中医体质量表-41条目简短版的结构效度和反应度评价

摘要

目的 分析中医体质量表-41条目简短版的结构效度和反应度,评价该量表辨识中医体质的应用价值.方法 选取2013年2月-2014年7月于广东省中医院珠海医院自愿接受治未病并完成26周中医体质综合干预的509例受试者为调查对象.依据干预前的体质判定结果,调查对象均自行实施干预措施并记录,并由专业医生进行监督和指导.分别于干预前和干预26周后,调查对象自行填写中医体质量表.采用因子分析评价中医体质量表-41条目简短版的结构效度;通过比较干预前后各条目及各亚量表得分,并计算变化率(CR)、效应量(ES)、标准化反应均数(SRM)评价反应度.结果 因子分析显示,提取的8个公因子解释的方差贡献率均≥4.00％,累积解释的方差贡献率53.57％;特征根均＞1.00,主要支配的条目与8种偏颇体质基本对应,形成较好的解释.调查对象干预前后条目26、44、49、52得分比较,差异无统计学意义(P＞0.05);其余条目干预后得分低于干预前(P＜0.05).各条目平均CR(绝对值)、ES(绝对值)、SRM(绝对值)分别为7.81％、0.16、0.20.调查对象干预后平和质亚量表得分高于干预前,气虚质、阳虚质、阴虚质、痰湿质、湿热质、血瘀质、气郁质、特禀质亚量表得分低于干预前(P＜0.05).各亚量表平均CR(绝对值)、ES(绝对值)、SRM(绝对值)分别为12.79％、0.25、0.35.结论 中医体质量表-41条目简短版结构明确、反应度良好,具有较高的测量价值.%Objective To assess the application value of the 41-item short version of Constitution in Chinese Medicine Questionnaire (CCMQ) by investigating its construct validity and responsiveness.Methods The enrolled participants were 509 cases who voluntarily received the program of preventive treatment of disease and completed the 26-week comprehensive intervention of body constitution based on TCM in Zhuhai Branch,Guangdong Provincial Hospital of TCM from February 2013 to July 2014.All the participants implemented the intervention by themselves based on the type of constitution assessed before the intervention,and recorded them under the supervision and guide of professional physicians.And they were surveyed by the CCMQ before and 26 weeks after the intervention.Factor analysis was conducted to investigate the construct validity of the 41-item short version of CCMQ.The scores of items and subscales of the 41-item short version of CCMQ were calculated and compared.The change ratio (CR),effect size (ES),and standardized response means (SRM) of each item and subscale were calculated for assessing the responsiveness of the 41-item short version of CCMQ.Results Each of the extracted eight common factors could explain more than 4.00％ of the total variance for the questionnaire,and comulatively 53.57％.Each factor's eigenvalue was greater than 1.00.The items dominated by these eight factors would be basically matched with and well defined the eight pathological constitutions.Statistically significant decrease of mean scores were detected in 37 items (P ＜ 0.05),except items 26,44,49,52 (P ＞0.05).The average absolute values of CR,ES and SRM for items were 7.81％,0.16,and 0.20,respectively.After the intervention,the gentleness type subscale scores were higher than before,while those of other subscales were lower (P ＜0.05).The average absolute values of CR,ES and SRM for all subscales were 12.79％,0.25,and 0.35,respectively.Conclusion The 41-item short version of CCMQ has clear construction and reasonable responsiveness,which indicates a high value of measurement.