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目的:使用条目反应理论(item response theory,IRT)对鼻咽癌患者生存质量(quality of life for nasopharyngeal carcinoma,QOL-NPC)量表进行评价,了解QOL-NPC量表的微观表现,了解每个条目的计量心理学特征。方法:采用横断面研究,使用QOL-NPC量表调查387例鼻咽癌患者,对身体机能(physical domain,PH)、心理精神状况(psychological domain,PS)、社会关系(social domain,SO)和不良反应领域(side-effect domain,SE)4个维度的条目构建部分评分模型,评价模型的信度系数,估计每个条目的阈值参数和残差,对性别、年龄和其他慢性病进行项目功能差异(differential item functioning,DIF)分析。结果:除了SO维度的信度系数为0.670外,其他维度的信度系数均>0.8。条目PH2、PS5、PS6、SO2、SO3、SO5、SE2、SE5、SE6和SE11的阈值出现颠倒情况,其他条目均未出现颠倒情况。条目的平均阈值位于-0.487~1.107,最大的为条目SE1(1.107),最小的为条目SE10(-0.487)。标准化残差绝对值>2.5的条目有PH7、PS4、PS5和SE5,其余条目残差绝对值均<2.5。DIF分析结果显示,所有的条目在性别、年龄和其他疾病均无一致性DIF和非一致性DIF。结论:QOL-NPC量表部分条目的拟合优度较差,出现颠倒的阈值,需要进一步完善。
OBJECTIVE: To evaluate the quality of life of nasopharyngeal carcinoma (QOL-NPC) scale using item response theory (IRT), to understand the microscopic behavior of the QOL-NPC scale, Metrological Psychological Characteristics of Entries. Methods: A cross-sectional study was conducted to investigate 387 NPC patients using the QOL-NPC scale. Physical status (PH), psychological domain (PS), social domain (SO) To construct partial scoring model, evaluate the confidence coefficient of the model, estimate the threshold parameters and residuals of each entry, and make project functional differences on gender, age and other chronic diseases by using the four dimensions of the side-effect domain (SE) (differential item functioning, DIF) analysis. Results: Except for the reliability coefficient of SO dimension being 0.670, the reliability coefficients of other dimensions were both> 0.8. The threshold values for entries PH2, PS5, PS6, SO2, SO3, SO5, SE2, SE5, SE6 and SE11 were reversed, and none of the other entries were reversed. The average threshold for entries ranges from -0.487 to 1.107, with the largest entry SE1 (1.107) and the smallest entry SE10 (-0.487). The entries with normalized residue absolute value> 2.5 are PH7, PS4, PS5 and SE5, and the remaining entries have absolute residuals <2.5. The DIF analysis showed that all entries did not have consistent DIF and non-consistent DIF for gender, age and other diseases. Conclusion: The goodness of fit of some items of QOL-NPC scale is poor, and the threshold of reversal appears to need to be further improved.