中文版工作同盟量表简版修订版在住院精神分裂症患者中的信度和效度研究
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摘要
目的·评价中文版工作同盟量表简版修订版(Working Alliance Inventory-Short Form Revised,WAI-SR)在住院精神分裂症群体中的信度和效度。方法·采用方便抽样的方法选取上海市精神卫生中心符合《国际疾病分类(第10版)》诊断的住院精神分裂症患者132名,获得有效量表124份。使用总样本进行条目分析、内部一致性信度分析、结构效度分析以及校标效度分析等,选用医患关系问卷(Patient-Doctor Relationship Questionnaire-15,PDRQ-15)和维克森林医师信任量表(Wake Forest Physician Trust Scale,WFPTS)中文修订版为校标。结果·探索性因子分析结果显示中文版WAI-SR具有"目标任务"和"情感联结"2个维度,累计方差贡献率为63.99%;验证性因子分析结果显示二因子模型拟合度良好。量表总分及维度得分与2个校标量表总分均呈正相关(r=0.324～0.726,均P<0.01)。信度检验结果显示中文版WAI-SR的Cronbach'sα系数为0.864,分半信度系数为0.919。结论·中文版WAI-SR在住院精神分裂症群体中有较好的信度和效度,可用于评估精神分裂症住院患者的医患工作同盟。
Objective · To investigate the reliability and validity of Chinese version of Working Alliance Inventory-Short Form Revised(WAI-SR) in the hospitalized schizophrenics. Methods · A sample of 124 inpatient schizophrenics who were diagnosed according to International Classification of Diseases 10 th Revision in Shanghai Mental Health Center and collected by convenience sampling, were interviewed by questionnaire. Item analysis,internal consistency, construct validity and criterion validity were tested using total sample. Patient-Doctor Relationship Questionnaire-15(PDRQ-15)and Chinese version of Wake Forest Physician Trust Scale(WFPTS) were used as criteria to test criterion validity. Results · Exploratory factor analysis extracted two dimensions labeled "goal and task" and "affective bond", and the cumulative variance contribution rate was 63.99%. Confirmatory factor analysis showed that the two-factor model had higher adjusted goodness of fit index. The scores of scale and its two dimensions exhibited positive correlations with PDRQ-15 and WFPTS(r=0.324-0.726, P<0.01). The internal consistency of the scale(Cronbach's a coefficient) was 0.864, and splithalf reliability was 0.919. Conclusion · The Chinese version of WAI-SR is acceptable in reliability and validity and can be recommended for alliance assessment in the inpatients with schizophrenia.
Objective · To investigate the reliability and validity of Chinese version of Working Alliance Inventory-Short Form Revised(WAI-SR) in the hospitalized schizophrenics. Methods · A sample of 124 inpatient schizophrenics who were diagnosed according to International Classification of Diseases 10 th Revision in Shanghai Mental Health Center and collected by convenience sampling, were interviewed by questionnaire. Item analysis,internal consistency, construct validity and criterion validity were tested using total sample. Patient-Doctor Relationship Questionnaire-15(PDRQ-15)and Chinese version of Wake Forest Physician Trust Scale(WFPTS) were used as criteria to test criterion validity. Results · Exploratory factor analysis extracted two dimensions labeled "goal and task" and "affective bond", and the cumulative variance contribution rate was 63.99%. Confirmatory factor analysis showed that the two-factor model had higher adjusted goodness of fit index. The scores of scale and its two dimensions exhibited positive correlations with PDRQ-15 and WFPTS(r=0.324-0.726, P<0.01). The internal consistency of the scale(Cronbach's a coefficient) was 0.864, and splithalf reliability was 0.919. Conclusion · The Chinese version of WAI-SR is acceptable in reliability and validity and can be recommended for alliance assessment in the inpatients with schizophrenia.
引文
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[14]史静,孙振球,蔡太生.良性前列腺增生症患者生活质量量表的编制与应用:虽量表的编制及条目筛选方法[J].中国卫生统计,2003, 20(3):158-161.
[15]侯丽华,杨志辉,蒋廷云,等.长期住院精神分裂症患者孤独感现状及相关因素研究[J].中外健康文摘,2012, 9(2):101-103.
[16] Ojeda N, Sanchez P, Pena J, et al. An explanatory model of quality of life in schizophrenia:the role of processing speed and negative symptoms[J]. Actas Esp Psiquiatr, 2012,40(1):10-18.
[17]朱旭,江光荣,于丽霞,等.工作同盟的结构:基于两种测星量工具的检验[J].心理科学,2011,34(4):981-986.
[18] Hatcher RL. Therapists'views of treatment alliance and collaboration in therapy[J]. Psychother Res, 1999, 9(4):405-423.
[19] Busseri MA, Tyler JD. Interchangeability of the Working Alliance Inventory and Working Alliance Inventory, Short Form[J]. Psychol Assess, 2003, 15(2):193-197.
[20] Andrusyna TP, Tang TZ, Derubeis RJ, et al. The factor structure of the Working Alliance Inventory in cognitive-behavioral therapy[J]. J Psychother Pract Res,2001, 10(3):173.
[21] Webb CA, Derubeis RJ, Amsterdam JD, et al. Two aspects of the therapeutic alliance:differential relations with depressive symptom change[J]. J Consult Clin Psycho, 2011, 79(3):279-283.
[22]贾晓,朱虹,韩世辉,等.精神分裂症自知力的自我参照效应研究[J].中国临床心理学杂志,2008, 16(5):503-505.
[23]杨慧,王洪奇.医患关系量表PDRQ-15中文译本的信度和效度评价[J].中国医学伦理学,2011,24(3):350-353.
[24]李丹.精神科医患关系的特点与医疗纠纷的防范[J].中国民康医学,2005,17(12):763-764.
[25] de Nadai AS, Karver MS, Murphy TK, et al. Common factors in pediatric psychiatry:a review of essential and adjunctive mechanisms of treatment outcome[J]. J Child Adolesc Psychopharmacol, 2017, 27(1):10-18.
[26]尚鹤睿.心理学视角下的医患关系[J].医学与哲学,2008, 29(7):12-15.
[27] Guedeney N, Fermanian J, Curt F, et al. Testing the Working Alliance Inventory(WAI)in a French primary care setting:predictive value and factor structure[J]. Soc Psychiatry Psychiatr Epidemiol, 2005, 40(10):844-852.
[2] Neale MS, Rosenheck RA. Therapeutic alliance and outcome in a VA intensive case management program[J]. Psychiatr Serv, 1995, 46(7):719-721.
[3] Solomon P, Draine J, Delaney MA. The working alliance and consumer case management[J]. J Ment Health Adm, 1995, 22(2):126-134.
[4] Horvath AO, Greenberg LS. Development and validation of the Working Alliance Inventory[J]. J Counsel Psychol,1989, 36(2):223-233.
[5] Tracey TJ, Kokotovic AM. Factor structure of the Working Alliance Inventory[J]. Psychol Assess, 1989, 1(1):207-210.
[6] Hatcher RI, Gillaspy JA. Development and validation of a revised short version of the Working Alliance Inventory[J]. Psychother Res,2006, 16(1):12-25.
[7] Tatman AW, Love KM. An offender version of the Working Alliance Inventory-Short Revised[J]. J Offender Rehabil, 2010, 49(3):165-179.
[8] Araujo AC, Filho RN, Oliveira CB, et al. Measurement properties of theBrazilian version of the Working Alliance Inventory(patient and therapist shortforms)and Session Rating Scale for low back pain[J]. J Back Musculoskelet Rehabil, 2017, 30(4):1-9.
[9]胡姝婧,江光荣.工作同盟和领悟对咨询效果的影响[J].心理科学,2014,37(6):1491-1496.
[10]郭金玉,李峥.量表引进的过程及评价标准[J].中华护理杂志,2012, 47(3):283-285.
[11] van der Feltz-Comelis CM, Van Oppen P, van Marwijk HW, et al. A patientdoctor relationship questionnaire(PDRQ-9)in primary care:development and psychometric evaluation[J]. Gen Hosp Psychiat, 2004, 26(2):115-120.
[12]杨慧.中文版本PDRQ/DDPRQ量表研制与评价[D].太原:山西医科大学,2011.
[13]董恩宏,鲍勇.维克森林医师信任量表中文修订版的信效度[J].中国心理卫生杂志,2012, 26(3):171-175.
[14]史静,孙振球,蔡太生.良性前列腺增生症患者生活质量量表的编制与应用:虽量表的编制及条目筛选方法[J].中国卫生统计,2003, 20(3):158-161.
[15]侯丽华,杨志辉,蒋廷云,等.长期住院精神分裂症患者孤独感现状及相关因素研究[J].中外健康文摘,2012, 9(2):101-103.
[16] Ojeda N, Sanchez P, Pena J, et al. An explanatory model of quality of life in schizophrenia:the role of processing speed and negative symptoms[J]. Actas Esp Psiquiatr, 2012,40(1):10-18.
[17]朱旭,江光荣,于丽霞,等.工作同盟的结构:基于两种测星量工具的检验[J].心理科学,2011,34(4):981-986.
[18] Hatcher RL. Therapists'views of treatment alliance and collaboration in therapy[J]. Psychother Res, 1999, 9(4):405-423.
[19] Busseri MA, Tyler JD. Interchangeability of the Working Alliance Inventory and Working Alliance Inventory, Short Form[J]. Psychol Assess, 2003, 15(2):193-197.
[20] Andrusyna TP, Tang TZ, Derubeis RJ, et al. The factor structure of the Working Alliance Inventory in cognitive-behavioral therapy[J]. J Psychother Pract Res,2001, 10(3):173.
[21] Webb CA, Derubeis RJ, Amsterdam JD, et al. Two aspects of the therapeutic alliance:differential relations with depressive symptom change[J]. J Consult Clin Psycho, 2011, 79(3):279-283.
[22]贾晓,朱虹,韩世辉,等.精神分裂症自知力的自我参照效应研究[J].中国临床心理学杂志,2008, 16(5):503-505.
[23]杨慧,王洪奇.医患关系量表PDRQ-15中文译本的信度和效度评价[J].中国医学伦理学,2011,24(3):350-353.
[24]李丹.精神科医患关系的特点与医疗纠纷的防范[J].中国民康医学,2005,17(12):763-764.
[25] de Nadai AS, Karver MS, Murphy TK, et al. Common factors in pediatric psychiatry:a review of essential and adjunctive mechanisms of treatment outcome[J]. J Child Adolesc Psychopharmacol, 2017, 27(1):10-18.
[26]尚鹤睿.心理学视角下的医患关系[J].医学与哲学,2008, 29(7):12-15.
[27] Guedeney N, Fermanian J, Curt F, et al. Testing the Working Alliance Inventory(WAI)in a French primary care setting:predictive value and factor structure[J]. Soc Psychiatry Psychiatr Epidemiol, 2005, 40(10):844-852.