荷兰语版手臂、肩部和手部功能障碍问卷（DASH-DLV）在成人手和腕部损伤患者中的结构效度。
Structural validity of the Dutch version of the disability of arm, shoulder and hand questionnaire (DASH-DLV) in adult patients with hand and wrist injuries.
作者信息
van Eck M E, Lameijer C M, El Moumni M
机构信息
University of Groningen, University Medical Center Groningen, Department of Surgery, Groningen, The Netherlands.
出版信息
BMC Musculoskelet Disord. 2018 Jun 30;19(1):207. doi: 10.1186/s12891-018-2114-7.
BACKGROUND
Fractures of the hand and wrist are one of the most common injuries seen in adults. The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire has been developed as a patient-reported assessment of pain and disability to evaluate the outcome after hand and wrist injuries. Patient reported outcomes (PROs) can be interpreted as pain, function or patient satisfaction. To be able to interpret clinical relevance of a PRO, the structural validity and internal consistency is tested. The Dutch version of the DASH has not yet been validated. The aim of this study was to evaluate the structural validity and the internal consistency of the existing Dutch version of the DASH. The relevance of reporting subscale scores was investigated.
METHODS
This study was a retrospective analysis of cross-sectional data of 370 patients with an isolated hand or wrist injury. Adult patients aged 18 to 65 years treated conservatively or surgically were included. Patients unable to understand or read the Dutch language were excluded. Confirmatory factor analysis was used to investigate the structural validity, while Cronbach's alpha and coefficient omega were used to assess internal consistency.
RESULTS
All investigated models (a single factor model, a 3-correlated factor, and a bifactor model) were associated with a good model fit. Both the single factor and the 3-correlated factor model were associated with factor loadings of at least 0.70. In addition, the covariance between the factors in the 3-correlated factor model was positive (at least 0.89) and statistically significant (p < 0.001). In the bifactor model, the additional value of subscales was limited as the items loaded high on the general factor but low on the subscale factors.
CONCLUSION
This study indicates that the Dutch version of the DASH should be considered as an unidimensional trait. A single score should be reported.
背景
手部和腕部骨折是成人中最常见的损伤之一。手臂、肩部和手部功能障碍（DASH）问卷已被开发出来，作为一种患者报告的疼痛和功能障碍评估工具，用于评估手部和腕部损伤后的结果。患者报告结局（PROs）可理解为疼痛、功能或患者满意度。为了能够解释PRO的临床相关性，需测试其结构效度和内部一致性。DASH的荷兰语版本尚未经过验证。本研究的目的是评估现有DASH荷兰语版本的结构效度和内部一致性。研究了报告子量表分数的相关性。
方法
本研究是对370例孤立性手部或腕部损伤患者的横断面数据进行的回顾性分析。纳入年龄在18至65岁之间接受保守或手术治疗的成年患者。排除无法理解或阅读荷兰语 的患者。采用验证性因素分析来研究结构效度，同时使用Cronbach's alpha和omega系数来评估内部一致性。
结果
所有研究模型（单因素模型、三相关因素模型和双因素模型）均具有良好的模型拟合度。单因素模型和三相关因素模型的因素载荷均至少为0.70。此外，三相关因素模型中各因素之间的协方差为正（至少0.89）且具有统计学意义（p < 0.001）。在双因素模型中，子量表的附加价值有限，因为各项目在一般因素上载荷较高，但在子量表因素上载荷较低。
结论
本研究表明，DASH的荷兰语版本应被视为一个单维特质。应报告单一分数。
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