简易应对方式量表评价及其与农村自杀死亡关系研究

Psychometric characteristics of the Simplified Coping Style Questionnaire and association between coping style and rural suicide

目的检验简易应对方式量表在农村自杀死亡研究中的信度、效度,探讨不同应对方式与农村自杀死亡之间的关系。方法采用配对病例对照研究,在山东省疾病监测点上选取2008年9月1日～2009年8月31日3个县(市)的25个乡镇农村自杀死亡病例200例作为病例组,并按照同性别、年龄(±3岁)、当地居住者1:1配比选取对照组。采用病例对照研究及心理解剖的方法进行问卷调查。结果病例组和对照组量表的Cronbach'sα系数分别为0.805和0.772,积极应对方式得分与消极应对方式得分在两组间差异均有统计学意义(P<0.001),两种应对方式得分与绝望量表得分均呈现负相关(r=-0.519,-0.196,P均<0.001)。对两组进行探索性因子分析,分别提取了5个和6个公因子,与原量表设计者的假设不一致。多因素条件Logistic回归分析发现,积极应对方式是农村自杀死亡的保护因素(OR=0.906,95%CI=0.850～0.966)。结论简易应对方式量表在农村自杀研究中有较好的信度和一定的效标效度与区分效度,但结构效度与原量表不一致,某些条目需要修正和完善。积极应对方式是农村自杀死亡的保护性因素。

Objective To assess the reliability and validity of the Simplified Coping Style Questionnaire,and explore the relationship between coping style and rural suicide.Methods Data from 200 suicides that happened from September 1,2008 to August 31,2009 were collected from 25 towns in 3 counties which were selected from disease surveillance points of Shandong Province.One informant of each suicide and the paired control with the same gender,age（no more than 3 years difference）,and district as the suicide were interviewed.Results The Cronbach＇sαof the Simplified Coping Style Questionnaire in suicides and controls were 0.805 and 0.772,respectively.The scores of positive and negative coping styles both showed significant differences between suicides and controls（P0.001）,and both of them had negative correlations with the scores of Beck Hopelessness Scale（r= -0.519,-0.196;both P0.001）.The exploratory factor analysis was carried out in the suicide group and the control group,and 5 and 6 factors were respectively produced,which were different from the hypothesis of the scale＇s original designer.Positive coping style was significantly negatively associated with suicide by multivariate conditional logistic regression analysis（OR =0.906,95% CI=0.850-0.966）.Conclusion The Simplified Coping Style Questionnaire has good reliability,discrimination validity, and criterion validity in rural suicide research.However,the structural validity is different from the original design and further research is needed to modify or delete some items to improve the structural validity.Positive coping style might be a protective factor for rural suicide.