中文版就医障碍评估量表信效度分析

发布时间：2018-10-26 11:38

【摘要】：目的对国外就医障碍评估量表(BACE)进行汉化,并对中文版BACE进行信效度分析,为今后的精神疾病患者就医行为相关研究及临床工作提供标准化的评估工具。方法采用便利抽样法选取2014年11月—2015年5月唐山市第五医院接受住院治疗且符合纳入标准的精神分裂症患者182例为调查对象。采用中文版BACE、精神疾病患者病耻感评估量表、专业心理求助自我污名量表对其进行调查。2周后行复本检测,除去脱落与无效问卷,共有62例患者进行复本检测。结果共发放问卷182份,回收有效问卷157份,有效回收率为86.3%。中文版BACE得分(31.6±13.4)分,污名分量表得分(13.8±9.2)分,非污名分量表得分(17.9±8.4)分;精神疾病患者病耻感评估量表得分(44.1±14.3)分,专业心理求助自我污名量表得分(30.6±6.4)分。将患者按中文版BACE得分从高到低排序,得分最高的27.4%患者组成高分组(43例),得分最低的28.7%患者组成低分组(45例)。两组患者条目3、5、8、9、14、15、17、19、24、26、28得分比较,差异有统计学意义(P0.05);两组患者条目21得分比较,差异无统计学意义(P0.05)。经过条目筛选,污名分量表删除1个条目,保留了11个条目。邀请1位心理测量学专家、2位职称为副主任以上的精神科专家及2位心理学专家评价中文版BACE内容效度,各条目内容效度指数(CVI)为0.80~1.00,所有条目平均CVI为0.96。污名分量表的KMO值为0.892,Bartlett球形检验χ2=1 016.076,P0.05,表明适合做探索性因子分析。采用主成分分析法抽取因子,污名分量表的11个条目得到1个因子(命名为污名),特征值为6.015,累计贡献率为54.678%。污名分量表得分与精神疾病患者病耻感量表得分及专业心理求助自我污名量表得分均呈正相关(r=0.595、0.690,P0.01),非污名分量表得分与精神疾病患者病耻感量表得分及专业心理求助自我污名量表得分无线性相关关系(r=0.001、0.105,P0.05)。污名分量表、非污名分量表、中文版BACE的Cronbach'sα系数分别为0.894、0.715、0.815。污名分量表、非污名分量表、中文版BACE 2周后重测信度分别为0.776、0.710、0.756。结论 BACE具有良好的信效度,可以用于评估国内精神疾病患者的就医行为。
[Abstract]:Objective to analyze the reliability and validity of the Chinese version of (BACE) and to provide a standardized evaluation tool for the study on the behavior of psychiatric patients seeking medical treatment and clinical work in the future. Methods from November 2014 to May 2015, 182 schizophrenic patients who were admitted to the Fifth Hospital of Tangshan City and met the inclusion criteria were selected by convenience sampling method. The Chinese version of BACE, scale was used to assess the stigma of patients with mental illness, and the professional psychological help self-stigma scale was used to investigate it. After 2 weeks, 62 patients were tested for duplicates, except for shedding and invalid questionnaires. Results 182 questionnaires were sent out, 157 valid questionnaires were collected, and the effective recovery rate was 86.3%. The score of Chinese version of BACE was (31.6 卤13.4), the score of stigma scale was (13.8 卤9.2), the score of non-stigma scale was (17.9 卤8.4). The score of the scale for evaluating the stigma of mental illness was (44.1 卤14.3), and the score of the professional psychological help seeking self-stigma scale was (30.6 卤6.4). The patients were ranked according to the Chinese version of BACE score from high to low. The highest score of 27.4% patients constituted a high score group (43 cases) and the lowest score of 28.7% patients constituted a low group (45 cases). The difference between the two groups was statistically significant (P0.05), while there was no significant difference between the two groups in item 21 (P0.05). After item screening, the stigma subscale deleted one item and retained 11 items. One psychometrics expert, two psychiatrists with titles above deputy director and two psychologists were invited to evaluate the content validity of the Chinese version of BACE. The content validity index (CVI) of each entry was 0.80 / 1.00, respectively. The average CVI for all entries is 0. 96. The KMO value of the tainted component table is 0.892n Bartlett spherical test 蠂 2 / 1016.076g / P 0.05, which indicates that it is suitable for exploratory factor analysis. The principal component analysis was used to extract the factors and 11 items in the stigma component table were used to obtain one factor (named the stigma) with a characteristic value of 6.015 and a cumulative contribution rate of 54.678. The scores of stigma scale were positively correlated with the scores of stigma scale and professional psychological self-stigma scale (r = 0.595.0.690 / P0.01). The score of non-stigma scale was correlated with the score of stigma scale and the score of professional psychological help self-stigma scale (rr 0.001 0.105 P 0.05). The Cronbach's 伪 coefficient of the Chinese version of BACE is 0.894 and 0.715 / 0.815, respectively. The test retest reliability of the Chinese version of BACE after 2 weeks was 0.710 ~ 0.756. Conclusion BACE has good reliability and validity, and can be used to evaluate the behavior of patients with mental illness in China.
【作者单位】：华北理工大学心理学院;华北理工大学冀唐学院;
【分类号】：R749

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