甲状腺癌歧视感量表在头颈癌患者中的修订  

Revision of Thyroid Cancer Self-perceived Discrimination Scale in head and neck cancer patients

作　　者：刘智金 李烽 刘跃文 冯林森 常馨莲 栾琳琳 甘琳[1] 徐骏 LIU Zhijin;LI Feng;LIU Yuewen;FENG Linsen;CHANG Xinlian;LUAN Linlin;GAN Lin;XU Jun(Department of Oncology,The Third Affiliated Hospital of Nanchang University/The First Hospital of Nanchang,Nanchang 330008,China;Department of Cadre Medical,The Third Affiliated Hospital of Kunming Medical University/Yunnan Cancer Hospital,Kunming 650118,China;Department of Oncology,Pingxiang People’s Hospital,Pingxiang 337000,Jiangxi Province,China;Department of General Surgery,Yongxin People’s Hospital,Jian 343400,Jiangxi Province,China;Department of Hematology,The Sixth Affiliated Hospital of Kunming Medical University/People’s Hospital of Yuxi City,Yuxi 653100,Yunnan Province,China;Operating Room,Shandong Provincial Hospital Affiliated to Shandong First Medical University/Shandong Provincial Hospital,Jinan 250021,China)

机构地区：[1]南昌大学第三附属医院/南昌市第一医院肿瘤科,南昌330008 [2]昆明医科大学第三附属医院/云南省肿瘤医院干部医疗科,昆明650118 [3]萍乡市人民医院肿瘤科,江西萍乡337000 [4]永新县人民医院普外科,江西吉安343400 [5]昆明医科大学第六附属医院/玉溪市人民医院血液科,云南玉溪653100 [6]山东第一医科大学附属省立医院/山东省立医院手术室,济南250021

出　　处：《医学新知》2024年第4期399-408,共10页New Medicine

基　　金：云南省哲学社会科学规划项目(QN202214);江西省卫生健康委科技计划项目(202311199)。

摘　　要：目的修订甲状腺癌歧视感量表(Thyroid Cancer Self-perceived Discrimination Scale,TCSPDS)以适用于头颈癌患者,检验其信效度及适用性,并分析歧视感与生活质量的相关性。方法采用经典测量理论对TCSPDS条目进行修订和补充,形成头颈癌歧视感量表(Head and Neck Cancer Self-perceived Discrimination Scale,HNCSPDS)。选取头颈癌患者进行问卷调查,检验HNCSPDS的信效度及适用性,并分析歧视感的影响因素及其与生活质量的相关性。结果共回收311份有效问卷。HNCSPDS共13个条目,包括污名化(6个条目)、自我否定(5个条目)及社交回避(2个条目)3个分量表。量表具有良好的效度(χ^(2)/df=2.660,RMSEA=0.073,GFI=0.927,CFI=0.972,NFI=0.957,IFI=0.972,TLI=0.963)、信度(Cronbach'sα系数为0.955,折半信度为0.967,重测信度为0.845)和适用性[问卷平均完成时间(14.14±2.18)min和91.5%的有效应答率]。性别和经济负担是患者歧视感的独立影响因素,患者歧视感与生活质量呈负相关。结论头颈癌患者普遍存在较强的歧视感,HNCSPDS在评价头颈癌患者歧视感中信效度良好,可作为未来开展健康宣教、医疗咨询和心理支持的有效评价工具,进一步提高患者身心健康和生活质量。Objective To revise the Thyroid Cancer Self-perceived Discrimination Scale(TCSPDS)for head and neck cancer patients,test its reliability,validity,and applicability,and analyze the correlation between discrimination and quality of life.Methods The TCSPDS was revised and supplemented with classical measurement theory to form the Head and Neck Cancer Self-perceived Discrimination Scale(HNCSPDS).Patients with head and neck cancer were investigated by questionnaire to test the reliability,validity and applicability of HNCSPDS,and analyze the correlation between discrimination and quality of life.Results 311 validated questionaire were collect in the research.The HNCSPDS consisted of 13 items,which were divided into 3 subscales:6 items for stigma,5 items for self-deprecation,and 2 items for social avoidance.The HNCSPDS had good validity(χ^(2)/df=2.660,RMSEA=0.073,GFI=0.927,CFI=0.972,NFI=0.957,IFI=0.972,TLI=0.963),reliability(Cronbach'sαcoefficient was 0.955,split half reliability was 0.967,test-retest reliability was 0.845)and applicability[average completion time(14.14±2.18)min and effective completion rate of 91.5%].Sex and economic burden were independent influencing factors of patients’discrimination,and patients’discrimination was negatively correlated with quality of life.Conclusion There was a strong discrimination in head and neck cancer patients,and HNCSPDS had good reliability and validity in evaluating the discrimination in head and neck cancer patients,which could be used as an effective evaluation tool for future health education,medical consultation and psychological support,and further improve the physical and mental health and quality of life of patients.

关 键 词：头颈癌 歧视感 量表 心理测量 生活质量 

分 类 号：R473.73[医药卫生—护理学]