非斜视性双眼视异常学龄儿童生活质量量表研制

目的 初步研制非斜视性双眼视异常学龄儿童的生活质量量表，并评价其效度、信度和反应度。方法 调查研究。根据量表设计原则，经统计学评价，综合眼视光学和公共卫生学专家意见，设计非斜视性双眼视异常学龄儿童生活质量量表（加注拼音）。非斜视性双眼视异常判断标准：眼部不适、酸胀、视物模糊、视觉疲劳、复像或文字跳行重叠等症状明显，根据Morgan正常值，Sheard、Percival准则，综合分析是否为非斜视性双眼视异常并进行疗效评价。调查非斜视性双眼视异常小学生116例，首次调查2周后接受再次调查，其中经治疗训练有效的103例于停止治疗后第3个月随诊时接受第3次调查；选择双眼视功能正常小学生100例作为对照。应用变异系数、相关系数、因子分析、逐步回归分析、逐步判别分析、克朗巴赫系数、重测信度和分半信度来筛选量表的有效条目，评价量表的效度、信度和反应度。结果 该量表20个条目，包括双眼视功能、生活自理能力、活动交往以及精神心理等4个分项，具有良好的结构效度（经因子分析提取的4个公因子与本量表的4个分项一致，累计方差贡献率53.15%，各条目在其所属公因子上的因子载荷值均大于0.50）、内容效度（每个条目得分与所属分项得分的相关系数r均大于0.55；4个分项与总得分的相关系数r分别为0.87、0.48、0.49、0.54）和区分效度双眼视功能正常与非斜视性双眼视异常小学生得分差异有统计学意义（t=1.97,P<0.01）及异常者经治疗训练前后得分差异有统计学意义（t=1.97,P<0.01）]；重测信度r为0.98（P<0.01），克朗巴赫α系数均达到0.70以上，分半信度Rh为0.78（P<0.01）；效应尺度统计量（ES）为0.53。结论 该量表符合生活质量量表效度、信度、反应度和容易分析的技术要求，可试用于临床研究。

Pilot study on a quality-of-life scale for school-age children with functional abnormalities in binocular vision

Objective To develop and evaluate a quality-of-life scale (QOL) for school-age children with functional abnormalities in binocular vision,and to evaluate its validity,reliability and responsiveness.Methods This was an investigation study.We designed a scale to evaluate the quality of life of school-age children with functional abnormalities in binocular vision,based on the design principle of the QOL,by statistical analysis,and by a comprehensive analysis of the opinions of experts in the binocular vision and public health fields.One hundred sixteen school-age children with functional abnormalities in binocular vision and 100 with normal vision were evaluated with the scale.Filter items and evaluation of validity,reliability and responsiveness were analyzed with a coefficient of variation,correlation coefficient,factor analysis,stepwise regression analysis,stepwise discriminatory analysis,Krone Bach's alpha coefficient,test-retest reliability and split half reliability.Results The 20-item scale covered four domains of QOL:binocular vision function,self-care ability,communication ability and psychology.The scale was rated for:Good format validity:Four common factors extracted by factor analysis were consistent with the four domains of the scale.Cumulative contribution rate:The cumulative contribution rate was 53.15％.Factor loading:Each item was above 0.50.Content validity:The correlation coefficient of the score for each item and its domain were more than 0.55.The correlation coefficient for the score of the four domains and the total score were 0.87,0.48,0.49,0.54,respectively.Discriminant validity:The score for children with functional abnormalities in binocular vision differed significantly from the normal group (t=1.97,P＜0.01).The score after treatment was significantly different from before treatment (t=1.97,P＜0.01).Test-retest reliability:Test retest reliability was 0.98 (P＜0.01).Krone Bach's alpha coefficient:The coefficient was above 0.70.Split-half reliability:The split-half reliability was 0.78 (P＜0.01).The effect size statistics:The result of the statistics was 0.53.Conclusion The scale has a satisfactory validity,reliability and responsiveness.It is suggested that the scale can be used in clinical trials.