《加拿大急性呼吸道疾病和流感量表》中文版本的修订与信度效度检验

Revision and evaluation of the reliability and validity of the Chinese version of Canadian Acute Respiratory Illness and Flu Scale

目的对《加拿大急性呼吸道疾病和流感量表》(CARIFS)行跨文化调适,检验其中文版本的信度、效度和反应度。方法①对CARIFS进行翻译、回译,语言、儿科临床和量表专家组成的专家委员会对CARIFS翻译版本进行讨论、修改后,形成中文CARIFS预试验版。②约请20名儿科临床专家和40名急性上呼吸道感染患儿监护人分别填写中文CARIFS预试验版,行初步内容效度和表面效度检验,形成中文版CARIFS。③依据纳入和排除标准对有发热的急性上呼吸道感染患儿家长采用相关系数法、克朗巴赫系数法等检验中文版CARIFS的信度,并行正式内容效度和反应度检验。结果中文CARIFS预试验版将"不爱玩耍"和"对任何事情都提不起兴趣"2个条目删除形成中文版CARIFS;中文版CARIFS初步内容效度指数为0.890 6,内容效度良好;40名急性上呼吸道感染患儿监护人均认为中文版CARIFS条目清楚易懂,完成时间均在15 min以内,表面效度良好。纳入193例急性上呼吸道感染患儿行中文版CARIFS信度和正式内容效度检验,①分半信度为0.851,总克朗巴赫系数为0.812,信度较好;②正式内容效度:功能维度、影响父母维度和症状维度,与中文版CARIFS总分的相关系数分别为0.848、0.700和0.632;对每个维度拟合所建立的不同维度模型(模型1:功能维度,模型2:功能+症状维度,模型3:功能+症状+影响父母维度)与中文版CARIFS总分行逐步回归分析并行拟合优度检验,上述模型均有统计学意义,其中模型3高度显著,3个维度得分对总分均有贡献;③间隔3 d来院复诊142例、电话随访51例,功能、症状、影响父母3个维度评分及总分经配对t检验第1次和3 d后差异均有统计学意义(P均为0.000),反应度很好。结论中文版CARIFS信度、效度和反应度均良好,适用于中国有发热的儿童急性上呼吸道感染病情严重程度评估。

To revise the Canadian Acute Respiratory- Illness and Flu Scale （CARIFS） for cross-cultural adaptation and evaluate its reliability-, validity- and responsiveness, to make it suitable for use in China, providing scientific measurenlent to evaluate the clinical effect of the acute upper respiratory- tract infeetion of children. Pretesting-version of CARIFS was introduced into China through translating, back translating and synthesizing, then each version was discussed and modified, and developed by the expert eomnlittee. Twenty- pediatric clinical experts and guardians of 40 children with acute upper respiratory- ilffeetion and fever were recruited to fill in the CARIFS scale Chinese pre-testing version, to evaluate the validity-, reliability- and responsiveness with relational coefficient, Cronbaeh coefficient and etc.. Results Expert evaluation results showed, after deleting items “not playing well” and “not interested in whatg going on”, the S-CVI/UA of the scale was 0. 890 6, content validity- was good;40 children guardians considered that the scale items clearly understood, completed filling in the scale within 15 minutes, the face validity- was good. Reliability- and validity- were evaluated in 193 children with acute upper respiratory- infeetion and showed ： ①The split-half reliability- was 0. 851, the Cronbaeh coefficient scale factor was 0. 812, both of them were over 0.8 indicating good reliability-. ②In content validity-, the correlation between chinese scale with physical function dimension, symptom and parent was 0. 848, 0.700 and 0. 632, respectively, all of which were over 0.4 and showing relatively high correlation. The stepwise multipleregression analysis between these three dimensions and the total scores showed that all dimensions could be calculated by regression equation with statistical significance. These 3 dimension scores all contributed to the total score. ③There were significant differences in 3 dimensions and the total scores in reaetivily of the first visit and return visit after 3 day-s, which suggested the reaetivily was very- good（ all P = 0.000）. Evaluation of the Chinese version of CAPdFS（ 16 items） shows that the validity, reliabilily and reactivity are relatively good. It can be applied to evaluate the illness severity of Chinese children with acute upper respiratory tract infeetion who have a fever.