可重复的成套心理状态测量表在维持性血液透析患者中的信效度分析

doi:10.3969/j.issn.1006-7795.2025.05.017

摘要/Abstract

摘要： 目的分析中文版可重复的成套心理状态测量表(Repeatable Battery for the Assessment of Neuropsychological Status, RBANS)在维持性血液透析（maintenance hemodialysis，MHD）患者中的信度和效度。方法以84例MHD患者为研究对象，分别进行简明精神状况(Mini-mental State Exam, MMSE)、蒙特利尔认知评估量表(Montreal Cognitive Assessment Scale, MoCA)及RBANS3种量表的检测。采用科隆巴赫（Cronbach α）系数以及折半信度评价量表的信度，应用验证性因子分析评估量表的结构及聚合效度，应用Spearman相关分析评估RBANS评分与MoCA以及MMSE评分的相关性，应用受试者工作特征(receiver operating characteristic，ROC)曲线检测RBANS总分对认知功能障碍(cognitive impairment, CI)的预测价值。结果被测试患者RBANS量表的内部一致性 Cronbachα系数检测信度为0.896，折半信度为0.911，各个维度的信度分别在0.618至0.791。验证性因子分析表明RBANS量表5维度模型整体拟合度一般(χ²/df=1.587, 近似误差均方根为 0.084，比较拟合指数为0.967，增值拟合指数为0.968，Tucker-Lewis指数为0.947，拟合优度指数为0.891)；RBANS 5个维度的平均方差提取量在0.525～0.863,CR范围在0.733～0.926，量表聚合效度良好。Spearman相关分析示RBANS总分与MHD患者的年龄呈负相关，与受教育年限、MMSE总分及MoCA总分呈正相关(均P<0.01)。ROC曲线显示RBANS总分用于预测CI的曲线下面积（area under the curve，AUC）为0.891（P<0.01），有较高的预测价值。结论在MHD患者中应用中文版RBANS的信度和效度良好,可作为检测认知功能的工具。

关键词: 神经心理测验, 认知障碍, 维持性血液透析, 信度, 效度, 中文版可重复的成套心理状态测量表

Abstract: Objective To evaluate the reliability and validity of the Chinese version of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) in patients with maintenance hemodialysis (MHD). Methods The general information and medical history of 84 MHD patients were collected, and the Mini-Mental State Exam (MMSE), Montreal Cognitive Assessment Scale (MoCA), and RBANS were conducted. The reliability of the scale was assessed by Cronbach α and split-half reliability. The structure and convergent validity of the scale were assessed by confirmatory factor analysis, and the RBANS scores’ correlation to MoCA and MMSE scores was analyzed by Spearman correlation analysis. The predictive value of the RBANS total score on cognitive impairment (CI) was analyzed by receiver operating characteristic (ROC) curve. ' The Cronbach's alpha coefficient of the RBANS total scale was 0.896, split-half reliability was 0.911， and reliability for the five dimensions of the RBANS ranged from 0.618 to 0.791. Confirmatory factor analysis indicated that the overall fit of the five-dimensional model of the RBANS scale was acceptable (χ²/df =1.587, root mean square error of approximation=0.084, comparative fit index=0.967, incremental fit index=0. 968, Tucker-Lewis index=0.947, goodness of fit index= 0.891). The average variance extracted (AVE) for the five dimensions of the RBANS ranged from 0.525 to 0.863, while the composite reliability (CR) ranged from 0.733 to 0.926, indicating good convergent validity of the scale. Furthermore, Spearman correlation analysis revealed that the total RBANS score was negatively correlated to the age of MHD patients and positively correlated to years of education, as well as the total scores of MMSE and MoCA (all P<0.01). The ROC curve analysis indicated that the area under the curve (AUC) for the total RBANS score in predicting CI was 0.891 (P<0.01), suggesting a high predictive value. Conclusion The Chinese version of RBANS has good reliability and validity in MHD patients, and can be used as a measure of cognitive function in MHD patients.

Key words: neuropsychological assessment, cognitive impairment, maintenance hemodialysis, reliability, validity, Repeatable Battery for the Assessment of Neuropsychological Status

中图分类号:

R692

王小琪, 刘聪慧, 邵枫, 周晶晶, 杨帆, 李忠心. 可重复的成套心理状态测量表在维持性血液透析患者中的信效度分析[J]. 首都医科大学学报, 2025, 46(5): 877-884.

Wang Xiaoqi, Liu Conghui, Shao Feng, Zhou Jingjing, Yang Fan, Li Zhongxin. Reliability and validity of the repeatable battery for assessment of neuropsychological status scale in maintenance hemodialysis patients[J]. Journal of Capital Medical University, 2025, 46(5): 877-884.

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