世界卫生组织残疾态度量表中文版的信度、效度分析**

背景：为客观科学地评价人们对待残疾和残疾人的态度,需研制出一份专门针对残疾和残疾人的态度量表,以了解人们对待残疾人的态度及其影响因素。 目的：考核世界卫生组织残疾态度量表中文版的信度和效度。 方法：采用全球多中心同步研究的方法研制世界卫生组织残疾态度量表。通过多阶段分层整群随机抽样抽取1 037名残疾人、507名残疾人照顾者及354名正常人,对其进行问卷调查。对其中109名残疾人间隔1周进行量表的重复测量。采用克朗巴赫α系数评价量表的内部一致性信度,通过前后2次测量各方面得分的相关系数以及配对检验来考察量表的重测信度,采用探索性因子分析评价量表的结构效度。 结果与结论：共回收残疾人问卷1 000份、残疾人照顾者问卷507份、正常人问卷354份。量表回收率大于95.0%,条目缺失率低于1.10%;量表各个方面的克朗巴赫α系数为0.588~0.837;重复测量前后得分差异无显著性意义;不同人群对待残疾的态度各有不同,因子分析结果表明量表反映出的内在结构与原量表构造基本一致。说明世界卫生组织残疾态度量表中文版具有较好的可接受性、信度和效度,可用于国人对待残疾和残疾人态度的研究。 关键词：残疾人;态度;信度;效度;世界卫生组织残疾态度量表     

福特应激失眠反应测试量表中文版的初步应用

目的:修订福特应激失眠反应测试量表(FIRST),并进行初步应用。方法:通过翻译及文化调试制定FIRST中文版,以431名含不同群体的志愿者(研究组)、121名某部卫生营官兵(对照组)为研究对象,以睡眠状况自评量表(SRSS)为验证关联效度工具,分析FIRST的信度与效度。结果:题目分析显示,FIRST中文版各题目与与总分之间均存在显著相关(P0.01);高、低分组在所有题目上的得分差异均有统计学意义(P0.01)。信度分析显示,FIRST中文版的内部一致性信度系数α为0.87,分半信度系数为0.91,再测信度相关系数为0.82(P0.01)。效度分析显示,FIRST中文版总分在研究组与对照组之间的差异有统计学意义(P0.01);FIRST中文版总分与SRSS总分之间存在显著正相关(r=0.62,P0.01)。探索性和验证性因素分析显示了量表的单维结构。结论:FIRST中文版具有较高的信、效度,可作为应激情境性失眠易感性的筛查工具。     

公众对癫痫患者态度测评量表中文版信度及效度分析

目的 中文翻译公众对癫痫患者态度测评(PATE)量表并在中国内地进行信度及效度分析.方法 采用国际通行的量表翻译程序,将PATE量表翻译为中文版.利用便利抽样的方法在湖南省长沙市选取210个具有经济文化代表性的汉族成人,分析中文版量表的信度及效度.结果 总计得到199份有效问卷,有效率为94.7％,问卷平均应答时间为7 min;199位有效问卷答卷者平均年龄为33.75岁,有一定的经济文化代表性;量表各条目与各自所属领域相关性显著,与总体量表及其他领域相关较弱;探索性因子分析及验证性因子分析表明中文版量表与原量表的内在构造基本一致;各领域及量表整体的Cronbach's Alpha系数处于0.853 ～0.909之间.结论 中文版的PATE量表的信度和效度良好,可以应用于中国公众对癫痫病人态度的评测.     

临床医生精神疾病态度量表中文版在社区精神卫生工作者中的信度、效度研究

目的:探讨临床医生精神疾病态度量表(MICA)中文版在社区精神卫生工作者中的信度、效度与可接受性。方法:应用MICA中文版对广州市8个区(市)80名社区精神卫生工作者进行间隔1周的两次调查、报告和意向行为量表(RIBS)调查,并附加关于生活中对精神疾病患者态度及对MICA理解度的调查。结果:MICA中文版内部一致性信度(Cronbach’α)为0.720,分半信度为0.685,重测信度为0.764(P0.05);表面效度良好;与RIBS总分及附加条目评分呈负相关(r=-0.516,r=-0.310;P均0.01)。主成份分析产生6个因子,共解释方差65.1%。该量表3 min内可完成。结论:MICA中文版是社区精神卫生工作者对精神疾病态度的有效评估工具。     

中文版心境障碍自知力量表信效度初步研究

目的:评价心境障碍自知力量表(mood disorders insight scale,MDIS)中文版的信度和效度。方法:131例符合美国精神障碍诊断与统计手册第4版心境障碍诊断标准的患者完成MDIS中文版测试,由精神科医师采用临床总体印象量表(CGI)和自知力视觉尺度量表评估其疾病严重程度和自知力;同时,家属也完成自知力视觉尺度量表。随机抽取50例患者间隔7 d后重测MDIS。计算量表Cronbach’sα系数和两次评分的相关系数,评价量表的内部一致性和1周重测信度;采用因子分析方法考评结构效度;通过MDIS评分与精神科医师及家属的自知力视觉尺度量表评分相关分析来考察效标效度;通过比较重度和轻中度疾病严重程度患者MDIS得分差异来考评实证效度。结果:1信度:MDIS量表总Cronbach’sα系数为0.81,1周重测信度系数为0.82;2效度:探索性因子分析显示MDIS符合两因子结构,贡献率达65.75%;验证性因子分析的拟合优度指数为0.900,赋范拟合指数为0.931,标准化残差均方根为0.064;3患者MDIS分值与精神科医师及家属自知力视觉尺度评分之间相关系数分别为0.74和0.59(P均0.05),与CGI评分相关系数为-0.87(P0.05)。轻中度与重度躁狂发作患者MDIS量表分值差异具有统计学意义(P0.05)。结论:MDIS中文版具有较好的信度和效度,可用于快速有效地评估心境障碍患者的自知力。     

居民心理健康状况筛查记录表的编制及信效度检验

目的 为建立社区心理健康档案、筛查社区里有心理疾病的居民而编制居民心理健康状况筛查记录表并进行信效度检验.方法 通过文献阅读并结合社区和临床实践经验,参考中文版复合性国际诊断交谈表3.0(CIDI-3.0),提出项目,以37名某课程培训班学员、32例精神科住院病人及5.12地震灾区1800名灾民进行信度、效度评定.结果 Cuttman系数(Cronbach's α)为0.682,分半信度系数为0.624,重测信度为0.880,ICC值为0.909.各因子与总分之间的相关为0.302～0.839,各条目与总分之间的相关为0.126～0.547.总分得分≥4时,筛选灵敏度为0.605,特异性为0.395.结论 居民心理健康状况筛查记录表适合做为社区居民的心理疾病的筛查量表.     

Eppendorf精神分裂症量表中文版的信度和效度

目的：研究Eppendorf精神分裂症量表(ESI)中文版的信度和效度。方法：信度评价采用分半信度、内部一致性、重测信度。效度评价采用区分效度、内容效度、平行效度、结构效度。结果：KSI量表和各因子的分半信度为0．8087—0．9738，Cronbach α系数为0．7694—0．9508；1周后重测信度为0．677—0．876。各因子与总分的相关系数在0．815—0．909之间，因子之间的相关小于因子与总分的相关；ESI与阳性症状与阴性症状量表(PANSS)有很好的相关性，因子分析得出4个因子与原作者的因子相关系数在0．747—0．943之间。结论：ESI量表有较好的信度和效度，值得推广和使用。     

卒中危险因素初筛表的信度及效度研究

目的 检验卒中危险因素初筛表的信度、效度。 方法 对130例测试对象进行卒中危险因素初筛表、改良弗明汉卒中风险评估量表（Framingham Stroke Profile,FSP）进行调查,检验卒中危险因素初筛表的信度及效度。 结果 卒中危险因素初筛表的Cronbach α系数为0.701,分半信度为0.826,重测信度为0.94。因子分 析法提取5个共性因子,公因子的累计方差贡献率为62.199%,量表的结构效度、内容效度、效标效度 达到测量学要求。 结论 卒中危险因素初筛表具有较好的信度与效度,符合量表测量学的要求,可作为我国卒中风险 评估的工具。     

临床医师连带病耻感量表中文版在精神卫生专业人员中的信效度

目的:评估临床医师连带病耻感量表中文版(CASS-C)在精神卫生专业人员中的信效度.方法:翻译英文版CASS为CASS-C,并在广东地区5家精神专科医院对804名精神卫生专业人员进行评估.采用内部一致性、相关性分析、分半信度分析来评估量表的信度;采用探索性因子分析、验证性因子分析以评价量表的结构效度.采用t检验或者单因...     

中文版剑桥人格解体量表的信度和效度检验

目的 翻译英文版剑桥人格解体量表（CDS）并对中文版CDS进行信、效度检验.方法 对119例健康受试者分别间隔2、3、4周进行CDS测验以计算其重测信度;临床医生按DSM-IV-TR诊断标准对76例门诊患者做出诊断,之后进行CDS测验,计算测验的重测信度、内部一致性、折半信度和效标关联效度、结构效度.结果 中文版CDS重测信度中等（0.651）,内部一致性和分半信度良好（Cronbach＇s α系数为0.938,Guttman折半信度为0.957）,效标关联效度良好（Mann-WhitneyZ值为-6.059,P＜0.001）,项目-总分相关系数从0.321～0.777,均达到显著性,结构效度尚可.结论 中文版CDS具有良好的信、效度,可以很好地评定人格解体症状.     

The stroke impact scale version 2.0. Evaluation of reliability, validity, and sensitivity to change.

BACKGROUND AND PURPOSE: To be useful for clinical research, an outcome measure must be feasible to administer and have sound psychometric attributes, including reliability, validity, and sensitivity to change. This study characterizes the psychometric properties of the Stroke Impact Scale (SIS) Version 2.0. METHODS: Version 2.0 of the SIS is a self-report measure that includes 64 items and assesses 8 domains (strength, hand function, ADL/IADL, mobility, communication, emotion, memory and thinking, and participation). Subjects with mild and moderate strokes completed the SIS at 1 month (n=91), at 3 months (n=80), and at 6 months after stroke (n=69). Twenty-five subjects had a replicate administration of the SIS 1 week after the 3-month or 6-month test. We evaluated internal consistency and test-retest reliability. The validity of the SIS domains was examined by comparing the SIS to existing stroke measures and by comparing differences in SIS scores across Rankin scale levels. The mixed model procedure was used to evaluate responsiveness of the SIS domain scores to change. RESULTS: Each of the 8 domains met or approached the standard of 0.9 alpha-coefficient for comparing the same patients across time. The intraclass correlation coefficients for test-retest reliability of SIS domains ranged from 0.70 to 0.92, except for the emotion domain (0.57). When the domains were compared with established outcome measures, the correlations were moderate to strong (0.44 to 0.84). The participation domain was most strongly associated with SF-36 social role function. SIS domain scores discriminated across 4 Rankin levels. SIS domains are responsive to change due to ongoing recovery. Responsiveness to change is affected by stroke severity and time since stroke. CONCLUSIONS: This new, stroke-specific outcome measure is reliable, valid, and sensitive to change. We are optimistic about the utility of measure. More studies are required to evaluate the SIS in larger and more heterogeneous populations and to evaluate the feasibility and validity of proxy responses for the most severely impaired patients.     

Translation and validation of the 15‐item Myasthenia Gravis Quality of life scale in Dutch

Introduction: The 15‐item Myasthenia Gravis Quality of Life (MG‐QOL15) scale has been developed to assess the health‐related quality of life of patients with myasthenia gravis (MG). The aim of this study was to translate the original English version into Dutch and to test the test–retest reliability and construct validity. Methods: Fifty patients with MG were included. Test–retest reliability and internal consistency were assessed using the intraclass correlation coefficient (ICC) and the Cronbach α. Construct validity was assessed by testing 5 predefined hypotheses. Results: A good test–retest reliability was confirmed with an ICC of 0.866. The Cronbach α was 0.93. The predefined hypotheses were confirmed in 80% of cases, which points to good construct validity. Discussion: The Dutch MG‐QOL15 has good test–retest reliability and good construct validity. It can be used for research in a Dutch‐speaking population. It is also suitable for monitoring individual patients in clinical practice. Muscle Nerve 57 : 206–211, 2018     

Evaluation of the quality of life in dementia with a generic quality of life questionnaire: the Duke Health Profile

OBJECTIVE: The study was designed to determine the acceptability, feasibility and validity of measuring quality of life in a representative sample of dementia patients with a generic instrument, the Duke Health Profile. METHOD: The French version of the Duke Health Profile was administered to 148 subjects with a mental disorder according to the DSM-III-R diagnostic criteria. The feasibility and acceptability of employing the instrument were determined by the refusal rate, the type of administration, and the percentage and distribution of missing data. Reliability was determined with Cronbach's alpha coefficient. Instrument reproducibility was assessed with the intraclass correlation coefficient for test-retest values. Internal construct validity was determined by factor analysis. Discriminant capacity was determined by comparing the average scores on each measure among patients with and without an additional chronic pathology. The measurements obtained were compared by source of information (patient, family proxy and care provider proxy). RESULTS: The feasibility and acceptability of the instrument was good. Only 2% of the patients refused to complete the questionnaire. Help from the interviewer was necessary in 79% of the cases. The average completion time was 10.6 min. Missing data exist in only 3.5% of the cases on average, except among patients with severe dementia (Mini Mental State Examination <10). For reliability, internal consistency was acceptable (Cronbach's coefficient alpha = 0.5--0.7) when the self-esteem (0.23) and social health (0.26) concepts were eliminated. Reproducibility as measured by test-retest scores was moderate to good (intraclass correlation coefficient r = 0.53--0.80), except for anxiety (0.48) and perceived health (0.45). Severity of dementia mainly affected the feasibility, acceptability and reproducibility of the instrument. The family proxy seemed to agree more with the patient than did the care provider proxy. CONCLUSION: Quality of life can be measured in patients with dementia, but special tools need to be developed for severe dementia.     

Psychometric evaluation of the multiple sclerosis impact scale (MSIS-29) for proxy use

BACKGROUND: There may be difficulties in the use of self report measurements in patients with cognitive impairment or serious mood disturbances which interfere with reliable self assessment, as may be the case in multiple sclerosis (MS). In such cases proxies may provide valuable information. However, before using any questionnaires in a proxy sample, the questionnaire should be evaluated for proxy use. OBJECTIVE: To evaluate the psychometric properties of the 29 item Multiple Sclerosis Impact Scale (MSIS-29) when used by proxies of MS patients. METHODS: A sample of 62 partners of MS patients completed the MSIS-29. The data were evaluated for the psychometric criteria of the MSIS-29, including data quality, scaling assumptions, acceptability, reliability, validity, and responsiveness. RESULTS: Psychometric evaluation was satisfactory; data quality was high, and scaling assumptions and acceptability were good. Reliability was high (alpha>0.80). Findings were consistent with results of a psychometric evaluation in a patient sample. CONCLUSIONS: The MSIS-29 can be used reliably in proxies of patients with MS. As a next step the relation between data obtained from patients and proxies needs to be studied, focusing on factors that may affect agreement and discrepancies.     

Evaluation of measures used to assess quality of life after stroke

BACKGROUND AND PURPOSE: Assessment of quality of life (QOL) after stroke is becoming common with the recognition that evaluation of treatment should include quality as well as quantity of survival. This article will outline the main conceptual and methodological issues in QOL assessment, highlight advantages and disadvantages of measures used in stroke QOL research, and discuss some unresolved issues. SUMMARY OF REVIEW: We undertook a MEDLINE search using the keywords "stroke" and "quality of life" and reviewed 3 key texts on QOL measurement in stroke. Fifteen generic and 10 condition-specific measures used to assess QOL in stroke were identified and evaluated with the following criteria: reliability, validity, responsiveness, precision, acceptability, suitability for proxy respondents, mode of administration, and use of patient-centered approaches in development. Domains covered and level of comprehensiveness varied widely between generic and stroke-specific measures. No stroke-specific instruments used patient-centered approaches in their development. Four stroke-specific measures (Frenchay Activities Index, Niemi QOL scale, Ferrans and Powers QOL Index-Stroke Version, and Stroke-Adapted Sickness Impact Profile [SA-SIP30]) provided evidence of reliability and validity. CONCLUSIONS: The need remains for a patient-centered, psychometrically robust, stroke-specific QOL measure. Patients should be involved in each stage of instrument development. Caution is needed in the selection of an instrument to measure QOL after stroke. Although the Ferrans and Powers QOL Index-Stroke Version, Niemi QOL scale, SA-SIP30, and Sickness Impact Profile come closest to satisfying many of the criteria outlined in this article, the selection of any individual instrument depends on the specific goals and constraints of a particular study.     

Comparison of patient and proxy responses on risk factors for stroke

Capelle LG, Vlak MHM, Algra A, Rinkel GJE. Comparison of patient and proxy responses on risk factors for stroke.
Acta Neurol Scand: 2011: 123: 160–166.
© 2010 John Wiley & Sons A/S. Background – For studies on chronic risk factors and trigger (i.e. acute risk) factors, stroke researchers often have to rely on proxies. The reliability of proxy responses regarding trigger factors for stroke is unknown. Methods – Thirty patients with stroke and their proxies were interviewed about chronic risk factors and trigger factors. We assessed the completeness of proxy‐derived data by calculating the level of non‐response and the level of agreement using Cohen kappa statistics. Results – For most chronic risk factors and trigger factors, the response rate to whether or not exposure had taken place in the past year was 87% or higher. If couples agreed on exposure, patient and proxy could also provide a comparable estimate of the average frequency of exposure. Although the non‐response on last time of exposure was higher, proxies who could answer provide a reasonably good estimate for most trigger factors. Conclusions – Proxies provide reliable information on exposure to chronic risk factors and trigger factors for stroke. For exposure and average frequency of exposure, non‐response is low and the level of agreement is high for most chronic risk factors; for last time of exposure non‐response is higher, but proxies who could respond provided reliable estimates of last time of exposure to most trigger factors.     

Assessing quality of life in dementia: Preliminary psychometric testing of the Quality of Life Assessment Schedule (QOLAS)

We adapted a generic, individualised, patient-centred quality of life (QOL) assessment technique, the Quality of Life Assessment Schedule (QOLAS) for use with patients with dementia. The QOLAS was administered to a group of patients with mild to moderate dementia alongside a number of other measures of well-being to assess its psychometric properties. Each patient's main carer also completed the QOLAS, giving a proxy rating of the QOL of the patient. The patients understood the interview and were able to describe their quality of life both qualitatively and quantitatively. In this preliminary study the QOLAS was demonstrated to have good validity (content, construct, and criterion) and good internal reliability. The carers rated the patients as having a worse QOL than did the patients themselves on all subdomains of the QOLAS. The results suggest that patients with mild to moderate dementia can rate their own QOL and that the QOLAS is a promising method for assessing QOL in this patient group. The discrepancy between the patients' own views and the views of their carers raises important issues about whether the patient or a proxy is the best judge of QOL in patients with dementia.     

Development and validation of NEWSQOL, the Newcastle Stroke-Specific Quality of Life Measure

BACKGROUND: A review of stroke-specific quality of life (QOL) measures indicated little evidence of their validity/reliability. PURPOSE: To describe the development/validation of a new measure - the Newcastle Stroke-Specific Quality of Life Measure (NEWSQOL). METHODS: Phase I: qualitative interviews (28 stroke patients) determined QOL issues for inclusion in the measure. Initial items/response categories were pre-tested (30 patients). Administration of the NEWSQOL in the item reduction stage (100 patients) identified poorly performing items and factor analysis showed likely domains. Internal consistency was examined. Phase II: NEWSQOL and comparator measures were administered (106 patients) to examine validity/test-retest reliability. RESULTS: Phase I: 140 items were identified for initial inclusion. Qualitative pre-testing led to an extensive revision. Item reduction resulted in a final measure of 56 items in 11 domains (feelings, activities of daily living/self-care, cognition, mobility, emotion, sleep, interpersonal relationships, communication, pain/sensation, vision, fatigue; Cronbach's alpha = 0.71-0.90). Phase II: NEWSQOL domain scores, except cognition, were moderately/highly correlated (0.45-0.76) with relevant comparator measures. NEWSQOL domains feelings, communication and cognition low/moderately correlated with Barthel Index scores (-0.49 to -0.28), as predicted. Test-retest reliability was high (intraclass correlation coefficient range 0.78-0.92). CONCLUSIONS: NEWSQOL is an acceptable, patient-derived, interviewer-administered, stroke-specific QOL measure with evidence of reliability and validity, making it a promising instrument for assessing QOL after stroke. Involvement of relevant patients in determining the content and format considerably enhances confidence in its validity.     

Caregivers' assessments of preference-based quality of life in Alzheimer's disease

BackgroundThis study was designed to evaluate the feasibility, reliability, and validity of use of caregivers' ratings of two health preference measures as outcomes for cost-effectiveness analyses in persons with very mild to moderate Alzheimer's disease (AD).MethodsCaregivers completed ratings of preference for AD patients' health by use of the EuroQol-5D system (EQ-5D) and the Health Utilities Index Mark 2 (HUI2). They also rated patients' cognition, mood, burden, AD-specific and generic health-related quality of life (QOL), and activities of daily living.ResultsCaregivers' HUI2 scores were reliable. Neither the caregiver ratings of the patients' health by use of the EQ-5D nor the HUI2 had a relationship with severity of cognitive impairment. Both the EQ-5D and the HUI2 had expected relationships with caregivers' assessments of patients' function, AD-specific QOL, and physical and mental health and selected subscales of the measures of AD-specific QOL and overall health. In addition, caregiver scores showed relationships with patient self-rated function, mood, and physical health but not AD-specific QOL. Caregiver burden was associated with caregivers' scores.ConclusionsCaregiver-completed ratings of preference for patients' health made by use of the EQ-5D and the HUI2 have many of the characteristics of valid preference measures. However, the lack of association with patient Mini-Mental Status Exam scores and patient self-rated AD-specific QOL and the associations with caregiver subjective burden might present limitations to their use as proxy measures for cost-effectiveness analyses.     

Psychometric properties of the Chinese-version Stroke and Aphasia Quality of Life Scale 39-generic version (SAQOL-39g)

Background and purpose: Aphasia is a common outcome of stroke affecting one-third of the post-stroke population in China. While the quality of life (QOL) may be affected, care is often inadequately guided due to lack of validated measure for Chinese population with stroke-induced aphasia. This study aimed to develop a Chinese-version of the Stroke and Aphasia Quality of Life-39 generic version (SAQOL-39g) and evaluate its feasibility, reliability, and validity in Chinese patients with stroke-induced aphasia.

Methods: The process of translation and adaptation suggested by WHO was used to develop the Chinese-version of SAQOL-39. We evaluated the feasibility, reliability, and validity of the scale in 84 aphasia patients and their proxies by assessing the internal consistency of the test items, test–retest consistency, and the structural validity of data.

Results: The self-report and the proxy-report form were completed within 21.4 and 13.3 min on average, respectively. Physical, communication, and psychological subdomains were extracted as three common factors. The Cronbach’s alpha coefficients of overall domain and subdomains for both forms ranged from 0.879 to 0.950, indicating high internal consistency. The intraclass correlation coefficients ranged from 0.804 to 0.987 for overall domain and subdomains of the forms. No significant difference was found between two forms.

Conclusions: The Chinese-version SAQOL-39g has excellent reliability, validity, and feasibility for measuring the QOL of Chinese post-stroke aphasia patients. The consistency between self-report and proxy-report forms was good, implying that the proxy-report form can be used to assess the QOL of post-stroke aphasia patients.