【摘要】 目的:使用条目反应理论(item response theory,IRT)对鼻咽癌患者生存质量(quality of life for nasopharyngeal carcinoma,QOL-NPC)量表进行评价,了解QOL-NPC量表的微观表现,了解每个条目的计量心理学特征。方法:采用横断面研究,使用QOL-NPC量表调查387例鼻咽癌患者,对身体机能(physical domain,PH)、心理精神状况(psychological domain,PS)、社会关系(social domain,SO)和不良反应领域(side-effect domain,SE)4个维度的条目构建部分评分模型,评价模型的信度系数,估计每个条目的阈值参数和残差,对性别、年龄和其他慢性病进行项目功能差异(differential item functioning,DIF)分析。结果:除了SO维度的信度系数为0.670外,其他维度的信度系数均>0.8。条目PH2、PS5、PS6、SO2、SO3、SO5、SE2、SE5、SE6和SE11的阈值出现颠倒情况,其他条目均未出现颠倒情况。条目的平均阈值位于-0.487~1.107,最大的为条目SE1(1.107),最小的为条目SE10(-0.487)。标准化残差绝对值>2.5的条目有PH7、PS4、PS5和SE5,其余条目残差绝对值均<2.5。DIF分析结果显示,所有的条目在性别、年龄和其他疾病均无一致性DIF和非一致性DIF。结论:QOL-NPC量表部分条目的拟合优度较差,出现颠倒的阈值,需要进一步完善。更多还原

【Abstract】 OBJECTIVE:To use item response theory(IRT)to analyze quality of life scale among nasopharyngeal carcinoma patients(QOL-NPC),and understand the psychometric characteristic of QOL-NPC scale.METHODS:The cross-sectional study was used.Totally 387nasopharyngeal carcinoma(NPC)patients were face-to-face interviewed with the QOL-NPC scale.Partial credit model was used to evaluated all items for each dimension(PH,PS,SO and SE dimen-sion).The reliability coefficient of each dimension,the threshold parameter and residual of each item were calculated.Dif-ferential item functioning(DIF)of each item among different gender,age,other diseases were tested.RESULTS:The reli-ability coefficient of all dimensions were greater than 0.80,except SO dimension(0.670).An ordered set of response threshold for almost each item was got,except for the item PH2,PS5,PS6,SO2,SO3,SO5,SE2,SE5,SE6and SE11,and the others were not.The mean threshold parameters were between-0.487and 1.107,with the maximum item SE1(1.107)and the minimum item SE10(-0.487).The standardized residuals which were greater than 2.5included item PH7,PS4,PS5and SE5,the other standardized residuals were samller than 2.5.All the items didn’t have uniform DIF or nonuniform DIF.CONCLUSIONS:IRT can provide accurate quantitative analysis on each item.Some items of QOL-NPC wasn’t good,therefore it’s necessary to improve.更多还原