椎-基底动脉系统缺血神经功能障碍评价量表的编制及信、效度检测

目的:编制一个针对椎-基底动脉系统缺血性脑血管病的神经功能障碍评价量表,并对该量表的信度和效度进行检测、分析。方法:本研究借鉴心理学测评编制的原则和方法,编制了"椎-基底动脉系统缺血性神经功能评价量表",并以200名后循环脑梗死患者为研究对象,对量表的"评分者信度"和"准则关联效度"进行检测分析。结果:评分者信度研究结果显示,该量表的"α信度系数"为0.99,P<0.01;准则关联效度检测中,"效度系数"为-0.502,P<0.01。同时,对不同临床转归预后的患者基线"椎-基底动脉系统缺血性神经功能评价量表"评分进行单因素方差分析(组的分析),结果提示,F=76.168,P<0.01。结论:在本研究的背景下,"椎-基底动脉系统缺血性神经功能障碍评价量表"显示了较好的信度和效度,有望成为椎-基底动脉系统缺血性脑血管病特异的神经功能障碍评价量表。     

颈内动脉系统急性缺血性脑血管病溶栓干预的风险-效益评价量表的编制及其应用价值研究

目的:本研究旨在于编制急性缺血性脑血管病溶栓干预风险-效益评价量表,以期预测溶栓干预的风险和收益,从而达到指导临床溶栓决策和提高溶栓疗效的目的。方法:本研究以2003-2～2006-9月间宣武医院卒中中心收治的88例颈内动脉系统急性缺血性脑血管病溶栓患者为研究对象,采用评分者信度、准则关联效度,以及受试者工作特征曲线(receiver operator characteristic curve,ROC)的方法对量表的信度、效度、临床预测价值进行检测分析。结果:信度检测结果提示,量表的总评分和分项评分均显示较高的α信度系数(0.9～1.0)。以患者接受溶栓干预后24小时NIHSS改善作为准则,溶栓干预前风险-效益量表评分与准则间的效度系数为-0.601,P<0.001;同时,对不同溶栓干预预后患者的基线风险-效益量表评分进行显著性检测分析提示,溶栓后改善组、无改善组、恶化组之间有十分显著的统计学差异(P<0.01)。ROC曲线分析结果提示,该量表用于溶栓干预安全性和有效性预测的ROC曲线下面积分别为0.832,95%CI=0.723～0.941,P=0.000和0.873,95%CI=0.795～0.950,P=0.000,同时以35分和55分分别作为溶栓干预有效性和安全性的评分界点显示较好的敏感性、特异性和阳性似然比。结论:在本研究的平台上,急性缺血性脑血管病溶栓干预的风险-效益评价量表显示较好的信度、效度和临床应用价值,有望成为一种新的用于预测溶栓治疗风险和收益、指导临床溶栓干预决策的简便、有效评价工具。     

Psychometric properties of the General Self Efficacy-12 Scale in Spanish: General and clinical population samples

The General Self Efficacy Scale (GSES-12) is a short version of the Sherer's Self-Efficacy Scale, and evaluates a general dimension and three aspects of self-efficacy: initiative, persistence and effort. The aim of this study is to explore the factorial structure, reliability, and criterion validity of the Spanish adaptation of the GSES-12 in general and clinical populations. The sample was composed of 714 volunteers (332 from the clinical population). Results of the principal components analysis yielded a 3-factor structure that was later confirmed through Confirmatory Factor Analysis. Moreover, this study shows good internal consistency and test–retest values, and differences in self-efficacy scores between the clinical and non-clinical groups. The present study demonstrates that the Spanish version of the GSES-12 is a valid and reliable measure, and it adds relevant information to the debate about the dimensional structure of general self-efficacy.     

Comparison of the Morel Emotional Numbing Test for Posttraumatic Stress Disorder to the Word Memory Test in neuropsychological evaluations

The most commonly feigned cognitive and psychiatric disorders for survivors of traumatic injury are memory dysfunction and posttraumatic stress disorder (PTSD). The position of the National Academy of Neuropsychology is that symptom validity tests (SVTs) should be part of any comprehensive neuropsychological evaluation. In this article the Morel Emotional Numbing Test for Posttraumatic Stress Disorder (MENT), a SVT for PTSD, was compared to a SVT for memory, the Word Memory Test (WMT). Available archival data on 216 consecutive referrals for neuropsychological evaluations at the Veterans Affairs Tennessee Valley Healthcare System were reviewed. Of the total records reviewed 37 patients had been administered both the MENT and the WMT. The clinically recommended cutoff on the WMT was used as the main criterion to classify patients into two groups: simulating impairment or credible. The results indicated that the simulating impairment group had significantly more errors on the MENT than the credible group did (p <.0001). The criterion-related characteristics of the MENT in assessing response bias in relation to the WMT were confirmed Clinical and research implications of the utilization of the MENT are discussed in this study.     

Comparison of the Morel Emotional Numbing Test for PostTraumatic Stress Disorder to the Word Memory Test in Neuropsychological Evaluations

The most commonly feigned cognitive and psychiatric disorders for survivors of traumatic injury are memory dysfunction and posttraumatic stress disorder (PTSD). The position of the National Academy of Neuropsychology is that symptom validity tests (SVTs) should be part of any comprehensive neuropsychological evaluation. In this article the Morel Emotional Numbing Test for Posttraumatic Stress Disorder (MENT), a SVT for PTSD, was compared to a SVT for memory, the Word Memory Test (WMT). Available archival data on 216 consecutive referrals for neuropsychological evaluations at the Veterans Affairs Tennessee Valley Healthcare System were reviewed. Of the total records reviewed, 37 patients had been administered both the MENT and the WMT. The clinically recommended cutoff on the WMT was used as the main criterion to classify patients into two groups: simulating impairment or credible. The results indicated that the simulating impairment group had significantly more errors on the MENT than the credible group did (p < .0001). The criterion-related characteristics of the MENT in assessing response bias in relation to the WMT were confirmed. Clinical and research implications of the utilization of the MENT are discussed in this study.     

Odd/Even Short Forms of the Boston Naming Test:Preliminary Geriatric Norms

It has been suggested that the 30-item version of the Boston Naming Test (BNT), in which either the odd or even items from the standard 60-item test are given, is the most psychometrically sound short form. However, no normative data are available for this version. We administered the Odd/Even BNT to 30 community-dwelling elderly individuals (age M = 72.93, range 61-84; education M = 13.73) in order to collect normative data. Odd and even forms were equivalent. The combined mean total correct score was 27.13 (SD = 2.06), a score consistent with that derived by retrospective extraction in the original odd/even test construction study. Each form discriminated normals from age- and education-matched patients with probable Alzheimer's disease, suggesting criterion-related validity.     

早期脑脊液置换治疗原发性蛛网膜下腔出血38例临床观察

目的 观察早期脑脊液置换加小量尿激酶和地塞米松椎管内注射治疗原发性蛛网膜下腔出血的疗效及安全性.方法 将74例病人随机分为置换组38例,对照组36例.置换组腰椎穿刺行脑脊液置换,置换总量每次35ml;对照组只做常规腰穿检查,不做脑脊液置换.观察指标血红蛋白(Hb)每日清除率及第7d总清除率、头痛缓解时间、大脑中动脉平均血流速度(VMMCA)、并发症及治疗效果评价等.结果 置换组Hb每日清除率及第7d总清除率分别为16.27%和97.6%,对照组分别为13.9%和83.6%,2组具有显著性差异(P＜0.05).头痛缓解时间较对照组明显缩短(P＜0.05),分别为3.35d和12.28d.置换组大脑中动脉平均血流速度较对照组显著增加(P＜0.05).置换组并发脑血管痉挛(5.26%)、脑积水(2.63%)的发生率较对照组(分别为22.2%和19.44%)显著降低(P＜0.05).再出血的发生率无显著差异;治疗组(86.84%)总有效率较对照组(69.44%)显著提高.结论 早期脑脊液置换加小量尿激酶和地塞米松椎管内注射治疗是原发性蛛网膜下腔出血、预防脑血管痉挛及脑积水发生的有效安全方法之一.     

Exploratory factor analysis and validation study of the lifetime severity index for cocaine, Spanish version (LSI-C-Spanish)

The purpose of the study was to do an exploratory factor analysis and to examine the criterion-related and discriminant validity of the Lifetime Severity Index for Cocaine (LSI-C), Spanish version. A sample of 171 outpatients from 10 drug centers in Spain participated in the study. We conducted the factor analysis with orthogonal rotation and examined correlations between the LSI-C total score and criterion variables as well as the score obtained by a quality of life measure. The factor analysis revealed 2 principal factors that explain 65.8% of the variance. Lower LSI-C scores were associated with taking medication, receiving social help, using cocaine fewer than 30 times during the previous 6 months, and with better scores on quality of life measures. Higher LSI-C scores were associated with unstable housing, overdose, hospitalization, cocaine consumption more than 100 times during the previous 6 months, and more years of drug consumption. The LSI-C Spanish version shows acceptable criterion-related and discriminant validity.     

Further studies of illness behaviour in long term haemodialysis.

A 34 item self-administered questionnaire designed to measure aspects of illness behaviour was completed by 30 patients undergoing long-term haemodialysis. A principal components analysis of the data yielded 8 factors (together accounting for 75% of the total variance) which were subjected to orthogonal rotation. The patterns of factor loadings suggested meaningful dimensions which were labelled: ‘helpless dependence’, ‘distressing preoccupation’, ‘openness vs concealment’, ‘paranoid non-involvement vs optimistic involvement’, ‘surrender vs fight’, ‘paranoid hostility to the illness as an enemy’, ‘illness as a non-attributable challenge’ and ‘lack of information about illness’. A comparison was made with an earlier study on a smaller group of patients and this revealed some encouraging similarities in the patterns of illness behaviour.     

Odd/Even short forms of the Boston Naming Test: preliminary geriatric norms

It has been suggested that the 30-item version of the Boston Naming Test (BNT), in which either the odd or even items from the standard 60-item test are given, is the most psychometrically sound short form. However, no normative data are available for this version. We administered the Odd/Even BNT to 30 community-dwelling elderly individuals (age M = 72.93, range 61-84; education M = 13.73) in order to collect normative data. Odd and even forms were equivalent. The combined mean total correct score was 27.13 (SD = 2.06), a score consistent with that derived by retrospective extraction in the original odd/even test construction study. Each form discriminated normals from age- and education-matched patients with probable Alzheimer's disease, suggesting criterion-related validity.