視功能指數(shù)量表（Vf-14）的修訂及評價
發(fā)布時間：2018-08-18 10:18
【摘要】：目的引進(jìn)并修訂國外視功能指數(shù)(Visual Function index-14)量表,形成VF-14中文修訂本,并對中文修訂本進(jìn)行信度、效度及可接受性的評價,為探索國內(nèi)適宜的視功能評價工具提供依據(jù)。 方法選取經(jīng)眼科醫(yī)師確診的年齡相關(guān)性白內(nèi)障患者440名、眼科專家12名及健康查體者80名作為研究對象。年齡相關(guān)性白內(nèi)障患者的診斷標(biāo)準(zhǔn)采用國家白內(nèi)障診斷分型標(biāo)準(zhǔn),年齡40-70歲之間,文化程度小學(xué)及以上,其中200名參與量表的修訂,240名參與量表的評價;80名健康查體者參與量表的評價;眼科專家為從事眼科臨床工作10年以上、職稱為副主任醫(yī)師以上,精通英文,其中一名有留美經(jīng)歷,參與量表的翻譯、回譯及修訂。 遵循量表的引進(jìn)原則,經(jīng)過眼科專家翻譯、回譯,與原量表比對,形成VF-14中文本一稿,然后向9名眼科專家及200名患者收集修訂意見和建議,對VF-14中文本一稿進(jìn)行文化適應(yīng)性修訂,最終形成VF-14量表中文修訂本。 以自行設(shè)計的調(diào)查問卷為工具向240名年齡相關(guān)性白內(nèi)障患者收集VF-14量表中文修訂本評定的資料,內(nèi)容包括:調(diào)查對象的一般情況,眼科檢查情況,VF-14量表中文修訂本的測評,視功能生存質(zhì)量量表(VF -QoL)的測評,自評視功能狀況及對可接受性信息的評價部分。其中80名患者分別進(jìn)行2次VF-14中文修訂本測評,時間間隔為一周;80名患者同一天內(nèi)由兩名不同調(diào)查員分別進(jìn)行VF-14量表中文修訂本的測評;80名患者于術(shù)前一天、術(shù)后一月分別進(jìn)行視力、VFQOl、自評視功能狀態(tài)及VF-14量表中文修訂本的測評,80名健康查體者進(jìn)行視力、VFQOl、自評視功能狀態(tài)及VF-14量表中文修訂本的測評。 全部調(diào)查問卷收回后進(jìn)行統(tǒng)一檢查、核對,建立Excel數(shù)據(jù)庫,利用SPSS13.0統(tǒng)計軟件進(jìn)行資料的處理分析,采用t檢驗(yàn)、Cronbach’α、ICC值、相關(guān)分析、因子分析等對量表的信度、效度、可接受性進(jìn)行評價。評價的指標(biāo):信度評價包括重測信度、內(nèi)部一致性信度、調(diào)查員間信度、分半信度,效度評價包括內(nèi)容效度、結(jié)構(gòu)效度、效標(biāo)關(guān)聯(lián)效度、辨別效度,可接受性評價:回答量表的把握度、量表的完成率、每次完成VF-14中文修訂本的時間。 結(jié)果1.VF-14量表的翻譯在遵循語義等價性、概念等價性的前提下兩名眼科專家各自將原量表翻譯成中文,兩份譯文綜合形成中文初譯本,另一名眼科專家進(jìn)行回譯,將其與原量表比對,對與原量表不一致的條目,反復(fù)進(jìn)行翻譯、回譯,直至達(dá)成統(tǒng)一,最終形成VF-14中文本一稿。 2.分別向眼科專家和年齡相關(guān)性白內(nèi)障患者收集對VF-14中文本一稿的修訂意見,專家認(rèn)為:在我國目前的經(jīng)濟(jì)文化生活背景下,VF-14中文本一稿的絕大部分條目能夠反映被測量的與視功能相關(guān)的生活內(nèi)容,各條目意思表達(dá)清楚,且表達(dá)的難易程度對調(diào)查對象適宜。100%的專家認(rèn)為第9項(xiàng)-娛樂活動(bingo,多米諾骨牌,打牌)和第10項(xiàng)-體育活動(保齡球、手球、網(wǎng)球或高爾夫運(yùn)動)所指內(nèi)容不符和我國國情、民情,遵循概念等價原則可改為我國大眾喜聞樂見的項(xiàng)目,如娛樂活動改為打麻將,撲克牌,下象棋,體育活動改為羽毛球,乒乓球,籃球,門球。95%的專家認(rèn)為13、14兩項(xiàng)涉及駕車的條目,與我國國情不符且無等價替代條目;患者認(rèn)為各條目內(nèi)容通俗易懂,沒有讀不懂的語句,表達(dá)意思清楚,表達(dá)的難易程度適宜,1-12項(xiàng)基本符合我國國情、民情,100%的患者認(rèn)為13、14兩項(xiàng)涉及駕車的條目不符合我國國情、民情。綜合專家和患者的意見和建議,最終形成VF-14量表中文修訂本。 3.VF-14量表中文修訂本的信度:①重測信度:量表兩次評分的各條目和總分的ICC范圍值在0.814～0.976 P0.05,說明量表重測信度較好;②內(nèi)部一致性信度:量表的Cronbach’α系數(shù)為0.916,說明量表的內(nèi)部一致性較高;③調(diào)查員間的信度:各條目和總分的ICC范圍值在0.854～0.996 P0.05,說明量表的調(diào)查員間的信度較好;④分半信度:VF-14量表中文修訂本的分半信度系數(shù)為0.817 P0.05,說明量表具有較好的分半信度。 4.VF-14量表中文修訂本的效度:①內(nèi)容效度:專家一致認(rèn)為VF-14量表中文修訂本的條目既包括了白內(nèi)障患者基本生存需要的視功能指標(biāo),又包括白內(nèi)障患者更高生活層次需要的指標(biāo),內(nèi)容效度良好;②結(jié)構(gòu)效度:采用因子分析得到4個公因子,這4個公因子共能夠解釋總方差的88.70%,各條目的因子載荷均表現(xiàn)為僅在某一因子上較大。其中第一公因子包括:娛樂活動、體育活動、烹飪等條目,反映患者的立體視功能情況;第二公因子包括:閱讀小字說明、讀書看報、做精細(xì)活、填表等條目,反映患者的近視力情況;第三公因子包括:看清樓梯和路緣石、看清各種標(biāo)識牌、看電視等條目,反映患者的視覺適應(yīng)情況;第四公因子包括:閱讀大體字、認(rèn)清楚人等條目,反映患者的主觀視覺情況。這與理論構(gòu)想相吻合,表明結(jié)構(gòu)效度較好。③效標(biāo)關(guān)聯(lián)效度:采用術(shù)前及術(shù)后患者視功能生存質(zhì)量量表(VFQol)與VF-14量表中文修訂本得分做相關(guān)分析,相關(guān)系數(shù)分別為0.55和0.67,P 0.01;采用患者術(shù)前術(shù)后視力與VF-14量表中文修訂本的得分做相關(guān)分析,相關(guān)系數(shù)分別為-0.63和-0.72 ,P 0.01,采用患者主觀視功能改善程度與VF-14量表中文修訂本的得分作相關(guān)分析,相關(guān)系數(shù)為0.65和0.76 ,P 0.01;表明量表的效標(biāo)關(guān)聯(lián)效度良好。④辨別效度:對患者術(shù)前術(shù)后VFQOL、視力、自評功能狀態(tài)的評分進(jìn)行配對t檢驗(yàn),可知患者術(shù)前與術(shù)后視功能狀況的差異有統(tǒng)計學(xué)意義,說明患者術(shù)前與術(shù)后的視功能狀況有變化;對患者術(shù)前術(shù)后VF-14量表中文修訂本測評的得分進(jìn)行配對t檢驗(yàn),得t=17.18,P0.01,說明VF-14量表中文修訂本能辨別患者視功能狀況的變化,對患者術(shù)前,及健康查體者的VFQOL、視力、自評功能狀態(tài)的評分進(jìn)行t檢驗(yàn),可知患者術(shù)前與術(shù)后視功能狀況的差異有統(tǒng)計學(xué)意義,說明患者與健康查體者的視功能狀況有變化;對患者及健康查體者的VF-14量表中文修訂本測評的得分進(jìn)行t檢驗(yàn),得t=18.674,P0.01,說明VF-14量表中文修訂本能辨別患者視功能狀況的變化,具有較好的辨別效度。 5.量表的可接受性:①在560人次的調(diào)查中,85.4%的患者認(rèn)為自己做出的評價“比較準(zhǔn)確可靠”,而14.6%的患者則認(rèn)為“絕對準(zhǔn)確可靠”;②在560人次的調(diào)查中,量表的完成率達(dá)100%;③在全部調(diào)查中,量表的完成時間最短5分鐘,最長10分鐘;表明VF-14量表中文修訂本容易被年齡相關(guān)性白內(nèi)障患者所接受。 結(jié)論本次研究經(jīng)過科學(xué)嚴(yán)謹(jǐn)?shù)姆椒ㄐ纬闪艘暪δ?VF-14)量表中文修訂本,且經(jīng)過評價可知其信度、效度良好,可接受性強(qiáng),適合目前我國經(jīng)濟(jì)文化和生活背景的需要,可作為我國眼科患者視功能狀況的評價工具。
[Abstract]:Objective To introduce and revise the Visual Function Index-14 (VF-14) in foreign countries to form a Chinese version of VF-14, and to evaluate the reliability, validity and acceptability of the Chinese version, so as to provide a basis for exploring suitable visual evaluation tools in China.
Methods 440 age-related cataract patients, 12 ophthalmologists and 80 healthy subjects were selected as the subjects. The diagnostic criteria of age-related cataract patients were classified according to the National Cataract Diagnostic Classification Standard. The age ranged from 40 to 70 years old and the educational level was elementary school or above. 200 of them participated in the revision of the scale. Eighty health examiners participated in the evaluation of the scale. Ophthalmologists had been engaged in ophthalmic clinical work for more than 10 years, with the title of deputy director physician or above, and were proficient in English. One of them had been in the United States and participated in the translation, back translation and revision of the scale.
Following the principle of introducing the scale, a Chinese version of the VF-14 was formed by translating, retranslating and comparing with the original scale. The revised version of the Chinese version of the VF-14 was then revised by collecting comments and suggestions from 9 ophthalmologists and 200 patients, and the Chinese version of the VF-14 was finally formed.
A self-designed questionnaire was used to collect data from 240 age-related cataract patients on the revised Chinese version of the VF-14 scale, including general conditions of the subjects, ophthalmological examinations, the revised Chinese version of the VF-14 scale, the evaluation of the visual function quality of life scale (VF-QoL), the status of self-assessment of visual function and the availability of the revised Chinese version of the VF-14 scale. The evaluation part of receptive information: 80 patients were assessed with VF-14 Chinese revised version twice, one week interval; 80 patients were assessed with VF-14 Chinese revised version by two different investigators within the same day; 80 patients were assessed with visual acuity, VFQOl, self-assessed visual function status and VF-14 Chinese revised version one day before surgery and one month after surgery respectively. Visual acuity, VFQOl, self-rated functional status and Chinese version of the VF-14 scale were assessed in 80 healthy subjects.
All questionnaires were checked, checked, Excel database was established, and SPSS13.0 statistical software was used to analyze the data. The reliability, validity and acceptability of the questionnaire were evaluated by t test, Cronbach'a, ICC value, correlation analysis, factor analysis and so on. Consistency reliability, inter-investigator reliability, split-half reliability, validity evaluation including content validity, structure validity, criterion-related validity, discrimination validity, acceptability evaluation: the grasp of the answer scale, the completion rate of the scale, each time to complete the Chinese version of VF-14.
Results 1. On the premise of semantic equivalence and conceptual equivalence, two ophthalmologists translated the original scale into Chinese, and two translations were combined to form the first Chinese version. Another ophthalmologist retranslated the original scale and compared it with the original scale. The items which were inconsistent with the original scale were repeatedly translated and retranslated until the original scale was completed. Achieve unification and eventually form a draft of Chinese version of VF-14.
2. Collect opinions from ophthalmologists and age-related cataract patients on the revision of the version of VF-14. Experts believe that: under the current economic and cultural background in China, the vast majority of the items in the version of VF-14 can reflect the measured content of life related to visual function, and the meaning of each item is clearly expressed and expressed. 100% of the experts believed that the contents of Item 9 (bingo, dominoes, playing cards) and item 10 (bowling, handball, tennis or golf) were not in conformity with the national conditions and conditions of our country. Following the principle of conceptual equivalence, the items that the public liked and welcomed could be changed, such as recreational activities to be replaced by sports activities. Playing mahjong, playing cards, chess, changing sports activities to badminton, table tennis, basketball, and goalball. 95% of the experts believed that 13,14 items related to driving were inconsistent with China's national conditions and there was no equivalent alternative items; the patients believed that the contents of the items were easy to understand, no unscrambled sentences, clear meaning, appropriate degree of difficulty in expression, 1-12 items. According to the situation of our country, 100% of the patients believed that the 13,14 items involved in driving did not accord with the situation of our country.
3. Reliability of the revised Chinese version of the VF-14 scale: 1. Retest Reliability: The ICC ranges of the items and total scores of the two scales were 0.814-0.976 P 0.05, indicating that the retest reliability of the scale was good; 2. Internal consistency reliability: the Cronbach'a coefficient of the scale was 0.916, indicating that the internal consistency of the scale was high; 3. Reliability among investigators: the items and total scores The total score of ICC ranged from 0.854 to 0.996 P 0.05, indicating that the reliability of the scale among investigators was good; 4. The split-half reliability: The split-half reliability coefficient of the revised Chinese version of the VF-14 scale was 0.817 P 0.05, indicating that the scale had good split-half reliability.
4. Validity of the revised Chinese version of the VF-14 scale: 1. Content validity: Experts agreed that the items in the revised Chinese version of the VF-14 scale included not only the visual function indicators of the basic survival needs of cataract patients, but also the indicators of the higher life level needs of cataract patients. The content validity was good; 2. Structure validity: Four common factors were obtained by factor analysis. These four common factors can explain 88.70% of the total variance, and the factor load of each item is larger only in a certain factor. The third common factor includes: see clearly stairs and curb stones, see clearly various signs, watch television and other items, reflecting the patient's visual adaptation; the fourth common factor includes: read general characters, recognize clearly the person and other items, reflecting the patient's subjective visual situation. The correlation coefficient was 0.55 and 0.67, P 0.01, respectively. The correlation coefficient was - 0.63 between preoperative and postoperative visual acuity and Chinese revised version of VF-14, respectively. And - 0.72, P The difference of visual function before and after operation was statistically significant, indicating that there were changes in visual function before and after operation. The scores of Chinese version of VF-14 scale before and after operation were tested by paired t test, and the results were t = 17.18, P 0.01, indicating that the Chinese revised VF-14 scale could distinguish the changes of visual function of patients before and after operation. And the scores of VFQOL, visual acuity and self-rated functional status of healthy subjects were tested by t-test. The difference of visual function between preoperative and postoperative patients was statistically significant, indicating that the visual function status of patients and healthy subjects had changed. The scores of Chinese revised version of VF-14 scale of patients and healthy subjects were tested by t-test, and t=18.674. The Chinese version of the VF-14 scale can distinguish the changes of visual function and has good discrimination validity.
5. The acceptability of the scale: 1. In 560 surveys, 85.4% of the patients thought their evaluation was "accurate and reliable", while 14.6% of the patients thought it was "absolutely accurate and reliable"; 2. In 560 surveys, the completion rate of the scale reached 100%; 3. In all surveys, the completion time of the scale was the shortest 5 minutes and the longest 10 minutes. The revised Chinese version of the VF-14 scale is easily accepted by patients with age-related cataract.
Conclusion The revised Chinese version of the Visual Function Scale (VF-14) has been formed by scientific and rigorous methods in this study. The reliability, validity and acceptability of the revised VF-14 scale are good. It can be used as a tool for evaluating the visual function of ophthalmic patients in China.
【學(xué)位授予單位】：河北聯(lián)合大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R770.4
本文編號：2189161
[Abstract]:Objective To introduce and revise the Visual Function Index-14 (VF-14) in foreign countries to form a Chinese version of VF-14, and to evaluate the reliability, validity and acceptability of the Chinese version, so as to provide a basis for exploring suitable visual evaluation tools in China.
Methods 440 age-related cataract patients, 12 ophthalmologists and 80 healthy subjects were selected as the subjects. The diagnostic criteria of age-related cataract patients were classified according to the National Cataract Diagnostic Classification Standard. The age ranged from 40 to 70 years old and the educational level was elementary school or above. 200 of them participated in the revision of the scale. Eighty health examiners participated in the evaluation of the scale. Ophthalmologists had been engaged in ophthalmic clinical work for more than 10 years, with the title of deputy director physician or above, and were proficient in English. One of them had been in the United States and participated in the translation, back translation and revision of the scale.
Following the principle of introducing the scale, a Chinese version of the VF-14 was formed by translating, retranslating and comparing with the original scale. The revised version of the Chinese version of the VF-14 was then revised by collecting comments and suggestions from 9 ophthalmologists and 200 patients, and the Chinese version of the VF-14 was finally formed.
A self-designed questionnaire was used to collect data from 240 age-related cataract patients on the revised Chinese version of the VF-14 scale, including general conditions of the subjects, ophthalmological examinations, the revised Chinese version of the VF-14 scale, the evaluation of the visual function quality of life scale (VF-QoL), the status of self-assessment of visual function and the availability of the revised Chinese version of the VF-14 scale. The evaluation part of receptive information: 80 patients were assessed with VF-14 Chinese revised version twice, one week interval; 80 patients were assessed with VF-14 Chinese revised version by two different investigators within the same day; 80 patients were assessed with visual acuity, VFQOl, self-assessed visual function status and VF-14 Chinese revised version one day before surgery and one month after surgery respectively. Visual acuity, VFQOl, self-rated functional status and Chinese version of the VF-14 scale were assessed in 80 healthy subjects.
All questionnaires were checked, checked, Excel database was established, and SPSS13.0 statistical software was used to analyze the data. The reliability, validity and acceptability of the questionnaire were evaluated by t test, Cronbach'a, ICC value, correlation analysis, factor analysis and so on. Consistency reliability, inter-investigator reliability, split-half reliability, validity evaluation including content validity, structure validity, criterion-related validity, discrimination validity, acceptability evaluation: the grasp of the answer scale, the completion rate of the scale, each time to complete the Chinese version of VF-14.
Results 1. On the premise of semantic equivalence and conceptual equivalence, two ophthalmologists translated the original scale into Chinese, and two translations were combined to form the first Chinese version. Another ophthalmologist retranslated the original scale and compared it with the original scale. The items which were inconsistent with the original scale were repeatedly translated and retranslated until the original scale was completed. Achieve unification and eventually form a draft of Chinese version of VF-14.
2. Collect opinions from ophthalmologists and age-related cataract patients on the revision of the version of VF-14. Experts believe that: under the current economic and cultural background in China, the vast majority of the items in the version of VF-14 can reflect the measured content of life related to visual function, and the meaning of each item is clearly expressed and expressed. 100% of the experts believed that the contents of Item 9 (bingo, dominoes, playing cards) and item 10 (bowling, handball, tennis or golf) were not in conformity with the national conditions and conditions of our country. Following the principle of conceptual equivalence, the items that the public liked and welcomed could be changed, such as recreational activities to be replaced by sports activities. Playing mahjong, playing cards, chess, changing sports activities to badminton, table tennis, basketball, and goalball. 95% of the experts believed that 13,14 items related to driving were inconsistent with China's national conditions and there was no equivalent alternative items; the patients believed that the contents of the items were easy to understand, no unscrambled sentences, clear meaning, appropriate degree of difficulty in expression, 1-12 items. According to the situation of our country, 100% of the patients believed that the 13,14 items involved in driving did not accord with the situation of our country.
3. Reliability of the revised Chinese version of the VF-14 scale: 1. Retest Reliability: The ICC ranges of the items and total scores of the two scales were 0.814-0.976 P 0.05, indicating that the retest reliability of the scale was good; 2. Internal consistency reliability: the Cronbach'a coefficient of the scale was 0.916, indicating that the internal consistency of the scale was high; 3. Reliability among investigators: the items and total scores The total score of ICC ranged from 0.854 to 0.996 P 0.05, indicating that the reliability of the scale among investigators was good; 4. The split-half reliability: The split-half reliability coefficient of the revised Chinese version of the VF-14 scale was 0.817 P 0.05, indicating that the scale had good split-half reliability.
4. Validity of the revised Chinese version of the VF-14 scale: 1. Content validity: Experts agreed that the items in the revised Chinese version of the VF-14 scale included not only the visual function indicators of the basic survival needs of cataract patients, but also the indicators of the higher life level needs of cataract patients. The content validity was good; 2. Structure validity: Four common factors were obtained by factor analysis. These four common factors can explain 88.70% of the total variance, and the factor load of each item is larger only in a certain factor. The third common factor includes: see clearly stairs and curb stones, see clearly various signs, watch television and other items, reflecting the patient's visual adaptation; the fourth common factor includes: read general characters, recognize clearly the person and other items, reflecting the patient's subjective visual situation. The correlation coefficient was 0.55 and 0.67, P 0.01, respectively. The correlation coefficient was - 0.63 between preoperative and postoperative visual acuity and Chinese revised version of VF-14, respectively. And - 0.72, P The difference of visual function before and after operation was statistically significant, indicating that there were changes in visual function before and after operation. The scores of Chinese version of VF-14 scale before and after operation were tested by paired t test, and the results were t = 17.18, P 0.01, indicating that the Chinese revised VF-14 scale could distinguish the changes of visual function of patients before and after operation. And the scores of VFQOL, visual acuity and self-rated functional status of healthy subjects were tested by t-test. The difference of visual function between preoperative and postoperative patients was statistically significant, indicating that the visual function status of patients and healthy subjects had changed. The scores of Chinese revised version of VF-14 scale of patients and healthy subjects were tested by t-test, and t=18.674. The Chinese version of the VF-14 scale can distinguish the changes of visual function and has good discrimination validity.
5. The acceptability of the scale: 1. In 560 surveys, 85.4% of the patients thought their evaluation was "accurate and reliable", while 14.6% of the patients thought it was "absolutely accurate and reliable"; 2. In 560 surveys, the completion rate of the scale reached 100%; 3. In all surveys, the completion time of the scale was the shortest 5 minutes and the longest 10 minutes. The revised Chinese version of the VF-14 scale is easily accepted by patients with age-related cataract.
Conclusion The revised Chinese version of the Visual Function Scale (VF-14) has been formed by scientific and rigorous methods in this study. The reliability, validity and acceptability of the revised VF-14 scale are good. It can be used as a tool for evaluating the visual function of ophthalmic patients in China.
【學(xué)位授予單位】：河北聯(lián)合大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R770.4
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