穴位敷贴治疗后哮喘缓解期儿童中医生存质量量表的研制

Development of TCM Quality of Life Scale for Children in Remission Stage of Asthma After Acupoint Application

目的:研制具有中医特色的穴位敷贴治疗后哮喘缓解期儿童中医生存质量量表,完善哮喘缓解期儿童中医外治疗效评价体系。方法:根据国际生存质量量表的编制原则和步骤,通过德尔菲法专家意见咨询,编制初始量表。随后对50例穴位敷贴治疗后的哮喘缓解期儿童进行为期两年的临床随访,以网页问卷方式填写初表。通过离散趋势、判别区分、因子分析、相关分析、克朗巴赫系数法筛选条目,形成正式量表,并考评信度、效度及反应度。结果:本次共发出三轮专家问卷,每轮12份,共计36份,实际回收有效问卷36份。建立临床表现、中医四诊、社会环境、心理共4个维度,合计36个条目组成的穴位敷贴治疗哮喘缓解期儿童中医生存质量量表。临床表现、中医四诊、社会环境三个维度的克朗巴赫系数a均超过0.7,而心理维度接近0.7,说明信度尚可。总量表的克朗巴赫系数a为0.925,信度良好。因子分析结果显示,提取11个公因子时获得了较好的专业解释,累计贡献率最高为80.653%,特真值为10.864。旋转后因子成分矩阵示每一个条目在公因子中因子负荷值均大于0.4。采用时间方面的纵向性考评,4周后让50例哮喘患儿家长重新填写问卷,结果示4周后各维度得分及量表总得分与先前结果的差异不服从正态分布(P<0.05),故行秩和检验,结果显示各维度不具有统计学意义(P>0.05)。结论:本量表具有较好的信度及效度,但反应度在4周前后不存在统计学差异。

Objective:To develop a TCM quality of life scale for children in remission stage of asthma after acupoint application treatment,and to improve the evaluation system of external therapeutic effect of TCM for children in remission stage of asthma.Methods:According to the principles and steps of the international quality of life scale,the initial scale was compiled through Delphi expert consultation.Then 50 asthmatic children in remission stage after acupoint application treatment were followed up for two years,and the initial form was filled in by web questionnaire.The items were screened by discrete trend,discrimination,facore analysis,correlation analysis and Cronbach coefficient method to form a formal scale,and evaluate the reliability,validity and responsiveness.Results:Three rounds of expert questionnaires were sent out,12 in each round,a total of 36,and 36 valid questionnaires were actually recovered.A TCM quality of life scale for children in remission of asthma was established,which was composed of 36 items in four dimensions:clinical manifestation,TCM four examinations,social environment and psychology.The Cronbach coefficient a of clinical manifestation,four TCM examinations and social environment was more than 0.7,while the psychological dimension was close to 0.7,indicating that the reliability was acceptable.The Cronbach coefficient a of the total scale was 0.925,which showed the reliability was good.The results of factor analysis showed that good professional interpretation was obtained when extracting 11 common factors,the highest cumulative contribution rate was 80.653%,and the special truth value was 10.864.After rotation,the factor component matrix showed that the factor load value of each item in the common factor was greater than 0.4.The results showed that the differences between the scores of each dimension and the total score of the scale after 4 weeks and the previous results did not obey the normal distribution(P<0.05),so the rank sum test was performed.The results showed that each dimension was not statistically significant(P>0.05).Conclusion:The scale has good reliability and validity,but there is no significant difference in response before and after 4 weeks of treatment.