Martínez-Martín Pablo, Rodríguez-Blázquez Carmen, Forjaz Maria João, de Pedro Jesús
National Centre for Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain.
Mov Disord. 2009 Jan 30;24(2):211-7. doi: 10.1002/mds.22320.
This study sought to provide further information about the psychometric properties of the Clinical Impression of Severity Index for Parkinson's Disease (CISI-PD), in a large, international, cross-culturally diverse sample. Six hundred and fourteen patients with PD participated in the study. Apart from the CISI-PD, assessments were based on Hoehn & Yahr (HY) staging, the Scales for Outcomes in PD-Motor (SCOPA-M), -Cognition (SCOPA-COG) and -Psychosocial (SCOPA-PS), the Cumulative Illness Rating Scale-Geriatrics, and the Hospital Anxiety and Depression Scale. The total CISI-PD score displayed no floor or ceiling effects. Internal consistency was 0.81, the test-retest intraclass correlation coefficient was 0.84, and item homogeneity was 0.52. Exploratory and confirmatory factor analysis (CFI = 0.99, RMSEA = 0.07) confirmed CISI-PD's unifactorial structure. The CISI-PD showed adequate convergent validity with SCOPA-COG and SCOPA-M (r(S) = 0.46-0.85, respectively) and discriminative validity for HY stages and disease duration (P < 0.0001). In a multiple regression model, main CISI-PD predictors were SCOPA-M, disease duration, and depression. The results obtained were not only comparable to but also extended those yielded by the preliminary validation study, thus showing that the CISI-PD is a valid instrument to measure clinical impression of severity in PD. Its simplicity and easy application make it an attractive and useful tool for clinical practice and research.
本研究旨在通过一个大规模、国际化、跨文化的多样样本，提供关于帕金森病严重程度临床印象指数（CISI-PD）心理测量特性的更多信息。614名帕金森病患者参与了该研究。除CISI-PD外，评估还基于霍恩和雅尔（HY）分期、帕金森病运动功能结局量表（SCOPA-M）、认知功能结局量表（SCOPA-COG）、心理社会功能结局量表（SCOPA-PS）、累积疾病评定量表-老年版以及医院焦虑抑郁量表。CISI-PD总分未显示出地板效应或天花板效应。内部一致性为0.81，重测组内相关系数为0.84，项目同质性为0.52。探索性和验证性因素分析（CFI = 0.99，RMSEA = 0.07）证实了CISI-PD的单因素结构。CISI-PD与SCOPA-COG和SCOPA-M具有充分的收敛效度（r(S)分别为0.46 - 0.85），对HY分期和疾病持续时间具有区分效度（P < 0.0001）。在多元回归模型中，CISI-PD的主要预测因素为SCOPA-M、疾病持续时间和抑郁。所获得的结果不仅与初步验证研究的结果相当，而且有所扩展，从而表明CISI-PD是一种测量帕金森病严重程度临床印象的有效工具。其简单性和易于应用使其成为临床实践和研究中一个有吸引力且有用的工具。
