Construct validity and reliability of the Rivermead Post-Concussion Symptoms Questionnaire
Construct validity and reliability of the Rivermead Post-Concussion Symptoms Questionnaire
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DOI：
10.1191/0269215505cr905oa
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发表时间：
2005-12-01
影响因子：
3
通讯作者：
Tennant, A
中科院分区：
文献类型：
--
作者：
Eyres, S;Carey, A;Tennant, A
目的：为Rivermead脑震荡后症状问卷的信度和内外效度提供进一步的证据。该问卷用于测量颅脑损伤后脑震荡症状的严重程度。设计和地点：对两家城市教学医院和一个社区信托机构连续的颅脑损伤患者进行横断面研究。患者：369名患者从1689名连续的18岁及以上的成年颅脑损伤患者中收回问卷，方法：内部结构效度用Fit to Rasch测量模型检验，外部结构效度用Rivermead颅脑损伤随访问卷(RHFUO)相关检验；重测信度以两周为间隔进行相关检验。结果：Rivermead震荡后症状问卷和Rivermead颅脑损伤随访问卷。主要结果：RPQ得分范围从0到(17.3%下限，0.3%上限)。与Rasch模型的总体拟合度较差(条目拟合度均值为-0.416，SD=1.989，卡方=172.486，p<；1.989)，表明缺乏统一维度。头痛、头晕和健忘显示了不匹配的残差，前两个项目也显示出显著的项目特质匹配统计(p<；0.0006)。在剔除头痛、头晕和随后的恶心后，RPQ在总体和个别项目水平上都表现出良好的适合性，对于其余13个项目(RPQ-13)和现在形成附属量表的三个项目(RPQ-3)都是如此。所有项目在不同年龄和性别之间的功能都是一致的。RPQ-13和RPQ-3量表的重测信度系数分别为0.89和0.72(P值均为0.01)，与RHFUQ得分呈正相关(P值分别为0.83和0.62，均为P值和0.01)。结论：RPQ-13和RPQ-3不符合现代心理测量学标准。它的16个项目不涉及相同的基本结构，不应在一个分数中求和。当RPQ被分成两个单独的量表，RPQ-13和RPQ-3，每组条目形成了一个无因次结构，适用于受伤后三个月的头部损伤患者。该量表具有良好的测评信度和良好的外部结构效度。
Objectives: To provide further evidence of reliability and internal and external construct validity of the Rivermead Post-Concussion Symptoms Questionnaire (RPQ), which measures severity of postconcussion symptoms following head injury.Design and setting: A cross-sectional study of consecutive patients presenting with a head injury in two urban teaching hospitals and a community trust.Patients: Three hundred and sixty-nine patients returned a questionnaire from 1689 consecutive adult patients (18 years and above) referred to radiology for a skull X-ray following a head injury, and those who were currently under the care of a community-based multidisciplinary head injury team.Method: Internal construct validity tested by fit to the Rasch Measurement model-, external construct validity tested by correlations with Rivermead Head Injury Followup Questionnaire (RHFUO); test-retest reliability tested by correlations at two-week intervals.Outcome measures: Rivermead Post-Concussion Symptoms Questionnaire and Rivermead Head Injury Follow-up Questionnaire.Main results: RPQ scores ranged from 0 to 64 (17.3% floor, 0.3% ceiling). Overall fit to the Rasch model was poor (item fit mean - 0.416, SD = 1.989, chi-squared = 172.486, p < 0.01) suggesting a lack of unidimensionality. The items headaches, dizziness and forgetful displayed misfitting residuals and the first two items also displayed significant item trait fit statistics (p < 0.0006). After removing the items headaches, dizziness and subsequently nausea the RPQ demonstrated good fit at overall and individual item levels, both for the remaining 13 items (RPQ-13) and the three items (RPQ-3) which now formed a subsidiary scale. All items functioned consistently across age and gender. The RPQ-13 and RPQ-3 scales showed test-retest reliability coefficients of 0.89 and 0.72 (both p-values < 0.01) and positive correlations with RHFUQ scores (0.83 for RPQ-13, 0.62 for RPQ-3, both p-values < 0.01).Conclusions: As currently used, the RPQ does not meet modern psychometric standards. Its 16 items do not tap into the same underlying construct and should not be summated in a single score. When the RPQ is split into two separate scales, the RPQ-13 and the RPQ-3, each set of items forms a undimensional construct for people with head injury at three months post injury. These scales show good testretest reliability and adequate external construct validity.