Oswestry功能障碍指数的改良及信度和效度检验

发布时间：2018-05-18 01:04

本文选题：腰痛 + 量表　；参考：《中国脊柱脊髓杂志》2017年03期

【摘要】：目的 :改良Oswestry功能障碍指数(Oswestry disability index,ODI)量表评价体系,评估其临床信度和效度。方法:采用包含多种评价指标的随访表对100例手术患者进行术前及术后3个月随访,根据随访结果,剔除依从性差的评价项目,筛选出适合国人的、能反映术后短期腰部功能改善情况的指标,将"生活自理"、"提重物"、"性生活"、"社会生活"、"旅游"5个评定项目换为"下肢麻木程度"、"卧位翻身"、"坐位站起"、"家务劳动"、"工作情况"5个评定项目,建立改良版ODI量表。采用JOA腰痛评分(Japanese Orthopaedic Association low back pain score)、ODI及改良版ODI量表对41例行手术治疗的患者进行随访评定,其中22例行微创椎间盘手术,19例行开放椎间盘手术。评定时间点为术前及术后1周、2周、4周、8周、12周、24周,以内部一致性、分半信度为指标评估量表的信度,以因子分析、Pearson相关系数评价量表的结构效度和内容效度。结果:改良版ODI量表总的Cronbach′sα系数为0.849,各项目的 Cronbach′sα系数均在0.813~0.861之间,分半信度系数为0.894;因子分析的检验结果显示,KMO值为0.857,Bartlett球形检验P0.001。主成分分析提取全部10个因子,累计方差贡献率为67.2%;内容效度的检验结果显示,改良ODI与JOA、ODI分值显著相关,相关系数分别为-0.695(P0.001)、0.819(P0.001)。结论:改良版ODI量表具有良好的信度和效度,适合国人进行腰椎功能评定及手术后短期的疗效评定,中长期的评定效果有待进一步验证。
[Abstract]:Objective: to evaluate the clinical reliability and validity of Oswestry dysfunction index (Oswestry disability index) evaluation system. Methods: 100 patients were followed up preoperatively and 3 months after operation with multiple evaluation indexes. According to the results of follow-up, the items of poor compliance were excluded, and the suitable ones for Chinese were selected. An index that can reflect the improvement of lumbar function in the short term after operation, The five items of "living self-care", "lifting heavy objects", "sexual life", "social life" and "tourism" were changed to "numbness degree of lower extremity", "lying position turn over", "sitting up", "housework work", "work condition", and established the improved ODI scale. JOA low back pain score and modified ODI scale were used to evaluate 41 cases of surgical treatment. 22 cases were treated with minimally invasive disc surgery and 19 cases with open disc surgery. The evaluation time points were pre-operation and postoperation 1 week, 2 weeks, 4 weeks, 8 weeks, 12 weeks and 24 weeks. The reliability of the scale was evaluated by internal consistency and split-half reliability. The structural validity and content validity of the scale were evaluated by factor analysis and Pearson correlation coefficient. Results: the total Cronbach's 伪 coefficient of modified ODI scale was 0.849, the Cronbach's 伪 coefficient of each item was between 0.813 and 0.861, and the split-half reliability coefficient was 0.894.The result of factor analysis showed that the total Cronbach's 伪 coefficient was 0.849, the Cronbach's 伪 coefficient of each item was between 0.813 and 0.861, and the factor analysis showed that the Cronbach's 伪 coefficient was 0.857Bartlett spherical test (P0.001). All 10 factors were extracted by principal component analysis (PCA), and the cumulative contribution rate of variance was 67.2%. The results of content validity test showed that there was a significant correlation between the scores of modified ODI and JOAA ODI, and the correlation coefficients were -0.695g P 0.001C 0.819g P0.001g. Conclusion: the modified version of ODI scale has good reliability and validity, which is suitable for the evaluation of lumbar spine function and the short-term curative effect after operation, and the medium and long term evaluation results need to be further verified.
【作者单位】：解放军第113医院骨科;第三军医大学附属新桥医院骨科;
【基金】：南京军区医药卫生科研基金项目(编号:15MS023) 宁波市科技富民惠民项目(编号:2015C50027)
【分类号】：R681.5

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