Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden.
Child Adolesc Psychiatry Ment Health. 2009 May 14;3(1):15. doi: 10.1186/1753-2000-3-15.
The origin of the present study was to develop the liaison work between the disciplines of child and adolescent psychiatry and paediatric surgery and nursing, so as to improve the quality of treatment and care of a group of children with imperforate anus (IA) and their families. Imperforate anus is a congenital disease involving a deformity of the anorectum. The early surgery and invasive follow-up treatment associated with IA may affect the child psychosocially, including the child-parent relationship. By developing and testing a questionnaire for children born with anorectal anomalies, a tool for measuring psychosocial functioning can be realized.
First, a literature review on "Imperforate Anus" was performed. Second, an exploratory interview study was conducted with patients/adolescents with IA and their parents. The findings from these interviews were the foundation for construction of the questionnaire. The Imperforate Anus Psychosocial Questionnaire (IAPSQ) was tested and revised three times before its completion. It contains 45 items on Likert scales. A total of 87 children completed the IAPSQ: 25 children with IA and two comparison groups. Face and content validity were considered. The Rasch approach, an item response theory model, was used to evaluate the psychometric properties of the IAPSQ, where item difficulty and person ability are concurrently approximated.
The findings of the Rasch analysis revealed that the psychological dimension was reasonable, and that person reliability (0.83) was moderate and item reliability (0.95) was sufficient. The social dimension showed satisfactory item reliability (0.87). The person reliability (0.52) of the social dimension was weak. Content validity seemed to be established and construct validity was recognized on the psychological dimension.
The IAPSQ provides a reasonably valid and reliable measure of psychosocial functioning for clinical use among children with IA, although some revisions are suggested for the next version of the IAPSQ. By using the Rasch model, we discovered that specific items should be discarded and other items should be reformulated to make the questionnaire more "on target". The social dimension has to be expanded with further items to reasonably capture a social dimension.
本研究旨在促进儿童和青少年精神病学与小儿外科学和护理学之间的联络工作，以提高一组先天性肛门闭锁（IA）患儿及其家庭的治疗和护理质量。先天性肛门闭锁是一种涉及肛门直肠畸形的先天性疾病。IA 的早期手术和相关的侵入性随访治疗可能会对儿童的心理社会产生影响，包括儿童与父母的关系。通过开发和测试用于患有肛门直肠畸形的儿童的问卷，可以实现一种用于测量心理社会功能的工具。
首先，对“先天性肛门闭锁”进行文献回顾。其次，对患有 IA 的儿童及其父母进行了探索性访谈研究。这些访谈的结果为问卷的构建奠定了基础。先天性肛门闭锁心理社会问卷（IAPSQ）经过三次测试和修订后才完成。它包含 45 个李克特量表项目。共有 87 名儿童完成了 IAPSQ：25 名患有 IA 的儿童和两个对照组。考虑了表面效度和内容效度。采用项目反应理论模型中的 Rasch 方法评估 IAPSQ 的心理测量特性，同时逼近项目难度和人员能力。
Rasch 分析的结果表明，心理维度是合理的，人员可靠性（0.83）中等，项目可靠性（0.95）充足。社会维度的项目可靠性（0.87）令人满意。社会维度的人员可靠性（0.52）较弱。似乎建立了内容效度，在心理维度上也承认了结构效度。
IAPSQ 为患有 IA 的儿童提供了一种合理有效的心理社会功能测量工具，可用于临床，但建议对下一个版本的 IAPSQ 进行修订。通过使用 Rasch 模型，我们发现应删除某些特定项目，并对其他项目进行重新制定，以使问卷更具针对性。需要扩展社会维度，增加更多项目，以合理地捕捉社会维度。
