呼吸系统疾病焦虑量表（AIR）的汉化及其在慢性阻塞性肺疾病患者的适用性研究

发布时间：2018-07-06 14:31

本文选题：慢性阻塞性肺疾病 + 焦虑　；参考：《天津医科大学》2017年硕士论文

【摘要】：目的1.对呼吸系统疾病焦虑量表(Anxiety Inventory for Respiratory disease,AIR)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呼吸系统疾病焦虑量表AIR。2.评价中文版AIR量表的信度和效度,并探讨量表在评估我国慢性阻塞性肺疾病(COPD)患者焦虑的适用性。3.初步评估COPD患者的焦虑现状并探讨COPD患者焦虑的影响因素。方法2015年10月至2016年4月,对英文版AIR量表进行翻译、回译及文化调试,邀请护理专家和双语专家对量表的内容进行修订,形成中文版AIR量表。抽取天津市胸科医院和天津市第一中心医院的呼吸科门诊COPD患者181例作为研究对象,对中文版AIR量表进行信度和效度检验。量表的信度使用内部一致性检验和重测信度进行评价,本研究采用Cronbach'sα系数对量表进行内部一致性检验,采用重测信度进行量表的稳定性分析。量表的效度主要使用内容效度、聚合效度和结构效度进行检验,量表的内容效度包括条目水平的内容效度及量表水平的内容效度;聚合效度主要是通过测量AIR量表与医院焦虑抑郁量表(HADS)、COPD评估测试(CAT)及日常生活能力量表(ADLS)的相关系数检验;结构效度采用验证性因子分析进行验证。2016年4月至2016年11月从天津市胸科医院和天津市第一中心医院呼吸科门诊另抽取COPD患者226例进行问卷调查,通过一般资料调查表收集研究对象的社会人口学资料和疾病相关资料,采用中文版AIR量表、COPD评估测试(CAT)、日常生活能力量表(ADLS)、社会支持评定量表(SSRS)、APGAR家庭功能评估量表调查COPD患者的焦虑状况、生活质量和功能状态以及社会家庭功能状况。了解我国COPD患者的焦虑现状,探讨影响我国COPD患者焦虑状况的因素。本研究采用SPSS19.0统计包软件对数据进行统计分析。描述性统计、t检验、单因素方差分析、Pearson/Spearman相关分析和多元线性回归分析作为本研究的主要统计方法。结果1.AIR量表的汉化及心理学测量181例COPD患者纳入并参与了本项研究,经过对量表的翻译、回译及文化调试,中文版AIR量表共包括10个条目。该量表显示较好的重测信度和内部一致性信度,量表的重测相关系数为0.90,整个量表的Cronbach'sα系数为0.91;量表的内容效度中条目水平的(item-level CVI,I-CVI)、平均量表水平的(scale-level CVI/Average,S-CVI/Ave)、全体一致性量表水平的(scale-level CVI//Universal Agreement,S-CVI/UA)内容效度指数,所得结果分别为0.89~1,0.90和0.98。聚合效度经相关性分析显示,与医院焦虑抑郁量表(HADS)的相关系数为0.83,与COPD评估测试(CAT)的相关系数为0.44,与日常生活能力量表(ADLS)的相关系数为0.36,均显示良好的相关性(P0.01);验证性因子分析结果显示,量表二因素(广泛性焦虑和惊恐障碍)模型拟合良好,各项指标较好,修正后标准化二因素模型的卡方自由度比值(CMIN/DF)、拟合优度指数(GFI)、残差均方和平方根(RMR)、近似误差均方根(RMSEA)、增值拟合指数(IFI)、非归准适配指数(TLI)、比较拟合指数(CFI)分别为2.011、0.93、0.01、0.07、0.97、0.95、0.97,提示中文版AIR量表结构效度较好。2.COPD患者的焦虑状况、单因素及多因素分析研究最终完成对226例患者有效资料的收集。患者中男性152例(67.3%),女性74例(32.7%),平均年龄为67.19±8.34岁。AIR量表总分最小值为0分,最大值为22分,焦虑分6(3-10)分。单因素分析结果显示,社会人口学资料中:文化程度、对疾病了解情况、经济负担、运动状况对患者焦虑得分有统计学意义(P0.05);疾病相关资料中:近一年加重次数、呼吸困难程度和COPD分级对患者焦虑得分差异有统计学意义(P0.05);连续性变量Spearman相关分析中:焦虑与生活质量(CAT评分)、家庭功能(APGAR家庭功能评分)、社会支持(SSRS评分)和日常生活能力(ADLS)的相关性有统计学意义(P0.001)。以患者焦虑得分为因变量进行多元线性回归分析结果显示:COPD分级、经济负担、疾病了解情况、CAT评分、家庭功能评分进入以AIR量表总分为因变量的回归方程,偏回归系数分别为0.693、0.838、-1.234、0.329、-0.653,5个变量共解释了焦虑总变异的52.6%。结论(1)本研究引进并汉化英文版AIR量表,并将中文版AIR量表应用于中国慢阻肺患者中进行量表的心理学检测。结果表明中文版AIR量表在慢性阻塞性肺疾病患者中具有良好的信度和效度,可以用于我国慢性阻塞性肺疾病患者焦虑状况的初步评估。该量表条目较少,并且内容较为简单可靠,患者相对容易理解,方便临床测试者使用,应用于临床COPD患者的焦虑初步评估,可以帮助医护人员及时了解慢性阻塞性肺疾病患者的焦虑状况并作出及时的干预治疗。(2)我国慢性阻塞性肺疾病患者的焦虑得分低于源量表作者对英国COPD患者评估的得分情况,焦虑水平较低。其中,COPD分级、经济负担、疾病了解情况、生活质量、家庭功能状况是患者焦虑的主要影响因素。临床应重视慢性阻塞性肺疾病患者的焦虑状况,将焦虑评估作为日常常规评估之一,在门诊初步评估患者的焦虑状况,及早发现患者的心理问题,从而及时进行针对性的干预治疗,改善患者的疾病状况,提高患者的生活质量。
[Abstract]:Objective 1. Anxiety Inventory for Respiratory disease (AIR) was translated, translated, and culture debugged, and the Chinese version of respiratory system disease anxiety scale AIR.2. was established to evaluate the reliability and efficacy of the Chinese version of the Chinese version of the respiratory system disease anxiety scale, and the scale was used to evaluate the chronic obstructive pulmonary disease in China. The applicability of anxiety in patients with disease (COPD).3. preliminarily assessed the anxiety status of COPD patients and explored the influencing factors of anxiety in COPD patients. Methods from October 2015 to April 2016, the English version of the AIR scale was translated, translated and tested, and the contents of the scale were revised by nursing experts and bilingual experts to form a Chinese version of the AIR scale. The reliability and validity of the Chinese version of the 181 COPD patients were tested in the Department of respiration of Tianjin Thoracic Hospital and the Department of respiration in the Department of respiration. The reliability of the Chinese version was tested by the internal consistency test and retest reliability. The Cronbach's alpha coefficient was used to test the internal consistency of the scale. The validity of the scale is mainly tested by content validity, aggregation validity and structural validity. The content validity of the scale includes the content validity of the entry level and the content validity of the scale. The aggregation validity is mainly by the measurement of the AIR scale and the hospital anxiety and Depression Scale (HADS), and the COPD assessment Test (CAT) and daily living capacity scale (ADLS) correlation coefficient test; structural validity using confirmatory factor analysis to verify 226 cases from April to November 2016 from Tianjin Thoracic Hospital and Department of respiration in Department of respiration, Department of respiration, 226 cases were investigated, and the research objects were collected through the general data questionnaire. The data of social demography and disease related information, using the Chinese version of the AIR scale, the COPD assessment test (CAT), the daily living capacity scale (ADLS), the social support assessment scale (SSRS), and the APGAR family function assessment scale (APGAR) to investigate the anxiety status of the COPD patients, the quality of life and function and the social family function, and to understand the COPD patients in China. The factors affecting anxiety status of COPD patients in China are discussed. This study uses SPSS19.0 statistical package software to analyze the data. Descriptive statistics, t test, single factor variance analysis, Pearson/Spearman correlation analysis and multiple linear regression analysis are used as the main statistical methods in this study. Results the 1.AIR scale is sinicized and heart of the heart. 181 cases of COPD were included and participated in this study. After the translation of the scale, translation and cultural debugging, the Chinese version of the AIR scale included a total of 10 items. The scale showed good retest reliability and internal consistency reliability, the retest correlation coefficient of the scale was 0.90, the Cronbach's alpha coefficient of the whole scale was 0.91; the content of the scale was content. The validity of the item level (item-level CVI, I-CVI), the average scale level (scale-level CVI/Average, S-CVI/Ave), the content validity index of the whole consistency scale (scale-level CVI//Universal Agreement, S-CVI/UA), and the results of 0.89~ 1,0.90 and the correlation analysis of aggregation validity, respectively, and the anxiety and depression of the hospital. The correlation coefficient of the scale (HADS) was 0.83, the correlation coefficient of the COPD assessment test (CAT) was 0.44, and the correlation coefficient of the daily living capacity scale (ADLS) was 0.36, which showed good correlation (P0.01). The results of confirmatory factor analysis showed that the scale of the scale factor (broad sexual anxiety and panic disorder) model was well fitted, the indexes were better, the correction was better. After standardized two factor model, the chi square degree of freedom ratio (CMIN/DF), fit goodness index (GFI), residual mean square and square root (RMR), approximate error mean square root (RMSEA), value added fitting index (IFI), non return quasi fitness index (TLI), and comparison fitting index (CFI) respectively 2.011,0.93,0.01,0.07,0.97,0.95,0.97, suggesting the structure validity of the Chinese version AIR scale The anxiety status of better.2.COPD patients, single factor and multi factor analysis study finally completed the collection of effective data for 226 patients. 152 (67.3%) and 74 women (32.7%) in the patients, the minimum of the average age of 67.19 + 8.34 years was 0, the maximum was 22, and the anxiety was 6 (3-10). The single factor analysis showed that the society was a society. In demographic data, the degree of culture, the understanding of disease, the economic burden, and the exercise status were statistically significant (P0.05). In the related data of disease, the times of aggravation, the degree of dyspnea and the classification of COPD were statistically significant (P0.05) for the anxiety score of the patients (P0.05), and in the Spearman correlation analysis of continuous variables: Anxiety The correlation between the family function (CAT score), the family function (APGAR family function score), the social support (SSRS score) and the daily living ability (ADLS) was statistically significant (P0.001). The multivariate linear regression analysis of the patient's anxiety scores showed that the COPD grade, the economic burden, the disease understanding, the CAT score, and the family function evaluation. The regression equation was divided into the AIR total score as the dependent variable, and the partial regression coefficient was 0.693,0.838, -1.234,0.329, and -0.653,5 respectively explained the 52.6%. conclusion of the total variation of anxiety (1) this study introduced and sinicate the English version of the English version of the AIR scale, and applied the Chinese version of the AIR scale to the psychological test of the scale of Chinese chronic obstructive pulmonary disease. The results show that the Chinese version of the AIR scale has good reliability and validity in the patients with chronic obstructive pulmonary disease. It can be used for the preliminary assessment of anxiety in patients with chronic obstructive pulmonary disease in China. The scale of the scale is less, and the content is relatively simple and reliable. The patient is relatively easy to solve, and it is convenient for clinical testing people to use and apply to clinical COPD. The initial assessment of the patient's anxiety can help the medical staff understand the anxiety status of the patients with chronic obstructive pulmonary disease and make timely intervention. (2) the scores of anxiety in the patients with chronic obstructive pulmonary disease in China are lower than that in the assessment of COPD patients in the UK, and the level of anxiety is low. Among them, the COPD classification is the economy. Burden, understanding of disease, quality of life and family function are the main factors that affect the anxiety of patients. We should pay attention to the anxiety status of patients with chronic obstructive pulmonary disease, take the assessment of anxiety as one of the routine routine assessment, evaluate the anxiety of the patients in the outpatient, and find out the psychological problems of the patients in a timely manner, so that the needles will be carried out in time. Sexual intervention therapy can improve the condition of patients and improve their quality of life.
【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】：R473.5

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