基于脑卒中患者报告结局量表的条目筛选

Item selection for the patient-reported outcome scale of stroke patients

目的研制适合我国地域文化特征的脑卒中患者报告结局(PRO)评价量表。方法按照国际患者报告结局(PRO)量表的研制规范,建立条目池,编制初始量表,对不同等级的医院、社区以及农村地区进行预调查和大规模的临床(现场)调查,回收后利用离散趋势法、因子分析法、相关系数法、克朗巴赫系数法、项目反应理论5种方法联合筛选条目,并对量表进行信度、效度和可行性的考核。结果经过内容效度指数(I-CVI)、预调查和正式调查3次条目修正,最终形成包含46个条目、10个维度、4个领域的"脑卒中PRO量表"。总量表的克朗巴赫系数为0.905。结构效度结果显示量表多维度的测量满足专业上的预期构想。抽样调查脑卒中患者,量表回收率为99.2%,有效率为98.8%,平均作答时间为8.9 min。结论形成的最终量表基本符合理论框架,较好地反映了脑卒中患者生命质量的内涵,对临床疗效评价具有指导意义。

Objective To develop a new rating scale which is suitable for Chinese culture to evaluate Chinese stoke patients based on Patient-Reported Outcomes(PRO). Methods The draft was based on international PRO instruction development standards and procedures. Data were collected twice including presurvey and clinical interview survey from various levels of hospitals and communities. Surveys were analyzed and items were selected with 5 methods includingmeasure of discrete tendency, factor analysis, correlation coefficient, Cronbach coefficient, Item Response Theory. Reliability, validity, and feasibility of the scale were checked. Results Final'Stroke Patient PRO Scale'consists of 46 items, 10 dimensions, and 4 domains. It was revised three times including analysis with the Item-Level Content Validity Index(I-CVI), pre-survey and formal survey. Reliability of the final scale is verified by Cronbach,s coefficient α as 0.905. Structural validity results proved that the multi-dimensional measurements of the scale fulfilled the hypothesis. Among stroke patients of the sample, the response rate was 99.2%, the valid rate was 98.8%, and the average filling time was 8.9 minutes. Conclusions The ultimate scale coincides with the theoretical framework, reflects the connotation of the stroke patients' quality of life. It will be useful as an instruction for clinical assessment.