鼻腔鼻窦结局测试-20（SNOT-20）量表中文版的研制

Development of the Sino-Nasal Outcome Test-20 Chinese version （SNOT-20 CV）

目的研制鼻腔鼻窦结局测试-20（sino-nasal outcome test-20，SNOT-20）量表中文版。方法通过前期SNOT-20量表的引进、翻译、预试、调适及性能初测试，形成中文量表试用版，进而收集国内10家医院的临床应用反馈意见，对量表作进一步修订，最终在60例慢性鼻-鼻窦炎患者中进行更加严格的性能再测试，并与英文源表作性能比较。结果中文量表修订版各项性能表现如下：①可行性：量表的接收率、回收率和有效率分别为98．4％、98．4％和98．3％，平均完成时间（6．0±3．0）min，患者无答卷负担的比例为96．7％；②信度：分半信度=0．95，克郎巴赫系数α=0．88，重测信度项内相关系数=0．98；③效度：条目内容通过专家认可及维度相关性检测，量表评分与标准量表“医学结局研究短表-36”的相关系数为-0．67；量表结构经证实性因子分析，拟合优度指数=0．93，提取“鼻部症状、相关症状、睡眠障碍、情感结局”4个因子，与源表设计结构吻合；④尺度：评分等级词条“无、轻、中、重”分别与数字“0、1、2、3”对应；⑤灵敏度：4个维度均能区分患者与健康人群的生存质量差异（P值均〈0．01）；⑥反应度：术后3个月全部条目总分和5大条目总分的标准化反应均数分别为0．48、0．57。中文量表修订版上述性能均达到或接近检验水准，与英文源表性能相当。结论SNOT-20中文版通过严格的性能测试，可在我国慢性鼻-鼻窦炎患者中推广应用。

Objective To develop the Sino-Nasal Outcome Test-20 Chinese Version （SNOT-20 CV）. Methods By introducing, translating, pretesting, adjusting, and performance testing of SNOT-20 inventory, a Chinese draft scale came into being. On the basis of the clinical applications and feedbacks from ten domestic hospitals, the scale was further modified and was more strictly tested in sixty patients with chronic rhinosinusitis, and then its psychometric properties were compared with that of the original edition. Results The SNOT-20 CV showed the following psychometric properties： The scale was easily accepted and answered in patients, showing a satisfactory feasibility. The split-half reliability, Cronbach＇ alpha and intraclass correlation coefficient were 0. 95, 0. 88, and 0. 98, respectively. The content validity was approved by experts of working group. The criteria validity calculated between SNOT-20 and SF-36 was - 0. 67. Factor analysis of construct validity showed that the comparative fit index was 0. 93 and the 20 items were classified into 4 domains which were accorded with the designed constructs. The category rating system was of reasonable additivity and comparability. Every domain was of sensitivity to effectively discriminate between patient population and healthy population （ P 〈 0. 01 ）. The standardized response mean of twenty items and five important items at three months postoperatively was respectively 0. 48 and 0. 57, suggesting moderate responsibility to clinical change. SNOT-20 CV passed the tests of feasibility, reliability, validity, scalability, sensitivity, and responsibility, showing good properties comparable to that of the original edition. Conclusions SNOT-20 CV passes the psychometric and clinimetric tests and can be used for measuring rhinosinusitis-specific quality of life in China.