采用项目反应理论对积极心理健康（PMH）量表进行心理计量学评估。
Psychometric evaluation of the Positive Mental Health (PMH) scale using item response theory.
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
BMC Psychiatry. 2022 Jul 28;22(1):512. doi: 10.1186/s12888-022-04162-0.
BACKGROUND
The investigation of patient-reported outcomes and psycho-oncological interventions mainly focuses on psychological distress or psychopathology. However, the recognition of the equal importance of positive mental health (PMH) has increased lately. The PMH-scale is a brief questionnaire allowing to assess well-being in individuals in the general population and in patients. Previous studies evaluated the psychometric properties of the PMH-scale using classical test theory (CTT). This study is the first to investigate the PMH-scale in patients with cancer using item analysis according to the Rasch model.
METHODS
In total, N = 357 cancer patients participated in the study. A Rasch analysis of the PMH-scale was conducted including testing of unidimensionality, local independence, homogeneity and differential item functioning (DIF) with regard to age, gender, type of cancer, the presence of metastases, psycho-oncological support, and duration of disease. Additionally, the ordering of the item thresholds as well as the targeting of the scale were investigated.
RESULTS
After excluding one misfitting item and accounting for local dependence by forming superitems, a satisfactory overall fit to the Rasch model was established (χ = 30.34, p = 0.21). The new PMH-8 scale proved to be unidimensional, and homogeneity of the scale could be inferred. All items showed ordered thresholds, there was no further item misfit. DIF was found for age, but as the impact of DIF was not substantial, no adjustment related to the age-DIF had to be made. The Person Separation Index (PSI = 0.89) was excellent, indicating excellent discriminatory power between different levels of positive mental health. Overall, the targeting of the PMH-8 was good for the majority of the present sample. However, at both ends of the scale item thresholds are missing as indicated by a slight floor effect (1.4%) and a considerable ceiling effect (9.8%).
CONCLUSIONS
Overall, the results of the analysis according to the Rasch model support the use of the revised PMH-scale in a psycho-oncological context.
背景
患者报告的结果和心理肿瘤学干预的研究主要集中在心理困扰或精神病理学上。然而，最近人们越来越认识到积极心理健康（PMH）同样重要。PMH 量表是一种简短的问卷，可用于评估普通人群和患者的幸福感。以前的研究使用经典测试理论（CTT）评估 PMH 量表的心理测量特性。这项研究是第一个使用 Rasch 模型的项目分析来研究癌症患者的 PMH 量表。
方法
共有 357 名癌症患者参与了这项研究。对 PMH 量表进行了 Rasch 分析，包括测试单维性、局部独立性、同质性和与年龄、性别、癌症类型、转移存在、心理肿瘤学支持以及疾病持续时间有关的差异项目功能（DIF）。此外，还研究了项目阈值的排序和量表的目标。
结果
在排除一个拟合不良的项目并通过形成超级项目来考虑局部依赖后，与 Rasch 模型的总体拟合情况令人满意（χ²=30.34，p=0.21）。新的 PMH-8 量表被证明是单维的，并且可以推断出量表的同质性。所有项目都显示出有序的阈值，没有进一步的项目不匹配。发现了年龄的 DIF，但由于 DIF 的影响不大，因此无需针对年龄-DIF 进行调整。个体分离指数（PSI=0.89）为优秀，表明在不同的积极心理健康水平之间具有出色的区分能力。总体而言，PMH-8 的目标针对大多数当前样本来说是良好的。但是，在量表的两端，由于轻微的地板效应（1.4%）和相当大的天花板效应（9.8%），项目阈值缺失。
结论
总体而言，根据 Rasch 模型的分析结果支持在心理肿瘤学背景下使用修订后的 PMH 量表。
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