摘要
目的研制基于患者报告的运动神经元病(MND)结局评价量表,并进行第一轮科学性考评。方法使用经典测量理论,创建MND量表条目池,采用Delphi法进行条目筛选,制定出基于患者报告的MND结局评价量表。进行第一轮科学性考评,分析量表的可行性(20例MND患者量表测评的回收率、有效率及测评完成时间)、项目区分度(各条目与量表总分的Spearman相关系数)、信度(折半信度、克朗巴哈α系数)、效度(拟合优度指数)。结果基于患者报告的MND结局评价量表,共包含核心症状、全身症状、心理精神、社会关系等4个维度、16个可操作性高的条目。可行性分析结果显示,回收率100%,有效率100%,测评完成时间(5.7±2.3)min。项目区分度分析结果显示,站立、行走、拿取物品、翻身、穿衣、夜间呼吸、肌肉跳动、饮水呛咳、言语、抬头、睡眠、疲劳、治疗渴望、急躁、对家人态度、人际交往与量表总分的Spearman相关系数分别为0.619、0.507、0.620、0.430、0.825、0.722、0.589、0.681、0.637、0.498、0.219、0.217、0、0.602、0.606、0.606,其中翻身、治疗渴望、睡眠、疲劳4个条目的Spearman相关系数低于0.447(样本量为20例时的Spearman相关系数界值为0.447)。信度分析结果显示,折半信度为0.73,克朗巴哈α系数为0.81。效度分析结果显示,拟合优度指数为0.57。结论成功研制出基于患者报告的MND结局评价量表,并经第一轮科学性考评验证该量表可行性、信度、效度均良好;该量表可较好反映MND患者总体疾病情况变化,为临床评价MND提供了新的方法。
Objective To develop and conduct the first-round assessment for the patient-reported outcomes scale for motor neuron disease(MND-PRO).Methods Based on the classical test theory,we developed the item bank and used Delphi method to screen the items to build the script MND-PRO.We used the feasibility parameter(recovery rate,efficiency and completion time),discrimination parameter(Spearman correlation within each items and with the total score),reliability(half-reliability,Cronbach′sαcoefficient)and validity(goodness of fit index,GOF)to assess the MND-PRO.Results The MND-PRO included 4 dimensions(core symptoms,systemic symptoms,psychosocial,and social relationships)and 16 items.The feasibility parameter showed that the recovery was 100%,the effective was 100%,and the completion time was(5.7±2.3)mins.Spearman correlation coefficients between all items(standing,walking,taking items,turning in bed,dressing,nocturnal breathing,muscle fibrillation,drinking,coughing,speech,raising head,sleep,fatigue,craving for treatment,irritability,attitude towards family members,interpersonal communication)and the total score were 0.619,0.507,0.620,0.430,0.825,0.722,0.589,0.681,0.637,0.498,0.219,0.217,0,0.602,0.606,and 0.606.The Spearman correlation coefficient of items(turning over,treatment craving,sleeping,and fatigue)were lower than 0.447(the cut-off value was 0.477 when there were 20 samples).The reliability showed that the half-reliability was 0.73,and the Cronbach'sαcoefficient was 0.81.The validity analysis showed that the GOF index was 0.57.Conclusions The MND-PRO is developed and shows good feasibility,reliability,and validity after the first-round assessment.The MND-PRO can reflect the changes in the overall disease status of MND patients and provide a new approach to clinically evaluate MND.
作者
韩奕
张斌龙
李建军
高颖
HAN Yi;ZHANG Binlong;LI Jianjun;GAO Yin(The First School of Clinical Medicine of Beijing University of Chinese Medicine,Beijing 100700,China)
出处
《山东医药》
CAS
2020年第11期16-20,共5页
Shandong Medical Journal
基金
中国博士后科学基金面上资助项目(2019M650594)。