亚健康状态评价问卷的拟定及其信度、效度检验

Development of an indicator system for recognizing the sub-health status and study on the related reliability and validity

目的制定亚健康状态评价的主观指标体系并考察其信度和效度，为亚健康状态的判定提供有效的测量工具。方法以“不适和能力减退”为基本特点，根据慢性应激对人体主要系统的影响，初步制定亚健康状态的评价指标，并经临床专家讨论和预调查分析，调整问卷条目获得正式调查问卷。将调查问卷在首都医科大学宣武医院3000名集体单位体检者中测试，采用Chronbach’s α系数、条目一维度相关系数（ⅡC）和重测相关系数（ICC）评价问卷的信度，采用因子分析和单因素方差分析分别考察问卷的结构效度和区分效度。结果经过测试最终形成包括5个维度、25个条目的亚健康状态评价问卷，调查共收回有效问卷2799份。问卷的总体Chronbach’s α系数为0．92，疲劳症状、心血管症状、胃肠道症状和精神症状4个维度的α系数均在0．7以上；问卷的条目-维度相关系数在0．51～0．72之间，各条目的重测相关系数在0．89～0．98之间。经因子分析，获得特征根〉1的公因子共5个，对总体方差的累计贡献率为62．35％，5个公因子与问卷的5个维度相符合；不同职业和年龄组人群的亚健康问卷得分差异有统计学意义（P〈0．05）。结论亚健康状态评价问卷有较好的信度和效度，可用于亚健康状态的初步评估及筛选。

Objective To establish a subjective indicator system for the evaluation of sub-health status and study on its reliability and validity. Methods Based on the basic features of general malice and losing ability of workforce, the indicator system for sub-health status evaluation was developed according to the chronic stress on human body＇ s main systems. The items were adjusted according to the experience from experts and the results of the pilot study. Indices as Chronbach＇ s α, IIC and ICC were used to evaluate the reliability of the questionnaire. Factor analysis and ANOVA were used to evaluate the construct validity and discriminative ability of the questionnaire. Results The formal sub-health survey questionnaire would include five domains and 25 questions in total. The whole questionnaire＇ s Chronbach＇ s α coefficient was 0.92. Cronbach＇ s α of the four domains, including cardiovascular, digestive tract, immunity and mental health were no less than 0.7 while IIC ranging from 0.51 to 0.72 and ICC ranging from 0.89 to 0.98. The five extracted common factors which contributed 62.35% to the total variation were basically consistent with the five dimensions. ANOVA showed significant differences among different groups （P〈0.05）. Conclusion The questionnaire appeared reliable and valid for measurement of sub-health status.