脊柱侧凸研究会-22问卷（SRS-22）中文版的信度及效度分析

Reliability and validity of chinese version of scoliosis research society-22（SRS-22） patient questionnaire

目的 用中文版SRS-22问卷评估中国青少年特发性脊柱侧凸患者的生活质量，考察SRS-22问卷中文版的信度及效度。方法 根据国际生活质量评估计划的规定，将SRS-22问卷英文版译成中文，并由脊柱外科专家讨论后确定最终版本。共有126例青少年特发性脊柱侧凸患者完成了SRS-22问卷中文版测试，男35例，女91例；年龄10-20岁，平均14．5岁；Cobb角15°-58°，平均为33°。为了完成对该问卷重测信度的评估，35例患者1周后进行了第2次问卷调查。SRS-22问卷中文版各领域的内部一致性通过Cronbach’a系数检验，使用相关性分析检验SRS-22中文版的重测信度并同时计算地板效应和天花板效应，最后对脊柱侧凸患者采用不同方式治疗后SRS-22问卷得分进行统计学分析。结果 SRS-22问卷中文版各领域的Cronbach’a系数分别为：功能状况／活动能力（0．49），疼痛（0．73），自我形象（0．67），心理状况（0．78），对治疗的满意度（0．48）；重测信度分别为：功能状况／活动能力（0．80），疼痛（0．68），自我形象（0．82），心理状况（0．81），对治疗的满意度（0．78）。SRS-22问卷中文版各领域均具有不同程度的天花板效应，术后患者功能状况／活动能力得分最低而对治疗的满意度得分较支具治疗高。结论 由于东西方医疗体制、人文文化及价值观等方面的差异，SRS-22问卷中文版仍存在一定的局限性，需要进行一定的改进以符合中国国情并进行更大规模的临床随访后方可用于中国青少年特发性脊柱侧凸患者生活质量的评估。

Objective To evaluate the validity and reliability of Chinese version of SRS-22 patient questionnaire. Methods The English version of the SRS-22 questionnaire was adapted to Chinese according to the International Quality of Life Assessment Project guidelines, and the final version was decided by the surgical experts of spine. 126 subjects （35 males and 91 females, mean age,14.5 years） with adolescent idiopathic scoliosis filled the questionnaire. The curve magnitude was 33°（15° to 58°A subgroup of 35 patients completed the questionnaire again 1 week later. Internal consistency, reproducibility were determined with Cronbach＇s acoefficient and interclass correlation coefficient, respectively. The SRS-22 scores by treatments was also assessed. Results Coefficients for individual domains were as follows： function/activity （0.49）, pain （0.73）, self-image （0.67）, mental health （0.78）, and satisfaction （0.48）. The test-retest correlation coefficients for individual domains were as follows： function （0.80）, pain （0.68）, self-image （0.82）, mental health （0.81）, and satisfaction （0.78）. The ceiling effects were found high in all domains. Patients in the surgery group had the highest satisfaction score and the lowest function/activity score. Conclusion Because of the differences between cultures and values, the Chinese version of SRS-22 patient questionnaire may need improvements and the large-scale follow-up.