严重精神障碍患者病耻感应激量表中文版信度和效度研究  

Psychometric properties of the Chinese version of the Stigma Stress Scale in patients with serious mental illness

作　　者：李洁[1] 钟华清 陈雯[2] 谭艳玲 Petra C Gronholm Nicolas Rüsch Graham Thornicroft LI Jie;ZHONG Huaqing;CHEN Wen;TAN Yanling;Petra C Gronholm;Nicolas Rüsch;Graham Thornicroft(The Affiliated Brain Hospital of Guangzhou Medical University,Guangzhou 510370,China)

机构地区：[1]广州医科大学附属脑科医院,广州510370 [2]中山大学公共卫生学院 [3]英国伦敦国王学院精神医学、心理学和神经科学研究所 [4]德国乌尔姆大学精神病学Ⅱ系

出　　处：《中国神经精神疾病杂志》2021年第6期336-340,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：广州市卫生计生科技重大项目(编号:2016A031002);英国医学研究理事会(Medical Research Council of UK,MRC)有关国际歧视与病耻感结局研究(International Study of Discrimination and Stigma Outcomes,INDIGO)项目(编号:MR/R023697/1)。

摘　　要：目的探讨病耻感应激量表(stigma stress scale,SSS)中文版在严重精神障碍患者中的信度和效度。方法按照初译、专家评议、回译和焦点小组访谈等步骤形成SSS中文版。采用SSS中文版、精神疾病内在病耻感调查表(internalized stigma of mental illness scale,ISMI)和9项患者健康问卷(patient health questionnaire-9 items,PHQ-9)对149例严重精神障碍患者进行调查。采用内部一致性、分半信度和重测信度评价分析SSS中文版信度,采用表面效度和结构效度评价分析该量表效度。结果信度分析显示,SSS亚量表一Cronbach'sα=0.959,亚量表二Cronbach'sα=0.905;亚量表一和亚量表二分半相关系数(r)分别为0.943和0.889;亚量表一和亚量表二重测信度的相关系数(r)分别为0.871和0.702(均P<0.001)。效度分析显示,SSS亚量表一分值与ISMI前4个维度总分呈正相关(r=0.570,P<0.001),亚量表二分值与ISMI第5个维度总分呈正相关(r=0.501,P<0.001)。此外,严重精神障碍患者中感知到的病耻感相关应激与抑郁呈正相关(r_(P)=0.410,P<0.001)。结论SSS中文版具有良好的信度和效度,可以作为评估严重精神障碍患者病耻感相关应激的心理评估工具。Objective To explore the reliability and validity of the Stigma Stress Scale(SSS)for patients with serious mental illness in China.The SSS is a measure of perceived stigma-related stress,based on perceived stigma-related harm(subscale 1)and perceived resources to cope with stigma(subscale 2).Stigma stress occurs if perceived harm exceeds perceived coping resources.Methods The SSS was translated and culturally adapted in China through forward-translation,expert panels,back-translation,focus groups interviews,and cognitive interviews.The SSS as well as Internalized Stigma of Mental Illness Inventory(ISMI)and Patient Health Questionnaire(PHQ-9)were administered to 149 participants with serious mental illness.The reliability and validity of the SSS were evaluated according to internal consistency,the Spearman-Brown split-half coefficient and test-retest reliability,and face validity and construct validity,respectively.Results Both SSS subscales showed high internal consistency(Cronbach's alpha 0.959 for subscale 1,0.905 for subscale 2).The Spearman-Brown split-half coefficient(r)of subscales 1 and 2 were 0.943 and 0.889,respectively.And the test-retest reliabilities(r)were 0.871 and 0.702,respectively(P<0.001).In terms of construct validity,self-stigma(ISMI)was positively related to perceived stigma-related harm(subscale 1,r=0.570,P<0.001).Stigma resistance was positively associated with coping resources(subscale 2,r=0.501,P<0.001).Besides,stigma stress was positively related to depression(r_(P)=0.410,P<0.001).Conclusion The Chinese version of the SSS has good reliability and validity.It is recommended as a tool for measuring stigma-related stress perceived by people with serious mental illness.

关 键 词：严重精神障碍 病耻感 应激 心理测量评估 

分 类 号：R749[医药卫生—神经病学与精神病学]