中文版患者尊严量表初步修订及信、效度评价

Preliminary revision of Chinese version PDI and its reliability and validity

目的 初步修订中文版患者尊严量表,并评价其信度和效度,为该量表在中国的推广使用提供科学依据。方法 2014年8月—2015年1月,在患者尊严量表（PDI）的基础上,辅以访谈法和问卷调查法初步对PDI量表的理论结构进行修订,并采用项目分析、验证性因素分析和信效度检验方法对山西省某2所三级甲等医院抽取的150例晚期癌症患者的尊严问题进行分析,验证该量表理论结构的合理性。结果 修订后的中文版PDI量表具有较好的项目区分度,除条目22之外,其他条目的相关系数均为0.270~0.768（均P〈0.01）;量表总体Cronbach＇sα系数和分半信度分别为0.924和0.885;验证性因素分析结果显示,χ2/df为2.32,比较拟合指数、规范拟合指数、不规范拟合指数、增量拟合指数分别为0.93、0.89、0.92、0.93,PDI模型与原量表因子拟合指数基本达到可接受的标准;效标效度检验结果显示,中文版PDI量表总分与癌症患者生命质量测定量表（EORTC QLQ-C30）5个功能领域和1个总体健康状况/生命质量领域得分均呈负相关,与症状领域中的疲倦、疼痛、气促、失眠、食欲丧失和经济困难均呈正相关（均P〈0.01）;与医院焦虑抑郁量表（HAD）焦虑和抑郁2个维度得分均呈正相关（均P〈0.01）。结论 修订的中文版PDI量表在晚期癌症患者中的信度和效度指标均符合心理测量学要求,可作为晚期癌症患者尊严研究的一个有效工具。

Objective To revise the Chinese version Patient Dignity Inventory（ PDI） and to assess its reliability and validity for the application of PDI in China. Methods Interviewand questionnaire survey were adopted to revise theoretic structure of Chinese version PDI and then palliative cancer patients were recruited from two cancer hospitals in Shanxi province and administered with the revised Chinese version PDI. Results The revised Chinese version PDI showed a good degree of item distinction and the correlation coefficients ranged from 0. 270 to 0. 768 for all the items except for item22. Cronbach＇s coefficient alpha and split-half reliability of the revised Chinese version PDI was 0. 924 and 0. 885. Confirmatory factor analysis suggested that the model was legitimate,with the χ2/ df value of 2. 32,comparative fit index of 0. 93,non-normed fit index of 0. 89,incremental fit index of 0. 92,and normed fit index of 0. 93,respectively. The total score of the revised Chinese version PDI was reversely correlated with the scores of five functional domains and general health andquality-of-life of European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30（ EORTC QLQ-C30）,but positively correlated with the scores of fatigue,nausea,vomiting,pain,dyspnea,sleep disturbance,appetite loss,and financial impact of EORTC QLQ-C30（ all P〈0. 01）; in addition,the total score of the revised Chinese version PDI was positively correlated with the scores of anxiety and depression of Hospital Anxiety and Depression Scale（ all P〈0. 01）. Conclusion The revised Chinese version PDI presents satisfactory reliability and validity when administered in palliative cancer patients and could be used as a useful testing tool in dignity research in palliative cancer patients.