《中小学生听力筛查量表》信度和效度研究

The reliability and validity of the Hearing Screening Scale for Students in Primary and Middle Schools

目的评价《中小学生听力筛查量表》的信度和效度,为轻、中度听力损失儿童的筛查工作提供可靠依据。方法随机抽取北京市房山区闫村小学和大董村小学共610名学生,年龄在6～15岁之间,由调查人员采用编制的听力筛查量表对每名儿童进行询问式调查,回收问卷进行信度分析;另选取1017名儿童进行预试验,35名已确诊的听力损失儿童来自中国聋儿康复研究中心门诊部,听力阈值在31～80dBHL,982名经过测试且听力正常的儿童来自北京市平谷区第四小学,对所有儿童分别进行询问式问卷调查和纯音测听(采用GVSLN-PC2B听力计测试),以纯音测听结果作为"金标准",以问卷调查总分是否为0作为筛查标准评价量表的真实性。结果13个指标的重测相关系数在0.90～1.00之间,分半信度为0.83,Cronbach’salpha系数为0.82;总体得分相关系数为0.94,准则关联效度为0.90(P=0.000),灵敏度为94.29%,特异度为90.43%。结论《中小学生听力筛查量表》具有较好的可行性与有效性,该量表整体符合量表编制的基本要求,建议进一步推广试用。

Objective To evaluate the reliability and validity of the Hearing Screening Scale for Students in Primary and Middle Schools （HSS-SPMS） for the potential use as a screening instrument for children with mild or moderate hearing loss. Methods 610 children of 6 - 15 years old were randomly selected from primary schools of the Fangshan District in Beijing. Each child was interviewed by different investigators using the same scale. Subsequently, a pilot study was conducted on 1017 children, including 35 children with hearing threshold at 31 - 80 dB HL and 982 children with normal hearing. All of them received questionnaire investigation and pure-tone audiometry with GVSLN- PC2B audiometer. The validity of the scale was evaluated with the results of pure-tone audiometry as the gold standard and the total score of zero for the scale as the screening standard. Results The test-retest reliability of 13 items ranged from 0.90 to 1.00, the split-half reliability was 0.83 and the Cronbach＇s alpha coefficient was 0.82; the correlation coefficient for the total score was 0.94 and criterion-related validity was 0.90（P=0.000）. The sensibility and specificity of the scale were 94.29% and 90.43%, respectively. Conclusion Based on the comprehensive evaluations on the reliability and validity of the scale, it is feasible and effective to prove clinically acceptable results and has the potential for further application.