亲密伴侣暴力评估工具的研究进展

亲密伴侣暴力（IPV）是指亲密伴侣之间发生的威胁或虐待行为，其具体形式包括身体、精神或性伤害。现有研究表明，IPV可给受害者带来一系列身体和心理上的损伤，严重影响受害者的生活质量。准确评估IPV是制定针对性预防措施的前提和基础。然而，国内对IPV的研究尚处于起步阶段，针对IPV的评估工具缺乏。本文将国外常用的8种IPV评估工具分为研究工具和筛查工具，对各工具的主要内容、应用情况及特点进行综述，并对这8种评估工具的优缺点进行比较，旨在为我国IPV相关研究提供借鉴，为准确评估和识别IPV受害者提供依据。     

Spinal Cord Injury–Functional Index/Capacity: Responsiveness to Change Over Time

ObjectiveTo establish responsiveness of 3 Spinal Cord Injury–Functional Index/Capacity (SCI-FI/C) item banks in the first year after spinal cord injury (SCI).DesignLongitudinal patient-reported outcomes assessment replicated through secondary analysis of an independent data set.SettingA total of 8 SCI Model Systems rehabilitation hospitals in the United States.ParticipantsStudy 1 participants included 184 adults with recent (≤4 months) traumatic SCI and 221 community-dwelling adults (>1 year post injury) (N=405). Study 2 participants were 418 individuals with recent SCI (≤4 months) (N=418).InterventionsIn study 1, SCI-FI/C computer adaptive tests were presented in a standardized interview format either in person or by phone call at baseline and 6-month follow-up. Responsiveness was examined by comparing 6-month changes in SCI-FI scores within and across samples (recently injured vs community-dwelling) because only the recent injury sample was expected to exhibit change over time. Effect sizes were also computed. In study 2, the study 1 results were cross-validated in a second sample with recent SCI 1 year after baseline measurement. Study 2 also compared the SCI-FI/C measures’ responsiveness to that of the Self-reported Functional Measure (SRFM) and stratified results by injury diagnosis and completeness.Main Outcome MeasuresThe SCI-FI Basic Mobility/C, Self-care/C and Fine Motor/C item banks (study 1 and study 2); Self-reported Functional Measure SRFM (study 2 only).ResultsIn study 1, changes in SCI-FI/C scores between baseline and 6-month follow-up were statistically significant (P<.01) for recently injured individuals. SCI-FI Basic Mobility/C, Self-care/C, and Fine Motor/C item banks demonstrated small to medium effect sizes in the recently injured sample. In the community-dwelling sample, all SCI-FI/C effects were negligible (ie, effect size<0.08). Study 2 results were similar to study 1. As expected, SCI-FI Basic Mobility/C and Self-care/C were responsive to change for all individuals in study 2, whereas the SCI-FI Fine Motor/C was responsive only for individuals with tetraplegia and incomplete paraplegia. The SRFM demonstrated a medium effect size for responsiveness (effect size=0.65).ConclusionsThe SCI-FI Basic Mobility/C and Self-care/C banks demonstrate adequate sensitivity to change at 6 months and 1 year for all individuals with SCI, while the SCI-FI/C Fine Motor item bank is sensitive to change in individuals with tetraplegia or incomplete paraplegia. All SCI-FI/C banks demonstrate stability in a sample not expected to change. Results provide support for the use of these measures for research or clinical use.     

Psychometric properties of the PCL-5 in a sample of first responders

Given that first responders experience elevated rates of posttraumatic stress disorder and suicide, there is a need for evidence-based assessments and treatments to accurately assess, diagnose, and evaluate treatment outcome. This study examined the psychometric properties of the Posttraumatic Stress Disorder (PTSD) Checklist for DSM-5 (PCL-5) in a sample of 133 firefighters/emergency medical technicians and police officers seeking treatment for PTSD. The results indicated that PCL-5 scores showed strong internal consistency and convergent and discriminant validity. Signal detection analyses indicated a good diagnostic accuracy and an optimal cutoff score of 41 for detecting PTSD. Consistent with recent studies, confirmatory factor analyses indicated that the anhedonia model of PTSD best fit the data. Overall, findings support use of the PCL-5 as a psychometrically sound measure of PTSD in individuals at high risk for exposure to trauma.     

Development and psychometric characteristics of the SCI-QOL Bladder Management Difficulties and Bowel Management Difficulties item banks and short forms and the SCI-QOL Bladder Complications scale

ObjectiveTo describe the development and psychometric properties of the Spinal Cord Injury – Quality of Life (SCI-QOL) Bladder Management Difficulties and Bowel Management Difficulties item banks and Bladder Complications scale.DesignUsing a mixed-methods design, a pool of items assessing bladder and bowel-related concerns were developed using focus groups with individuals with spinal cord injury (SCI) and SCI clinicians, cognitive interviews, and item response theory (IRT) analytic approaches, including tests of model fit and differential item functioning.SettingThirty-eight bladder items and 52 bowel items were tested at the University of Michigan, Kessler Foundation Research Center, the Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital, and the James J. Peters VA Medical Center, Bronx, NY.ParticipantsSeven hundred fifty-seven adults with traumatic SCI.ResultsThe final item banks demonstrated unidimensionality (Bladder Management Difficulties CFI = 0.965; RMSEA = 0.093; Bowel Management Difficulties CFI = 0.955; RMSEA = 0.078) and acceptable fit to a graded response IRT model. The final calibrated Bladder Management Difficulties bank includes 15 items, and the final Bowel Management Difficulties item bank consists of 26 items. Additionally, 5 items related to urinary tract infections (UTI) did not fit with the larger Bladder Management Difficulties item bank but performed relatively well independently (CFI = 0.992, RMSEA = 0.050) and were thus retained as a separate scale.ConclusionThe SCI-QOL Bladder Management Difficulties and Bowel Management Difficulties item banks are psychometrically robust and are available as computer adaptive tests or short forms. The SCI-QOL Bladder Complications scale is a brief, fixed-length outcomes instrument for individuals with a UTI.     

Measuring grief and loss after spinal cord injury: Development,validation and psychometric characteristics of the SCI-QOL Grief and Loss item bank and short form

ObjectiveTo develop an item response theory (IRT) calibrated Grief and Loss item bank as part of the Spinal Cord Injury – Quality of Life (SCI-QOL) measurement system.DesignA literature review guided framework development of grief/loss. New items were created from focus groups. Items were revised based on expert review and patient feedback and were then field tested. Analyses included confirmatory factor analysis (CFA), graded response IRT modeling and evaluation of differential item functioning (DIF).SettingWe tested a 20-item pool at several rehabilitation centers across the United States, including the University of Michigan, Kessler Foundation, Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital and the James J. Peters/Bronx Department of Veterans Affairs hospital.ParticipantsA total of 717 individuals with SCI answered the grief and loss questions.ResultsThe final calibrated item bank resulted in 17 retained items. A unidimensional model was observed (CFI = 0.976; RMSEA = 0.078) and measurement precision was good (theta range between −1.48 to 2.48). Ten items were flagged for DIF, however, after examination of effect sizes found this to be negligible with little practical impact on score estimates.ConclusionsThis study indicates that the SCI-QOL Grief and Loss item bank represents a psychometrically robust measurement tool. Short form items are also suggested and computer adaptive tests are available.     

Measuring positive affect and well-being after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Positive Affect and Well-being bank and short form

ObjectiveTo develop an item response theory (IRT)-calibrated spinal cord injury (SCI)-specific Positive Affect and Well-being (PAWB) item bank with flexible options for administration.DesignQualitative feedback from patient and provider focus groups was used to expand on the Neurological Disorders and Quality of Life (Neuro-QOL) positive affect & well-being item bank for use in SCI. New items were created and revised based on expert review and patient feedback and were then field tested. Analyses included confirmatory factor analysis, graded response IRT modeling and evaluation of differential item functioning (DIF).SettingWe tested a 32-item pool at several rehabilitation centers across the United States, including the University of Michigan, Kessler Foundation, Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital and the James J. Peters/Bronx Department of Veterans Affairs hospital.ParticipantsA total of 717 individuals with SCI answered the PAWB questions.ResultsA unidimensional model was observed (Confirmatory Fit Index = 0.947; Root Mean Square Error of Approximation = 0.094) and measurement precision was good (reliability in theta of –2.9 to 1.2 is roughly equivalent to classical reliability of 0.95 or above). Twelve items were flagged for DIF, however, after examination of effect sizes, the DIF was determined to be negligible and would have little practical impact on score estimates. The final calibrated item bank resulted in 28 retained itemsConclusionsThis study indicates that the Spinal Cord Injury – Quality of Life PAWB bank represents a psychometrically robust measurement tool. Short form items are also suggested and a computer adaptive test is available.     

A study on craniofacial morphology of Japanese subjects with normal occlusion and esthetic profile

This study was designed to properly characterize the cephalometric values of Japanese individuals with both normal occlusion and esthetic profiles. Multivariate statistics were applied to analyze the collected data. Cephalometric values identified are expected to help in the simplification of orthodontic diagnosis. Lateral cephalometric radiographs from 50 men and 50 women with normal occlusion were traced and the dimensions of hard and soft tissues recorded. The corresponding values were classified by cluster analysis, and selected representative values were subjected to principal component analysis. From these values, characteristics of hard and soft tissue morphology were extracted. The subjects were grouped by sex, and subdivided into esthetic and unesthetic profile groups. The principal component scores from each group were plotted on a scattergram and the characteristics of each group investigated. The hard tissue characteristics in men with esthetic profiles were primarily vertical factors, including a tendency for smaller lower facial heights, a smaller mandibular plane angle, and a larger Nasion-ANS/ANS-Menton (N-ANS/ANS-Me). Soft tissue features included a more posteriorly placed maxilla and a high nasal crest. These features yield a less marked maxillary prognathism and a greater nose prominence. In females, hard tissue characteristics associated with esthetic profiles primarily involved the cranial base and posterior facial area. These included a smaller saddle angle, larger articulare angle, and smaller Sella-Articulare/Articlare-Gonion (S-Ar/Ar-Go). Female soft tissue characteristics primarily included retracted upper and lower lips, a shallow inferior sulcus with a smaller lower lip-Frankfort plane angle, and a shorter mentolabial sulcus and subnasale perpendicular-upper lip.     

口腔健康影响程度量表的验证研究

目的通过对口腔健康影响程度量表（OHIP-14中文版）的验证研究及其性质的考评，对该量表的信度、效度作出评价，探讨其在中国人群中进一步应用的可行性。方法按照国际生存质量评价（IQOLA）项目的标准程序，对OHIP-14进行翻译、回译、文化调适和改造，建立口腔健康影响程度量表。使用该量表和《口腔健康自我评价表》，对广东省部分地区年龄在18～65岁之间的居民应用多阶段简单随机抽样法，共抽取592个个体进行口腔健康相关生存质量调查，对调查结果进行统计学分析，考评量表的信度和效度。结果共有592位个体接受调查。回收有效问卷550份，其中数据缺失问卷38份。口腔健康影响程度量表内部一致性Cronbach’s α系数为0．93，条目与量表间的相关系数在0．53～0．71之间。因子分析提取的4个维度显示，口腔健康影响程度量表存在预想的连带关系和逻辑关系。量表得分与自我评价的口腔健康、自我感觉的治疗需要间呈显著正相关，相关系数分别为0．54、0．49（P〈0．0001）。结论口腔健康影响程度量表具有良好的信度、效度，其良好的心理测量学性质，为该量表在中国人群中的进一步推广应用提供了理论依据。     

Psychometric evaluation of the Perceived Barriers to Health Care-seeking Decision in Chinese patients with acute coronary syndromes

Objectives

This study aimed to develop the Chinese version of the Perceived Barriers to Health Care-seeking Decision (PBHSD-C) and evaluate its psychometric properties in Chinese patients with acute coronary syndromes (ACS).

Background

The assessment of the level of perceived barriers in the care-seeking trajectory of ACS patients is important for the understanding of its impact on pre-hospital delay in seeking care.

Methods

The psychometric properties of PBHSD-C were evaluated among 114 ACS patients in the cardiac unit of two major hospitals in Hong Kong.

Results

The Content Validity Indexes were ranged from .88 to 1. The Cronbach's alpha of the PBHSD-C was .74. The intraclass correlation coefficients of all items were above .80. The convergent validity of the PBHSD-C was also supported.

Conclusion

The PBHSD-C is reliable and valid to be used to assess the level of perceived barriers in the care-seeking of Chinese patients with ACS.     

Convergent Validity and Responsiveness of the SULCS

Objective

To evaluate the convergent validity and responsiveness of the Stroke Upper Limb Capacity Scale (SULCS) in comparison to the Arm Motor Ability Test (AMAT), the Box and Blocks Test (BBT), and the upper limb Fugl-Meyer Assessment (FMA). The SULCS is a relatively new measure that was designed to be easier to score and less time consuming than some existing measures.