腰椎间盘突出症患者报告结局量表结构探索△

Structure exploration of patient reported outcome scale for lumbar disc herniation

摘要:

［目的］构建腰椎间盘突出症患者报告结局概念模型，初步探索腰椎间盘突出症患者报告结局量表结构，为量表进一步编制提供基础。［方法］通过文献回顾、专家咨询和患者访谈构建腰椎间盘突出症患者报告结局的概念模型、预设维度和条目池。使用初始问卷对某综合医院门诊就诊的 200 例腰椎间盘突出症患者进行调查，使用经典测量理论对初始问卷条目进行筛选，使用探索性因子分析和平行分析探索量表结构。［结果］构建出包含 4 个一级指标、9 个二级指标的腰椎间盘突出症患者报告结局概念模型。经过条目筛选形成，形成 25 个条目的初始量表。探索性因子分析结合平行分析提取出 6 个公因子，分别反映患者社会适应、心理情感、功能限制、治疗效果、站立行走、躯体症状，方差贡献率分别为 13.4%、12.5%、11.0%、9.9%、 7.7%、4.5%。［结论］提取出的 6 个公因子均涵盖在所构建的概念模型内，能够解释腰椎间盘突出症对患者的影响，应围绕社会适应、心理情感、功能限制、治疗效果、站立行走、躯体症状 6 个维度编制腰椎间盘突出症患者报告结局量表。

Abstract:

[Objective] To develop a conceptual model for lumbar disc herniation patient reported outcome, and to explore the structure of patient reported outcome scale preliminary, in order to provide the basis for scale compilation. [Methods] A conceptual model, initial di- mension and item pool were developed by literature review, expert consultation and patient interviews. A total of 200 patients with lumbar disc herniation in a general hospital were investigated and the items of initial questionnaire were screened by using classical test theory. Scale structure was explored using exploratory factor analysis and parallel analysis. [Results] A conceptual model for lumbar disc herniation patient reported outcome was constructed which consists of 4 first-level indicators and 9 second-level indicators. Six common factors were extracted according to the exploratory factor analysis and parallel analysis. The variance contribution rates were 13.4% , 12.5% , 11.0% , 9.9%, 7.7% and 4.5%, respectively, reflecting the social adaptation, psychological emotion, functional limitation, therapeutic effect, standing and walking, and somatic symptoms of patients. [Conclusion] The 6 common factors extracted were all covered in the constructed conceptu- al model, which could explain the impact of lumbar disc herniation on patients. The lumbar disc herniation patient reported outcome scale should be complied in 6 dimensions , including social adaptation, psychological emotion, functional limitation, therapeutic effect, standing and walking, and somatic symptoms of patients.