Terluin Berend, Smits Niels, Miedema Baukje
Department of General Practice and Elderly Care Medicine & EMGO Institute for Health and Care Research, VU University Medical Centre , Amsterdam , the Netherlands.
Eur J Gen Pract. 2014 Dec;20(4):320-6. doi: 10.3109/13814788.2014.905826. Epub 2014 Apr 29.
Translations of questionnaires need to be carefully validated to assure that the translation measures the same construct(s) as the original questionnaire. The four-dimensional symptom questionnaire (4DSQ) is a Dutch self-report questionnaire measuring distress, depression, anxiety and somatization.
To evaluate the equivalence of the English version of the 4DSQ.
4DSQ data of English and Dutch speaking general practice attendees were analysed and compared. The English speaking group consisted of 205 attendees, aged 18-64 years, in general practice, in Canada whereas the Dutch group consisted of 302 general practice attendees in the Netherlands. Differential item functioning (DIF) analysis was conducted using the Mantel-Haenszel method and ordinal logistic regression. Differential test functioning (DTF; i.e., the scale impact of DIF) was evaluated using linear regression analysis.
DIF was detected in 2/16 distress items, 2/6 depression items, 2/12 anxiety items, and 1/16 somatization items. With respect to mean scale scores, the impact of DIF on the scale level was negligible for all scales. On the anxiety scale DIF caused the English speaking patients with moderate to severe anxiety to score about one point lower than Dutch patients with the same anxiety level.
The English 4DSQ measures the same constructs like the original Dutch 4DSQ. The distress, depression and somatization scales can employ the same cut-off points as the corresponding Dutch scales. However, cut-off points of the English 4DSQ anxiety scale should be lowered by one point to retain the same meaning as the Dutch anxiety cut-off points.
问卷的翻译需要经过仔细验证，以确保翻译后的问卷与原始问卷测量的是相同的结构。四维症状问卷（4DSQ）是一份荷兰语的自我报告问卷，用于测量痛苦、抑郁、焦虑和躯体化症状。
评估4DSQ英文版的等效性。
对说英语和说荷兰语的全科医疗就诊者的4DSQ数据进行分析和比较。说英语的组由加拿大205名年龄在18 - 64岁的全科医疗就诊者组成，而荷兰组由荷兰302名全科医疗就诊者组成。使用Mantel - Haenszel方法和有序逻辑回归进行差异项目功能（DIF）分析。使用线性回归分析评估差异测试功能（DTF，即DIF对量表的影响）。
在16项痛苦症状条目中有2项、6项抑郁症状条目中有2项、12项焦虑症状条目中有2项以及16项躯体化症状条目中有1项检测到DIF。就平均量表得分而言，DIF对所有量表在量表水平上的影响可忽略不计。在焦虑量表上，DIF导致中度至重度焦虑的说英语患者比具有相同焦虑水平的荷兰患者得分低约1分。
英文版4DSQ与原始荷兰版4DSQ测量的是相同的结构。痛苦、抑郁和躯体化量表可以采用与相应荷兰量表相同的截断点。然而，英文版4DSQ焦虑量表的截断点应降低1分，以保持与荷兰焦虑截断点相同的含义。
