中国综合医院患者心身症状量表（PSSS）的编制及其信效度评估
Development of the psychosomatic symptom scale (PSSS) and assessment of its reliability and validity in general hospital patients in China.
作者信息
Li Lei, Peng Tianci, Liu Rui, Jiang Ronghuan, Liang Dongfeng, Li Xiangping, Ni Aihua, Ma Huan, Wei Xianwen, Liu Hanxiang, Zhang Jing, Li Hengfen, Pang Jianyue, Ji Yunxin, Zhang Li, Cao Yin, Chen Yun, Zhou Bo, Wang Jinny, Mao Xueqin, Yang Lejin, Fang Jianqun, Shi Honglan, Wu Aiqin, Yuan Yonggui
机构信息
Department of Psychosomatics and Psychiatry, Affiliated ZhongDa Hospital of Southeast University, Medical School of Southeast University, Nanjing, China; Department of Clinical Psychology, The Forth People's Hospital of Lianyungang, Lianyungang, China.
School of Information Science and Engineering, Southeast University, Nanjing, China.
出版信息
Gen Hosp Psychiatry. 2020 May-Jun;64:1-8. doi: 10.1016/j.genhosppsych.2020.01.008. Epub 2020 Feb 1.
OBJECTIVES
To develop and verify the Psychosomatic Symptom Scale (PSSS) among psychosomatic patients and the cut-off value of PSSS in distinguishing psychosomatic patients from health controls.
METHODS
The PSSS was drafted by an expert workgroup. 996 patients and 366 controls from 14 general hospitals in China were recruited to complete PSSS, Patient Health Questionnaire-15 (PHQ-15) and Symptom Checklist-90 (SCL-90). Student's t-test, Kruskal-Wallis test, Cronbach's α, Spearman's correlation, and confirmatory factor analysis (CFA) were used to verify the PSSS. Receiver operating characteristic (ROC) analyses were used to determine the cut-off value.
RESULTS
Cronbach α of PSSS was 0.907. The PSSS was significantly correlated with SCL-90 somatization subscale (r = 0.682, P < 0.001) and PHQ-15 (r = 0.724, P < 0.001). CFA supported the theoretical two-factor structure of the PSSS, with comparative fit index (CFI) = 0.979, Tucker-Lewis index (TLI) = 0.977, root mean square error of approximation (RMSEA) = 0.039 (90% CI: 0.035-0.042), and standardized root mean residual (SRMR) = 0.054. As the sum score of PSSS was significantly higher in female, cut-off values were determined as 11 in females and 10 in males respectively.
CONCLUSIONS
The PSSS is a reliable and valid instrument for measuring psychosomatic symptoms.
目的
编制并验证心身疾病患者的心身症状量表（PSSS），以及PSSS区分心身疾病患者与健康对照的临界值。
方法
PSSS由一个专家工作组起草。招募了来自中国14家综合医院的996例患者和366例对照，完成PSSS、患者健康问卷-15（PHQ-15）和症状自评量表90（SCL-90）。采用学生t检验、Kruskal-Wallis检验、Cronbach's α、Spearman相关性分析和验证性因素分析（CFA）来验证PSSS。采用受试者工作特征（ROC）分析来确定临界值。
结果
PSSS的Cronbach α为0.907。PSSS与SCL-90躯体化因子（r = 0.682，P < 0.001）和PHQ-15（r = 0.724，P < 0.001）显著相关。CFA支持PSSS的理论两因素结构，比较拟合指数（CFI）= 0.979，塔克-刘易斯指数（TLI）= 0.977，近似均方根误差（RMSEA）= 0.039（90%CI：0.035 - 0.042），标准化均方根残差（SRMR）= 0.054。由于女性的PSSS总分显著更高，因此分别确定女性的临界值为11，男性为10。
结论
PSSS是一种测量心身症状的可靠且有效的工具。
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