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病人健康问卷抑郁自评量表在住院糖尿病足溃疡患者中应用的信效度研究

发布时间:2018-03-27 15:28

  本文选题:糖尿病足 切入点:住院病人 出处:《中国全科医学》2016年28期


【摘要】:目的评价病人健康问卷抑郁自评量表(PHQ-9)在住院糖尿病足溃疡患者中应用的信效度。方法选取2014年8月—2015年6月在广州市某三甲医院内分泌科住院治疗的糖尿病足溃疡患者120例。采用自行设计的一般资料调查表收集患者的一般资料;采用PHQ-9评价患者的抑郁情况,并对量表进行信效度检验,包括内容效度、结构效度、已知族群效度、内部一致性及重测信度;采用美国《精神障碍诊断与统计手册(4版)》(DSM-IV)临床定式访谈(SCID)抑郁量表对PHQ-9的评价结果进行验证,并确定重性抑郁的诊断临界值。结果 PHQ-9共包括9个条目,各条目内容效度指数(I-CVI)分别为1.00、1.00、1.00、0.83、1.00、1.00、0.83、1.00、1.00,总量表内容效度指数(S-CVI)为0.96。PHQ-9的平均总得分为(11.7±6.4)分,Pearson相关分析结果显示,各条目得分与量表总得分间均呈线性正相关(P0.05)。因子分析共获得2个公因子,分别为认知-情感因子、躯体症状因子,可共同解释量表62.1%的变异量。不同性别、家庭人均月收入、自理能力、Wagner分级、足溃疡疼痛评分(NRS)以及有无截肢/趾史或风险患者的认知-情感维度得分比较,差异有统计学意义(P0.05);不同自理能力、足溃疡NRS以及有无截肢/趾史或风险患者的躯体症状维度得分比较,差异有统计学意义(P0.05)。总量表、认知-情感维度、躯体症状维度的Cronbach'sα系数分别为0.88、0.86、0.70,重测信度分别为0.87、0.89、0.83。受试者工作特征(ROC)曲线显示,PHQ-9用于筛查住院糖尿病足溃疡患者抑郁情况有统计学意义〔曲线下面积(AUC)=0.914,95%CI(0.862,0.967),P0.05〕,10分为重性抑郁的诊断临界值,灵敏度为0.928、特异度为0.804。结论PHQ-9在住院糖尿病足溃疡患者中应用的信效度较好,10分为重性抑郁的诊断临界值,灵敏度和特异度均较高,建议应用于住院糖尿病足溃疡患者的抑郁筛查。
[Abstract]:Objective to evaluate the reliability and validity of self-rating depression scale (PHQ-9) in patients with diabetic foot ulcer. Methods Diabetic foot was selected from August 2014 to June 2015 in Department of Endocrinology, a third Class Hospital in Guangzhou. 120 patients with ulcers were collected by self-designed general information questionnaire. PHQ-9 was used to evaluate the depression of the patients, and the reliability and validity of the scale were tested, including content validity, structural validity, known population validity, internal consistency and test-retest reliability. The evaluation results of PHQ-9 were verified by using PHQ-9 depression scale with DSM-IVD depression scale, and the critical value of diagnosis of severe depression was determined. Results PHQ-9 included 9 items. The content validity index (I-CVI) of each item was 1.00 / 1.001.00 / 0.83 / 1.00 / 1.001.00 respectively, and the content validity index (S-CVI) of the total table was an average total score of 0.96.PHQ-9 (11.7 卤6.4). The results of Pearson correlation analysis showed that, There was a linear positive correlation between the scores of each item and the total score of the scale (P 0.05). Two common factors were obtained by factor analysis, which were cognitive-affective factor and somatic symptom factor, which could explain the variation of 62.1% of the scale. The scores of cognitive and affective dimensions of patients with self-care ability, foot ulcer pain score (NRSs) and those with or without amputation / toe history or risk were significantly different (P 0.05). The scores of NRS and somatic symptoms in patients with foot ulcers with or without amputation / toe history or risk were statistically significant (P 0.05). The Cronbach's 伪 coefficient of somatic symptom dimension was 0.88 / 0.86 / 0.70, and the test-retest reliability was 0.870.89 / 0.83 respectively. The test results showed that PHQ-9 was used to screen depression in hospitalized diabetic foot ulcer patients with statistical significance (the area under the curve was 0.8620.967C 0.8620.967g / 10). Diagnostic threshold for depression, The sensitivity was 0.928 and the specificity was 0.804.Conclusion the reliability and validity of PHQ-9 in patients with diabetic foot ulcer is better than that in patients with severe depression. It is suggested that it should be applied to the screening of depression in patients with diabetic foot ulcer.
【作者单位】: 南方医科大学南方医院护理部;南方医科大学南方医院内分泌科;
【分类号】:R587.2

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