CAJ | 학술논문

目的通过Rasch分析提炼中国成人斜视生存质量量表(CAS-20),以能更好地用于评估成人斜视患者的生存质量状况.方法横断面研究.246例成人斜视患者,独立完成CAS-20问卷调查.根据量表每一条目的得分情况进行Rasch分析,分析条目及答案的心理计量特征.分析的项目包括分解维度、选项排序、局部独立性、适合度指标、项目差别功能、项目适中性分析、最终确定维度等.结果原CAS-20包括2个维度,为“社会心理维度”和“视觉功能维度”.通过Rasch分析可将量表分为4个维度,分别为“自我评价”、“与他人交往”、“阅读功能”和“一般功能”.原先的选项排序对每个维度均非常合理.每个维度的各条目之间标准残差相关系数均＜0.7,说明同一维度内条目之间具有一定的独立性.通过适合度指标分析,除“与他人交往”维度外,其他3个维度均需剔除1个条目.项目差别功能分析提示年龄和性别在4个维度中均无明显差异.项目适中性分析发现项目难度和研究对象个体能力之间匹配较好,阅读功能维度条目相对于患者个体能力来说略为简单.结论 CAS-20通过Rasch分析,20个条目缩减为17个条目,并且分为4个维度,分别是“自我评价”、“与他人交往”、“阅读功能”和“一般功能”,每个条目的选项仍为5个.优化的CAS-20可以更敏感地反映中国成人斜视患者的生存质量状态.
목적 통과Rasch분석제련중국성인사시생존질량량표(CAS-20),이능경호지용우평고성인사시환자적생존질량상황.방법 횡단면연구.246례성인사시환자,독립완성CAS-20문권조사.근거량표매일조목적득분정황진행Rasch분석,분석조목급답안적심리계량특정.분석적항목포괄분해유도、선항배서、국부독립성、괄합도지표、항목차별공능、항목괄중성분석、최종학정유도등.결과 원CAS-20포괄2개유도,위“사회심리유도”화“시각공능유도”.통과Rasch분석가장량표분위4개유도,분별위“자아평개”、“여타인교왕”、“열독공능”화“일반공능”.원선적선항배서대매개유도균비상합리.매개유도적각조목지간표준잔차상관계수균＜0.7,설명동일유도내조목지간구유일정적독립성.통과괄합도지표분석,제“여타인교왕”유도외,기타3개유도균수척제1개조목.항목차별공능분석제시년령화성별재4개유도중균무명현차이.항목괄중성분석발현항목난도화연구대상개체능력지간필배교호,열독공능유도조목상대우환자개체능력래설략위간단.결론 CAS-20통과Rasch분석,20개조목축감위17개조목,병차분위4개유도,분별시“자아평개”、“여타인교왕”、“열독공능”화“일반공능”,매개조목적선항잉위5개.우화적CAS-20가이경민감지반영중국성인사시환자적생존질량상태.
Objective To further refine the Chinese Adult Strabismus-20 (CAS-20) health-related quality of life (HRQOL) questionnaire using Rasch analysis.Methods In this cross-sectional study,the CAS-20 questionnaire was independently completed by 246 adult strabismus patients.Based on the score for each item,Rasch analysis was performed on the original CAS-20 using the following aspects:dimensionality,response order,local dependence,infit and outfit analysis,differential item function,subject targeting and confirmatory dimensionality.Results The original CAS-20 was divided into 4 subscales,which were labeled "self-perception","interaction","reading function",and "general function".Response ordering was appropriate for all of the 4 subscales.As a result of infit and outfit analysis,3 items were removed,one each from "self-perception","reading function",and "general function".No significant differential item function was found for sex or age.Compared with the ability of the patients and item difficulty,the 3 subscales matched well except for "reading function".Conclusion The original CAS-20 was reduced to 17 items,and divided into 4 subscales,which were "self-perception","interaction","reading function",and "general function".Subject response choices saved 5 test options.The refined CAS-20 may prove to be more responsive to HRQOL changes in adult strabismus patients.