Oswestry功能障碍指数评定慢性腰痛患者的效度分析

Validity of Chinese version of Oswestry disability index in assessment for patients with chronic low back pain

目的:探讨中文版Oswestry功能障碍指数(CODI)的效度,为临床应用提供客观依据。方法:107例慢性腰痛患者参加测试,患者根据自己情况独立完成CODI、视觉模拟评分法(VAS)和健康状况调查问卷(SF-36)3个量表。应用因子分析对CODI进行分析来检验其结构效度;应用Person相关分析计算CODI每一条目与所属领域和其他领域的相关系数来检验其内容效度和区分效度;比较CODI和VAS、CODI和SF-36的Person相关系数来检验其同期效度。结果:患者对CODI的条目8回答率较低(32.7%),没有纳入统计分析。CODI的9个条目提取出3个公因子,累计方差贡献率为76.3%;每一条目与所属领域的相关系数r=0.78—0.89(P<0.05),且每一条目与所属领域的相关系数均高于该条目与其他领域的相关系数;CODI的三大领域得分和VAS评分的相关系数分别为r=0.88,0.81,0.76(P<0.05);CODI的三大领域得分与SF-36各项目分值相关性r=-0.36—-0.87(P<0.05)。结论:CODI具有良好的结构效度、内容效度、区分效度和同期效度,可用于慢性腰痛患者的临床评定。

Objective： To study validity of Chinese version of Oswestry Disability Index （CODI） in assessment for patients with chronic low back pain（LBP） so as to guide clinical application. Method： One hundred and seven patients with chronic LBP participated in the study. All the patients were assessed with CODI, visual analogue scale （VAS） and SF-36. The construct validity, content validity, discriminant validity and concurrent validity were examined by factor analysis and Person correlation analysis. Result： The answer rate of item 8 of CODI was 32.7%, so it was not brought into statistical analysis. Factor analysis revealed 3 factors drawn from 9 items of CODI showed the total cumulative variance contribution rate was 76.3% . Significant correlations were shown between each item of CODI and its domain, the correlation coefficients were 0.78—0.89 （P〈0.05）;the correlation coefficients between each item and it′s domain were higher than those between each item and other two domains. The scores of three domains of CODI were highly correlated with VAS scores （r=0.88,0.81,0.76, P〈0.05）; and were correlated with scores of items of SF-36 （r=- 0.36—-0.87,P〈0.05）. Conclusion： Chinese version of Oswestry Disability Index has good construct validity, content validity, discriminant validity and concurrent validity. It is an appropriate tool to assess function of Chinese patients with chronic LBP.