当前位置:主页 > 医学论文 > 眼科论文 >

视功能指数量表(Vf-14)的修订及评价

发布时间:2018-08-18 10:18
【摘要】:目的引进并修订国外视功能指数(Visual Function index-14)量表,形成VF-14中文修订本,并对中文修订本进行信度、效度及可接受性的评价,为探索国内适宜的视功能评价工具提供依据。 方法选取经眼科医师确诊的年龄相关性白内障患者440名、眼科专家12名及健康查体者80名作为研究对象。年龄相关性白内障患者的诊断标准采用国家白内障诊断分型标准,年龄40-70岁之间,文化程度小学及以上,其中200名参与量表的修订,240名参与量表的评价;80名健康查体者参与量表的评价;眼科专家为从事眼科临床工作10年以上、职称为副主任医师以上,精通英文,其中一名有留美经历,参与量表的翻译、回译及修订。 遵循量表的引进原则,经过眼科专家翻译、回译,与原量表比对,形成VF-14中文本一稿,然后向9名眼科专家及200名患者收集修订意见和建议,对VF-14中文本一稿进行文化适应性修订,最终形成VF-14量表中文修订本。 以自行设计的调查问卷为工具向240名年龄相关性白内障患者收集VF-14量表中文修订本评定的资料,内容包括:调查对象的一般情况,眼科检查情况,VF-14量表中文修订本的测评,视功能生存质量量表(VF -QoL)的测评,自评视功能状况及对可接受性信息的评价部分。其中80名患者分别进行2次VF-14中文修订本测评,时间间隔为一周;80名患者同一天内由两名不同调查员分别进行VF-14量表中文修订本的测评;80名患者于术前一天、术后一月分别进行视力、VFQOl、自评视功能状态及VF-14量表中文修订本的测评,80名健康查体者进行视力、VFQOl、自评视功能状态及VF-14量表中文修订本的测评。 全部调查问卷收回后进行统一检查、核对,建立Excel数据库,利用SPSS13.0统计软件进行资料的处理分析,采用t检验、Cronbach’α、ICC值、相关分析、因子分析等对量表的信度、效度、可接受性进行评价。评价的指标:信度评价包括重测信度、内部一致性信度、调查员间信度、分半信度,效度评价包括内容效度、结构效度、效标关联效度、辨别效度,可接受性评价:回答量表的把握度、量表的完成率、每次完成VF-14中文修订本的时间。 结果1.VF-14量表的翻译在遵循语义等价性、概念等价性的前提下两名眼科专家各自将原量表翻译成中文,两份译文综合形成中文初译本,另一名眼科专家进行回译,将其与原量表比对,对与原量表不一致的条目,反复进行翻译、回译,直至达成统一,最终形成VF-14中文本一稿。 2.分别向眼科专家和年龄相关性白内障患者收集对VF-14中文本一稿的修订意见,专家认为:在我国目前的经济文化生活背景下,VF-14中文本一稿的绝大部分条目能够反映被测量的与视功能相关的生活内容,各条目意思表达清楚,且表达的难易程度对调查对象适宜。100%的专家认为第9项-娱乐活动(bingo,多米诺骨牌,打牌)和第10项-体育活动(保龄球、手球、网球或高尔夫运动)所指内容不符和我国国情、民情,遵循概念等价原则可改为我国大众喜闻乐见的项目,如娱乐活动改为打麻将,扑克牌,下象棋,体育活动改为羽毛球,乒乓球,篮球,门球。95%的专家认为13、14两项涉及驾车的条目,与我国国情不符且无等价替代条目;患者认为各条目内容通俗易懂,没有读不懂的语句,表达意思清楚,表达的难易程度适宜,1-12项基本符合我国国情、民情,100%的患者认为13、14两项涉及驾车的条目不符合我国国情、民情。综合专家和患者的意见和建议,最终形成VF-14量表中文修订本。 3.VF-14量表中文修订本的信度:①重测信度:量表两次评分的各条目和总分的ICC范围值在0.814~0.976 P0.05,说明量表重测信度较好;②内部一致性信度:量表的Cronbach’α系数为0.916,说明量表的内部一致性较高;③调查员间的信度:各条目和总分的ICC范围值在0.854~0.996 P0.05,说明量表的调查员间的信度较好;④分半信度:VF-14量表中文修订本的分半信度系数为0.817 P0.05,说明量表具有较好的分半信度。 4.VF-14量表中文修订本的效度:①内容效度:专家一致认为VF-14量表中文修订本的条目既包括了白内障患者基本生存需要的视功能指标,又包括白内障患者更高生活层次需要的指标,内容效度良好;②结构效度:采用因子分析得到4个公因子,这4个公因子共能够解释总方差的88.70%,各条目的因子载荷均表现为仅在某一因子上较大。其中第一公因子包括:娱乐活动、体育活动、烹饪等条目,反映患者的立体视功能情况;第二公因子包括:阅读小字说明、读书看报、做精细活、填表等条目,反映患者的近视力情况;第三公因子包括:看清楼梯和路缘石、看清各种标识牌、看电视等条目,反映患者的视觉适应情况;第四公因子包括:阅读大体字、认清楚人等条目,反映患者的主观视觉情况。这与理论构想相吻合,表明结构效度较好。③效标关联效度:采用术前及术后患者视功能生存质量量表(VFQol)与VF-14量表中文修订本得分做相关分析,相关系数分别为0.55和0.67,P 0.01;采用患者术前术后视力与VF-14量表中文修订本的得分做相关分析,相关系数分别为-0.63和-0.72 ,P 0.01,采用患者主观视功能改善程度与VF-14量表中文修订本的得分作相关分析,相关系数为0.65和0.76 ,P 0.01;表明量表的效标关联效度良好。④辨别效度:对患者术前术后VFQOL、视力、自评功能状态的评分进行配对t检验,可知患者术前与术后视功能状况的差异有统计学意义,说明患者术前与术后的视功能状况有变化;对患者术前术后VF-14量表中文修订本测评的得分进行配对t检验,得t=17.18,P0.01,说明VF-14量表中文修订本能辨别患者视功能状况的变化,对患者术前,及健康查体者的VFQOL、视力、自评功能状态的评分进行t检验,可知患者术前与术后视功能状况的差异有统计学意义,说明患者与健康查体者的视功能状况有变化;对患者及健康查体者的VF-14量表中文修订本测评的得分进行t检验,得t=18.674,P0.01,说明VF-14量表中文修订本能辨别患者视功能状况的变化,具有较好的辨别效度。 5.量表的可接受性:①在560人次的调查中,85.4%的患者认为自己做出的评价“比较准确可靠”,而14.6%的患者则认为“绝对准确可靠”;②在560人次的调查中,量表的完成率达100%;③在全部调查中,量表的完成时间最短5分钟,最长10分钟;表明VF-14量表中文修订本容易被年龄相关性白内障患者所接受。 结论本次研究经过科学严谨的方法形成了视功能(VF-14)量表中文修订本,且经过评价可知其信度、效度良好,可接受性强,适合目前我国经济文化和生活背景的需要,可作为我国眼科患者视功能状况的评价工具。
[Abstract]:Objective To introduce and revise the Visual Function Index-14 (VF-14) in foreign countries to form a Chinese version of VF-14, and to evaluate the reliability, validity and acceptability of the Chinese version, so as to provide a basis for exploring suitable visual evaluation tools in China.
Methods 440 age-related cataract patients, 12 ophthalmologists and 80 healthy subjects were selected as the subjects. The diagnostic criteria of age-related cataract patients were classified according to the National Cataract Diagnostic Classification Standard. The age ranged from 40 to 70 years old and the educational level was elementary school or above. 200 of them participated in the revision of the scale. Eighty health examiners participated in the evaluation of the scale. Ophthalmologists had been engaged in ophthalmic clinical work for more than 10 years, with the title of deputy director physician or above, and were proficient in English. One of them had been in the United States and participated in the translation, back translation and revision of the scale.
Following the principle of introducing the scale, a Chinese version of the VF-14 was formed by translating, retranslating and comparing with the original scale. The revised version of the Chinese version of the VF-14 was then revised by collecting comments and suggestions from 9 ophthalmologists and 200 patients, and the Chinese version of the VF-14 was finally formed.
A self-designed questionnaire was used to collect data from 240 age-related cataract patients on the revised Chinese version of the VF-14 scale, including general conditions of the subjects, ophthalmological examinations, the revised Chinese version of the VF-14 scale, the evaluation of the visual function quality of life scale (VF-QoL), the status of self-assessment of visual function and the availability of the revised Chinese version of the VF-14 scale. The evaluation part of receptive information: 80 patients were assessed with VF-14 Chinese revised version twice, one week interval; 80 patients were assessed with VF-14 Chinese revised version by two different investigators within the same day; 80 patients were assessed with visual acuity, VFQOl, self-assessed visual function status and VF-14 Chinese revised version one day before surgery and one month after surgery respectively. Visual acuity, VFQOl, self-rated functional status and Chinese version of the VF-14 scale were assessed in 80 healthy subjects.
All questionnaires were checked, checked, Excel database was established, and SPSS13.0 statistical software was used to analyze the data. The reliability, validity and acceptability of the questionnaire were evaluated by t test, Cronbach'a, ICC value, correlation analysis, factor analysis and so on. Consistency reliability, inter-investigator reliability, split-half reliability, validity evaluation including content validity, structure validity, criterion-related validity, discrimination validity, acceptability evaluation: the grasp of the answer scale, the completion rate of the scale, each time to complete the Chinese version of VF-14.
Results 1. On the premise of semantic equivalence and conceptual equivalence, two ophthalmologists translated the original scale into Chinese, and two translations were combined to form the first Chinese version. Another ophthalmologist retranslated the original scale and compared it with the original scale. The items which were inconsistent with the original scale were repeatedly translated and retranslated until the original scale was completed. Achieve unification and eventually form a draft of Chinese version of VF-14.
2. Collect opinions from ophthalmologists and age-related cataract patients on the revision of the version of VF-14. Experts believe that: under the current economic and cultural background in China, the vast majority of the items in the version of VF-14 can reflect the measured content of life related to visual function, and the meaning of each item is clearly expressed and expressed. 100% of the experts believed that the contents of Item 9 (bingo, dominoes, playing cards) and item 10 (bowling, handball, tennis or golf) were not in conformity with the national conditions and conditions of our country. Following the principle of conceptual equivalence, the items that the public liked and welcomed could be changed, such as recreational activities to be replaced by sports activities. Playing mahjong, playing cards, chess, changing sports activities to badminton, table tennis, basketball, and goalball. 95% of the experts believed that 13,14 items related to driving were inconsistent with China's national conditions and there was no equivalent alternative items; the patients believed that the contents of the items were easy to understand, no unscrambled sentences, clear meaning, appropriate degree of difficulty in expression, 1-12 items. According to the situation of our country, 100% of the patients believed that the 13,14 items involved in driving did not accord with the situation of our country.
3. Reliability of the revised Chinese version of the VF-14 scale: 1. Retest Reliability: The ICC ranges of the items and total scores of the two scales were 0.814-0.976 P 0.05, indicating that the retest reliability of the scale was good; 2. Internal consistency reliability: the Cronbach'a coefficient of the scale was 0.916, indicating that the internal consistency of the scale was high; 3. Reliability among investigators: the items and total scores The total score of ICC ranged from 0.854 to 0.996 P 0.05, indicating that the reliability of the scale among investigators was good; 4. The split-half reliability: The split-half reliability coefficient of the revised Chinese version of the VF-14 scale was 0.817 P 0.05, indicating that the scale had good split-half reliability.
4. Validity of the revised Chinese version of the VF-14 scale: 1. Content validity: Experts agreed that the items in the revised Chinese version of the VF-14 scale included not only the visual function indicators of the basic survival needs of cataract patients, but also the indicators of the higher life level needs of cataract patients. The content validity was good; 2. Structure validity: Four common factors were obtained by factor analysis. These four common factors can explain 88.70% of the total variance, and the factor load of each item is larger only in a certain factor. The third common factor includes: see clearly stairs and curb stones, see clearly various signs, watch television and other items, reflecting the patient's visual adaptation; the fourth common factor includes: read general characters, recognize clearly the person and other items, reflecting the patient's subjective visual situation. The correlation coefficient was 0.55 and 0.67, P 0.01, respectively. The correlation coefficient was - 0.63 between preoperative and postoperative visual acuity and Chinese revised version of VF-14, respectively. And - 0.72, P The difference of visual function before and after operation was statistically significant, indicating that there were changes in visual function before and after operation. The scores of Chinese version of VF-14 scale before and after operation were tested by paired t test, and the results were t = 17.18, P 0.01, indicating that the Chinese revised VF-14 scale could distinguish the changes of visual function of patients before and after operation. And the scores of VFQOL, visual acuity and self-rated functional status of healthy subjects were tested by t-test. The difference of visual function between preoperative and postoperative patients was statistically significant, indicating that the visual function status of patients and healthy subjects had changed. The scores of Chinese revised version of VF-14 scale of patients and healthy subjects were tested by t-test, and t=18.674. The Chinese version of the VF-14 scale can distinguish the changes of visual function and has good discrimination validity.
5. The acceptability of the scale: 1. In 560 surveys, 85.4% of the patients thought their evaluation was "accurate and reliable", while 14.6% of the patients thought it was "absolutely accurate and reliable"; 2. In 560 surveys, the completion rate of the scale reached 100%; 3. In all surveys, the completion time of the scale was the shortest 5 minutes and the longest 10 minutes. The revised Chinese version of the VF-14 scale is easily accepted by patients with age-related cataract.
Conclusion The revised Chinese version of the Visual Function Scale (VF-14) has been formed by scientific and rigorous methods in this study. The reliability, validity and acceptability of the revised VF-14 scale are good. It can be used as a tool for evaluating the visual function of ophthalmic patients in China.
【学位授予单位】:河北联合大学
【学位级别】:硕士
【学位授予年份】:2011
【分类号】:R770.4

【参考文献】

相关期刊论文 前10条

1 刘小阳;;白内障超声乳化术后与小切口囊外摘除术后患者生存质量比较[J];国际眼科杂志;2006年05期

2 陈莉;杨新光;;生存质量在白内障患者中的应用[J];国际眼科杂志;2008年12期

3 刘春玲,侯川,刘谊,栾荣生,严密,王静思,李幼平,刘东磊,黄建华,张天德;成都城乡老年性白内障的流行病学调查[J];华西医科大学学报;2002年02期

4 管怀进;周激波;顾海雁;;白内障患者超声乳化术后视功能和生存质量的调查研究[J];眼科新进展;2005年06期

5 刘晓玲;谷岩;刘彦才;缪爱红;梁仲琪;;视功能指数(VF-14)量表的修订及其信度效度检验[J];疑难病杂志;2009年02期

6 方积乾,万崇华,郝元涛;与健康有关的生存质量的研究概况[J];中国康复医学杂志;2000年01期

7 马文军,潘波;问卷的信度和效度以及如何用SAS软件分析[J];中国卫生统计;2000年06期

8 万崇华;生命质量研究中一些重要问题的商讨(二)[J];中国行为医学科学;1999年02期

9 何明光,许京京,吴开力,李绍珍;中老年人群视功能和生存质量的研究[J];中华眼科杂志;1999年05期

10 邹海东,张皙,许迅,柏林;低视力者生活质量量表中文版的研制和信度与效度考评[J];中华眼科杂志;2005年03期



本文编号:2189161

资料下载
论文发表

本文链接:https://www.wllwen.com/yixuelunwen/yank/2189161.html


Copyright(c)文论论文网All Rights Reserved | 网站地图 |

版权申明:资料由用户8b6fd***提供,本站仅收录摘要或目录,作者需要删除请E-mail邮箱bigeng88@qq.com