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

【摘要】：目的對多元認知能力自評量表(Multiple Ability Self-Report Questionnaire,MASQ)進行翻譯、回譯及文化調試,并結合我國的文化背景建立中文版MASQ量表,利用該量表調查癲癇患者的認知功能狀況并探討影響該群體認知功能的因素。方法2015年10月至2016年1月,對英文版MASQ進行翻譯、回譯及文化調試,邀請專家對量表的內容進行修訂,形成中文版MASQ量表。選取天津市某三級甲等醫(yī)院的神經內科門診或病房的癲癇患者200例作為研究對象,對中文版MASQ量表進行信度和效度檢驗。量表信度采用Cronbach'sα系數(shù)和重測信度來檢驗,使用內容效度、效標關聯(lián)效度和結構效度對量表的效度進行評價,結構效度采用驗證性因子分析。采用便利抽樣的方法于2016年2月至2016年5月從天津醫(yī)科大學總醫(yī)院抽取癲癇患者220例作為研究對象。采用問卷調查法,通過一般資料調查表收集社會人口學指標和疾病指標,采用醫(yī)院焦慮抑郁量表(HADS)、總體幸福感量表(GWB)、社會支持量表(SSRS)、癲癇患者生活質量量表(QOLIE-31)調查癲癇患者的焦慮抑郁情緒、總體幸福感和社會支持水平以及生活質量現(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間認知功能的差異,使用相關性分析檢驗各連續(xù)性變量與認知功能的相關系數(shù),運用多元線性回歸分析探討國內癲癇患者認知功能的影響因素。結果(1)量表漢化引進階段:經過對量表的翻譯、回譯及文化調試,中文版MASQ量表包括37個條目,分為5個維度。量表的Cronbach’sa系數(shù)為0.948,5個維度的Cronbach’sa系數(shù)分別為0.902、0.797、0.733、0.893、0.848,重測相關系數(shù)(重測信度)為0.960,各維度的重測信度分別為0.866、0.860、0.850、0.899、0.841。5名專家對量表進行評定,各條目CVI(item-level CVI,I-CVI)均在0.80以上,總條目內容效度指數(shù)(scale-level CVI,S-CVI)為0.98。MASQ得分與QOLIE-31得分呈負相關(r=-0.732,P0.001),與HADA、HADD呈正相關(r=0.590、0.524,P0.001)。驗證性因子分析顯示量表的模型擬合較好,修正后標準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)、非歸準適配指數(shù)(TLI)、比較擬合指數(shù)(CFI)、簡約擬合優(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,標準化回歸系數(shù)0.33~0.93。(2)量表應用階段:最終完成對220例癲癇患者有效資料的收集。患者認知功能總得分范圍48~135分,平均(87.86±19.30)分。各維度得分情況:語言(16.95±5.66)分,視知覺功能(12.29±3.70)分,言語記憶(20.40±5.09)分,視覺空間記憶(20.50±3.57)分,注意力(17.74±4.58)分。單因素分析結果顯示:社會人口學變量中不同工作情況、文化程度和家庭月收入因素間的認知功能得分差異有統(tǒng)計學意義(P0.001);疾病相關變量中不同發(fā)作類型、癲癇灶部位、發(fā)作頻率、發(fā)作持續(xù)時間及服藥類型的認知功能得分差異有統(tǒng)計學意義(P0.05);連續(xù)性變量作Pearson或Spearman相關分析,發(fā)現(xiàn)認知功能與年齡、焦慮抑郁情緒、總體幸福感水平、社會支持水平、和生活質量的相關性有統(tǒng)計學意義(P0.001)。多元線性回歸分析結果顯示:年齡、文化程度、發(fā)作頻率、焦慮、總體幸福感水平、社會支持水平、生活質量對認知功能有影響,偏回歸系數(shù)分別為0.182、個-4.318、-1.000、3.645、0.379、-0.504、-1.023,7個變量可解釋總變異的62.4%。結論本研究將英文版MASQ漢化,并對中文版MASQ進行信度和效度檢測,結果顯示中文版MASQ具有良好的信度和效度,可用做國內癲癇患者認知功能的自評工具。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、社會支持水平、生活質量是認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,及早識別并干預患者焦慮抑郁等負性情緒,提高總體幸福感水平和社會支持水平,改善患者的生活質量,對于改善癲癇患者的認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.

【學位授予單位】：天津醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R473.74

【參考文獻】

相關期刊論文 前10條

1 宋杰;李真;許陽;李浩;繩宇;;癲癇患者羞恥感現(xiàn)狀調查及影響因素分析[J];中華護理雜志;2016年01期

2 鄭萍萍;張軍;陳芳;;老年心血管病住院患者主觀幸福感及影響因素[J];中國老年學雜志;2015年22期

3 李潔;姚迪;劉曉芹;;老年人總體幸福感與人格特征、社會支持的關系[J];中國健康心理學雜志;2015年06期

4 汪東興;趙合慶;;癲癇相關認知障礙及篩查量表研究進展[J];中華神經科雜志;2015年03期

5 劉陽;孫濤;徐文中;張震;王峰;;75例癲癇患者認知功能與影響因素分析[J];臨床神經外科雜志;2014年06期

6 石景鶴;王家勤;陳國洪;;常用新型抗癲癇藥物對癲癇患兒認知功能的影響[J];中華腦科疾病與康復雜志(電子版);2014年05期

7 朱培培;卓文燕;陳玲;;癲癇患者焦慮抑郁、社會支持狀況與主觀幸福感的相關性[J];中國神經精神疾病雜志;2014年09期

8 張倩楠;常紅;孫會芳;陳余雪;祁悅;趙莉;董春波;;原發(fā)性癲癇患者認知功能障礙的臨床特征及其相關因素分析[J];中國醫(yī)師進修雜志;2014年21期

9 胡崇宇;高小平;肖波;劉昕;;部分性發(fā)作癲癇患者的認知功能損害與情緒障礙的分析[J];中國傷殘醫(yī)學;2014年10期

10 何陽;徐文中;丁健;;癲癇患者認知功能研究[J];中國實用醫(yī)藥;2014年01期

相關碩士學位論文 前8條

1 楊二娟;顳葉和額葉癲癇認知功能特點及相關因素的研究[D];天津醫(yī)科大學;2013年

2 楊如美;英文版循證實踐知識、態(tài)度、行為問卷及循證實踐影響因素問卷的初步修訂與應用[D];中南大學;2010年

3 王琴;顳葉癲癇患者認知功能及相關因素的分析[D];中南大學;2009年

4 常紅;原發(fā)性癲癇患者不同發(fā)作類型認知功能障礙的研究[D];大連醫(yī)科大學;2009年

5 聶光軍;新型抗癲癇藥物對認知功能的影響[D];吉林大學;2009年

6 徐亞媛;癲癇患者認知功能的變化及其影響因素的研究[D];復旦大學;2008年

7 王彬成;抗癲癇藥物對認知功能的影響[D];河北醫(yī)科大學;2008年

8 程建華;成人癲癇患者生活質量影響因素調查與分析[D];暨南大學;2005年

，

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