ICF检查表在老年慢性心力衰竭患者中应用的信效度及优势研究

Reliability,validity and advantage of ICF Check-list in elderly patients with chronic heart failure

目的:探讨应用ICF检查表调查老年慢性心力衰竭患者健康状态的信效度及优势。方法:对140例患者采用ICF检查表与生活质量调查量表36(SF-36)和坎斯坦城心肌病生活质量量表(KCCQ)进行评估,应用信效度比较以上量表的临床效果,应用ROC曲线探索ICF检查表在不同年龄层患者的界值点,使用频数表现不同年龄段患者ICF类目特点。结果:ICF检查表Cronbach’sα系数为0.933~0.962,75岁以上人群Cronbach’sα系数为0.962,SF-36量表Cronbach’sα系数为0.904~0.906。ICF检查表内部效度spearman相关系数为0.411~0.944(P<0.01),总分与SF-36量表外部效度r系数为-0.483^-0.678(P=0.000)。ICF检查表与SF-36量表ROC曲线下面积分别为0.700~0.790,0.340~0.493,前者界值点兼具良好的灵敏度与特异度。不同年龄段人群总体或各维度高频ICF类目不尽相同,相比而言60~74岁人群b 134.睡眠功能、d 920.娱乐与休闲功能损伤问题更突出;75岁以上人群b 440.呼吸功能、d 430.举起与搬运物体、s 430.呼吸系统的结构和s 110.脑的结构功能损伤问题更突出。结论:相比于SF-36与KCCQ量表,ICF检查表在老年CHF患者中应用具有更好的信效度与病情严重度的诊断价值,不同年龄段患者损伤的功能种类存在差异,今后临床工作应有针对性的进行评估与治疗。

Objective:To evaluate the reliability,validity and advantage of the ICF Check-list in elderly patients with chronic heart failure(CHF).Methods:One hundred and forty patients with CHF were recruited in this study.The health state of patients was assessed by the ICF Check-list,the 36-items short form health survey(SF-36)and the Kansas City Cardiomyopathy Questionnaire(KCCQ).Reliability and validity of those scales were conducted to compare their clinical effects.The cut-off points of different age of the patients were evaluated by ROC curve.The characteristics of patients in different age groups were shown by the frequency of the ICF category.Results:The Cronbach’sαcoefficients of the ICF Check-list were 0.933-0.906 and those for the population over the age of 75 were 0.962.The Cronbach’sαcoefficients of the SF-36 were 0.904-0.906.Spearman correlation coefficients of the ICF Check-list were 0.411-0.944(P<0.01),and its total score was also statistically significantly related to the SF-36(r=-0.483 to-0.678,P=0.000).Areas under the ROC curve of the ICF Check-list and the SF-36 were 0.700-0.790 and 0.340-0.493 respectively,and the former boundary points have better sensitivity and specificity.There were various high frequency ICF categories in different age groups or dimensions.Relatively,in patients aged 60-74,b134 sleep function,d920 entertainment and leisure were the higher frequency categories.In patients over 75 years old,b440 respiratory function,d430 lifting and transporting objects,s440 respiratory structure and s110 brain structure category were the higher frequency categories.Conclusion:ICF Check-list has better reliability,validity and diagnostic value than the SF-36 and KCCQ.There are significant differences in the types of injury in different ages,and the clinical work should be targeted for evaluation and treatment in the future.