脑性瘫痪儿童生存质量评估问卷的内容效度分析

摘要

目的:通过对脑性瘫痪(脑瘫)儿童生存质量评估(CPQOL)问卷项目与《国际功能、残疾和健康分类》儿童和青少年版(ICF-CY)类目的关联分析,明确CPQOL问卷的内容效度和使用价值.方法:由2名从事儿童临床评估5年以上的康复医生独立确定CPQOL每个项目所包含的概念,在完成概念提取后召开讨论会,统一概念用语,删除错误提取的概念,提取概念不一致时通过讨论决定,最终确定CPQOL 66个项目包含的概念,然后根据联系规则,通过讨论将CPQOL的项目概念与ICF-CY类目编码进行匹配,如果在确定类目编码意见不一致时,邀请第三方做出决定.通过分析CPQOL项目概念与ICF-CY类目编码关联的分布状况分析CPQOL问卷的内容效度.结果:共计从CPQOL66个项目中提取了104个概念,与ICF-CY编码发生了118次关联,涉及59个编码以及4个其他代码.在身体功能成分中主要与b1精神功能相关联,其中b152情绪功能被关联的次数最多;在活动和参与成分中关联较多的为d7人际交往与人际关系,d8主要生活领域和d9社区、社会和公民生活;环境因素成分中被关联最多的是e4态度、e3支持和相互联系和e5服务、体制和政策.结论:CPQOL问卷涵盖了脑瘫儿童生存质量评价所需涉及的各项生物和心理因素,更多地注重评价脑瘫儿童在参与过程中的感受和感受能力,以及环境因素对生存质量的影响,可以很好地符合目前关于生存质量评价的概念框架.%Objective:To determine the content validity of CPQOL and its clinical value through relevance analysis of items in CPQOL and categories in ICF-CY.Method:All the items in CPQOL were independently determined by two rehabilitation doctors who have over 5 years' experience in clinical evaluation.After all the concepts were extracted,a panel meeting was held to discuss the terms for the same concept and remove the concepts wrongly extracted.When there was inconsistency on the concept extraction,a discussion would be made to make a settlement.66 items in CPQOL contain concepts.Two doctors who were familiar with CPQOL and ICF-CY matched the items in CPQOL and category coding in ICF-CY according to the association rules through discussion.When there was a disagreement,a third partner would make an informal decision.The content validity of CPQOL was determined through the analysis on the association distribution of CPQOL items and ICF-CY category coding.Result:There are altogether 118 times of association between the 66 items in CPQOL and 59 codes and 4 other codes in ICF-CY.The items in body and function area are mainly associate with bl,in which b152 is the one to be associated with emotional functioning mostly.In activity and participation area,d7,d8 and d9 are associated much more often.In environmental area,the mainly associated items are e4,e3 and e5.Conclusion:The items of CPQOL covered all the biological and psychological factors which are necessary to evaluate the life quality of children with cerebral palsy.The CPQOL focuses much more on the children's ability to feel and their feelings during participating experience,as well as the environmental factors' effecting on the life quality.CPQOL is consistent well with current concept frame which is used to evaluate life quality.