应用德尔菲法筛选美沙酮治疗者脱失风险评估量表条目

目的为研制美沙酮维持治疗（MMT）者脱失风险评估量表,筛选、优化条目。方法在文献研究基础上编制专家咨询问卷,应用德尔菲（Delphi）法,向22位在艾滋病防治和MMT工作领域的专家发送3次问卷并对咨询结果进行分析。结果专家权威系数均值为0．93,三轮咨询后,量表条目的重要性和可行性评分的协调系数分别为0．33和0．29（P〈0．01）,研制的《美沙酮维持治疗者脱失风险评估量表》包含6个维度,共32个条目;量表的内容效度比（CVR）为0．91,内部一致性信度测量显示Cronbach’a系数为0．83,相隔7d的重测信度达到可接受的水平（组内相关系数为0。96）。结论应用Delphi法对《美沙酮维持治疗者脱失风险评估量表》条目筛选的结果可取,量表具有良好的信度和效度。     

痴呆心理社会干预质量指标的德尔菲法研究

目的:构建我国痴呆心理社会干预质量的评估指标(简称"质量指标")。方法:共30名痴呆诊治、护理和管理等领域的专家及9名经验丰富的痴呆照护者参与两轮德尔菲法专家咨询,基于欧洲痴呆心理社会干预质量指标以及国内实践经验设计的国内质量指标初稿(18项条目)。每一轮咨询过程中,专家和照护者对指标的重要性等级、判断依据、熟悉程度做出评价,并提出增删意见。计算各质量指标的重要性等级评分算数均数与变异系数及专家协调系数,并对专家积极性和权威程度加以评估。结果:专家咨询问卷回收率97.5%。首轮专家咨询对质量指标草案进行补充和细化,形成质量指标修改稿;第二轮专家咨询确定质量指标共5类20项条目,包括患者与照护者的评估(4项,重要性等级8.5~9.7,变异系数9%~19%)、讨论与沟通诊断(1项,重要性等级9.6,变异系数10%)、常规情况及有精神行为问题时心理社会干预方案的制定和执行(10项,重要性等级8.0~9.5,变异系数11%~22%)、主要照护者干预(2项,重要性等级分别为9.7和9.3,变异系数分别为8%和13%)及多学科团队管理(3项,重要性等级8.5~9.4,变异系数11%~22%)。两轮咨询专家协调系数分别为0.21和0.17(均P0.05),专家权威系数平均为0.70。结论:本研究构建了我国痴呆心理社会干预质量的评估指标,该指标具有较好的重要性等级评价,取得专家共识。     

中文版重症监护室患者睡眠质量量表的效度与信度

目的:汉化并检验中文版重症监护室患者睡眠质量量表(Richards-Campbell Sleep Questionnaire,RCSQ)的效度和信度。方法:通过翻译、回译形成中文版RCSQ,选取福州市2家省级三级甲等医院的4间重症监护病房的352例患者进行问卷调查,回收有效问卷338份。通过条目分析确定项目条数,探索性因子分析检验量表结构效度,利用专家咨询法对量表进行内容效度的评定。采用Cronbachα系数和相关分析检验量表内部一致性信度。2周后,从总样本中选取20名患者进行重测。结果:应用项目分析最终确定中文版RCSQ共有5个条目,5个条目进行探索性因子分析最终确定得到1个公因子,累计方差贡献率为84.5%。各条目的内容效度指数(I-CVI)为0.83~1.00,全部条目的平均内容效度(S-CVI/Ave)为0.93。量表的Cronbachα为0.95。各条目间以及与总分的相关系数分别为0.75~0.85,0.91~0.93(均P﹤0.01)。重测信度为0.77。结论:中文版RCSQ具有良好的效度和信度,适合中国文化背景下ICU患者对监护期间其主观睡眠质量的评估。     

运用德尔菲法制定北京居民心理健康评价指标

目的:制定北京居民心理健康评价指标体系。方法:在文献回顾基础上运用德尔菲法,通过对全国范围内相关领域专家进行3轮函询制定出适用于北京居民的心理健康评价指标体系。结果:3轮专家咨询的积极系数分别为93.5%、100%、80%,权威程度分别为0.83、0.85、0.85,所有指标重要性协调系数分别为0.137、0.224、0.221,对其进行检验P0.05,专家意见具有一致性。制定出北京居民心理健康评价指标体系包括自我意识、自觉性、情绪和情感、人际关系、环境适应、挫折应对6个一级维度及19个二级维度。结论:专家的代表性强,权威程度高,协调性较好,对此研究关心程度较高,制定了较为科学可靠的北京居民心理健康评价指标体系。此外,德尔菲法在心理健康评价指标制定中得到了创新性的运用。     

中文版布罗塞特暴力风险评估量表的效度和信度检验

目的:测评布罗塞特暴力风险评估量表(BVC)中文版(BVC-C)的效度和信度。方法:经原作者授权,将英文版BVC量表翻译为中文,邀请从事精神科工作20年以上的5名专家(3名临床医生及2名护士)对该评估工具进行内容效度评定,结果应用内容效度指数(CVI)表示。选取556例诊断符合疾病和有关健康问题国际统计分类第十次修订本(ICD-10)诊断标准的各种精神障碍患者进行正式测试。应用BVC量表每8h对患者评估一次,应用修订版外显攻击行为量表(MOAS)检验量表的同时效度;根据攻击真实结果检验量表的效标效度;应用Cronbachα系数检验内部一致性信度。结果:量表的内容效度指数为0.93;除自身攻击分量表外,MOAS总分及其他3个分量表得分与中文版BVC总分及条目得分均正相关(r=0.11~0.69,P0.01);经分析8h的效标效度最佳,ROC曲线下面积AUC为0.98,截断点为2时,工具的灵敏度为78.9%,特异度为95.1%。内部一致性信度Cronbachα系数为0.76,题总相关性r=0.47~0.80(P0.01)。结论:中文版BVC量表具有较好的效度和信度,可作为国内精神科暴力风险评估的有效预测工具。     

居民心理健康量表的编制及信效度检验

目的:编制居民心理健康量表(MHSR)并检验其信效度。方法:在"居民心理健康体系"和专家论证的基础上形成量表初稿,初测形成量表二稿,选取北京市居民700人施测,进行验证性因子分析形成量表终稿并进行信效度检验;选取其中100人进行第2周后到第4周内的重测;选取非精神病性障碍患者110人进行实证效度检验;使用艾森克个性问卷(成人)(EPQ)、安全感量表(SQ)、特质应对方式问卷(TCSQ)、正性负性情绪量表(PANAS)进行校标检验。结果:量表包括6个维度80个条目,各维度分别可解释的总变异为52. 16%～57. 14%;验证性分析表示各维度因子模型拟合良好(X~2/df=1.74～4.32;GFI=0. 90～0.97; RMSEA=0. 04～0.08);量表总分及各维度得分与内外向、SQ、积极应对、正性情绪得分呈正相关(r=0.28～0.62,均P0.01),与神经质、消极应对、负性情绪得分呈负相关(r=-0.26～-0.60,均P0.01);居民组的量表总分及各维度得分均高于患者组(均P0.001)。总量表的Cronbachα系数为0.97,各维度的系数为0.77～0.90;总量表的重测信度为0.79,各维度的重测信度为0.63～0.83。结论:居民心理健康量表具有较好的信效度,可作为居民心理健康的测评工具。     

中文版攻击性问卷在成年男性罪犯中的试用

目的:对攻击性问卷(AQ)在成年男性罪犯群体中进行初步的试用。方法:根据量表修订方法,随机选取北京某3所监狱的190名罪犯进行测验,分析中文版信效度。结果:1攻击性问卷得分及项目分析结果表明,成年男性罪犯在攻击性问卷上的得分比较均衡,有5道题目项目鉴别力系数低于0.3,剩余题目项目鉴别力良好(r0.348);2探索性因素分析得到问卷5个因素(特征根大于1.5,累积方差解释量为50.744),这5个因素分别为身体攻击、言语攻击、间接攻击、愤怒和敌意。项目的载荷范围在0.402~0.825之间;3问卷的5个分量表内容效度均在0.551~0.833之间(P0.01),具有良好的内容效度。选取WFS量表作为问卷的效标,相关系数均在0.574以上(P0.01),由此可见整个问卷具有较好的效标效度;4整个问卷的Cronbach`sα系数为0.797,5个分量表的Cronbach`sα系数在0.536~0.710范围内,整个量表的内部一致性良好,问卷分半信度均在0.770之上,重测信度为0.832,说明整个量表达到一定信度要求。结论:攻击性问卷在成年男性罪犯中试用具有较高信度和效度,可以作为测量罪犯攻击性的有效工具。     

中文版ECOS-16问卷在骨质疏松患者中的应用信效度

目的:翻译英文版16条目骨质疏松症患者健康相关生存质量评估问卷(16-item Assessment of Health-Related Quality of Life in Osteoporosis,ECOS-16),并验证其在骨质疏松患者中的信效度.方法:对英文版问卷进行翻译汉化,通过便利抽样的方法对97名骨质疏松患者进行调查,收集数据并进行项目分析、探索性因子分析、验证性因子分析、效标效度、内容效度、内部一致性及重测信度等检验和分析.结果:在效度方面,中文版ECOS-16问卷共计16个条目,各个条目的鉴别效度均较好;在结构效度方面,可分为疼痛、躯体功能和心理功能3个维度,共可解释69.3%的方差贡献率,各条目因子载荷度0.501~0.863,共同度0.479~0.733,与总分的相关性0.483~0.822,同时各拟合指数均在合理范围内;在效标关联效度方面,问卷各维度与简明健康测量问卷(Short Form 36 Health survey Questionnaire,SF-36)对应维度的相关系数在?0.632~?0.489(P<0.01);在内容效度方面,各条目的内容效度0.94~1.0,量表的总内容效度为0.90;各维度间的相关性系数r=0.406~0.465(P<0.05),各维度与总量表的相关性系数0.635~0.732(P<0.05);在信度方面,问卷的总克伦巴赫α系数为0.898,重测信度为0.918.结论:中文版ECOS-16问卷具有较高的信效度,适用于中国骨质疏松患者的生活质量评估.     

儿童被忽视量表在湘潭地区871名儿童中的试用

目的:编制符合我国文化背景的儿童被忽视量表。由儿童自评,对其被忽视的程度作出定量评估,为研究儿童被忽视提供可操作的量化工具。方法:通过文献分析和修订既往量表中的相关条目,建立条目库。经相关专家评定,筛选出效价高的条目。在湘潭市某中学初中一、二年级学生及湘潭市某职业技术学院一年级新生中施测,有效问卷871份。以父母养育方式评价量表为效标。结果:儿童被忽视量表总的Cronbach α系数为0.85,重测系数为0.90。各分量表的α系数在0.79~0.81之间,重测系数在0.82~0.90之间。安全忽视、交流忽视、躯体忽视、情感忽视四个分量表各条目的负荷为0.30~0.71。验证性因素分析显示:卡方值与自由度的比值为1.77,拟合优度指数为0.92,Tucker-Lewis指数为0.92,近似误差均方根为0.04。儿童被忽视量表与父母养育方式评价量表中父母情感温暖得分负相关(父亲r=-0.27~-0.45,母亲r=-0.31~-0.47,P<0.05)。结论:儿童被忽视量表条目区分度符合测量学要求,具有较为理想的信度、效度。     

中国士兵人格问卷维吾尔语版的效度和信度

目的:修订中国士兵人格问卷(Chinese Soldier Personality Questionnaire,CSPQ)维吾尔语版,并考察其在维吾尔族应征青年群体中的效度和信度。方法:将全部条目编成双向细目表,请专家按条目归属进行逐条评判,以检验内容效度;选取维吾尔族聚居区常住人口101名(正常人组)及处于住院治疗缓解期的精神分裂症患者102名进行施测(样本1),用于区分效度检验。选取维吾尔族应征青年460名进行施测(样本2),用于分量表正态分布分析和内部一致性信度检验;3周后,对乌鲁木齐市民族干部学院中的118名学员进行重测(样本3),检验重测信度。结果:修订后的维吾尔语版CSPQ包含283个条目8个分量表,专家评定各分量表归类认可率在74.6%~91.5%之间,精神分裂症患者组的各分量表得分均高于正常人组。问卷8个分量表的内部一致性信度在0.69~0.91之间,重测信度在0.85~0.92之间。结论:修订后的中国士兵人格问卷维吾尔语版具有良好的效度和信度,可以作为维吾尔族应征青年心理检测的有效工具。     

妇幼保健人员对产后抑郁认知问卷的编制及评价

目的:尝试编制适合我国妇幼保健人员对产后抑郁认知的问卷并初步检验其信效度。方法:整理分析产后抑郁相关文献,以认知及知-信-行理论模式为构架,探讨妇幼保健人员对产后抑郁认知的内容,咨询相关专家,在此基础上建立问卷条目池,编制初始问卷,抽取46例小样本进行预试,结合预试结果、被试意见、专家建议、课题组讨论,形成正式问卷,抽取231名妇幼保健人员进行调查,采用信效度分析、相关分析等统计方法评价该问卷。结果:正式问卷由100个条目、4个维度组成;问卷的Cronbach’sα系数为0.917,分半信度系数为0.936,重测相关系数为0.956(P0.001),内容效度指数(S-CVI)为0.942,校标效度相关系数为0.865(P0.001)。结论:本研究编制的妇幼保健人员对产后抑郁认知的问卷结构清晰、内容全面、具有一定代表性,信效度良好,可用于调查妇幼保健人员对产后抑郁认知的状况。     

对UPI测伪题有效性的评估

目的 :分析评价UPI测伪题的有效性。方法 :根据 2 5 98名入校新生UPI答卷 ,对测伪题的选择情况、测伪题选择数与UPI总分及心理健康状况的关系作统计分析。结果 :平均每名学生选择 2 .37个测伪题 ;UPI总分与测伪题的选择数呈负相关 ;一类学生选择的测伪题数低于二类学生 ,二类学生选择的测伪题数低于三类学生。结论 :UPI测伪题已丧失反映被测应答态度的功效 ;建议UPI修订者对测伪题进行再次修订 ,完善量表     

北京市朝阳区社区居民精神卫生知识与态度现况调查

目的 了解北京市朝阳区社区居民对精神卫生的知识和态度.方法 采用分层随机整群抽样的方法,在朝阳区4个社区3985名居民中进行《精神卫生与心理保健知识问卷》和《精神疾病有关态度问卷》调查.结果 ①朝阳区居民精神卫生知识知晓率平均达67.5％,平均得分（13.72±3.64）分,城市居民和农村居民间有显著差异[（15.05±3.36） vs.（12.46±3.44）,P＜0.0001];②朝阳区居民《精神疾病有关态度问卷》平均得分（34.10±5.52）分,城市居民和农村居民间有显著差异[（35.66±5.31）vs.（33.77±5.69）,P=0.005].结论 朝阳区社区居民精神卫生与心理保健知识知晓率已达到《全国精神卫生工作体系发展指导纲要（2008年-2015年）》的要求,但城市居民对精神卫生知识的了解程度要好于农村居民,且歧视程度轻于农村居民.     

The development and internal consistency of the satisfaction with Antipsychotic Medication Scale

BACKGROUND: Satisfaction with antipsychotic medication is an important outcome variable. To date, there is a lack of a well-established measure to quantify patient satisfaction with psychiatric medication. This paper describes the development, dimensionality, reliability and validity of the Satisfaction with Antipsychotic Medication (SWAM) scale. METHOD: Clinical and academic experts devised a 33-item Likert scale satisfaction questionnaire. Following a pilot study in a sample of 69 people with schizophrenia, 315 people with schizophrenia on the caseload of local mental health services in three London boroughs completed the questionnaire. The dimensionality, internal consistency and validity of the devised instrument were assessed. RESULTS: Reliability of the SWAM scale was good for subscales and total scores. The alpha coefficient for the two subscales: treatment acceptability and medication insight were 0.92 and 0.84 respectively. The a coefficient for the SWAM scale total score was 0.91 and ranged from 0.92 to 0.90. CONCLUSION: Testing of the psychometric properties of the SWAM scale demonstrate that it is a reliable instrument for measuring patient satisfaction with antipsychotic medication. The measure could be used in routine clinical practice in mental health services to assess patient satisfaction with psychiatric medication.     

老年心理健康问卷的编制

目的 :编制适用于中国老年人的心理健康问卷。方法 :根据心理健康内涵包括性格、情绪、适应、人际和认知五个方面的理论构想 ,建立包含 5 8题的初试卷。在北京地区分层随机取样 110 0例 5 5岁以上老年人为调查对象。结果 :通过因素分析从 5 8道题中筛选出 5 0道题组成正式的老年心理健康问卷。对全量表和分量表的项目进行一致性检验 ,α系数为 0 .5 8～ 0 .89,各分量表与所属题目及总分均存在显著的相关 (P <0 .0 0 1) ;因素分析证实了问卷的结构效度 ;问卷得分与流调中心抑郁量表得分、生活满意度、健康满意度、慢性疾病患病数和遭遇重大生活事件数等因素显著相关 ,不同群体心理健康状况的比较表明该问卷具有良好的实证效度。此外 ,还建立了北京城区老年人心理健康常模。结论 :问卷编制符合心理测量学要求 ,已到达预期目的     

The current status of gender-sensitive mental health services for women—findings from a global survey of experts

Integrating gender in all aspects of health services is important and mental health is no exception. Despite several recommendations regarding the need for gender-sensitive mental health services, the actual availability of these is not clear, both in high and low-income countries. We sought to understand what aspects of gender-sensitive mental health care were considered a priority by global experts in women’s mental health and how satisfied they were with the current availability of these services in their own place of work. A survey with 43 items under 7 domains of gender-sensitive mental health care for women was sent to 150 experts in women’s mental health across the world, of whom 73 responded. Rating on each item was from 0 to 5. While majority of the experts rated most of the items as being very important (median score of 4 and above), some areas that were considered most important included training of mental health professionals in gender sensitivity, having private spaces for examination, using a life course approach to service planning and delivery, and assisting women who find it difficult to navigate the system and mother-baby units. However, satisfaction rates with available services were quite low overall and much lower among experts in low-income countries compared with those from high-income countries. Even in high-income countries, only 6 of the top 20 items were scored as satisfactory by at least 50% of experts. This expert survey method to arrive at consensus on top priorities for improving delivery of gender-sensitive mental health care indicates that at least 72% of the items provided in the survey were considered extremely important. Poor satisfaction of experts in both high- and low-income countries with availability of gender-sensitive services indicates the need for local and global strategic action and multilevel stakeholder engagement.

     

Appraising the methodological quality of cadaveric studies: validation of the QUACS scale

Although systematic reviews are conducted in the field of anatomical research, no instruments exist for the assessment of study quality. Thus, our objective was to develop a valid tool that reliably assesses the methodological quality of observational cadaveric studies. The QUACS scale (QUality Appraisal for Cadaveric Studies) was developed using an expert consensus process. It consists of a 13-item checklist addressing the design, conduct and report of cadaveric dissection studies. To evaluate inter-rater reliability, a blinded investigator obtained an initial pool of 120 observational cadaveric studies. Sixty-eight of them were selected randomly according to sample size calculations. Three independent researchers rated each publication by means of the QUACS scale. The reliability of the total score was estimated using the intraclass correlation coefficient (ICC). To assess agreement among individual items, margin-free kappa values were calculated. For construct validity, two experts (an anatomist and an experienced physician) categorized the quality of 15 randomly selected studies as ‘excellent’ (4 points), ‘moderate to good’ (3 points), poor to moderate’ (2 points) or ‘poor’ (1 point). Kendall''s tau rank correlation was used to compare the expert ratings with the scores on the QUACS scale. An evaluation of feasibility was carried out during the reliability analysis. All three raters recorded the duration of quality appraisal for each article. Means were used to describe average time exposure. The ICC for the total score was 0.87 (95% confidence interval: 0.82–0.92; P < 0.0001). For individual items, margin-free kappa values ranged between 0.56 and 0.96 with an agreement of 69–97% among the three raters. Kendall''s tau B coefficient of the association between expert ratings and the results obtained with the QUACS scale was 0.69 (P < 0.01). Required rating time per article was 5.4 ± 1.6 min. The QUACS scale is highly reliable and exhibits strong construct validity. Thus, it can confidently be applied in assessing the methodological quality of observational dissection studies.     

Validation of a menopause quality of life scale: the MENCAV scale

OBJECTIVE: To assess the criterion validity, construct validity and test-retest reliability of the MENCAV menopause quality of life scale. METHODS: Observational, cross-sectional study covering a random sample of 470 women aged 40-60 years. Two questionnaires were administered, namely, the MENCAV, made up of 37 items in 5 dimensions, and the SF-36. A confirmatory factorial analysis was performed, leaving a final scale with 35 items. To evaluate criterion validity, the relationship between the physical and mental health dimensions of both instruments was estimated. Two experts assessed 40 menopausal women and recorded the correlations with the MENCAV. Construct validity was evaluated by comparing the mean scores of menopausal and non-menopausal women for each of the MENCAV dimensions. To assess test-retest reliability, we estimated the correlation between MENCAV scores when the questionnaire was administered on two separate occasions, 2 weeks apart. RESULTS: The final questionnaire comprised 35 items divided into 5 dimensions. All dimensions displayed high levels of reliability, with Cronbach's alpha values ranging from 0.71 to 0.91, and Cronbach's alpha for the total scale being 0.89. The intraclass correlation was 0.77 (95% CI: 0.61-0.87). Correlations between the questionnaire and the SF-36 were significant; and those with the experts were significant for the physical, mental and sexual dimensions. CONCLUSIONS: The MENCAV is a valid and reliable questionnaire for assessing quality of life in menopausal women.