慢性病保健评估量表的汉化及条目评价

目的：汉化英文版的慢性病保健评估量表(assessment of chronic illness care，ACIC)，并在湖南省试用进行文化调试，以形成适合中国国情的慢性病保健评估量表。方法：根据WHO规定的量表翻译程序汉化英文版的ACIC，并进行文化调试。对湖南省365名基层医疗卫生服务机构从事慢性病管理工作的人员进行调查，随机抽取183份有效问卷，采用离散趋势法、G-P分析法、相关系数法、逐步回归分析法、Cronbach’s α法、因子分析法6种方法进行条目筛选，用以评价量表条目。结果：6种方法评价C-ACIC量表条目显示：1)敏感性好，离散趋势法中每个条目的标准差均大于2；G-P分析法中高低分两组进行t检验，差异有统计学意义(均P<0.001)；2)代表性好，相关系数法中各条目与量表总分、所属维度的总分的相关系数范围为0.588~0.916；3)内部一致性高，量表的总Cronbach’s α法为0.975，各维度的范围为0.854~0.936；4)独立性强，因子分析中各条目的因子载荷均大于0.40，因子载荷范围为0.487~0.798；5)重要性，逐步回归分析(α入=0.01，α出=0.05)中，34个条目均留在方程中。6种方法筛选条目结果保留了原英文版ACIC的7个维度34个条目。结论：中文版C-ACIC量表保留了原英文版的ACIC的34个条目，且条目具有较好的敏感性、代表性、内部一致性、独立性、重要性。

Localization of the assessment of chronic illness care and item evaluation

Objective: To translate the English version of the assessment of chronic illness care (ACIC) toChinese, to conduct a trial in Hunan province and to develop a Chinese version ACIC.Methods: According to the WHO rules, we translated the English version of the ACIC to Chineseand took the culture factor into account. Three hundred and ninety persons, who engaged in thework of chronic disease management in primary medical and health services in Hunan province,were enrolled for this study. One hundred and eighty three valid questionnaires were randomlyselected. Six methods including discrete tendency method, good-poor analysis, correlationanalysis, stepwise regression analysis, Cronbach’s alpha coefficient and factor analysis were used forevaluation the questionnaire items.Results: The items in Chinese version ACIC showed as follows: 1) good sensitivity. The standarddeviation of each item was more than 2 and the P value from the t test between the good and poor groupwas less than 0.001; 2) good representation. The correlation coefficients range of each item with thetotal score and each dimension score was 0.588-0.916; 3) high internal consistency. Cronbach’s alphacoefficient for the total scale was 0.975, and for each dimension range was 0.854-0.936; 4) independent.Factor loadings were greater than 0.40 entries, and factor loadings ranged from 0.487-0.798; 5)importance. Stepwise regression analysis (αin=0.01, αout=0.05) showed 34 items were kept in the equation.Conclusion: Items of Chinese version ACIC retains ACIC 7 dimensions of 34 items in the originalEnglish version, which are sensitivity and typical with the internal consistency, independence andimportance.