中文版言语障碍指数量表的信效度评价

Reliability and validation of Chinese version of Speech Handicap Index

目的评价中文版言语障碍指数(Speech Handicap Index,SHI)量表的信度和效度。方法采用跨文化量表翻译流程对英文版SHI量表进行前译、回译,形成中文版SHI量表,对97例喉咽癌术后6个月内的患者及32名健康志愿者进行调查。结果中文版SHI量表总的Cronbach′sα系数为0.91,2个维度的Cronbach′sα系数分别为0.82、0.93;总量表重测信度为0.73;内容效度为0.90;量表的区分效度较好(P<0.01)。中文版SHI临界值为6分时筛查言语障碍者的灵敏度和特异度分别为0.950和0.914,ROC曲线下面积为0.945(95%CI:0.899,0.990,P<0.01)。结论中文版SHI量表信、效度好,有合适的临界值,可作为言语障碍者自我评估、临床筛查及科研应用的有效工具。未来的研究可进行量表结构效度及反应度的检验,以供语言干预治疗的效果评价。

Objective To evaluate the reliability and validity of Chinese version of Speech Handicap Index （SHI）. Methods The English SHI was translated into Chinese according to the cross-cultural adaptation procedure and used to investigate 97 outpatients with hypopharyngeal cancer no more than 6 months after surgery and 32 healthy controls. Results Cronbachls alpha coefficients were found to be 0.91, 0.82 and 0.93 for the total scale and both two dimensions respectively; the test-retest reliability for the total scale was 0. 73. Besides, content validity index for all items was 0.90, with the discriminate validity proven to be good （P〈 0.01）. Whatts more, a cut-off score of 6 points was evident to identify patients with speech problem, with sensitivity of 0. 950, specificity of 0. 914 and the area under the curve （AUC） 0. 945 （95% CI：0. 899, 0. 990, P〈0.01）. Conclusion The Chinese version of the SHI is a reliable and valid measurement with appropriate cut-off score. We recommend it to be used as a tool to screen speech disorder among hypopharyngeal cancer patients. Future studies are needed to assess its construct validity and response validity, thus, evaluation of the effect of speech intervention could be fulfilled.