慢性病患者生命质量测定量表体系之冠心病量表的效度及反应度分析

Analysis on Validity and Responsiveness of Coronary Heart Disease Scale of the System of Quality of Life Instruments for Chronic Diseases

目的分析慢性病患者生命质量测定量表体系之冠心病量表(QLICD-CHD)的效度和反应度。方法用QLICD-CHD对133名冠心病患者在住院治疗前后进行测试,从而对量表的效度和反应度进行分析。效度从内容效度、结构效度、效标效度3个方面反映。其中量表的结构效度用条目和小方面及领域的相关情况、主成分因子分析情况反映。反应度通过比较治疗前后各领域及小方面患者生命质量的得分均数,计算各小方面及领域的得分变化的百分比和SMR值来考评。用到的统计学方法包括相关分析、主成分因子分析法、配对t检验等。结果量表各条目与所属小方面或领域的相关均大于该条目与其他小方面或领域的相关,且相关系数大多在0.70以上;量表可以测出患者治疗前后躯体功能、心理功能和特异模块领域的生命质量变化,其中体现症状和焦虑情绪的小方面最为显著。结论冠心病患者生命质量测定量表QLICD-CHD具有较好的效度、反应度和可行性,可以作为我国冠心病患者生命质量的测评工具。

Objective To Analyze validity and the responsiveness of the coronary heart disease scale of the system of quality of life instruments for chronic diseases（QLICD-CHD）.Methods Totally 133 cases of coronary heart disease inpatients were measured by QLICD-CHD before and after treatment.The validity of the instrument was evaluated by the content validity,construction validity and criterion validity.Of which the construction validity was analyzed with item-facet,item-domain correlation analysis and principle factor analysis;the responsiveness was evaluated by comparing the scores between the domains and facet before and after treatment,with the change percentage over treatment in each facet score and the standard mortality ratio（SMR）.The statistic methods used in this research included Pearson correlation,factor analysis and paired t test.Results Almost all of the correlation coefficients between each item and it＇s facet or domain were higher than the item with other facets or other domains,and most of those correlation coefficients were above 0.7.The scale could detect clinical change in physical,psychological and specific domains after treatment,especially in facets of symptom and anxious emotion.Conclusion The QLICD-CHD can be used to assess quality of life for patients with coronary heart disease with good validity,responsiveness and feasibility.