中文版糖尿病问题量表的修订和信效度检验

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Abstract Objective：To revise the Chinese version of the Problem Areas in diabetes Scale （PAID） and to test its reliability and validity， to improve its application in the evaluation of diabetes‐specific emotional distress in China.Methods：A convenience sampling method was used to select 361 diabetic patients from four hospitals in Anhui Province to complete the PAID，of which 318 also completed validated questionnaires， including the Diabetes Distress Scale （DDS）， Diabetes Specific Quality of Life Scale（DSQL）， Self‐Rating Anxiety Scale （SAS），and Patient Health Questionnaire‐9（PHQ‐9）.The revised version of the PAID was formed by analysing the items of the PAID in accordance with Item Response Theory and Classical Measurement Theory， and further internal consistency test， confirmatory factor analysis，as well as test of criterion validity were performed on the revised instrument.Fifty patients were randomly selected to receive the PAID retest 4 to 6 weeks after the baseline survey.Results：The final version of PAID included 17 items，which were obtained based on the selection criteria of the applicable parameters and indicators，combined with the discussion of the research team，deleting the original items 1， 2， and 15. The difficulty of each item in PAID ‐ 17 was reasonable， with no inverse thresholds， and good item discrimination， information quantity and item characteristic curves.The Cronbach′s alpha coefficient of the scale was 0.913，and the retest reliability was 0.656 P<0.001 ）.Confirmatory factor analysis on the external sample showed that the PAID fit the unidimensional structure of the data well. Correlational analyses with the DDS， SAS， and PHQ ‐ 9 all showed satisfactory concurrent validity for the PAID（ P<0.001 ）. Furthermore， receiver operating characteristic（ROC） analysis showed that the instrument had the optimal predictive validity for DSQL， with an area under the curve of 0.812（95%CI 0.743–0.881，P<0 P<0.001 ）. Conclusions： The revised Chinese version of PAID is a reliable and effective tool for measuring the specific emotional distress of diabetic patients.It could effectively predict health-related quality of life and its clinical application merits further exploration.

Keywords diabetes mellitus; the Problem Areas in Diabetes Scale; reliability; validity; scale摘要 目的：修订中文版糖尿病问题量表（the Problem Areas in Diabetes Scale，PAID），并进行信效度检验，以提高其在国内糖尿病病人特异性情绪困扰评估中的应用。（剩余14982字）