多元认知能力自评量表（MASQ）的汉化及其在癫痫病人群中的应用

发布时间：2018-04-24 23:41

本文选题：癫痫 + 认知功能　；参考：《天津医科大学》2017年硕士论文

【摘要】：目的对多元认知能力自评量表(Multiple Ability Self-Report Questionnaire,MASQ)进行翻译、回译及文化调试,并结合我国的文化背景建立中文版MASQ量表,利用该量表调查癫痫患者的认知功能状况并探讨影响该群体认知功能的因素。方法2015年10月至2016年1月,对英文版MASQ进行翻译、回译及文化调试,邀请专家对量表的内容进行修订,形成中文版MASQ量表。选取天津市某三级甲等医院的神经内科门诊或病房的癫痫患者200例作为研究对象,对中文版MASQ量表进行信度和效度检验。量表信度采用Cronbach'sα系数和重测信度来检验,使用内容效度、效标关联效度和结构效度对量表的效度进行评价,结构效度采用验证性因子分析。采用便利抽样的方法于2016年2月至2016年5月从天津医科大学总医院抽取癫痫患者220例作为研究对象。采用问卷调查法,通过一般资料调查表收集社会人口学指标和疾病指标,采用医院焦虑抑郁量表(HADS)、总体幸福感量表(GWB)、社会支持量表(SSRS)、癫痫患者生活质量量表(QOLIE-31)调查癫痫患者的焦虑抑郁情绪、总体幸福感和社会支持水平以及生活质量现状。采用单因素分析的方法比较各分类变量中不同类别指标间认知功能的差异,使用相关性分析检验各连续性变量与认知功能的相关系数,运用多元线性回归分析探讨国内癫痫患者认知功能的影响因素。结果(1)量表汉化引进阶段:经过对量表的翻译、回译及文化调试,中文版MASQ量表包括37个条目,分为5个维度。量表的Cronbach’sa系数为0.948,5个维度的Cronbach’sa系数分别为0.902、0.797、0.733、0.893、0.848,重测相关系数(重测信度)为0.960,各维度的重测信度分别为0.866、0.860、0.850、0.899、0.841。5名专家对量表进行评定,各条目CVI(item-level CVI,I-CVI)均在0.80以上,总条目内容效度指数(scale-level CVI,S-CVI)为0.98。MASQ得分与QOLIE-31得分呈负相关(r=-0.732,P0.001),与HADA、HADD呈正相关(r=0.590、0.524,P0.001)。验证性因子分析显示量表的模型拟合较好,修正后标准化五因素模型的卡方自由度比值(CMIN/DF)、拟合优度指数(GFI)、调整拟合优度指数(AGFI)、残差均方和平方根(RMR)、近似误差均方根(RMSEA)、规范拟合指数(NFI)、增值拟合指数(IFI)、非归准适配指数(TLI)、比较拟合指数(CFI)、简约拟合优度指数(PGFI)分别为2.155、0.879、0.902、0.045、0.076、0.881、0.869、0.856、0.868、0.636,标准化回归系数0.33~0.93。(2)量表应用阶段:最终完成对220例癫痫患者有效资料的收集。患者认知功能总得分范围48~135分,平均(87.86±19.30)分。各维度得分情况:语言(16.95±5.66)分,视知觉功能(12.29±3.70)分,言语记忆(20.40±5.09)分,视觉空间记忆(20.50±3.57)分,注意力(17.74±4.58)分。单因素分析结果显示:社会人口学变量中不同工作情况、文化程度和家庭月收入因素间的认知功能得分差异有统计学意义(P0.001);疾病相关变量中不同发作类型、癫痫灶部位、发作频率、发作持续时间及服药类型的认知功能得分差异有统计学意义(P0.05);连续性变量作Pearson或Spearman相关分析,发现认知功能与年龄、焦虑抑郁情绪、总体幸福感水平、社会支持水平、和生活质量的相关性有统计学意义(P0.001)。多元线性回归分析结果显示:年龄、文化程度、发作频率、焦虑、总体幸福感水平、社会支持水平、生活质量对认知功能有影响,偏回归系数分别为0.182、个-4.318、-1.000、3.645、0.379、-0.504、-1.023,7个变量可解释总变异的62.4%。结论本研究将英文版MASQ汉化,并对中文版MASQ进行信度和效度检测,结果显示中文版MASQ具有良好的信度和效度,可用做国内癫痫患者认知功能的自评工具。其中癫痫患者的年龄、文化程度、发作频率、焦虑、总体幸福感水平、社会支持水平、生活质量是认知功能的主要影响因素。因此,采取有效措施控制癫痫发作,及早识别并干预患者焦虑抑郁等负性情绪,提高总体幸福感水平和社会支持水平,改善患者的生活质量,对于改善癫痫患者的认知功能具有重要意义。
[Abstract]:Objective to translate, translate and debug the Multiple Ability Self-Report Questionnaire (MASQ), and to establish a Chinese version of the MASQ scale based on the cultural background of our country, to investigate the cognitive function of epileptic patients and to explore the factors affecting the cognitive function of the group in October 2015. Method October 2015 To January 2016, the English version of MASQ was translated, translated and tested, and experts were invited to revise the content of the scale to form a Chinese version of the MASQ scale, and select 200 cases of epileptic patients in the neurology outpatient or ward of a three grade a hospital in Tianjin as the research object, and test the reliability and validity of the Chinese version of the MASQ scale. The reliability was tested by Cronbach's alpha coefficient and retest reliability. Content validity was used to evaluate the validity of the scale. The structure validity was verified by confirmatory factor analysis. 220 cases of epileptic patients were selected from General Hospital Affiliated to Tianjin Medical University from February 2016 to May 2016 by convenient sampling. Objective. Through the questionnaire survey, the general data questionnaire was used to collect the social demographic and disease indicators. The hospital anxiety and Depression Scale (HADS), the overall happiness scale (GWB), the social support scale (SSRS), the quality of life scale (QOLIE-31) of epileptic patients were used to investigate the anxiety and depression of the epileptic patients, the overall well-being and social support. A single factor analysis was used to compare the differences in cognitive function among the different categories of the classification variables, the correlation analysis was used to test the correlation coefficient between the successive variables and cognitive functions, and the factors of cognitive function of epilepsy patients in China were analyzed by multiple linear regression analysis. Results (1) Table Sinicization introduction stage: after the translation of the scale, translation and cultural debugging, the Chinese version of the MASQ scale consists of 37 items and is divided into 5 dimensions. The Cronbach 'sa coefficient of the Cronbach' sa coefficient of the scale is 0.902,0.797,0.733,0.893,0.848, the retest correlation coefficient (retest reliability) is 0.960, and the retest reliability of each dimension is divided. Do not evaluate the scale for 0.866,0.860,0.850,0.899,0.841.5 experts. All items CVI (item-level CVI, I-CVI) are above 0.80. The total item content validity index (scale-level CVI, S-CVI) is a negative correlation between the 0.98.MASQ score and QOLIE-31 score (r=-0.732, P0.001). The model fitting is better, the chi square degree of freedom ratio (CMIN/DF) of the revised standard five factor model, the goodness of fit index (GFI), the adjusted goodness of fit index (AGFI), the residual mean square and the square root (RMR), the approximate error mean square root (RMSEA), the norm fitting index (NFI), the value added fitting index (IFI), the non return quasi fitness index (TLI), and the comparison of the non return quasi fitness index (TLI) are compared. The fitting index (CFI), the simplified fitting goodness index (PGFI) were 2.155,0.879,0.902,0.045,0.076,0.881,0.869,0.856,0.868,0.636, and the standardized regression coefficient 0.33~0.93. (2) was used to collect the effective data of 220 cases of epileptic patients. The total range of cognitive function scores of patients was 48~135, average (87.86 + 19.30) points. Degree score: Language (16.95 + 5.66), visual perception (12.29 + 3.70), speech memory (20.40 + 5.09), visual spatial memory (20.50 + 3.57), and attention (17.74 + 4.58). The results of single factor analysis showed the differences in cognitive function scores between social demographic variables and family monthly income factors. There were statistical significance (P0.001); there were significant differences in the scores of different types of seizures, the location of the epileptic foci, the frequency of seizures, the duration of seizures and the cognitive function of the type of medication (P0.05); the continuous variables were related to Pearson or Spearman, the cognitive function and age, the anxiety and depression, and the overall happiness level. The correlation between social support level and quality of life was statistically significant (P0.001). Multiple linear regression analysis showed that age, educational level, attack frequency, anxiety, overall well-being, social support level, and quality of life had an impact on cognitive function, and the partial regression coefficient was 0.182, -4.318, -1.000,3.645,0.379, -0.504, -1.0, respectively. The 23,7 variables can explain the 62.4%. conclusion of the total variation. The English version of MASQ is sinicization, and the reliability and validity of the Chinese version of MASQ is tested. The results show that the Chinese version MASQ has good reliability and validity. It can be used as a self-assessment tool for the cognitive function of domestic epileptic patients. Overall happiness level, social support level and quality of life are the main influencing factors of cognitive function. Therefore, taking effective measures to control epileptic seizures, identifying and intervening negative emotions such as anxiety and depression, improving the level of overall happiness and social support, improving the quality of life of the patients, and improving the cognition of epileptic patients. Function is of great significance.

【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.74

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