中文版晚期痴呆患者生活质量量表的信效度研究

摘要

目的：翻译晚期痴呆患者生活质量量表（QUALIDS）并检验其信效度，探讨其在我国的适用性。方法于2015年12月—2016年1月，采用多阶段整群抽样方法，选取湖南省养老机构特别照护单元的晚期痴呆患者205例为研究对象。将英文版 QUALIDS 翻译成中文，再次回译成英文，发给原作者进行审核，经反复对照比较形成中文版QUALIDS。由患者的照护者自行填写量表，当场发放和收回。由长沙市两所大型养老机构23例患者的两位不同班次的照护者重复填写中文版 QUALIDS，两周后再次进行中文版 QUALIDS 评价。采用内部一致性、评分者间信度、重测信度、分半信度评价量表信度；采用内容效度、关联效度、结构效度评价量表效度。结果中文版 QUALIDS 的Cronbach′s α系数为0.738，各条目与总分的相关系数（r 值）为0.354~0.755。两位不同班次的照护者针对23例患者再次填写中文版 QUALIDS，各条目组内相关系数（ICC）为0.783~0.964，总分 ICC 为0.892。两周后再次对23例患者进行中文版 QUALIDS 评价，各条目重测相关系数为0.575~0.878，总分重测相关系数为0.819，分半信度为0.874。根据专家反馈结果，内容效度指数（CVI）为0.910。中文版 QUALIDS 与全面衰退量表（GDS）、神经精神症状调查问卷（NPI-Q）严重程度分量表、NPI-Q痛苦程度分量表、躯体生活自理量表（PSMS）评分相关系数（r 值）为-0.270、0598、0.576、0.267（P <0.01）。因子分析得到3个公因子，公因子1包括条目2、3、4，公因子2包括条目6、7、11，公因子3包括条目1、9、10。结论中文版 QUALIDS 具有较好的信度和效度，可用来评价晚期痴呆患者的生活质量。%Objective To translate and test the reliability and validity of the Quality of Life in Late - stage Dementia Scale(QUALIDS),and to investigate its applicability in China. Methods From December 2015 to January 2016,205 patients with late - stage dementia who were in special care unit of old - age care institutions in Hunan province were selected by multistage cluster sampling method. The QUALIDS in English version was translated into Chinese,and then translated back to English again. Then it was sent to the original author for review,and finally the QUALIDS of Chinese version was formed after repeated contrast and comparison. The scale was filled in by the caregivers of the patients,and the scales were sent out and recovered on the spot. Two different caregivers filled in the QUALIDS of Chinese version repeatedly by targeting at 23 patients in two large old - age care institutions in Changsha city. The QUALIDS of Chinese version was reevaluated after 2 weeks. The reliability of the scale was evaluated by internal consistency,inter - rater reliability,test - retest reliability,and split - half reliability;the validity of the scale was evaluated by content validity,association validity and structure validity. Results The Cronbach′s α coefficient of the QUALIDS of Chinese version was 0. 738,and the correlation coefficients of each item and total score were 0. 354 - 0. 755. Two different caregivers targeting at the 23 patients fill in the QUALIDS of Chinese version again,the intraclass correlation coefficients( ICC)of each item were 0. 783 - 0. 964,and the total scores of ICC was 0. 892. The QUALIDS of Chinese version was evaluated again for the 23 patients after two weeks. The correlation coefficients of test - retest of each item were 0. 575 - 0. 878,and the total score of test - retest correlation coefficient was 0. 819. The split - half reliability was 0. 874. According to the feedback of experts,the content validity index(CVI)was 0. 910. The correlation coefficients between QUALIDS of Chinese version and GDS,severity scale of NPI-Q,pain degree subscale of NPI-Q and PSMS score were - 0. 270, 0598,0. 576,and 0. 267(P < 0. 01). Three common factors were obtained by factor analysis,common factor 1 had items 2, 3,and 4,the common factor 2 had items 6,7,and 11,and the common factor 3 had items 1,9,and 10. Conclusion The QUALID of Chinese version of is a reliable and valid instrument to evaluate the quality of life of patients in late - stage dementia.