汉化版执行功能表现测试的信效度研究

The reliability and validity of the Chinese version of the executive function performance test for patients with a brain injury

目的评价执行功能表现测试(EFPT)在我国文化背景下的适用性以及其临床使用价值。方法将获得性脑损伤患者46例设为患者组,健康自愿者49例设为正常组。2组受试者均接受EFPT、神经心理学测试(Flanker)任务、颜色形状转换任务、言语及视空间2-Back和威斯康辛卡片分类测试(WCST)以及工具性日常生活活动能力量表(IADL)检查,并于入组四周后随机抽取30例正常人再次进行EFPT评估。将本研究结果中所得数据采用Spearman相关分析进行信度和效度分析,其中人口资料学(性别、年龄和受教育年限)以及执行功能相关测试的组间差异分析采用两独立样本的非参数符号秩和检验。结果①信度——通过对EFPT的各定量指标进行同质性信度及重复信度检验,发现EFPT具有良好的同质性信度(Cronbach′sα系数为0.73~0.83)和较高的重复信度,组内相关系数(ICCs)范围为0.50~0.85。②效标效度——EFPT与神经心理学测试各指标的相关分析发现,EFPT与WCST中的总应答数、完成分类数、持续性应答数、非持续性错误数及概括水平百分数的相关系数绝对值范围为0.29~0.57,具有显著相关性(P<0.05)。③生态效度——EFPT与IADL相关分析发现,EFPT中除外服药得分与IADL无相关性外,其他分测验及EFPT总分与IADL的相关系数绝对值范围为0.37~0.68,具有显著相关性(P<0.05)。④区分效度——通过两独立样本的非参数秩和检验发现,在EFPT总分、各分测验得分以及测试时间指标上,获得性脑损伤组均显著高于性别、年龄、受教育年限匹配的正常组(Z=-3.62^-8.32,P<0.05)。结论汉化版的EFPT在获得性脑损伤患者中具有良好的信效度,且具有良好的临床使用价值,能够反映获得性脑损伤患者与日常生活功能相关的执行功能障碍情况。

Objective To test the reliability and validity of the Chinese version of the executive function performance test(EFPT)when it is used with persons with a brain injury.Methods Forty-six brain injury patients comprised the patient group,and forty-nine healthy counterparts formed the normal group.All completed the EFPT,the Flanker task,a color shape task,the speech and visual space 2-back and the Wisconsin Card Sorting Test(WCST).Thirty normal subjects were asked to complete the EFPT again 4 weeks after the first test.Spearman correlation analysis was used for reliability and validity analysis.Results The EFPT scale showed good internal consistency,as Cronbach′sαcoefficient was 0.73 to 0.83.Test-retest reliability was good,as the internal correlation coefficients ranged from 0.50 to 0.85.The results of the EFPT correlated moderately well(r=0.29-0.57)with the total number of responses,the number of completed collocations,persistent responses and non-persistent errors,as well as with the percentage of the generalized level of the WCST.Moreover,all of the EFPT results correlated moderately well with those of the IADL except for the task of taking medication.Compared with the control group,the brain-injured group got significantly higher sub-test and total scores on the EFPT.Conclusions The Chinese version of the EFPT has demonstrated adequate reliability and validity with brain-injured Chinese persons.It is a good tool for evaluating the executive functioning of such persons and can reflect any executive dysfunction in their daily living activities.