摘要目的:通过Rasch分析评估中文版低视力者生活质量量表(CLVQOL),优化提炼该量表.方法:回顾性系列病例研究.收集2017年1—12月在温州医科大学附属眼视光医院低视力门诊就诊的低视力患者189例,对其进行CLVQOL问卷调查.患者的年龄为(40.9±20.2)岁,男/女比例为1.6:1.根据每一量表的每一条目得分情况使用Winsteps 3.72.2软件的等级模式进行Rasch分析,分析条目及答案的心理计量特征.分析的项目内容分别为:分解维度、选项排序、局部独立性、适合度分析、项目差别功能和项目适中性分析.结果:CLVQOL由4个维度组成.各维度选项之间存在互相包含现象,且第一特征根均在2左右,单维性检验尚在可接受范围内.选项排序发现选项2和4与其相邻选项分离不够清晰.同一维度内条目间具有较好的独立性.第四维度Q24的适合均方为1.55,不适合均方为1.58,超过了0.60～1.40的标准范围.按性别分析4个维度的项目功能差异,Q24在性别间差异大于5.项目与个体匹配不是很好,除了第三维度项目平均分高于个体平均得分外,其他维度项目平均得分均低于个体平均得分.同时,各维度对个体的测量信息也较低.结论:CLVQOL具有良好的信效度,通过Rasch分析表明其量表选项应根据我国社会经济背景及低视力人群生活需求进行重新设计优化,使量表更适用于中国低视力人群.

abstractsObjective: To use Rasch analysis to analyze and refine the Chinese version of the Low Vision Quality of Life Questionnaire (CLVQOL). Methods: The CLVQOL was completed by 189 low vision patients who attended the Low Vision & Vision Rehabilitation Center of the Eye Hospital, Wenzhou Medical University from January 2017 to December 2017. Mean age of the patients was 40.9±20.2 years, and the male/female ratio was 1.6:1. Based on the score for each item, Rasch analysis was performed on CLVQOL using the following steps: Dimensionality, response ordering, local dependence, infit and outfit analyses, differential item functioning, and subject targeting by using the Winsteps software version 3.72.2. Results: The CLVQOL contains four subscales. The eigen value of first contrast showed that the unexplained responses in each dimension are all around 2; the single-dimension test is still acceptable. Response ordering in each subscale showed options 2 and 4 were not clearly separated from their adjacent options. No notable local dependence was found for any subscale. According to the results of fit analysis, the mean square infit value of Q24 was 1.55, the mean square outfit value of Q24 was 1.58, both out of the range of 0.60 to 1.40. Differential item functioning was noted for sex on Q24, with a contrast difference >5. Analysis of targeting indicated relatively poor matches. The mean person in each dimension was higher than the mean item except on subscale 3, and the test information of each dimension was relatively narrow. Conclusion:The Rasch analysis of the CLVQOL shows that CLVQOL has a good degree of reliability and validity, but the option response to each item must redesigned to fit Chinese low vision patients according to their socioeconomic status.