39项帕金森病调查表中文版（中国大陆）的信度和效度研究
摘要
目的：评定39项帕金森病调查表(the 39-item Parkinson's Disease Questionnaire, PDQ-39)中文版在中国大陆应用的信度和效度。
方法：由确诊的71位帕金森病患者自己完成PDQ-39量表和健康测量量表SF36(The Medical Outcomes Study 36-Item Short-Form Health Survey,SF-36)的评定,并让这些病人一周后再次填写PDQ-39量表。采用统一帕金森病评定量表(the United Parkinson's Disease Rating Scale,UPDRS)和Hoehn and Yahr分级量表(H&Y)对所有参与者进行评估。量表信度采用克朗巴哈系数(Cronbach'sα)和内在等级相关系数(intra-class correlation coefficients,ICC)评价,效度采用PDQ-39与SF-36,UPDRS量表中相关子量表之间的相关系数来验证。
结果：PDQ-39量表中文版被证实具有较好的信度(Cronbach'sα:0.84-0.88,ICC：0.56-0.82)以及令人满意的集合效度与区分效度(条目-维度相关系数：0.33-0.88,区分效度的平均成功率：77.56%)。PDQ-39与UPDRS量表中相关子量表之间的相关系数(0.44-0.68)以及PDQ-39与SF-36量表中相关子量表之间的相关系数(-0.46--0.69)均表明PDQ-39量表具有较好的聚合效度(p<0.01)。除了耻辱、认知与身体不适三个维度之外,PDQ-39量表的其他维度均能明确区分出H&Y分级不同病情阶段的患者。
结论：尽管我们的研究提示PDQ-39某些子量表(如耻辱、认知、社会支持)可能需要进一步改进与完善,但我们这项研究表明PDQ-39量表中文版在中国大陆的应用具有较好的信度和效度。
Objective:To assess the Mainland Chinese version of the 39-item Parkinson's Disease Questionnaire (PDQ-39).
Methods:Seventy-one patients with Parkinson's Disease (PD) completed the PDQ-39 and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) by themselves. All the participants were retested with the PDQ-39 a week later. The United Parkinson's Disease Rating Scale (UPDRS) and the Hoehn and Yahr scale (H&Y) were used to evaluate the patients. Reliability was assessed by Cronbach's a and intra-class correlation coefficients (ICC). Validity was examined in terms of agreement with SF-36, UPDRS and H&Y scales.
Results:The Mainland Chinese version of the PDQ-39 demonstrated acceptable reliability (Cronbach'sα=0.84-0.88; ICC:0.56-0.82). Item-total correlations (0.33-0.88) and scaling success rates (mean:77.56%) indicated satisfactory convergent and discriminant validity of the PDQ-39 items. The correlations between related constructs of the PDQ-39 and UPDRS (r=0.44-0.68), and between those of the PDQ-39 and SF-36 (r=-0.46--0.69) were all statistically significant (p<0.01). Except for stigma, cognitions and bodily discomfort, all other dimensions of the PDQ-39 significantly discriminated patients at different H&Y stages indicated by the H&Y scale.
Conclusions:lthough our observations indicate that some problematic subscales of this version of the PDQ-39 could be improved upon, this study suggests acceptable reliability and validity of the Mainland Chinese version of the PDQ-39.
方法：由确诊的71位帕金森病患者自己完成PDQ-39量表和健康测量量表SF36(The Medical Outcomes Study 36-Item Short-Form Health Survey,SF-36)的评定,并让这些病人一周后再次填写PDQ-39量表。采用统一帕金森病评定量表(the United Parkinson's Disease Rating Scale,UPDRS)和Hoehn and Yahr分级量表(H&Y)对所有参与者进行评估。量表信度采用克朗巴哈系数(Cronbach'sα)和内在等级相关系数(intra-class correlation coefficients,ICC)评价,效度采用PDQ-39与SF-36,UPDRS量表中相关子量表之间的相关系数来验证。
结果：PDQ-39量表中文版被证实具有较好的信度(Cronbach'sα:0.84-0.88,ICC：0.56-0.82)以及令人满意的集合效度与区分效度(条目-维度相关系数：0.33-0.88,区分效度的平均成功率：77.56%)。PDQ-39与UPDRS量表中相关子量表之间的相关系数(0.44-0.68)以及PDQ-39与SF-36量表中相关子量表之间的相关系数(-0.46--0.69)均表明PDQ-39量表具有较好的聚合效度(p<0.01)。除了耻辱、认知与身体不适三个维度之外,PDQ-39量表的其他维度均能明确区分出H&Y分级不同病情阶段的患者。
结论：尽管我们的研究提示PDQ-39某些子量表(如耻辱、认知、社会支持)可能需要进一步改进与完善,但我们这项研究表明PDQ-39量表中文版在中国大陆的应用具有较好的信度和效度。
Objective:To assess the Mainland Chinese version of the 39-item Parkinson's Disease Questionnaire (PDQ-39).
Methods:Seventy-one patients with Parkinson's Disease (PD) completed the PDQ-39 and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) by themselves. All the participants were retested with the PDQ-39 a week later. The United Parkinson's Disease Rating Scale (UPDRS) and the Hoehn and Yahr scale (H&Y) were used to evaluate the patients. Reliability was assessed by Cronbach's a and intra-class correlation coefficients (ICC). Validity was examined in terms of agreement with SF-36, UPDRS and H&Y scales.
Results:The Mainland Chinese version of the PDQ-39 demonstrated acceptable reliability (Cronbach'sα=0.84-0.88; ICC:0.56-0.82). Item-total correlations (0.33-0.88) and scaling success rates (mean:77.56%) indicated satisfactory convergent and discriminant validity of the PDQ-39 items. The correlations between related constructs of the PDQ-39 and UPDRS (r=0.44-0.68), and between those of the PDQ-39 and SF-36 (r=-0.46--0.69) were all statistically significant (p<0.01). Except for stigma, cognitions and bodily discomfort, all other dimensions of the PDQ-39 significantly discriminated patients at different H&Y stages indicated by the H&Y scale.
Conclusions:lthough our observations indicate that some problematic subscales of this version of the PDQ-39 could be improved upon, this study suggests acceptable reliability and validity of the Mainland Chinese version of the PDQ-39.
引文
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[2]Hagell P, Tornqvist AL Hobart J. Testing the SF-36 in Parkinson's disease. Implications for reporting rating scale data. J Neurol,2008,255:246-254.
[3]Peto V, Jenkinson C, Fitzpatrick R, et al. The development and validation of a short measure of functioning and well being for individuals with Parkinson's disease. Qual Life Res,1995,4:241-248.
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[6]Marinus J, Visser M, Jenkinson C, et al. Evaluation of the Dutch version of the Parkinson's Disease Questionnaire 39. Parkinsonism Relat Disord,2008,14: 24-27.
[7]Martinez-Martin P Frades Payo B. Quality of life in Parkinson's disease: validation study of the PDQ-39 Spanish version. The Grupo Centro for Study of Movement Disorders. J Neurol,1998,245 Issue Suppl 1:S34-38.
[8]Luo N, Tan LC, Li SC, et al. Validity and reliability of the Chinese (Singapore) version of the Parkinson's Disease Questionnaire (PDQ-39). Qual Life Res, 2005,14:273-279.
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[22]Portney LG Watkins MP. Foundations of Clinical Research:Applications to Practice,2nd ed. Upper Saddle River, NJ:Prentice-Hall,2000.
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[18]Weintraub D, Koester J, Potenza M, et al. Dopaminergic therapy and impulse control disorders in Parkinson's disease:top line results of a cross-sectional study of over 3,000 patients.. Mov Disord,2008,23:LB4.
[19]Vogel HP Schiffter R. Hypersexuality-a complication of dopaminergic therapy in Parkinson's disease. Pharmacopsychiatria,1983,16:107-110.
[20]Harvey NS. Serial cognitive profiles in levodopa-induced hypersexuality. Br J Psychiatry,1988,153:833-836.
[21]Klos KJ, Bower JH, Josephs KA, et al. Pathological hypersexuality predominantly linked to adjuvant dopamine agonist therapy in Parkinson's disease and multiple system atrophy. Parkinsonism Relat Disord,2005,11: 381-386.
[22]Witjas T, Kaphan E, Azulay JP, et al. Nonmotor fluctuations in Parkinson's disease:frequent and disabling. Neurology,2002,59:408-413.
[23]Hillen ME Sage JI. Nonmotor fluctuations in patients with Parkinson's disease. Neurology,1996,47:1180-1183.
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[2]Hagell P, Tornqvist AL Hobart J. Testing the SF-36 in Parkinson's disease. Implications for reporting rating scale data. J Neurol,2008,255:246-254.
[3]Peto V, Jenkinson C, Fitzpatrick R, et al. The development and validation of a short measure of functioning and well being for individuals with Parkinson's disease. Qual Life Res,1995,4:241-248.
[4]Bushnell DM Martin ML. Quality of life and Parkinson's disease:translation and validation of the US Parkinson's Disease Questionnaire (PDQ-39). Qual Life Res,1999,8:345-350.
[5]Katsarou Z, Bostantjopoulou S, Peto V, et al. Quality of life in Parkinson's disease:Greek translation and validation of the Parkinson's disease questionnaire (PDQ-39). Qual Life Res,2001,10:159-163.
[6]Marinus J, Visser M, Jenkinson C, et al. Evaluation of the Dutch version of the Parkinson's Disease Questionnaire 39. Parkinsonism Relat Disord,2008,14: 24-27.
[7]Martinez-Martin P Frades Payo B. Quality of life in Parkinson's disease: validation study of the PDQ-39 Spanish version. The Grupo Centro for Study of Movement Disorders. J Neurol,1998,245 Issue Suppl 1:S34-38.
[8]Luo N, Tan LC, Li SC, et al. Validity and reliability of the Chinese (Singapore) version of the Parkinson's Disease Questionnaire (PDQ-39). Qual Life Res, 2005,14:273-279.
[9]Ma HI, Hwang WJ Chen-Sea MJ. Reliability and validity testing of a Chinese-translated version of the 39-item Parkinson's Disease Questionnaire (PDQ-39). Qual Life Res,2005,14:565-569.
[10]Tsang KL, Chi I, Ho SL, et al. Translation and validation of the standard Chinese version of PDQ-39:a quality-of-life measure for patients with Parkinson's disease. Mov Disord,2002,17:1036-1040.
[11]Zhang ZX, Roman GC, Hong Z, et al. Parkinson's disease in China:prevalence in Beijing, Xian, and Shanghai. Lancet,2005,365:595-597.
[12]Hughes AJ B-SY, Daniel, Lees AJ.. What features improve the accuracy of clinical diagnosis in Parkinson's disease:a clinicopathologic study.. Neurology, 1992,42:1142-1146.
[13]Cockrell JR Folstein MF. Mini-Mental State Examination (MMSE). Psychophar macol Bull,1988,24:689-692.
[14]Fahn S ER. The unified Parkinson's disease rating scale. In:Fahn S, Marsden C, Calne D, Goldstein M, (eds), Recent Developments in Parkinson's Disease, 1987,153-304.
[15]Hoehn MM Yahr MD. Parkinsonism:onset,progression and mortality. Neuro logy,1967,17:427-442.
[16]Jenkinson C FR, Peto V. The Parkinson's Disease Questionnaire:User Manual for the PDQ-39, PDQ-8 and PDQ Summary Index. Oxford, UK:University of Oxford,1998.
[17]Ware JE, Jr. Sherbourne CD. The MOS 36-item short-form health survey (SF-36).Ⅰ. Conceptual framework and item selection. Med Care,1992,30: 473-483.
[18]Nunnally JC. Psychometric theory. New York:McGraw-Hill,1978:p.701.
[19]Deyo RA, Diehr P Patrick DL. Reproducibility and responsiveness of health status measures. Statistics and strategies for evaluation. Control Clin Trials, 1991,12:142S-158S.
[20]LAA. Designing and Conducting Health Surveys:A Comprehensive Guide. San Francisco:Jossey-Bass,1991,41-50.
[21]Fayers PM MD. Quality of Life:Assessment, Analysis and Interpreta tion. Chichester:John Wiley & Sons,2000.
[22]Portney LG Watkins MP. Foundations of Clinical Research:Applications to Practice,2nd ed. Upper Saddle River, NJ:Prentice-Hall,2000.
[1]Lawrence AD, Evans AH Lees AJ. Compulsive use of dopamine replacement therapy in Parkinson's disease:reward systems gone awry?. Lancet Neurol, 2003,2:595-604.
[2]Giovannoni G, O'Sullivan JD, Turner K, et al. Hedonistic homeostatic dysregulation in patients with Parkinson's disease on dopamine replacement therapies. J Neurol Neurosurg Psychiatry,2000,68:423-428.
[3]O'Sullivan SS, Evans AH Lees AJ. Dopamine dysregulation syndrome:an overview of its epidemiology, mechanisms and management. CNS Drugs,2009, 23:157-170.
[4]Fan W, Ding H, Ma J, et al. Impulse control disorders in Parkinson's disease in a Chinese population. Neurosci Lett,2009,465:6-9.
[5]Bearn J, Evans A, Kelleher M, et al. Recognition of a dopamine replacement therapy dependence syndrome in Parkinson's disease:a pilot study. Drug Alcohol Depend,2004,76:305-310.
[6]Spigset O von Scheele C. Levodopa dependence and abuse in Parkinson's disease. Pharmacotherapy,1997,17:1027-1030.
[7]Tack E, De Cuypere G, Jannes C, et al. Levodopa addiction. A case study. Acta Psychiatr Scand,1988,78:356-360.
[8]Pezzella FR, Colosimo C, Vanacore N, et al. Prevalence and clinical features of hedonistic homeostatic dysregulation in Parkinson's disease. Mov Disord, 2005,20:77-81.
[9]Friedman JH. Punding on levodopa. Biol Psychiatry,1994,36:350-351.
[10]Silveira-Moriyama L, Evans AH, Katzenschlager R, et al. Punding and dyskinesias. Mov Disord,2006,21:2214-2217.
[11]Evans AH, Katzenschlager R, Paviour D, et al. Punding in Parkinson's disease: its relation to the dopamine dysregulation syndrome. Mov Disord,2004,19: 397-405.
[12]Voon V, Thomsen T, Miyasaki JM, et al. Factors associated with dopaminergic drug-related pathological gambling in Parkinson disease. Arch Neurol,2007, 64:212-216.
[13]Voon V Fox SH. Medication-related impulse control and repetitive behaviors in Parkinson disease. Arch Neurol,2007,64:1089-1096.
[14]Voon V, Hassan K, Zurowski M, et al. Prevalence of repetitive and reward-seeking behaviors in Parkinson disease. Neurology,2006,67:1254-1257.
[15]Voon V, Hassan K, Zurowski M, et al. Prospective prevalence of pathologic gambling and medication association in Parkinson disease. Neurology,2006, 66:1750-1752.
[16]Molina JA, Sainz-Artiga MJ, Fraile A, et al. Pathologic gambling in Parkinson's disease:a behavioral manifestation of pharmacologic treatment?. Mov Disord, 2000,15:869-872.
[17]Grosset KA, Grosset DG, Macphee G, et al. Dopamine agonists and pathological gambling. Parkinsonism Relat Disord,2007,13:259; author reply 260.
[18]Weintraub D, Koester J, Potenza M, et al. Dopaminergic therapy and impulse control disorders in Parkinson's disease:top line results of a cross-sectional study of over 3,000 patients.. Mov Disord,2008,23:LB4.
[19]Vogel HP Schiffter R. Hypersexuality-a complication of dopaminergic therapy in Parkinson's disease. Pharmacopsychiatria,1983,16:107-110.
[20]Harvey NS. Serial cognitive profiles in levodopa-induced hypersexuality. Br J Psychiatry,1988,153:833-836.
[21]Klos KJ, Bower JH, Josephs KA, et al. Pathological hypersexuality predominantly linked to adjuvant dopamine agonist therapy in Parkinson's disease and multiple system atrophy. Parkinsonism Relat Disord,2005,11: 381-386.
[22]Witjas T, Kaphan E, Azulay JP, et al. Nonmotor fluctuations in Parkinson's disease:frequent and disabling. Neurology,2002,59:408-413.
[23]Hillen ME Sage JI. Nonmotor fluctuations in patients with Parkinson's disease. Neurology,1996,47:1180-1183.
[24]Menza MA, Sage J, Marshall E, et al. Mood changes and "on-off" phenomena in Parkinson's disease. Mov Disord,1990,5:148-151.
[25]Comings DE Blum K. Reward deficiency syndrome:genetic aspects of behavioral disorders. Prog Brain Res,2000,126:325-341.
[26]Evans AH, Pavese N, Lawrence AD, et al. Compulsive drug use linked to sensitized ventral striatal dopamine transmission. Ann Neurol,2006,59: 852-858.
[27]Schultz W. Getting formal with dopamine and reward. Neuron,2002,36: 241-263.
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