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社会影响量表在脑卒中患者病耻感测量中的信效度 研究
黄朝军黎巧玲韩梅胡晓红刘晓博
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摘要:
目的 检验中文版社会影响量表应用于我国脑卒中患者病耻感的信度和效度,为评估脑 卒中患者的病耻感提供有效工具。方法 在陕西省西安市某三甲医院康复医学科采用便利抽样的方法 抽取2018 年4—9 月符合纳入标准的脑卒中患者170 例,应用中文版社会影响量表进行病耻感调查。采 用鉴别度、变异系数法、相关性分析法对量表条目进行分析,采用Cronbach's α系数、内容效度指数、分 层面探索性因子分析,分别评定量表的信度、内容效度、结构效度,效标关联效度用于测量社会影响量 表与日常活动能力、自尊、抑郁的相关性。结果 共发放170 份问卷,回收有效问卷164 份,回收有效 率96.5%。社会影响量表能够鉴别高分组和低分组(P < 0.01),量表各条目变异系数均> 15%,量表各 维度与总分的相关系数为0.739~0.875(P< 0.01),各条目得分与量表总得分的相关系数为0.325~0.738 (P< 0.01)。分层面探索性因素分析结果最终保留18 个条目,各维度提取1 个公因子,每个公因子方差 贡献率均达到45%以上,最终各维度所包含的条目不少于3 个,且因素负荷量均> 0.60。量表各条目水 平内容效度指数为0.875~1.000,量表水平内容效度指数为0.944。经过修正后的社会影响量表由4 个 维度、18 个条目组成,总量表的内部一致性Cronbach's α系数为0.908,各维度Cronbach's α系数分别为 0.711、0.662、0.840、0.777,各条目相关系数为0.457~0.783(P < 0.01),各维度相关系数为0.749~0.867 (P<0.01)。修订后的社会影响量表得分与日常活动能力、自尊得分呈负相关(r值分别为-0.238、-0.309, P < 0.01),与抑郁得分呈正相关(r=0.537,P < 0.01)。结论 修正后的社会影响量表具有较理想的信度 和效度,可用于我国脑卒中患者病耻感的测评。
关键词:  卒中  病耻感  社会影响量表  信效度  因子分析
DOI:10.3969/j.issn.1009-6574.2019.04.020
基金项目:
Reliability and validity of the Social Impact Scale in measuring the stigma in stroke patients
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Abstract:
Objectives To test the reliability and validity of the Chinese version of the Social Impact Scale( SIS) for the stigma of stroke patients in China, and to provide an effective tool for assessing the stigma of stroke patients. Methods A total of 170 stroke patients who met the inclusion criteria were selected by the Rehabilitation Medicine Department of a tertiary hospital in Xi'an, Shaanxi Province. The Chinese version SIS was used to investigate the stigma. Using the degree of discrimination, coefficient of variation, and correlation analysis to analyze the scale items, Cronbach's alpha, content validity index, and exploratory factor analysis were used to evaluate the reliability, content validity, structural validity of the scale. The criterion-related validity is used to measure the correlation between social impact scale and daily activity ability, self-esteem, and depression. Results A total of 170 questionnaires were distributed, and 164 valid questionnaires were returned. The response rate was 96.5%. The SIS can identify high and low groups( P<0.01), the coefficient of variation of each item of the scale is over 15%, and the correlation coefficient between each dimension and total score of the scale is 0.739-0.875( P< 0.01). The correlation coefficient between the score and the total score of the scale is 0.325-0.738( P<0.01). The results of the exploratory factor analysis retain 18 items, and one common factor is extracted for each dimension. The contribution of each common factor to variance is more than 45%. Finally, each dimension contained no less than three items, and the factor load is > 0.60. The content validity index of each item of the scale is 0.875-1.000, and the content validity index of the scale is 0.944. The revised social impact scale consists of 4 dimensions and 18 items. The internal consistency of the total scale Cronbach's α coefficient is 0.908, and the Cronbach's α coefficients of each dimension are 0.711, 0.662, 0.840, 0.777, respectively. The correlation coefficient of each item is 0.457-0.783( P<0.01). The correlation coefficient of each dimension is 0.449-0.867( P<0.01). The revised SIS score was negatively correlated with daily activity ability and self-esteem score( r=-0.238, -0.309, P < 0.01), and positively correlated with depression score( r=0.537, P<0.01). Conclusions The revised SIS has ideal reliability and validity and can be used to evaluate the stigma in stroke patients in China.
Key words:  Stroke  Stigma  Social Impact Scale  Reliability and validity  Factor analysis

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