非快速眼动相关异态睡眠评定量表测评儿少患者的效度和信度

Validity and reliability of the Chinese version Paris Arousal Disorders Severity Scale among children and adolescents

目的:评价中文版非快速眼动相关异态睡眠评定量表(PADSS)在儿少患者中的效度和信度。方法:选取58例非快速眼动相关异态睡眠(NREMPS)患者(6～14岁)、60例快速眼动睡眠行为异常(RBD)患者(49～81岁)和60例正常睡眠者(6～13岁)。使用PADSS评定NREMPS严重程度(PADSS包含A睡眠相关异常行为、B发生频率、C所致危害),Epworth困倦问卷(ESS)评价日间嗜睡程度,视频多导睡眠监测(vPSG)明确诊断和评估睡眠结构和事件。间隔27～93 d,22例NREMPS患者接受了PADSS的复测。结果:NREMPS组的中文版PADSS呈现正态分布,而且PADSS分值与ESS分值、SWS比例和SWS的觉醒事件次数的相关有统计学意义。PADSS趋向于2因子结构(行走和复杂性动作因子、暴力和操作性动作因子),方差解释值为54. 7%,各条目载荷为0. 36～0. 84。受试者的工作特征曲线(ROC曲线)显示PADSS (0～50)的最佳划界分为12/13 (灵敏度0. 85、特异度0. 85)。PADSS和PADSS-A的Chronbachα系数分别为0. 84和0. 82,Spearman Brow n分半信度分别为0. 91和0. 77。结论:中文版PADSS具有较好的心理测量学特征,可以作为儿少NREMPS患者的筛查和评估工具。

Objective:To test the validity and reliability of the Chinese version Paris Arousal Disorders Severity Scale(PADSS)among Children and Adolescents.Methods:Fifty-eight patients(6-14 years old)with NREM-related parasomnia(NREMPS),60 patients(49-81 years old)with REM behavior disorder(RBD),and 60 normal controls(6-13 years old)were recruited in this study.Their arousal disorders severity and daytime sleepiness were assessed with PADSS and Epworth sleepiness scale(ESS),and their diagonosis and sleep structure were confirmed with video-PSG(vPSG).After 27-93 days,22 NREMPS patients were assessed with PADSS again.PADSS was consisted with three parts,including an inventory of behaviors(PADSS-A),the frequency of episodes(PADSS-B)and the general consequences of the disorder(PADSS-C).Results:PADSS scores were characteristic of a normal distribution and two-factor structure("wandering/complexity"factor and"violence/handling"factor).The best cut-off score for the overall PADSS(ranging 0-50)was found at 12/13 and had high sensitivity(0.85)and specificity(0.85).In addition,the load scores of items were 0.36-0.84,the Cronbach'sαcoefficient of PADSS and PADSS-A were 0.84 and 0.82,and Spearman Brown split reliability of PADSS and PADSS-A were 0.91 and 0.77.Conclusion:PADSS has robust psychometric properties and could be used for screening patients with NREMPS among children and adolescents.