基于寻常性银屑病患者报告结局评价量表的研制及其信度和效度评价

目的研制基于寻常性银屑病患者报告以主症为疗效评价指标的临床结局评价量表(寻常性银屑病主症量表),并评价其信度和效度。方法通过文献研究、专家共识、小组反复讨论制定寻常性银屑病主症量表初版,通过进行现场问卷调查进行信度和效度分析。信度分析主要采用克朗巴赫α系数测量内部一致性信度,并采用探索性因子分析方法考评量表的效度,采用PASI分级为效标评价量表的效标关联度。结果发放213份量表,回收率为99.5%,完成率为98.6%。重测信度Spearman平均相关系数0.88(P0.01),内在一致性分析克朗巴赫α系数为0.86(13个条目)、0.87(14个条目);结构效度分析,13个条目的因子分析共提取了2个公因子,累计因子贡献率为51.28%(KMO=0.87,x±s=914.26,P0.001);14个条目的因子分析共提取了4个公因子,累计因子贡献率为70.42%,(KMO=0.75,x±s=334.06,P0.001);效标关联度分析,13个条目的量表与PASI分为轻中重度分级(PAIS7","7≤PASI≤12","PASI12")评分之间的Spearman相关系数为r=0.26,P0.05。结论构建的寻常性银屑病主症量表有14个条目,且具有良好的信度和效度,这可能成为中医药治疗寻常性银屑病诊疗评价的补充工具。     

Scalpdex中文版在头皮银屑病患者应用中的信度和效度评价

目的测评Scalpdex中文版应用在头皮银屑病患者中的信度和效度。方法调查了272例头皮银屑病的门诊患者和住院患者。使用克朗巴赫系数、分半信度和重测信度检验Scalpdex中文版的信度,使用内容效度、聚合效度、判别效度、区分效度和结构效度考察其效度。结果 Scalpdex中文版的克朗巴赫系数范围是0.82～0.91,分半信度为0.81～0.88,重测信度为0.76～0.90。除有2个条目与所属维度相关系数小于0.4外,其余条目与所属维度的相关系数均大于0.4。Scalpdex中文版能区分患者自评不同病情程度和不同病程的生命质量。探索性因子分析共提取3个公因子,所得的因子累计贡献率均高于61.55%,因子结构与源量表预设时的结构能部分吻合。结论 Scalpdex中文版在头皮银屑病患者中具有良好的信度和效度,可用于中国文化背景下的头皮银屑病的生命质量评估及临床决策的研究。但本次研究也发现个别条目还需要进一步调适、修订和验证,使得相关概念呈现得更加清晰和完整。     

中国银屑病患者生活质量量表的编制与考评

目的:编制银屑病患者生活质量量表(psoriasis quality of life scale,PQOLS),并验证该量表信度和效度。方法:根据WHO对生活质量的定义提出理论框架,通过文献回顾和专家咨询的方式编制PQOLS测试版。然后采用初始量表测定银屑病患者的生活质量,根据结果对条目筛选,形成PQOLS的正式版。结果:通过文献回顾和专家咨询建立包含40个条目的备选条目池。通过条目筛选,最终形成了含22个条目的PQOLS,包括疾病、心理、生理、社会4个维度。对136例患者进行测试结果表明:量表各维度及整个量表的Cronbachα均0.8,Sperman-Brown系数均0.7;因子分析发现单因素能够代表量表的大多数因子;PQOLS与皮肤病生活质量指数(DLQI)的Pearson相关系数为0.821;PQOLS总分与银屑病皮损面积和严重程度指数(PASI)值的相关系数为0.506,生活质量与病情严重度呈显著负相关。结论:编制的PQOLS具有较好的信度、效度,适用于银屑病患者生活质量的测评。     

DLQI测量寻常型痤疮及白癜风患者生活质量的研究

目的比较寻常型痤疮患者与白癜风患者的生活质量。方法采用中文版皮肤病生活质量指标（delmatolo-gylifequalityindex,DLQI）对门诊寻常型痤疮患者与白癜风患者进行调查,并检测量表的信度和效度。结果寻常型痤疮患者DLQI得分为8．68,白癜风组得分为6．34．除条目1、条目3以及条目7,痤疮组得分高于白癜风组外,其余7个方面两组得分均无差别。DLQI量表测量痤疮与白癜风均具有较好的信度和效度,但条目1不能在白癜风患者间形成有效地区分度一结论寻常型痤疮患者的生活质量低于白癜风患者。DLQI量表用于测量白癜风患者的生活质量时应进行修订。     

中文版女性性功能量表在乳腺癌幸存者中应用的信效度评价

目的:评价中文版女性性功能量表在乳腺癌幸存者人群中的信效度。方法:采用中文版女性性功能量表调查2015年3月至2016年3月在上海市某2所三级甲等医院乳腺外科或门诊就诊的乳腺癌幸存者322例,最终纳入分析279例。采用相关分析和极端组检验法进行项目分析;采用Cronbach’sα评价量表内部一致性信度;采用因子分析评价结构效度。结果:中文版女性性功能量表各个条目与其对应维度总分的相关系数为0.728~0.997,维度之间的相关系数为0.514~0.925,各维度与总分的相关系数为0.767~0.873,P均小于0.01;极端组检验法结果显示两组之间的差异具有统计学意义;量表总体内部一致性信度Cronbach’sα系数为0.976,各维度的内部一致性信度Cronbach’sα系数为0.540~0.987;因子分析共提取3个因子,累计方差贡献率为67.669%。结论:中文版FSFI在乳腺癌人群中经检验信效度良好,可作为相关研究的测量工具评价乳腺癌幸存者的性生活状态。     

青少年女性性健康促进量表的构建与信效度研究

目的:依计划行为理论为基础,构建性健康促进量表(SHPS),并检验量表的信度与效度。方法:通过性健康促进量表、青少年性与生殖健康文献分析、深度访谈、以及专家咨询,形成SHPS预实验量表,对183名青少女进行问卷调查,对预实验量表进行条目分析、探索性因子分析归纳维度,形成正式量表。正式问卷调查,采分层集束比例抽样,以388名青少女[平均年龄为(18.15±0.39)岁]为对象,分析及建构量表的信效度。结果:SHPS通过探索性因子分析,由22个条目组成,包括性健康知识、性生理需求、避孕态度、艾滋病认知等4个公因子,累积方差贡献率为67.982%;总体内容效度指数为0.926;总量表的Cronbach’sα系数为0.904,重测信度为0.882;而验证性因子分析(χ2/df=2.562,P<0.001,GFI=0.962,RMSEA=0.048,AGFI=0.950,NFI=0.958,CFI=0.934),具有较好的适配度。结论:青少女性健康促进量表具有较好的信度与效度,为评价国内青少女性与生殖健康现状提供科学依据。     

公众应急准备现状评价量表在北京市小学生人群中的适用性研究

目的在北京市小学生人群中对《公众应急准备现状评价量表》的信度效度进行检验。方法采用多阶段随机整群抽样的方法,在朝阳区、海淀区、大兴区、延庆区选取高年级小学生,使用《公众应急准备现状评价量表》进行问卷调查,使用一致性检验、因子分析等方法对量表信度、效度进行检验。结果有效调查2376人,男生1259人(52.99%),女生1117人(47.01%);量表一致性Cronbach'sα系数为0.79,Spearman-Brown系数为0.53,Gutt?man系数为0.53,按年龄、性别特征分层后,均达到问卷统计学的稳定性要求,去除条目后Cronbach'sα系数均无明显变化;因子分析结果显示量表由4个因子构成,累计方差贡献率解释为58.62%。结论量表可以应用于高年级小学生,但部分条目表述需要进行调整。     

护士性健康照护素养量表的编制与信效度检验

目的:编制评价我国护士性健康照护素养量表,并检验其信度与效度。方法:以简单随机抽样对258名护士进行问卷调查,并采用探索性因子分析与验证性因素以简单随机抽样分析对量表进行检验。结果:性健康照护素养量表共17个条目,经探索性因子分析产生3个公因子(因子1为性健康照护知识;因子2为性健康照护态度;因子3为性健康照护效能),累计贡献率为55.334%。各条目内容效度指数(ICVI)为0.896~0.922,量表内容效度指数(S-CVI)为0.920;而验证性因子分析表明(χ~2=163.218,df=115,P0.001,GFI=0.948,AGFI=0.988,NFI=0.916,NNFI=0.925,CFI=0.941,RFI=0.903)。总量表的Cronbach’sα系数为0.862,重测信度为0.888。结论:护士性健康照护素养量表具有较好的信、效度,可做为评价护士性健康照护素养的现状。     

病耻感量表在男性不育症患者中的信效度检验

目的 检验病耻感量表在我国男性不育症患者中的信效度。方法 采用方便取样法,选取2021年12月15日至2022年2月15日在北京市某三甲医院生殖医学中心诊治的338例男性不育症患者作为研究对象。采用基本情况调查表、修订后的病耻感量表及生育生活质量量表进行研究调查。结果 本研究最终形成了包含4个公因子和22个条目的病耻感量表。修订后量表总的Cronbach′s α系数为0.974,折半信度为0.924。方差累计贡献率为78.9%,量表结构效度、聚敛效度、组合信度与区分效度经检验结果均较好,且与生育生活质量有较好的效标关联效度。结论 修订后的病耻感量表信效度良好,可用于我国男性不育症患者病耻感的评估。     

国人皮肤病患者生活质量调查问卷的制定

目的制定适合于国人皮肤病患者的生活质量调查问卷方法问卷的制定过程包括以下步骤:(1)通过与皮肤病患者沟通及查阅已有文献,初步构建条目池;(2)根据专家和患者的意见修改条目池;(3)使用修订的条目池对皮肤科门诊病人进行问卷调查,使用专家评分法、因子分析法、变异系数法、克伦巴赫α值法、条目-预期维度相关性分析法、条目-非预期维度相关性分析法对得到的结果进行分析,6项统计标准中如果有4条证明条目需要保留池,则予以保留;(4)去除表达不恰当的条目,进行信度和效度评价,最终确定量表。结果通过对50名患者进行调查并结合已有文献,制定出88项条目,经专家和患者的共同修订后,定位86条,经过因子分析、专家评分等统计分析后,最终确定了含有23条项目的陕西省皮肤病患者生活质量调查问卷。结论本量表适用于今后陕西省皮肤病患者的生活质量调查,并且具有良好的信度和效度,将在日后用于评估不同病种及进行病种间比较,不足之处在于病种的局限性和疾病的季节性。     

Measuring quality of life in psoriasis: the CALIPSO questionnaire

In dermatology, several instruments are available to measure health-related quality of life (HRQoL) of patients. They vary in content emphasis and in the extent to which their measurement properties have been investigated and reported. In this study, we summarized five dermatology- and psoriasis-specific HRQoL questionnaires into a new psoriasis-specific questionnaire, the Comprehensive Appraisal of Life Impact of PSOriasis (CALIPSO). The questionnaires were completed by 936 patients with a diagnosis of psoriasis. Rasch's unidimensional measurement model was used to verify the construct validity and the operational characteristics of each instrument separately. The items with the best performance according to the Rasch model were selected. The final 30 items constitute the CALIPSO. Responses are given on a 3-point scale: "never", "sometimes/quite frequently", "often/all the time". The properties of the CALIPSO now need to be verified through the analysis of new data from different populations of people with psoriasis. In future, clinicians may use it without having to decide amongst several competing scales, to evaluate HRQoL in patients with psoriasis.     

2例垂体萎缩患者性功能障碍治疗始末

目的:补充引起勃起功能障碍的病因之一:垂体萎缩,分析性腺功能不足导致激素水平低下与勃起功能障碍、性欲障碍的关系。方法:回顾2例因垂体萎缩导致勃起功能障碍患者的详细病史、体格检查、实验室检查、诊断分析和治疗经过。结果:病例一在给予雄激素补充治疗后,勃起功能和性欲反应良好;病例二给予抗焦虑药、PDE5抑制剂和雄激素补充治疗后,除了患者自觉晨勃硬度较前改善外,性欲和同房成功率均无改善。结论:雄激素对性欲的产生和性功能的维持十分重要,但又不是唯一的因素,还受心理因素的影响。     

The Japanese version of Skindex-16: a brief quality-of-life measure for patients with skin diseases

A practical quality-of-life measure applicable to patients with skin diseases is necessary. Recently developed dermatological quality-of-life measures must be translated and adapted for use in cultures other than the ones in which they were created. In this study, we translated and adapted culturally into Japanese a skin-disease-specific, brief quality-of-life measure, Skindex-16, and studied its reliability and validity. Forward-and back-translations of Skindex-16 were carried out. Six doubtful items as well as the term "skin condition" required a second forward- and back-translation to reach satisfactory agreement with the original instrument. Cross-cultural adaptation and cross-sectional questionnaire studies were then performed to evaluate the reliability and validity of the instrument. One hundred patients and 30 healthy adults responded to the Japanese version. The internal-consistency reliability of the final Japanese version of Skindex-16 was high (range of Cronbach's alpha for each scale, symptoms, emotions, and functioning, was 0.83-0.92). The Japanese version showed construct and content validity. As hypothesized, scores for dermatological patients were higher than those for healthy persons (mean global scores 36 +/- 23 vs 1 +/- 2, p < 0.001) and scores for patients with inflammatory diseases were higher than those for patients with isolated skin lesions (mean global scores 48 +/- 21 vs 22 +/- 17, p < 0.001), indicating a poorer quality of life. Most patients' responses to an open-ended question about their skin disease were similar to those of the American responders and were addressed according to the items. In conclusion, we have developed a semantically equivalent translation of Skindex-16 into Japanese. It is a reliable and valid measure of the effects of skin disease on the quality of life in Japanese patients.     

ECCA grading scale: an original validated acne scar grading scale for clinical practice in dermatology

INTRODUCTION: The ECCA grading scale (échelle d'évaluation clinique des cicatrices d'acné) is a tool designed to help dermatologists to assess the severity of acne scars and to standardize the discussions about the treatments of scars. METHODS: We developed an acne scar clinical grading scale called ECCA, which consists of 6 items designed to assess easily and quickly the severity of acne scars by a global score. The interobserver reliability of the ECCA grading was statistically validated. RESULTS: The statistical analysis showed the interinvestigator reliability of the ECCA grading scale among 7 dermatologists who used it on the same group of 10 acne patients. CONCLUSION: ECCA is a new tool which will now be available for dermatologists to use in their everyday practice and for clinical trials evaluating the efficacy of treatments on acne scars.     

Development and validation of a questionnaire measuring quality of life in primary caregivers of children with atopic dermatitis (QPCAD)

Background  Disease-specific health-related quality of life (HRQoL) instruments for primary caregivers of children with atopic dermatitis are useful in evaluating the efficacy of treatment in clinical practice and study. However, no such scale has been available in Japan.
Objectives  To develop and validate a self-administered instrument specifically designed to measure quality of life in primary caregivers of children with atopic dermatitis (QPCAD).
Methods  This study consisted of three successive phases: the item generation phase, pilot test phase and validation phase. In the item generation phase, questionnaire items were derived from 33 qualitative interviews with primary caregivers. In the pilot test phase, the face and content validity of the preliminary scale were assessed ( n  = 33). In the validation phase, the questionnaire was finalized and assessed in terms of statistical performance ( n  = 416).
Results  The QPCAD included 19 items in the following categories: 'exhaustion', 'worry about atopic dermatitis', 'family cooperation' and 'achievement'. The reliability of internal consistency was fair (Cronbach's alpha coefficients 0·66–0·87). The QPCAD subscales and total score were significantly correlated with psychological health, physical health, anxiety, depression and severity score, with mild to moderate correlation coefficients. Test–retest reliability and responsiveness to change in severity were also satisfactory.
Conclusions  The QPCAD is an appropriate tool for assessing HRQoL of primary caregivers of children with atopic dermatitis in clinical practice and clinical trials.     

Identification of metallic items that caused nickel dermatitis in Danish patients

Introduction: Nickel allergy is prevalent as assessed by epidemiological studies. Objectives: In an attempt to further identify and characterize sources that may result in nickel allergy and dermatitis, we analysed items identified by nickel‐allergic dermatitis patients as causative of nickel dermatitis by using the dimethylglyoxime (DMG) test. Materials and methods: Dermatitis patients with nickel allergy of current relevance were identified over a 2‐year period in a tertiary referral patch test centre. When possible, their work tools and personal items were examined with the DMG test. Results: Among 95 nickel‐allergic dermatitis patients, 70 (73.7%) had metallic items investigated for nickel release. A total of 151 items were investigated, and 66 (43.7%) gave positive DMG test reactions. Objects were nearly all purchased or acquired after the introduction of the EU Nickel Directive. Only one object had been inherited, and only two objects had been purchased outside of Denmark. Conclusions: DMG testing is valuable as a screening test for nickel release and should be used to identify relevant exposures in nickel‐allergic patients. Mainly consumer items, but also work tools used in an occupational setting, released nickel in dermatitis patients. This study confirmed ‘risk items' from previous studies, including mobile phones.     

The Spanish version of Skindex-29

BACKGROUND: Most currently available dermatologic quality-of-life measures were originally created in English, and must be translated and adapted for use in other cultures. Our purpose was to translate and adapt culturally into Spanish a skin-related quality-of-life measure, Skindex-29, and to begin preliminary assessments of its reliability and validity. METHODS: Transcultural adaptation and cross-sectional questionnaire studies were performed. One hundred and fourteen adult persons (patients and healthy people) responded to the Spanish version of Skindex-29. Evaluations of the semantic equivalence of back-translated items, reliability, construct validity, and content validity of the Spanish version were the main outcome measures. Comparison between Spanish and American responses was also performed. RESULTS: Six problematic items required a second translation and back-translation to achieve satisfactory agreement with the original instrument. The final Spanish version of Skindex-29 was internally reliable (range of Cronbach alpha for the scales, 0.70-0.87). The instrument demonstrated both construct and content validity. As hypothesized, scores for dermatologic patients were higher than those for healthy persons (mean global scores 21 vs. 5, P < 0.01) and scores for patients with inflammatory diseases were higher than those for persons with isolated skin lesions (mean global scores 32 vs. 11, P < 0.01), indicating a poorer quality of life. In addition, most patients' responses to an open-ended question about their skin disease were addressed by items in the instrument. Skindex scale scores of American and Spanish respondents were similar. CONCLUSIONS: We have developed a semantically equivalent translation of Skindex-29 into Spanish. Our preliminary evaluation of its measurement properties suggests that it is a reliable and valid measure of the effects of skin disease on the quality of life in Spanish patients.     

Psychological and psychosexual aspects of vulvar vestibulitis.

AIMS: To objectively assess the psychological and psychosexual morbidity of patients with vulvar vestibulitis. METHODS: 30 patients with variable degrees of vulvar vestibulitis were recruited from a vulval clinic. Each patient underwent a detailed history and clinical examination. Friedrich's criteria were used for the diagnosis of vulvar vestibulitis. Standardised questionnaires to assess psychological and psychosexual function were completed by the patient before review. These questionnaires were the STAI and a modified psychosexual questionnaire introduced by Campion. RESULTS: Patients experienced considerable psychological dysfunction compared with controls. All aspects of psychosexual dysfunction were affected. CONCLUSIONS: When managing patients, psychosexual and psychological issues must be considered in addition to other conventional types of therapy. Vulvar vestibulitis may be a risk factor for developing psychosexual complications including vaginismus, low libido, and orgasmic dysfunction. Consideration of these factors must be an integral part of the management of patients with all chronic vulval conditions.