脊髓损伤患者日常生活活动自评问卷的研制与信效度检验

Development of a self-assessing questionnaire for activities of daily living in patients with spinal cord injury and examination of its reliability and validity

中文关键词:  脊髓损伤  问卷  生活自理

英文关键词:Spinal cord injury  Questionnaire  Self-care

中文摘要:

  【摘要】 目的：研制并检验日常生活活动自评问卷的信度与效度，通过自评的方式获得脊髓损伤者自理活动表现，为脊髓损伤社区作业治疗提供评估工具。方法：采用方便抽样的方法选取上海市某医院参加康复训练的脊髓损伤者（141例）为研究对象。采用文献分析法、访谈法构建初始量表后，通过德尔菲法（Delphi）形成待验问卷。通过统计分析检验问卷的区分度、内部一致性及构建效度、内容效度和校标关联效度。同时对问卷的功能独立性评定（functional independence measure，FIM）能力进行评价。结果：最终获得由“自我照护”和“社区参与”两个维度19个项目组成的自评问卷。多数问卷项目区分度大于0.48。问卷克朗巴哈系数（α）为0.942，内部一致性良好。探索性因子分析累计方差贡献率62.03%，项目分布与原构建相一致。问卷内容效度良好，仅项目“家务”（0.44，P<0.01）和“手机使用”（0.49，P<0.01）内容相关性较低。问卷与SCIM-Ⅲ评分斯皮尔曼相关系数为0.813（P<0.01），关联效度良好。通过线性回归，对FIM的预测模型分析准确度达71.6%，AIC（信息准则）=657.460。结论：日常生活活动自评问卷的信效度良好，能够较准确地反映脊髓损伤患者社区生活状态。

英文摘要:

  【Abstract】 Objectives: To develop a self-assessing questionnaire for activities of daily living(ADL) in patients with spinal cord injury and examine the reliability and validity of the questionnaire, obtain the performance of self-care activities of patients with spinal cord injury through self-assessment, so as to provide an evaluation tool for community occupational therapy. Methods: 141 patients with spinal cord injury participating in the rehabilitation trainings in a hospital in Shanghai were selected by convenience sampling as the research objects. The initial scale was structured by literature analysis and interview forming the questionnaire to be tested through the Delphi method. And the discrimination, internal consistency and validity including construction validity, content validity and criterion-related validity were evaluated through statistical analysis. The ability of the questionnaire to predict functional independence measure(FIM) was evaluated at the same time. Results: A self-evaluation questionnaire consisting of 19 items in two dimensions of "self-care" and "community integration" was obtained. The discrimination of items in the questionnaire was mostly greater than 0.48. The α coefficient was 0.942 for good internal consistency. The cumulative variance contribution rate of exploratory factor analysis was 62.03%, and the distribution of items was consistent with the original. The content validity of the questionnaire was good except the items of "housework" (0.44, P<0.01) and "use of mobile phone" (0.49, P<0.01) were with low correlations. The criterion-related validity was good, and the Spearman correlation coefficient between the questionnaire and SCIM-Ⅲ score was 0.813 (P<0.01). The accuracy of analysis to predict FIM by linear regression was 71.6%, and Akaike information criterion(AIC)=657.460. Conclusions: The "ADL self-assessment questionnaire" has good reliability and validity, which can accurately reflect the community life status of patients with spinal cord injury.