WHO卫生系统反应性量表用于社区严重精神障碍患者管理服务的评价~  

Psychometric tests of WHO Health System Responsiveness Questionnaire in evaluation on community management and services for psychosis

作　　者：周蔚[1] 余钰[2] 肖溪 肖水源[2] ZHOU Wei;YU Yu;XIAO Xi;XIAO Shuiyuan(Research Center for Public Health and Social Security,School of Public Administration,Hunan University,Changsha 410082,China;Xiangya School of Public Health,Central South University,Changsha 410078,China;Changsha Psychiatric Hospital,Changsha 410000,China)

机构地区：[1]湖南大学公共管理学院公共健康与社会保障研究所,长沙410082 [2]中南大学湘雅公共卫生学院,长沙410078 [3]长沙市精神病医院,长沙410000

出　　处：《中国心理卫生杂志》2021年第12期1007-1012,共6页Chinese Mental Health Journal

基　　金：国家社会科学基金项目(17CGL050)。

摘　　要：目的:翻译、修订世界卫生组织卫生系统反应性量表,检验修订后量表在我国社区严重精神障碍患者管理服务评价中应用的可行性、效度和信度。方法:根据我国基本公共卫生服务规范的要求以及相关专家、患者及家属的意见,对翻译后的反应性量表进行内容修订。选取225名在社区接受管理服务的严重精神障碍患者进行测试。采用问卷完成时间和条目填写的缺失比评价可行性;采用内部一致性信度和重测信度检验信度;应用探索性因子分析检验结构效度;通过患者及其家属评分的相关性分析检验实证效度。结果:修订后量表的平均完成时间为12 min,条目填写的缺失比均小于6%。全量表的Cronbachα系数及重测信度系数分别为0.75和0.68。探索性因子分析提取的6个公因子累计解释的总方差为81.31%,其中2个因子包含的条目和原量表略有不同。患者及其家属对全量表及4个维度的评分呈正相关。结论:修订后的卫生系统反应性量表对于评价我国社区严重精神障碍患者管理服务具有可行性;全量表的信度和实证效度良好,但结构效度有待进一步探索。Objective:To translate and adapt the World Health Organization's health system responsiveness questionnaire,and to test its feasibility,validity and reliability in evaluation on management and services for psychosis in China.Methods:The translated responsiveness questionnaire was adapted based on the Guidelines on the Basic Public Health Services and opinions from experts,patients and their family members.A sample of 225 community patients receiving the Management and Services for Psychosis was recruited for psychometric tests.Feasibility was evaluated by time of completing the questionnaire and item missing rates.Internal consistency reliability and retest reliability were adopted to test reliability.Exploratory factor analysis was conducted for the structure validity.Empirical validity was tested through correlation analysis between patients'and their family members'scores.Results:The average time of completing the questionnaire was 12 minutes,and item missing rates were below 6%.The Cronbach's α and test-retest reliability cofficients of the adapted questionnaire were 0.75 and 0.68 respectively.Exploratory factor analysis showed the cumulative variances of 6 factors were 81.31%,and items extracted to 2 factors were slightly different from the original structure.The scores of patients and their families on the whole scale and 4 dimensions were positively corelated.Conclusion:The adapted responsiveness scale is feasible for evaluation on management and services for psychosis w ith acceptable reliability and empirical validity,while its construct validity needs further verification.

关 键 词：社区精神卫生服务 精神障碍 患者管理 可行性 效度 信度 

分 类 号：R749[医药卫生—神经病学与精神病学] R473.2[医药卫生—临床医学]