中文版哥德堡赋能量表在四肢伤残患者中的信效度研究

关键词：四肢伤残  康复  患者赋能  探索性结构方程模型  量表  汉化

Keywords:limb disabilities  rehabilitation  patient empowerment  exploratory structural equation model  scale  Chineselization

摘要：

      摘要 目的：汉化适用于成年长期疾病康复患者的通用型的心理赋能量表——哥德堡赋能量表（GES），评价中文版GES在四肢伤残样本中的信效度和文化适用性。 方法：遵循Beaton DE的翻译原则对GES进行直译、回译和调试，形成中文版GES。采取便利抽样的方法抽取上海市养志康复医院>18周岁的四肢伤残患者为研究对象。采用Mplus 8.3对量表进行验证性因子分析（CFA）、探索性结构方程模型分析（ESEM），评价因子效度、区分效度和聚敛效度；Cronbach’s α系数、McDonald’s ω系数用于信度检验；地板和天花板效应用于量表响应性评价。 结果：共获得274份有效四肢伤残患者数据。中文版GES共15个条目，知识和理解、个体控制、认同、共同决策和赋能他人各连接3个条目。总量表及5个维度的Cronbach’s α系数范围为0.759—0.896，CFA和ESEM模型的McDonald’s ω系数范围为0.737—0.953。CFA、ESEM、二阶验证性因子分析模型均拟合良好。ESEM的拟合指数（χ2/df=1.113，RMSEA=0.020，TLI=0.994，CFI=0.998，SRMR=0.014）显著优于CFA的拟合指数（χ2/df=1.516，RMSEA=0.043，TLI=0.972，CFI=0.978，SRMR=0.042）。中文版GES的区分效度和聚敛效度较好，响应性较高。 结论：中文版GES的各项指标达到了心理测量学要求，可用于成年四肢伤残康复患者的心理健康研究中。

Abstract:

      Abstract Objective：Chineselization of patient empowerment scale suitable for adult rehabilitation patients with long-term diseases- the Gothenburg empowerment scale（GES）.To evaluate the reliability， validity and cultural applicability of the Chinese version GES in limb disabilities. Method：The Chinese version of the GES was produced by translating，back translating，and adjusting the GES according to the process of Beaton， DE. Convenience sampling method was used to select patients with limb disabilities over 18 years old from Shanghai YangZhi rehabilitation hospital as research object. The factor validity，discriminant validity，convergent validity，confirmatory factor analysis（CFA） and exploratory structural equation model（ESEM）were evaluated by Mplus 8.3. Adopt Cronbach’s α coefficient and McDonald’s ω coefficient were used for reliability test of the scale. The floor and ceiling effects were used to evaluate the responsiveness of the scale. Result：Total 274 valid samples with limb disabilities were obtained. The Chinese version GES consisted of 15 items，with 3 items connected to each dimension：Knowledge and understanding，personal control，identity，shared decision-making，and Enabling others. The Cronbach’s α of total scale as well as the five dimensions ranged from 0.759—0.896.The McDonald’s ω ranged from 0.737—0.953 in CFA and ESEM. CFA，ESEM， and second-order confirmatory factor analysis model all fitted well. The ESEM’s fit indices （χ2/df=1.113，RMSEA=0.020， TLI=0.994， CFI=0.998， SRMR=0.014） were significantly better than the CFA’s fit indices （χ2/df=1.516， RMSEA=0.043， TLI=0.972， CFI=0.978， SRMR=0.042）.The Chinese version GES had good discriminate and convergent validity，and responsiveness was good. Conclusion：The various indicators of the Chinese version GES meet the requirements of psychometrics and can be used in the mental study of adult limb disability rehabilitation patients.