研究背景與目的：精神分裂症患者的整個生活各方面都會受到症狀所影響，不但會遭受到壓力、失能、生產力降低，連帶其生活品質也受到影響。生活品質的概念提供了以個案為中心、以顧客的角度來評估慢性精神疾病需求的評估。此研究之目的便是在檢測一份精神分裂症病患生活品質問卷（Schizophrenia Quality of Life Scale Revision 4；SQLS-R4）中文版之信效度，探討其內在一致性、再測信度、敏感度及聚斂效度。研究方法：三位精神科專科醫師以簡短精神症狀量表（Brief Psychiatric Rating Scale）評估參與者的精神心理狀態，接下來以所需用到的評估工具及問卷評估參與者以測試聚斂效度，評估工具包括了SQLS-R4，以及另外兩份健康相關生活品質問卷SF-36與LQOLP。兩週後再進行一次簡短精神症狀量表及SQLS-R4的施測以測試再測信度及敏感度。結果：SQLS-R4的內在一致性高，再測信度係數都在0.8以上。進步組的敏感度係數在0.9以上，而退步組的敏感度係數則是在0.4以上。聚斂效度的結果則是與預測相符合。結論：SQLS-R4之內在一致性、再測信度、聚斂效度、對變化之敏感度皆佳，此份問卷為一可行且實用之臨床評估工具。

關鍵詞：精神分裂症，生活品質，信度，效度，敏感度

Background and purpose: People with schizophrenia suffer distress, disability, reduced productivity and then their quality of life (QOL) is affected. The concept of QOL offers a client-centered and consumer perspective for assessing the needs and outcomes of chronic mental patients. The purpose of this research is to validate a QOL questionnaire for patients with schizophrenia in Taiwan, the Schizophrenia Quality of Life Scale Revision 4 (SQLS-R4). The internal consistency, test-retest reliability, responsiveness and convergent validity of SQLS-R4 were investigated. Method: Three experienced psychiatrists rated Brief Psychiatric Rating Scale (BPRS) to identify the participant’s present condition and function. The participants were evaluated with Medical Outcome Study 36 Item Short Form (SF-36), Lancashire Quality of Life Profile (LQOLP), and SQLS-R4 to test the convergent validity. And the cohort had a re-evaluation of BPRS and SQLS-R4 two weeks later for test-retest reliability and responsiveness testing. Results: Cronbach’s a of SQLS-R4 in both dimensions were above .8. Item-total consistency coefficients of SQLS-R4 were high. The Intra-class Correlation Coefficients of test-retest reliability of SQLS-R4 were also above .8. The responsiveness coefficients of SQLS-R4 in both dimensions were above .9 in the improved group. The responsiveness coefficients of SQLS-R4 in both dimensions were above .4 in the deteriorated group. The results of convergent validity testing are in the expected direction and suggest that the instruments capture similar conceptual areas. Conclusion: SQLS-R4 had good internal consistency, good test-retest reliability, and acceptable convergent validity. This questionnaire could detect the change of psychological status in patients with schizophrenia and could be applied in clinical practice. SQLS-R4 is a practical and useful questionnaire in assessing QOL of schizophrenic patients.

Key words: schizophrenia, quality of life, reliability, validity, responsiveness

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