简体中文版Oswestry功能障碍指数评定社区康复治疗腰椎间盘突出症的信度及效度分析

The reliability and validity of the simplified Chinese version of the Oswestry disability index for treating lumbar disc herniation in the community

目的 研究简体中文版Oswestry功能障碍指数（SCODI）评定社区综合康复治疗腰椎间盘突出症（LDH）的疗效及信度、效度,为全面推广社区综合康复治疗LDH提供参考依据.方法 共选取在社区接受康复治疗的LDH患者165例,根据其病情程度给予相应康复治疗.于治疗前及治疗3个月后,分别采用SCODI、Roland-Morris功能障碍问卷（RMDQ）及目测类比评分（VAS）对患者进行评估;并对SCODI量表的信度及效度进行分析,其中信度分析指标包括内部一致性Cronbach＇s α系数、重测信度内部相关系数（ICC）;效度分析指标包括Spearman相关系数（分析效标效度）及因子分析（分析构架效度）,并对SCODI评分及RMDQ、VAS结果进行相关性分析.结果 不同程度病情LDH患者经社区相应康复治疗后,发现上述各量表评分均较治疗前明显改善,提示社区综合康复治疗能有效改善LDH患者病情,促进生活质量提高;本研究还同时发现SCODI量表在评价LDH患者疗效方面具有较好的信度及效度,其结果与RMDQ、VAS评分具有明显相关性.结论 社区综合康复治疗能显著改善LDH患者病情,促进生活质量提高;采用SCODI量表评定LDH患者疗效具有良好的信度及效度,可作为康复疗效评价指标之一,为全面推广社区综合康复治疗LDH提供参考依据.

Objective To explore the reliability and validity of the simplified Chinese version of the Oswestry disability index （SCODI） and the curative effect of community-based rehabilitation for patients with lumbar disc herniation （LDH）. Methods 165 patients with LDH received community-based rehabilitation according to the severity of their LDH. Before treatment and after 3 months, the SCODI, the Roland-Morris disability questionnaire （RMDQ） and a visual analogue scale （VAS） were used to evaluate the effects. The reliability and validity of the SCODI was thus tested. The reliability analysis included internal consistency as measured by Cronbach＇s coefficient,and test-retest reliability as measured by an interclass correlation coefficient （ICC）. The validity analysis used Spearman＇s correlation coefficient （for concurrent efficacy validity） and factor analysis （for construct validity）. The correlation between SCODI, RMDQ and VAS results was analyzed. Results There was statistically significant functional improvement and better QOL in LDH patients after community-based rehabilitation. The SCODI showed good validity and reliability. There was significant correlation among the SCODI, RMDQ and VAS results. Conclusion Community-based rehabilitation can significantly alleviate symptoms for patients with LDH and improve their QOL.The SCODI is a reliable and valid instrument for measuring the curative effect of community-based rehabilitation on patients with LDH.