38卷6期

• Link 政策論壇 Policy Forum
• 食品安全促進Food Safety Promotion
• 許輔
  Fuu Sheu
• 無
  none
• 無
  none
• 563-565
• 10.6288/TJPH.201912_38(6).PF06

• Link 政策論壇 Policy Forum
• 欠缺風險溝通的食品風險治理架構Deficit risk communication in the food risk governance frameworkimplications for Taiwan’s long-term care system development
• 徐健銘、周桂田
  Chien-Ming Hsu, Kuei-Tien Chou
• 無
  none
• 無
  none
• 566-568
• 10.6288/TJPH.201912_38(6).PF07

• Link 公衛論壇 Public Health Forum
• 中藥調劑資格與產業傳承之政策改革Policy reforms concerning qualification of Chinese medicine dispensing and inheritance of chinese herbal industry
• 陳俞沛
  Yu-Pei Chen
• 無
  none
• none
  none
• 569-573
• 10.6288/TJPH.201912_38(6).108104

• Link 綜論 Review Article
• 台灣醫療院所各類病床發展回顧：1985-2017年A review of hospital and clinics beds in Taiwan from 1985 to 2017
• 葉馨婷、吳肖琪
  Shin-Ting Yeh, Shiao-Chi Wu
• 醫療網計畫、病床、醫院整合醫學、社區式照護、居家式照護
  Medical Care Network Plan, beds, hospitalist, community care, home care
• 第一期醫療網計畫訂定2000年一般醫療設施每萬人口40床（含精神病床）之目標。本文系統性回顧我國醫療院所病床的分類與沿革發展。研究結果發現病床分類上越趨精細，且總病床數持續增加，2000年後醫院急性一般病床數增加趨緩，然特殊病床明顯增加，且以安寧病床、慢性呼吸照護病床、血液透析床、及亞急性呼吸照護病床增加最多；2017年每萬人口病床數為69.83床，已超過醫療網40床之目標。2064年預估我國總人口數將減少至1,758萬人，每萬人口病床數將因人口數減少而增加，減少病床與增加使用效率同等重要。本研究建議(1)將加護病床、燒傷病床、燒傷加護病床、嬰兒病床、急診觀察床等急性特殊病床納入管理；(2)因應多重慢性住院病人的增加，一般內科病房宜轉型為醫院整合醫學病房；(3)慢性一般病床應加速退場，(4)透析病床、安寧療護、呼吸照護治療、急性後期照護不應計入急性病床；透析病床屬治療床，其它後三者宜朝使用長期照顧機構提供服務。
  The Medical Care Network Plan, established in 1986, set the goal of having 40 physical and mental health beds per 10,000 people in general medical facilities by 2000. This study systematically reviewed the classification and development history of hospital and clinic beds in Taiwan. The classification of beds has become more complex, and the number of bed types has continued to increase. After 2000, the number of acute care beds increased slowly, but the number of special beds increased significantly. The most-increased special beds included hospice palliative care beds, chronic respiratory care beds, hemodialysis beds, and subacute respiratory care beds. In 2017, the number of beds per 10,000 people was 69.83, exceeding the original goal of 40 beds. In 2064, the total population will decrease to 17.58 million; thus, the number of beds per 10,000 people will automatically increase. Reducing the number of beds is as important as increasing efficiency. We suggest: (1) incorporating acute special care beds such as intensive care beds, burn beds, burn unit intensive care beds, infant care beds, and emergency observation beds into management; (2) transforming general medical beds into hospitalist beds to better respond to the increasing number of multiple chronic patients; (3) accelerating the withdrawal of chronic beds; and (4) excluding hemodialysis beds, hospice palliative care beds, respiratory care beds, and postacute care beds from the acute beds category. Regarding this last suggestion, the hemodialysis bed is a treatment bed, and the others should be served by long-term care institutions.
• 574-589
• 10.6288/TJPH.201912_38(6).108063

• Link 綜論 Review Article
• WHOQOL-BREF之心理計量特徵的回顧研究A review on the psychometric properties of the WHOQOL-BREF
• 林立中、姚開屏
  Li-Chung Lin, Grace Yao
• 世界衛生組織生活品質問卷簡明版、系統性回顧研究、生活品質
  WHOQOL-BREF, review study, quality of life
• 世界衛生組織生活品質問卷簡明版（WHOQOL-BREF）是一個廣泛使用於醫藥、公衛界的跨文化測量工具，目前已發展50餘國版本，然缺乏在不同國家或地區檢驗其心理計量特徵，本研究採用系統性回顧法，以評估其在不同樣本族群的信、效度。本研究於PsycINFO與MEDLINE資料庫，搜尋1998至2019年6月檢驗WHOQOL-BREF心理計量特徵的英文研究，共50篇文獻。研究發現WHOQOL-BREF之生理、心理、社會關係、與環境範疇具有高內部一致性信度與再測信度。此4範疇可有效區辨健康組與疾病組，並與健康相關問卷有顯著正相關，與疾病相關問卷有顯著負相關，具良好的區辨與效標關聯效度。然其建構效度不佳，部份研究無法驗證世界衛生組織所提出的4因素模型。綜觀此50篇研究發現，採取較不嚴謹的分析方法可能是造成WHOQOL-BREF建構效度不佳的原因。本研究依據心理計量理論及其模擬研究結果，建議未來在檢驗WHOQOL-BREF之建構效度時，於EFA採用迭代主軸法、多重方法決定因素數、與promax轉軸。於CFA採用較嚴謹的模型適配指標切結分數，並謹慎採用模型修正指數。
  The short version of the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire, a cross cultural instrument, is widely used in medical and public health fields, with versions developed in over 40 countries. Because research to evaluate the psychometric properties of the WHOQOL-BREF in diverse sample groups is scant, this study systematically reviewed the reliability and validity of such research. We searched studies, written in English, of psychometric properties examined in the WHOQOL-BREF in MEDLINE and PsycINFO (from 1998 to the May 2019). Fifty papers were finally included. The findings showed that the physical, psychological, and social relationships and the environmental domains of the WHOQOL-BREF had appropriate Cronbach’s a and test–retest reliabilities. All these four domains showed good discriminant and criterion-related validity, representing a significant differentiation between the healthy and unhealthy groups, and exhibited significantly positive and negative correlations on questionnaires measuring health and syndrome of illness symptoms. However, the WHOQOL-BREF performed poorly in construct validity. The four-factor model proposed by the WHO was not fully validated in studies reviewed. An overview of these 50 papers indicates that inappropriate statistical analysis approaches may be a reason for poor construct validity. Based on the psychometric theory and its results from simulation studies, this study recommends conducting exploratory factor analysis using iterative principle axis factoring, promax rotation, and multiple methods to determine the number of factors as well as using confirmatory factor analysis with strict cut-off scores in goodness-of-fit indices and cautiously adopting a modification index for evaluating the psychometric properties of the WHOQOL-BREF.
• 590-603
• 10.6288/TJPH.201912_38(6).108087

• Link 原著 Original Article
• 中醫資源可近性對於中醫門診利用之影響The association between the resource accessibility and the utilization of Traditional Chinese Medicine
• 林宜瑾、郭年真
  Yi-Chin Lin, Raymond N. Kuo
• 中醫資源不足地區、中醫資源可近性、中醫門診利用、差異中之差異法
  areas deficient in TCM resources, accessibility of TCM resources, ambulatory care utilization of TCM, difference in difference
• 目標：探討中醫資源可近性不同變化情形，對於民眾中醫門診利用之影響，並分析中醫資源可近性與不同利用習慣者的關係。方法：本研究以中醫巡迴醫療施行區域與各年度的每萬人口中醫師數作為可近性之測量指標，共分為兩個子研究樣本：「可近性增加組」與「可近性降低組」，並依照可近性變化情形再區分個案組（中醫資源可近性有改變）與對照組。利用傾向分數配對（Propensity Score Matching）篩選對照組，以廣義估計方程式（GEE）進行差異中的差異法，搭配使用二部模型（Two-part model）進行分析；本研究採用健保資料庫進行分析，研究期間為2011年至2013年。結果：可近性增加組的個案其中醫門診利用皆顯著增加，中醫利用率的勝算比（odds ratio, OR）為1.094，個案組的中醫利用次數與費用改變率分別較對照組增加0.022%與0.128%；但對於可近性降低組的個案而言，其中醫門診利用皆顯著減少。結論：中醫資源對於中醫門診利用會造成影響，故建議主關機關能持續保障醫療資源缺乏地區民眾的之中醫就醫權益，並且須擬定相關政策以改善當前不同地區中醫利用差異之問題，以落實全民健保精神。
  Objectives: Our objective in this study was to characterize the means by which changes in the availability of TCM affect the ambulatory utilization of TCM among various groups of TCM users. Methods: TCM mobile health care coverage and the number of TCM physicians per 10,000 were used to define accessibility. We focused on two groups of patients, as follows: individuals who faced an increase in access to TCM and individuals who faced a decrease in access to TCM. We also considered individuals who did not face any changes in access to TCM as a control group. Propensity score matching was used in the selection of the control group. After parameter matching, difference-in-difference analysis was used in conjunction with the generalized estimating equation (GEE) within a two-part model for analysis. Results: Individuals who were provided greater access to TCM increased their utilization of TCM, compared to the control group, as follows: probability (+1.094 x), frequency (+1.022 x), and cost (1.128 x). Individuals who experienced a reduction in access to TCM decreased their utilization of TCM, compared to the control group, as follows: probability (-0.823 x), frequency (-0.940 x), and cost (-0.763 x). Conclusions: Our results reveal that access to TCM resources affects the ambulatory utilization of TCM. We therefore recommend that efforts be made to improve access to TCM in areas where TCM resources are scarce and that the government develops policies aimed at narrowing the differences in the utilization of TCM.
• 604-616
• 10.6288/TJPH.201912_38(6).108072

• Link 原著 Original Article
• 應用離散事件電腦模擬技術推估主治醫師工時限制對我國醫療服務提供之影響—以六個外科系專科別為例Application of discrete-event simulation modeling to project the effect of limiting the work hours of visiting staff on medical service volume: the case of 6 surgical specialties
• 陳仁傑、譚家惠、吳育庭、陳錫杰、陳佳宜、楊銘欽
  Jen-Chieh Chen, Elise Chia-Hui Tan, Yu-Ting Wu, Hsi-Chieh Chen, Chia-Yi Chen, Ming-Chin Yang
• 主治醫師、工時、醫療服務、離散事件、系統模擬
  visiting staff, work-hours, medical service, discrete event, system simulation
• 目標：主治醫師納入勞動基準法的議題爭議許久，然而有關制定工時上限對醫療服務提供與民眾就醫衝擊的相關研究尚付之闕如。本研究以電腦模擬方法推估健保特約西醫醫院六個外科系科別之主治醫師工時限縮後對醫療服務量的影響。方法：以問卷調查與深度訪談收集醫師工作內容、每項工時及排班邏輯；分析健保申報資料之全年門診、檢查及手術服務、手術耗用時間等醫療服務量資料，建構主治醫師全年醫療服務量現況模型，並依據三種可能工時限縮方案（每週總工時及連續工時上限：80/28, 76/28, 72/24）進行推估，比較其對於醫療服務提供的影響。結果：相較於主治醫師現行工作現況，三種工時限縮方案皆可能導致門診量的減少與手術排程的延後，且對於區域醫院層級以下的醫療服務提供者影響較大。工時限縮方案中以每週工時上限72小時，連續工時上限24小時的方案，對醫療服務提供與民眾就醫權益影響最鉅。結論：本醫師工時模型及分析結果可供主管機關做為制訂主治醫師工時限縮決策之參考。
  Objectives: Research is lacking on the effect of implementing work-hour limitations for hospitals’ visiting staff in terms of the provision of medical services and accessibility to the public. This study used discrete-event computer simulation to estimate the effect of limiting the work hours of visiting staff on the medical service volume of 6 surgical specialties in hospitals under the National Health Insurance system. Methods: In-depth interviews and questionnaires were used to collect data on visiting staff’s work content, elapsed working time, and scheduling logic. We also analyzed the National Health Insurance claims database to obtain the annual volume of outpatients, examinations, and surgical services and the total elapsed time. Based on these data, we developed a medical service model for the 6 surgical specialties and proposed 3 work-hour limitation models (maximum weekly working hours/maximum hours of continuous work: 80/28, 76/28, and 72/24); the effects of the models on the provision of medical services were compared. Results: Compared with the model currently applied for visiting staff, the model in which work hours were reduced led to decreased outpatient volume and delay in the surgical schedule. It had a greater effect on hospitals with an accreditation level lower than that of regional hospitals. The work-hour limitation model with a maximum of 72 working hours per week and a 24-hour limit on continuous duty had the greatest effect on the provision of medical services. Conclusions: The model and research results established in this study provide the competent authorities with a reference when making decisions regarding the limitation of work hours for visiting staff.
• 617-632
• 10.6288/TJPH.201912_38(6).108066

• Link 原著 Original Article
• 台灣醫療機構執行公開揭露機制之可行性分析Feasibility analysis of the incorporation of open disclosure practices in medical institutions in Taiwan
• 張修維、翁詩亮、蔡家瑜、林東龍
  Shiu-Wei Chang, Shih-Liang Weng, Chia-Yu Tsai, Dong-Long Lin
• 公開揭露、不良事件、德菲研究法、醫療事故預防及爭議處理法
  open disclosure, adverse event, Delphi Method, Medical Incident Prevention and Dispute Resolution Bil
• 目標：衛生福利部已擬定「醫療事故預防及爭議處理辦法」草案，該草案融入歐美先進國家公開揭露機制之作法和精神。未來台灣實際推動該法案，可能遭遇何種障礙和需要哪些配套措施，需進一步探究。方法：除參考國外推動公開揭露經驗的文獻外，以德菲研究法收集國內16名對醫療爭議議題學有專精者的意見，瞭解其對於台灣推行公開揭露機制之障礙和所需配套措施等看法。結果：歷經三回合問卷，專家共提出38項醫療機構推行公開揭露的障礙，其中30個項目具高度共識；共提出41項推行公開揭露所需配套措施，其中34項具高度共識。結論：本研究建議包括：第一，面對醫療不良事件時，醫療機構需破除隱晦和究責個人的管理框架，建立說明真相的機制和組織文化；二是，改善負面或敵對的社會文化與法制，創造處理醫療爭議的友善環境；三是，透過教育訓練建立醫療人員揭露技巧與自信。
  Objectives: The Ministry of Health and Welfare has recently drafted a bill entitled “Medical Incident Prevention and Dispute Resolution,” which seeks to incorporate the strategy and content of open disclosure practices that are in place in Europe and the United States. In the event that Taiwan implements this bill, the potential obstacles that may be encountered should be investigated as well as the coordinated set of measures that the bill will require. Methods: In addition to referring to the experience of other countries practicing open disclosure, this study employed the Delphi method to collect opinions from 16 domestic experts on the question of medical disputes. The aim was to analyze the obstacles and evaluate the coordinated set of measures needed to implement open disclosure in Taiwan. Results: After 3 rounds of questionnaires, the experts surveyed proposed 38 recommendations addressing the barriers medical institutions may face when implementing open disclosure. High consensus was reached on 30 of these recommendations. Additionally, 41 recommendations were offered regarding a coordinated set of measures for implementing open disclosure, with high consensus achieved for 34. Conclusions: The recommendations obtained through this research include the following. First, when medical institutions deal with adverse medical events, the tendency of management to conceal and blame individuals should cease. Instead, solutions should be implemented to establish mechanisms and bring changes to the organizational culture to ensure the truth is preserved. Second, improvements are warranted in terms of the hostile social culture and legal system. A friendly environment should be created to ensure that medical disputes are resolved amicably. Third, efforts should be made to foster mature open disclosure behaviors and enhance the confidence of medical staff through education and training.
• 633-645
• 10.6288/TJPH.201912_38(6).108105

• Link 評論 Commentary
• 評論：台灣醫療機構執行公開揭露機制之可行性分析Commentary: feasibility analysis of the incorporation of open disclosure practices in medical institutions in Taiwan
• 林金定
  Jin-Ding Lin
• 無
  none
• 無
  none
• 646
• 10.6288/TJPH.201912_38(6).10810501

• Link 作者回覆 Authors' response to commentary
• 作者回覆：台灣醫療機構執行公開揭露機制之可行性分析Authors' response to commentary: feasibility analysis of the incorporation of open disclosure practices in medical institutions in Taiwan
• 張修維、翁詩亮、蔡家瑜、林東龍
  Shiu-Wei Chang, Shih-Liang Weng, Chia-Yu Tsai, Dong-Long Lin
• 無
  none
• 無
  none
• 647
• 10.6288/TJPH.201912_38(6).10810502

• Link 原著 Original Article
• Study of Osteoporotic Fractures（SOF Index）衰弱量表的效度驗證—一般社區長者以及獨居長者的應用Validity of the Study of Osteoporotic Fractures Index (SOF Index): cases of community-dwelling older adults and older adults living alone
• 胡倍瑜、游曉微、邱慈穎、林莉玲、陳端容、陳雅美
  Bei-Yu Hu, Hsiao-Wei Yu, Tzu-Ying Chiu, Li-Ling Lin, Duan-Rung Chen, Ya-Mei Chen
• 衰弱、衰弱量表比較、效標關聯效度、獨居長者
  frailty, comparison of frailty index, criterion-related validity, old adults living alone
• 目標：台灣長照照顧管理評估量表以Study of Osteoporotic Fractures（SOF Index）指標作為衰弱篩檢工具。本研究目的是以國際常用Frieds Frailty Phenotype作為標準，檢視SOF與Frieds Frailty Phenotype量表一致性。方法：本研究為橫斷研究採立意取樣面訪問卷收案，收案對象為台北市某行政區65歲以上社區長者（N = 471，包含一般社區長者369位、列冊關懷獨居長者102位）。資料分析探討Frieds Frailty Phenotype量表與SOF量表在全部長者、社區長者、及獨居長者的同時效度為何。結果：以Frieds Frailty Phenotype量表為標準量表時，全部長者結果顯示與SOF量表呈現中度相關（r = 0.51*）。在一般社區長者以及列冊關懷獨居長者中，亦與SOF量表呈現中度相關（r = 0.53*; r = 0.44*）。SOF加入Frieds Frailty Phenotype緩慢指標後，與Frieds Frailty Phenotype的一致性在全部長者、一般社區長者以及列冊關懷獨居長者分別提升到0.70*、0.72*、0.56*。結論：兩量表評估結果與世界先進國家研究結果相似，SOF量表雖有低估傾向，但是可以作為評估台灣社區長者及獨居長者衰弱的工具。使用SOF量表加入「緩慢」指標可以進一步提升SOF量表的準確性。
  Objectives: To measure the degree of frailty in older adults, it is common to use Frieds frailty phenotype index in Taiwan and advanced countries, whereas the Taiwanese government uses the Study of Osteoporotic Fractures (SOF) index. This study aimed to compare the consistency between SOF index and Frieds frailty phenotype index to assess frailty in general community-dwelling older adults and those living alone in one district in Taipei City, Taiwan. Methods: This was a cross-sectional survey study. Purposive sampling was employed to collect data from 471 older adults living in Taipei City, including 369 community-dwelling older adults living with families and 102 living alone. Spearmans rank correlation analysis was employed to assess the concurrent validities of the two indices in all elderly by residential status , communitydwelling older adults, and those living alone. Results: There was a moderate association between Frieds frailty phenotype index and SOF index in all older adults (r = 0.51*), community-dwelling older adults (r = 0.53*), and those living alone (r = 0.44*). When the indicator of slowness from the Frieds frailty phenotype index was included in the SOF index, the value between the two indices increased for all older adults (r = 0.70*), community-dwelling adults (r = 0.72*), and older adults living alone (r = 0.56*). Conclusions: The SOF index can be a valid screening tool to evaluate frailty for older adults in Taiwan, consistent with results from advanced countries. Adding the indicator of slowness to SOF index is recommended as effective frailty screening tool.
• 648-659
• 10.6288/TJPH.201912_38(6).108093

• Link 原著 Original Article
• 學齡兒童社會信任：家庭與班級層級因素探討Family and class characteristics associated with social trust among school-aged children
• 簡毓嫺、王郁婷、王一安、蔡貞慧、張淑慧、陳娟瑜
  Yu-Hsian Chien, Nadia Wang, I-An Wang, Jen-Huoy Tsay, Su-Hui Chang, Chuan-Yu Chen.
• 社會信任、兒童晚期、多層次、班級、學校
  social trust, late childhood, multilevel, class, school
• 目標：探討國小學童社會信任分布及相關之家庭與班級層級環境因素。方法：本研究資料來源為台灣北部某縣市「兒童少年身心發展生活需求現況調查」。研究族群為公立小學共2,691位四年級學童，回應率為97.3%。該項行政調查資料採自填式紙筆問卷收集資訊，問卷內容包含有社會信任、個人及家庭狀況、學校及社區環境特性等。統計分析採多層次多元邏輯斯迴歸模型估計不同層級之社會環境因素與兒童晚期社會信任之相關性。結果：父母社經地位和親子關係與學童社會信任有正向相關：父母一位（含）以上非本國籍與學童低社會信任程度有顯著相關（調整勝算比1.36，95%信賴區間1.02-1.80）、感到被家人忽略與學童低社會信任程度有顯著相關（調整勝算比1.61，95%信賴區間1.22-2.11）。父母曾出席親師會與學童高社會信任程度呈正相關的現象出現於父母教育程度相對較高的班級中，而若班級父母教育程度相對較低，父母曾參加過親師會與學童社會信任程度較低相關。結論：個人及學校班級環境皆與學齡孩童的社會信任程度有關，尤其是個人的家庭特性。當社會資本為兒童健康發展的保護因子時，有必要進一步瞭解個體的社會信任於兒童晚期至青春期時的演變以及在家庭、學校與社區等層級中的可修飾環境因子，這將有助於兒童社會資本的正向發展。
  Objectives: Social trust, an essential component of social capital, plays a significant role in shaping one’s health and well-being. The present study aims to investigate the distribution of social trust in late childhood and associated social factors. Methods: Data were obtained from the Survey of Physical and Mental Development and Living Needs of Children. A total of 2,691 fourth-grade students were ascertained from public elementary schools in one of the northern counties/cities in Taiwan (response rate = 97.3%). Data were collected from a paperand-pencil self-report questionnaire containing questions about individual demographics, parentchild interaction, community violence exposure, and social trust. Results: Multilevel multinomial logistic regression analyses indicated that parental socioeconomic status (e.g., having at least one immigrant parent (adjusted Odds Ratio [aOR] = 1.35, 95% confidence interval [CI] = 1.02-1.79)) and parent-child relationship (e.g., feeling neglected (aOR = 1.61, 95% = 1.23-2.12)) are strongly correlated with children’s low social trust level. The reduced odds of low social trust level associated with parent-teacher meeting attendance was salient only in the classes characterized by higher parental education (p<0.05). Conclusions: Non-native parents, unfavorable parentchild interaction, and community violence exposure were strongly associated with one’s endorsed low social trust in late childhood. Future research is needed to explore how social trust evolves through adolescence and to delineate probable modifiable social factors.
• 660-672
• 10.6288/TJPH.201912_38(6).108080

• Link 原著 Original Article
• 評估台灣飲食頻率問卷效度之初探研究Pilot study of the validity of food frequency questionnaires in Taiwan
• 盧立卿、游家佳、劉志怡
  Li-Ching Lyu, Chia-Chia Yu, Chih-Yi Liu
• 飲食頻率問卷、食材、餐次結構、相對效度、熱量校正
  food frequency questionnaire, food ingredient, meal structure, relative validity, energy calibration
• 目標：評估本研究室研發兩種飲食頻率問卷之效度（validity），分別為食材為主飲食頻率問卷（food and ingredients-based food frequency questionnaire, FIFFQ）以及餐次結構食譜為主飲食頻率問卷（meal and dish-based food frequency questionnaire, MDFFQ），亦探討熱量校正（energy calibration）前後的差異。方法：150位受試者執行141項之MDFFQ後，5個月後再執行161項之FIFFQ，並以24HDR校正兩種FFQ，並評估FFQ校正前後的相對效度（relative validity）。結果：以平均相關係數而言，FIFFQ與24HDR營養素校正前後為0.03與0.25，六個食物類別校正前後為0.17與0.32。MDFFQ與24HDR營養素校正前後為0.03與0.25。以平均一致性比例而言，FIFFQ和24HDR營養素校正前後為35%與41%，食物類別校正前後為37%與43%。MDFFQ和24HDR營養素校正前後為33%與41%。以FFQ和24HDR的加權kappa結果而言，FIFFQ營養素校正後Kw範圍為0.00-0.39，MDFFQ校正後為0.02-0.43。結論：不論在營養素或食物種類的相關性與一致性，熱量校正後的FFQ普遍優於校正前，且兩者與24HDR之效度結果為可接受的（acceptable）。因此，建議以飲食頻率問卷探討飲食與其他結果變項（如：疾病）關聯時，熱量調整（energy adjustment）或使用定量飲食評估工具（如：飲食回憶或飲食紀錄法）進行熱量校正可能是必須的。
  Objectives: The main purpose of this study was to assess the validity of two food frequency questionnaires: the food and ingredients–based food frequency questionnaire (FIFFQ) and the meal and dish–based food frequency questionnaire (MDFFQ). The effect of energy calibration on validity was also examined. Methods: A total of 151 participants completed the 141-item MDFFQ and then the 161-item FIFFQ 5 months later. Validity was assessed by comparing the questionnaires according to 24-hour recall (24HDR) and after energy calibration. Results: The average of the correlation coefficients between the FIFFQ and 24HDR for 28 nutrients was .03, which increased to 0.25 after energy calibration; for six food groups, it was 0.17 or 0.32 after energy calibration. The average of the coefficients of the correlation between the MDFFQ and 24HDR was 0.03, which increased to 0.25 after energy calibration. Before and after energy calibration, the average percent agreement between the FIFFQ and 24HDR was 35% and 41% for 28 nutrients and was 37% and 43% for 6 food groups, respectively. The average percent agreement between the MDFFQ and 24HDR was 33% or 41% after energy calibration. The weighted kappa ranged from -0.01 to 0.40 for the FIFFQ and 24HDR and from 0.02 to 0.43 for the MDFFQ and 24HDR after energy calibration. Conclusions: The FIFFQ and MDFFQ exhibited acceptable correlations and validity after energy calibration. Therefore, the use of these food frequency questionnaires to assess dietary patterns may require energy adjustment or quantitative dietary measurements such as recall or records for calibration purposes to improve their association with outcome variables.
• 673-686
• 10.6288/TJPH.201912_38(6).108062