McArthur J H
Chase-Brexton Health Services, Baltimore, Maryland, USA.
J Assoc Nurses AIDS Care. 1998 Jul-Aug;9(4):84-94. doi: 10.1016/S1055-3290(98)80048-4.
Painful sensory neuropathy (PSN) is the most common neurological disorder associated with HIV infection and affects up to 30% of HIV-positive individuals. PSN may develop as a consequence of HIV infection or from the toxic effect of the antiretrovirals. Although several tools have been developed to screen for PSN, their validity and reliability has yet to be established among HIV-positive patients. The Subjective Peripheral Neuropathy Screen (SPNS) is a brief self-report tool that is currently being administered in the AIDS Clinical Trials Group. The objective of this study was to establish the psychometric properties of the SPNS screening tool for the correct identification of PSN in HIV-positive individuals. Specifically the goals were to determine the reliability, the validity, and the diagnostic efficiency of the SPNS in the detection of PSN. Data were abstracted on subjects enrolled in an ongoing natural history cohort. The SPNS was administered to a convenience sample of 39 HIV-positive individuals with PSN and 44 HIV-positive controls. Results showed the SPNS to be internally consistent (Cronbach's alpha = .86). SPNS score differences assessed by t-test were significantly different for individual symptoms of parasthesias, numbness, and pain of the lower extremities, and for severity measures (the Clinical Severity Grade, and the Average Severity Score) between the HIV-positive groups (p < .05). Using Spearman's rank, significant correlations were demonstrated between the neurological exam and the Clinical Severity Grade and the Average Severity Score, the neurological exam and vibratory quantitative sensory testing (QST) only, and the severity measures and vibratory QST only. Sensitivity and specificity analysis demonstrated that numbness of the lower extremities was the symptom with the highest efficiency for correctly classifying PSN. Thus, internal consistency, construct validity, and criterion related validity were confirmed with the SPNS for the correct classification of PSN in HIV-positive individuals.
疼痛性感觉神经病变（PSN）是与HIV感染相关的最常见神经疾病，高达30%的HIV阳性个体受其影响。PSN可能是HIV感染的结果，也可能是抗逆转录病毒药物的毒性作用所致。尽管已经开发了几种工具来筛查PSN，但它们在HIV阳性患者中的有效性和可靠性尚未确立。主观周围神经病变筛查（SPNS）是一种简短的自我报告工具，目前正在艾滋病临床试验组中使用。本研究的目的是确定SPNS筛查工具在正确识别HIV阳性个体中的PSN方面的心理测量特性。具体目标是确定SPNS在检测PSN方面的可靠性、有效性和诊断效率。从一个正在进行的自然史队列中纳入的受试者提取数据。对39名患有PSN的HIV阳性个体和44名HIV阳性对照的便利样本进行了SPNS测试。结果显示SPNS具有内部一致性（Cronbach's alpha = 0.86）。通过t检验评估的SPNS得分差异在HIV阳性组之间的感觉异常、麻木和下肢疼痛的个体症状以及严重程度测量（临床严重程度分级和平均严重程度评分）方面有显著差异（p < 0.05）。使用Spearman等级相关分析，神经检查与临床严重程度分级和平均严重程度评分之间、神经检查与仅振动定量感觉测试（QST）之间以及严重程度测量与仅振动QST之间均显示出显著相关性。敏感性和特异性分析表明，下肢麻木是正确分类PSN效率最高的症状。因此，对于HIV阳性个体中PSN的正确分类，SPNS的内部一致性、结构效度和与标准相关的效度得到了证实。
