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目的:在2型糖尿病患者中,对糖尿病问题量表(PAID)的效度和信度进行检验,用以测量2型糖尿病患者的疾病压力问题。方法:在北京市某综合三甲医院内分泌科门诊搜集2型糖尿病患者203例。采用条目分析、探索性因子分析检验量表的条目鉴别力和结构效度,入组患者同时完成汉密顿抑郁量表(HAMD-17)、患者健康问卷-9(PHQ-9)、世界卫生组织五项身心健康指标(WHO-5)、简明国际神经精神访谈(MINI)以及糖化血红蛋白浓度(Hb A1C)数据收集,以检验量表的效标效度。对31例患者完成间隔1个月的重测,评定量表的重测信度。结果:探索性因子分析提取出糖尿病相关的情绪、治疗、饮食和社会支持感问题4个因子,方差贡献率为64.33%,除条目7、20外,未出现横跨多个因子的条目;各条目与所属因子得分的相关性在0.67~0.86之间;PAID总分与HAMD-17、PHQ-9及Hb A1C评分呈正相关(r=0.48、0.43、0.21,P<0.001或0.01),与WHO-5得分呈负相关(r=-0.46,P<0.001);抑郁患者PAID得分高于非抑郁患者(P<0.001)。总量表的Cronbachα系数为0.94,4个因子的α系数在0.81~0.88之间;量表的重测信度为0.65,4个因子的重测信度在0.53~0.73之间。结论:糖尿病问题量表中文版具有较好的效度和信度,适用于对内地2型糖尿病患者疾病压力问题的评估。
OBJECTIVE: To examine the validity and reliability of the Diabetes Questionnaire (PAID) in patients with type 2 diabetes to measure disease stress in patients with type 2 diabetes. Methods: Totally 203 type 2 diabetic patients were collected from endocrinology clinic in a comprehensive top three hospital in Beijing. Entry analysis and exploratory factor analysis were used to check the item discrimination and structural validity of the questionnaire. HAMD-17, PHQ-9, The WHO-5, Concise International Neuropsychiatric Interviews (MINI) and Hb A1C data were collected to verify the validity of the scale. 31 patients completed an interval of 1 month retest, assess the test retest reliability. Results: Exploratory factor analysis extracted four factors related to emotion, treatment, diet and social support, and the variance contribution rate was 64.33%. There were no entries across multiple factors except for items 7 and 20; The correlation between the items and the scores of the affiliated factors was between 0.67 and 0.86. The total score of PAID was positively correlated with the scores of HAMD-17, PHQ-9 and Hb A1C (r = 0.48,0.43,0.21, P <0.001 or 0.01) -5 score (r = -0.46, P <0.001). PAID scores of depression patients were higher than those of non-depression patients (P <0.001). The Cronbach’s alpha coefficient of the total scale was 0.94, the alpha coefficients of the four factors were between 0.81 and 0.88, the retest reliability of the scale was 0.65, and the retest reliability of the four factors was between 0.53 and 0.73. Conclusion: The Chinese version of the Diabetes Questionnaire has good validity and reliability and is suitable for assessing the disease pressure in type 2 diabetic patients in the Mainland.