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    题名: 中文版生活品質問卷應用於自閉症成人之心理計量特性檢驗
    Examining Psychometric Properties of the Chinese Version of Quality of Life Measures for Adults with Autism Spectrum Disorder
    作者: 曾子華
    Tseng, Tzu-Hua
    贡献者: 姜忠信
    Chiang, Chung-Hsin
    曾子華
    Tseng, Tzu-Hua
    关键词: 生活品質
    身心障礙
    自閉症類群障礙症
    神經多樣性
    信效度
    Quality of Life
    Disability
    Autism Spectrum Disorder
    Neurodiversity
    Reliability and Validity
    日期: 2025
    上传时间: 2025-07-01 14:12:06 (UTC+8)
    摘要: 背景：生活品質近年來漸受重視，為一複雜而多面向的概念。隨著身心障礙者的權利與倡議運動的發展，與以神經多樣性的角度來思考神經發展障礙，探討個體主觀生活品質有其必要，亦可作為介入服務的結果指標。過去研究採用許多不同的工具來探討身心障礙者生活品質，世界衛生組織生活品質問卷—簡版（WHOQOL-BREF）是臺灣較為廣泛使用的生活品質問卷。考量自閉症類群障礙症之族群特性，使用世界衛生組織生活品質問卷—身心障礙版（WHOQOL-DIS）與自閉症生活品質問卷（ASQoL）可以更了解其生活品質的不同面向與感受。
    目的：檢驗生活品質量表WHOQOL-DIS與ASQoL中文版應用於自閉症類群障礙症成人之心理計量特性。
    方法：完成WHOQOL-DIS與ASQoL雙向翻譯及文化調整後，邀請3位成年自閉症類群障礙症者提供對於題項翻譯的質性建議，修訂為最終版的問卷。以臺灣地區自閉症類群障礙症成人為研究對象，主要使用線上方式自填問卷，共136位參與者，平均年齡26.35歲。
    結果：WHOQOL-DIS與ASQoL具良好的內部一致性及一個月再測信度。以過去研究之因素結構進行驗證性因素分析，模型適配度不佳，細看WHOQOL-DIS各因素，歧視向度關於支持（Advocacy）的標準化因素負載量特別低，推測與文化和語言使用的差異有關。兩份問卷與WHOQOL-BREF、健康調查簡表（SF-36）之心理健康領域、生活滿意度量表（SWLS）皆具顯著正相關，和壓力知覺量表（PSS）皆呈現顯著負相關，支持其收斂效度和效標關聯效度。另外，生活品質分數和自評自閉症特質程度為顯著負相關。
    結論：WHOQOL-DIS與ASQoL中文版仍具一定的應用價值。未來在擴大研究樣本數的同時，也需探討文化差異或題目構念的文化適用性。
    Background: Quality of life (QoL) has received increasing attention in recent years, recognized as a complex and multifaceted concept. With the development of the rights and advocacy movement for people with disabilities, alongside a neurodiversity perspective on neurodevelopmental disorders, it is necessary to explore individuals' subjective QoL, which can also serve as an outcome indicator for intervention services. Previous studies have employed various tools to assess the QoL of people with disabilities. The World Health Organization Quality of Life -Brief Version (WHOQOL-BREF) is one of the most widely used QoL questionnaires in Taiwan. Considering the specific characteristics of individuals with Autism Spectrum Disorder (ASD), using the World Health Organization Quality of Life -DISABILITIES Module (WHOQOL-DIS) and Autism Spectrum Quality of Life (ASQoL) could provide a more comprehensive understanding of the different aspects and experiences of QoL in this population.
    Objectives: This study aims to examine the psychometric properties of the Chinese version of the WHOQOL-DIS and ASQoL for adults with ASD.
    Methods: After completing the forward and backward translation and cultural adaptation of the WHOQOL-DIS and ASQoL, three adults with ASD were invited to provide qualitative feedback on the translation of the items, which were then revised into the final versions of the questionnaires. Participants were adults with ASD in Taiwan, recruited primarily through online questionnaires. A total of 136 participants completed the survey, with a mean age of 26.35 years.
    Results: Results showed that the WHOQOL-DIS and ASQoL demonstrated good internal consistency and one-month test-retest reliability. Confirmatory factor analysis (CFA) using the factor structure from previous studies indicated suboptimal model fit. Examining the standardized factor loadings of the WHOQOL-DIS revealed that the loadings for the Advocacy item in the Discrimination dimension were particularly low, which may be attributed to cultural and linguistic differences in the use of the concepts of advocacy and support. Both questionnaires were significantly positively correlated with the WHOQOL-BREF, the mental health component of the Short Form-36 (SF-36), and the Satisfaction with Life Scale (SWLS), and negatively correlated with the Perceived Stress Scale (PSS), supporting their convergent and criterion-related validity. In addition, a significant negative correlation was observed between QoL scores and self-reported levels of autistic traits.
    Conclusions: The Chinese version of the WHOQOL-DIS and ASQoL retain a certain degree of practical applicability. In the future, while expanding the sample size, the cultural appropriateness of the item constructs also need to be explored.
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    國立政治大學
    心理學系
    110752021
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