西安大略和麦克马斯特大学骨关节炎指数量表应用于大骨节病的信度和效度评价

The reliability and validity assessment of western Ontario and McMaster university osteoarthritis index scale applied with Kashin-Beck disease

目的 评价西安大略和麦克马斯特大学骨关节炎指数（WOMAC）量表对我国大骨节病患者的适用性.方法 选择陕西省永寿县和麟游县两个历史大骨节病重病区,依据病区历史诊断资料,排除其他慢性病,并结合《大骨节病诊断标准》（GB 16003-1995）,抽取临床Ⅰ度及以上成人大骨节病患者.运用中文版WOMAC量表,采用重测信度、分半系数和克朗巴赫系数α（Cronbach＇α）分析WOMAC的信度;采用主成分因子分析和相关分析等方法分析量表的效度.结果 共调查大骨节病患者200人,收回有效问卷177份（88.5％）.其中重测信度为0.754～0.853,分半系数为0.886～0.971,Cronbach＇α信度系数为0.878～0.956;主成分因子分析WOMAC量表的3个维度（疼痛、僵硬、关节功能）,提取1个公因子,累计方差贡献率为81.238％;WOMAC量表的所有条目得分与其所属领域得分及总得分之间的Pearson相关系数均大于0.600.不同年龄、不同分级的成人大骨节病患者WOMAC量表得分比较差异均无统计学意义（P均＞0.05）.结论 WOMAC量表应用于大骨节病具有较好的效度和信度,但是其区分度不高.

Objective To evaluate the applicability of western Ontario and McMaster university osteoarthritis index （WOMAC） on Kaschin-Beck disease （KBD）.Methods Clinical degree Ⅰ adult patients with KBD came from Yongshou and Linyou Counties in Shaanxi Province were investigated according to the historical diagnostic data and ＆quot;The Diagnosis Standard of Kashin-Beck Disease＆quot; （GB 16003-1995）,exclusion of other chronic diseases.Reliability of WOMAC was measured by retest reliability,1/2 coefficient and Cronbach＆#39;α reliability coefficient analysis; validity of the WOMAC was tested by the principal components,factor analysis and correlation analysis methods.Results Totally 200 adults patients with KBD were investigated,and 177 effective questionnaires were taken back （88.5 %）.Retest reliability was 0.754-0.853,1/2 coefficient was 0.886-0.971,and Cronbach＆#39;α reliability coefficient was 0.878-0.956.In three dimensions of WOMAC scale extracted a common factor,the cumulative variance contribution rate was 81.238% through principal component factor.The pearson correlation coefficient between all items score of WOMAC and scale score and total score of WOMAC was more than 0.600.The differences of WOMAC score were not statistically significant in different ages,different grading of adult KBD patients （all P 〉 0.05）.Conclusion WOMAC scale used in KBD has good validity and reliability,but has low degree of differentiation.