第六章 結論與建議
第三節 應用與建議
1. 本研究對象均為 COPD 患者，缺少對照組（健康族群）的資料，較難 表現出COPD 患者生活品質受損的情形，未來可增加對照組的資料來 幫助了解COPD 患者生活品質受損的情形。
2. 藉由現代測量理論可以幫助了解 COPD 患者在兩份問卷中各個題目的 表現情形，未來可針對不符合單一向度假設的題目加以修改，或者是 將其刪除。
3. 本研究利用訊息函數的原理針對 SGRQ 的日常活動範疇嘗試進行挑 題，挑出來的題目難度相當符合不同病情患者的能力，而且可以提供 最大的訊息量。未來可以針對挑選出來的題目再進行研究分析，以確 認其在臨床上的可用性。
4. 針對病情嚴重的 COPD 族群（如：stage 4），在臨床上欲測量其日常活 動相關生活品質時，可嘗試讓其回答「某些活動使您喘不過氣來」題 組中的”
坐著不動或躺著不動
”、”梳洗或穿衣
”、”在家中走動
”這三題 與「呼吸問題如何影響您的活動」題組中的”我會花費長時間在洗或穿 衣上
”、”我不能自己泡澡或淋浴，或我會花長時間
”、”我走路比別人 慢，或者我會停下來休息
”這三題即可，來減輕患者在答題時的負擔。5. 本研究與電腦化適性測驗的原理相同，均利用 IRT 方法中所提供之題 目訊息量特性，因此可視為是發展電腦化適性測驗的先驅研究，未來 可針對WHOQOL-BREF 與 SGRQ 的題目進行挑選，再納入 COPD 患 者發展電腦適性測驗的題庫中，朝向發展電腦適性測驗的目標邁進。
6. 此外，發展題庫以更適當的題目來測量，不但可達到縮短題目、同時 亦可提高測量的準確性，現代測量理論提供了改善測量品質理想的基 礎架構與前瞻性的機制。針對年長及慢性病患者如 COPD，此理論在 臨床上的應用更可預見其潛力與重要性。
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附錄一 世界衛生組織生活品質問卷（WHOQOL-BREF）
附錄二 聖喬治呼吸問卷（SGRQ）
四、以下是更多有關最近這些日子，您的咳嗽及喘不過氣狀況之一些問題
八、我們想知道您的呼吸問題通常如何影響您的日常生活。