高血压患者报告的临床结局评价量表研制及评价.docVIP

精品论文 参考文献 高血压患者报告的临床结局评价量表研制及评价 1.昆明医科大学公共卫生学院 昆明 650500； 2.昆明医科大学第二附属医院 昆明 650000； 3.云南省怒江州人民医院五官科 怒江 673100 【摘 要】目的：研制基于高血压患者报告的临床结局评价量表（PRO量表），并对其进行考评。 方法：通过对多个医院和社区卫生服务中心的490名高血压患者583份有效问卷进行分析，采用相关系数法、因子分析法、克朗巴赫系数法和配对t检验等方法分别从不同角度来分析量表,并对其信度、效度和反应度等指标进行考评。结果：终量表由4个维度10个小方面44个条目组成，量表各领域重测相关系数在0.957～0.983之间，量表的分半信度系数为0.88，总量表的Cronbachalpha;系数为0.925，因子分析与量表本身的内在结构存在明显的逻辑关系，量表的结构与理论构想的基本吻合，终量表所有条目与所属领域间的相关系数均有统计学意义(P＜0.05），该量表基本能反映出患者治疗前后临床结局的变化情况。结论：高血压患者PRO量表具有较好的信度、效度、反应度和临床可行性，量表可以作为高血压患者临床疗效评价研究的工具。 【关键词】高血压；患者报告的临床结局（PRO）；条目筛选；信度；效度；反应度 【中图分类号】R544.1 【文献标识码】A 【文章编号】1674-8999（2015）9-0785-02 【Abstract】Objective：To develop and evaluate the instrument based on patient-reported outcomes for hypertension patients. Method：By analyzing the valid data from 490 Hy-patients reported 583 questionnaires. The factor analysis, cronbachs alpha; coefficient，spearman correlation coefficient and paired t test were used for analyzing the entry of rating scale from different angles on the basis of these information. The validity, reliability and responsiveness of the Hy-PRO instrument were evaluated. Result The final Hy-PRO instrument composed of 4 domains, 10 facets and 44 items. The results showed that test-retest Spearman correlation coefficient of the domains were between 0.957 and 0.983, the Split-half reliability coefficient was 0.88, Cronbachs alpha; was 0.925, faction analysis showed that fit-well with the theoretical structure model. The correlations of the facets and every item-domains correlation coefficient had a significant difference (Plt;0.05), and the instrument can basically reflect outcome for patients with hypertension after treatment. Conclusion The result showed that the instrument had a good reliability, validity, responsiveness and clinical feasibility, and can be applied in clinical evaluation. 【Key words】Hypertension; PRO; item screening; reliability; validity; responsiveness 原发性高血压（essential hypertension）（简称高血压）是导致心脑血管病、肾脏病发生