摘要
目的对心力衰竭毒邪证诊断量表的信度、效度、可行性进行评价,检验其应用于临床辨证的可靠性与有效性。方法采用横断面研究方法,选择2024年3月1日—9月30日于北京中医药大学东直门医院等4家医院就诊的心力衰竭患者,收集患者一般情况,包括性别、年龄、吸烟史、饮酒史、合并疾病,运用克朗巴赫α系数、分半信度、重测信度评价量表的信度;运用表面效度、区分效度和结构效度评价量表的效度;通过接受率、完成率和完成时间来评估可行性。结果共纳入符合研究标准的心力衰竭患者600例,男性290例,女性310例,年龄中位数(四分位数间距)为66.50(58.00,70.00)岁。内部一致性信度:总量表和4个维度的量表克朗巴赫α系数均大于0.6,表明量表各条目之间的一致性程度良好;总量表和4个维度的斯皮尔曼-布朗系数均大于0.7,表明量表内部具有良好的稳定性与同质性。外部一致性信度:总量表和4个维度的Kappa系数均大于0.7,表明量表具有良好外部一致性。区分效度评价将患者分为毒邪证组(n=180)与非毒邪证组(n=420),两组患者在性别、年龄、吸烟史、饮酒史、合并疾病方面差异无统计学意义(P>0.05),运用心力衰竭毒邪证诊断量表对两组患者评分,毒邪证组4个维度及总量表评分均高于非毒邪证组(P<0.01),表明量表具有较好的区分效度。结构效度评估采用主成分法对28项因子进行提取,共提取7个公因子,总方差贡献率为60.554%,各条目的负荷绝对值基本大于0.5,提取相应维度的共同度介于52.1%~96.5%之间,表明本量表具有很好的结构效度。本次测评量表接受率100%,完成率100%,平均完成时间在6~8 min之间,量表可行性良好。结论心力衰竭毒邪证诊断量表具有较好的信度、效度,可行性良好。
Objective To evaluate the reliability,validity,and feasibility of the diagnostic scale for toxic pathogen syndrome in heart failure(HF),and to verify its reliability and effectiveness in clinical diagnosis.Methods A cross-sectional study was conducted.Patients with HF who visited four hospitals,including Dongzhimen Hospital,Beijing University of Chinese Medicine,from March 1st to September 30th,2024 were selected.General information of the patients,including gender,age,smoking history,drinking history,and comorbidities,was collected.Cronbach′sαcoefficient,split-half reliability,and test-retest reliability were used to evaluate the reliability of the scale.Surface validity,discriminant validity,and structural validity were used to assess the validity of the scale.Acceptance rate,completion rate,and completion time were used to evaluate the feasibility.Results A total of 600 patients with HF meeting the research criteria were included,including 290 males and 310 females,with a median(IQR)age of 66.50(58.00,70.00)years.Internal consistency reliability:the Cronbach′sαcoefficients of the total scale and the four dimensions were all greater than 0.6,indicating a good consistency among the items of the scale.The Spearman-Brown coefficients of the total scale and the four dimensions were all greater than 0.7,indicating good stability and homogeneity within the scale.External consistency reliability:the Kappa coefficients of the total scale and the four dimensions were all greater than 0.7,indicating good external consistency of the scale.Discriminant validity evaluation:patients were divided into the toxic pathogen syndrome group(n=180)and the non-toxic pathogen syndrome group(n=420).There were no statistically significant differences in gender,age,smoking history,drinking history,and comorbidities between the two groups(P>0.05).The scores of the two groups were evaluated using the diagnostic scale for the toxic pathogen syndrome in HF.The toxic pathogen syndrome group had higher scores in all four dimensions and the total scale than the non-toxic pathogen syndrome group(P<0.01),indicating good discriminant validity of the scale.Structural validity assessment:principal component analysis was used to extract 28 factors,and a total of 7 common factors were extracted,with a total variance contribution rate of 60.554%.The absolute values of the loadings of each item were basically greater than 0.5,and the commonalities of the corresponding dimensions ranged from 52.1%to 96.5%,indicating good structural validity of the scale.The acceptance rate of the scale in this evaluation was 100%,the completion rate was 100%,and the average completion time was between 6 and 8 minutes,indicating good feasibility of the scale.Conclusion The diagnostic scale for the toxic pathogen syndrome in HF has good reliability,validity,and feasibility.
作者
肖狄
李蒙
吴卓然
王策
刘佳尚
张立晶
XIAO Di;LI Meng;WU Zhuoran;WANG Ce;LIU Jiashang;ZHANG Lijing(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)
出处
《北京中医药大学学报》
北大核心
2025年第10期1404-1412,共9页
Journal of Beijing University of Traditional Chinese Medicine
基金
国家重点研发计划项目(No.2022YFC3500101)。
关键词
心力衰竭
毒邪证
信度
效度
heart failure
toxic pathogen syndrome
reliability
validity
