视觉模拟测量和利克特测量用于评价中风痉挛性瘫痪患者报告结局的比较

目的 比较“视觉模拟测量”和“利克特测量”对中风痉挛性瘫痪患者报告结局的评价,选择相对适合的测量尺度.方法 横断面现场调查的方式,利用先前研制的“基于中风痉挛性瘫痪患者报告结局评价量表”中的19个问题,104例患者分别使用“连续型”和“离散型”视觉模拟测量进行回答,另有110例患者使用5级“典型的”和5级“形式的”利克特测量进行回答.信度分析采用克拉巴赫α系数,相关分析采用Spearman相关系数法,结构效度采用因子分析.结果 除心理领域外,症状和社会领域得分,以及量表总分方面,“连续型”和“离散型”视觉模拟测量量表的克朗巴赫系数均高于5级“典型的”和5级“形式的”利克特测量.“视觉模拟测量”比“利克特测量”在量表的内部一致性信度方面更占优势.每个条目与其所属领域得分间相关系数绝大多数在0.4以上,使用“视觉模拟测量”可以获得更高的相关性.“视觉模拟测量”在量表的探索性因子分析,形成了3个因子,其结果与量表预想的症状、心理、社会三个领域大体一致；“利克特测量”在量表结构效度方面,结果并不理想.结论 测量精度越高,性能评价越好.如果患者不需要他人辅助完成量表,优先选择“视觉模拟测量”.

Comparison of visual analogue scale and Likert scale in assessing the PROs for patient with spastic paralysis from the stroke

Objectives To assess if visual analogue scale(VAS) or Likert scale was relatively more suitable when measuring self-reported clinical outcomes for apoplexy spastic-paralysis patients.Methods Nineteen questions were made from the "serf-evaluating instrument based on patient reported outcomes for apoplexy spasticparalysis patients" developed previously in cross-sectional study.104 patients answered the questions by both continuous and discrete visual analogue scale(VAS),while other 110 patients by both five-point Likert scales and Likert-typo scales.Cronbach'sαfor internal consistency reliability,spearman for correlation,and exploratory factor analysis for construct validity were applied.Results Except for emotional domain,the α coefficients of physical domain,social domain and overall score with continuous and discrete VAS are higher than that with five-point Likert scales and Likert-type scales.Internal consistency reliability was stronger for VAS.lntraclass correlation coefficients were above 0.4 mostly for each item with its domain,and VAS may produce the higher correlation.For VAS,there were three factors in the exploratory factor analysis,which confirmed the domain hypotheses of physical,mental and social functions,but for the Likert scales,the result was undesiable.Conclusion The more accurate for the response options,the better for the performance.When the patient can complete the measurement without the help of others,VAS seems better suited.