优化儿童创伤康复需求量表及其信效度检验

Optimization, reliability and validity test of Manchester needs tool for injured children

目的优化儿童创伤康复需求(MANTIC)量表,并在创伤患儿中检验其信效度。方法通过德尔菲专家函询、预测试对MANTIC量表进行优化。2023年3月至2023年6月使用一般资料、优化MANTIC量表及效标量表青少年欧洲五维健康量表(EQ-5D-Y)对浙江省、山东省共7所三甲医院收治的317例创伤患儿及家庭进行问卷调查。对优化MANTIC量表资料采用同质性检验和决断值法进行项目分析,采用条目水平的内容效度指数(I-CVI)、量表水平的内容效度指数(S-CVI)评价量表的内容效度;根据KMO值及Bartlett球形检验评估量表是否适合做探索性因子,根据K1准则及碎石图确定公因子数,进一步获取条目载荷值评估量表的结构效度;根据优化MANTIC量表与EQ-5D-Y的相关系数评估量表的效标关联效度。以Cronbachɑ系数和Guttman折半系数评价量表的信度。结果共发放问卷332份,回收有效问卷317份,有效回收率为95.6%。项目分析中同质性检验示各条目与量表总分之间的相关系数为0.40~0.80,决断值法结果示高分组与低分组各条目临界比率值为6.08~28.01,所有题项质量均符合保留要求,可以继续行信效度检验。效度检验中量表内容效度示I-CVI为0.83~1.00,全体一致S-CVI为0.83,平均S-CVI为0.95;结构效度示KMO值为0.96,Bartlett球形检验χ2值为10755.76(P<0.01),K1准则提取出9个公因子(特征值>1),碎石图提示有9个公因子,累计方差贡献率为73.46%,因子的提取和旋转结果示量表各条目载荷值为0.589~0.874;效标关联效度示优化MANTIC量表与EQ-5D-Y的相关系数r=0.55(P<0.01)。信度检验示量表总的和各维度的Cronbachɑ系数为0.96、0.77~0.98,Guttman折半信度系数为0.76、0.73~0.98。结论优化MANTIC量表具有较好的信效度、一致性和稳定性,能够体现想要表达的概念及想要评估的内容,提示可以用来评估创伤患儿及其家庭在整个治疗过程中的创伤康复需求。

Objective To optimize the Manchester needs tool for injured children(MANTIC)scale,and evaluate its reliability and validity among injured children.Methods The MANTIC scale was optimized through Delphi expert consultation and pre-tests.From March 2023 to June 2023,a total of 317 injured children admitted in 7 level A tertiary hospitals in Zhejiang and Shandong provinces and their families were surveyed with general data,optimized MANTIC scale,and EuroQol 5-dimension health questionnaire for youth(EQ-5D-Y).Item analysis was conducted on the data of the 317 patients collected with optimized MANTIC scale through the test for homogeneity and value-based decision-making method and the content validity test of the scale was evaluated with item-level content validity index(I-CVI)and scale-level content validity index(S-CVI).It was evaluated with KMO test values and Bartlett′s test of sphericity to determine whether the scale was suitable for exploratory factors.The number of common factors was determined based on the K1 criterion and scree plot to further obtain the structural validity of the scale of the item load value.The correlation validity of the scale was evaluated with the correlation coefficient of the optimized MANTIC scale and EQ-5D-Y.The reliability of the scale was tested with Cronbach alpha coefficient and Guttman split-half reliability coefficient.Results A total of 332 questionnaires were distributed,among which 317 valid ones were collected,with a response rate of 95.6%.The test of homogeneity in the item analysis showed that the correlation coefficient between each item and the total score of the scale was 0.40-0.80.The results of the value-based decision-making method showed that the critical ratio of high-and low-scored groups was 6.08-28.01.The quality of all the items met the retention requirements so that the reliability and validity tests could be continued.Validity test found that I-CVI was 0.83-1.00,consistent S-CVI was 0.83,and mean S-CVI was 0.95.In structural validity analysis,the KMO value was 0.96,and the Chi-square value of Bartlett′s test of sphericity was 10755.76(P<0.01).A total of 9 common factors were extracted with the K1 criterion(eigen value>1),and the scree plot indicated 9 common factors with a cumulative variance contribution rate of 73.46%.Factor extraction and rotation showed that the load value of each item of the scale ranged from 0.589 to 0.874.The correlation coefficient of the optimized MANTIC scale and EQ-5D-Y was r=0.55(P<0.01).Reliability test showed that the Cronbach alpha coefficient of the total scale and all dimensions was 0.96 and 0.77-0.98,and the Guttman split-half reliability coefficient was 0.76 and 0.73-0.98.Conclusion The optimized MANTIC scale can attain good reliability,validity,consistency and stability,and can reflect the concept to be expressed and the content to be evaluated,indicating that it can be used to evaluate the injury rehabilitation needs of injured children and their families throughout the entire treatment process.