脑损伤患者中文版吞咽障碍指数量表的信度及效度研究

关键词：吞咽障碍  生存质量  效度  信度

Keywords:dysphagia  quality of life  validity  reliability

摘要：

      摘要 目的：探讨经翻译的中文版吞咽障碍指数（dysphagia handicap index，DHI）量表的信度和效度特征，评定吞咽障碍患者的生存质量。 方法：对DHI量表进行系统化翻译并对100例吞咽障碍患者、80例健康对照者进行评估，重测60例。从内部一致性信度和重测信度两方面对DHI进行信度分析；采用有吞咽障碍组和健康人进行群组效度分析；吞咽障碍特异性生存质量量表（swallowing quality of life questionnaire，SWAL-QOL）与DHI量表进行集合效度与区分效度的分析比较。此外，电视荧光吞咽造影检查（video fluoroscopic swallowing study,VFSS）作为吞咽障碍检查的“金标准”，本文对DHI量表与VFSS检查吞咽障碍严重程度的关系也进行了效度的分析。 结果：因子分析共提取6个公因子，且均可代表一定的量表内容。群组效度独立t检验结果,P<0.05差异具有显著性意义。集合效度与区分效度Pearson相关系数绝对值越接近1，项目之间相关性越大。内部一致性信度Cronbachα系数>0.70信度良好。重测信度由（ICC)相关系数分析。 结论：DHI对吞咽障碍患者具有良好的信度和效度，适合大陆人群，是一个临床有效的、统计学上强有力的患者报告结局量表。

Abstract:

      Abstract Objective: To investigate the validity and reliability of the Chinese version of dysphagia handicap index(DHI) scale and assess the quality of life for patients with dysphagia. Method: DHI was translated systematically.Total of 100 patients with dysphagia, 80 normal swallowing were evaluated with it. Of which 60 cases were tested and retested. The internal consistency reliability and test-retest reliability were analyzed. The groups of presence or absence of dysphagia were evaluated with DHI scale and SWAL-QOL,and the convergent validity and discriminant validity were analyzed. In addition，comparing with video fluoroscopic swallowing study（VFSS）as the "gold standard" of swallowing disorder examination，we studied the validity of DHI for evaluation of VF-evaluated swallowing disorder severity. Result: A total of six common factors were extracted by Factor analysis, and they can represent a certain scale content respectively. Groups validity independent t-test was significant (P<0.05). The absolute value of convergent validity and discriminant validity of the Pearson correlation coefficient closed to 1, the correlation between the larger project. Internal consistency reliability Cronbach alpha coefficient is good with higher than 0.70. Test-retest reliability depends on Spearman's Rho-related coefficient. Conclusion: The Chinese version of DHI is suitable to the mainland population，and having good validity and reliability. It is clinically efficient, statistically robust patient-reported outcomes tool.