筛选型老年听力残疾量表中文版的研译及初步应用

发布时间：2018-10-10 14:09

【摘要】：目的:在英文版筛选型老年听力残疾量表（the Hearing HandicapInventory for the Elderly-Screening Version，HHIE-S）的基础上对量表内容进行研译，并结合传统汉语言文化特点对其进行文化调试，使之能在汉语言文化背景下使用。将研译的中文版的量表在老年人群中初步应用，经过统计学分析验证其信度和效度，研究该量表是否能用于汉族老年性聋的筛查。方法:通过英文文献检索获得全英文源量表，由研究人员对量表进行翻译、回译，并参照国内文献报道的中文量表，对量表进行对比、检查、修订，形成量表研译的初始版本。随机选取30名老年人对我们的初始量表进行初次预问卷，征求对量表内容的具体修改意见，，修改后初步定稿；再次随机抽取30名老年人对修正后的量表进行预问卷，确定对量表内容无疑义后最终定稿、问卷研究。选择170名65岁以上非独居老年人，采用直接采访法，将研译的量表分由老年人本人及其亲近家属回答。1-2周后重测，评价量表的信度、效度，并将量表的最后得分与安静环境下（本底噪声控制在40dB以内）较好耳的纯音听阈（0.5kHz、1kHz、2kHz、4kHz）对比分析，了解其筛查价值。结果:经过系统的翻译、回译、修订，最后定稿，保留了源量表的所有条目，共10条，结合汉语言文化背景，将其中部分条目中的用语进行调整，以便更适合老年人群接受。利用SPSS15.0软件包进行统计学分析，研译后所得的HHIE-S中文版量表在各项检验中均有较好表现。研译后量表中的2个维度，其10个条目均有较强关联性，予以完全保留。该量表平均完成时间约为5分钟，完成率为100%。信度检验：HHIE-S量表共有2个维度：情感和情境维度，量表总的Cronbach’s α系数为0.935，量表总的分半信度为0.836，量表的重测信度为0.963。效度检验：通过计算量表各条目与各维度、总量表间的相关性评价内容效度，量表各条目与各维度、总量表的相关性在0.659~0.927之间。对量表进行KMO和Bartlett’s球形检验，KMO检验值为0.907，Bartlett’s球形检验近似2值为1351.357，P0.001，差异存在统计学意义，量表的相关矩阵间有共同因素存在，适合进行因子分析。通过主成分分析和正交旋转法对量表分析，2个公因子即情感和情境两个维度的特征值均大于1，总方差解释率为73.874%。量表中的10个条目的因子负荷在0.684和0.871之间，所有条目在相应因子上的因子负荷均0.60。用平均听阈作为“金标准”，量表的两个维度和总分与纯音听阈间呈正相关性，代理者问卷结果与纯音听阈比较，类似于自评问卷结果，呈现出正相关性。HHIE-S量表对老年性聋的特异性值为95.24%，对老年性聋的整体敏感性为59.06%，并随着听阈值得提高，量表的敏感性增加。平均听阈升高的有149人(占总数87.65%)，听阈为轻至中度聋的患者中有50人HHIE-S得分＞8，提示有听力障碍，其中10-22分的有39人，提示为轻至中度聋，有11人得分在24-40分之间，提示为重度听力障碍；听阈为重度聋及以上的患者共有38人HHIE-S得分＞8，提示有听力障碍，其中在10-22分的有9人，提示为轻至中度聋，有29人得分在24-40分之间，提示为重度听力障碍。随着纯音听阈值的增高，HHIE-S得分增加，助听器的选配比例也明显升高，当量表得分在24-40分之间时，助听器选配比例达42.5%。结论:我们研译的中文版筛选型老年听力残疾量表（HHIE-S）符合汉语言文化特点，结构稳定，具有较高的信度及效度，量表在老年性聋的筛查中表现出较高的敏感性和特异性，该量表可以作为我国老年性聋的一种稳定的筛查工具，应用于老年性聋的早期初步筛查；同时，代理者量表与自评量表一样，也可以用于老年性聋的筛查。HHIE-S不仅能够初步体现出老年人听力下降程度，还能反映出听力下降对老年人社会生活及个人情感的影响，与纯音测听诊断相结合，能够更全面地对老年性聋患者进行评估，有利于推动老年性聋患者早期积极治疗和康复。
[Abstract]:Objective: To study and translate the scale content on the basis of the Heart HandicapInventory for the Elderly-Sreening Version (HASH-S), and to carry out cultural debugging in combination with the characteristics of the traditional Chinese language culture, so that it can be used in the cultural background of Chinese language. The Chinese version of the scale was applied to the elderly population, and the reliability and degree of validity were verified by statistical analysis, and whether the scale could be used in the screening of senile deafness in the Han nationality. Methods: A full English source scale was obtained from the English literature search. The scale was translated and translated by the researchers, and the initial versions of the scale were compared, examined and revised with reference to the Chinese scale reported by domestic literature. 30 elderly people were randomly selected to conduct initial pre-questionnaire on our initial scale, to obtain a detailed review of the content of the scale and to finalize the revised scale; 30 older persons were randomly taken to pre-questionnaire the revised scale to determine that the content of the scale was eventually finalized, Questionnaire study. selecting 170 elderly persons over 65 years of age, adopting a direct interview method, and answering the scale points of the research and translation into the answers of the old people themselves and their close family members. And compare the final score of the scale with the low noise threshold (0. 5kHz, 1kHz, 2kHz, 4kHz) in the quiet environment (within 40dB) to understand their screening value. Results: After the translation, translation, revision and finalization of the system, all entries of the source scale were retained, 10 were retained, and the language in some of the entries was adjusted in combination with the cultural background of the Chinese language, so as to be more suitable for the acceptance of the elderly population. SPSS10.0 software package was used for statistical analysis, and the HSG-S Chinese version scale obtained after translation was well represented in all kinds of tests. There are 2 dimensions in the post-translation scale, and 10 entries have strong correlation and are fully retained. The average completion time of the gauge was about 5 minutes and the mean time was 100%. The reliability test: The HASH-S scale has two dimensions: emotion and context dimension, the total Cronbach's index of the scale is 0.935, the total score of the scale is 0. 836, and the retest reliability of the scale is 0. 963. Efficiency test: The correlation between each item of the scale and each dimension and the total quantity table was evaluated, and the correlation between each item of the scale and each dimension and the total amount table was between 0. 659 ~ 0. 927. KMO and KMO's spherical test were performed on the scale, and the KMO test value was 0.907, and the spherical test approximate 2 value was 1351. 357, P0.001, the difference was statistically significant, there were common factors among the correlation matrix of the scale, and it was suitable for factor analysis. By the principal component analysis and the orthogonal rotation method, the eigenvalue of the two dimensions of the two factors, namely emotion and context, was greater than 1, and the total variance interpretation rate was 73. 874%. The factor load of 10 entries in the scale is between 0. 684 and 0. 871. All entries have a factor load of 0. 60 on the corresponding factors. Using the average hearing threshold as the 鈥済old standard鈥

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