Center for Applied Health Research on Aging (CAHRA), Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Division of General Internal Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Med Decis Making. 2024 Nov;44(8):914-926. doi: 10.1177/0272989X241275676. Epub 2024 Sep 12.
Context-specific measures with adequate external validity are needed to appropriately determine psychosocial effects related to screening for cognitive impairment.
Two-hundred adults aged ≥65 y recently completing routine, standardized cognitive screening as part of their Medicare annual wellness visit were administered an adapted version of the Psychological Consequences of Screening Questionnaire (PCQ), composed of negative (PCQ-Neg) and positive (PCQ-Pos) scales. Measure distribution, acceptability, internal consistency, factor structure, and external validity (construct, discriminative, criterion) were analyzed.
Participants had a mean age of 73.3 y and were primarily female and socioeconomically advantaged. Most had a normal cognitive screening result (99.5%, = 199). Overall PCQ scores were low (PCQ-Neg: = 1.27, possible range 0-36; PCQ-Pos: = 7.63, possible range 0-30). Both scales demonstrated floor effects. Acceptability was satisfactory, although the PCQ-Pos had slightly more item missingness. Both scales had Cronbach alphas >0.80 and a single-factor structure. Spearman correlations between the PCQ-Neg with general measures of psychological distress (Impacts of Events Scale-Revised, Perceived Stress Scale, Kessler Distress Scale) ranged from 0.26 to 0.37 ('s < 0.001); the correlation with the World Health Organization-Five Well-Being Index was -0.19 ( < 0.01). The PCQ-Neg discriminated between those with and without a self-reported subjective cognitive complaint ( = 2.73 v. 0.89, < 0.001) and was associated with medical visit satisfaction ( = -0.24, < 0.001) on the Patient Satisfaction Questionnaire. The PCQ-Pos predicted self-reported willingness to engage in future screening ( = 8.00 v. 3.00, = 0.03).
The adapted PCQ-Neg is an overall valid measure of negative psychological consequences of cognitive screening; findings for the PCQ-Pos were more variable. Future studies should address measure performance among diverse samples and those with abnormal screening results.
The PCQ scale is an overall valid measure of psychological dysfunction related to cognitive screening in older adults receiving normal screen results.PCQ scale performance should be further validated in diverse populations and those with abnormal cognitive screening results.The adapted PCQ may be useful to both health research and policy stakeholders seeking improved assessment of psychological impacts of cognitive screening.
需要具有充分外部有效性的特定情境下的措施来适当确定与认知障碍筛查相关的心理社会影响。
最近完成常规标准化认知筛查的 200 名≥65 岁成年人作为其医疗保险年度健康检查的一部分，接受了改编后的心理后果筛查问卷（PCQ）的测试，该问卷由负面（PCQ-Neg）和正面（PCQ-Pos）量表组成。分析了量表的分布、可接受性、内部一致性、因子结构和外部有效性（结构、判别、标准）。
参与者的平均年龄为 73.3 岁，主要是女性，社会经济地位较高。大多数人的认知筛查结果正常（99.5%，200 人）。总体 PCQ 得分较低（PCQ-Neg：=1.27，可能范围为 0-36；PCQ-Pos：=7.63，可能范围为 0-30）。两个量表都有地板效应。可接受性是令人满意的，尽管 PCQ-Pos 有稍微更多的项目缺失。两个量表的克朗巴赫阿尔法系数均大于 0.80，具有单因素结构。PCQ-Neg 与一般心理困扰量表（修订后的事件影响量表、感知压力量表、凯斯勒痛苦量表）之间的 Spearman 相关系数范围为 0.26 至 0.37（<0.001）；与世界卫生组织-五个幸福指数的相关性为-0.19（<0.01）。PCQ-Neg 可以区分有和没有自我报告的主观认知抱怨的人群（=2.73 v. 0.89，<0.001），并且与患者满意度问卷中的医疗就诊满意度相关（=−0.24，<0.001）。PCQ-Pos 预测了自我报告愿意参与未来的筛查（=8.00 v. 3.00，=0.03）。
改编后的 PCQ-Neg 是一种有效的认知筛查负面心理后果的衡量标准；PCQ-Pos 的结果则更加多变。未来的研究应该在不同的样本和那些认知筛查结果异常的人群中进一步验证该量表的表现。
PCQ 量表是评估接受正常筛查结果的老年人群认知筛查相关心理功能障碍的一种整体有效的衡量标准。PCQ 量表在不同人群和认知筛查结果异常的人群中的表现应进一步验证。改编后的 PCQ 可能对寻求改善认知筛查心理影响评估的健康研究和政策利益相关者都有用。
