Leon A C, Olfson M, Portera L, Farber L, Sheehan D V
Cornell University Medical College, Department of Psychiatry, New York, NY 10021, USA.
Int J Psychiatry Med. 1997;27(2):93-105. doi: 10.2190/T8EM-C8YH-373N-1UWD.
Several recent studies have documented that substantial functional impairment is associated with many of the mental disorders seen in primary care. However, brief measures of mental health-related functional impairment are not commonly applied in primary care settings. The Sheehan Disability Scale (SDS), a three-item instrument for assessing such impairment, is evaluated in this study.
A psychometric analysis of the SDS was conducted with a sample of 1001 primary care patients at Kaiser Permanente In Oakland, California. The SDS and the Symptom Driven Diagnostic System for Primary Care assessments were completed.
The internal consistency reliability of the SDS is high, with coefficient alpha of 0.89. The construct validity was substantiated in two ways. A one-factor model fit the data quite well. Furthermore, patients with each of six psychiatric disorders had significantly higher impairment scores than those who did not. Finally, over 80 percent of the patients with mental disorder diagnoses had an elevated SDS score and nearly 50 percent of those with elevated SDS scores had at least one disorder.
The psychometric properties of the SDS were evaluated in primary care. The internal consistency reliability was high. The analyses also lend empirical support for the construct validity. The scale is a sensitive tool for identifying primary care patients with mental health-related functional impairment, who would warrant a diagnostically-oriented mental health assessment.
近期的多项研究表明，在初级保健中常见的许多精神障碍都伴有严重的功能损害。然而，与心理健康相关的功能损害的简短测量方法在初级保健环境中并不常用。本研究对用于评估此类损害的三项式希恩残疾量表（SDS）进行了评估。
对加利福尼亚州奥克兰凯撒医疗集团的1001名初级保健患者样本进行了SDS的心理测量分析。完成了SDS和初级保健症状驱动诊断系统评估。
SDS的内部一致性信度较高，α系数为0.89。结构效度通过两种方式得到证实。单因素模型与数据拟合良好。此外，六种精神障碍患者的损害得分均显著高于无精神障碍者。最后，超过80%的精神障碍诊断患者SDS得分升高，近50%的SDS得分升高者至少患有一种疾病。
在初级保健中对SDS的心理测量特性进行了评估。内部一致性信度较高。分析也为结构效度提供了实证支持。该量表是识别有心理健康相关功能损害的初级保健患者的敏感工具，这些患者需要进行以诊断为导向的心理健康评估。
