【摘要】：目的:在英文版篩選型老年聽力殘疾量表（the Hearing HandicapInventory for the Elderly-Screening Version，HHIE-S）的基礎(chǔ)上對(duì)量表內(nèi)容進(jìn)行研譯，并結(jié)合傳統(tǒng)漢語言文化特點(diǎn)對(duì)其進(jìn)行文化調(diào)試，使之能在漢語言文化背景下使用。將研譯的中文版的量表在老年人群中初步應(yīng)用，經(jīng)過統(tǒng)計(jì)學(xué)分析驗(yàn)證其信度和效度，研究該量表是否能用于漢族老年性聾的篩查。方法:通過英文文獻(xiàn)檢索獲得全英文源量表，由研究人員對(duì)量表進(jìn)行翻譯、回譯，并參照國內(nèi)文獻(xiàn)報(bào)道的中文量表，對(duì)量表進(jìn)行對(duì)比、檢查、修訂，形成量表研譯的初始版本。隨機(jī)選取30名老年人對(duì)我們的初始量表進(jìn)行初次預(yù)問卷，征求對(duì)量表內(nèi)容的具體修改意見，，修改后初步定稿；再次隨機(jī)抽取30名老年人對(duì)修正后的量表進(jìn)行預(yù)問卷，確定對(duì)量表內(nèi)容無疑義后最終定稿、問卷研究。選擇170名65歲以上非獨(dú)居老年人，采用直接采訪法，將研譯的量表分由老年人本人及其親近家屬回答。1-2周后重測(cè)，評(píng)價(jià)量表的信度、效度，并將量表的最后得分與安靜環(huán)境下（本底噪聲控制在40dB以內(nèi)）較好耳的純音聽閾（0.5kHz、1kHz、2kHz、4kHz）對(duì)比分析，了解其篩查價(jià)值。結(jié)果:經(jīng)過系統(tǒng)的翻譯、回譯、修訂，最后定稿，保留了源量表的所有條目，共10條，結(jié)合漢語言文化背景，將其中部分條目中的用語進(jìn)行調(diào)整，以便更適合老年人群接受。利用SPSS15.0軟件包進(jìn)行統(tǒng)計(jì)學(xué)分析，研譯后所得的HHIE-S中文版量表在各項(xiàng)檢驗(yàn)中均有較好表現(xiàn)。研譯后量表中的2個(gè)維度，其10個(gè)條目均有較強(qiáng)關(guān)聯(lián)性，予以完全保留。該量表平均完成時(shí)間約為5分鐘，完成率為100%。信度檢驗(yàn)：HHIE-S量表共有2個(gè)維度：情感和情境維度，量表總的Cronbach’s α系數(shù)為0.935，量表總的分半信度為0.836，量表的重測(cè)信度為0.963。效度檢驗(yàn)：通過計(jì)算量表各條目與各維度、總量表間的相關(guān)性評(píng)價(jià)內(nèi)容效度，量表各條目與各維度、總量表的相關(guān)性在0.659~0.927之間。對(duì)量表進(jìn)行KMO和Bartlett’s球形檢驗(yàn)，KMO檢驗(yàn)值為0.907，Bartlett’s球形檢驗(yàn)近似2值為1351.357，P0.001，差異存在統(tǒng)計(jì)學(xué)意義，量表的相關(guān)矩陣間有共同因素存在，適合進(jìn)行因子分析。通過主成分分析和正交旋轉(zhuǎn)法對(duì)量表分析，2個(gè)公因子即情感和情境兩個(gè)維度的特征值均大于1，總方差解釋率為73.874%。量表中的10個(gè)條目的因子負(fù)荷在0.684和0.871之間，所有條目在相應(yīng)因子上的因子負(fù)荷均0.60。用平均聽閾作為“金標(biāo)準(zhǔn)”，量表的兩個(gè)維度和總分與純音聽閾間呈正相關(guān)性，代理者問卷結(jié)果與純音聽閾比較，類似于自評(píng)問卷結(jié)果，呈現(xiàn)出正相關(guān)性。HHIE-S量表對(duì)老年性聾的特異性值為95.24%，對(duì)老年性聾的整體敏感性為59.06%，并隨著聽閾值得提高，量表的敏感性增加。平均聽閾升高的有149人(占總數(shù)87.65%)，聽閾為輕至中度聾的患者中有50人HHIE-S得分＞8，提示有聽力障礙，其中10-22分的有39人，提示為輕至中度聾，有11人得分在24-40分之間，提示為重度聽力障礙；聽閾為重度聾及以上的患者共有38人HHIE-S得分＞8，提示有聽力障礙，其中在10-22分的有9人，提示為輕至中度聾，有29人得分在24-40分之間，提示為重度聽力障礙。隨著純音聽閾值的增高，HHIE-S得分增加，助聽器的選配比例也明顯升高，當(dāng)量表得分在24-40分之間時(shí)，助聽器選配比例達(dá)42.5%。結(jié)論:我們研譯的中文版篩選型老年聽力殘疾量表（HHIE-S）符合漢語言文化特點(diǎn)，結(jié)構(gòu)穩(wěn)定，具有較高的信度及效度，量表在老年性聾的篩查中表現(xiàn)出較高的敏感性和特異性，該量表可以作為我國老年性聾的一種穩(wěn)定的篩查工具，應(yīng)用于老年性聾的早期初步篩查；同時(shí)，代理者量表與自評(píng)量表一樣，也可以用于老年性聾的篩查。HHIE-S不僅能夠初步體現(xiàn)出老年人聽力下降程度，還能反映出聽力下降對(duì)老年人社會(huì)生活及個(gè)人情感的影響，與純音測(cè)聽診斷相結(jié)合，能夠更全面地對(duì)老年性聾患者進(jìn)行評(píng)估，有利于推動(dòng)老年性聾患者早期積極治療和康復(fù)。
[Abstract]:Objective: To study and translate the scale content on the basis of the Heart HandicapInventory for the Elderly-Sreening Version (HASH-S), and to carry out cultural debugging in combination with the characteristics of the traditional Chinese language culture, so that it can be used in the cultural background of Chinese language. The Chinese version of the scale was applied to the elderly population, and the reliability and degree of validity were verified by statistical analysis, and whether the scale could be used in the screening of senile deafness in the Han nationality. Methods: A full English source scale was obtained from the English literature search. The scale was translated and translated by the researchers, and the initial versions of the scale were compared, examined and revised with reference to the Chinese scale reported by domestic literature. 30 elderly people were randomly selected to conduct initial pre-questionnaire on our initial scale, to obtain a detailed review of the content of the scale and to finalize the revised scale; 30 older persons were randomly taken to pre-questionnaire the revised scale to determine that the content of the scale was eventually finalized, Questionnaire study. selecting 170 elderly persons over 65 years of age, adopting a direct interview method, and answering the scale points of the research and translation into the answers of the old people themselves and their close family members. And compare the final score of the scale with the low noise threshold (0. 5kHz, 1kHz, 2kHz, 4kHz) in the quiet environment (within 40dB) to understand their screening value. Results: After the translation, translation, revision and finalization of the system, all entries of the source scale were retained, 10 were retained, and the language in some of the entries was adjusted in combination with the cultural background of the Chinese language, so as to be more suitable for the acceptance of the elderly population. SPSS10.0 software package was used for statistical analysis, and the HSG-S Chinese version scale obtained after translation was well represented in all kinds of tests. There are 2 dimensions in the post-translation scale, and 10 entries have strong correlation and are fully retained. The average completion time of the gauge was about 5 minutes and the mean time was 100%. The reliability test: The HASH-S scale has two dimensions: emotion and context dimension, the total Cronbach's index of the scale is 0.935, the total score of the scale is 0. 836, and the retest reliability of the scale is 0. 963. Efficiency test: The correlation between each item of the scale and each dimension and the total quantity table was evaluated, and the correlation between each item of the scale and each dimension and the total amount table was between 0. 659 ~ 0. 927. KMO and KMO's spherical test were performed on the scale, and the KMO test value was 0.907, and the spherical test approximate 2 value was 1351. 357, P0.001, the difference was statistically significant, there were common factors among the correlation matrix of the scale, and it was suitable for factor analysis. By the principal component analysis and the orthogonal rotation method, the eigenvalue of the two dimensions of the two factors, namely emotion and context, was greater than 1, and the total variance interpretation rate was 73. 874%. The factor load of 10 entries in the scale is between 0. 684 and 0. 871. All entries have a factor load of 0. 60 on the corresponding factors. Using the average hearing threshold as the 鈥済old standard鈥

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