Beijing University of Chinese Medicine, Beijing 100029, China.
J Tradit Chin Med. 2012 Jun;32(2):129-36. doi: 10.1016/s0254-6272(13)60001-1.
Sub-optimal health status (SHS), in which a person's mind and body exists in a low-quality state of being between disease and health, has become a public health problem that cannot be ignored in China. SHS measurement presents a challenge to the academic fields. We developed and evaluated a questionnaire from the perspective of traditional Chinese medicine (TCM) that embodies the features of TCM syndrome diagnosis for measuring SHS in China.
The construction of the theoretical framework of the questionnaire was based on a literature review, an expert questionnaire survey and group interviews. The subscales and questionnaire items were screened through a pilot study using statistical means and qualitative analysis. Reliability tests that were used included test-retest reliability, Cronbach's a coefficient, split-half reliability; validity tests included content validity, criterion validity, discrimination validity and construct validity.
The final questionnaire, the SHSQ-50, included 50 five-class quantifiable items that encompassed nine subscales: liver stagnation syndrome, liver-Qi deficiency syndrome, spleen-Qi deficiency syndrome, liver-fire syndrome, heart-fire syndrome, stomach-fire syndrome, heart-Qi deficiency syndrome, lung-Qi deficiency syndrome and dampness syndrome. Questionnaires were completed by 268 of the 288 SHS subjects (93.0%) and by 86 of the 94 healthy subjects (91.5%). The Cronbach a coefficients, split-half coefficients and stability coefficients ranged from 0.70 to 0.95, 0.67 to 0.87 and 0.88 to 0.98, respectively, for the overall scores and subscales. The Wilcoxon rank test showed statistically significant differences in the subscales and overall scores between the SHS group and the healthy group (P < 0.01). Twelve factors with an eigenvalue greater than one were extracted by factor analysis and merged into nine factors, for which the cumulative contribution rate was 63.63%. The nine factors were corresponded to the overall structure of the questionnaire.
The SHSQ-50 is a reliable and valid instrument for measuring TCM syndrome diagnosis of SHS in China.
亚健康状态（SHS）是指一个人的身心处于疾病和健康之间的低质量状态，这种状态已经成为中国不容忽视的公共卫生问题。SHS 的测量对学术领域提出了挑战。我们从中医（TCM）的角度开发并评估了一个体现 TCM 证候诊断特征的问卷，用于测量中国的 SHS。
问卷的理论框架构建基于文献回顾、专家问卷调查和小组访谈。通过使用统计方法和定性分析的试点研究对亚量表和问卷条目进行筛选。可靠性测试包括重测信度、克朗巴赫α系数、半分信度；有效性测试包括内容有效性、标准有效性、判别有效性和结构有效性。
最终的问卷，即 SHSQ-50，包括 50 个五级可量化项目，涵盖九个亚量表：肝郁证、肝气虚证、脾气虚证、肝火证、心火证、胃火证、心气虚证、肺气虚证和湿证。288 名 SHS 受试者中有 268 名（93.0%）和 94 名健康受试者中有 86 名（91.5%）完成了问卷。总体评分和亚量表的克朗巴赫α系数、半分系数和稳定性系数范围分别为 0.70 至 0.95、0.67 至 0.87 和 0.88 至 0.98。Wilcoxon 秩检验显示 SHS 组和健康组在亚量表和总分上有统计学差异（P < 0.01）。因子分析提取出 12 个特征值大于 1 的因子，并合并为 9 个因子，累积贡献率为 63.63%。这 9 个因子与问卷的总体结构相对应。
SHSQ-50 是一种可靠有效的测量中国 TCM 证候诊断 SHS 的工具。
