慢性阻塞性肺疾病患者夜间睡眠症状评估量表的编制及其效度和信度分析  

Reliability and validity of nocturnal symptom assessment test for chronic obstructive pulmonary disease

作　　者：陈淑靖 金晓燕[2] 高习文[3] 杜春玲 赵蕾[5] 周超 郑聪 彭清[3] 周磊 高宏昌[5] 韩力 宋元林 CHEN Shujing;JIN Xiaoyan;GAO Xiwen;DU Chunling;ZHAO Lei;ZHOU Chao;ZHENG Cong;PENG Qing;ZHOU Lei;GAO Hongchang;HAN Li;SONG Yuanlin(Department of Pulmonary Medicine Zhongshan Hospital,Fudan University,Shanghai 200032,China;Corresponding author：E-mail：song.yuanlin@zs-hospital,sh.cn;contributed equally to this work)

机构地区：[1]复旦大学附属中山医院呼吸科,上海200032 [2]上海交通大学医学院附属同仁医院呼吸科 [3]复旦大学附属闵行医院呼吸科 [4]复旦大学附属中山医院青浦分院呼吸科 [5]上海市浦东新区公利医院呼吸科 [6]上海市浦东新区周浦医院呼吸科

出　　处：《上海医学》2018年第10期584-587,共4页Shanghai Medical Journal

基　　金：国家重点基础研究发展计划(973)项目(2015CB553404);上海市科学技术委员会重大项目(12411950100);卫生与计划生育委员会重点项目(201540370)

摘　　要：目的编制慢性阻塞性肺疾病(COPD)患者夜间睡眠症状评估量表,并评价量表的信度和效度。方法采用方便抽样法选择上海市6家医院268例已确诊的稳定期COPD门诊患者,通过前期访谈,结合COPD的病理生理学特点、患者主诉,在国内外相关睡眠问题量表基础上形成本研究量表,共13个条目,包含睡眠概况(4题)、夜间觉醒(5题)和日间评价(4题)3个维度。在研究对象完成量表后,需立即填写COPD患者自我评估测试(CAT)问卷,由调查员对量表进行检查和回收。评价本研究量表的内容效度和结构效度,并采用同质信度(Cronbach’sα系数)考察该量表的内部一致性。将本研究量表内各条目与CAT问卷中"我的睡眠非常好"题项作相关性分析。结果本研究量表的睡眠概况、夜间觉醒和日间评价各项目得分与3个分量表得分均呈正相关(Spearman相关系数分别为0.692～0.819、0.639～0.854和0.798～0.876,P值均为0.001),3个分量表得分与总量表得分均呈正相关(相关系数分别为0.871、0.821和0.896,P值均<0.001),表明睡眠概况、夜间觉醒和日间评价3个分量表得分与其各个条目和总量表得分的相关性一致,内容效度较好。因子分析结果显示,13个条目的因子载荷为0.50～0.86,可解释的方差变异的和为68.62%,公因子分别对应睡眠概况、夜间觉醒和日间评价,说明本研究量表具有良好的结构效度。信度分析结果显示,总量表的Cronbach’sα系数为0.905,各维度Cronbach’sα系数为0.610～0.873,提示本研究量表可信度较好。本研究量表中"你觉得自己的睡眠质量如何?"与CAT问卷"我的睡眠非常好"相关性最高(相关指数为0.810,P<0.05),其他条目与"我的睡眠非常好"的相关性亦均有统计学意义(P值均<0.05)。结论 COPD夜间睡眠状况评估量表具有良好的效度和信度,可在评估COPD患者夜间睡眠症状相关研究中使用。Objective To develop a nocturnal symptom assessment test for chronic obstructive pulmonarydisease （COPD）, and to test the reliability and validity of the scale. Methods A convenient sample method was used to select 268 confirmed stable OOPD patients from 6 hospitals in Shanghai. Through the earlier interviews,pathophysiological characteristics of COPD and patients＇ complaints, and based on worldwide scales of sleep related problems, a total of 13 items were namely, induded sleep overview （4 items）, nocturnal awakening（5 items）and daytime assessment （4 items）. After the completion of the questionnaire, the COPD Assessment Test （CAT） questionnaire was filled out immediately, checked and recovered by the investigators. The content validity and construct validity of the scale were evaluated. Homogeneity reliability （Cronbach^s alpha coefficient） was used to examine the internal consistency of the scale. The correlations between the items in the study scale and the ＂very good sleep＂ item in the CAT questionnaire were analyzed. Results The score of sleep overview, nocturnal awakening and daytime evaluation of each item were positively correlated to the score of 3 subscales（Spearman correlation coefficient were 0. 692 to 0. 819, 0. 639 to 0. 854 and 0. 798 to 0. 876, respectively, all P = 0. 001 ）. The scores of 3 subscales were positively correlated with the total scale （correlation coefficient were 0. 871, 0.821 and 0. 896, respectively, all P〈O. 001）, which showed that the correlation between the scores of 3 subscales of sleep overview, nocturnal awakening and day evaluation were consistent with the scores of each item and the total scale, and the content validity was good. The results of factor analysis showed that the load of 13 factors were between 0.50 and 0.86, and the sum of explanatory variance variation was 68.62 %. The common factors corresponded to the sleep overview, nocturnal awakening and daytime evaluation, which showed that the scale had good structural validity.

关 键 词：觉醒 夜间症状 慢性阻塞性肺疾病患者自我评估测试 

分 类 号：R563.9[医药卫生—呼吸系统]