《妊娠期多维心理社会应激评定问卷》编制及其信效度研究

发布时间：2018-01-20 12:44

本文关键词： 妊娠应激项目分析信度效度　出处：《安徽医科大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的编制适合我国孕妇使用的评定妊娠期心理社会应激状况的问卷,并对其信度、效度进行评价,为妇女妊娠期心理社会应激症状的筛查提供依据。方法在广泛查阅文献和参考相关心理社会应激问卷的基础上提出理论构想,将妊娠期心理社会应激分为7个维度,分别为人际交往障碍、家庭经济问题、工作压力、失业、担心胎儿、担心自我、担心分娩,由此建立量表的初始项目库。并通过专题小组讨论、专家咨询等方法对项目进行修改,初步确定问卷由2个分问卷共50个条目(生活事件评定项目35条,妊娠相关焦虑评定项目15条)组成。以2011年5月16日至2013年2月28日合肥市第一人民医院产科门诊就诊的孕早期孕妇3 195名为受试者,建立孕早期妇女随访队列,收集孕期心理社会应激信息,回收有效量表3 123份。检验项目的遗漏率和应答率,采用两样本t检验的方法比较极端组,运用相关性分析、因子分析等方法对问卷的项目进行筛选。最终初步编制成由23个项目组成的《妊娠期多维心理社会应激评定问卷》(MPPQ)。进一步对问卷的信度和效度进行评价。对34名孕妇在2~4周内进行重测,采用Pearson相关系数法分析问卷的重测信度系数,计算Cronbach’sα系数评价问卷的内部一致性信度。收集1 075名孕妇的妊娠结局,运用F检验考察孕妇在不同年龄段、不同学历、不同家庭月收入等的得分差异,考察问卷的区分效度。运用χ2检验考察问卷得分与妊娠结局的关联,评价问卷的预测效度。结果通过分析项目的阳性应答率,删除应答率0.1的12个项目;采用t检验法分析项目的鉴别度,删除生活事件问卷中的一个项目,妊娠相关焦虑问卷的所有项目均入选;生活事件问卷和妊娠相关焦虑问卷中各有3个和5个项目的因子分析值0.4,考虑删除;生活事件问卷中,有3个项目删除后,问卷的Cronbach’sα系数升高,妊娠相关焦虑问卷中,有1个项目删除后,问卷的Cronbach’sα系数升高,这4个项目都应删除;相关系数筛选方法中共计3项指标,若达到规定标准的指标总数小于2项者,考虑删除该项目,分析后,所有的项目均入选。最终共删除27个项目(其中生活事件问卷20个,妊娠相关焦虑问卷7个),从而初步确定了妊娠期多维心理社会评价量表由23个项目组成。MPPQ的两个分问卷的重测相关系数分别为0.679、0.615,Cronbach’sα系数分别为0.637、0.758。MPPQ分为人际关系问题、家庭经济问题、工作压力问题、丈夫工作问题、自我工作问题、担心胎儿、担心分娩、担心自我8个维度,与最初的理论构想基本一致。生活事件问卷的因子分析提取5个公因子,累积方差贡献率为55.363%;妊娠相关焦虑问卷的因子分析提取3个公因子,累积方差贡献率为66.193%。不同孕妇年龄、文化程度和丈夫吸烟频率的MPPQ得分差异有统计学意义(P0.5),说明MPPQ的区分效度良好。未发现MPPQ的得分与不良妊娠结局的关联有统计学意义,MPPQ的预测效度需要进一步考证。结论初步完成了MPPQ的编制及信效度评价的工作,《妊娠期心理社会评定问卷》(MPPQ)基本上是可信、有效的,可以作为妊娠期孕妇社会心理应激的基本检测工具。尚需进一步的研究考察问卷的预测效度。
[Abstract]:Objective to prepare for evaluation of Chinese pregnant women during pregnancy psychosocial stress status questionnaire, and to evaluate its reliability, validity, provide the basis for the screening of pregnant women psychological stress symptoms. Methods the theory based on extensive literature review and reference to the relevant psychosocial stress questionnaire, pregnancy psychological society stress can be divided into 7 dimensions, respectively, interpersonal disturbances, family economic problems, work pressure, unemployment, fear of fetal, fear self, fear of childbirth, the scale of the initial project library. And through focus group discussion, expert consultation method to modify the project, determine the preliminary questionnaire consists of 2 sub questionnaires 50 items (life events evaluation project 35, pregnancy related anxiety assessment project 15). In the first people's Hospital of Hefei city from May 16, 2011 to February 28, 2013 on the maternity clinic Diagnosis of early pregnancy in 3195 pregnant women as subjects, the establishment of early pregnant women during pregnancy cohort, psychosocial stress information collection, recycling 3123 valid scales. The omission rate and response rate of test items, the method using two sample t test compared to the extreme group, using correlation analysis and factor analysis methods of questionnaire the preliminary screening. The final program consists of 23 items: period of multidimensional psychosocial stress questionnaire "(MPPQ) to evaluate pregnancy. Further reliability and validity of the questionnaire. On 34 pregnant women at 2~4 weeks test-retest, test-retest reliability coefficient analysis questionnaire using Pearson correlation coefficient method, calculation Cronbach 's alpha coefficient to evaluate the internal consistency of the questionnaire reliability. The pregnancy outcome of 1075 pregnant women were collected, using F inspection of pregnant women in different ages, different degree, different family income differences, investigation The validity of questionnaire. Using 2 test investigation questionnaire score and the outcome of pregnancy associated predictive validity evaluation questionnaire. Results the positive rate of project through response analysis, delete 12 items a response rate of 0.1; t test was used to analyze the project identification, delete life events ask a project volume, all project related anxiety questionnaire of pregnancy were selected; life events questionnaire and pregnancy related anxiety questionnaire has 3 factors and 5 items of value 0.4, consider deleting; life events questionnaire, there are 3 items removed, increased Cronbach questionnaire s alpha coefficient, pregnancy related anxiety questionnaire, 1 a project after deletion, increased Cronbach s alpha coefficient of questionnaire, the 4 projects should be deleted; the correlation coefficient method for screening a total of 3 indicators, if the required total standard index less than 2, consider deleting the item analysis after all. The projects were selected. The final is to delete 27 items (including life events questionnaire 20, pregnancy related anxiety questionnaire 7), and determine the evaluation of multidimensional psychosocial pregnancy scale consisted of 23 items of.MPPQ two questionnaires test-retest correlation coefficients were 0.679,0.615, Cronbach, s' alpha coefficient 0.637,0.758.MPPQ were divided into interpersonal problems, family economic problems, work stress, husband work, self work, worry about the fetus, fear of childbirth, worried about their 8 dimensions, consistent with the initial theoretical hypothesis. The factors of life events questionnaire analysis extracted 5 common factors, the cumulative variance contribution rate was 55.363%; factors related to pregnancy anxiety questionnaire analysis extracted 3 common factors, the cumulative variance contribution rate of 66.193%. different maternal age, culture degree and the husband smoking frequency of MPPQ was statistically significant difference ( P0.5), that the validity of MPPQ. No significant statistical difference was found between MPPQ score and adverse pregnancy outcomes, the predictive validity of MPPQ need further research. Conclusion the initial completion of the evaluation system and the reliability and validity of the MPPQ work, psychosocial questionnaire > < period of pregnancy (MPPQ) is basically credible, effective that can be used as a basic tool for detection of pregnant women psychological stress during pregnancy. Further research is needed to examine the predictive validity of the questionnaire.

【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R173

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