中文版癌症患者功能评估-认知功能量表在胃肠肿瘤患者中的信效度检验和最佳界值研究

Psychometric Evaluation of the Chinese Version of Functional Assessment of Cancer Therapy-Cognitive Function among Gastrointestinal Tumor Patients

目的 验证中文版癌症患者功能评估-认知功能量表(functional assessment of cancer therapy-cognitive function FACT-Cog)在胃肠肿瘤人群中的信效度,并探讨其最佳界值。方法 采用随机抽样方法选取311位胃肠肿瘤患者进行调查,评价问卷的信效度,应用受试者工作特性曲线(receiver operating characteristic curve, ROC)以确定量表的最佳界值。结果 中文版FACT-Cog量表的Cronbach’s α系数为0.876,4个维度的Cronbach’s α系数分别为0.851、0.946、0.838和0.969,重测信度为0.975;探索性因子分析共提取4个公因子,累积方差贡献率为76.515%;验证性因子结果显示模型拟合良好;效标效度与蒙特利尔认知评估量表呈正相关(r=0.291);量表最佳界值为75分,此时ROC曲线下面积为0.967、敏感度为84.6%、特异度为90.7%。结论 中文版FACT-Cog量表在我国胃肠肿瘤患者人群中具有较好的信效度,推荐最佳界值为75分,可用于评价我国胃肠肿瘤患者的认知功能。

Objective To examine the reliability and validity of the Chinese version of FACT-Cog among gastrointestinal tumor patients,and explore its optimal critical value.Methods Random sampling was used to select 311 gastrointestinal tumor patients for investigation.The reliability and validity of the tool was examined,and its optimal critical value was determined using the receiver operating characteristic(ROC)curve.Results The Cronbach’sαcoefficient of the Chinese version of FACT-Cog was 0.876,and those of the four dimensions were 0.851,0.946,0.838 and 0.969,respectively;the retest reliability was 0.975.Four common factors were extracted by exploratory factor analysis,with the cumulative variance contribution rate of 76.515%.Confirmatory factor analysis showed a good model fit.The criterion validity was a positive correlation with the Montreal Cognitive Assessment(r=0.291).The optimal critical value was 75 points,with the area under ROC curve of 0.967,the sensitivity of 84.6%and the specificity of 90.7%.Conclusions The Chinese version of FACT-Cog shows good reliability and validity among Chinese gastrointestinal tumor patients,with the recommended optimal critical value of 75 points.This tool can be used to evaluate the cognitive function of gastrointestinal tumor patients in China.