适用于前庭功能障碍患者的视空间认知能力筛查问卷的初步编制与验证

Preliminary Development and Validation of a Visuospatial Cognitive Ability Screening Questionnaire

目的初步编制适用于前庭功能障碍患者的视空间认知能力筛查问卷,并进行信效度检验。方法首先,通过阅读文献和患者访谈编制出相关问题,并进行专家函询;然后,以136例前庭功能障碍患者为被试对函询后的问卷进行评估,将结果进行项目分析,再次剔除题项;最后,以224例前庭功能障碍患者和105例正常健康人群为被试进行问卷评估,并对结果进行信效度检验。结果初始问卷共22个题项;专家函询和项目分析后保留16个题项,包括空间导航与导航策略(8题)、继发慢性化精神改变(4题)和空间记忆(4题)共3个维度。该问卷整体的克隆巴赫α系数为0.886,各维度的克隆巴赫α系数为0.631~0.871;问卷具有较好的重测信度,总分和各维度重测信度的相关系数为0.528~0.748;问卷总分与认知失败问卷总分呈显著正相关(r=0.647,P<0.001);验证性因子分析的χ^(2)/df值为2.996,近似误差均方根为0.102;与健康组相比,眩晕障碍量表DHI得分高的前庭功能障碍患者总分和各维度得分均高于正常对照组(P均<0.05)。结论初步编制的问卷具有一定的信度与效度,今后需不断优化。

Objective To preliminarily develop a visuospatial cognitive ability screening questionnaire and reliability testing for patients with vestibular dysfunction.Methods First,relevant questions were compiled by literature reading and patient interviews,and these questions were subjected to expert correspondence.Then,129 patients with vestibular dysfunction were recruited as subjects to evaluate the modified questionnaire after consultation.The results were analyzed,and the questions items were eliminated again.At last,224 patients with vestibular dysfunction and 105 normal healthy people were invited as subjects to evaluate the questionnaire,and the reliability and validity of the test results were analyzed.Results The initial questionnaire consisted of 22 questions after expert consultation.Through project analysis,6 items were removed and 16 items were retained.These 16 items covered a total of 3 dimensions including spatial navigation and navigation strategies(8 questions),secondary chronic mental alterations(4 questions),and spatial memory(4 questions).The Cronbach’s alpha for the overall questionnaire was 0.886,and the Cronbach’s alpha for each dimension ranged from 0.631 to 0.871.The questionnaire had good retest reliability,and the correlation coefficients between the total score and the retest reliability of each dimension were between 0.523 and 0.748.A significant positive correlation was found between the total score of the questionnaire and the total score of the cognitive failure questionnaire(r=0.647,P<0.001).Theχ^(2)/df value in the validated factor analysis was 2.996 and the root-mean-square error of approximation RMSEA was 0.102.Compared to the healthy group,patients with vestibular dysfunction in the high DHI subgroup had higher scores than normal controls on both total and all dimensions(all P<0.05).Conclusion The preliminary questionnaire has a certain degree of reliability and validity,which needs to be optimized in the future.