老年慢性病患者多维健康测定量表共性模块条目分析

Item analysis on the general module in a multidimensional health measurement scale for elderly patients with chronic diseases

目的应用经典测量理论(classical test theory,CTT)和项目反应理论(item response theory,IRT)对老年慢性病患者多维健康测定量表共性模块(MHIEC-GM)(V1.0)进行条目分析和评价。方法采用MHIEC-GM(V1.0)量表对2375名老年慢性病患者进行自评式调查。采用变异度法、相关系数法、因子分析法、Cronbach′sα系数法对量表条目质量进行分析,采用IRT分析软件MULTILOG 7.03分析量表条目的难度系数、区分度系数和信息量。结果CTT结果显示,9个条目的标准差均>0.9。相关系数法、因子分析法和Cronbach′sα系数法的结果显示,除GMI9条目以外,其他条目与总量表的相关系数均>0.5,因子载荷均>0.5,删除该条目后的Cronbach′sα系数均<0.763。综合4种分析方法的结果,除GMI9条目之外,其他条目均有较好的特性。IRT结果显示,除GMI4、GMI6、GMI8之外其他条目信息量均>0.333(5/15);条目的区分度均为1.44;难度系数符合[-4,4]入选标准的条目有GMI2、GMI3、GMI5、GMI7、GMI9,随难度等级增加而呈现出单调递增趋势。GMI1、GMI4、GMI6、GMI8还需进一步完善。结论经CTT和IRT方法分析显示,MHIEC-GM(V1.0)量表的大部分条目的性能良好,但仍有部分条目需进一步根据老年慢性病特点进行修订和验证。

Objective To analyze and evaluate the items of the general module of multidimensional health measurement instruments system for elderly patients with chronic disease(MHIEC-GM)(V1.0)based on classical test theory(CTT)and item response theory(IRT).Methods A self-administered survey of 2375 elderly patients with chronic diseases was conducted using the MHIEC-GM(V1.0)scale.The quality of items was analyzed using the variability method,correlation coefficient method,factor analysis method,and Cronbach'sαcoefficient method based on CTT.The difficulty coefficient,differentiation coefficient,and information content of items were analyzed using the IRT analysis software MULTILOG 7.03.Results The CTT results showed that the standard deviations of all nine items were greater than 0.9.The results of the correlation coefficient method,the factor analysis method and the Cronbach′sαcoefficient method showed that except for the GMI9 item,the correlation coefficients between the other items and the total scale were all greater than 0.5,and the factor loads were all greater than 0.5,and the Cronbach′sαcoefficients after the deletion of the items were all less than 0.763.Based on the results of the four analysis methods,except for the GMI9 item,all the other items had good characteristics.The IRT results showed that the information contents of all items were>0.333(5/15)except for the GMI4,GMI6,and GMI8,and the differentiation coefficient of each item was 1.44.The items that difficulty coefficient met the[-4,4]inclusion criteria were the GMI2,GMI3,GMI5,GMI7 and GMI9,showing a monotonically increasing trend with increasing difficulty level.The items of GMI1,GMI4,GMI6,and GMI8 needed further improvement.Conclusion Most of items of the MHIEC-GM(V1.0)scale have good psychometric properties,but some items need to be further revised and validated according to the characteristics of chronic diseases in the elderly.