Jordan A, Manniche C, Mosdal C, Hindsberger C
Department of Medical Orthopedics T9, National University Hospital, Denmark.
J Manipulative Physiol Ther. 1998 Oct;21(8):520-7.
To determine whether a newly developed disability scale for patients with neck pain demonstrated acceptable reliability and validity.
Testing was conducted using three different samples of patients with neck pain (n = 162). Test-retest reliability of the scale was carried out on the same day with one sample (n = 39), and between-day reliability was carried out with another (n = 21). Differential item functioning with regard to the influence of gender and age was carried out with these two patient groups, as was construct validity. Responsiveness was measured using patients participating in a clinical trial involving patients with chronic neck pain (n = 102). Additionally, scale scores were compared with a wide range of physical measurements using the patients in the clinical trial.
Short-term, between-day and postal questionnaire reliability coefficients were all extremely high. The Cronbach's alpha coefficient for internal consistency was 0.9 for the entire scale, and the coefficients for individual items were all greater than 0.88. Disability scale scores correlated strongly to pain scores as well as to doctor and patient global assessments, indicating good construct validity. Relative changes in disability scores demonstrated a moderately strong correlation to changes in pain scores after treatment. Scale scores correlated weakly to all physical measurements.
The disability scale demonstrated excellent practicality and reliability. The scale accurately reflects patient perceptions regarding functional status and pain as well as doctor's global assessment and is responsive to change over long periods of time. We feel that this scale can be a valuable tool for the assessment of patients in future clinical trials and quality of care studies.
确定一种新开发的颈部疼痛患者残疾量表是否具有可接受的信度和效度。
使用三组不同的颈部疼痛患者样本（n = 162）进行测试。对其中一个样本（n = 39）在同一天进行量表的重测信度测试，对另一个样本（n = 21）进行日间信度测试。使用这两组患者样本研究性别和年龄对量表项目功能差异的影响以及结构效度。通过参与一项涉及慢性颈部疼痛患者的临床试验的患者（n = 102）来测量反应度。此外，使用该临床试验中的患者将量表得分与一系列身体测量结果进行比较。
短期、日间和邮寄问卷的信度系数都极高。整个量表的内部一致性Cronbach's alpha系数为0.9，各个项目的系数均大于0.88。残疾量表得分与疼痛评分以及医生和患者的整体评估密切相关，表明具有良好的结构效度。残疾评分的相对变化与治疗后疼痛评分的变化呈中度强相关。量表得分与所有身体测量结果的相关性较弱。
该残疾量表具有出色的实用性和信度。该量表准确反映了患者对功能状态和疼痛的认知以及医生的整体评估，并且对长期变化有反应。我们认为该量表可成为未来临床试验和医疗质量研究中评估患者的有价值工具。
