SF-36量表应用于晚期血吸虫病患者的信度和效度分析

目的评价SF-36量表应用于晚期血吸虫病(晚血)患者的信度和效度,为血吸虫病防治工作者选择适宜的健康测量工具提供科学依据。方法在湖南省汉寿县及湖北省江陵县,以SF-36量表中文版作为生命质量测评工具对晚血患者进行入户调查,评价其应用于晚血患者的信度和效度。结果SF-36量表在晚血患者生命质量测评中具有良好的分半信度(分半信度系数为0.95)和内部一致性信度(8个维度Cronbachα系数范围为0.86～0.88);效度评价显示集合效度(集合效度试验成功率为97.14%)和区分效度(区分效度试验成功率为87.86%)良好,效标效度尚好(与EQ-5D+C量表患者VAS生命质量自评得分之间的相关系数为0.70),但结构效度欠佳(仅2个维度在因子负荷上与理论模型完全一致)。除生理职能和情感职能地板效应分别高达50.31%和48.16%外,其余维度地板效应和天花板效应均不显著。结论SF-36适用于晚血患者生命质量评价,但尚需根据实际情况对部分条目进行完善。

Reliability and validity of SF-36 in advanced schistosomiasis

Objective To evaluate the reliability and validity of SF-36 in patients with advanced schistosomiasis,so as to proride scientific basis for the selection of suitable tools for health measure.Methods A Chinese version of SF-36 scale was applied to evaluate the health of patients with advanced schistosomiasis by a household survey in Hanshou County of Hunan Province and Jiangling County of Hubei Province,then the reliability and validity of the scale were tested.Results Atotal of 326 patients were investigated in the two counties.The split-half reliability(with a split-half coefficient of 0.95) and the internal consistency (Cronbach'α coefficients of the eight dimensions ranged from 0.86 to 0.88)were satisfying;the convergent and discriminative validity were high with the test successful rates of 97.14%and 87.86%,respectively;the criterion validity was acceptable with a correlation coefficient between the total score of SF-36 and EQ-5D+C VAS score of 0.70.However,the construct validity seemed to be not so reasonable as only 2 dimensions out of 8 were completely in accordance with the theoretical model on factor loading.The percentages of floor effect and ceiling effect in most dimensions were not significant except RP and RE(with the percentages of floor effect of 50.31%and 48.16%,respectively).Conclusions SF-36 is appropriate to be used in patients with advanced schistosomiasis.but some items need to be improved according to the local settings of endemic areas.