在西班牙初级保健样本中，Sheehan 残疾量表的因子结构、内部一致性和构念效度。
Factor structure, internal consistency and construct validity of the Sheehan Disability Scale in a Spanish primary care sample.
机构信息
Parc Sanitari Sant Joan de Déu, Mental, Fundación Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.
出版信息
J Eval Clin Pract. 2010 Oct;16(5):895-901. doi: 10.1111/j.1365-2753.2009.01211.x.
RATIONALE, AIMS AND OBJECTIVES: The Sheehan Disability Scale (SDS) is a three-item instrument that measures disability in three inter-related domains: work, family life/home responsibilities and social/leisure activities. The main objective of the present study was to examine the factor structure, reliability and construct validity of the SDS in a wide Spanish sample of primary care (PC) patients.
METHODS
One phase cross-sectional survey. A total of 3815 patients, aged 18 years or older attending PC for a medical visit, were interviewed between October 2005 and March 2006. The interviews included the Structured Clinical Interview for DSM-IV Axis I Disorders for depressive and anxiety disorders, the Mini-International Neuropsychiatric Interview for the rest of mental disorders, a medical conditions checklist, the 2.0 version of the 12-item Short-Form Health Survey (SF-12) for measuring quality of life and the SDS.
RESULTS
The principal component analysis and the subsequent confirmatory factor analysis indicated that the SDS is one-dimensional (normed fit index = 0.990, non-normed fit index = 0.987, comparative fit index = 0.991, goodness-of-fit index = 0.993, standardized root mean-square residual = 0.037, root mean-square error of approximation = 0.053). The internal consistency of the scale was good (α = 0.83) and it was significantly associated with the physical and mental component of the SF-12. Concerning discriminative validity, patients with major depression or panic disorder scored higher on the SDS than patients with chronic medical conditions or with no chronic pathology. We also found that a cut-off point of 8 in the SDS adequately discriminated between patients with and without depression (area under the curve = 0.814, sensitivity = 81.60%, specificity = 70.60%).
CONCLUSIONS
The SDS seems a reliable, valid and useful clinical tool for measuring disability in Spanish PC patients.
背景、目的和目标：Sheehan 残疾量表（SDS）是一种三项目工具，用于测量工作、家庭生活/家庭责任和社会/休闲活动三个相互关联的领域的残疾程度。本研究的主要目的是在广泛的西班牙初级保健（PC）患者样本中检验 SDS 的因子结构、信度和构念效度。
方法
一项单阶段横断面调查。2005 年 10 月至 2006 年 3 月期间，对 3815 名年龄在 18 岁或以上、因医疗就诊而在 PC 就诊的患者进行了访谈。访谈包括 DSM-IV 轴 I 障碍的结构化临床访谈，用于抑郁和焦虑障碍；其余精神障碍的 Mini-国际神经精神访谈；医疗状况检查表；用于测量生活质量的 12 项短式健康调查（SF-12）第 2.0 版和 SDS。
结果
主成分分析和随后的验证性因子分析表明，SDS 是单维的（标准化拟合指数=0.990，非标准化拟合指数=0.987，比较拟合指数=0.991，拟合优度指数=0.993，标准化均方根残差=0.037，均方根误差逼近=0.053）。该量表的内部一致性良好（α=0.83），与 SF-12 的身体和心理成分显著相关。关于判别效度，患有重性抑郁症或惊恐障碍的患者在 SDS 上的得分高于患有慢性疾病或无慢性疾病的患者。我们还发现，SDS 的 8 分切点可充分区分抑郁患者和非抑郁患者（曲线下面积=0.814，敏感性=81.60%，特异性=70.60%）。
结论
SDS 似乎是一种可靠、有效和有用的临床工具，可用于测量西班牙 PC 患者的残疾程度。
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