头颈癌患者自我感知歧视量表的开发、验证及应用  

Development,validation and application of head and neck cancer self-perceived discrimination scale

作　　者：刘智金 李烽 徐骏 甘琳[1] 卢致辉[3] 章健 占志强[2] LIU Zhijin;LI Feng;XU Jun;GAN Lin;LU Zhihui;ZHANG Jian;ZHAN Zhiqiang(Department of Oncology,the Third Affiliated Hospital of Nanchang University-the First Hospital of Nanchang,Jiangxi Nanchang 330008,China;Department of Oncology,Pingxiang People's Hospital,Jiangxi Pingxiang 337000,China;Department of Oncology,the First Affiliated Hospital,Jiangxi Medical College,Nanchang University,Jiangxi Nanchang 330000,China)

机构地区：[1]南昌大学第三附属医院暨南昌市第一医院肿瘤科,江西南昌330008 [2]萍乡市人民医院肿瘤科,江西萍乡337000 [3]南昌大学江西医学院第一附属医院肿瘤科,江西南昌330000

出　　处：《现代肿瘤医学》2024年第22期4290-4295,共6页Journal of Modern Oncology

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

摘　　要：目的:开发头颈癌患者自我感知歧视量表(head and neck cancer self-perceived discrimination scale,HNCSPDS),检验其信效度及适用性,并分析患者自我感知歧视与生活质量的相关性。方法:采用经典测量理论,选取326例头颈癌患者开发HNCSPDS;Delphi专家咨询和条目分析用来提升HNCSPDS的内容效度;采用因子分析(factor analysis,FA)和结构方程模型(structural equation modeling,SEM)检验HNCSPDS的结构效度,采用Cronbach's alpha系数、Spearman-Brown系数和组内相关系数(intra-class correlation coefficient,ICC)检验HNCSPDS的内部一致性和重测可靠性;采用多元逐步线性回归分析患者自我感知歧视的危险因素,采用Pearson相关系数分析自我感知歧视与生活质量的相关性。结果:HNCSPDS共14个条目,包括3个维度(形象污名、社交隔离和自我贬低),具有良好的效度(χ^(2)/df=2.311,RMSEA=0.064,GFI=0.937,AGFI=0.904,CFI=0.972,NFI=0.957,IFI=0.972,TLI=0.963)、信度(Cronbach'sα系数为0.957,分半信度为0.967,重测信度为0.878)和适用性[平均完成时间(14.33±2.315)min和93.14%的有效完成率]。经济负担和性别是患者自我感知歧视的独立危险因素(P<0.01),自我感知歧视与生活质量呈负相关。结论:头颈癌患者普遍存在较强的自我感知歧视,HNCSPDS在自我感知歧视测量中信效度良好,为将来预防和缓解患者自我感知歧视心理,提高患者身心健康和生活质量提供科学有效的评估工具。Objective:To develop the head and neck cancer self-perceived discrimination scale(HNCSPDS),test its reliability,validity and applicability,and analyze the correlation between patients'self-perceived discrimination and quality of life.Methods:Using classical measurement theory,a total of 326 patients with head and neck cancer were selected to develop HNCSPDS.Delphi expert consultation and item analysis were used to improve the content validity of HNCSPDS.Factor analysis(FA)and structural equation modeling(SEM)were used to test the structural validity of HNCSPDS.Cronbach's alpha coefficient,Spearman-Brown coefficient and intra-class correlation coefficient(ICC)were used to test the internal consistency and retest reliability of HNCSPDS.Multiple stepped-linear regression was used to analyze the influencing factors of discrimination,and Pearson correlation coefficient was used to analyze the correlation between discrimination and quality of life.Results:HNCSPDS consisted of 14 items,including three subscales:Image stigma,social avoidance,and self-deprecation.It had good validity(χ^(2)/df=2.311,RMSEA=0.064,GFI=0.937,AGFI=0.904,CFI=0.972,NFI=0.957,IFI=0.972,TLI=0.963),reliability(Cronbach'sαcoefficient was 0.957,split half reliability was 0.967,retest reliability was 0.878)and applicability[average completion time(14.33±2.315)min and effective completion rate of 93.14%].The results of multiple stepped-linear regression analysis showed that economic burden and gender were independent risk factors of discrimination(P<0.01),and self-perceived discrimination was negatively correlated with quality of life.Conclusion:Patients with head and neck cancer generally have a strong self-perceived discrimination.HNCSPDS has good reliability and validity in measuring self-perceived discrimination in head and neck cancer patients,providing a scientific and effective evaluation tool for preventing and alleviating self-perceived discrimination in patients,improving their physical and mental health and quality of life in the future.

关 键 词：头颈癌 自我感知歧视 量表 心理健康 心理测量 

分 类 号：R739.91[医药卫生—肿瘤]