世界卫生组织残疾评定量表第2版中文版在精神残疾评定中的信效度检验

摘要

目的:检验世界卫生组织残疾评定量表第2版中文版(WHO-DASⅡ)在精神残疾评定中的信度和效度,以探讨其在精神疾病患者中的适用性.方法:对218例精神残疾者进行WHO-DASⅡ评定,采用相关分析和Cronbach α系数检验量表内部一致性信度；应用探索和验证性因素分析检验量表结构效度；以不同精神疾病的得分差异检验量表的实证效度.结果:总量表内部一致性Cronbach α系数为0.93,6个分量表α系数在0.69～0.94之间；评定者一致性为0.93.除分量表6外其余5个分量表内部各条目间、6个分量表之间以及分量表与总分之间均呈正相关(r =0.17 ～0.91,P＜0.05).探索性因素分析显示,6个因子累积解释的总方差为63.68％,所有因子特征根均大于1；但各因子包含题项均与原量表不一致；验证性因素分析显示原量表结构与样本的拟合度较差(x2/df=4.24,P＜0.001、GFI=0.57、NFI=0.58、CFI =0.64、RMSEA =0.12).器质性精神障碍组的总分和理解与交流、身体移动、自我照料3个分量表得分均高于情感性精神障碍组和精神分裂症组(P＜0.05).结论:世界卫生组织残疾评定量表第2版中文版具有较好的内部一致性信度和实证效度,但结构效度不理想,有待进一步探索和验证.%Objective: To test the reliability and validity of the Chinese version of WHO Disability Assessment Schedule 2.0( WHO-DASⅡ) in mental disability assessment Methods: Totally 218 patients with mental disability were assessed with the WHO-DAS Ⅱ. The consistency of the scale was tested by using correlation analysis and Cronbach's a coefficient The constructive validity was tested by using exploratory factory analysis (EFA) and confirmatory factory analysis (CFA). The score difference in different mental patients was used to test the validate validity. Results:The Cronbach's a coefficient of the WHO-DAS Ⅱ was 0.93, the coefficient of the subscales ranged from 0.69 to 0.94, and the inter-rater consistency was 0. 93. There was significant positive correlation a-mong the item scores of the 5 subscales except 6, the scores of 6 subscales, and the sub-scores and the total scores (r = 0. 17 - 0. 91, P <0. 05). The EFA showed that the accumulating variances of six factors contributed to 63. 68% of the total variance, and all the characteristic roots of factors were more than 1. The items extracted to the factor were inconsistent with those in the original scale. The CFA extracted poor constructive validity in original scale structure. The total score and sub-scores of understanding and communicating, getting around, self-care were higher in the organic mental disorders group than in the schizophrenia group and mood disorders group. Conclusion: It suggests that the WHO Disability Assessment Schedule 2. 0 has relatively good internal consistency reliability and validate validity, but its constructive validity may be not ideal and need further exploration and verification.