中文版吞咽障碍造影评分量表的信度和效度研究

关键词：脑卒中  吞咽障碍造影评分  信度  效度

Keywords:stroke  videofluoroscopicdysphagia scale  reliability  validity

摘要：

      摘要 目的：汉化吞咽障碍造影评分量表（videofluoroscopic dysphagia scale，VDS）并分析其信度和效度，为评估脑卒中患者吞咽障碍提供简单、有效的工具。 方法：对英文版VDS进行翻译和文化调适，并采用中文版VDS对47例脑卒中患者进行评估，对其结果进行信度和效度分析。 结果：中文版VDS量表总体Cronbach’s α系数为0.769，各维度的Cronbach’s α系数是0.707—0.912；重测信度总体的组内相关系数（intraclass correlation coefficient， ICC）为0.951，各条目的ICC为0.732—1.000；测量者间信度总体的ICC为0.731，各条目的ICC为0.703—0.877；每一个条目与其所在维度的相关系数为0.721—0.854（P<0.01），每一个条目与其所在维度的相关系数均高于其他维度的相关系数；结构效度采用因子分析，共提取出4个公因子，累积贡献率为64.59%；通过spearman相关分析其外部效度发现中文版VDS量表结果与中文版经口摄食功能评估量表结果、健康调查简表结果相关。 结论：中文版VDS量表在脑卒中患者检验中具有好的信度与效度，可用于评估我国脑卒中后吞咽障碍患者的吞咽功能。

Abstract:

      Abstract Objective：To revise and analyse the reliability and validity of Chinese version of videofluoroscopic dysphagia scale(VDS). Method:The process of translation and adaptation was used to develop a Chinese-version of VDS. We evaluated the reliability and validity of scale in 47 dysphagia patients. Result:The Cronbach’s α coefficients of overall score is 0.769 and subdomains ranged from 0.707 to 0.912.Its test-retest intraclass correlation coefficient of overall score is 0.951， subdomains ranged from 0.732 to 1.000.Its inter-rater intraclass correlation coefficient of overall score is 0.731，subdomains ranged from 0.703 to 0.877.These revealed significant correlation between each item of VDS and its domain except the sixth and eighth items， with correlation coefficient between 0.721 to 0.854（P<0.01）.Factor analysis of each item of the 2 domains of VDS extracted 4 common factors with a cumulative contribution of 64.59%. Significant correlations were found between VDS scores and Functional oral intake scale（FOIS）， the MOS item short from health survey and SF—36 using the spearman correlation coefficient. Conclusion：The Chinese version of VDS shows good reliability and validity. And it can be used as a tool to assess dysphagia in stroke patients.