乳腺癌化疗所致脱发压力量表的汉化及信效度检验

Localization and validation of Chemotherapy-induced Alopecia Distress Scale for breast cancer

目的对乳腺癌化疗所致脱发压力量表(CADS)进行汉化,并验证其信效度。方法应用比利斯林跨文化翻译原则对CADS量表进行汉化调适,采用便利抽样的方法,选取2016年1月—2017年12月在郑州大学附属肿瘤医院(河南省肿瘤医院)住院化疗的190例乳腺癌患者为研究对象,应用CADS量表、焦虑自评量表(SAS)对患者实施调查,分析中文版CADS量表的信效度。共回收有效问卷171份。结果中文版CADS量表保留17个条目;各条目的内容效度(I-CVI)为0.833~1.000,总量表的内容效度(S-CVI)为0.956;通过探索性因子分析中文版CADS量表共可提取4个特征根值大于1的公因子,累积方差贡献率为73.4%;各因子的相关系数为0.386~0.548,与总分的相关系数为0.713~0.803(P<0.05);受试者工作特征(ROC)曲线显示,其曲线下面积为0.830,95%CI为0.776~0.883(P<0.01),并且在CADS得分≥38.5分时,其约登指数最大,为0.691,对应的敏感度为0.776,特异度为0.915;量表总的Cronbach'sα系数为0.963,重测相关系数为0.768。结论中文版CADS量表具有良好的信效度,适用于我国乳腺癌化疗患者脱发心理压力的评估和筛查。

Objective To localize the Chemotherapy-induced Alopecia Distress Scale( CADS) for breast cancer and to validate its reliability and validity. Methods Blyth Lin's cross-cultural translation principle was used for localizing and adjusting CADS in Chinese. A total of 190 breast cancer inpatients receiving chemotherapy in He'nan Cancer Hospital between January 2016 and December 2017 were selected by convenient sampling and investigated with CADS and Self-Anxiety Scale( SAS). The reliability and validity of the Chinese version of CADS was analyzed. A total of 171 valid questionnaires were collected. Results Totally 17 items were reserved for the Chinese version of CADS. The reliability and validity of each item( I-CVI) ranged 0.833-1.000, and that of the Chinese scale( S-CVI) was 0.956. By exploratory factor analysis( EFA), totally 4 common factors whose characteristic root value was > 1 could be extracted from the Chinese version of CADS, whose cumulative variance proportion was 73.4%. The coefficient of correlation of each factor ranged 0.386-0.548, while the coefficient of correlation with the total score ranged 0.713-0.803( P<0.05). The area under receiver operating curves( AUC-ROC) was 0.830( 95%CI=0.776-0.883, P < 0.01). When the score of CADS was ≥ 38.5, the Youden index was the largest, 0.691, whose sensitivity was 0.776 and whose specificity was 0.915. The total Cronbach's α coefficient was 0.963, and the retest coefficient of correlation was 0.768. Conclusions The Chinese version of CADS has sound reliability and validity and applies to the evaluation and screening of alopecia distress for breast cancer patients in China.