摘要
目的:评价中文版简明健康状况调查表(SF-36)用于调查中国脑卒中患者的生存质量时的信度、效度和可应用性。方法:选择2000-06/2001-03在广州中医药大学两所附属医院诊治的,意识清醒,能够清楚地表达自己的意见的急性期、恢复期和后遗症期的脑卒中患者197例,由经培训的访谈员进行调查,内容包括简明健康状况调查表(共36条,包括躯体活动功能、躯体功能对角色功能的影响、疼痛、健康总体自评、活力、社会功能、情绪对角色功能的影响和心理健康等8个维度)、生存质量指数、日常生活活动能力(Barthel指数)、神经功能缺损计分、总的生活能力状态及部分社会人口经济学特征等。采用量表的内部一致率Cronbachsα系数和分半信度评价量表的信度;结构效度用因子分析法进行;标准效度用相关分析;区分效度用方差分析法进行。结果:①信度:简明健康状况调查表总体来讲具有较好的信度,8个分量表的Cronbachsα系数为0.56～0.95。②效度:生理功能、精神健康维度的标准效度较好;总体健康维度的标准效度尚可。简明健康状况调查表区分不同疾病严重程度、不同生活依赖程度和不同生存质量的脑卒中患者时区分效度较好。③存在问题与缺点:躯体疼痛和活力两个分量表的α系数较低,分别为0.56和0.69;精神健康和活力的结构效度分析与原设想的量表结构不吻合;生理职能(1.0版)出现了严重的“地板效应”(72.3%)。结论:简明健康状况调查表总体上有较好的信度和效度;但由于文化背景的不同和疾病、人群的特殊性,部分维度的分量表不大适合,应引起足够的重视。建议应用于类似人群时应进行修改、补充部分脑卒中特异性问题、或结合其他专用量表。
AIM：To assess the reliability, validity and applicability of the Chinese version of SF-36 in evaluating the quality of life （QOL） of Chinese stroke patients. METHODS： Between June 2000 and March 2001, 197 out-patients and in-patients with strokes at exacerbation, at remission and at swquela period,who were conscious and able to clearly express their own opinions, were selected from the two affiliated hospitals of Guangzhou University of Traditional Chinese Medicine. The patients were investigated by trainedin-terviewers with the 36-item short form （SF-36）, neruologic deficit score （NDS）, their QOL index, activities of daily life （ADL, assessed with Barthel index） general QOL and some demographic＇ features were also detected. The SF-36 involved 36 items, including 8 dimensions of the influence of physical motor function and physical function on role function, body pain, self-evaluation of general health, vitality, social function, influence of emotion on role function, and mental health, The reliability was assessed with Cronbach＇s α coefficient and split half reliability test,the structural validity with the component factor analysis,criteria validity with correlation analysis,and discriminant validity by multivariate analysis of variance （MANOVA）. RESULTS： ① Reliability： Generally speaking, SF-36 had good reliability, Cronbach＇s α coefficient of eight subscales ranged 0.56-0.95. ② Validity： The criteria validities of physiological function and mental health were better, and that of general health was moderate. Three different methods showed that SF-36 had good discriminant validity in discriminating stroke patients with different severity, different independence, or different QOL. ③Disadvantages and shortcomings：The Cronbach＇s α coefficients for body pain and vitality subscales were lower （α=0.56,0.69 respectively）; Mental health and vitality construct analysis did not accord with the original design. Physiological function （version 1.0） appeared serious “floor effect” （72.3%）. CONCLUSION： SF-36 has good reliability and validity as a whole, but the shortages of some subscale needs more attention for different culture, disease and population. It is suggested that it should be modified, amended with some stroke specific items,or combined with other disease specific Scales.
出处
《中国临床康复》
CSCD
北大核心
2005年第33期12-15,共4页
Chinese Journal of Clinical Rehabilitation
基金
四川大学华西公共卫生学院社会医学硕士及国际临床流行病学网(InternationEaplidermiologyNetworkINCLEN)PHASEⅡ培训计划科学硕士课题~~
作者简介
郭新峰☆，男，1973年生，河南右薪乡市人，汉族，2001年广州中医药大学毕业，博士，副研究员，主要从事中医药领域的临床流行病学／DME、循证医学的研究。drguoxf@sohu．com.
