中文版SF-36 v2量表评价住院心房颤动患者生命质量的适用性研究

Evaluation on the Applicability of the Chinese Version of SF-36 v2 Scale in Assessing the Quality of Life of Patients With Atrial Fibrillation

目的：探讨中文版SF-36 v2量表评价住院心房颤动患者生命质量的适用性。方法于2013年1—9月，采用目的抽样法选取年龄≥18周岁、精神正常、能够自我表达的某三甲医院心内科住院心房颤动患者86例作为调查对象，对其进行问卷调查，包括一般情况调查和SF-36 v2量表调查。通过集合效度和区分效度、内部一致性信度和折半信度、结构效度和判别效度评定SF-36 v2量表评价住院心房颤动患者生命质量的适用性。结果共发放问卷86份，回收有效问卷86份。患者SF-36 v2量表躯体疼痛（ BP）、一般健康状况（ GH）、生理功能（ PF）、生理职能（RP）、情感职能（RE）、社会功能（SF）、活力（ⅤT）、精神健康（mH）8个维度得分转换分分别为：（83.2±16.3）、（34.6±8.4）、（61.5±25.0）、（48.8±31.3）、（59.0±29.7）、（63.7±18.8）、（58.8±16.6）、（61.4±15.0）分；地板效应分别为：1.2%、1.2%、1.2%、7.0%、4.7%、2.3%、1.2%、1.2%；天花板效应分别为：38.4%、1.2%、1.2%、17.4%、10.5%、7.0%、1.2%、2.3%。条目集合效度除GH1（总的来说，你认为你的健康状况是）相关性为0.280，其余34个条目均达到标准，总成功率为97.1%；BP、RE、SF维度的区分效度成功率达到100.0%，GH维度较低，为51.4%，总成功率为84.1%。8个维度的Cronbach′s α系数为0.704~0.939，折半信度为0.732~0.947。SF-36 v2量表通过主成分分析，产生了两大领域，分别代表生理健康和心理健康，共解释66.61%的总方差。年龄与生理健康呈负相关（ rs =-0.389，P=0.003），自评健康状况与生理健康、心理健康均呈正相关（ rs =0.294、0.367，P=0.010、0.013）。结论 SF-36 v2量表作为SF-36 v1修订版，问题和答案布局更合理，地板效应和天花板效应降低，评价住院心房颤动患者的生命质量有较好的信效度，可用于住院心房颤动患者的生命质量评价。

Objective To evaluate the application of the Chinese version of SF-36 v2 scale in assessing the quality of life of patients with atrial fibrillation. Methods Using purposive sampling method,we enrolled 86 patients who were admitted into the Department of Cardiology of a grade -3 and first -class hospital from January to September in 2013. The inclusion criteria were age≥18,eunoia and clear self - expression. Questionnaire surveys were conducted on the subjects,including general information and SF-36 v2. The application of SF-36 v2 scale in assessing the quality of life of inpatients with atrial fibrillation was evaluated by convergent validity,discriminative validity,internal consistency reliability,split-half reliability, construct validity and discriminant validity. Results A total of 86 questionnaires were distributed, and 86 effective questionnaires were taken back. The scores of eight dimensions in SF -36 v2 scale,including bodily pain（ BP）,general health（ GH）,physical function（ PF）,role-physical（ RP）,role-emotion（ RE）,social function（ SF）,vitality（ⅤT）,and mental health（mH）were：（83. 2 ±16. 3）,（34. 6 ±8. 4）,（61. 5 ±25. 0）,（48. 8 ±31. 3）,（59. 0 ±29. 7）,（63. 7 ± 18. 8）,（58. 8 ± 16. 6）and（61. 4 ± 15. 0）,respectively;the floor effects were：1. 2%,1. 2%,1. 2%,7. 0%,4. 7%, 2. 3%,1. 2% and 1. 2% respectively;the ceiling effects were：38. 4%,1. 2%,1. 2%,17. 4%,10. 5%,7. 0%,1. 2%and 2. 3% respectively. The item-convergent validity of 34 items achieved the standard except the item of GH1 （ in general, what do you think about your health） with a convergent validity of 0. 280,and the total success rate of item-convergent validity was 97. 1%. The dimensions′success rates of discriminative validity for BP,RE and SF were 100. 0%,and that for GH was 51. 4%,and the total success rate of discrimination validity was 84. 1%. Cronbach′sαcoefficients of the eight dimensions were within 0. 704-0. 939,and the split-half reliability was within 0. 732 -0. 947. By factor analysis,two common factors were confirmed, separately representing physical health and mental health, altogether making contribution of 66. 61% total variance. Age and physical health were negatively correlated（rs = -0. 389,P=0. 003）,and self-evaluated health condition was positively correlated with physical health and mental health（rs =0. 294,0. 367;P=0. 010,0. 013）. Conclusion As the revision of SF-36 v1,SF-36 v2 scale is more friendly in the layout of questions and answers,and the floor effect and ceiling effect are reduced. It also shows comparatively well reliability and validity. Therefore,we can believe that the SF-36 v2 scale could be used to assess the quality of life of patients with atrial fibrillation.