中文修订版卒中后沟通效果量表的信效度研究

关键词：卒中后沟通效果量表  脑卒中  沟通障碍  信效度

Keywords:communication outcomes after stroke scale  post stroke  communication disorder  reliability and validity

摘要：

      摘要 目的：汉化及修订卒中后沟通效果量表，并进行信效度检验。 方法：采用Brislin翻译模型对英文版卒中后沟通效果量表（COAST）进行翻译，经专家小组讨论和预调查对翻译量表进行文化调适。采用便利抽样方法，选取183例卒中后言语语言障碍患者进行调查，选取34例患者在1周后进行重测，并对量表进行内容效度、结构效度、内部一致性信度及重测信度分析。 结果：中文修订版COAST各项目CVI（item CVI， I-CVI）为0.89—1，总量表CVI（scale CVI， S-CVI）为0.8。探索性因子分析显示提取到3个公因子，累计方差贡献率为卒中后沟通57.954%。各项目因子载荷值为0.448—0.815。验证性因子分析显示修正后模型CMIN/DF为1.816，SRMR为0.056，GFI为0.868，AGFI为0.830，TLI为0.917，CFI为0.929，RMSEA为0.067；本研究收敛效度AVE值为0.39—0.51，CR值为0.71—0.91；3个潜变量的相关系数介于0.404到0.641之间，小于相应潜变量AVE值的平方根（0.625—0.714）。中文修订版COAST各维度内部一致性信度Cronbach’s α系数为0.849—0.928，重测信度组内相关系数为0.826—0.866。 结论：中文修订版COAST信效度良好，是一种实用可靠的测量方法，可用于评估卒中后失语症和/或构音障碍患者的沟通情况。

Abstract:

      Abstract Objective：To test the reliability and validity of the Chinese revised version of the communication outcomes after stroke scale （COAST-CN） in stroke patients. Method：The Brislin translation model was used to translate the English version of the COAST scale. Cultural adjustments were made to the translated scale through expert group discussions and pre-surveys. 183 stroke patients with aphasia and/or dysarthria were investigated using the convenience sampling method， 34 patients were retested again one week after the first evaluation. The data were analyzed with content validity， construct validity， internal consistency reliability， and retest reliability analysis. Result：The item content validity index （I-CVI） is 0.89—1 and the scale content validity index （S-CVI） is 0.8 in the COAST-CN. Exploratory factor analysis showed that three factors were extracted from 20 items in COAST-CN， with a cumulative variance contribution of 57.954%. The factor load value of each item is 0.448—0.815. Confirmatory factor analysis showed that the modified model had CMIN/DF of 1.816， SRMR of 0.056， GFI of 0.868， AGFI of 0.830， TLI of 0.917， CFI of 0.929， and RMSEA of 0.067； The convergence validity AVE value of this study is 0.39—0.51，and the CR value is 0.71—0.91. The correlation coefficients of the three latent variables in this study range from 0.404 to 0.641， which are less than the square root of the AVE values （0.625—0.714）. The Cronbach's alpha coefficient of internal consistency reliability for each dimension of the COAST-CN is 0.849—0.928， and the retest reliability ICC is 0.826—0.866. Conclusion：The COAST-CN has good reliability and validity； it is a practical and reliable evaluation method that can be used to evaluate the self-perceived communication situation of patients with post-stroke aphasia and/or dysarthria.