Toner B B, Stuckless N, Ali A, Downie F, Emmott S, Akman D
Women's Mental Health Research Programme, Clarke Institute of Psychiatry, Toronto, Ontario, Canada.
Psychosom Med. 1998 Jul-Aug;60(4):492-7. doi: 10.1097/00006842-199807000-00017.
The importance of psychosocial factors in patients with Functional Bowel Disorders (FBD) has been well-established. However, most psychosocial measures used in research with FBD patients were not designed or validated on this population. A recent international team report recommended that psychosocial measures be developed to increase our understanding and treatment of FBD. The purpose of this study was to develop a reliable and valid instrument designed specifically to assess cognitions of patients with FBD.
An initial set of 204 scale items was generated from a large pool of thought diaries from patients diagnosed with FBD. Items were additionally refined using several methods, including consultation with a multidisciplinary team of international experts on FBD. The remaining 95 items were administered, along with a set of validating questionnaires, to a new sample of 75 FBD patients in Canada and the United States.
The findings indicate that the final 25-item scale has high reliability (Cronbach's alpha = .93; inter-item correlation = .36); high concurrent criterion validity evidenced by the correlation of the scale with a global rating of life interference caused by bowel symptoms (r = .71; p<.001); acceptable convergent validity evidenced by the correlation of the scale with the Dysfunctional Attitudes Scale (r = .38; p<.01); high content validity and face validity; and minimal social desirability contamination (r = .15; NS).
The Cognitive Scale for Functional Bowel Disorders is a valid and reliable scale that can be used as an outcome measure in evaluating the efficacy of different forms of psychotherapeutic intervention for FBD, and can also serve as a helpful assessment tool for health professionals working with patients diagnosed with FBD.
心理社会因素在功能性肠病（FBD）患者中的重要性已得到充分证实。然而，大多数用于FBD患者研究的心理社会测量方法并非针对该人群设计或验证。最近一个国际团队的报告建议开发心理社会测量方法，以增进我们对FBD的理解和治疗。本研究的目的是开发一种专门设计用于评估FBD患者认知的可靠且有效的工具。
从大量被诊断为FBD患者的思维日记中生成了一组初始的204个量表项目。通过多种方法对项目进行了进一步完善，包括与国际FBD专家多学科团队进行咨询。其余95个项目与一组验证问卷一起，施测于加拿大和美国的75名FBD患者新样本。
研究结果表明，最终的25项量表具有高信度（克朗巴哈系数α =.93；项目间相关性 =.36）；量表与肠道症状引起的生活干扰总体评分的相关性证明具有高同时效度（r =.71；p<.001）；量表与功能失调性态度量表的相关性证明具有可接受的聚合效度（r =.38；p<.01）；具有高内容效度和表面效度；且社会期望性污染最小（r =.15；无显著性差异）。
功能性肠病认知量表是一种有效且可靠的量表，可作为评估不同形式心理治疗干预对FBD疗效的结果指标，也可作为与诊断为FBD患者的医护人员的有用评估工具。
