中文版晚期痴呆患者生活质量量表的信效度研究

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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’sα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 evaluate the quality of life of patients with advanced dementia (QUALIDS) and test its reliability and validity to explore its applicability in China. Methods From December 2015 to January 2016, 205 patients with advanced dementia in the special care unit of pension institutions in Hunan Province were selected as the study objects by multistage cluster sampling method. The English version of QUALIDS translated into Chinese, once again translated into English, sent to the original author for review, after repeated comparison to form the Chinese version of QUALIDS. The patient’s caregivers fill in the form by themselves and issue them on the spot. The Chinese version of QUALIDS was repeatedly filled in by two caregivers of two different shifts from 23 patients in two large-scale pension institutions in Changsha City. Two weeks later, the Chinese version of QUALIDS was again evaluated. The internal consistency, inter-rater reliability, test-retest reliability and half reliability were used to evaluate the reliability of the questionnaire. The validity of the questionnaire was evaluated by the content validity, the relevance validity and the structural validity. Results The Cronbach’s alpha coefficient of Chinese version of QUALIDS was 0.738, and the correlation coefficient (r value) of each item was 0.354-0.755. Caregivers from two different classes re-filled Chinese version of QUALIDS for 23 patients. The correlation coefficient (ICC) of each item group was 0.783-0.964, and the total score of ICC was 0.892. Two weeks later, 23 Chinese patients were evaluated again by Chinese version of QUALIDS. The correlation coefficient of each item was 0.575-0.878, the correlation coefficient of total score was 0.819, and the half reliability was 0.874. Based on expert feedback, the content-validity index (CVI) was 0.910. The correlation between QUALIDS and GDS, NPI-Q severity scale, NPI-Q pain scale and PSMS score (r value) -0.270, 0598, 0.576, 0.267 (P <0.01). The factorial analysis results in three common factors, the common factor 1 including entries 2, 3 and 4, the common factor 2 including entries 6, 7 and 11, and the common factor 3 including entries 1, 9 and 10. Conclusion The Chinese version of QUALIDS has good reliability and validity and can be used to evaluate the quality of life of patients with advanced dementia.
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