发育筛查量表的评价者间信度和共聚效度分析

Evaluation of the interviewer reliability and copolymerization validity of the development screening test

目的分析发育筛查量表(DST)在婴幼儿发育评估中的可靠性和有效性。方法选取2016年4月1日~2017年3月31日在贵州省人民医院儿科康复门诊就诊的0~6岁婴幼儿。两名经过严格培训的专业评估师对纳入研究对象进行DST评估,分析其评价者间的信度。纳入研究对象同时进行Peabody运动发育量表评估,该工具作为金标准评估工具,分析DST的共聚效度。结果共有174患儿(男99例,56.9%)纳入本次研究,年龄为(10.23±9.43)个月。DST中发育商(DQ)得分为(67.83±19.63)分,智商(MI)得分为(61.94±15.90)分,女孩DQ和MI得分均高于男孩,差异有统计学意义(P<0.05)。DST各维度得分的组内相关系数(ICC值)为0.76~0.89,提示评估师评分之间具有较好的相关性。Peabody中的粗大运动商(GMQ)、精细运动商(FMQ)、总运动商(TMQ)得分与DST的DQ和MI得分之间的相关系数分别为0.59 vs.0.57、0.62 vs.0.68、0.63 vs.0.64。Peabody中粗大运动中反射、姿势和移动得分与DQ和MI的相关系数分别为0.42 vs.0.36、0.54 vs.0.50、0.56 vs.0.58;精细运动中抓握和视觉运动整合的分与DQ和MI得分的相关系数分别为0.65 vs.0.70、0.62 vs.0.68,DST各维度与Peabody精细运动维度相关性最好,与粗大运动维度相关性稍低。结论 DST发育筛查测试量表具有较好的评价者间信度和共聚效度,提示该量表在中国儿童人群中是一个可靠和有效的运动发育筛查工具。

Objective To analyze the reliability and validity of development screening test（DST） in the evaluation of infant development.Methods Infants and children in 0-6 years old who were treated in Department of Pediatric Rehabilitation of Guizhou Provincial People′s Hospital during the period of April 1,2016 to March 31,2017 were selected as the subject of this research.The DSTs of the subject were evaluated by two highly trained professional evaluators to analyze the reliability of their interviewer.The subjects also participated in the Peabody sports development test,which was used as a gold standard assessment tool to analyze the copolymerization validity of DST.Results A total of 174 children（male99 cases,56.9%） were included in this study,with an average age of（10.23 ±9.43） months.The developmental quotient（DQ） score in DST was（67.83±19.63） points,and the mental index（MI） score was（61.94±15.9） points.The DQ and MI scores of girls were all higher than those of boys,with statistically significant difference（P〈0.05）.The intra-class correlation coefficient（ICC） value of each dimension of DST was between 0.76-0.89,and the results showed that there was a good correlation between the interviewers′ score.The correlation coefficients between gross motor operator（GMQ）,fine motion operator（FMQ）,total motion operator（TMQ） in Peabody and DQ,MI scores of DST were 0.59 vs.0.57,0.62 vs. 0.68,0.63 vs. 0.64,respectively.The correlation coefficient of Peabody in gross motor between reflection,posture,mobile score and DQ,MI were 0.42 vs. 0.36,0.54 vs. 0.50,0.56 vs. 0.58;the correlation coefficient of grasping and visual motor integration in fine motor and DQ and MI scores were 0.65 vs. 0.70,0.62 vs. 0.68;each dimension of DST was best correlated with fine motor in the Peabody and slightly lower correlated with gross motor dimensions.Conclusion DST has good inter-interviewer reliability and copolymerization validity,indicating that the test is a reliable and effective tool for motor development screening in Chinese children.