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中国循证儿科杂志

中国循证儿科杂志 ›› 2023, Vol. 18 ›› Issue (6): 442-446.DOI: 10.3969/j.issn.1673-5501.2023.06.006

• 论著 • 上一篇    下一篇

中文版儿科症状筛查工具的信度与效度研究

黄佳颖1,张静1,梁丽婵2,孟江南3,叶红雨2,王为杰1,朱文婷1,史蕾1   

  1. 1 南方医科大学护理学院广州，510515；2 南方医科大学珠江医院小儿血液科广州，510260；3 南方医科大学南方医院儿科广州，510515


  • 收稿日期:2023-10-31 修回日期:2023-11-18 出版日期:2023-12-25 发布日期:2024-01-22
  • 通讯作者: 史蕾

Reliability and validity of Symptom Screening in Pediatrics Tool in Chinese

HUANG Jiaying1，ZHANG Jing1，LIANG Lichan2，MENG Jiangnan3，YE Hongyu2，WANG Weijie1，ZHU Wenting1，SHI Lei1   

  1. 1 School of Nursing，Southern Medical University，Guangzhou 510515，China；2 Department of Pediatric Hematology，Zhujiang Hospital Southern Medical University，Guangzhou 510260，China；3 Department of Pediatrics，Nanfang Hospital Southern Medical University，Guangzhou 510515，China
  • Received:2023-10-31 Revised:2023-11-18 Online:2023-12-25 Published:2024-01-22
  • Contact: SHI Lei，email：35508897@qq.com

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摘要： 背景：癌症患儿治疗过程中面临不同程度的症状困扰，科学、快速、准确地评估患儿真实症状对于临床干预尤为重要。 目的：引进英文版儿科症状筛查工具（SSPedi），并在癌症患儿及其父母中检验量表信效度。 设计：横断面研究。 方法：采用Brislin翻译模型对SSPedi汉化翻译，行跨文化调适和预调查后形成中文版SSPedi患儿自评版（SSPedi-C）和SSPedi父母代评版（SSPedi-P）。正式调查选取2022年12月1日至2023年5月26日在南方医科大学南方医院儿科和南方医科大学珠江医院小儿血液科住院治疗的8~18岁癌症患儿及其父或母。在患儿入院当天或第2天，由1名经统一培训的调查人员进入病房，向患儿及其父母分别发放和回收纸质版中文版SSPedi-C和 SSPedi-P。问卷数据由调查人员当天录入、核对后行项目分析和信、效度分析。 主要结局指标：中文版SSPedi-C和SSPedi-P的信度和效度指标。 结果：220例（95.6%）有效问卷进入本文分析，220例癌症患儿年龄8~17（11.3±2.3）岁，男130例（59.1%），女90例。患儿父或母年龄28~59（40.2±5.2）岁；量表填写人为父亲50名（22.7），母亲170名。项目分析：中文版SSPedi-C和SSPedi-P的15个条目临界比值分别为3.987~8.824和4.817~13.829，P均＜0.001；条目与量表总分的相关系数分别为0.431~0.701（P均＜0.001）和0.482~0.787（P均＜0.001）。信度分析：中文版SSPedi-C和SSPedi-P总Cronbach's α系数分别为0.877和0.893，折半信度分别为0.843和0.806。内容效度分析：两个量表条目内容效度指数及量表内容效度指数均为1.000。验证性因子分析：2个量表卡方自由度比均<3.000，近似误差均方根均<0.080，各项拟合指标均>0.900。 结论：中文版SSPedi在癌症患儿及其父母中具有良好的信效度，简便易行，可作为评估8~18岁癌症患儿症状困扰程度的工具。

关键词: 癌症, 自我报告, 症状困扰, 儿科症状筛查工具, 量表汉化

Abstract: Background: Children undergoing cancer treatment experience varying levels of symptom distress. It is crucial for clinical intervention that a scientific, rapid and accurate assessment is conducted to accurately identify the true symptoms in these children. Objective: To introduce the Symptom Screening in Pediatrics Tool（SSPedi）and to test the reliability and validity of its Chinese version in children with cancer and their parents. Design: Cross-sectional study. Methods: The Brislin translation model was employed to covert the scale into Chinese. Six experts were enlisted to conduct cultural adjustments, and a pre-survey was executed to formulate the Chinese versions of SSPedi for children and parents（SSPedi-C and SSPedi-P）.The formal survey targeted children aged 8-18 undergoing cancer treatment and their parents, who were hospitalized in the Department of Pediatrics at Nanfang Hospital of Southern Medical University and the Department of Pediatric Hematology at Zhujiang Hospital of Southern Medical University from December 1, 2022, to May 26, 2023. After obtaining consent from the hospital and relevant departments, a uniformly trained investigator from each hospital entered the ward on the day of admission or the following day to distribute SSPedi-C and SSPedi-P in Chinese to the children and their parents. After the questionnaire data were entered and verified by the investigators on the same day, item analysis, reliability analysis, and validity analysis were conducted. Main outcome measures: The reliability and validity of the Chinese versions of SSPedi-C and SSPedi-P. Results: A total of 220 (95.65%) valid questionnaires were included in the analysis. The age of the 220 children with cancer ranged from 8 to 17 years old （11.26±2.28）, with 130 males (59.1%) and 90 females. The parents' ages ranged from 28 to 59 years （40.15±5.23）, comprising 50 fathers (22.7%) and 170 mothers. Item analysis revealed that the critical ratio for all 15 items in the Chinese versions of SSPedi-C and SSPedi-P were between 3.987-8.824 (all P<0.001) and 4.817-3.829 (all P<0.001), respectively. The correlation coefficients between each item and the total score of the Chinese versions of SSPedi-C and SSPedi-P were between 0.431-0.701 (all P<0.001) and 4.817-3.829 (all P<0.001), respectively. The correlation coefficients between each item and the total score were 0.431-0.701 (P<0.001) for the Chinese SSPedi-C and 0.482-0.787 (P<0.001) for Chinese SSPedi-P. Reliability analysis showed that the total Cronbach's α coefficients of Chinese SSPedi-C and SSPedi-P were 0.877 and 0.893, respectively, and the split-half reliability coefficients were 0.843 and 0.806, respectively. Content validity analysis showed that the item-level content validity index and averaging scale-level content validity index of Chinese SSPedi-C and SSPedi-P were both 1.000. For both two Chinese scales, confirmatory factor analysis showed that the chi-square degree of freedom ratio (χ2/df was <3.000, RMSEA was <0.080, and fitting index was >0.900. Conclusion: The Chinese version of SSPedi demonstrates good reliability and validity among children with cancer and their parents. Its simplicity and ease of operation make it a valuable tool for evaluating the level of symptom distress in children aged 8-17 undergoing cancer treatment.

Key words: Cancer, Self-report, Symptom disturbance, Symptom Screening in Pediatrics Tool, Scale translation