CAJ | 학술논문

背景：在制定慢性精神障碍患者管理计划时需要解决的一个重要问题就是照料者的负担，但是迄今为止，国内还没有可靠的方法来评估上述负担。目标：评估家庭负担访谈问卷（Family Experience Inter-view Schedule,FEIS）中文简化版在国内住院精神障碍患者的照料者中使用的信度和效度。方法：我们翻译114项条目的英文版FEIS，并回译。然后用中文版评估606名住院精神障碍患者的主要照料者。排除9项社会人口学变量和9项超过15％的受访者都不能回答的条目后，我们随机选取一半样本问卷对剩余的96项进行了探索性因子分析，并根据因子分析的结果选择最终简化版量表包含的项目。利用另一半样本数据，通过相关性分析、验证性因子分析和内部一致性方法来评估最终简化版量表的信度和效度。结果：最终的中文版量表由28个条目组成，包括五个维度：(a)患者的暴力行为；(b)患者的自杀倾向；(c)照料者的抑郁和焦虑症状；(d)照料者的日常生活受扰乱；(e)照料者对医疗服务的满意度。这五个维度解释了总方差的50.5％。验证性因子分析发现该五因子模型是合理的[χ2/df=2.94，p<0.001，拟合优度指数[GFI]=0.85，比较拟合指数[CFI]=0.85，近似均方根误差[RMSEA]=0.08]。每个条目和对应的因子之间的相关系数均在0.5以上。整个量表的Cronbach α系数为0.76，五个维度的Cronbach α系数在0.71和0.84之间。结论：28项FEIS简化中文版评估的家庭负担五个维度具有良好的内部一致性，因此，可以用来评估国内重性精神障碍患者照料者的家庭负担的各个维度。还需要进一步工作来评估该量表的重测信度和随时间而改变的灵敏度。
배경：재제정만성정신장애환자관리계화시수요해결적일개중요문제취시조료자적부담，단시흘금위지，국내환몰유가고적방법래평고상술부담。목표：평고가정부담방담문권（Family Experience Inter-view Schedule,FEIS）중문간화판재국내주원정신장애환자적조료자중사용적신도화효도。방법：아문번역114항조목적영문판FEIS，병회역。연후용중문판평고606명주원정신장애환자적주요조료자。배제9항사회인구학변량화9항초과15％적수방자도불능회답적조목후，아문수궤선취일반양본문권대잉여적96항진행료탐색성인자분석，병근거인자분석적결과선택최종간화판량표포함적항목。이용령일반양본수거，통과상관성분석、험증성인자분석화내부일치성방법래평고최종간화판량표적신도화효도。결과：최종적중문판량표유28개조목조성，포괄오개유도：(a)환자적폭역행위；(b)환자적자살경향；(c)조료자적억욱화초필증상；(d)조료자적일상생활수우란；(e)조료자대의료복무적만의도。저오개유도해석료총방차적50.5％。험증성인자분석발현해오인자모형시합리적[χ2/df=2.94，p<0.001，의합우도지수[GFI]=0.85，비교의합지수[CFI]=0.85，근사균방근오차[RMSEA]=0.08]。매개조목화대응적인자지간적상관계수균재0.5이상。정개량표적Cronbach α계수위0.76，오개유도적Cronbach α계수재0.71화0.84지간。결론：28항FEIS간화중문판평고적가정부담오개유도구유량호적내부일치성，인차，가이용래평고국내중성정신장애환자조료자적가정부담적각개유도。환수요진일보공작래평고해량표적중측신도화수시간이개변적령민도。
Background:Caregiver burden is an important issue that needs to be addressed when developing management programs for persons with chronic mental illnesses, but there is, as yet, no reliable way for assessing this in China. Aim:Assess the validity and reliability of a brief adapted Chinese version of the Family Experience Interview Schedule (FEIS) among caregivers of inpaitents with mental disorders in China. Methods:We first translated and back-translated the original 114-item FEIS and administered it to 606 primary caregivers of psychiatric inpaitents. Atfer excluding 9 items about sociodemographic variables and 9 items that over 15% of respondents were unable to answer, we conducted an exploratory factor analysis using a random half of the sample on the remaining 96 items and, based on the results of the factor analysis, selected the items to be included in the final shortened scale. Correlation analysis, confirmatory factor analysis, and internal consistency measures were used to assess the reliability and validity of the ifnal scale using data from the second half of the sample. Results:The final scale included 28 items that loaded on five dimensions: (a) patients’ violent behavior; (b) patients’ suicidal tendency; (c) caregivers’ depression and anxiety; (d) disruption of caregivers’ daily rouitnes; and (e) caregivers’ saitsfaciton with health services. These ifve dimensions explained 50.5% of the total variance. Conifrmatory factor analysis found reasonable ift of this 5-factor model (χ2/df=2.94,p<0.001, goodness-of-ift index [GFI]=0.85, comparaitve ift index [CFI]=0.85, root-mean-square error of approximaiton [RMSEA]=0.08). The correlaiton coeffcients between each item and the corresponding factor were all above 0.5. The Cronbach α coeffcient of the enitre scale was 0.76 and that for the ifve dimensions varied between 0.71 and 0.84. Conclusions:The ifve dimensions of family burden assessed by the 28-item brief Chinese version of FEIS have good internal consistency and, thus, appear to assess valid dimensions of family burden in Chinese care-givers of persons with serious mental illnesses. Further work is needed to assess the test-retest reliability of this scale and its sensiitvity to change over itme.