心理弹性量表中文版在医学生中的信效度检验

目的:对心理弹性量表中文版(CD-RISC)在医学生样本中进行信效度检验。方法:采用整群抽样的方法对463名大三到大五的中南大学医学生进行问卷调查,利用同质性信度、分半信度、重测信度、校标关联效度、结构效度等统计指标对量表进行信效度分析。同时比较2个条目和10个条目的心理弹性量表与25个条目的心理弹性量表进行信效度系数。结果:对量表进行探索性因素分析得出3个因子,项目分析结果显示心理弹性量表中文版(CD-RISC)各条目分与量表总分相关系数在0.348~0.809之间,各分量表分与总分之间的相关系数在0.512~0.952之间,均达到显著水平(P0.01),27%标准分出的高分组和低分组的平均数的差异检验中中文版CDRISC总分的CR值为35.146,各条目的 CR值在0.568~1.696之间,均达到显著差异(P0.001);总量表的Cronbach’sα系数为0.951,分半信度为0.928,一周后重测信度为0.590;中文版CD-RISC总分与DASS-21总分的相关系数为-0.470,与其分量表分的相关系数在-0.309~-0.506之间,均达到显著水平(P0.01)。验证性因素分析结果显示χ2/df=2.685,CFI=0.935,TLI=0.928,RMSEA=0.060,RMR=0.037。结论:心理弹性量表中文版(CDRISC)在医学生样本中具有良好的信效度,可以用于医学生心理弹性水平测验。     

相倚性自我价值量表中文版在医学生中的信效度检验

目的评估相倚性自我价值(Contingencies of Self-Worth,CSW)量表中文版的信度和效度。方法在某医科大学随机抽取70名临床专业本科生进行预实验,之后采取分层抽样,选取该医科大学临床专业本科生372名进行CSW中文版的测试,2周后随机抽取70名被试进行重测。结果 CSW中文版各分量表Cronbachα系数在0.74~0.88之间,全量表α系数为0.90,重测相关系数为0.71~0.83(P<0.01)。CSW中文版的KMO值为0.82,Bartlet t检验χ2=3547.89(df=435.00,P<0.01),表明条目间有共同因子存在,可以进行因素分析。验证性因素的拟合指标NFI,CFI,GFI,RMSEA分别为0.90,0.92,0.90,0.06。结论宗教信仰分量表的内部一致性很差,不适用于我国大学生的评测,CSW中文版其他6个分量表具有良好的信度和效度,可以满足国内今后相关研究和应用的需要。     

工作不安全感问卷在医学院校教师中的初步修订

目的:在我国医学院校教师群体中对工作不安全感问卷进行修订并考察其信效度。方法:用工作不安全感问卷在我国医学院校教师群体中进行施测,通过项目分析、探索性因子分析和验证性因子分析对问卷的信效度进行检验。结果:经项目分析和探索性因子分析,删除了项目11、15、22,保留了其余27个项目,提取了特征值大于1的薪酬晋升不安全感、过度竞争不安全感、人际关系不安全感、工作丧失不安全感、工作执行不安全感5个因子。27个项目的题总相关系数均大于0.3,因子载荷大于0.5。5个因子累积解释总变异量的75.59%。问卷的建构效度和效标效度都符合心理测量学的要求。问卷的内部一致性信度Cronbach'sα系数为0.949,5个因子的Cronbach'sα系数分别为工作丧失不安全感0.966、薪酬晋升不安全感0.918、过度竞争不安全感0.847、人际关系不安全感0.888、工作执行不安全感0.730;组合信度分别为工作丧失不安全感0.967、薪酬晋升不安全感0.891、过度竞争不安全感0.856、人际关系不安全感0.919、工作执行不安全感0.749。结论:修订后的工作不安全感问卷具有良好的信效度,可以作为测量和评估我国医学院校教师工作不安全感的工具。     

Validating the MPI-DLV Using Experience Sampling Data

The present study investigates the relationship between scale scores on the Dutch version of the Multidimensional Pain Inventory (MPI-DLV) and data derived from comparable items from an experience sampling procedure. Fifty-seven chronic pain patients participated in the study, which lasted 6 consecutive days. Special attention was given to the relationship between the MPI-DLV pain intensity score and the mean experience sampling pain intensity score. Significant correlations were found between the MPI-DLV scales Pain Severity, Interference, Solicitous, Punishing and Distracting Responses, and Household Chores and their experience sampling analogues. A marginally significant correlation was found with regard to the MPI-DLV Life Control scale. The General Activity and Affective Distress scales had no relationship with the analogous experience sampling items. The significant correlations were regarded as further validation of the MPI-DLV. A regression analysis revealed that 58% of the variance of the experience sampling pain intensity score could be explained by the MPI-DLV present pain intensity item score.     

医学生自主学习能力测评量表的信效度检验

目的对自制的医学生自主学习能力测评量表,进行信度、效度检验,检验其在医学生中的适用性。方法采用横断面调查的方法,用医学生自主学习能力测评量表对全国3423名医学生进行测评。结果总量表重测信度为0.992(P0.001),各分量表重测信度为0.983(P0.001),0.975(P0.001),均在0.700以上,说明此量表具有较好的重复性;总量表Cronbach'α系数为0.929(P0.001),各分量表的Cronbach'α系数为0.809(P0.001),0.914(P0.001),均在0.700以上,说明此量表具有较好的内在一致性;总量表分半信度为0.892(P0.001),各分量表分半信度为0.795(P0.001),0.883(P0.001),均在0.700以上,符合量表评价标准;专家对量表总体评定的内容效度指数为0.970(P0.001),表明量表各条目有效反映了其所属维度的内容;结构效度采用因子分析提取出6个因子,累计贡献率为53.194%,数据分析的理论结构与假设基本一致,量表结构效度较好;标准关联效度为0.510(P0.001)说明量表的关联效度高。结论本研究编制的量表具有较好的信度、效度,对于了解医学生自主学习能力,提高其自身素质,具有一定应用价值,同时对医学教育也有一定启示作用。     

ATM germline mutations in classical ataxia-telangiectasia patients in the Dutch population

Germline mutations in the ATM gene are responsible for the autosomal recessive disorder ataxia-telangiectasia (A-T). In our study, we have determined the ATM mutation spectrum in 19 classical A-T patients, including some immigrant populations, as well as 12 of Dutch ethnic origin. Both the protein truncation test (PTT) and the restriction endonuclease fingerprinting (REF) method were used and compared for their detection efficiency, identifying 76% and 60% of the mutations, respectively. Most patients were found to be compound heterozygote. Seventeen mutations were distinct, of which 10 were not reported previously. Mutations are small deletions or point mutations frequently affecting splice sites. Moreover, a 16.7-kb genomic deletion of the 3′ end of the gene, most likely a result of recombination between two LINE elements, was identified. The most frequently found mutation, identified in three unrelated Turkish A-T individuals, was previously described to be a Turkish A-T founder mutation. The presence of a founder mutation among relatively small ethnic population groups in Western Europe could indicate a high carrier frequency in such communities. In patients of Dutch ethnic origin, however, no significant founder effect could be identified. The observed genetic heterogeneity including the relative high percentage of splice-site mutations had no reflection on the phenotype. All patients manifested classical A-T and increased cellular radioresistant DNA synthesis. Hum Mutat 12:330–337, 1998.© 1998 Wiley-Liss, Inc.     

自我-他人医疗决策差异研究

目的:考察医疗情境中,自我决策与为他人提供建议是否存在决策偏差,并基于解释水平的理论,解释这种偏差的由来。方法:改编Ficchhoff等使用过的医疗决策问题,分别以正/负框架(2)×自我/他人(2)进行描述。355名临床专业大学生被随机分为四组完成决策任务。结果:社会距离对医疗决策影响显著(χ2=8.636,P=0.003),自我决策与向他人建议相比,被试更倾向短期获益,长期受损的保守方案。框架效应对医疗决策影响显著(χ2=9.804,P=0.002),正性框架相比负性框架,被试更倾向短期受损,长期获益的手术方案。解释水平与框架效应交互作用显著:正性框架中,自我-他人决策差异显著(χ2=12.309,P<0.001),自我决策更倾向手术方案,负性框架中,自我-他人决策无显著差异(χ2=0.706,P=0.401);自我决策中,框架效应不显著(χ2=0.91,P=0.340),向他人建议,框架效应显著(χ2=13.256,P<0.001)。结论:社会距离与框架描述对医疗决策存在影响。     

一般行政能力倾向测验的建构及信度、效度研究

目的：为省,地（市）级公务员录用考试编制“一般行政能力倾向测验（简称ＧＡＡＴ）。方法：通过工作分析等方法确定ＧＡＡＴ的内容和结构,经实际使用后进行结构及内容分析,并作信度和效度检验。结果：测验总体难度为０．５３８,试题的区分度〉０．２;各分量表间存在中,低度相关（０．２１４３－０．４９０９）,与总分的相关较高（０．５８５８－０．８３２６）,按分量表进行因素分析得两个特征值〉１的因素,按分测验进行因     

伯克利情绪表达量表中文版在中国大学生中的信、效度分析

目的:本研究旨在探讨伯克利情绪表达量表在中国文化背景下的信、效度。方法:采用伯克利情绪表达量表测量1037名18-24岁的中国大学生,另采用中文版情绪调节量表、正负性情绪量表及自评抑郁量表检验效标关联效度。一个月后抽取105名大学生进行重测。结果:修订的伯克利情绪表达量表包括正性情绪表达、负性情绪表达、负性情绪抑制、正性情绪表达强度和负性情绪表达强度五个维度,共16个题项。探索性因素分析和验证性因素分析结果支持了中文版情绪表达量表的五因素模型。问卷总体的内部一致性系数为0.77,五个分量表的内部一致性信度在0.58-0.72之间,重测信度在0.53-0.63之间。伯克利情绪表达量表中文版具有较好的效标关联效度。结论:伯克利情绪表达量表中文版具有良好的信度和效度,可以用于中国大学生情绪表达的测量。     

新疆某医院医疗不良事件网络报告三年数据分析

目的 研究医疗机构不良事件及安全隐患报告实施的效果及存在的问题。方法 回顾性分析2013年~2015年医院医疗不良事件报告实施的情况,并对报告中的相关数据进行分析。结果 护理人员为不良事件上报的主要人群,占比66.28%;病区为不良事件发生的主要场所,占比90.93%;从发生后果看,2级不良事件占比58.99%;护理不良事件年报告例数在200~250件,诊疗不良事件、药物相关不良事件、非诊疗不良事件报告例数较少。结论 不良事件报告需构建多种方式进行激励;报告渠道的便捷及多样化有利于医务人员进行报告;培训体制及安全文化的引领需要进一步加强。     

中国大学生多维完美主义量表在728名大学生中的试用

目的测定中国大学生多维完美主义量袁在非原始样本中的实用性。方法对800名大学生被试的测试结果进行探索性和验证性因素分析等统计处理。结果量表项目聚合为6个维度（分量表）,分别是完美期待、个人高标准、担心错误、务理性、自省和重要他人要求。6个维度可解释总方差的54．09％,各维度的项目载荷在0．42～0．80之间,分量表的分半信度为0．73～0．86．同质性信度为0．70～0．89,重测信度为0．73～0．88（P〈0．01）,与SCL～90的相关为0．42～0．57。验证性因素分析指标χ^2、RMSEA、NFI、CFI、GFI分别为1123．876、0．079、0．835、0．885、0．832。结论中国大学生多维完美主义量表在大学生群体中具有较理想的信效度,适合其使用。     

Rey-Osterrieth复杂图形测验在中国正常老人中的应用

目的：检验Ｒｅｙ－Ｏｓｔｅｒｒｉｅｔｈ复杂图形测验在中国正常老人中的适用性和基本的信度与效度。方法：应用Ｒｅｙ－Ｏｓｔｅｒｒｉｅｔｈ复杂图形测验９ＣＦＴ甲式）、简明精神状态量表评定１１１名健康中国老人。其中４０名老人另完成ＣＦＴ乙式和积木测验、图形再生测验。结果：ＣＦＴ甲式和乙式的摹仿、延迟回忆和再认得分没有显著差异。正常老人模仿图片时最易发生错误或溃漏的局部是大长方形周边细节，延迟回忆时除了周边细节，还有大长方形内部细节。大长方形轮廓不易忘记。结论：Ｒｅｙ－Ｏｓｔｅｒｒｉｅｔｈ复杂图形测验适用于中国正常老人，其信度和效果良好。     

12项坚毅量表(12-Item Grit Scale)的中文修订

目的:对12项坚毅量表(12-Item Grit Scale)在中国成年人群中进行中文版的初步修订。方法:按量表翻译程序将12项目坚毅量表翻译成中文版,然后采用验证性因素分析对其结构效度进行分析,以心理弹性量表(RS-14)作为校标工具。在北京市随机选取360名成年人进行测验,两周后随机选取其中80名成年人进行重测,分析中文版信效度。结果:坚毅量表中文版所有题目的决断值(CR)均达到0.001的显著性水平,每个题目与对应量表的相关系数较高。因素分析结果表明,坚毅量表符合Duckworth两因素模型结构,量表的结构效度良好(RMR=0.037,NFI=0.927,GFI=0.957,RMSEA=0.049)。用心理弹性量表(RS-14)作为效标,坚毅量表得分与心理弹性量表的得分呈现正相关(r=0.671,P0.001)。量表的Cronbach`sα系数为0.729,折半信度为0.784,两周后的重测信度为0.804(P0.001)。结论:12项坚毅量表在成年人中试用具有较高信度和效度,可以作为测量成年人坚毅品质的有效工具。     

海量医学数据场的快速多分辨率体绘制方法

基于小波和Shear-Warp算法，提出一种快速多分辨率体绘制方法（Fast Multi—resolution Volume Rendering Method，FMVRM）。本算法首先基于小波对体数据进行压缩；接着，结合所选的分辨率，利用不透明度传递函数（Opacity transfer function，OTF）引导数据的解压；最后，基于Shear—Warp算法，利用数据结构基于子数据块的队长编码（Block—based run length encoded，BRLE）和预合成体绘制技术，实现快速而高质量的体绘制。实验证明该方法不仅效率高，而且显示效果好。     

Exploring variables related to medical surrogate decision-making accuracy during the COVID-19 pandemic

ObjectiveSurrogate medical decision making is common in the United States healthcare system. Variables that may influence surrogate decision making have been proposed. Little work has examined relations between these variables and outcomes of surrogate decision making. This study investigated whether surrogates’ characteristics, including their knowledge of treatment options, and interpersonal factors predicted surrogates’ accuracy and intervention selections. Specifically, predictor variables included: trust in the medical profession, trait-level anxiety, depression, anxiety about COVID-19, religiosity, perceived emotional support, understanding of treatment options, empathy, willingness to accept responsibility for medical decisions, reluctance to burden others, and perceived similarity between oneself and the patient.Methods154 pairs of patients and their surrogates completed an online survey. Patients indicated preferred treatments in hypothetical decision scenarios. Surrogates indicated the treatment that they thought the patient would prefer.ResultsWhen taken all together in a predictive model, the variables significantly predicted surrogates? accuracy, F (6) = 3.03, R² = .12, p = .008. Variables also predicted selection of intensive interventions, F (4) = 5.95, R² = .14, p = .00. Surrogates reporting greater anxiety about COVID-19 selected more intensive interventions.ConclusionsConsistent with prior research, this study found that surrogates’ characteristics influence the interventions they choose, with anxiety about COVID-19 having considerable bearing on their chosen interventions.Practice implicationsThese findings can inform development of decision-making interventions to improve surrogates’ accuracy. Providers may attend to variables highlighted by this study to support surrogates, particularly within the stressful context of COVID-19 and possible future pandemics.     

Effectiveness of a short course in clinical communication skills for hospital doctors: results of a crossover randomized controlled trial (ISRCTN22153332)

Objective

Assistance for patients faced with medical decisions has largely focussed on the clarification of information and personal values. Our aim is to draw on the decision research describing the role of emotion in combination with health behaviour models to provide a framework for conceptualizing patient decisions.

Methods

A review of the psychological and medical decision making literature concerned with the role of emotion/affect in decision making and health behaviours.

Results

Emotion plays an influential role in decision making. Both current and anticipated emotions play a motivational role in choice. Amalgamating these findings with that of Leventhal's (1970) SRM provide a framework for thinking about the influence of emotion on a patient medical decision.

Conclusion

Our framework suggests that a patient must cope with four sets of elements. The first two relate to the need to manage the cognitive and emotional aspects of the health threat. The second set relate to the management of the cognitive and emotional elements of the decision, itself.

Practice implications

The framework provides a way for practitioners and researchers to frame thinking about a patient medical decision in order to assist the patient in clarifying decisional priorities.     

情绪调节困难量表在中国人群中的初步测试

目的 引进情绪调节困难量表,考察其在中国人群中的信度和效度.方法 采用情绪调节困难量表对1017名大学生被试进行了测查.结果 情绪调节困难量表总量表的重测信度为0.86,各分量表在0.59～0.86之间;总量表的内部一致性信度为0.89,各分量表在0.79～0.88之间.探索性因素分析的结果显示该量表为6因子结构,所有的项目在对应维度上的载荷值均大于0.4.验证性因素分析的结果显示6因子测量模型与实际数据拟合较好.结论 情绪调节困难量表的信度和效度基本达到了心理测量学的要求,但仍需要进一步改进.     

龚氏非文字智力测验中老年常模的初步编制

目的 :建立龚氏非文字智力测验 (GNIT)中老年人群的初步常模 ,检验它的测量学特征。方法 :在华东、中南和西南地区采样 ,共收集 4 2 7例样本 ,按照 4 5岁以上每 10岁一组 ,75岁以上共一组 ,共分 4组。结果 :常模包括分测验的粗、量表分、总标准分和百分位数。信度和效度均达到了测量学要求 ,量表结构模型比较理想。结论 :GNIT可以用中老年人群     

Hypoplastic left heart syndrome: knowledge discovery with a data mining approach

Hypoplastic left heart syndrome (HLHS) affects infants and is uniformly fatal without surgical palliation. Post-surgery mortality rates are highly variable and dependent on postoperative management. A data acquisition system was developed for collection of 73 physiologic, laboratory, and nurse-assessed parameters. The acquisition system was designed for the collection on numerous patients. Data records were created at 30s intervals. An expert-validated wellness score was computed for each data record. To efficiently analyze the data, a new metric for assessment of data utility, the combined classification quality measure, was developed. This measure assesses the impact of a feature on classification accuracy without performing computationally expensive cross-validation. The proposed measure can be also used to derive new features that enhance classification accuracy. The knowledge discovery approach allows for instantaneous prediction of interventions for the patient in an intensive care unit. The discovered knowledge can improve care of complex to manage infants by the development of an intelligent bedside advisory system.     

创造性4C认知量表(PC4CS)中文版的信、效度检验

目的:对创造性4C认知量表(PC4CS)中文版进行信、效度检验,探讨创造性4C理论在中国本土文化中的适用性。方法:从在线大学生QQ群中招募全国各地3360名在校大学生为被试,填写PC4CS中文版初测量表,分析其信效度。结果:1各项目的区分度与鉴别性较好(t=14.01~34.77,r=0.31~0.55;P均0.001);2经探索性因子分析,得到与原量表一致的创造性4C结构,累积方差解释率为55.22%;3总量表Cronbachα系数为0.85,重测信度为0.88,各分量表的α系数在0.72~0.82之间,重测信度在0.81~0.90之间;与Lawdsei认知创造力量表和Rudowicz—Hui创造力概念调查量表的关联效度分别为0.67、0.77;各分量表与总分以及各分量表之间的相关分别在0.53~0.74、0.10~0.60之间,结构效度良好。结论:PC4CS中文版具有良好的心理测量学指标,适用于在中国文化背景下大学生的创造性4C认知测量。