基于SEM模型的慢性胃炎患者报告结局量表测评

Evaluation of Patient-Reported Outcome Scale for Chronic Gastritis based on SEM Model

目的检验慢性胃炎患者报告结局(PROISCD-CG)量表的信效度,为测评慢性胃炎患者报告结局提供科学依据。方法以便利抽样的形式对云南省两家医院消化内科的297名慢性胃炎患者进行问卷调查。计算共性模块各维度以及共性模块、特异模块和总量表的Cronbach'sα系数即做内部一致性检验。分析条目维度相关性,验证性因子分析法分析结构效度,检验修正后量表的收敛效度、组合信度和区别效度。结果总量表的Cronbach'sα为0.86,共性模块的Cronbach'sα为0.82,共性模块各维度的Cronbach'sα为0.61~0.76,特异模块的Cronbach'sα为0.82。条目维度相关性较好,PHD、MHD、SHD和SBD维度得分与共性模块得分相关系数分别为0.78、0.79、0.77和0.66(P<0.05)。验证性因子分析表明原始量表部分条目质量不佳,结构效度较差。修正后量表的CMIN/DF为2.91,RMSEA值为0.08,GFI、IFI、TLI及CFI指数增大至更接近0.90,各条目对其所属维度差异均有统计学意义(P<0.05),收敛效度一般,组合信度较好,区别效度一般。结论PROISCD-CG量表整体信度较好,各条目所属维度划分合理。原量表结构效度一般,修正后量表结构效度有所改善。PROISCD-CG量表部分条目有待修订和进一步验证。

Objective To test the reliability and validity of the Chronic Gastritis Patient Reported Outcomes(PROISCD-CG)scale,and to provide the scientific basis for evaluating the reported outcomes of chronic gastritis patients.Methods A questionnaire survey was conducted on 297 patients with chronic gastritis in the gastroenterology department of two tertiary hospitals in Yunnan Province through convenient sampling.Internal consistency test was performed by calculating Cronbach'sαcoefficient of each dimension of the common module,the common module,the specific module and the total scale.The correlation of item dimensions was analyzed.Confirmatory factor analysis was used to analyze the construct validity,and the convergent validity,combined reliability and discriminant validity of the revised scale were tested.Results The Cronbach'sαof the total scale is 0.86,the Cronbach'sαof the common module is 0.82,the Cronbach'sαof each dimension of the common module is 0.61 to 0.76,and the Cronbach'sαof the specific module is 0.82.The correlation of item dimensions is good,and the correlation coefficients of the PHD,MHD,SHD,and SBD dimension scores with the scores of the common module were 0.78,0.79,0.77 and 0.66(P<0.05).Validation factor analysis indicated that some of the entries of the original scale were of poor quality and had poor structural validity.The CMIN/DF of the revised scale is 2.91,the RMSEA value is 0.08,and the GFI,IFI,TLI,and CFI indices have increased to closer to 0.90,and the difference of each entry for the dimension to which it belonged was statistically significant(P<0.05).Convergent validity was moderate,composite reliability was moderate,and discriminant validity was moderate.Conclusion The overall reliability of the PROISCD-CG scale is good,and the dimensions of each item are reasonably divided.The structural validity of the original scale is average,but the structural validity of the revised scale has improved.Some items in the PROISCD-CG scale need to be revised and further validated.