尘肺患者自我管理量表的建立与评价

目的建立尘肺患者自我管理量表,并进行信度和效度检验。方法采用文献法、半定式访谈确定量表条目基本框架,通过专家咨询修订条目池。60位专家应用德尔菲法对条目进行评价,根据各个条目的平均分、满分比、变异系数联合筛选条目,最后评价量表的信度和效度。结果专家的积极系数为91.6%,权威系数均值为0.81,筛选后形成7个维度包含44个条目,其中症状管理维度6个,疾病知识管理维度3个,不良嗜好管理维度3个,依从性管理维度6个,日常生活管理维度10个,情绪管理维度5个,自我管理效能维度11个。整个量表的Cronbachα系数为0.945,分半信度为0.901,条目间的相关系数为0.265~0.916(P<0.05)。结论建立的尘肺患者自我管理量表具有较好的信度和效度,可在实践中应用。     

住院患者走失风险评估量表制订与信效度检验研究

目的制订住院患者走失风险评估量表,为评估住院患者走失风险提供适应工具量表,并验证量表信效度。 方法通过查阅文献、咨询专家、质性访谈、Delphi法拟定住院患者走失风险评估量表,采取随机抽样法选择2019年105例符合标准的住院患者,应用制订的住院患者走失风险评估量表对患者进行调查研究。 结果最终编制形成住院患者走失风险评估量表,内容包括既往史、支持系统、意识状态、认知功能、高危疾病、影响药物等6个维度共16个条目,6个维度的内部一致性信度Cronbach α系数为0.783～0.879,效度(CVI)为0.870～1.000。 结论住院患者走失风险评估量表总体的信度与效度较高,对于住院患者走失行为的发生风险具有一定的价值     

基于有限理性的住院患者信任度评价量表研制

以有限理性与患者信任为基础,结合公立医院现状和患者人群特征,开发住院患者信任度评价量表。方法通过鉴别度分析、一致性检验、因子分析等确定编制量表的信度和效度。结果量表所有条目高低分组差异检验均达到0.05的显著水平,内部一致性Cronbach's Alpha系数为0.960,KMO检验值>0.80,Bartlett球型检验P<0.05,因子分析量表维度结构合理。结论基于有限理性的住院患者信任度评价量表有较高的鉴别度、信度和效度,具有一定的适用性、科学性和实用性,可用于住院患者信任度评价。     

中国医院住院患者体验和满意监测量表的信效度评价

目的评价"中国医院住院患者体验和满意监测量表"的信度与效度,为改进量表、推广应用提供依据。方法采用邮寄方式对出院患者进行问卷调查,使用SPSS数据分析软件,分别对量表的内部一致性、折半信度、内容效度及结构效度进行评价。结果量表总体Cronbach’sα系数为0.956,所包含6个维度的Cronbach’sα系数均大于0.8。分半信度为0.971。各条目与量表总体的相关系数介于0.51~0.79之间。以所有条目为变量进行因子分析,共提取5个公因子,其累计贡献率为66.2%,各条目至少在其中一个公因子上负荷值大于0.4。结论量表具有良好的信度和效度,适用于中国医院住院患者满意度的测评。     

IRT等级反应模型在冠心病PRO量表编制中的应用

目的 探讨项目反应理论中的等级反应模型在基于冠心病患者报告临床结局量表(CHD-PRO)条目筛选中的应用.方法 对CHD-PRO初始量表所有条目拟合等级反应模型,依据区分度参数和难度等级参数对条目进行评价和筛选.结果 通过等级反应模型理论对量表条目进行筛选,初始量表共计62个条目,建议删除12个条目.结论 与经典测量理论和传统方法相比,项目反应理论与等级反应模型能够克服等级资料的限制,增加了对受试对象能力的估计,更加适合量表条目的筛选.     

农村留守妇女心理健康服务需求量表的编制

目的 编制农村留守妇女心理健康服务需求问卷并评估其信效度。方法 通过项目分析法、探索性因素分析、验证性因素分析以及信效度检验法,对447名农村留守妇女心理健康服务需求现状进行分析,编制并验证问卷结构的合情性。结果 农村留守妇女心理健康服务需求可以分为心理健康服务要求、心理健康服务内容、心理健康服务需求程度、心理健康服务队伍、心理健康服务方式、心理健康服务途径等6个维度,其中心理健康服务要求包含8个条目,心理健康服务内容包含9个条目,心理健康服务需求程度包含5个条目,心理健康服务队伍包含6个条目,心理健康服务需求形式与心理健康服务知识渠道各含3个条目,总问卷Cronbach′s α系数为0.87,各分量表Cronbach′s α系数0.77~0.94,各分量表分半信度为0.76~0.92。结论 农村留守妇女心理健康服务需求问卷的信、效度符合心理测量学要求,可进行实际应用。     

正性负性情绪量表在住院患者中的适用性研究

评估正性负性情绪量表在住院患者中的适用性。方法调查461位住院患者,通过一致性分析、相关分析、因子分析等确定量表的信度和效度。结果PANAS量表所有条目的Cronbach's α系数为0.727,正负性情绪量表Cronbach's α系数分别为0.887、0.773;各条目与总分的相关系数均大于0.4;KMO检验值>0.80,Bartlett球型检验P<0.05;不同分组患者在情绪得分上有显著差异,P<0.05。结论正性负性情绪量表在住院患者中具有较好的信度、效度,可以为正确评估患者正负性情绪提供依据。     

甲状腺功能亢进症患者自报健康结局量表的编制与测评

目的 编制甲亢患者报告的PRO量表,考评其信度与效度,为甲亢临床疗效评价提供新方法 .方法通过文献查阅,病例访谈,专家咨询等方法,形成条目池,筛选优化条目,预调查,形成初量表,现场调查、收集数据,采用SPSS15.0软件分析量表的信度和效度.结果 初步形成生理领域、心理领域、社会领域、治疗领域36个条目组成的甲亢患者报告的PRO量表,4个领域的克朗巴赫α系数分别为0.688、0.656、0.693、0.698.生理领域提取3个因子,累计方差贡献率为52.30%,保留躯体症状、生理功能2个因子;心理领域提取焦虑、抑郁、敌对和偏执4个因子,累计方差贡献率为82.65%;社会领域提取社会支持、社会活动2个因子,累计方差贡献率为62.61%;治疗领域提取依从性、满意度、药物评价3个因子,累计方差贡献率为77.80%.量表的结构效度符合理论构想,每个条目在相应因子上的载荷均大于0.30,少数条目存在交叉符合.结论 该量表效度较好,信度尚可,需大样本多中心收集数据进一步完善.     

Zung氏焦虑抑郁量表测评心血管内科住院患者的适用性分析

目的探讨Zung氏焦虑自评量表和抑郁自评量表测评心血管病住院患者的适用性。方法采用问卷对209例住院患者进行一般资料、焦虑和抑郁自评量表的调查,利用项目分析、相关分析、信度分析探讨两量表的适用性。结果调查对象中焦虑和抑郁的发生率分别为27.3%和34.0%。焦虑自评量表和抑郁自评量表的Cronbach’sα系数分别为0.803和0.814。焦虑自评量表中有4个条目与总标准分相关性低(r<0.4),抑郁自评量表中有8项条目与总标准分相关性低(r<0.4)。两个量表中分别有2项条目删除后Cronbach’sα系数增大。结论虽两个自评量表操作简便、易于掌握并被广泛应用,但本研究结果却证实两个自评量表对心血管病住院患者的焦虑和抑郁心理评估的适用性较差,应不用或慎用。     

哮喘患儿家长报告结局概念模型构建与量表结构探索

目的 构建哮喘患儿家长报告结局概念模型,初步探索哮喘患儿家长报告结局量表结构,为量表的进一步编制提供基础。方法 回顾文献,结合专家咨询和目标人群访谈构建哮喘患儿家长报告结局的概念模型、量表初始维度和条目池。根据30名哮喘儿童家长的测试结果和5名专家的评价意见,对条目进行初步筛选和修改,形成包含72个条目的初始问卷。通过对212名哮喘儿童家长的调查,采用经典测量理论对初始问卷条目进行筛选,结合平行分析、探索性因子分析和专家意见,确定哮喘患儿家长报告结局量表的结构。结果 构建出了包含4个一级指标、8个二级指标的哮喘患儿家长报告结局概念模型。在此基础上,编制了包含72个条目的初始问卷并实施现场调查,经过条目筛选、平行分析和探索性因子分析提取出了5个公因子,累积方差贡献率为51.6%,5个公因子分别反映患儿身体状况、心理状况、日常活动、行为限制和家庭影响。结论 提取出的5个公因子均涵盖在所构建的概念模型内,能够解释哮喘对儿童的影响。哮喘患儿家长报告量表应以身体状况、心理状况、日常活动、行为限制和家庭影响5个维度进行编制。     

HDFS量表和SFSTC量表对住院患儿跌倒风险预测价值比较

目的比较Humpty Dumpty跌倒量表（HDFS）和Schmid儿童跌倒评估量表（SFSTC）对住院患儿跌倒风险的预测价值。方法采用便利抽样法,选取2020年3月-2021年4月两所医院儿科病区4 323例住院患儿为研究对象,使用HDFS量表和SFSTC量表评估住院患儿跌倒风险。采用ROC曲线下面积、灵敏度、特异度和约登指数等指标比较两种量表的预测价值。结果4 323例住院患儿中,有32例发生跌倒（0.74%）;发生跌倒组住院患儿HDFS量表和SFSTC量表总分均高于未发生跌倒组住院患儿（P＜0.001）。HDFS量表ROC曲线下面积为0.941,当总分为13分时,约登指数为0.743,量表预测价值最大;SFSTC量表ROC曲线下面积为0.827,当总分为4分时,约登指数为0.739,量表预测价值最大。结论HDFS量表和SFSTC量表均能有效预测住院患儿跌倒发生风险,但HDFS量表预测价值高于SFSTC量表。     

International versions of the Menopause Rating Scale (MRS)

Background  

Symptom scales for aging women have clinically been used for years and the interest in measuring health-related quality of life (HRQoL) has increased in recent years. The Menopause Rating Scale (MRS) is a formally validated scale according to the requirements for quality of life instruments. The aim of this paper is to review the current state of the instrument particularly concerning versions of the scale in different languages.     

肝肾移植患者生命质量量表研究进展

生命质量量表是评价肝肾移植患者术后生活质量的重要工具,对患者的治疗和预后起到监测与指导作用.生命质量量表包括普适性量表与特殊疾病量表,各自有其优势和不足.研究者在研究中要根据研究目的选择适合的量表,并结合现有量表优势特点与我国国情,积极研制适合我国肝肾移植患者的生命质量量表.     

Assessment of the psychometric properties of the Detection of Emotional Distress Scale in cancer patients

Objective

To evaluate and alleviate the emotional distress suffered by advanced cancer patients, simple screening methods that can be easily used by health staff and easily understood by patients are required. The objective of this multicenter study was to analyze the psychometric properties and clinical utility of the Detection of Emotional Distress (DED) scale in advanced cancer patients attending a palliative care unit.

Methods

The DED scale was administered to 105 advanced cancer patients attended in five palliative care units in Catalonia (Spain).

Results

A total of 58.3% of the patients had moderate to severe emotional distress, a result similar to those of other scales such as the emotional thermometer. Statistical analysis of ROC curves suggested that the cutoff for the detection of emotional distress by the DED scale was equivalent to a score of ≥ 9 points, with a sensitivity and specificity above 75%.

Conclusions

The DED scale is useful and easy to use in the identification of emotional distress in advanced cancer patients attended in palliative care units. This scale could also be applied in other patients and health care fields, such as patients with chronic diseases, home care, and primary care.     

A 3-Item Screening Scale for Caregiver Burden in Dementia Caregiving: Scale Development and Score Mapping to the 22-Item Zarit Burden Interview

ObjectivesBrief screening scales for caregiver burden are much needed in routine dementia services to efficiently identify caregivers of persons with dementia (PWD) for further intervention. Although the 22-item Zarit Burden Interview (ZBI) is often used, its available screening versions have not performed as well as the full version in distinguishing significant burden. We developed a brief screening scale that is valid and comparable to ZBI in distinguishing caregiver burden.Design and settingBaseline data of an ongoing cohort study.ParticipantsFamily careivers of community-dwelling PWD (n = 394).MeasuresParticipants completed questionnaires containing ZBI and other caregiving scales. Initially, we split the study samples into 2—the derivation sample (n = 215) was used to develop a brief scale that best distinguishes significant burden (using the best-subset approach with 10-fold cross-validation), whereas the validation sample (n = 179) verified its actual performance in distinguishing significant burden. We then evaluated the derived scale in its internal consistency reliability, factorial validity, known group validity, and construct validity, and mapped the scores between the brief scale and ZBI using the equipercentile equating method.ResultsWe derived a 3-item scale which had comparable performance to ZBI in distinguishing significant burden (area under the receiver operating characteristic curve 0.86, 95% confidence interval 0.81-0.92). It had a single dimension in exploratory factor analysis and maintained good psychometric properties similar to those of ZBI. It also explained 77.8% of the variability in ZBI, and had scores that could be mapped to ZBI with reasonable precision.Conclusions and ImplicationsWe have derived a highly accessible tool to screen for caregiver burden, which can have a wider health system effect of expanding the reach of caregiver-focused interventions to services involved in the care of PWD. Notably, this screening tool was developed using rigorous methods and demonstrated comparability to ZBI in its validity, reliability, and total scores.     

Development of a new Adolescent Patient-Provider Interaction Scale (APPIS) for youth at risk for STDs/HIV

PurposeAlthough an adult model of patient-provider mutual exchange of information has been proposed, there is no guiding model for adolescents or measurement methodology. Our purpose was to develop a new scale of patient-provider interaction for adolescents accessing reproductive health care and at risk for sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV), and assess the reliability and validity of the scale.MethodsThe Adolescent Patient-Provider Interaction Scale (APPIS) was developed from the Roter and Hall theory of doctor-patient relationships, previously validated adolescent satisfaction and communication scales, and focus group and individual elicitation interviews. To assess construct validity, the new nine-item APPIS was compared with the satisfaction scale used by the Young Adult Health Care Survey (YAHCS), and Kahn’s Provider Communication Scale. Pearson correlation coefficients were used to examine convergence across scales, and factor analysis of the APPIS was performed.ResultsThe study recruited 192 African American girls aged 17.9 ± 1.7 years (range 15–21 years) from three sites: a county STD clinic (n = 51), urban adolescent clinic (n = 99), and a family planning clinic (n = 42). Most participants (85%) rated their overall health care highly (≥ 7 on a 10-point scale); 49% felt that both the provider and patient were “in charge” of the visit, and 88% “strongly agreed” or “agreed” that there was an equal “exchange of information” during the visit. The APPIS showed good internal consistency (Cronbach alpha = .75), and moderate convergence with the six-item YAHCS scale (r = .57, p < .001) and seven-item Kahn scale (r = .48, p < .001). Three factors emerged from exploratory factor analyses, supporting our conceptualization of patient-provider interaction as being multi-dimensional.ConclusionsA new theory-based scale of adolescent patient-provider interaction compares favorably with previous scales of health care satisfaction and communication. The new APPIS may be useful for evaluating approaches to improve health care outcomes for adolescents at-risk for STDs and HIV.     

基于计划行为理论的重复献血行为调查量表的信效度分析

目的检验基于计划行为理论的重复献血行为调查量表的信效度,为分析重复献血的意向及影响因素提供有效的测量工具。方法采用分层抽样方法选取调查对象,以短信发送加H5答题的方式获取数据,获取有效问卷3093份。采用克朗巴赫系数、折半系数、因子分析等方法分别对量表内部一致性信度、结构效度进行分析。结果条目7的相关性系数低于0.5,予以删除,其余条目的相关性系数均大于0.5。最终量表包含29个问卷条目,其Cronbach’sα系数0.933>0.800,各维度Cronbach’sα系数均大于0.700。探索性因素分析结果均显示量表大部分条目的因素载荷均超过0.4,大部分因子平均方差抽取量大于0.5;高分组和低分组各条目得分差异均有统计学意义(P<0.01)。结论该量表具有良好的信效度,可用于发现进一步强化献血人群献血意向的具体因素,进而为提升人群重复献血率提供干预方案。     

Item Response Theory Methods can Improve the Measurement of Physical Function by Combining the Modified Health Assessment Questionnaire and the SF-36 Physical Function Scale

Objective:

To compare the measurement properties of the Modified Health Assessment Questionnaire [MHAQ], the SF-36^® Health Survey 10 item Physical Functioning scale [PF10], and scores from an item response theory (IRT) based scale combining the two measures.

Study Design:

Rheumatoid arthritis (RA) patients (n = 339) enrolled in a multi-center, randomized, double-blind, placebo-controlled trial completed the MHAQ and the SF-36 pre- and post-treatment. Psychometric analyses used confirmatory factor analysis and IRT models. Analyses of variance were used to assess sensitivity to changes in disease severity (defined by the American College of Rheumatism (ACR)) using change scores in MHAQ, PF10, and IRT scales. Analyses of covariance were used to assess treatment responsiveness.

Results:

For the entire score range, the 95% confidence interval around individual patient scores was smaller for the combined (total) IRT based scale than for other measures. The MHAQ and PF10 were about 70% and 50% as efficient as the total IRT score of physical functioning in discriminating among ACR groups, respectively. The MHAQ and PF10 were also less efficient than the total IRT score in discriminating among treatment groups.

Conclusions:

Combining scales from the two short forms yields a more powerful tool with greater sensitivity to treatment response.     

SF-36健康调查量表中文版的研制及其性能测试

目的 研制SF-36健康调查量表中文版并验证量表维度建立及记分假设、信度和效度。方法 采用多阶段混合型等概率抽样法,用SF-36健康调查量表中文版对1000户家庭的居民进行自评量表式调查;参照国际生命质量评价项目的标准程序,进行正式的心理测验学试验。结果 在收回的1985份问卷中,18岁以上的有效问卷1972份,其中应答者1688人(85．6％),1316人回答了所有条目,372人有1个或以上的缺失答案,无应答者中文盲、半文盲占65．5％。等距假设在活力(VT)和精神健康(MH)维度被打破了,按重编码后值计算维度分数;条目集群的分布接近源量表及其他2个中文译本;除了生理功能(PF)、躯体疼痛(BP)、社会功能(SF)维度,其余维度有相似的标准差;除了SF、VT维度,其余6个维度条目维度相关一致;除了SF维度,7个维度集合效度成功率范围为75％～100％,,区分效度成功率范围为87．5％～100％。一致性信度系数除了SF、VT维度,其余6维度变化范围为0．72～0．88,满足群组比较的要求。两周重测信度变化范围为0．66～0．94。因子分析产生了2个主成分,分别代表生理健康和心理健康,解释了56．3％的总方差。结论 为SF-36健康调查量表适用于中国提供了证据,已知群效度试验将为量表效度提供更有意义的证据。     

Clarifying Anticipated Feelings of Jealousy: Development and Validation of the Anticipated Jealousy Scale

This study examined the construct of anticipated jealousy, conceptually clarifying the components of this construct and creating an optimized scale. Total of 18 items from three widely used self-report measures of jealousy (Multidimensional Jealousy Scale–Emotional Subscale, Anticipated Sexual Jealousy Scale, and Chronic Jealousy Scale) and additional 11 potential anticipated jealousy items were given to 1852 individuals in relationships. Exploratory and confirmatory factor analyses and item response theory (IRT) analyses were used to develop and evaluate the Anticipated Jealousy Scale (AJS). By augmenting the item pool, the results highlighted that anticipated jealousy could take two distinct forms: (1) sexual—getting upset over thoughts of a partner engaging in sexual activity with someone else and (2) possessive—getting upset over a partner forming friendships and emotional bonds with others. IRT analyses helped identify the five most effective items for assessing each of those domains to create the AJS. Results suggested that the subscales of the AJS offered greater precision and power in detecting meaningful differences among respondents than the existing measures, representing short yet psychometrically optimized scales. The AJS subscales demonstrated strong convergent validity with other measures of anticipated sexual and possessive jealousy, and excellent construct and discriminant validity with anchor scales from the nomological net surrounding the construct. Finally, regression analyses demonstrated distinct predictors and correlates for anticipated sexual jealousy, anticipated possessive jealousy, and chronic jealousy. Given the potential utility in distinguishing between the many forms of jealousy, AJS offers an optimized scale measuring anticipated sexual and possessive jealousy.