Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, USA.
Clin Orthop Relat Res. 2013 Dec;471(12):4037-44. doi: 10.1007/s11999-013-3213-2. Epub 2013 Aug 3.
The Pain Catastrophizing Scale (PCS) and Short Health Anxiety Inventory (SHAI) can help hand surgeons identify opportunities for psychologic support, but they are time consuming. If easier-to-use tools were available and valid, they might be widely adopted.
QUESTIONS/PURPOSES: We tested the validity of shorter versions of the PCS and SHAI, the PCS-4 and the SHAI-5, by assessing: (1) the difference in mean scaled scores of the short and long questionnaires; (2) floor and ceiling effects between the short and long questionnaires; (3) correlation between the short questionnaires and the outcome measures (an indication of construct validity); and (4) variability in disability and pain, between the short and long questionnaires.
One hundred sixty-four new or followup adult patients in one hand surgery clinic completed the SHAI-18, SHAI-5, PCS-13, PCS-4, Patient Health Questionnaire (PHQ)-9, PHQ-2, DASH, and QuickDASH questionnaires, and an ordinal pain scale, as part of a prospective cross-sectional study. Mean scores for the short and long questionnaires were compared with paired t-tests. Floor and ceiling effects were calculated. Pearson's correlation was used to assess the correlation between the short and long questionnaires and with outcome measures. Regression analyses were performed to find predictors of pain and disability.
There were small, but significant differences between the mean scores for the DASH and QuickDASH (QuickDASH higher), SHAI-18 and SHAI-5 (SHAI-18 higher), and PCS-13 and PCS-4 (PCS-4 higher), but not the PHQ-9 and PHQ-2. Floor effects ranged between 0% and 65% and ceiling effects between 0% and 3%. There were greater floor effects for the PHQ-2 than for the PHQ-9, but floor and ceiling effects were otherwise comparable for the other short and long questionnaires. All questionnaires showed convergent and divergent validity and criterion validity was shown in multivariable analyses.
Content validity, construct convergent validity, and criterion validity were established for the short versions of the PCS and SHAI. Using shorter forms creates small differences in mean values that we believe are unlikely to affect study results and are more efficient and advantageous because of the decreased responder burden.
疼痛灾难化量表（PCS）和简短健康焦虑量表（SHAI）可以帮助手外科医生识别获得心理支持的机会，但它们耗时较长。如果有更易于使用且有效的工具，它们可能会被广泛采用。
问题/目的：我们通过评估以下内容来测试 PCS 和 SHAI 的更简短版本（PCS-4 和 SHAI-5）的有效性：（1）短问卷和长问卷的平均标度得分之间的差异；（2）短问卷和长问卷之间的地板和天花板效应；（3）短问卷与结果测量之间的相关性（表明结构有效性）；（4）短问卷和长问卷之间残疾和疼痛的变异性。
在一家手外科诊所，164 名新患者或随访患者完成了 SHAI-18、SHAI-5、PCS-13、PCS-4、患者健康问卷（PHQ）-9、PHQ-2、DASH 和 QuickDASH 问卷，以及一个有序疼痛量表，作为一项前瞻性横断面研究的一部分。用配对 t 检验比较短问卷和长问卷的平均得分。计算地板和天花板效应。采用 Pearson 相关评估短问卷和长问卷与结果测量之间的相关性。进行回归分析以寻找疼痛和残疾的预测因子。
DASH 和 QuickDASH（QuickDASH 更高）、SHAI-18 和 SHAI-5（SHAI-18 更高）以及 PCS-13 和 PCS-4（PCS-4 更高）之间的平均得分存在较小但有统计学意义的差异，但 PHQ-9 和 PHQ-2 之间没有差异。地板效应范围为 0%至 65%，天花板效应范围为 0%至 3%。PHQ-2 的地板效应大于 PHQ-9，但其他短问卷和长问卷的地板和天花板效应则相当。所有问卷均显示出收敛和发散有效性，多变量分析显示出标准有效性。
PCS 和 SHAI 的简短版本具有内容有效性、结构收敛有效性和标准有效性。使用较短的形式会导致平均值的微小差异，我们认为这不太可能影响研究结果，并且由于应答者负担减少，因此效率更高，更有利。
