中国心理卫生杂志
中國心理衛生雜誌
중국심리위생잡지
CHINESE MENTAL HEALTH JOURNAL
2001年
1期
9-12
,共4页
胜利%蒋宝琦%方耀奇%沈渔屯
勝利%蔣寶琦%方耀奇%瀋漁屯
성리%장보기%방요기%침어둔
患病行为信度效度
患病行為信度效度
환병행위신도효도
目的：引进并测定《患病行为问卷》(Illiness Behavior Questionnaire)的信度和效度。方法：将《患病行为问卷》译成中文，并回译。以心内科住院病人(25例)为样本，间隔2周评定复测信度。以胸闷胸痛为确诊冠心病而住院的患者(46例)为样本，评定效标效度。对效度测评组患者进行了精神科临床诊断(ICD-10标准)，同时采用的工具有：《一般健康问卷-28》( General Health Questionnaire - 28)《医院内焦虑抑郁量表》(Hospital Anxiety and Depression)以及汉密尔顿焦虑、抑郁量表。另外，在精神科门诊连续收集躯体症状类似的焦虑性精神障碍及神经衰弱(ICD-10标准)的初诊患者18例作为精神科对照组。结果：中译本回译一致率95％，复测信度82.5％。原量表共11个因子，主要分为两个维度，分别反映不良情绪和病感。以我国心内科的住院患者为样本，反映情绪的4个因子与《一般健康问卷》、《医院内焦虑抑郁量表》结果相关(r=0.5-0.6，P＜0.01)，与精神科医生用汉密尔顿焦虑、抑郁量表评定的结果相关(r=0.5-0.6,p＜0.01)。综合考虑《患病行为问卷》的病感因子和情绪因子，不同心理健康水平的心内科患者间有所区别，《患病行为问卷》各因子综合考虑，能够反映出内科就诊患者中心理健康状况较差者与相对健康的患者间的不同，即前者不良情绪明显，且病感强；同时也能反映出内科心理健康状况不佳者与在精神科就诊的神经症患者之间的差异：即两者在病感上类似，而到精神科就诊者不良情绪更明显。量表中译本反映的情况与临床观察一致，体现了原量表设计者的理论构想。在中国综合医院筛查的临界值与英文原本的临界值接近。结论：《患病行为问卷》中译本经初步测试信度、效度满意，建议可以扩大样本试用，进行因子分析，并在此基础上进一步修订。
目的：引進併測定《患病行為問捲》(Illiness Behavior Questionnaire)的信度和效度。方法：將《患病行為問捲》譯成中文，併迴譯。以心內科住院病人(25例)為樣本，間隔2週評定複測信度。以胸悶胸痛為確診冠心病而住院的患者(46例)為樣本，評定效標效度。對效度測評組患者進行瞭精神科臨床診斷(ICD-10標準)，同時採用的工具有：《一般健康問捲-28》( General Health Questionnaire - 28)《醫院內焦慮抑鬱量錶》(Hospital Anxiety and Depression)以及漢密爾頓焦慮、抑鬱量錶。另外，在精神科門診連續收集軀體癥狀類似的焦慮性精神障礙及神經衰弱(ICD-10標準)的初診患者18例作為精神科對照組。結果：中譯本迴譯一緻率95％，複測信度82.5％。原量錶共11箇因子，主要分為兩箇維度，分彆反映不良情緒和病感。以我國心內科的住院患者為樣本，反映情緒的4箇因子與《一般健康問捲》、《醫院內焦慮抑鬱量錶》結果相關(r=0.5-0.6，P＜0.01)，與精神科醫生用漢密爾頓焦慮、抑鬱量錶評定的結果相關(r=0.5-0.6,p＜0.01)。綜閤攷慮《患病行為問捲》的病感因子和情緒因子，不同心理健康水平的心內科患者間有所區彆，《患病行為問捲》各因子綜閤攷慮，能夠反映齣內科就診患者中心理健康狀況較差者與相對健康的患者間的不同，即前者不良情緒明顯，且病感彊；同時也能反映齣內科心理健康狀況不佳者與在精神科就診的神經癥患者之間的差異：即兩者在病感上類似，而到精神科就診者不良情緒更明顯。量錶中譯本反映的情況與臨床觀察一緻，體現瞭原量錶設計者的理論構想。在中國綜閤醫院篩查的臨界值與英文原本的臨界值接近。結論：《患病行為問捲》中譯本經初步測試信度、效度滿意，建議可以擴大樣本試用，進行因子分析，併在此基礎上進一步脩訂。
목적：인진병측정《환병행위문권》(Illiness Behavior Questionnaire)적신도화효도。방법：장《환병행위문권》역성중문，병회역。이심내과주원병인(25례)위양본，간격2주평정복측신도。이흉민흉통위학진관심병이주원적환자(46례)위양본，평정효표효도。대효도측평조환자진행료정신과림상진단(ICD-10표준)，동시채용적공구유：《일반건강문권-28》( General Health Questionnaire - 28)《의원내초필억욱량표》(Hospital Anxiety and Depression)이급한밀이돈초필、억욱량표。령외，재정신과문진련속수집구체증상유사적초필성정신장애급신경쇠약(ICD-10표준)적초진환자18례작위정신과대조조。결과：중역본회역일치솔95％，복측신도82.5％。원량표공11개인자，주요분위량개유도，분별반영불량정서화병감。이아국심내과적주원환자위양본，반영정서적4개인자여《일반건강문권》、《의원내초필억욱량표》결과상관(r=0.5-0.6，P＜0.01)，여정신과의생용한밀이돈초필、억욱량표평정적결과상관(r=0.5-0.6,p＜0.01)。종합고필《환병행위문권》적병감인자화정서인자，불동심리건강수평적심내과환자간유소구별，《환병행위문권》각인자종합고필，능구반영출내과취진환자중심리건강상황교차자여상대건강적환자간적불동，즉전자불량정서명현，차병감강；동시야능반영출내과심리건강상황불가자여재정신과취진적신경증환자지간적차이：즉량자재병감상유사，이도정신과취진자불량정서경명현。량표중역본반영적정황여림상관찰일치，체현료원량표설계자적이론구상。재중국종합의원사사적림계치여영문원본적림계치접근。결론：《환병행위문권》중역본경초보측시신도、효도만의，건의가이확대양본시용，진행인자분석，병재차기출상진일보수정。
Objective: To introduce Illness Behavior Questionnaire (IBQ) into China, and test the reliability and validity of its Chinese Version. Method: The text of IBQ came from its author, Prof. Issy Pilowsky and was translated into Chinese by Shengli. The back translation was done by a Canadian psychotherapist not familiar with it. The test- retest reliability was done at an interval of 2 weeks in 25 inpatients in a cardiac ward. Based on a sample of 46 inpatients with chest pain in a cardiac ward, the criteria validity was tested. All 46 patients were interviewed by one psychiatrist. Psychiatric diagnosis was made if necessary (according to ICD - 10) . Other instruments included: General Health Questionnaire (GHQ),Hospital Anxiety and Depression Scale (HAD) . Another group sampled in psychiatric out- clinic (18 patients with anxiety disorder or neurasthnia) was used as neurotic control. Results: Judged by meaning, the consistency between back- translation and the original text was 95％. The test- retest reliability was 82.5％. From all 11 indices of IBQ, there were positive correlation between scores of indices reflecting mood ( GH, AD, I and AS) and the scores of GHQ or HAD (r = 0.5 ～ 0.6,p＜0.01) . Positive correlation also existed between them and the scores assessed by HAMA and HAMD (r=0.5～0.6, p＜0.01) . The difference of illness behavior between inpatients with chest pain with mental disorders or in sub- clinical states and those without could be reflected by IBQ, i.e. those with mental health problems had higher scores in disease conviction (DC) and Whiteley Index (WI), as well as had higher scores in negative affection staes (AS) . Compared with neurotic group, patients without mental health problem had lower score in DC, WI and AS, while tbose with such problems had similar results in DC and WI with the neurotic control, but lower AS score. The cut- off points for screening mental health problem using DC and WI were 2 ～ 3 and 6 ～ 7 respectively, similar to the cut - off points of the English version (2 ～ 3 and 7 ～ 8 respectively) . Conclusion: The reliability and validity of IBQ - Chinese Version is satisfying. It is worth of doing more work in factor analysis.
