中国城市版围产期抑郁筛查量表的编制及信效度检验  

Development and reliability-validity testing of Chinese urban version of perinatal depression screening scale

作　　者：张珊 高雪云 许媚娜 李静[1] 窦成茵 李清红 张丹 陈汝芳[4] 王珊 米阳 朱忠良[6,7] 李晖 Zhang Shan;Gao Xueyun;Xu Meina;Li Jing;Dou Chengyin;Li Qinghong;Zhang Dan;Chen Rufang;Wang Shan;Mi Yang;Zhu Zhongliang;Li Hui(Department of Neonatology,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China;School of Public Health,Xi'an Jiaotong University Health Science Center,Xi'an 710061,China;Department of Neonatology,Northwest Women's and Children's Hospital,Xi'an 710061,China;Department of Obstetrics and Gynecology,the First People's Hospital of Foshan,Foshan 528000,China;Department of Obstetrics and Gynecology,Northwest Women's and Children's Hospital,Xi'an 710061,China;Institute for Maternal and Child Health,Northwest University,Xi'an 710069,China;Institute of Maternal-Infant Health Care,Maternal and Children's Health Care Hospital of Jiujiang,Jiujiang 332001,China;Department of Neonatology,Maternal and Children's Health Care Hospital of Jiujiang,Jiujiang 332001,China)

机构地区：[1]西安交通大学第一附属医院新生儿科,西安710061 [2]西安交通大学公共卫生学院,西安710061 [3]西北妇女儿童医院新生儿科,西安710061 [4]广东省佛山市第一人民医院妇产科,佛山528000 [5]西北妇女儿童医院妇产科,西安710061 [6]西北大学母婴健康研究院,西安710069 [7]江西省九江市妇幼保健院(九江市母婴健康研究所),九江332001 [8]江西省九江市妇幼保健院新生儿科,九江332001

出　　处：《中华围产医学杂志》2024年第12期1042-1048,共7页Chinese Journal of Perinatal Medicine

基　　金：国家自然科学基金(82372086);科技创新2030项目(2021ZD0200500)。

摘　　要：目的编制中国本土化的城市版围产期抑郁筛查量表,并检验其信效度。方法在西安、佛山等城市招募妊娠12周至产后4周的自然受孕且正常产前检查或分娩的孕产妇。通过对其中50例孕产妇的临床访谈和专家论证,建立初始条目。采用相关性分析、临界比值法、同质性检验和因子分析等方法进行条目筛选和信效度检验,形成最终问卷,对研究对象进行测试。抽取有效完成问卷的50例孕产妇在测评结束10~15 d重测。以爱丁堡产后抑郁量表(Edinburgh Postpartum Depression Scale,EPDS)为校标,构建结构方程模型对量表进行探索性和验证性因素分析。以受试者工作特征曲线确定量表的界值。结果(1)研究发放问卷1300份,剔除不合格问卷251份,收集有效问卷1049份(80.7%),其中601份数据用于探索性因素分析和相关性分析,448份数据用于验证性因素分析。(2)量表初始条目共63个。剔除指标未达到项目分析要求的指标后,最终形成的量表共包括22个条目,包含“情绪异常”“兴趣和愉悦感丧失”“睡眠障碍”“有自责自罪感”“自觉思考能力下降”和“精力减退”等6个维度。上述6个维度与EPDS的相关系数分别为0.609、0.322、0.423、0.522、0.545和0.516,量表总分与EPDS的相关系数为0.715(P值均<0.01)。(3)验证性因子分析结果显示各项模型适配指标均在可接受范围内,本量表因素结构稳定。卡方自由度比为2.504;近似误差平方根为0.058;标准化均方根残差为0.048,比较拟合指数为0.925,Tueker-Lewis指数为0.911。保留22个条目后,各维度的克隆巴赫系数为0.708~0.870。(5)量表总分重测信度为0.936,各维度的重测信度在0.786~0.846,各条目重测信度为0.720~0.886。(6)以EPDS≥13分为界,绘制本量表的受试者工作特征曲线,其曲线下面积(area under the curve,AUC)为0.808(95%CI:0.744~0.872)。当原始分为21分时,约登指数最大(0.561),此时灵敏度和特ObjectiveTo develop a perinatal depression screening scale for Chinese urban version and test its reliability and validity.MethodsNaturally conceived women who were≥12 weeks of gestation and had regular prenatal examinations or delivered within four weeks in Xi'an and Foshan were recruited using convenience sampling.Initial entries were created through clinical interviews and expert validation of 50 of these pregnancies.Further item screening and testing for reliability and validity using correlation analysis,critical ratio method,homogeneity test,and factor analysis were performed.The final questionnaire was formed and then used to test the subjects.Fifty women who had completed the questionnaire effectively were selected for retesting 10 to 15 days after the initial evaluation.A structural equation model was constructed using the Edinburgh Postpartum Depression Scale(EPDS)as the reference criterion to conduct the scale's exploratory and confirmatory factor analysis.The receiver operating characters curve was used to determine the cut-off point of the scale.Results(1)1300 questionnaires were issued,and 1049 valid questionnaires were received with a recovery rate of 80.7%.Among them,601 were used for exploratory and correlation analysis,and 448 were used for confirmatory factor analysis.(2)The initial entries of the scale totaled 63.After eliminating indicators that did not meet the requirements for item analysis,the final scale consisted of 22 entries in total.The final scale consisted of six dimensions,including"abnormal mood","loss of interest and pleasure,""sleep disorder,""self-blame and guilt,""decline in conscious thought ability,"and"lack of energy".(3)The correlation coefficients between the above six dimensions and EPDS were 0.609,0.322,0.423,0.522,0.545,and 0.516,respectively.The one between the total scale and EPDS was 0.715(all P<0.01).(4)The confirmatory factor analysis of each model and the scale showed an acceptable fit and a stable factor structure with indices Chi-square/degrees of freedom=2.5

关 键 词：抑郁症 围产期 抑郁评估量表编制 影响因素分析 结果可重复性 

分 类 号：R714.7[医药卫生—妇产科学]