【摘要】：研究目的參照患者報(bào)告結(jié)局指標(biāo)(patient reported outcomes,PRO)量表研制的程序,結(jié)合我國獨(dú)特的文化以及對視障兒童的認(rèn)知和臨床特點(diǎn),制定出適合我國視障兒童的生命質(zhì)量測定量表,采用現(xiàn)場調(diào)查方法收集樣本,修訂并考核該量表的信效度和區(qū)分度。該量表將用于評價(jià)視障兒童的生命質(zhì)量,為全面的了解視障兒童健康狀況以及社會(huì)參與能力提供測量工具。研究方法1、根據(jù)PRO量表制作原理及PRO的程序,運(yùn)用文獻(xiàn)研究法、核心小組討論法,構(gòu)建視障兒童生命質(zhì)量量表的共性模塊和特異性模塊,形成條目池。2、運(yùn)用德爾菲專家咨詢法,收集專家意見,建立數(shù)據(jù)庫,考察專家的積極程度、意見集中程度、協(xié)調(diào)一致程度和權(quán)威程度,反復(fù)進(jìn)行兩輪,形成視障兒童生命質(zhì)量測定初選量表。3、采用視障兒生命質(zhì)量測定初選量表進(jìn)行現(xiàn)場調(diào)查,對回收的數(shù)據(jù)使用相關(guān)系數(shù)法、因子分析法、項(xiàng)目反應(yīng)理論進(jìn)行分析,測量量表的信效度和區(qū)分度,得出最終量表。研究結(jié)果1、視障兒童生命質(zhì)量測定量表包含6個(gè)領(lǐng)域41個(gè)條目,根據(jù)不同年齡階段視障兒童認(rèn)知水平、理解能力的不同,在量表測量領(lǐng)域及條目結(jié)構(gòu)不變的基礎(chǔ)上,將該量表分為了7歲以下組和8歲以上組,同時(shí)設(shè)計(jì)了在特殊情況下家長代評問卷。2、兩輪專家權(quán)威程度系數(shù)的平均值分別為0.700、0.745;第二輪專家咨詢重要性和準(zhǔn)確性的協(xié)調(diào)系數(shù)分別為0.206、0.270;同時(shí)采用界值法對條目進(jìn)行篩選。3、信度評價(jià):總量表的克朗巴赫α系數(shù)為0.868,各個(gè)領(lǐng)域克朗巴赫α系數(shù)在0.527~0.777之間;總量表的分半信度為0.765,各個(gè)領(lǐng)域分半信度在0.451~0.660之間;總量表重測信度為0.808,各個(gè)領(lǐng)域的重測信度在0.760~0.894之間。4、效度評價(jià):維度相關(guān)性方面,各條目與其所在領(lǐng)域的相關(guān)性較高,但與其他領(lǐng)域的相關(guān)性較低,量表各領(lǐng)域與總量表之間的相關(guān)系數(shù)均大于0.5,各條目與其所在領(lǐng)域的相關(guān)系數(shù)多數(shù)在0.6以上。因子分析結(jié)果顯示,提取13個(gè)公因子,累計(jì)方差貢獻(xiàn)率為66.157%,方差最大旋轉(zhuǎn)后結(jié)果顯示與理論框架基本相符。驗(yàn)證性因子分析結(jié)果顯示,總量表的CFI為0.71,各個(gè)領(lǐng)域的CFI分別為0.95、0.97、0.92、0.92、0.87、0.80。5、區(qū)分度評價(jià):量表各條目ICC曲線構(gòu)圖良好,條目信息包含量大,誤差小。6、可行性評價(jià):每份量表的完成時(shí)間均可以控制在15~20分鐘,可行性較高。研究結(jié)論視障兒童生命質(zhì)量測定量表具有較高的信度、效度、區(qū)分度及可行性,可以作為視障兒童生命質(zhì)量測評的工具,評價(jià)視障兒童康復(fù)效果極其社會(huì)參與能力。
[Abstract]:Objective to develop the quality of life (QOL) measurement scale for visually impaired children according to the procedure of the development of the patient report outcome index (patient reported outcomes,PRO) scale, combined with the unique culture and the cognitive and clinical characteristics of the children with visual impairment in China. The reliability, validity and distinction of the scale were revised and evaluated by field survey. The scale will be used to evaluate the quality of life of children with visual impairment and to provide a comprehensive understanding of the health status of children with visual impairment and the ability to participate in society. Methods 1.According to the principle of PRO scale and the procedure of PRO, using the method of literature research and core group discussion, the common and specific modules of quality of life scale for children with visual impairment were constructed, and the item pool was formed. 2. Using Delphi's expert consultation method, collecting expert opinions, setting up databases, examining experts' positivity, concentration, coordination and authority, and carrying out two rounds over and over again. The primary quality of life measurement scale for visually impaired children was formed. 3. The primary quality of life measurement scale for visually impaired children was used to conduct field investigation. The data collected were analyzed by correlation coefficient method, factor analysis method and item response theory. The reliability and validity of the scale were measured and the final scale was obtained. Results 1. The quality of life measurement scale for visually impaired children includes 41 items in 6 fields. According to the cognitive level and understanding ability of children with visual impairment at different ages, the measurement field and item structure of the scale are unchanged. The scale was divided into 7 years old group and 8 years old group. At the same time, the parents' substitute questionnaire was designed under special circumstances. 2. The average value of the two rounds of expert authority coefficient was 0.700 鹵0.745; The coordination coefficient of the importance and accuracy of the second round of expert consultation is 0.206 and 0.270 respectively; At the same time, the method of boundary value was used to screen the items. 3. Reliability evaluation: the total amount of the krombach 偽 coefficient was 0.868, and the cornbach 偽 coefficient in all fields was between 0.527 and 0.777; The split-half reliability of total table is 0.765.The split-half reliability of each field is between 0.451and 0.660; The test-retest reliability of total table is 0.808, the retest reliability of each field is between 0.760,0.894. 4. Validity evaluation: in dimensional correlation, each item has a higher correlation with its domain, but a lower correlation with other fields. The correlation coefficient between each field and total scale is more than 0.5, and the correlation coefficient between each item and its field is more than 0.6. The results of factor analysis show that 13 common factors are extracted and the cumulative contribution rate of variance is 66.157. The results of maximum rotation of variance are basically consistent with the theoretical framework. The results of confirmatory factor analysis showed that the CFI of the total table was 0.71, and the CFI of each field was 0.95 / 0.970.92 / 0.920.87 / 0.80.The degree of discrimination was as follows: the ICC curve of each item of the scale was well composed and the amount of item information was large. The error is small. 6, feasibility evaluation: the completion time of each scale can be controlled in 1520 minutes, and the feasibility is high. Conclusion the quality of life measurement scale for children with visual impairment has high reliability, validity, distinction and feasibility. It can be used as a tool to evaluate the quality of life of children with visual impairment, and to evaluate the rehabilitation effect of children with visual impairment and their ability to participate in society.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R779.7

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