孕妇焦虑量表的编制及信效度分析

Pregnancy anxiety scale: development, reliability and validity

目的编制适合中国孕妇群体的焦虑量表并检验其信效度。方法结合已有研究成果和临床经验,编制孕妇焦虑量表(pregnancy anxiety scale,PAS),选取509名孕妇进行初测,2周后随机选取其中65名被试进行重测。通过项目分析筛选项目,对数据进行探索性因素分析和验证性因素分析检验问卷的结构效度,运用Cronbach's α系数、重测信度和Pearson相关系数对量表信度和效标效度进行评价。结果经过探索性因素分析,最后得到27个条目的PAS量表,提取分娩焦虑、自身焦虑、胎儿焦虑和一般性焦虑这4个因子,累积方差贡献率为62.48%;验证性因素分析所得的模型拟合良好(χ^2/df=1.89,RMR=0.04,RMSEA=0.06,IFI=0.92,TLI=0.91,CFI=0.92,PGFI=0.70,PNFI=0.74,PCFI=0.81)。孕妇焦虑量表得分及各分维度得分与妊娠相关焦虑量表(PAQ)得分和分娩恐惧量表(CAQ)得分的相关系数分别为0.60~0.80,0.50~0.78,均P<0.01。总量表的Cronbach's α系数为0.93,各分维度的Cronbach's α系数为0.82~0.90;总量表的重测信度(r)为0.68,分维度的重测信度(r)为0.54~0.75。结论孕妇焦虑量表具有良好的信效度,可作为测量孕妇焦虑水平的有效工具。

Objective To develop anxiety scale suitable for Chinese pregnant women and evaluate its reliability and validity. Methods Based on existing research results and clinical experience, this study compiled pregnancy anxiety scale(PAS). A sample of 509 pregnant women were selected for investigation and 65 of them were randomly retested for test-retest reliability with 2 week interval.Item analysis was conducted to screen valid items.Then the construct validity of the scale was tested by exploratory factor analysis (EFA) and confirmatory factor analysis(CFA). Finally the reliability and criterion validity of the scale were evaluated using Cronbach's α coefficient, retest reliability coefficient and Pearson correlation coefficient. Results The PAS was composed of 27 items in four factors, including worry about delivery, worry about themselves, worry about fetal health and general anxiety.The four factors were extracted by EFA which could explain 62.48% of the total variance.Besides, the result of CFA demonstrated that the model fitted the data with well construct validity (χ^2/df=1.89, RMR=0.04, RMSEA=0.06, IFI=0.92, TLI=0.91, CFI=0.92, PGFI=0.70, PNFI=0.74, PCFI=0.81). The score of the pregnancy-related anxiety scale and its factors scores were positively correlated with the scores of pregnancy-related anxiety questionnaire(PAQ) and childbirth attitudes questionnaire(CAQ). The correlation coefficients were 0.60-0.80 and 0.50-0.78 respectively (all P<0.01). The Cronbach's α coefficient was 0.93 for the total scale and that of the four factors ranged from 0.82 to 0.90. The test-retest reliability was 0.68 for the total scale and ranged from 0.54 to 0.75 for the four factors. Conclusion The PAS has a good reliability and validity, and it can be used as a valid tool to measure the anxiety level of pregnant women.