College of Nursing, The University of Arizona, Tucson, Arizona 85721-0203, USA.
J Pain Symptom Manage. 2011 Mar;41(3):535-48. doi: 10.1016/j.jpainsymman.2010.06.011. Epub 2010 Dec 4.
Symptom assessment has increasingly focused on the evaluation of total symptom distress or burden rather than assessing only individual symptoms. The challenge for clinicians and researchers alike is to assess symptoms, and to determine the symptom distress associated with the symptoms and the patient's ability for symptom management without a lengthy and burdensome assessment process.
The objective of this article was to discuss the psychometric evaluation of a brief general symptom distress scale (GSDS) developed to assess specific symptoms and how they rank in relation to each other, the overall symptom distress associated with the symptom schema, and provide an assessment of how well or poorly that symptom schema is managed.
Results from a pilot study about the initial development of the GSDS with 76 hospitalized patients are presented, followed by a more complete psychometric evaluation of the GSDS using three samples of cancer patients (n=190) and their social network members, called partners in these studies (n=94). Descriptive statistics were used to describe the GSDS symptoms, symptom distress, and symptom management. Point biserial correlations indexed the associations between dichotomous symptoms and continuous measures, and conditional probabilities were used to illustrate the substantial comorbidities of this sample. Internal consistency was examined using the KR-20 coefficient, and test-retest reliability was examined. Construct validity and predictive validity also were examined.
The GSDS demonstrated satisfactory internal consistency and test-retest reliability, and good construct validity and predictive validity. The total score on the GSDS, symptom distress, and symptom management correlated significantly with related constructs of depression, positive and negative affect, and general health. The GSDS was able to demonstrate its ability to distinguish between those with or without chronic illness, and was able to significantly predict scores on criterion measures such as depression.
Collectively, these results suggest that the GSDS is a straightforward and useful instrument for rapidly assessing symptoms that can disrupt health-related quality of life.
症状评估越来越关注总症状困扰或负担的评估，而不是仅评估单个症状。临床医生和研究人员面临的挑战是评估症状，并确定与症状相关的症状困扰以及患者的症状管理能力，而无需冗长和繁琐的评估过程。
本文旨在讨论一种简短的一般症状困扰量表（GSDS）的心理计量学评估，该量表旨在评估特定症状及其相互之间的排名，与症状模式相关的整体症状困扰，并评估该症状模式的管理情况。
介绍了一项关于 GSDS 初步开发的试点研究结果，该研究纳入了 76 名住院患者，随后使用三批癌症患者（n=190）及其社交网络成员（在这些研究中称为合作伙伴，n=94）对 GSDS 进行了更全面的心理计量学评估。使用描述性统计来描述 GSDS 症状、症状困扰和症状管理。点二项式相关系数索引了二项症状和连续测量之间的关联，条件概率用于说明该样本的大量共病情况。使用 KR-20 系数检查内部一致性，并用测试-重测信度进行检查。还检查了构念效度和预测效度。
GSDS 表现出令人满意的内部一致性和测试-重测信度，以及良好的构念效度和预测效度。GSDS 的总分、症状困扰和症状管理与抑郁、积极和消极情绪以及一般健康的相关结构显著相关。GSDS 能够区分是否患有慢性疾病，并且能够显著预测抑郁等标准测量的得分。
总的来说，这些结果表明 GSDS 是一种快速评估可能影响健康相关生活质量的症状的简单而有用的工具。
