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采用 RASCH 模型对德国 12 项世界卫生组织残疾评定量表(WHODAS 2.0)进行项目分析。

An item analysis according to the Rasch model of the German 12-item WHO Disability Assessment Schedule (WHODAS 2.0).

机构信息

Department of Clinical Psychology and Psychotherapy, Faculty of Human Sciences, University of Cologne, Pohligstr. 1, 50969, Cologne, Germany.

Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen, Aachen, Germany.

出版信息

Qual Life Res. 2021 Oct;30(10):2929-2938. doi: 10.1007/s11136-021-02872-8. Epub 2021 May 20.

Abstract

PURPOSE

The World Health Organization Disability Assessent Schedule 2.0 (WHODAS 2.0) assesses disability in individuals irrespective of their health condition. Previous studies validated the usefulness of the WHODAS 2.0 using classical test theory. This study is the first investigating the psychometric properties of the 12-items WHODAS 2.0 in patients with cancer using item analysis according to the Rasch model.

METHODS

In total, 350 cancer patients participated in the study. Rasch analysis of the 12-items version of the WHODAS 2.0 was conducted and included testing unidimensionality, local independence, and testing for differential item functioning (DIF) with regard to age, gender, type of cancer, presence of metastases, psycho-oncological support, and duration of disease.

RESULTS

After accounting for local dependence, which was mainly found across items of the same WHODAS domain, satisfactory overall fit to the Rasch model was established (χ = 36.14, p = 0.07) with good reliability (PSI = 0.82) and unidimensionality of the scale. DIF was found for gender (testlet 'Life activities') and age (testlet 'Getting around/Self-care'), but the size of DIF was not substantial.

CONCLUSION

Overall, the analysis results according to the Rasch model support the use of the WHODAS 2.0 12-item version as a measure of disability in cancer patients.

摘要

目的

世界卫生组织残疾评估表 2.0(WHODAS 2.0)评估了个体的残疾情况,无论其健康状况如何。先前的研究使用经典测试理论验证了 WHODAS 2.0 的有用性。本研究首次根据 Rasch 模型使用项目分析对癌症患者进行了 12 项 WHODAS 2.0 的心理测量特性研究。

方法

共有 350 名癌症患者参与了这项研究。对 WHODAS 2.0 的 12 项版本进行了 Rasch 分析,包括测试单维性、局部独立性以及测试年龄、性别、癌症类型、转移存在、心理肿瘤学支持和疾病持续时间方面的差异项目功能(DIF)。

结果

在考虑到局部依赖性后,主要在同一 WHODAS 域的项目之间发现了局部依赖性,对 Rasch 模型的总体拟合情况良好(χ=36.14,p=0.07),具有良好的可靠性(PSI=0.82)和量表的单维性。发现了性别(测试单元“生活活动”)和年龄(测试单元“四处走动/自我护理”)的 DIF,但 DIF 的大小并不显著。

结论

总体而言,根据 Rasch 模型的分析结果支持使用 WHODAS 2.0 12 项版本作为癌症患者残疾的衡量标准。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4731/8481170/bdcaedf6f65e/11136_2021_2872_Fig1_HTML.jpg

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