scales of “Health-related quality of life” on patients of schizophrenia will be deeply investigated. They are World Health Organization Quality of Life-BREF(WHOQOL-BREF), Short From 36(SF-36), Taiwan Lancashire Quality of Life Profile(T-LQOLP) and Schizophrenia Quality of Life Scale-Revision4(SQLS-R4). It is hoped that understanding of test-retest reliabilities and Smallest Real Difference(SRD) of these scales can more accurately measure the changes of health-related quality of life of the patients.

Methods:
The candidates are selected from long stay patients of schizophrenia in a hospital in the southern part of Taiwan. The conditions of recruiting them are as follows: the candidates must be diagnosed as patient of schizophrenia by DSM-IV. Then by selection by BPRS and MMSE, they must have a stable clinical course and adequate cognitive ability to participate in the assessment. The number of patients recruited about 100. The “Scales of health-related quality of life” will be assessed twice, two weeks apart.. Using ICC, Bland and Altman Analysis, SEM and SRD, the test-retest reliabilities and responsiveness are obtained.

Results:
Relative index: The four scales have a ICCs greater than 0.75, showing excellent confidence level.
Absolute index: 1. Measured the standard error of measurement (measured standard error of measurement percentages) are: WHOQOL-BREF=3.25(5.67%), SF-36=6.21(5.70%), T-LQOLP=6.74(5.89%), and SQLS R4=6.54(15.73%) respectively. The standard error of measurement percentage of the first three are less 10%, in the acceptable ranges. 2. Smallest Real Difference (Smallest Real Difference percentages) are WHOQOL-BREF=9.01(15.72%), SF-36=17.20(15.79%), T-LQOLP=18.69(16.34%) and SQLS- R4=18.12(43.60%). The Smallest Real Difference percentages of the former three are less than 30%, in the acceptable range.(3)The Bland and Altman analysis revealed no systematic errors between test-retest of all four HRQOL Questionnaires.

Conclusions：
The WHOQOL-BREF(generic)、SF-36(generic)、T-LQOLP(specific) and SQLS-R4 (specific) were well test-retest reliabilities in this study . For the responsiveness results, the WHOQOL-BREF was interpreted the real change easily in individual. Researchers and clinical professionals can accord the value of SEM and SRD to determine the real change of the HRQOL of the patients of Schizophrenia.

Key Words：Test-retest reliability、Schizophrenia、Health-Related Quality of Life、Responsiveness

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