Gabel Charles Philip, Cuesta-Vargas Antonio I, Osborne Jason W, Burkett Brendan, Melloh Markus
Faculty of Science, Health and Education, Centre for Healthy Activities, Sport and Exercise, University of the Sunshine Coast, Sippy Downs Dve, Sippy Downs, Sunshine Coast Qld 4556 Australia.
Department of Psychiatry and Physiotherapy, Faculty of Medicine, Malaga University, SpainAvenida Estación de el Palo, Málaga, 29017 Spain.
Spine J. 2014 Aug 1;14(8):1410-6. doi: 10.1016/j.spinee.2013.08.026. Epub 2013 Nov 5.
The Neck Disability Index frequently is used to measure outcomes of the neck. The statistical rigor of the Neck Disability Index has been assessed with conflicting outcomes. To date, Confirmatory Factor Analysis of the Neck Disability Index has not been reported for a suitably large population study. Because the Neck Disability Index is not a condition-specific measure of neck function, initial Confirmatory Factor Analysis should consider problematic neck patients as a homogenous group.
We sought to analyze the factor structure of the Neck Disability Index through Confirmatory Factor Analysis in a symptomatic, homogeneous, neck population, with respect to pooled populations and gender subgroups.
This was a secondary analysis of pooled data.
A total of 1,278 symptomatic neck patients (67.5% female, median age 41 years), 803 nonspecific and 475 with whiplash-associated disorder.
The Neck Disability Index was used to measure outcomes.
We analyzed pooled baseline data from six independent studies of patients with neck problems who completed Neck Disability Index questionnaires at baseline. The Confirmatory Factor Analysis was considered in three scenarios: the full sample and separate sexes. Models were compared empirically for best fit.
Two-factor models have good psychometric properties across both the pooled and sex subgroups. However, according to these analyses, the one-factor solution is preferable from both a statistical perspective and parsimony. The two-factor model was close to significant for the male subgroup (p<.07) where questions separated into constructs of mental function (pain, reading headaches and concentration) and physical function (personal care, lifting, work, driving, sleep, and recreation).
The Neck Disability Index demonstrated a one-factor structure when analyzed by Confirmatory Factor Analysis in a pooled, homogenous sample of neck problem patients. However, a two-factor model did approach significance for male subjects where questions separated into constructs of mental and physical function. Further investigations in different conditions, subgroup and sex-specific populations are warranted.
颈部功能障碍指数常用于评估颈部疾病的治疗效果。对该指数的统计严谨性评估结果不一。迄今为止，尚未有针对足够大样本量人群的颈部功能障碍指数验证性因素分析报告。由于颈部功能障碍指数并非颈部功能的特定疾病测量指标，初始验证性因素分析应将有问题的颈部患者视为一个同质群体。
我们试图通过对有症状的同质颈部患者群体、汇总人群和性别亚组进行验证性因素分析，来剖析颈部功能障碍指数的因素结构。
这是对汇总数据的二次分析。
共有1278例有症状的颈部患者（女性占67.5%，中位年龄41岁），其中803例为非特异性颈部疾病，475例为挥鞭样损伤相关疾病。
采用颈部功能障碍指数评估治疗效果。
我们分析了六项独立研究的汇总基线数据，这些研究中的颈部问题患者在基线时完成了颈部功能障碍指数问卷。验证性因素分析考虑了三种情况：全样本和按性别分组。通过实证比较模型以确定最佳拟合模型。
两因素模型在汇总人群和性别亚组中均具有良好的心理测量学特性。然而，根据这些分析，从统计学角度和简约性来看，单因素解决方案更为可取。两因素模型在男性亚组中接近显著水平（p<0.07），其中问题分为心理功能（疼痛、阅读性头痛和注意力集中）和身体功能（个人护理、提举、工作、驾驶、睡眠和娱乐）两个结构。
在汇总的同质颈部问题患者样本中进行验证性因素分析时，颈部功能障碍指数呈现单因素结构。然而，两因素模型在男性受试者中接近显著水平，其中问题分为心理和身体功能两个结构。有必要在不同病情、亚组和特定性别人群中进一步开展研究。
