【摘要】： 醫(yī)學(xué)、心理學(xué)及社會(huì)學(xué)研究中存在許多不可直接觀測(cè)的現(xiàn)象,通常采用潛變量(latentvariable)對(duì)之進(jìn)行描述。分析潛變量常采用結(jié)構(gòu)方程模型(structure equation modeling,SEM),其中測(cè)量模型反映了可觀測(cè)變量與潛變量之間的關(guān)系,結(jié)構(gòu)模型反映了潛變量之間的結(jié)構(gòu)關(guān)系,能夠處理潛變量和測(cè)量誤差是結(jié)構(gòu)方程模型特有的優(yōu)勢(shì)。 目前結(jié)構(gòu)方程模型在醫(yī)學(xué)領(lǐng)域的應(yīng)用越來(lái)越多,通過(guò)考察方差/協(xié)方差結(jié)構(gòu),獲得結(jié)構(gòu)效度與關(guān)聯(lián)性的結(jié)果。這樣往往忽略了潛變量的均值結(jié)構(gòu)與測(cè)量模型的截距。如果研究人員僅為評(píng)價(jià)潛變量之間的效應(yīng),以上分析尚可,但有時(shí)研究人員希望對(duì)比不同組的同一個(gè)或多個(gè)對(duì)應(yīng)潛變量的均值與測(cè)量模型的截距,此時(shí)則須擬合均值結(jié)構(gòu)模型(means structure model)。 用結(jié)構(gòu)方程分析比較潛變量的組間均值差異,相比傳統(tǒng)的方差分析有以下的優(yōu)點(diǎn):(1)用潛變量可以正確調(diào)整測(cè)量上的誤差,而傳統(tǒng)的方差分析一般情況下不能夠處理由信度所導(dǎo)致的問(wèn)題;(2)未考察測(cè)量工具(如量表)的可比性而不合理地選用了方差分析,而用結(jié)構(gòu)方程模型可進(jìn)行測(cè)量的等同性檢驗(yàn)(即可比性),在具有可比性的前提下,采用均值結(jié)構(gòu)模型分析;(3)結(jié)構(gòu)方程模型還能處理只有部分等同性的(partialinvariance)的多組比較,而方差分析卻不能處理這類問(wèn)題。 本文系統(tǒng)詳細(xì)地討論了均值結(jié)構(gòu)模型的統(tǒng)計(jì)原理,同時(shí)實(shí)現(xiàn)了均值結(jié)構(gòu)模型的多組比較,并將均值結(jié)構(gòu)模型應(yīng)用于醫(yī)學(xué)研究中。利用抑郁癥病例——對(duì)照臨床研究中的特質(zhì)應(yīng)對(duì)方式問(wèn)卷(TCSQ)、社會(huì)支持(SSS)量表進(jìn)行分組比較。驗(yàn)證性的均值結(jié)構(gòu)模型結(jié)果顯示患抑郁癥的人消極應(yīng)對(duì)方式高于正常人,而積極應(yīng)對(duì)方式低于正常人;獲主觀支持、客觀支持和對(duì)支持的利用都要比正常人低。均值結(jié)構(gòu)方程模型結(jié)果進(jìn)一步表明患抑郁癥的人獲主觀支持、客觀支持和對(duì)支持的利用都要低于正常人;并且在控制了主觀支持與客觀支持的效應(yīng)的前提下,客觀支持對(duì)支持的利用的作用無(wú)統(tǒng)計(jì)學(xué)意義,而對(duì)支持利用的作用主要來(lái)自于主觀支持。
[Abstract]:There are many unobservable phenomena in medical, psychological and sociological research, which are usually described by the latent variable (latentvariable). The structural equation model (structure equation modeling,SEM) is often used to analyze latent variables, in which the measurement model reflects the relationship between observable variables and latent variables, and the structural model reflects the structural relations between latent variables. The ability to deal with latent variables and measurement errors is the unique advantage of the structural equation model. At present, the structural equation model is applied more and more in the field of medicine. By investigating the variance / covariance structure, the results of structural validity and correlation are obtained. In this way, the mean structure of the latent variable and the intercept of the measuring model are often ignored. If the researchers were only to evaluate the effects between the underlying variables, the above analysis would be fine, but sometimes the researchers wanted to compare the mean values of the same or more corresponding latent variables in different groups with the intercept of the measuring model. In this case, the mean value structure model (means structure model). Must be fitted. Compared with the traditional ANOVA, structural equation analysis has the following advantages: (1) the errors in measurement can be adjusted correctly by using latent variables. However, the traditional ANOVA can not deal with the problems caused by reliability in general. (2) without examining the comparability of measurement tools (such as the scale) and using ANOVA unreasonably, the equivalence test (i.e. comparability), which can be measured by using structural equation model, can be carried out under the premise of comparability. The mean value structure model is used. (3) the structural equation model can also deal with multiple comparisons of (partialinvariance) with only partial equivalence, but ANOVA can not deal with this kind of problems. In this paper, the statistical principle of the mean value structure model is discussed in detail. At the same time, the multi-group comparison of the mean value structure model is realized, and the mean value structure model is applied to the medical research. The trait coping style questionnaire (TCSQ), Social support (SSS) was used to compare depression case-control clinical study. The results of the confirmatory mean structure model showed that the negative coping style of depression patients was higher than that of normal people, but the positive coping style was lower than that of normal people, and the subjective support, objective support and utilization of support were lower than those of normal people. The results of the mean structural equation model further showed that the patients with depression received subjective support, objective support and the use of support are lower than the normal people; On the premise of controlling the effect of subjective support and objective support, the effect of objective support on the utilization of support has no statistical significance, but the role of support utilization mainly comes from subjective support.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2008
【分類號(hào)】：R311

【參考文獻(xiàn)】

相關(guān)期刊論文 前9條

1 郝元濤,方積乾;結(jié)構(gòu)方程模型及其在醫(yī)學(xué)中的應(yīng)用研究[J];中國(guó)醫(yī)院統(tǒng)計(jì);2003年04期

2 曲波;郭海強(qiáng);任繼萍;孫高;張陽(yáng);于曉松;;結(jié)構(gòu)方程模型及其在醫(yī)學(xué)中的應(yīng)用[J];數(shù)理醫(yī)藥學(xué)雜志;2006年04期

3 張巖波,劉桂芬,鄭建中,徐秀娟;驗(yàn)證性因子分析模型的潛變量得分及其應(yīng)用[J];現(xiàn)代預(yù)防醫(yī)學(xué);2005年04期

4 徐秀娟;張巖波;劉桂芬;盧莉;董麗芳;;醫(yī)護(hù)人員職業(yè)緊張的結(jié)構(gòu)方程模型分析[J];現(xiàn)代預(yù)防醫(yī)學(xué);2006年08期

5 陳琦,梁萬(wàn)年,孟群;結(jié)構(gòu)方程模型及其應(yīng)用[J];中國(guó)衛(wèi)生統(tǒng)計(jì);2004年02期

6 方敏;孫影;;結(jié)構(gòu)方程模型應(yīng)用的幾個(gè)問(wèn)題[J];中國(guó)衛(wèi)生統(tǒng)計(jì);2006年02期

7 黃仙紅;沈毅;;結(jié)構(gòu)方程模型在醫(yī)學(xué)生心理健康影響因素分析中的應(yīng)用[J];中國(guó)臨床心理學(xué)雜志;2006年01期

8 曾武,黃子杰,林大熙;醫(yī)學(xué)生心理健康對(duì)學(xué)習(xí)成績(jī)影響的研究[J];中國(guó)心理衛(wèi)生雜志;2003年10期

9 郭文斌,姚樹(shù)橋,盧永紅,朱熊兆,吳大興;抑郁癥患者生活事件及社會(huì)支持特征的研究[J];中國(guó)心理衛(wèi)生雜志;2003年10期

相關(guān)碩士學(xué)位論文 前1條

1 徐秀娟;結(jié)構(gòu)方程模型及其在醫(yī)學(xué)研究中的應(yīng)用[D];山西醫(yī)科大學(xué);2004年

，

本文編號(hào)：2382915