Arcuri Giovanni G, Palladini Lisa, Dumas Gabrielle, Lemoignan Josée, Gagnon Bruno
Division of Clinical Epidemiology, Royal Victoria Hospital, McGill University Health Centre, 687 Pine Avenue West, Ross Pavilion 4.29, Montréal, Québec, H3A 1A1, Canada,
Support Care Cancer. 2015 Sep;23(9):2779-87. doi: 10.1007/s00520-015-2643-7. Epub 2015 Feb 14.
Cancer and cancer-related treatments are associated with a constellation of physical and psychological changes. Treatments associated with noncentral nervous system neoplasms can have short- and long-term effects on cognition, affecting quality of life in people with cancer. Clinical measurement tools specific to cancer-related mild cognitive impairment (MCI) are lacking. The Montreal Cognitive Assessment (MoCA) has been validated in a geriatric population and used in studies assessing MCI in persons with cancer, but no studies have yet shown its psychometric properties when used with this population.
The purpose of this study is to explore the psychometric properties of the MoCA within a population of persons with noncentral nervous system cancer.
A total of 74 participants were included from persons attending a Cancer Nutrition-Rehabilitation Program at the McGill University Health Centre. Rasch analyses were conducted.
The MoCA data fit all the properties of the Rasch model with a person separation index of 1.04 and person reliability of 0.52. The MoCA items were found to measure a unidimensional construct and spanned 6.57 logits, with item difficulty levels between 2.49 and -4.08 logits. However, the MoCA presented a lack of items of higher difficulty, as person cognitive ability levels ranged from -0.51 to 5.17 logits.
Within the limits of a small sample size, the results of this exploratory study suggest the possibility that the MoCA, when used within a population of persons with cancer, may meet criteria for unidimensionality and adequate item fit but may present weaknesses when used with participants of higher cognitive abilities.
癌症及与癌症相关的治疗会引发一系列生理和心理变化。与非中枢神经系统肿瘤相关的治疗会对认知产生短期和长期影响，进而影响癌症患者的生活质量。目前缺乏针对癌症相关轻度认知障碍（MCI）的临床测量工具。蒙特利尔认知评估量表（MoCA）已在老年人群中得到验证，并用于评估癌症患者的MCI，但尚无研究表明其在该人群中使用时的心理测量特性。
本研究旨在探讨MoCA在非中枢神经系统癌症患者群体中的心理测量特性。
从麦吉尔大学健康中心参加癌症营养康复项目的人员中纳入了74名参与者。进行了拉施分析。
MoCA数据符合拉施模型的所有特性，人员分离指数为1.04，人员信度为0.52。发现MoCA项目测量的是一个单维结构，跨度为6.57对数单位，项目难度水平在2.49至 -4.08对数单位之间。然而，MoCA缺乏更高难度的项目，因为人员认知能力水平范围为 -0.51至5.17对数单位。
在小样本规模的限制范围内，这项探索性研究的结果表明，MoCA在癌症患者群体中使用时，可能符合单维性和适当项目拟合的标准，但在用于认知能力较高的参与者时可能存在弱点。
