缩小版伤残接受度量表（修订版）在慢性脊髓损伤者中的应用

关键词：慢性脊髓损伤  缩小版伤残接受度量表修订版  信度  效度  现况分析  影响因素

Keywords:chronic spinal cord injury  the brief adaptation to disability scale-revised  reliability  validity  status quo analysis  associated factors

摘要：

      摘要 目的：评估缩小版伤残接受度量表修订版（简称缩小版量表）的信效度并分析慢性脊髓损伤者的伤残接受度及其影响因素。 方法：研究对象为277例慢性脊髓损伤者。采用缩小版量表、抑郁自评量表、广泛性焦虑自评量表、EQ-VAS和一般资料调查表收集数据。应用描述性分析、分层多元线性回归和信效度分析等方法进行统计分析。 结果：缩小版量表不存在地板效应和天花板效应，内部一致性信度良好，复测信度的相关系数除了扩大维度外，其余均在0.6以上。各条目与维度的相关系数都在0.7以上；探索性因子分析发现缩小版量表包括两个因子：正向维度和负向维度，验证性因子分析发现该模型可接受（CFI=0.96，RMSEA=0.07）；效标效度良好；不同个人特征患者的伤残接受度得分差异符合预期。慢性脊髓损伤者伤残接受度总体处于中等偏下水平，且正向维度得分好于负向维度。伤残接受度的正向影响因素包括没有焦虑或抑郁、有工作、教育水平更高、单身、受伤水平较低和完全性损伤，家庭收入和受伤年限的影响有限，性别和年龄不是影响因素。 结论：缩小版量表在慢性脊髓损伤者中的信效度总体良好。慢性脊髓损伤者伤残接受度水平较低，其主要影响因素包括焦虑抑郁情况、个人和家庭社会经济状况和受伤情况。

Abstract:

      Abstract Objective： To evaluate the reliability and validity of the brief adaptation to disability scale-revised （B-ADS-R）， and the status quo and its associated factors of acceptance of disability （AOD） of individuals with chronic spinal cord injury （CSCI） in China. Method： The participants were 277 individuals with CSCI. The B-ADS-R， Zung self-rating depression scale （SDS）， Zung self-rating anxiety scale （SAS）， self-designed questionnaire， EQ-VAS and basic characteristics were collected. Descriptive analysis， reliability and validity analysis， and hierarchical multiple linear regression analysis were used in statistical analysis. Result： The B-ADS-R showed no floor or ceiling effects， and had good internal consistency reliability， and the correlation coefficients of retest reliability were above 0.6 except for the enlargement subscale. The correlation coefficients between each item and its corresponding dimension were above 0.7. The result of exploratory factor analysis revealed two factors： positive factor and negative factor. Confirmatory factor analysis showed the acceptable validity of the construct （CFI=0.96， RMSEA=0.07）. The criterion-related validity was good and the B-ADS-R domains and total scores showed the predicted pattern among a priori known groups. The AOD of our participants located on medium to low level， and the score of positive domain was higher than that of the negative domain. The positive associated factors of AOD included no anxiety or depression， employment， higher education background， singlehood， lower injury level and complete injury. The family income and the time span since injury had limited influence， and sex and age were not associated factors of AOD. Conclusion： The B-ADS-R had good reliability and validity. The level of AOD of the individuals with CSCI was relatively low. The main associated factors of ADO were anxiety and depression， personal and family socioeconomic status， and injury charactertics.