目的 评价疾病认知问卷(ICQ)在乳腺癌患者中应用的信度和效度,为评估乳腺癌患者心理康复水平提供有效工具。方法 2016年10月至2017年5月,采用ICQ、疾病感知问卷(简化版)(B-IPQ)对北京天坛医院乳腺科和北京抗癌乐园的297例乳腺癌患者进行问卷调查,分析问卷的信度和效度。结果 ICQ 3个维度(无助感、接纳、感知益处)的Cronbach α 信度系数分别为0.855、0.857、0.878;重测信度分别为0.946、0.963、0.901 (P<0.001);验证性因子分析显示模型拟合指数χ2/df=2.5000,SRMR=0.063,CFI=0.920,3个维度各条目的 因子载荷为0.37~0.84,各维度之间的相关系数为-0.49~0.81 (P<0.001)。ICQ 3个维度中的无助感维度得分与B-IPQ总分的Pearson相关系数为0.727 (P<0.001)。结论 ICQ具有较好的信度和效度,适合在乳腺癌患者人群中应用。
Objective To test the reliability and validity of Chinese version of Illness Cognition Questionnaire (ICQ) in women with breast cancer.Methods From October, 2016 to May, 2017, 297 women with breast cancer were investigated with the Chinese version of the ICQ and Brief Illness Perception Questionnaire (B-IPQ). The reliability and validity of the Chinese version of ICQ were tested.Results The Cronbach's α of three subscales of ICQ (helplessness, acceptance and perceive benefits) were 0.855, 0.857, 0.878, and the test-retest reliability of three subscales were 0.946, 0.963, 0.901 (P<0.001). A confirmatory factor analysis was tested, χ2/df=2.500,SRMR=0.063, CFI=0.920. The factor load capacity of each subscales was 0.37 to 0.84 and the correlation of helplessness, acceptance and perceive benefits was -0.49 to 0.81 (P<0.001). The correlation coefficient of criterion-related validity of the helplessness subscale of ICP with B-IPQ was 0.727 (P<0.001).Conclusion The Chinese version of ICQ has good reliability and validity, which is a valuable research tool in clinical studies of psychological cognition of patients with breast cancer.
[1] 曹召伦. 慢性乙型肝炎病毒感染者疾病认知与神经心理学研究[D]. 合肥:安徽医科大学, 2007.
[2] Richters A, Derks J, Husson O, et al. Effect of surgical margin status after radical prostatectomy on health-related quality of life and illness perception in patients with prostate cancer [J]. Urol Oncol, 2015, 33(1): 16.e9-16.e15.
[3] Hudson JL, Bundy C, Coventry PA, et al.Exploring the relationship between cognitive illness representations and poor emotional health and their combined association with diabetes selfcare. A systematic review with meta-analysis[J]. J Psychosom Res, 2014, 76(4): 265-274.
[4] Postolica R, Iorga M, Petrariu FD, et al.Cognitive-behavioral coping, illness perception, and family adaptability in oncological patients with a family history of cancer[J]. Biomed Res Int, 2017, 2017(1): 1-11.
[5] 李爽,叶旭春. 疾病认知的研究及其对护理的启示[J]. 护理研究, 2012, 26(10): 2789-2791.
[6] Chen WQ, Zheng RS, Baade PD, et al.Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66(2): 115-132.
[7] Fan L, Strasser-Weippl K, Li JJ, et al.Breast cancer in China[J]. Lancet Oncol, 2014, 15(7): e279-e289.
[8] Niclas CM.Breast cancer: the chronic disease[J]. J Rehabil Res Dev, 2005, 42(5): 6-10.
[9] Millar K, Purushotham AS, McLatchie E, et al. A 1-year prospective study of individual variation in distress, and illness perceptions, after treatment for breast cancer[J]. J Psychosom Res, 2005, 58(4): 335-342.
[10] 江端英,高丽梅,侯香传,等. 中晚期乳腺癌病人就医延迟原因的质性研究[J]. 护理研究, 2013, 27(10): 3229-3230.
[11] Weinman J, Petrie KJ, Moss-Morris R, et al.The illness perception questionnaire: a new method for assessing the cognitive representation of illness[J]. Psychol Health, 1996, 11(3): 431-445.
[12] Leventhal H, Safer MA, Panagis DM.The impact of communications on the self-regulation of health beliefs, decisions, and behavior[J]. Health Educ Q, 1983, 10(1): 3-29.
[13] Leventhal H.I know distraction works even though it doesn't![J]. Health Psychol, 1992, 11(4): 208-209.
[14] 马纯华,张丽娟,颜君,等. 中文版改良疾病感知问卷的修订及其在乳腺癌患者中的信效度检验[J]. 中国全科医学, 2015, 18(27): 3328-3334.
[15] 梅雅琪,李惠萍,杨娅娟,等. 中文版疾病感知问卷简化版在女性乳腺癌患者中的信效度检验[J]. 护理学报, 2015, 22(24): 11-14.
[16] Evers AWM, Kraaimat F, van Lankveld W, et al. Beyond unfavorable thinking: the illness cognition questionnaire for chronic disease[J]. J Consult Clin Psychol, 2001, 69(6): 1026-1036.
[17] Lauwerier E, Crombez G, Van Damme S, et al.the construct validity of the Illness Cognition Questionaire: the robustness of the three-factor stucture across patients with chronic pain and chronic fatigue[J]. Int J Behav Med, 2010, 17(2): 90-96.
[18] Verhoof EJ, Mauricestam H, Heymans HS, et al.Psychosocial well-being in young adults with chronic illness since childhood: the role of illness cognitions[J]. Child Adolesc Psychiatry Ment Health, 2014, 8(12): 1-10.
[19] 李峥,刘宇. 护理学研究方法[M]. 北京:人民卫生出版社, 2012.
[20] 史静琤,莫显昆,孙振球. 量表编制中内容效度指数的应用[J]. 中南大学学报(医学版), 2012, 37(2): 152-155.
[21] Broadbent E, Petrie KJ, Maina J, et al.The brief Illness Perception Questionnaire[J]. J Psychosom Res, 2006, 60(6): 631-637.
[22] McLintire SA, Miller LA. 心理测量[M]. 骆方,孙晓敏,译. 北京:中国轻工业出版社, 2009.
[23] 方积乾. 生物医学研究的统计方法[M]. 北京:高等教育出版社, 2006.
[24] 王权. 国外实证性因素分析研究综述[J]. 心理科学, 2000, 23(3): 353-354.
[25] Hu LT, Bentler PM.Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives[J]. Struct Equ Modeling, 1999, 6(1): 1-55.
[26] 竺培梁. 心理测量-理论与应用[M]. 合肥:中国科学技术大学出版社, 2008.
