养老院中痴呆症特异性生活质量工具 QUALIDEM 的德语版本的可扩展性和内部一致性 - 二次数据分析。
Scalability and internal consistency of the German version of the dementia-specific quality of life instrument QUALIDEM in nursing homes - a secondary data analysis.
机构信息
German Center for Neurodegenerative Diseases DZNE, Stockumer Straße 12, 58453 Witten, Germany.
出版信息
Health Qual Life Outcomes. 2013 Jun 5;11:91. doi: 10.1186/1477-7525-11-91.
BACKGROUND
Quality of life (Qol) is a widely selected outcome in intervention studies. The QUALIDEM is a dementia-specific Qol-instrument from The Netherlands. The aim of this study is to evaluate the scalability and internal consistency of the German version of the QUALIDEM.
METHODS
This secondary data analysis is based on a total sample of 634 residents with dementia from 43 nursing homes. The QUALIDEM consists of nine subscales that were applied to a subsample of 378 people with mild to severe dementia and six consecutive subscales that were applied to a subsample of 256 people with very severe dementia. Scalability, internal consistency and distribution scores were calculated for each predefined subscale using the Mokken scale analysis.
RESULTS
In people with mild to severe dementia, seven subscales, care relationship, positive affect, negative affect, restless tense behavior, positive self-image, social relations and feeling at home, were scalable (0.31 ≤ H ≤ 0.65) and internally consistent (Rho ≥ 0.62). The subscales social isolation (H = 0.28) and having something to do (H = 0.18) were not scalable and exhibited insufficient reliability scores (Rho ≤ 0.53). For people with very severe dementia, five subscales, care relationship, positive affect, restless tense behavior, negative affect and social relations, were scalable (0.33 ≤ H ≤ 0.65), but only the first three of these subscales showed acceptable internal consistency (Rho 0.59 - 0.86). The subscale social isolation was not scalable (H = 0.20) and exhibited poor internal consistency (Rho = 0.42).
CONCLUSIONS
The results show an acceptable scalability and internal consistency for seven QUALIDEM subscales for people with mild to severe dementia and three subscales for people with very severe dementia. The subscales having something to do (mild to severe dementia), negative affect (very severe dementia), social relations (very severe dementia) and social isolation (both versions) produced unsatisfactory results and require revision.
背景
生活质量（Qol）是干预研究中广泛选择的结果。QUALIDEM 是荷兰专门针对痴呆症的生活质量工具。本研究的目的是评估 QUALIDEM 德语版本的可扩展性和内部一致性。
方法
本二次数据分析基于来自 43 家养老院的 634 名痴呆症患者的总样本。QUALIDEM 由九个分量表组成，适用于轻度至重度痴呆症患者的 378 人样本和六个连续分量表，适用于重度痴呆症患者的 256 人样本。使用 Mokken 量表分析为每个预定义的分量表计算可扩展性、内部一致性和分布得分。
结果
在轻度至重度痴呆症患者中，七个分量表（护理关系、积极影响、消极影响、不安紧张行为、积极自我形象、社会关系和在家感觉）具有可扩展性（0.31≤H≤0.65）和内部一致性（Rho≥0.62）。社会隔离（H=0.28）和有事情做（H=0.18）两个分量表不可扩展，可靠性得分不足（Rho≤0.53）。对于重度痴呆症患者，五个分量表（护理关系、积极影响、不安紧张行为、消极影响和社会关系）具有可扩展性（0.33≤H≤0.65），但只有前三个分量表具有可接受的内部一致性（Rho 0.59-0.86）。社会隔离分量表不可扩展（H=0.20），内部一致性差（Rho=0.42）。
结论
结果表明，轻度至重度痴呆症患者的七个 QUALIDEM 分量表和重度痴呆症患者的三个分量表具有可接受的可扩展性和内部一致性。有事情做（轻度至重度痴呆症）、消极影响（重度痴呆症）、社会关系（重度痴呆症）和社会隔离（两个版本）分量表的结果不尽如人意，需要修订。
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