【摘要】：研究目的：基于世界衛(wèi)生組織關(guān)于健康相關(guān)生活質(zhì)量的定義,按照量表編制程序,編制具有較好操作性、代表性、有效性、準(zhǔn)確性的適合我國(guó)文化背景的腹膜透析生活質(zhì)量量表,建立腹膜透析患者生活質(zhì)量科學(xué)評(píng)價(jià)方法,為我國(guó)腹膜透析人群的生活質(zhì)量測(cè)評(píng)提供可靠的評(píng)價(jià)工具。并對(duì)該量表進(jìn)行條目分析和信度、效度檢驗(yàn)。研究方法：通過(guò)文獻(xiàn)檢索及患者訪(fǎng)談分別構(gòu)建量表?xiàng)l目池的共性模塊及特異性模塊,共5個(gè)維度74個(gè)條目。應(yīng)用Delphi專(zhuān)家咨詢(xún)法對(duì)條目進(jìn)行初步篩選,共納入來(lái)自全國(guó)各地的20名從事腎臟專(zhuān)業(yè)的專(zhuān)家,進(jìn)行包含預(yù)調(diào)研在內(nèi)的三輪專(zhuān)家咨詢(xún),形成包括5個(gè)維度52個(gè)條目的初試量表(軀體生理功能9個(gè)條目、疾病因素16個(gè)條目、心理狀態(tài)11個(gè)條目、社會(huì)角色功能10個(gè)條目、滿(mǎn)意度6個(gè)條目)。通過(guò)現(xiàn)場(chǎng)調(diào)查的方法,對(duì)360名患者進(jìn)行了測(cè)試,應(yīng)用條目分析法、條目分布法、變異系數(shù)法、條目間相關(guān)系數(shù)法、條目與維度間相關(guān)系數(shù)法、Cronbach's Alpha系數(shù)、因子分析法7種方法從量表的信度、效度角度出發(fā)對(duì)量表?xiàng)l目進(jìn)行再次篩選,形成5個(gè)維度41條目的量表(軀體生理功能5個(gè)條目,疾病因素14個(gè)條目、心理狀態(tài)9個(gè)條目、社會(huì)角色功能7個(gè)條目、滿(mǎn)意度6個(gè)條目)。量表的考評(píng)階段,通過(guò)對(duì)304份有效量表的的統(tǒng)計(jì)分析,應(yīng)用重測(cè)信度、半分信度及內(nèi)部一致性檢驗(yàn)量表信度,內(nèi)容效度、效標(biāo)關(guān)聯(lián)度、區(qū)分效度及結(jié)構(gòu)效度考評(píng)了量表的效度。研究結(jié)果：PD患者生活質(zhì)量量表一周后重測(cè)信度0.748；Cronbach's Alpha系數(shù)為0.936,半分信度為0.814,結(jié)果均大于0.7,顯示量表具備較好的信度。在對(duì)量表效度檢驗(yàn)時(shí)顯示本量表針對(duì)腹膜透析患者與非患者間具備較好的區(qū)分效度,差異具有統(tǒng)計(jì)學(xué)意義。將本量表與SF-36量表做效標(biāo)效度分析的結(jié)果則顯示,本量表各維度與SF-36量表各維度間相關(guān),兩量表總分的相關(guān)系數(shù)為0.956,結(jié)果具有統(tǒng)計(jì)學(xué)意義。對(duì)量表結(jié)構(gòu)效度考評(píng)時(shí),通過(guò)主成分因子分析提取了10個(gè)公因子,公因子的分布與維度間的聯(lián)系基本符合研究者的理論構(gòu)想及預(yù)期結(jié)果,對(duì)于個(gè)別條目的錯(cuò)位,研究者予以了調(diào)整。最終形成了包含41個(gè)條目的腹膜透析患者生活質(zhì)量量表包含軀體生理功能5個(gè)條目,疾病因素15個(gè)條目、心理狀態(tài)10個(gè)條目、社會(huì)角色功能6個(gè)條目、滿(mǎn)意度5個(gè)條目的最終版量表。研究結(jié)論：1、本研究形成了適合中國(guó)文化背景的中文版腹膜透析患者生活質(zhì)量量表。2、中文版腹膜透析患者生活質(zhì)量量表具有較好的信度和效度,可在我國(guó)腹膜透析患者生活質(zhì)量的測(cè)評(píng)中推廣應(yīng)用。
[Abstract]:Objective: based on the World Health Organization's definition of health-related quality of life, according to the development program of the scale, the compilation has better operability, representativeness and effectiveness. The quality of life (QOL) of peritoneal dialysis patients was evaluated by using the peritoneal dialysis quality of life scale, which was accurate and suitable for Chinese culture background. The scientific evaluation method of quality of life of peritoneal dialysis patients was established to provide a reliable evaluation tool for the quality of life evaluation of Chinese peritoneal dialysis population. The item analysis and reliability and validity test of the scale were carried out. Methods: by literature retrieval and patient interview, the common and specific modules of the inventory pool were constructed, with 74 items in 5 dimensions. Using the Delphi expert consultation method to carry out preliminary screening of the entry, a total of 20 experts engaged in kidney specialty from all over the country were included to conduct three rounds of expert consultation, including pre-investigation. The first test scale consisted of 52 items in 5 dimensions (9 items for somatic physiological function, 16 items for disease factors, 11 items for mental state, 10 items for social role function and 6 items for satisfaction). Through the method of field investigation, 360 patients were tested by item analysis method, item distribution method, variation coefficient method, inter-item correlation coefficient method, Cronbach's Alpha coefficient between items and dimension correlation coefficient method, between items and dimension correlation coefficient method, between item and dimension correlation coefficient method, between item and dimension correlation coefficient method, between item and dimension correlation coefficient method. From the reliability and validity of the scale, 7 methods of factor analysis were used to re-screen the items of the scale, forming a scale of 5 dimensions and 41 items (5 items of physical function, 14 items of disease factors, 9 items of mental state). Social role function 7 items, satisfaction 6 items). In the evaluation stage of the scale, through the statistical analysis of 304 effective scales, the validity of the scale was tested by means of test-retest reliability, semi-reliability and internal consistency. The validity of the scale was determined by testing the reliability of the scale, the content validity, the effect correlation degree, the distinguishing validity and the structural validity. Results: after one week, the reliability of PD patients was 0.748% Cronbachs Alpha coefficient was 0.936, half score reliability was 0.814, the results were all greater than 0.7, which showed that the scale had better reliability. The validity test showed that the scale had good distinguishing validity between peritoneal dialysis patients and non-patients, and the difference was statistically significant. The results of validity analysis of this scale and SF-36 scale showed that each dimension of this scale was correlated with that of SF-36 scale, the correlation coefficient of the total score of the two scales was 0.956, the results were statistically significant. Ten common factors were extracted by principal component factor analysis (PCA). The relationship between the distribution of common factors and the dimensions was basically consistent with the theoretical conception and expected results of the researchers, and the dislocation of individual items. The researchers adjusted it. Finally, 41 items of peritoneal dialysis patients' quality of life scale including 5 items of physical function, 15 items of disease factors, 10 items of mental state, 6 items of social role function were formed. The final version of the satisfaction scale for 5 items. Conclusions: 1. The Chinese version of quality of life scale for peritoneal dialysis patients was developed, which is suitable for Chinese culture. 2. The Chinese version of quality of life scale for peritoneal dialysis patients has good reliability and validity. It can be popularized and applied in the quality of life of peritoneal dialysis patients in China.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R473.5

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