视障儿童生命质量测定量表的研制与评价

发布时间：2018-11-25 08:44

【摘要】：研究目的参照患者报告结局指标(patient reported outcomes,PRO)量表研制的程序,结合我国独特的文化以及对视障儿童的认知和临床特点,制定出适合我国视障儿童的生命质量测定量表,采用现场调查方法收集样本,修订并考核该量表的信效度和区分度。该量表将用于评价视障儿童的生命质量,为全面的了解视障儿童健康状况以及社会参与能力提供测量工具。研究方法1、根据PRO量表制作原理及PRO的程序,运用文献研究法、核心小组讨论法,构建视障儿童生命质量量表的共性模块和特异性模块,形成条目池。2、运用德尔菲专家咨询法,收集专家意见,建立数据库,考察专家的积极程度、意见集中程度、协调一致程度和权威程度,反复进行两轮,形成视障儿童生命质量测定初选量表。3、采用视障儿生命质量测定初选量表进行现场调查,对回收的数据使用相关系数法、因子分析法、项目反应理论进行分析,测量量表的信效度和区分度,得出最终量表。研究结果1、视障儿童生命质量测定量表包含6个领域41个条目,根据不同年龄阶段视障儿童认知水平、理解能力的不同,在量表测量领域及条目结构不变的基础上,将该量表分为了7岁以下组和8岁以上组,同时设计了在特殊情况下家长代评问卷。2、两轮专家权威程度系数的平均值分别为0.700、0.745;第二轮专家咨询重要性和准确性的协调系数分别为0.206、0.270;同时采用界值法对条目进行筛选。3、信度评价:总量表的克朗巴赫α系数为0.868,各个领域克朗巴赫α系数在0.527~0.777之间;总量表的分半信度为0.765,各个领域分半信度在0.451~0.660之间;总量表重测信度为0.808,各个领域的重测信度在0.760~0.894之间。4、效度评价:维度相关性方面,各条目与其所在领域的相关性较高,但与其他领域的相关性较低,量表各领域与总量表之间的相关系数均大于0.5,各条目与其所在领域的相关系数多数在0.6以上。因子分析结果显示,提取13个公因子,累计方差贡献率为66.157%,方差最大旋转后结果显示与理论框架基本相符。验证性因子分析结果显示,总量表的CFI为0.71,各个领域的CFI分别为0.95、0.97、0.92、0.92、0.87、0.80。5、区分度评价:量表各条目ICC曲线构图良好,条目信息包含量大,误差小。6、可行性评价:每份量表的完成时间均可以控制在15~20分钟,可行性较高。研究结论视障儿童生命质量测定量表具有较高的信度、效度、区分度及可行性,可以作为视障儿童生命质量测评的工具,评价视障儿童康复效果极其社会参与能力。
[Abstract]:Objective to develop the quality of life (QOL) measurement scale for visually impaired children according to the procedure of the development of the patient report outcome index (patient reported outcomes,PRO) scale, combined with the unique culture and the cognitive and clinical characteristics of the children with visual impairment in China. The reliability, validity and distinction of the scale were revised and evaluated by field survey. The scale will be used to evaluate the quality of life of children with visual impairment and to provide a comprehensive understanding of the health status of children with visual impairment and the ability to participate in society. Methods 1.According to the principle of PRO scale and the procedure of PRO, using the method of literature research and core group discussion, the common and specific modules of quality of life scale for children with visual impairment were constructed, and the item pool was formed. 2. Using Delphi's expert consultation method, collecting expert opinions, setting up databases, examining experts' positivity, concentration, coordination and authority, and carrying out two rounds over and over again. The primary quality of life measurement scale for visually impaired children was formed. 3. The primary quality of life measurement scale for visually impaired children was used to conduct field investigation. The data collected were analyzed by correlation coefficient method, factor analysis method and item response theory. The reliability and validity of the scale were measured and the final scale was obtained. Results 1. The quality of life measurement scale for visually impaired children includes 41 items in 6 fields. According to the cognitive level and understanding ability of children with visual impairment at different ages, the measurement field and item structure of the scale are unchanged. The scale was divided into 7 years old group and 8 years old group. At the same time, the parents' substitute questionnaire was designed under special circumstances. 2. The average value of the two rounds of expert authority coefficient was 0.700 卤0.745; The coordination coefficient of the importance and accuracy of the second round of expert consultation is 0.206 and 0.270 respectively; At the same time, the method of boundary value was used to screen the items. 3. Reliability evaluation: the total amount of the krombach 伪 coefficient was 0.868, and the cornbach 伪 coefficient in all fields was between 0.527 and 0.777; The split-half reliability of total table is 0.765.The split-half reliability of each field is between 0.451and 0.660; The test-retest reliability of total table is 0.808, the retest reliability of each field is between 0.760,0.894. 4. Validity evaluation: in dimensional correlation, each item has a higher correlation with its domain, but a lower correlation with other fields. The correlation coefficient between each field and total scale is more than 0.5, and the correlation coefficient between each item and its field is more than 0.6. The results of factor analysis show that 13 common factors are extracted and the cumulative contribution rate of variance is 66.157. The results of maximum rotation of variance are basically consistent with the theoretical framework. The results of confirmatory factor analysis showed that the CFI of the total table was 0.71, and the CFI of each field was 0.95 / 0.970.92 / 0.920.87 / 0.80.The degree of discrimination was as follows: the ICC curve of each item of the scale was well composed and the amount of item information was large. The error is small. 6, feasibility evaluation: the completion time of each scale can be controlled in 1520 minutes, and the feasibility is high. Conclusion the quality of life measurement scale for children with visual impairment has high reliability, validity, distinction and feasibility. It can be used as a tool to evaluate the quality of life of children with visual impairment, and to evaluate the rehabilitation effect of children with visual impairment and their ability to participate in society.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R779.7

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