改良版西安大略和麦克马斯特大学骨关节炎指数量表在膝骨关节炎中的应用

摘要

Objective To modify Western Ontario and McMaster University Osteoarthritis Index (WOMAC) for more accurate evaluation of patients with knee osteoarthritis in China,and its reliability and validity were measured.Methods The WOMAC was modified through reviewing relevant literatures and practical survey.Total of 120 patients were enrolled in this study.The subjects completed the WOMAC,the modified WOMAC and Medical Outcomes Study 36-item Short Form(SF-36),and 113 of the questionnaires were valid for analysis [27 males (23.9％),86 females (76.1％),aged (59± 10) years].Intraclass correlation coefficient and Cronbach α reliability coefficient were used to analyze the modified WOMAC's reliability;exploratory factor analysis was adopted to analyze the validity of WOMAC and the modified WOMAC;Spearman rank correlation coefficient was used to make a correlation analysis among SF-36,WOMAC and the modified WOMAC.Results For the four dimensions:pain,stiffness,function and life quality in the modified WOMAC,the intraclass correlation coefficient values were 0.861-0.910 and Cronbach α values were 0.751-0.936.In the content validity analysis,the number of extracted common factors for the four dimensions:pain,stiffness,function and life quality in the modified WOMAC were 1,1,2 and 1 respectively.The total variance interpretation rate was 65.684％,84.367％,67.252％ and 67.572％,respectively.In the construct validity analysis,4 common factors were extracted for WOMAC and the modified WOMAC respectively.The total variance interpretation rate was 70.100％ and 67.213％,respectively.Both WOMAC and the modified WOMAC had a significant correlation with SF-36.Conclusion The modified WOMAC is more suitable for Chinese living habits,but it still needs to be further evaluated with larger samples.%目的 为了使西安大略和麦克马斯特大学骨关节炎指数(WOMAC)量表更加准确的对我国膝骨关节炎患者进行评估,对传统的WOMAC量表进行改良,并对其信度和效度进行测量.方法 通过查阅文献及实际调查,对WOMAC量表进行改良.对120例患者进行调查并完成WOMAC、改良版WOMAC量表及医疗结果研究36项简表(SF-36),其中113例有效[男27例(23.9％),女86例(76.1％),平均年龄(59±10)岁].采用组内相关系数和克朗巴赫系数α分析改良版WOMAC量表的信度;采用探索性因子分析法分析WOMAC量表及改良版WOMAC量表的效度;应用Spearman秩相关系数对SF-36与WOMAC量表、改良版WOMAC量表进行相关性分析.结果 改良版WOMAC量表中疼痛、僵硬、功能以及生活质量四个维度的组内相关系数值在0.861～0.910;克朗巴赫系数α值在0.751～0.936.在内容效度的分析中,改良版WOMAC量表疼痛、僵硬、功能、生活质量4个维度分别提取出1、1、2和1个公共因子,总方差解释率分别为65.684％、84.367％、67.252％、67.572％.在结构效度的分析中,WOMAC量表、改良版WOMAC量表均提取出4个公共因子,总方差解释率分别为70.100％、67.213％,WOMAC量表、改良版WOMAC量表均与SF-36量表有明显相关性.结论 改良版WOMAC更加符合我国国民生活习惯,但仍需在更大的样本量进一步评估.