腹膜透析生活质量量表的编制及考评

发布时间：2018-10-10 17:47

【摘要】：研究目的：基于世界卫生组织关于健康相关生活质量的定义,按照量表编制程序,编制具有较好操作性、代表性、有效性、准确性的适合我国文化背景的腹膜透析生活质量量表,建立腹膜透析患者生活质量科学评价方法,为我国腹膜透析人群的生活质量测评提供可靠的评价工具。并对该量表进行条目分析和信度、效度检验。研究方法：通过文献检索及患者访谈分别构建量表条目池的共性模块及特异性模块,共5个维度74个条目。应用Delphi专家咨询法对条目进行初步筛选,共纳入来自全国各地的20名从事肾脏专业的专家,进行包含预调研在内的三轮专家咨询,形成包括5个维度52个条目的初试量表(躯体生理功能9个条目、疾病因素16个条目、心理状态11个条目、社会角色功能10个条目、满意度6个条目)。通过现场调查的方法,对360名患者进行了测试,应用条目分析法、条目分布法、变异系数法、条目间相关系数法、条目与维度间相关系数法、Cronbach's Alpha系数、因子分析法7种方法从量表的信度、效度角度出发对量表条目进行再次筛选,形成5个维度41条目的量表(躯体生理功能5个条目,疾病因素14个条目、心理状态9个条目、社会角色功能7个条目、满意度6个条目)。量表的考评阶段,通过对304份有效量表的的统计分析,应用重测信度、半分信度及内部一致性检验量表信度,内容效度、效标关联度、区分效度及结构效度考评了量表的效度。研究结果：PD患者生活质量量表一周后重测信度0.748；Cronbach's Alpha系数为0.936,半分信度为0.814,结果均大于0.7,显示量表具备较好的信度。在对量表效度检验时显示本量表针对腹膜透析患者与非患者间具备较好的区分效度,差异具有统计学意义。将本量表与SF-36量表做效标效度分析的结果则显示,本量表各维度与SF-36量表各维度间相关,两量表总分的相关系数为0.956,结果具有统计学意义。对量表结构效度考评时,通过主成分因子分析提取了10个公因子,公因子的分布与维度间的联系基本符合研究者的理论构想及预期结果,对于个别条目的错位,研究者予以了调整。最终形成了包含41个条目的腹膜透析患者生活质量量表包含躯体生理功能5个条目,疾病因素15个条目、心理状态10个条目、社会角色功能6个条目、满意度5个条目的最终版量表。研究结论：1、本研究形成了适合中国文化背景的中文版腹膜透析患者生活质量量表。2、中文版腹膜透析患者生活质量量表具有较好的信度和效度,可在我国腹膜透析患者生活质量的测评中推广应用。
[Abstract]:Objective: based on the World Health Organization's definition of health-related quality of life, according to the development program of the scale, the compilation has better operability, representativeness and effectiveness. The quality of life (QOL) of peritoneal dialysis patients was evaluated by using the peritoneal dialysis quality of life scale, which was accurate and suitable for Chinese culture background. The scientific evaluation method of quality of life of peritoneal dialysis patients was established to provide a reliable evaluation tool for the quality of life evaluation of Chinese peritoneal dialysis population. The item analysis and reliability and validity test of the scale were carried out. Methods: by literature retrieval and patient interview, the common and specific modules of the inventory pool were constructed, with 74 items in 5 dimensions. Using the Delphi expert consultation method to carry out preliminary screening of the entry, a total of 20 experts engaged in kidney specialty from all over the country were included to conduct three rounds of expert consultation, including pre-investigation. The first test scale consisted of 52 items in 5 dimensions (9 items for somatic physiological function, 16 items for disease factors, 11 items for mental state, 10 items for social role function and 6 items for satisfaction). Through the method of field investigation, 360 patients were tested by item analysis method, item distribution method, variation coefficient method, inter-item correlation coefficient method, Cronbach's Alpha coefficient between items and dimension correlation coefficient method, between items and dimension correlation coefficient method, between item and dimension correlation coefficient method, between item and dimension correlation coefficient method, between item and dimension correlation coefficient method. From the reliability and validity of the scale, 7 methods of factor analysis were used to re-screen the items of the scale, forming a scale of 5 dimensions and 41 items (5 items of physical function, 14 items of disease factors, 9 items of mental state). Social role function 7 items, satisfaction 6 items). In the evaluation stage of the scale, through the statistical analysis of 304 effective scales, the validity of the scale was tested by means of test-retest reliability, semi-reliability and internal consistency. The validity of the scale was determined by testing the reliability of the scale, the content validity, the effect correlation degree, the distinguishing validity and the structural validity. Results: after one week, the reliability of PD patients was 0.748% Cronbachs Alpha coefficient was 0.936, half score reliability was 0.814, the results were all greater than 0.7, which showed that the scale had better reliability. The validity test showed that the scale had good distinguishing validity between peritoneal dialysis patients and non-patients, and the difference was statistically significant. The results of validity analysis of this scale and SF-36 scale showed that each dimension of this scale was correlated with that of SF-36 scale, the correlation coefficient of the total score of the two scales was 0.956, the results were statistically significant. Ten common factors were extracted by principal component factor analysis (PCA). The relationship between the distribution of common factors and the dimensions was basically consistent with the theoretical conception and expected results of the researchers, and the dislocation of individual items. The researchers adjusted it. Finally, 41 items of peritoneal dialysis patients' quality of life scale including 5 items of physical function, 15 items of disease factors, 10 items of mental state, 6 items of social role function were formed. The final version of the satisfaction scale for 5 items. Conclusions: 1. The Chinese version of quality of life scale for peritoneal dialysis patients was developed, which is suitable for Chinese culture. 2. The Chinese version of quality of life scale for peritoneal dialysis patients has good reliability and validity. It can be popularized and applied in the quality of life of peritoneal dialysis patients in China.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R473.5

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