老年抑郁量表城乡项目功能差异分析

摘要

目的：探讨老年抑郁量表（ GDS-5）在城乡项目功能差异（ DIF）中的应用。方法2012年1—2月利用GDS-5对老龄化期望研究中的550例老年人进行资料收集。采用χ2检验分析GDS-5各条目〔条目1“您对您现在的生活是否基本上满意”、条目2“您是否经常感到无聊、厌倦”、条目3“您是否常感到生活没有希望”、条目4“您是否常更想待在家里而不喜欢外出”、条目5“您是否觉得像现在这样活着毫无意义”〕的城乡差异；采用单维性检验分析主要指标〔比较拟合指数（ CFI ）、非规范拟合指数（ TLI ）、近似误差均方差（ REMSEA ）、标准化残差均方根（ SRMR）〕；采用EASY－DIF软件包进行GDS-5城乡DIF的探测。结果条目2、条目3的城乡差异比较，差异有统计学意义（ P＜0.05）；其余条目的城乡差异比较，差异无统计学意义（ P ＞0.05）。单维性检验显示， CFI、 TLI、REMSEA、 SRMR均符合适配标准，表明GDS-5各条目测量的是同一概念特质，具有较好的结构效度。 EASY－DIF软件包分析结果显示，条目2、条目3的MH值比较，差异有统计学意义（ P＜0.05）；其他条目的MH值比较，差异无统计学意义（P＞0.05）。条目2、条目3的ΔαMH值分别为0.915、1.279。结论 GDS-5的条目3存在中等强度城乡DIF问题，今后在解释抑郁城乡差异时需注意条目城乡DIF问题。%Objective To explore the differential item functioning ( DIF) of geriatric depression scale-5 ( GDS-5 ) for urban-rural differences.Methods From January to February in 2012, the data of 550 elderly people enrolled in a previous research of expectation on aging by GDS-5 were collected.DIF of GDS-5 for urban -rural differences was analyzed by χ2 test.There were five items:1."Are you basically satisfied with your current life"; 2."Do you often feel bored and weary";3."Do you often feel there is no hope for life"; 4."Do you often prefer to stay at home rather than go out"; 5."Do you often feel current life is pointless".Unidimensional test was conducted to analyze CFI, TLI, REMSEA and SRMR, and EASY-DIF software was employed to investigate the DIF of GDS-5 for urban-rural differences.Results Significant rural-urban differences existed in item 2 and item 3 ( P <0.05 ); no significant rural -urban differences existed in other items ( P >0.05 ) . Unidimensional test showed that CFI, TLI, REMSEA and SRMR all accorded with fit standard, which suggested that each item of GDS-5 was measuring the same concept characteristic and had good construct validity.EASY-DIF software analysis showed that item 2 and item 3 were significantly different in MH value ( P<0.05 ) and no significant difference of MH value existed among other items (P>0.05) .TheΔαMH of item 2 was 0.915 and that of item 3 was 1.279.Conclusion The third item of GDS-5 has moderate DIF for urban -rural differences.DIF for urban-rural differences should be considered in the future comparison of depression between urban and rural elders.