简体中文版慢性病TBQ汉化及信效度研究

林恺; 郭丽红; 黄周红; 陈永松

doi:10.16766/j.cnki.issn.1674-4152.002502

简体中文版慢性病TBQ汉化及信效度研究

doi: 10.16766/j.cnki.issn.1674-4152.002502

林恺^{1, 2},
郭丽红¹,
黄周红¹,
陈永松^2, ,

1.
汕头大学医学院第一附属医院全科医学分院, 广东汕头 515041
2.
汕头大学医学院第一附属医院临床研究中心

基金项目:

广东省医学科学技术研究基金项目 A2020441

详细信息

通讯作者:
陈永松, E-mail: yongsongchen@126.com

中图分类号: R181.2 R499
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- 文章访问数: 492
- HTML全文浏览量: 336
- PDF下载量: 19
- 被引次数: 0
出版历程
- 收稿日期: 2021-09-12
- 网络出版日期: 2022-09-21

Sinicization, reliability and validity of the simplified Chinese Treatment Burden Questionnaire for chronic disease

1.
Family Medicine Center, the First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong 515041, China

摘要

摘要: 目的针对我国治疗负担研究刚起步, 临床研究缺乏治疗负担评价工具的问题, 引进和汉化治疗负担问卷(treatment burden questionnaire, TBQ), 并在临床进行验证性研究。方法按照自评量表测试的跨文化翻译过程指南对源量表进行翻译、跨文化调适和临床验证。于2020年6-11月选取粤东地区住院和社区卫生中心治疗的慢性病患者352例为研究对象, 开展信效度检验。采用Cronbach's α系数、折半信度系数值和重测信度进行信度检验。通过内容效度、结构效度和收敛效度进行效度检验。结果简体中文版TBQ的总体Cronbach's α系数为0.91, 折半信度系数为0.87, 二周重测信度为0.80。内容效度指数(content validity index, CVI)为0.80~1.00;球形检验值为2 466.45(P < 0.01), Kaiser Meyer Olkin (KMO)测量值为0.91(>0.80);采用探索性因子分析法提取的3个公因子方差解释率分别是23.14%、20.89%、16.37%, 并解释了总方差的60.40%。收敛效度分析显示, 中文版TBQ总分值与慢性病患者的生存质量、共病数量以及健康状况均存在密切相关。结论简体中文版慢性病TBQ具有良好的信效度, 便捷易懂, 可接受度良好, 适用于中国文化背景的慢病、共病患者治疗负担评价及研究。
- 慢性病 /
- 治疗负担 /
- 测评工具 /
- 信度 /
- 效度
Abstract: Objective To introduce and translate the chronic disease Treatment Burden Questionnaire (TBQ) in simplified Chinese and conduct a clinical validation study. Methods The original English version of the questionnaire was translated, cross-cultural adapted and verified in a clinical context.From June to November 2020, 352 patients with chronic diseases who were hospitalised and treated in community health centres in eastern Guangdong were selected as the research objects to carry out reliability and validity tests.The reliability was tested by Cronbach's α, Spearman-Brown value and retest reliability.The validity was tested by content validity, structure validity and convergence validity. Results The Chinese TBQ had a Cronbach's α of 0.91, Spearman-Brown value of 0.87 and retest reliability of 0.80.The CVI was 0.80-1.00.The structure validity was tested by Bartlett's test and calculated to be 2 466.45[P < 0.01, KMO=0.91(>0.80)].Exploratory factor analysis showed that the variance explanatory rates of the three common factors were 23.14%, 20.89% and 16.37%, respectively, and explained 60.40% of the total variance.Convergence validity analysis showed that there is significant correlation amongst global scores and quality of life, number of comorbidities and health status. Conclusion The simplified Chinese TBQ for chronic diseases has good reliability and validity.The questionnaire is simple, convenient and acceptable for clinical practice and research of the treatment burden amongst Chinese patients with chronic diseases and comorbidity.
- Chronic diseases /
- Treatment burden /
- Measuring instrument /
- Reliability /
- Validity

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表 1 352例慢性病患者一般资料及其健康相关特征

Table 1. Demographics of 352 patients with chronic diseases and their health-related characteristics

项目	分类	数值
年龄(x±s, 岁)	住院患者	64.42±10.56
	社区患者	70.86±5.90
性别[例(%)]	女性	181(51.4)
	男性	171(48.6)
住院患者[例(%)]	呼吸内科	28(8.0)
	急诊内科	25(7.1)
	内分泌+糖尿病科	52(14.8)
	神经内科	25(7.1)
	肿瘤内科	55(15.6)
社区患者[例(%)]	社区卫生服务中心	167(47.4)
共病情况[例(%)]	2种	271(77.0)
	3种	56(15.9)
	4种	20(5.7)
	≥5种	5(1.4)

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表 2 352例慢性病患者按照共病情况分类汇总分析结果[M(P₂₅, P₇₅)]

Table 2. Results of the treatment burden of 352 patients with chronic diseases categorised by co-morbidities [M(P₂₅, P₇₅)]

条目	2种(n=271)	3种(n=56)	4种(n=20)	≥5种(n=5)	H值	P值
TBQ1A	0.00(0.00, 1.00)	1.50(0.00, 5.75)	0.00(0.00, 3.00)	5.00(3.50, 8.00)	36.809	< 0.001
TBQ1B	0.00(0.00, 1.00)	1.00(0.00, 3.00)	2.00(0.00, 5.00)	5.00(1.50, 8.00)	32.031	< 0.001
TBQ1C	0.00(0.00, 2.00)	0.00(0.00, 2.00)	1.00(0.00, 5.00)	0.00(0.00, 5.50)	2.710	0.439
TBQ1D	0.00(0.00, 2.00)	0.00(0.00, 3.00)	2.00(0.00, 5.00)	5.00(0.00, 6.00)	10.785	0.013
TBQ2A	0.00(0.00, 2.00)	3.00(1.00, 6.00)	2.00(1.00, 6.00)	7.00(3.50, 9.00)	52.058	< 0.001
TBQ2B	0.00(0.00, 1.00)	0.00(0.00, 2.00)	2.00(0.00, 6.00)	5.00(0.00, 9.50)	14.511	0.002
TBQ2C	0.00(0.00, 3.00)	1.50(0.00, 4.00)	1.00(0.00, 7.00)	5.00(0.50, 8.00)	17.558	< 0.001
TBQ2D	0.00(0.00, 2.00)	0.00(0.00, 1.00)	0.00(0.00, 3.00)	3.00(0.50, 6.50)	8.090	0.044
TBQ2E	0.00(0.00, 3.00)	3.00(0.00, 6.00)	2.00(0.00, 7.00)	7.00(5.00, 9.00)	20.619	< 0.001
TBQ3	0.00(0.00, 2.00)	2.00(0.00, 4.00)	3.00(0.00, 4.00)	8.00(2.50, 9.00)	30.533	< 0.001
TBQ4	0.00(0.00, 4.00)	5.00(2.25, 8.00)	4.00(3.00, 8.00)	5.00(4.00, 8.00)	53.324	< 0.001
TBQ5	0.00(0.00, 2.00)	2.00(0.25, 3.75)	4.00(1.00, 6.00)	4.00(1.00, 6.00)	34.458	< 0.001
TBQ6	0.00(0.00, 3.00)	3.00(0.00, 5.00)	2.00(0.00, 3.00)	0.00(0.00, 4.00)	11.794	0.008
TBQ7	0.00(0.00, 3.00)	2.00(0.00, 4.00)	2.00(0.00, 5.00)	1.00(0.00, 8.00)	10.995	0.012
TBQ8	0.00(0.00, 4.00)	4.00(1.25, 5.00)	4.00(0.00, 6.00)	5.00(0.50, 8.00)	27.679	< 0.001
TBQ总分	13.00(6.00, 31.00)	40.50(27.00, 52.00)	42.00(23.00, 63.00)	55.00(38.50, 101.50)	56.431	< 0.001

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表 3 352例慢性病患者简体中文版慢性病TBQ因子载荷系数

Table 3. Factor analysis of the simplified Chinese TBQ for chronic disease in 352 patients with chronic disease

项目	类别	因子载荷系数
项目	类别	因子1	因子2	因子3	因子4	因子5	共同度
总体	特征根值	3.47	3.13	2.46			9.06
	方差解释率(%)	23.14	20.89	16.37			60.40
	KMO值	0.91
	巴特球形值	2 466.45		< 0.01
住院	特征根值	3.93	3.01	2.49			9.43
	方差解释率(%)	26.17	20.08	16.63			62.87
	KMO值	0.90
	巴特球形值	1 403.16		< 0.01
社区	特征根值	2.32	2.04	1.88	1.80	1.60	9.64
	方差解释率(%)	15.47	13.57	12.50	12.00	10.69	64.23
	KMO值	0.71
	巴特球形值	689.40		< 0.01

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表 4 TBQ及其生活质量评分的Spearman相关系数分析结果(r值)

Table 4. Spearman ' s correlation coefficient analysis of TBQ global score and quality of life (r values)

类别	MMAS-8 评分	EQ-5D-3L 总分	EQ-5D VAS	WONCA/COOP
类别	MMAS-8 评分	EQ-5D-3L 总分	EQ-5D VAS	身体健康	自我感觉	日常活动	社会活动	健康变化	整体健康
TBQ总分	0.01	-0.47^a	-0.20^a	0.38^a	0.36^a	0.34^a	0.30^a	0.36^a	-0.24^a
TBQ总分(住院)	-0.22^a	-0.38^a	-0.21^a	0.15^b	0.26^a	0.13	0.12	0.22^a	-0.25^a
TBQ总分(社区)	0.10	-0.37^a	-0.03	0.35^a	0.37^a	0.17^b	0.07	0.28^a	-0.05
注：^aP＜0.01，^bP＜0.05。

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