中文版疾病和功能障碍接受程度问卷在慢性阻塞性肺疾病患者中的应用信效度

摘要

目的:对疾病和功能障碍接受程度问卷(Acceptance of Disease and Impairments Questionnaire,ADIQ)进行汉化,并分析其在慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者应用的信效度.方法:翻译汉化问卷,形成中文版ADIQ问卷;选择147名COPD患者进行测量评估,并分析其信效度.结果:中文版ADIQ问卷的量表水平内容效度(Scale-Content Validity Index,S-CVI)为0.93,条目水平的内容效度(Item-Content Validity Index,I-CVI)在0.8~1.0之间,通过探索性因子分析(exploratory factor analysis,EFA)可提取4个公因子,分别命名为拒绝维度、抵抗维度、伤心维度和接受维度,共可解释方差变异量的63.2%;进一步行验证性因子分析(confirmatory factor analysis,CFA)结果显示,问卷的卡方自由度比(χ2/df)为1.301,比较拟合优度指数(comparative fit index,CFI)为0.982,适配度指数(goodness of fit index,GFI)为0.936,增值拟合指数(incremental fit index,IFI)为0.983,非标准拟合指数(Tucker-Lewis index,TLI)为0.976,残差均方和平方根(root meansquare residual,RMR)为0.029,渐进残差均方和平方根(root mean square error of approximation,RMSEA)为0.022,模型的结构拟合度较好;问卷的总分及各维度得分与与Beck抑郁自评问卷(Beck Depression Inventory,BDI)总分及圣-乔治呼吸问卷(St-George's Respiratory Questionnaire,SGRQ)总分呈明显相关关系(P<0.01),聚合效度较好;在信度方面,问卷的Cronbach'sα系数为0.846,各维度的Cronbach'sα系数在0.730~0.862之间重测信度为0.857,各维度的重测信度在0.835~0.923之间,具有较好的信度.结论:中文版ADIQ问卷在COPD患者群体中具有良好的信度和效度,可用于COPD患者的心理状态的评估.%Objective: To translate Acceptance of Disease and Impairments Questionnaire (ADIQ) into Chinese, and to analyze the reliability and validity of its application to patients with chronic obstructive pulmonary disease (COPD).Methods: The questionnaire was translated into Chinese version. A total of 147 COPD patients were selected for measurement and evaluation, and the reliability and validity of ADIP were analyzed.Results: The scale level content validity index (S-CVI) of Chinese-version ADIQ was 0.93; the item level content validity index (I-CVI) was 0.8-1.0. Four common factors could be extracted via exploratory factor analysis (EFA), namely refusal dimension, resistance dimension, sorrow dimension and acceptance dimension. These four factors could explain 63.2% of variance together. As indicated by the further conflrmatory factor analysis (CFA), χ2/df of the questionnaire was 1.301; comparative flt index (CFI) was 0.982; goodness flt index (GFI0) was 0.936; incremental flt index (IFI) was 0.983; non-normed flt index (TLI) was 0.976; root mean square residual (RMR) was 0.029; root mean square error of approximation (RMSEA) was 0.022; and the structural goodness of flt of the model was good. The total score and the scores of all dimensions of the questionnaire were obviously correlated with Beck Depression Inventory (BDI) score and St-George's Respiratory Questionnaire (SGRQ) score (P<0.01); so the convergent validity was good. In terms of reliability, Cronbach's α coefficient of the questionnaire was 0.846; Cronbach's α coefficient of all dimensions varied from 0.730 to 0.862; test-retest reliability was 0.857; test-retest reliability of all dimensions varied from 0.835 to 0.923; so the questionnaire was of good reliability. Conclusion: Chinese-version ADIQ is of good reliability and validity among the COPD patient group, so it can be used to evaluate the psychological states of COPD patients.