医学新生网络测评SCL-90量表的参考值和信效度研究

Network-Based Survey Exploring the Reference Value, Reliability and Validity of SCL-90 among Medical Freshman

摘要: 目的：揭示医学专业新生网络施测症状自评量表(SCL-90)的参考值和信效度，探讨时代变迁对问卷信度的影响。方法：以某医学院校2010~2019年间10个年级的35446名新生的SCL-90问卷的测验数据(有效数据33673份，有效率95.0%)为样本，对SCL-90问卷进行内部一致性信度、内容效度和结构效度分析。结果：① 男生和女生的心理问题发生率分别为23.89%和23.87%，城市和农村学生心理问题发生率分别为23.54%和24.11%，心理问题发生率在不同性别和不同生源地上的差异均无统计学意义(P值均 > 0.05)；② 以题总相关为指标的项目分析发现80道题目与总分相关在0.40~0.69之间(均P < 0.01)；③ 10个因子的内部一致性信度系数在0.70~0.89之间；④ 躯体化、强迫、人际关系、抑郁、偏执、精神病性、睡眠及饮食7个因子的信度系数与测评年份的相关系数在0.70~0.99之间(均P < 0.01)；⑤ 以因子分与总分相关为指标的内容效度分析发现10个因子与总分之间的相关系数在0.76~0.92之间(均P < 0.01)；⑥ 以各因子分之间的相关系数为指标的结构效度分析发现因子分间的相关系数为中等或中等偏上(0.55~0.82)；⑦ 来自10个因子的12道题目之间的相关均具有统计学意义(均P < 0.01)，来自同一因子的两道题目间的相关甚至小于与其他因子题目间的相关。结论：① SCL-90问卷的内部一致性信度、内容信度较高，但结构效度存在问题；② 网络施测没有导致问卷信度的下降。

Abstract: Objective: To explore the marginal value, reliability and validity of Symptom Check List 90 (SCL-90) and assess the effect of network-based survey on reliability. Method: The item analysis, internal consistency reliability, content validity and construct validity of SCL-90 were analyzed based on 35446 freshmen’s data (including 33673 valid data) of 10 grades in the past 10 years (2010~2019) from a medical university. Results: ① The rate of mental disturbances of male and female students was 23.89% and 23.87%, while the rate of mental disturbances of urban and rural students was 23.54% and 24.11%. The rate of psychological problems between male and female or urban and rural students had no significant difference; ② With regard to internal consistency, 80 item-total correlations were more than 0.4 (Ps < 0.01); ③ The Cronbach’s α of all ten factors reached 0.70~0.89; ④ The correlation coefficients between α of somatization, obsessive-compulsive, interpersonal sensitivity, depression, paranoid ideation, psychoticism and sleep-diet and the data collected year were 0.70~0.99 (Ps < 0.01); ⑤ With regard to content validity, the correlation coefficients between the scores of ten factors and total score were 0.76~0.92 (Ps < 0.01); ⑥ With regard to construct validity, the correlation coefficients between the score of each factor and another were moderate or even higher (0.55~0.82); ⑦ The correlations between the 12 items from 10 factors were statistically significant (Ps < 0.01), and the correlation coefficients between the 2 items from the same factor were lower than that between the 2 items from the different factors. Conclusion: ① The internal consistency reliability and content validity were satisfied, while the construct validity was somewhat of a question. ② There were no effects of network-based survey on the reliability of SCL-90.