国人白内障视功能相关生存质量简表的研制及其测量特性评价

目的 研制国人白内障视功能相关生存质量简表Catquest-9SF并评价其在中国白内障人群中的适用性、项目区分度及信、效度，为中国白内障人群的视功能相关生存质量评价提供科学、简便的工具，并初步分析白内障术前患者生存质量的影响因素。方法 横断面调查研究。对原Catquest-9SF量表进行翻译、回译和跨文化调试，选取在温州医科大学附属眼视光医院确诊的白内障住院患者150例行量表调查，其中50例患者由2名调查者先后进行调查。对数据进行内部一致性、评定者间信度、内容效度和结构效度等分析，评价量表的适用性、项目区分度及信、效度，并分析得分的相关因素。结果 国人白内障视功能相关生存质量简表Catquest-9SF简短易行，项目区分度好；总表的Cronbach′s α系数为0.90；评定者间信度的Bland-Altman 95%一致性界限为-2.1~2.0，Pearson相关性分析表明评定者间信度高度相关（r=0.988，P＜0.01）；量表水平内容效度指数为0.98；结构效度的探索性因子分析提取出1个公因子，解释方差百分比为55.89%，累积方差贡献率为55.89%。量表得分和视力（r=0.43，P＜0.01）及年龄（r=-0.22，P<0.01）的相关性显著，不同性别的患者得分差异有统计学意义（t=-2.30，P<0.05），不同文化程度和第一眼/第二眼手术的患者得分差异无统计学意义。结论 国人Catquest-9SF量表在中国南方地区适用性好，且具有良好的信、效度，是评价中国南方地区白内障人群视功能相关生存质量简单而有效的可行工具。

Development and assessment of a revised Chinese version of the Catquest 9SF questionnaire for a Chinese cataract population

Objective To develop a revised Chinese version of the Catquest-9SF questionnaire and assess its applicability， item discrimination， reliability and validity in a Chinese cataract population； to provide a comprehensive and easy instrument for measuring vision function-related quality of life in China； and to analyze the influence on quality of life for patients awaiting cataract surgery. Methods This was a cross-sectional investigation. Translation， back translation and cross-cultural adaptation were used to create a revised version of the Catquest-9SF questionnaire for a Chinese cataract population. One examiner interviewed 150 cataract patients waiting for surgery at the Eye Hospital of Wenzhou Medical University. A second examiner independently interviewed 50 patients from the same group. The revised Chinese version of the 9SF was tested for its applicability， item discrimination， reliability and validity through internal consistency， inter-scorer reliability， content validity and format validity. An analysis of related factors affecting the score was also conducted. Results The revised Chinese version of the Catquest-9SF demonstrated excellent applicability and item discrimination. The questionnaire showed good internal consistency with Cronbach′s α value of 0.90 and inter-scorer reliability with the Bland-Altman 95% limit of agreement value of -2.1~2.0. Pearson's correlation coefficient （0.988） also confirmed excellent inter-scorer reliability. The scale-level content validity index （S-CVI） value was 0.98. One common factor was extracted by exploratory factor analysis and explained 55.89% of the variance. The cumulative variance contribution rate also reached 55.89%. The scores showed significant correlation with visual acuity （r=0.43， P<0.01） and age （r=-0.22， P<0.01）. There were statistical differences between genders （t=-2.30， P<0.05）， but there were no differences in education level， or first eye or second eye surgery. Conclusion The revised Chinese version of the Catquest-9SF is a simple and effective instrument for evaluating visual function related to quality of life in South Chinese cataract patients. The questionnaire has good applicability， item discrimination， reliability and validity.