Mosimann Urs Peter, Collerton Daniel, Dudley Robert, Meyer Thomas Daniel, Graham Gemma, Dean Jennifer Louise, Bearn Daniel, Killen Alison, Dickinson Lucy, Clarke Mike Patrick, McKeith Ian Grant
Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK.
Int J Geriatr Psychiatry. 2008 Jul;23(7):712-8. doi: 10.1002/gps.1965.
Visual hallucinations are under-reported by patients and are often undiscovered by health professionals. There is no gold standard available to assess hallucinations. Our objective was to develop a reliable, valid, semi-structured interview for identifying and assessing visual hallucinations in older people with eye disease and cognitive impairment.
We piloted the North-East Visual Hallucinations Interview (NEVHI) in 80 older people with visual and/or cognitive impairment (patient group) and 34 older people without known risks of hallucinations (control group). The informants of 11 patients were interviewed separately. We established face validity, content validity, criterion validity, inter-rater agreement and the internal consistency of the NEVHI, and assessed the factor structure for questions evaluating emotions, cognitions, and behaviours associated with hallucinations.
Recurrent visual hallucinations were common in the patient group (68.8%) and absent in controls (0%). The criterion, face and content validities were good and the internal consistency of screening questions for hallucinations was high (Cronbach alpha: 0.71). The inter-rater agreements for simple and complex hallucinations were good (Kappa 0.72 and 0.83, respectively). Four factors associated with experiencing hallucinations (perceived control, pleasantness, distress and awareness) were identified and explained a total variance of 73%. Informants gave more 'don't know answers' than patients throughout the interview (p = 0.008), especially to questions evaluating cognitions and emotions associated with hallucinations (p = 0.02).
NEVHI is a comprehensive assessment tool, helpful to identify the presence of visual hallucinations and to quantify cognitions, emotions and behaviours associated with hallucinations.
患者对视幻觉的报告不足，且往往未被医疗专业人员发现。目前尚无评估幻觉的金标准。我们的目的是开发一种可靠、有效的半结构化访谈，用于识别和评估患有眼部疾病和认知障碍的老年人的视幻觉。
我们在80名有视觉和/或认知障碍的老年人（患者组）和34名无幻觉已知风险的老年人（对照组）中试用了东北视幻觉访谈（NEVHI）。对11名患者的 informant 进行了单独访谈。我们确立了NEVHI的表面效度、内容效度、效标效度、评分者间一致性和内部一致性，并评估了评估与幻觉相关的情绪、认知和行为的问题的因子结构。
复发性视幻觉在患者组中很常见（68.8%），而在对照组中不存在（0%）。效标效度、表面效度和内容效度良好，幻觉筛查问题的内部一致性较高（Cronbach α系数：0.71）。简单和复杂幻觉的评分者间一致性良好（kappa值分别为0.72和0.83）。确定了与幻觉体验相关的四个因素（感知控制、愉悦感、痛苦和意识），共解释了73%的总方差。在整个访谈过程中，informant 给出的“不知道”答案比患者多（p = 0.008），尤其是在评估与幻觉相关的认知和情绪的问题上（p = 0.02）。
NEVHI是一种全面的评估工具，有助于识别视幻觉的存在，并量化与幻觉相关的认知、情绪和行为。
