世界卫生组织生活质量-100量表在脊髓损伤人群生活质量评价中的信度和效度

目的：评价世界卫生组织生活质量-100(WHOQOL-100)量表在中国脊髓损伤人群中应用的信度、效度。方法：对1989—01／2002—12在中国康复研究中心进行过康复的386例脊髓损伤患者进行信访方式的问卷调查。采用内在一致性信度Cronbach’s α系数和劈半信度系数分析量表的信度，用因子分析来评价量表的结构效度。结果：回收有效问卷209份。Cronbach’s α系数除生理领域外，在量表的6个领域均高于0．75，而劈半信度系数为0．8360。因子分析显示提取的4个公因子，可解释总方差的64．65％。脊髓损伤者与一般人群在量表的所有领域和22个方面的得分差异有显著性意义。结论：使用WHOQOL-100量表评价脊髓损伤人群的生活质量是有效而可靠的。     

中文版创伤性颅脑损伤患者生活质量量表的信度及效度研究

目的研究中文版创伤性颅脑损伤患者生活质量评定量表（QOLIBRI）的信度和效度。 方法对符合纳入标准的93例创伤性颅脑损伤患者应用中文版QOLIBRI进行评价,共49例患者资料数据搜集完整,进行统计学分析。通过分析量表内各条目间相关性、量表重测信度及内部同质性,考察其信度;通过检验变量间偏相关性KMO（Kaiser Meyer Olkin）检验、巴特利特球形检验（Bartlett′s test of sphericity）及因子分析对所得结果进行结构效度分析,与情绪量表（HADS）、健康状况简表（SF 36）、扩展的Glasgow预后量表（GOSE）相关性分析,评价其校标关联效度。 结果信度分析：量表内部多数条目之间显著相关,相关系数为0.45～0.76（P<0.001）;重测信度稳定,重测相关系数为0.906～0.987（P<0.001）;具有较高的内部一致性,内部一致性系数Cronbach′s α为0.498～0.921（P<0.001）。效度分析：量表结构效度理想,KMO=0.813,Bartlett球形假设检验2=1397.12,P<0.001,主成分分析法提取4个公因子,累计贡献率68.4%;量表多数条目与HADS高度相关,与GOSE中等度相关,各条目与SF 36均显著相关。 结论中文版QOLIBRI具有较高的信度和效度,且内容全面,可操作性强。     

中华生存质量量表的信度和效度

目的：考评中华生存质量量表的信度和效度，使其能够在临床和科研研究中应用。 方法：选择2003-01／06广州中医药大学第一附属医院和宁夏医学院附属医院的193例慢性疾病患者和广东广州和宁夏银川两地的社区人群（80例健康者），在调查过程中，除了使用中华生存质量量表外。同时也让调查对象填写世界卫生组织生存质量测定量表中文版和健康状况调查问卷中文版。所有量表都由调查对象自己填写完成。计算该量表的内部一致性信度，重测信度，结构效度，内容效度、效标效度和区分效度等。其中效标效度以世界卫生组织生存质量测定量表中文版和健康状况调查问卷中文版作为效标。 结果：273份问卷均进入结果分析。量表的所有方面和领域的克朗巴赫α系数都大于0．7；方面的重测相关系数0．67～0．84，领域0．83～0．90；拟合优度指数除领域情（0．872）和方面气候适应（0．820）之外，其他均大于0．9；与世界卫生组织生存质量测定量表中文版和健康状况调查问卷中文版相比，各领域之间存在很好相关性。 结论：中华生存质量量表是一份较好的用于测定生存质量的量表，具有较好的信度和效度，可以应用于临床和科研研究。     

脊髓损伤护理相关ICF组合的信度与效度研究

目的:检验《脊髓损伤护理相关ICF组合》的信度和效度。方法:2013年12月~2014年3月,4个研究中心的140例脊髓损伤患者参与研究,采用《脊髓损伤护理相关ICF组合》和《脊髓独立测量量表》第3版(SCIMⅢ)评定患者,以检验《脊髓损伤护理相关ICF组合》的内在一致性信度、评定者间信度、重测信度和校标关联效度。结果:《脊髓损伤护理相关ICF组合》的身体功能、身体结构、活动和参与以及背景性因素这四个成份的Cronbach'sα系数分别为0.85、0.54、0.97和0.85;两个评定者之间平均kappa系数为0.51;重测信度检验显示两次评定之间平均kappa系数为0.78;身体功能、活动和参与成份与SCIMⅢ的各分量表和总分呈中度至高度负相关(r=-0.528~-0.896,P0.01),身体结构成份和背景性因素成份与其呈低度负相关(r=-0.204~-0.396,P0.05)。结论:《脊髓损伤护理相关ICF组合》作为脊髓损伤患者的临床护理评估工具是稳定和可靠的。     

世界卫生组织残疾人照顾质量量表中文版的信度和效度

目的:评价世界卫生组织残疾人照顾质量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人照顾质量量表.通过多阶段分层整群随机抽样的方法,从广州市抽取1037例残疾人(一般残疾者814例,智力残疾者223例),对其进行问卷调查.对其中109例一般残疾人间隔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,通过前后两次测量各领域得分的组内相关系数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:共收回问卷1000份(一般残疾者807份,智力残疾者193份),量表回收率为97.94％(一般残疾版本99.2％,智力残疾版本86.4％),条目缺失率低于1％;量表各个领域的克朗巴赫α系数为0.720-0.860;重复测量前后得分的组内相关系数为0.639-0.837;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.结论:世界卫生组织残疾人照顾质量量表中文版具有较好的可接受性、信度和效度,可用于中国残疾人的照顾质量的研究.     

中文版成人斜视患者生活质量量表的信度和效度

目的探讨中文版成人斜视患者生活质量量表(adult strabismus questionnaire,AS-20)的信度和效度。方法对英文版AS-20通过系统地前译-回译形成中文版AS-20,并对117例成人斜视患者进行测定,用折半信度、重测信度、Cronbachα系数评定条目间的内部一致性信度;用各条目分与总分之间的相关性检验其理论结构,用主成分分析和正交最大旋转法提取特征根大于1的因子,测定结构效度。结果中文版AS-20量表共20个条目,总量表的Cronbachα系数为0.912,重测信度为0.837～1.000,折半信度为0.866。各条目得分和量表总分均相关(r=0.416～0.847,P<0.01),因子分析提取了3个特征根大于1的因子,各条目载荷的范围是0.455～0.773,3个因子累积解释了57.26%的方差。结论 AS-20中文版本具有良好的信度和效度,适合中国成人斜视患者生活质量的测量。     

中文版脑卒中后失语症生活质量量表的信度和效度研究

目的通过对脑卒中失语症生活质量量表（SAQOL-39g）的编译和心理测量学考评,建立适合中国脑卒中后失语症患者使用的生活质量专表。 方法参考国内外量表的编译程序,将英文版脑卒中失语症生活质量量表（SAQOL-39g）编译为中文。使用中文版SAQOL-39g量表的自评和代评量表对脑卒中失语症患者86例及其陪护（代评者）86例进行问卷调查。考察量表的可行性、信度、效度及自评代评量表间的一致性。 结果中文版量表的回收率为100％,自评量表和代评量表的平均完成时间分别为（21.4±4.37）min和（13.25±5.6）min。自评和代评量表的总体和各维度内在信度指标Cronbach′s alpha系数的范围分别为0.879～0.950和0.863～0.943;自评和代评量表的总体和各维度重测信度相关系数范围分别为0.804～0.974和0.861～0.987。量表的结构效度检验使用因子分析共提取出3个公因子,累积贡献率59.7%。自评和代评量表之间的一致性好（P>0.05）。 结论中文版SAQOL-39g量表具有良好的可行性、信度、效度,自评和代评量表间的一致性好,可有效地对脑卒中后失语症患者的生活质量进行评估。     

脊髓损伤清洁间歇导尿患者自我管理量表的编制及信度和效度检验

摘要 目的：编制脊髓损伤清洁间歇导尿患者自我管理量表并检验其信度和效度。 方法：第一阶段：通过文献研究、半结构式访谈和Delphi法,初步拟定脊髓损伤清洁间歇导尿患者自我管理量表,并招募10例患者进行预调查。第二阶段：选取266例患者进行问卷调查,并进行信效度检验。 结果：最终形成的量表包括4个维度、37个条目。总量表的内容效度指数为0.939,探索性因子分析提取出4个公因子,4个维度的方差贡献率分别为60.887%、61.291%、64.181%、66.764%。总量表Cronbach α系数为0.969,各维度Cronbach α系数为0.755—0.937,总量表的折半信度为0.912,各维度2周后重测信度为0.733—0.933。 结论：编制的脊髓损伤清洁间歇导尿患者自我管理量表具有较好的信效度,可用于评价脊髓损伤清洁间歇导尿患者的自我管理水平。     

动态脊柱支撑机器人评测脊髓损伤患者坐位躯干控制的信度与效度研究

摘要目的：探究动态脊柱支撑机器人评测脊髓损伤患者坐位躯干控制功能的重测信度和效标效度。方法：2022年10—12月,共招募20例不能步行的脊髓损伤患者。所有受试者穿戴动态脊柱支撑机器人完成坐位机器人躯干控制测试,包括静态控制测试和动态控制测试。评测指标为静态控制测试中机器人平台给躯干左右、上下、侧弯、屈伸方向施加的支撑力矩回归斜率即Kx、Ky、Kθ、Kα,以及支撑力矩平均值即Fx、Fy、Mθ、Mα;动态控制测试中躯干的主动前屈、后伸、左侧屈和右侧屈活动角度（ROM）。同时完成躯干控制测试量表（TCT）评估作为效标。间隔1周后,脊髓损伤患者进行第2次机器人躯干控制测试,计算两次测试间的组内相关系数（ICC值）。结果：共20例患者完成首次机器人测试和TCT评估,13例患者完成两次机器人测试。静态控制测试中4项评测参数的ICC值为0.418—0.742,动态控制测试中所有参数的ICC值为0.633—0.848,均呈中等及以上的重测信度。静态控制测试中Ky、Mθ和Mα（|r|=0.467—0.561,P<0.05）与TCT评估结果具有低到中度相关性;动态控制测试中除右侧屈ROM外所有指标（r=0.559—0.758,P<0.05）均与TCT具有中度到高度的相关性。结论：动态脊柱支撑机器人在脊髓损伤患者坐位躯干控制的评测中具有可接受的重测信度和效标效度。     

中文版脑卒中后失语症生活质量量表的信度和效度研究

目的通过编译及心理测量学考评脑卒中失语症生活质量量表,建立脑卒中失语症适合的生活质量专用表。方法应用中文版脑卒中失语症生活质量量表(SAQOL-39g)以问卷形式对2017年1月至2019年1月我院收治的88例脑卒中失语患者及其88名陪护(代评者)进行调查,全面考察该量表信度、效度、可行性及及自评代评量表间一致性。结果量表回收率为100%,其中自评量表和代评量表平均完成时间为(21.61±4.38)min和(13.26±5.70)min。中文版SAQOL-39g Cronbach’s alpha系数内自评量表和代评量表的总体和各维度内在信度范围分别为0.881~0.946和0.884~0.941;重测信度相关系数范围分别为0.803~0.973和0.862~0.986。使用量表结构效度检验因子分析显示提取3个公因子,贡献率为59.7%。中文版SAQOL-39g中自评量表和代评量表之间具有较高一致性(P>0.05)。结论应用中文版SAQOL-39g具有较高的信度、效度及可行性,自评量表和代评量表间具有较好的一致性,可有效评估脑卒中失语症患者的生活质量。     

ICF检查表应用于脊髓损伤患者信、效度检验研究

目的探讨《国际功能、残疾和健康分类》(ICF)检查表中文版应用于脊髓损伤临床评定的信度与效度。方法运用ICF检查表、ADL和ASIA表对 5 0例脊髓损伤患者进行测试 ,采取患者自我报告、临床记录、医学检查等方式。结果与结论《国际功能、残疾和健康分类》检查表有较高的重测信度与内容和结构效度 ,可用于脊髓损伤临床评定。     

A validity study of the WHOQOL-BREF assessment in persons with traumatic spinal cord injury

OBJECTIVE: To examine the distribution of the scores, internal consistency, structure, and discriminant validity of the abbreviated version of the World Health Organization Quality of Life (WHOQOL-BREF) assessment in persons with traumatic spinal cord injury (SCI). DESIGN: Validation study using multitrait analysis and known-groups methods. SETTING: Community and hospital. PARTICIPANTS: Persons with SCI (N=111) and non-SCI respondents (N=169). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: The WHOQOL-BREF assessment. RESULTS: The frequency distribution of the 4 domains of the WHOQOL-BREF assessment was nearly symmetric and showed no floor or ceiling effects. All domains showed good internal consistency (Cronbach alpha range, .74-.78), with the exception of the social relationships domain (alpha=.54). The 4-domain structure of the WHOQOL-BREF assessment was confirmed using multitrait analysis. The discriminant validity of the WHOQOL-BREF assessment in persons with SCI was satisfactory. CONCLUSIONS: The WHOQOL-BREF assessment is suitable for measuring QOL as perceived by a person with SCI.     

Reliability and validity of World Health Organization Quality of Life-100 in homeless substance-dependent veteran population

The number of homeless individuals and specifically homeless veterans is increasing. Accurate assessment of quality of life is an important need in working with this population because of the myriad problems encountered. However, the reliability and validity of quality-of-life instruments have not been assessed in this population. This study evaluated the psychometric properties of the U.S. version of the World Health Organization Quality of Life-100 in a homeless veteran population. Results found adequate internal consistency for all domain and most facet scores, while test-retest stability varied for the facet scores. We confirmed validity by using subsamples with physical, emotional, and social problems and by comparing scores from populations that returned to the community with employment and housing. Limitations and directions for future study are discussed.     

Reliability and validity of a self-report FIM (FIM-SR) in persons with amputation or spinal cord injury and chronic pain

OBJECTIVE: To evaluate the reliability and validity of a self-report FIM (FIM-SR) in two samples of adults with disabilities. DESIGN: Participants in a clinical trial of amitriptyline for pain (n = 84 with spinal cord injury [SCI], n = 38 with amputation) provided responses to the study measures via telephone interview. Reliability was estimated using Cronbach's alpha and test-retest correlation coefficients, and validity was examined by comparing FIM-SR scores with the Craig Handicap Assessment and Reporting Technique (CHART) by comparing the CHART scores between the participants with SCI and amputation, and by comparing CHART scores between subjects with different levels of SCI. RESULTS: In the SCI sample, the FIM-SR demonstrated adequate reliability, and correlational analyses supported the validity of the FIM-SR motor scales. In addition, the FIM-SR motor scales discriminated subjects with different diagnoses (SCI vs. amputation) and injury levels (paraplegia vs. tetraplegia). The psychometric properties of the entire FIM-SR in the amputation sample and of the FIM-SR cognitive scales in the SCI sample were difficult to determine due to a ceiling effect in which these scale scores were skewed toward the top end of the range. CONCLUSIONS: The FIM-SR motor scales and total FIM-SR score are reliable and valid measures of perceived functional independence in individuals with SCI. However, all of the FIM-SR scales in the amputation sample, and the FIM-SR cognitive scales in the SCI sample, seem to be less useful measures of functioning due to subjects reporting high levels of independence. The FIM-SR should be retested in amputation samples with more variable levels of functioning.     

The reliability and validity of pain interference measures in persons with spinal cord injury.

The current study compared the psychometric properties of 2 commonly used measures of pain-related interference, the Graded Chronic Pain (GCP) Disability scale and 3 modified versions of the Brief Pain Inventory (BPI) Interference scale. Participants were 127 persons with spinal cord injury (SCI) who reported pain on a survey. The results suggest that the GCP Disability scale and 3 versions of the BPI Interference scale are reliable and valid measures of pain-related interference in persons with SCI and pain. All 4 measures evidenced excellent internal consistency. The composite scores and individual items of the GCP Disability scale and each version of the BPI Interference scale were significantly related to average pain intensity during the past week and a global measure of psychological functioning. Finally, as pain intensity ratings increased (from mild to moderate to severe), so did the composite and item-level ratings of interference for each version of the BPI Interference scale and GCP Disability scale. Strengths and weaknesses of each measure for use with persons with disability and pain are discussed. PERSPECTIVE: The GCP Disability scale and 3 versions of the BPI Interference scale (modified for use in persons with disabilities) appear to be reliable and valid measures of pain-related interference in persons with SCI. Future research should examine their psychometric properties in other disability populations.     

Measuring fatigue in persons with spinal cord injury

Anton HA, Miller WC, Townson AF. Measuring fatigue in persons with spinal cord injury.

Objective

To evaluate the psychometric properties of the Fatigue Severity Scale (FSS) in persons with spinal cord injury (SCI).

Design

A 2-week methodologic study was conducted to assess the internal consistency, reliability, and construct validity of the FSS.

Setting

A tertiary spinal cord rehabilitation facility.

Participants

Forty-eight community-living subjects at least 1 year post-SCI with American Spinal Injury Association (ASIA) grade A or B SCI and no medical conditions causing fatigue. The sample was predominantly male (n=31 [65%]) with tetraplegia (n=26 [54%]) and ASIA grade A injuries (n=30 [63%]). The average duration since injury was 14.9 years.

Interventions

Not applicable.

Main Outcome Measures

The ASIA Impairment Scale, the FSS, a visual analog scale for fatigue (VAS-F), the vitality scale of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and the Center for Epidemiologic Studies Depression Scale (CES-D).

Results

Mean FSS score ± standard deviation at baseline was 4.4±1.4, with 54% (n=26) scoring greater than 4. The internal consistency of the FSS was excellent (Cronbach α=.89). Two-week test-retest reliability was adequate (intraclass correlation coefficient, .84; 95% confidence interval, .74-.90). The magnitude of the relationship was as hypothesized for the VAS-F (r=.67) and CES-D (r=.58) and lower than hypothesized for the vitality subscore (r=−.48) of the SF-36.

Conclusions

The FSS has acceptable reliability with regard to internal consistency, test-retest reliability, and validity in persons with motor complete SCI.     

Symptom burden in persons with spinal cord injury

OBJECTIVE: To determine (1) the frequency, severity, and reported course of 7 symptoms in persons with spinal cord injury (SCI) and (2) the association between these symptoms and patient functioning. DESIGN: Postal survey. SETTING: Community. INTERVENTION: A survey that included measures of the frequency, severity, and recalled course of pain, fatigue, numbness, weakness, shortness of breath, vision loss, and memory loss, as well as a measure of community integration and psychologic functioning was mailed to a sample of persons with SCI. One hundred forty-seven usable surveys were returned (response rate, 43% of surveys mailed). MAIN OUTCOME MEASURES: The frequency and average severity of each symptom was computed, and the frequencies of each type of reported course were noted. Analyses estimated the associations among the symptoms, and between symptom severity and measures of patient functioning. RESULTS: The most common symptoms were pain, weakness, fatigue, and numbness. All symptoms were reported to remain the same or to get worse more often than they were reported to improve once they began. Pain, weakness, fatigue, and memory loss were the symptoms most closely associated with patient functioning. CONCLUSIONS: Patients with SCI must deal with a number of secondary complications in addition to any disability caused by the injury itself. Of 7 symptoms studied, pain, weakness, and fatigue appeared to be most common and most closely linked to patient social and mental health functioning. Research is needed to identify the causal relationships between perceived symptoms and quality of life in patients with SCI and to identify effective treatments for those symptoms shown to impact patient functioning.     

Adapted manual wheelchair circuit: test-retest reliability and discriminative validity in persons with spinal cord injury

Cowan RE, Nash MS, de Groot S, van der Woude LH. Adapted manual wheelchair circuit: test-retest reliability and discriminative validity in persons with spinal cord injury.

Objective

To assess the test-retest reliability and discriminative validity of a 14-item manual wheelchair circuit adapted from previous research (AMWC).

Design

Two AMWC trials per subject completed within 15 days.

Setting

Two clinical research and 3 rehabilitation centers.

Participants

Convenience sample of individuals with spinal cord injury (N=50) from centers in the United States (n=38) and the Netherlands (n=12). Mean age ± SD was 46±13 years, and mean injury duration ± SD was 12±11 years. Fifteen had cervical injuries, and 42 were men.

Interventions

An existing 8-task manual wheelchair circuit was modified to remove the need for a wheelchair treadmill and expanded to 14 tasks to attenuate floor and ceiling effects: 5 original tasks—figure-of-8, .012-m doorstep crossing, .10-m platform, 15-m sprint, and making a level transfer; 3 modified tasks—3% and 6% ramp, and 3-minute overground wheeling; and 6 new tasks—.04-m doorstep crossing, propelling over artificial grass, opening/closing a door, 3% side slope, holding a wheelie for 10 seconds, and propelling in a wheelie.

Main Outcome Measures

Reliability of the primary outcomes, sum ability score (sum of all tasks; 0–14 [no.]) and sum performance time (figure-of-8 + sprint + grass; 0–360 [s]), was determined by intraclass correlation coefficients (ICCs) for the whole sample and paraplegia (PP) and tetraplegia (TP) subsets. Independent t tests compared PP and TP trial 1 sum ability score and sum performance time.

Results

Sum ability and sum performance time ICCs exceeded .90 for the full sample and the PP/TP subsets. Sum ability was higher for PP than TP (PP, 12.9±1.2; TP, 9.8±2.8; P<.00), and sum performance times were lower for PP than TP (20.0±4.0s vs 32.0±1.97s, P<.00).

Conclusions

AMWC primary outcomes, sum ability score and sum performance time, are reliable and discriminate between TP and PP.     

ICF康复量表应用于创伤性脊髓损伤恢复期患者的信效度研究

目的：检验ICF康复量表在创伤性脊髓损伤（TSCI）人群的信效度情况。方法：采用ICF康复量表、改良Barthel指数、Berg平衡能力、SDS抑郁量表等常用量表对45个TSCI恢复期患者进行综合评估。Cronbachα系数和Spearman相关系数分别检验ICF康复量表的内部一致性信度和与其他量表的校标关联效度。结果：采用ICF康复量表评估TSCI患者最主要障碍表现在：b640性功能、b280G痛觉、b455运动和耐受能力、b710关节活动能力、b620排尿功能，S610泌尿系统的结构、S430呼吸系统的结构，d660帮助别人、d450G步行、d470利用交通工具、d230进行日常事务、d540穿着、d850有报酬的就业，e115个人日常生活用的用品和技术、e580卫生的服务、体制和政策。ICF康复量表及4个子领域Cronbachα系数分别为0.870、0.560、0.368、0.896、0.717，如删除一些条目可提升整体的内部一致性。患者在身体功能（BF）与抑郁量表分数呈高度正相关（P＜0.05），活动与参与（AP）和改良Barthel指数呈高度负相关（P＜0.05）。环境因素（EF）与其他量表的相关性低(P＞0.05)。结论：ICF康复量表可用于评估TSCI恢复期患者的功能状况，具有可靠的内部一致性信度和较好的校标关联效度。