帮助联盟问卷的德文版：在持续性抑郁障碍患者中的心理测量特性。
The German version of the helping alliance questionnaire: psychometric properties in patients with persistent depressive disorder.
机构信息
Central Institute of Mental Health, Department of Clinical Psychology, Medical Faculty Mannheim/Heidelberg University, J5, 68159 Mannheim, Heidelberg, Germany.
Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg-Eppendorf, Hamburg, Germany.
出版信息
BMC Psychiatry. 2018 Apr 23;18(1):107. doi: 10.1186/s12888-018-1697-8.
BACKGROUND
The Helping Alliance Questionnaire (HAQ) is a frequently used and highly relevant instrument to assess the therapeutic alliance. The questionnaire was translated into German by Bassler and colleagues (1995) and is available for patients (HAQ-P) and therapists (HAQ-T). Whereas the HAQ-P has been tested regarding psychometrics, the HAQ-T has not. This study aimed at further investigating the psychometric properties of both the HAQ-P and HAQ-T. We hypothesized that the instrument is reliable and shows factorial as well as convergent validity.
METHODS
Within the framework of a multisite, randomized-controlled clinical trial, comparing the efficacy of Cognitive Behavioral Analyses System of Psychotherapy (CBASP) and supportive psychotherapy (SP) in the treatment of early onset persistently depressed outpatients, the HAQ was filled out by patients (n = 255) and therapists (n = 81). 66.0% of patients were female; average age at randomization was 44.9 years (SD = 11.8). Several confirmatory factor analyses were conducted to test different structures for the HAQ. In addition, correlations between the HAQ and the Inventory of Interpersonal Problems (IIP) were calculated to test for convergent validity.
RESULTS
Goodness of fit indices for both a model with two different but strongly related factors named 'relation to the patient/ therapist ' and 'satisfaction with therapeutic outcome' and a second model with only one global helping alliance factor were comparable: Chi-Square-based indices rejected the models; RMSEA closely approached the threshold of good model fit, and CFI/ TLI and SRMR suggested that both models sufficiently fit the data. The internal consistency (Cronbach's α) calculated for the different scales of the HAQ ranges between questionable to good. Finally, the HAQ scores were significantly related to some of the IIP scores.
CONCLUSIONS
The German versions of the HAQ offer sufficient reliable instruments for the quick assessment of different facets of the therapeutic alliance. The HAQ global scores can be used as indicators for the global impression of the patients and therapists perception of the quality of the therapeutic alliance. However, the small correlations found between the IIP and the HAQ puts the question of external validity into perspective.
TRIAL REGISTRATION
This study analysed data from a RCT which was registered on ClinicalTrials.com ( NCT00970437 ). First submitted on September 1, 2009.
背景
《帮助联盟问卷》（HAQ）是一种常用于评估治疗联盟的高度相关的工具。该问卷由 Bassler 及其同事于 1995 年翻译成德文，有患者版（HAQ-P）和治疗师版（HAQ-T）。HAQ-P 已经在心理测量学方面进行了测试，而 HAQ-T 则没有。本研究旨在进一步研究 HAQ-P 和 HAQ-T 的心理测量特性。我们假设该工具是可靠的，并且具有因子和收敛效度。
方法
在一项比较认知行为分析系统心理治疗（CBASP）和支持性心理治疗（SP）治疗早期持续抑郁门诊患者疗效的多站点、随机对照临床试验中，由患者（n=255）和治疗师（n=81）填写 HAQ。患者中 66.0%为女性；随机分组时的平均年龄为 44.9 岁（SD=11.8）。进行了几次验证性因子分析，以测试 HAQ 的不同结构。此外，还计算了 HAQ 与人际关系问题量表（IIP）之间的相关性，以测试收敛效度。
结果
两个不同但密切相关的因素，即“与患者/治疗师的关系”和“对治疗结果的满意度”的模型以及仅具有一个总体帮助联盟因素的第二个模型的拟合优度指数都相当：基于卡方的指数拒绝了这些模型；RMSEA 接近良好模型拟合的阈值，CFI/TLI 和 SRMR 表明这两个模型都充分适用于数据。HAQ 不同量表的内部一致性（Cronbach's α）在可疑到良好之间。最后，HAQ 评分与一些 IIP 评分显著相关。
结论
HAQ 的德文版本提供了足够可靠的工具，可快速评估治疗联盟的不同方面。HAQ 总分可作为患者和治疗师对治疗联盟质量感知的总体印象的指标。然而，HAQ 和 IIP 之间发现的小相关性使外部有效性的问题受到关注。
试验注册
本研究分析了一项 RCT 的数据，该 RCT 已在 ClinicalTrials.com 上注册（NCT00970437）。于 2009 年 9 月 1 日首次提交。
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