针对临床治疗的知情同意能力筛查量表编制及其在精神分裂症患者中的信效度研究  

A study of reliability and validity of Screening Assessment for Capacity to Consent to Clinical Treatment in clinical treatment of patients with schizophrenia

作　　者：黄晶晶[1] 邵阳 谢斌[1] 马华舰 杨卫敏[1] 沈一峰[1] 李华芳[1] 

机构地区：[1]上海交通大学医学院附属精神卫生中心,上海市200030

出　　处：《精神医学杂志》2017年第2期85-87,共3页Journal of Psychiatry

基　　金：科技重大专项"精神药物新药临床评价研究技术平台"(编号:2012ZX09303-003);国家"十二五"科技支撑计划(编号:2012BAK16B04);上海市重性精神病重点实验室(编号:13dz2260500)

摘　　要：目的检验知情同意能力筛查量表(SACC-CT)在精神分裂症患者临床治疗中的信度和效度。方法应用SACC-CT和麦克阿瑟针对临床治疗的知情同意能力评估工具(Mac CAT-T)对109例精神分裂症患者进行测评,检验SACC-CT在精神分裂症患者临床治疗中的信度和效度。结果 SACC-CT由10个条目组成,分成表达、理解、鉴别和推理4个维度。SACC-CT的克朗巴哈系数、重测组内相关系数、不同评定者之间的组内相关系数分别为0.850(P<0.01)、0.907(P<0.01)、0.972(P<0.01)。Mac CAT-T与SACC-CT各维度及总分的Pearson相关系数为0.670~0.974(P<0.01)。SACC-CT的ROC曲线下面积为0.865±0.035,SACC-CT界值取10分时对应的灵敏度和特异度分别为0.806和0.730。结论 SACC-CT在精神分裂症患者临床治疗中具有较好的信度和效度,以"10"分为分界值可达到中等程度的筛选效能。Objective To explore reliability and validity of Screening Assessment for Capacity to Consent to Clinical Treatment（ SACC-CT） in clinical treatment of patients with schizophrenia. Methods A total of 109 patients with schizophrenia were selected and assessed with SACC-CT and Mac Arthur Competency Assessment Tool-Treatment（ Mac CAT-T） for the reliability and validity of SACC-CT in clinical treatment of patients with schizophrenia. Results There were 10 items and four subparts,including expressing,understanding,appreciating and reasoning in SACC-CT. The coefficient of inter-item consistency（ Cronbach＇s α）,test-retest reliability and interrater reliability in SACC-CT were 0. 850（ P〈0. 01）,0. 907（ P〈0. 01） and0. 972（ P〈0. 01） respectively. The correlation coefficients between total score and all subparts of SACC-CT and total score and all subparts of Mac CAT-T were 0. 670 ~ 0. 974（ P〈0. 01）. The area under the ROC curve of SACC-CT was 0. 865 ± 0. 035 and the cut-off score was 10 for SACC-CT with sensitivity of 80. 6% and specificity of 73. 0%. Conclusion There is good reliability and validity of SACC-CT in the clinical treatment of patients with schizophrenia,which should be moderate degree of screening efficiency with ＂10＂divided into the cut-off value.

关 键 词：知情同意能力 伦理 精神医学 

分 类 号：R749.3[医药卫生—神经病学与精神病学]