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中文版爱丁堡产后抑郁量表的Rasch分析
高爽1,姚春立1,王欣怡1,白宁萱1,尚星辰2*
0
(1. 广州医科大学卫生管理学院基础心理学教研室, 广州 511436;
2. 扬州大学护理学院·公共卫生学院临床护理教研室, 扬州 225009
*通信作者)
摘要:
目的 运用Rasch分析检验中文版爱丁堡产后抑郁量表(EPDS)在产褥期妇女产后抑郁筛查中的适用性,为临床使用适合的产后抑郁筛查工具提供参考。方法 采用横断面研究方法对江苏省扬州市某三级综合医院产科门诊的产褥期妇女234例应用EPDS进行施测。应用Rasch模型对EPDS项目进行单维性、信度、难度、模型拟合度分析。结果 中文版EPDS共10个项目,Cronbach’s α系数为0.812。中文版EPDS具有单维性,量表的信度为0.82,点值相关系数为0.46~0.76。量表各项目拟合指标良好,加权均方值的范围在0.64~1.29之间,非加权均方值的取值介于0.62~1.34之间。项目难度估计值的范围是—2.26~3.16,与被试抑郁程度匹配较好。项目各选项之间相互独立,有较好的区分度。结论 中文版EPDS的信度良好并具有单维特性,对筛查产褥期妇女产后抑郁程度具有较好的适用性。基于Rasch模型分析发现该量表主要适合轻度和中度的产后抑郁患者,对高度抑郁不够敏感,可通过增加部分难度较高的项目进一步提高该量表在临床应用中的有效性与灵敏度。
关键词:  爱丁堡产后抑郁量表  Rasch分析  产后抑郁症  筛查
DOI:10.16781/j.CN31-2187/R.20230572
投稿时间:2023-10-18修订日期:2024-02-27
基金项目:广州市重点领域研发计划项目(202206060004),广东省教育厅青年创新人才类项目(2023KQNCX059),扬州市科技计划社会发展项目(YZ2021067).
Rasch analysis of Chinese version of Edinburgh postnatal depression scale
GAO Shuang1,YAO Chunli1,WANG Xinyi1,BAI Ningxuan1,SHANG Xingchen2*
(1. Department of Basic Psychology, School of Health Management, Guangzhou Medical University, Guangzhou 511436, Guangdong, China;
2. Department of Clinical Nursing, School of Nursing, School of Public Health, Yangzhou University, Yangzhou 225009, Jiangsu, China
*Corresponding author)
Abstract:
Objective To investigate the applicability of the Chinese version of the Edinburgh postnatal depression scale (EPDS) for postpartum depression screening in puerperal women using Rasch analysis, so as to provide reference for the clinical use of appropriate postpartum depression screening tools. Methods A cross-sectional study was conducted on 234 puerperal women in the outpatient department of obstetrics of a tertiary general hospital in Yangzhou, Jiangsu province. Rasch model was used to analyze the unidimensionality, reliability, difficulty and model fit of EPDS items. Results The Chinese version of EPDS had 10 items, and the Cronbach’s α coefficient was 0.812; it had unidimensionality, the reliability of the scale was 0.82, and the point biserial were 0.46 to 0.76. The fitting index of each item of the scale was good, the infit mean square value ranged from 0.64 to 1.29, and the outfit mean square value ranged from 0.62 to 1.34. The range of item difficulty was—2.26 to 3.16, matching well with the depression level of the participants. The options of each item were independent and had good discrimination. Conclusion The Chinese version of EPDS has good reliability and unidimensionality, and has good applicability in screening postpartum depression in puerperal women. Based on Rasch model analysis, it is found that the scale is primarily suitable for postpartum depression patients with mild to moderate severity, being less sensitive to high levels of depression. The effectiveness and sensitivity of the scale in clinical application can be further improved by adding items with higher difficulty levels.
Key words:  Edinburgh postnatal depression scale  Rasch analysis  postpartum depression  screening