中文版癌症治疗功能评估疲乏量表在肿瘤患者中应用的信效度分析

摘要

Objective To explore the reliability and validity of the Chinese version of the function assessment of cancer therapy - fatigue(FACT-F)for the treatment of patients with cancer. Methods Patients with cancer who were treated in the Affiliated Hospital of Jining Medical College from January to June in 2015,were selected as study subjects. After obtaining the consent of the original author,the original FACT-F scale was translated into Chinese,and the Chinese version of the FACT-F scale was established. Some patients were investigated by the Chinese version of the FACT-F scale by convenience sampling method. Two weeks later,50 patients with cancer were randomly selected by drawing lots,and they were investigated with the same method. The content validity and construct validity of the scale were evaluated,the reliability of the scale was also evaluated through calculating the Cronbach’s α coefficient,the split - half reliability and the retest reliability. According to total score of the Chinese version of FACT-F scale,among 500 cases of patients,135 patients entered into the high score group(these cases got 128 - 164,accounted for 27% of total cases),135 cases entered into the low score group( these cases got 40 - 78, accounted for 27% of total cases),each dimension score of Chinese version of FACT-F was compared between two groups of patients respectively. Results A total of 510 questionnaires were issued,and 500 qualified questionnaires were recovered,the effective recovery rate was 98. 04% . The total score of the Chinese version of FACT-F scale was(90. 9 ± 21. 2),score of physiology dimension was(16. 2 ± 10. 4),score of social family dimension was(15. 2 ± 6. 6),score of emotional dimension was(11. 2 ± 5. 0),score of function dimension was(17. 5 ± 8. 3),score of fatigue dimension was(4. 7 ± 2. 7),and score of doctor - patient relationship dimension was(28. 2 ± 18. 2). The Cronbach’s α coefficient of the Chinese version of FACT-F scale was 0. 762,and the Cronbach’s α coefficient of various dimensions ranged from 0. 728 to 0. 939. The split - half reliability of the Chinese version of FACT-F scale was 0. 882,the split - half reliability of various dimensions ranged from 0. 686 to 0. 896. Cases were investigated repeatly two weeks later,the retest reliability r value was 0. 865,and the retest reliability r value of various dimensions ranged from 0. 668 to 0. 811. The correlation coefficient r value between the total score of the Chinese version of FACT-F scale and the score of various dimensions ranged from 0. 438 to 0. 802. The content validity index(CVI)of the Chinese version of FACT-F scale was 0. 840. The item content validity index( I-CVI)was 0. 872,and the scale level content validity index(S-CVI)was 0. 856. The exploratory factor analysis showed that KMO value was 0. 910,Bartlett’s sphericity test showed χ2 was 3 080. 91,the cumulative variance contribution rate was 56. 052% . A total of 6 common factors were extracted. Score of various dimensions of the Chinese version of the FACT-F scale among patients in high score group was significantly higher than that among patients in low score group respectively( P ﹤ 0. 05). Conclusion The Chinese version of FACT-F scale has a good reliability and validity in evaluation of Chinese patients with cancer.%目的：探讨中文版癌症治疗功能评估疲乏量表（FACT-F）在肿瘤患者中应用的信效度。方法选取2015年1—6月济宁医学院附属医院肿瘤科收治的肿瘤患者为研究对象。征得原作者同意后，获取原版 FACT-F，对其进行汉化，形成中文版 FACT-F。采用方便取样的方法通过调查员面对面询问、患者回答的方式对中文版 FACT-F 进行问卷调查。2周后采用抽签法随机抽取50例肿瘤患者用相同的方法进行重复调查。评价中文版 FACT-F 的内容效度、结构效度，同时进行信度评价，包括 Cronbach’s α系数、分半信度和重测信度。根据中文版 FACT-F 总得分，500例患者中135例进入高分组（总得分上27％即128~164分），135例进入低分组（总得分下27％即40~78分），比较两组患者中文版 FACT-F 各维度得分的差异。结果共发放问卷510份，回收有效问卷500份，有效回收率为98.04％。中文版 FACT-F 总得分为（90.9±21.2）分，其中生理维度得分为（16.2±10.4）分，社会家庭维度得分为（15.2±6.6）分，情感维度得分为（11.2±5.0）分，功能维度得分为（17.5±8.3）分，疲乏维度得分为（4.7±2.7）分，与医生关系维度得分为（28.2±18.2）分。中文版 FACT-F Cronbach’s α系数为0.762，各维度 Cronbach’s α系数为0.728~0.939；中文版 FACT-F 分半信度为0.882，各维度分半信度为0.686~0.896。2周后重测，中文版 FACT-F 重测信度 r 值为0.865，各维度重测信度 r 值为0.668~0.811。中文版 FACT-F 总得分及各维度得分间相关系数 r 值为0.438~0.802。中文版 FACT-F 内容效度指数（CVI）为0.840，各条目水平内容效度指数（I-CVI）为0.872，量表水平内容效度指数（S-CVI）为0.856。探索性因子分析 KMO ＝0.910，Bartlett’s 球形检验χ2＝3080.91，累计方差贡献率56.052％，共提取6个主成分。高分组患者中文版 FACT-F 各维度得分均高于低分组，差异有统计学意义（P ﹤0.05）。结论中文版 FACT-F 具有良好的信效度，可在国内肿瘤患者中应用。