上海交通大学学报（医学版）

上海交通大学学报（医学版） >

2021 , Vol. 41 >Issue 6: 793 - 798

DOI: https://doi.org/10.3969/j.issn.1674-8115.2021.06.015

论著 · 公共卫生

中文版挫败感量表在男男性行为人群中的信度和效度评估

  • 刘尚滨 ,
  • 杨皓 ,
  • 徐晨 ,
  • 董婧雯 ,
  • 喻晓月 ,
  • 蔡泳 ,
  • 袁东 ,
  • 王英
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  • 1.上海交通大学公共卫生学院，上海 200025
    2.上海市疾病预防控制中心，上海 200336
刘尚滨（1997—），男，硕士生；电子信箱：liushangbin12139@163.com。

网络出版日期: 2021-06-29

基金资助

国家自然科学基金(71673187);上海市公共卫生学科带头人(GWV-10.2-XD13);第五轮上海市公共卫生三年行动计划重点学科建设(GWV-10.1-XK15);上海交通大学公共卫生学院卓越人才培养成果为导向本科生拔尖培育项目(17ZYGW23)

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Validity and reliability of the Chinese version of Defeat Scale in men who have sex with men

  • Shang-bin LIU ,
  • Hao YANG ,
  • Chen XU ,
  • Jing-wen DONG ,
  • Xiao-yue YU ,
  • Yong CAI ,
  • Dong YUAN ,
  • Ying WANG
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  • 1.Shanghai Jiao Tong University School of Public Health, Shanghai 200025, China
    2.Shanghai Municipal Center for Disease Control, Shanghai 200336, China

Online published: 2021-06-29

Supported by

National Natural Science Foundation of China(71673187);Leader of Public Health Discipline in Shanghai(GWV-10.2-XD13);Construction of Key Disciplines in the Fifth Round of Shanghai Public Health Three-year Action Plan(GWV-10.1-XK15);The Top Training Program for Undergraduates Guided by the Achievements in the Training of Outstanding Talents in Shanghai Jiao Tong University School of Public Health(17ZYGW23)

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摘要

目的·检验中文版挫败感量表（Defeat Scale，DS）在上海市和沈阳市男男性行为人群（men who have sex with men，MSM）中的信度、效度，探索其对该群体抑郁状态的判断价值。方法·使用DS和患者健康问卷抑郁量表（Patient Health Questionnaire-9，PHQ-9），在上海市和沈阳市选择年龄18周岁以上且在过去的6个月曾经发生过男男性行为的530名男性展开横断面调查。使用Excel 2010建立数据库，采用SPSS 23.0和AMOS 25.0软件对数据进行信度和效度分析。使用Shapiro-Wilk检验方法判断数据是否服从正态分布。采用探索性因子分析和验证性因子分析验证其结构效度。用Spearman相关系数评价DS的内容效度。采用Cronbach's α系数和Spearman-Brown系数评价其信度。采用二元Logistic回归判断挫败感是否能影响抑郁状态，在此结果基础上进一步使用受试者操作特征曲线（receiver operator characteristic curve，ROC curve）判断其诊断价值。结果·DS与PHQ-9数据均不服从正态分布。探索性因子分析共提取出2个公因子，分别为颓败感（13个条目）和低成就感（3个条目），累计方差贡献率为69.35%。验证性因子分析显示，修正后的两因子模型中的各个条目因子载荷均大于0.50，最小值为0.52。两因子模型拟合优良［卡方自由度比（χ2/df）=3.430，<5；近似误差均方根（root mean square error of approximation，RMSEA）=0.068，标准化均方根残差（standardized root mean square residual，SRMR）=0.043，均<0.080；标准适配指数（normed fit index，NFI）=0.944，增值适配指数（incremental fit index，IFI）=0.959，比较适配指数（comparative fit index，CFI）=0.959，拟合优度指数（goodness of fit index，GFI）=0.909，塔克·刘易斯指数（Tucker-Lewis Index，TLI）=0.958，均＞0.900］。16个条目的DS内部一致性Cronbach's α系数为0.934，2个维度即颓败感和低成就感的Cronbach's α分别为0.962和0.758。以抑郁状态作为因变量，DS得分为协变量，进行二元Logistic回归，结果显示：β值为0.178，P=0.000；比值比（odds ratio，OR）为1.195，95%置信区间（confidence interval，CI）为1.147~1.245。ROC曲线下面积（area under the curve，AUC）为0.891，P=0.000；最大约登指数值为0.667，其所对应的DS得分为21.5，其灵敏度和特异度分别为87.0%和80.7%。结论·中文版DS在MSM中有良好的信度和效度，并且对该人群的抑郁状态具有判断价值。

关键词： 挫败感量表; 男男性行为人群; 信度; 效度

本文引用格式

刘尚滨 , 杨皓 , 徐晨 , 董婧雯 , 喻晓月 , 蔡泳 , 袁东 , 王英 . 中文版挫败感量表在男男性行为人群中的信度和效度评估[J]. 上海交通大学学报（医学版）, 2021 , 41(6) : 793 -798 . DOI: 10.3969/j.issn.1674-8115.2021.06.015

Abstract

Objective

·To test the reliability and validity of the Chinese version of Defeat Scale (DS) in the men who have sex with men (MSM) in Shanghai and Shenyang, China, and explore its value in judging the depressive state of the population.

Methods

·A cross-sectional survey was conducted among 530 men over the age of 18 who had made sex with men in the past 6 months in Shanghai and Shenyang. DS and Patient Health Questionnaire-9 (PHQ-9) were used. Excel 2010 was used to establish the database, and SPSS 23.0 and Amos 25.0 software were used to analyze the reliability and validity of the data. Shapiro-Wilk test was used to determine whether the data obeyed normal distribution. Exploratory factor analysis and confirmatory factor analysis were used to verify its structural validity of DS. Spearman correlation coefficient was conducted to evaluate the content validity. Cronbach's α coefficient and Spearman-Brown coefficient were used to evaluate the reliability of DS. Binary Logistic regression was used to determine whether defeat can affect depression, and then, receiver operator characteristic (ROC) curve was used to determine its diagnostic value.

Results

·The data of DS and PHQ-9 did not obey the normal distribution. The exploratory factor analysis showed that two factors including decadence (13 items) and low sense of achievement (3 items) could be extracted. Explained variance of the scale was 69.35%. The confirmatory factor analysis showed that each item of the revised two-factor model was greater than 0.50, and the minimum value was 0.52. The model fitted well [ χ2/df =3.430<5; root mean square error of approximation (RMSEA)= 0.068, standardized root mean square residual (SRMR)=0.043, all<0.080; normed fit index (NFI)=0.944, incremental fit index (IFI)=0.959, comparative fit index (CFI)=0.959, goodness of fit index (GFI)=0.909, Tucker-Lewis Index (TLI)=0.958, all＞0.900]. The Cronbach's α coefficient of DS of the 16 items was 0.934, and the Cronbach's α of two dimensions, namely "decadence" and "low achievement" were 0.962 and 0.758, respectively. With depression as the dependent variable and DS score as the covariant, binary Logistic regression was carried out. The results showed that β value was 0.178, P=0.000. Odds ratio (OR) value was 1.195 and 95% confidence interval (CI) was 1.147－1.245. The area under the curve (AUC) was 0.891, P=0.000. The maximum Youden index value was 0.667, its corresponding DS score was 21.5, and its sensitivity and specificity were 87.0% and 80.7%, respectively.

Conclusion

·The Chinese version of DS has good reliability and validity in MSM, and also has the value in judging the state of depression in this population.

Key words： defeat scale (DS); men who have sex with men (MSM); reliability; validity

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