中文版SF-36量表应用于肛肠良性疾病患者生命质量评价的信度和效度研究  

Reliability and validity of the Mos item short form health survey in evaluating quality of life for patients with benign anorectal diseases

作　　者：孙松朋[1] 龙俊红 张书信[1] Sun Songpeng;Long Junhong;Zhang Shuxin(Anorectal Department, Dongzhimen Hospital Beijing University of Chinese Medicine, Beijing 100700, China)

机构地区：[1]北京中医药大学东直门医院肛肠科

出　　处：《结直肠肛门外科》2019年第5期497-505,512,共10页Journal of Colorectal & Anal Surgery

摘　　要：目的研究健康调查简表(SF-36)测量肛肠良性疾病患者生命质量(QOL)的信度和效度。方法应用中文版SF-36量表测量择期手术治疗的肛肠良性疾病患者(n=355)的生命质量,其中有89例患者同时填写了世界卫生组织生命质量测定简表(WHOQOL-BRER),有109例患者同时填写了欧洲五维健康量表(EQ-5D-3L)和49例患者同时填写了肛肠疾病严重程度VAS评分(VAS-AD),并选择58例普通人群作为对照组,分析SF-36量表的内部一致性、分半信度、结构效度、效标效度、区别效度。结果观察组生理职能(RP)、躯体疼痛(BP)、社会功能(SF)、情感职能(RE)四个维度、心理领域(MCS)和总分得分均低于对照组,差异有统计学意义(均P<0.05);除了活力(VT)外,SF-36量表其他维度、领域和总分Chonbach’a均大于0.6;除了总体健康(GH)、VT、精神健康(MH)外,SF-36量表其他维度Spearman-Brown分半系数均大于0.6;在生理功能(PF)、RP、BP、SF、RE五个维度上出现天花板效应,在RP、RE这两个维度出现了地板效应;主成分探索性因子分析法提取出7个公因子,累计负荷量66.795%;SF-36量表的生理领域(PCS)、MCS和总分与WHOQLO-BRER量表生理健康(PHYS)相关系数r在0.5~0.7,显示强相关;MCS和总分与心理健康(PSYCH)、环境(ENVIR)呈强相关;EQ-5D-3L与PCS、MCS、总分之间相关系数r在0.3~0.5,显示具有一定的相关性;RP、RE、PCS、总分与VAS-AD相关系数r在-0.5^-0.3,显示RP、RE、PCS、总分与患者自评的肛肠疾病严重程度具有一定的负相关性。结论SF-36量表对肛肠良性疾病人群的测量具有良好的信度和效度以及一定的区别能力,其测量能够反映肛肠疾病对QOL的影响,能够区分肛肠良性疾病患者和普通对照人群,可以用于评价肛肠良性疾病患者的QOL。Objectives To investigate the reliability and validity of the Mos item short form health survey (SF-36) in evaluat ing quality of life (QOL) for patients with benign anorectal diseases. Methods Patients (n = 355) who underwent elective surgery for benign anorectal diseases and normal controls (n = 58) completed the Chinese version of SF-36. 89 patients completed the WHOQOL-BREF questionnaire, 109 patients completed the EQ-5D-3L, and 49 patients completed the VAS-AD for anorectal dis ease severity at the same time. Internal consistency, split-half reliability, structural validity, scale validity and differential validity of SF-36 were analyzed. Results Compared with normal controls, patients had significantly lower scores in four domains including role-physical (RP), bodily pain (BP), social function (SF) and role-emotional (RE), mental component score (MCS), and total score ( P < 0.05). Except for vitality (VT), all domains of SF-36, component scores, and total scores had Cronbach’s alpha larger than 0.6. Except for global health (GH), VT, and mental health (MH), all domains had Spearman-Brown split-half reliability coef ficient larger than 0.6. The ceiling effect appears in five dimensions of physiological function (PF), RP, BP, SF and RE, and the floor effect appears in the two dimensions of RP and RE. Principal component exploratory factor analysis extracted seven com mon factors with a cumulative load of 66.795%. The correlation coefficients of physical component score (PMS), MCS, total score and PHYS of WHOQLO-BRER ranged between 0.5 and 0.7, indicating a strong correlation. There was a strong correlation be tween MCS and total score with PSYCH and ENVIR. The correlation coefficients of EQ-5D-3L and PCS, MCS and total score ranged between 0.3 and 0.5, indicating mild to moderate correlation. The correlation coefficients of RP, RE, PCS, total score and VAS-AD score ranged between -0.5 and -0.3, indicating mild to moderate negative correlation between these scores and pa tients’self-report severity of the

关 键 词：肛肠良性疾病 SF-36量表 信度 效度 

分 类 号：R657.1[医药卫生—外科学]