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多元認(rèn)知能力自評(píng)量表(MASQ)的漢化及其在癲癇病人群中的應(yīng)用

發(fā)布時(shí)間:2018-04-24 23:41

  本文選題:癲癇 + 認(rèn)知功能 ; 參考:《天津醫(yī)科大學(xué)》2017年碩士論文


【摘要】:目的對(duì)多元認(rèn)知能力自評(píng)量表(Multiple Ability Self-Report Questionnaire,MASQ)進(jìn)行翻譯、回譯及文化調(diào)試,并結(jié)合我國(guó)的文化背景建立中文版MASQ量表,利用該量表調(diào)查癲癇患者的認(rèn)知功能狀況并探討影響該群體認(rèn)知功能的因素。方法2015年10月至2016年1月,對(duì)英文版MASQ進(jìn)行翻譯、回譯及文化調(diào)試,邀請(qǐng)專家對(duì)量表的內(nèi)容進(jìn)行修訂,形成中文版MASQ量表。選取天津市某三級(jí)甲等醫(yī)院的神經(jīng)內(nèi)科門(mén)診或病房的癲癇患者200例作為研究對(duì)象,對(duì)中文版MASQ量表進(jìn)行信度和效度檢驗(yàn)。量表信度采用Cronbach'sα系數(shù)和重測(cè)信度來(lái)檢驗(yàn),使用內(nèi)容效度、效標(biāo)關(guān)聯(lián)效度和結(jié)構(gòu)效度對(duì)量表的效度進(jìn)行評(píng)價(jià),結(jié)構(gòu)效度采用驗(yàn)證性因子分析。采用便利抽樣的方法于2016年2月至2016年5月從天津醫(yī)科大學(xué)總醫(yī)院抽取癲癇患者220例作為研究對(duì)象。采用問(wèn)卷調(diào)查法,通過(guò)一般資料調(diào)查表收集社會(huì)人口學(xué)指標(biāo)和疾病指標(biāo),采用醫(yī)院焦慮抑郁量表(HADS)、總體幸福感量表(GWB)、社會(huì)支持量表(SSRS)、癲癇患者生活質(zhì)量量表(QOLIE-31)調(diào)查癲癇患者的焦慮抑郁情緒、總體幸福感和社會(huì)支持水平以及生活質(zhì)量現(xiàn)狀。采用單因素分析的方法比較各分類變量中不同類別指標(biāo)間認(rèn)知功能的差異,使用相關(guān)性分析檢驗(yàn)各連續(xù)性變量與認(rèn)知功能的相關(guān)系數(shù),運(yùn)用多元線性回歸分析探討國(guó)內(nèi)癲癇患者認(rèn)知功能的影響因素。結(jié)果(1)量表漢化引進(jìn)階段:經(jīng)過(guò)對(duì)量表的翻譯、回譯及文化調(diào)試,中文版MASQ量表包括37個(gè)條目,分為5個(gè)維度。量表的Cronbach’sa系數(shù)為0.948,5個(gè)維度的Cronbach’sa系數(shù)分別為0.902、0.797、0.733、0.893、0.848,重測(cè)相關(guān)系數(shù)(重測(cè)信度)為0.960,各維度的重測(cè)信度分別為0.866、0.860、0.850、0.899、0.841。5名專家對(duì)量表進(jìn)行評(píng)定,各條目CVI(item-level CVI,I-CVI)均在0.80以上,總條目?jī)?nèi)容效度指數(shù)(scale-level CVI,S-CVI)為0.98。MASQ得分與QOLIE-31得分呈負(fù)相關(guān)(r=-0.732,P0.001),與HADA、HADD呈正相關(guān)(r=0.590、0.524,P0.001)。驗(yàn)證性因子分析顯示量表的模型擬合較好,修正后標(biāo)準(zhǔn)化五因素模型的卡方自由度比值(CMIN/DF)、擬合優(yōu)度指數(shù)(GFI)、調(diào)整擬合優(yōu)度指數(shù)(AGFI)、殘差均方和平方根(RMR)、近似誤差均方根(RMSEA)、規(guī)范擬合指數(shù)(NFI)、增值擬合指數(shù)(IFI)、非歸準(zhǔn)適配指數(shù)(TLI)、比較擬合指數(shù)(CFI)、簡(jiǎn)約擬合優(yōu)度指數(shù)(PGFI)分別為2.155、0.879、0.902、0.045、0.076、0.881、0.869、0.856、0.868、0.636,標(biāo)準(zhǔn)化回歸系數(shù)0.33~0.93。(2)量表應(yīng)用階段:最終完成對(duì)220例癲癇患者有效資料的收集。患者認(rèn)知功能總得分范圍48~135分,平均(87.86±19.30)分。各維度得分情況:語(yǔ)言(16.95±5.66)分,視知覺(jué)功能(12.29±3.70)分,言語(yǔ)記憶(20.40±5.09)分,視覺(jué)空間記憶(20.50±3.57)分,注意力(17.74±4.58)分。單因素分析結(jié)果顯示:社會(huì)人口學(xué)變量中不同工作情況、文化程度和家庭月收入因素間的認(rèn)知功能得分差異有統(tǒng)計(jì)學(xué)意義(P0.001);疾病相關(guān)變量中不同發(fā)作類型、癲癇灶部位、發(fā)作頻率、發(fā)作持續(xù)時(shí)間及服藥類型的認(rèn)知功能得分差異有統(tǒng)計(jì)學(xué)意義(P0.05);連續(xù)性變量作Pearson或Spearman相關(guān)分析,發(fā)現(xiàn)認(rèn)知功能與年齡、焦慮抑郁情緒、總體幸福感水平、社會(huì)支持水平、和生活質(zhì)量的相關(guān)性有統(tǒng)計(jì)學(xué)意義(P0.001)。多元線性回歸分析結(jié)果顯示:年齡、文化程度、發(fā)作頻率、焦慮、總體幸福感水平、社會(huì)支持水平、生活質(zhì)量對(duì)認(rèn)知功能有影響,偏回歸系數(shù)分別為0.182、個(gè)-4.318、-1.000、3.645、0.379、-0.504、-1.023,7個(gè)變量可解釋總變異的62.4%。結(jié)論本研究將英文版MASQ漢化,并對(duì)中文版MASQ進(jìn)行信度和效度檢測(cè),結(jié)果顯示中文版MASQ具有良好的信度和效度,可用做國(guó)內(nèi)癲癇患者認(rèn)知功能的自評(píng)工具。其中癲癇患者的年齡、文化程度、發(fā)作頻率、焦慮、總體幸福感水平、社會(huì)支持水平、生活質(zhì)量是認(rèn)知功能的主要影響因素。因此,采取有效措施控制癲癇發(fā)作,及早識(shí)別并干預(yù)患者焦慮抑郁等負(fù)性情緒,提高總體幸福感水平和社會(huì)支持水平,改善患者的生活質(zhì)量,對(duì)于改善癲癇患者的認(rèn)知功能具有重要意義。
[Abstract]:Objective to translate, translate and debug the Multiple Ability Self-Report Questionnaire (MASQ), and to establish a Chinese version of the MASQ scale based on the cultural background of our country, to investigate the cognitive function of epileptic patients and to explore the factors affecting the cognitive function of the group in October 2015. Method October 2015 To January 2016, the English version of MASQ was translated, translated and tested, and experts were invited to revise the content of the scale to form a Chinese version of the MASQ scale, and select 200 cases of epileptic patients in the neurology outpatient or ward of a three grade a hospital in Tianjin as the research object, and test the reliability and validity of the Chinese version of the MASQ scale. The reliability was tested by Cronbach's alpha coefficient and retest reliability. Content validity was used to evaluate the validity of the scale. The structure validity was verified by confirmatory factor analysis. 220 cases of epileptic patients were selected from General Hospital Affiliated to Tianjin Medical University from February 2016 to May 2016 by convenient sampling. Objective. Through the questionnaire survey, the general data questionnaire was used to collect the social demographic and disease indicators. The hospital anxiety and Depression Scale (HADS), the overall happiness scale (GWB), the social support scale (SSRS), the quality of life scale (QOLIE-31) of epileptic patients were used to investigate the anxiety and depression of the epileptic patients, the overall well-being and social support. A single factor analysis was used to compare the differences in cognitive function among the different categories of the classification variables, the correlation analysis was used to test the correlation coefficient between the successive variables and cognitive functions, and the factors of cognitive function of epilepsy patients in China were analyzed by multiple linear regression analysis. Results (1) Table Sinicization introduction stage: after the translation of the scale, translation and cultural debugging, the Chinese version of the MASQ scale consists of 37 items and is divided into 5 dimensions. The Cronbach 'sa coefficient of the Cronbach' sa coefficient of the scale is 0.902,0.797,0.733,0.893,0.848, the retest correlation coefficient (retest reliability) is 0.960, and the retest reliability of each dimension is divided. Do not evaluate the scale for 0.866,0.860,0.850,0.899,0.841.5 experts. All items CVI (item-level CVI, I-CVI) are above 0.80. The total item content validity index (scale-level CVI, S-CVI) is a negative correlation between the 0.98.MASQ score and QOLIE-31 score (r=-0.732, P0.001). The model fitting is better, the chi square degree of freedom ratio (CMIN/DF) of the revised standard five factor model, the goodness of fit index (GFI), the adjusted goodness of fit index (AGFI), the residual mean square and the square root (RMR), the approximate error mean square root (RMSEA), the norm fitting index (NFI), the value added fitting index (IFI), the non return quasi fitness index (TLI), and the comparison of the non return quasi fitness index (TLI) are compared. The fitting index (CFI), the simplified fitting goodness index (PGFI) were 2.155,0.879,0.902,0.045,0.076,0.881,0.869,0.856,0.868,0.636, and the standardized regression coefficient 0.33~0.93. (2) was used to collect the effective data of 220 cases of epileptic patients. The total range of cognitive function scores of patients was 48~135, average (87.86 + 19.30) points. Degree score: Language (16.95 + 5.66), visual perception (12.29 + 3.70), speech memory (20.40 + 5.09), visual spatial memory (20.50 + 3.57), and attention (17.74 + 4.58). The results of single factor analysis showed the differences in cognitive function scores between social demographic variables and family monthly income factors. There were statistical significance (P0.001); there were significant differences in the scores of different types of seizures, the location of the epileptic foci, the frequency of seizures, the duration of seizures and the cognitive function of the type of medication (P0.05); the continuous variables were related to Pearson or Spearman, the cognitive function and age, the anxiety and depression, and the overall happiness level. The correlation between social support level and quality of life was statistically significant (P0.001). Multiple linear regression analysis showed that age, educational level, attack frequency, anxiety, overall well-being, social support level, and quality of life had an impact on cognitive function, and the partial regression coefficient was 0.182, -4.318, -1.000,3.645,0.379, -0.504, -1.0, respectively. The 23,7 variables can explain the 62.4%. conclusion of the total variation. The English version of MASQ is sinicization, and the reliability and validity of the Chinese version of MASQ is tested. The results show that the Chinese version MASQ has good reliability and validity. It can be used as a self-assessment tool for the cognitive function of domestic epileptic patients. Overall happiness level, social support level and quality of life are the main influencing factors of cognitive function. Therefore, taking effective measures to control epileptic seizures, identifying and intervening negative emotions such as anxiety and depression, improving the level of overall happiness and social support, improving the quality of life of the patients, and improving the cognition of epileptic patients. Function is of great significance.

【學(xué)位授予單位】:天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】:碩士
【學(xué)位授予年份】:2017
【分類號(hào)】:R473.74

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