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Article(id=1323941250218459445, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1323941237702668764, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202506158, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1749657600000, receivedDateStr=2025-06-12, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793581791691, onlineDateStr=2026-11-02, pubDate=1765296000000, pubDateStr=2025-12-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793581791691, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793581791691, creator=13701087609, updateTime=1793581791691, updator=13701087609, issue=Issue{id=1323941237702668764, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='23', pageStart='4225', pageEnd='4416', issueExtLink='null', onlineDate='null', pubDate='1765296000000', pubDateStr='2025-12-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793581788707, creator='13701087609', updateTime=1793581887795, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1323941653374959780, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1323941237702668764, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1323941653374959781, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1323941237702668764, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=4257, endPage=4261, ext={EN=ArticleExt(id=1323941250566586678, articleId=1323941250218459445, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Reliability and validity testing of the Chinese version of McCusker Subjective Cognitive Impairment Inventory-Self Report, columnId=1240413921954295836, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods, runingTitle=null, highlight=null, articleAbstract=
Objective

To translate McCusker Subjective Cognitive Impairment Inventory-Self Report (McSCI-S) into Chinese and to examine its reliability and validity.

Methods

The modified Brislin model was adopted to form the Chinese version of the McSCI-S scale through translation and back-translation processes. A convenience sampling method was used to investigate 460 residents from Huzhou. The reliability and validity of the scale were evaluated based on item response theory and classical test theory.

Results

The Chinese version of the McSCI-S was a unidimensional instrument comprising 29 items. The S-CVI/Ave was 0.986. Confirmatory factor analysis showed that the model fit was good. The criterion-related validity coefficient was 0.506.The total Cronbach’s α coefficient of the scale was 0.970, and the test-retest reliability was 0.903.

Conclusion

The Chinese version of the McSCI-S has good reliability and validity and can be used as a self-report instrument for assessing subjective cognitive impairment among residents in China.

, authors=Dong-yan LU, Juan FANG, Jian-miao WANG, Mei-juan CAO, Li-bing ZHANG, authorsList=Dong-yan LU, Juan FANG, Jian-miao WANG, Mei-juan CAO, Li-bing ZHANG, authorCompany=null, correspAuthors=Li-bing ZHANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1323941251527082297, articleId=1323941250218459445, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=McCusker主观认知障碍自我报告量表的汉化及信效度检验, columnId=1228016567632462653, journalTitle=现代预防医学, columnName=流行病与统计方法, runingTitle=null, highlight=null, articleAbstract=
目的

对McCusker主观认知障碍自我报告量表进行汉化和信效度检验。

方法

采用改良版Brislin模型，通过翻译、回译过程形成中文版McSCI-S量表。采用便利抽样法，对湖州市460名居民进行调查，基于项目反应理论和经典测量理论对量表进行信效度评价。

结果

中文版McSCI-S量表为单维度量表，共29个条目。该量表的内容效度指数为0.986。验证性因子分析显示模型拟合良好。效标关联系数为0.506。Cronbach α系数为0.970，重测信度为0.903。

结论

中文版McSCI-S量表信效度良好，可作为国内居民主观认知障碍的自我报告测评工具。

, authors=陆冬燕, 方娟, 王俭苗, 曹梅娟, 张利兵, authorsList=陆冬燕, 方娟, 王俭苗, 曹梅娟, 张利兵, authorCompany=null, correspAuthors=张利兵, authorNote=

陆冬燕（1993—），女，硕士，讲师，研究方向：老年健康照护

, correspAuthorsNote=
张利兵，E-mail：
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陆冬燕（1993—），女，硕士，讲师，研究方向：老年健康照护

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陆冬燕（1993—），女，硕士，讲师，研究方向：老年健康照护

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(In Chinese), articleTitle=Summary of evidence on cognitive interventions for patients with subjective cognitive decline, refAbstract=null)], funds=[Fund(id=1323941254484066662, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941250218459445, awardId=Y202454166, language=CN, fundingSource=浙江省教育厅一般科研项目(Y202454166), fundOrder=null, country=null), Fund(id=1323941254559564135, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941250218459445, awardId=2023GZ67, language=CN, fundingSource=湖州市科技计划项目(2023GZ67), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1323941251778740538, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941250218459445, xref=null, ext=[AuthorCompanyExt(id=1323941251787129147, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941250218459445, companyId=1323941251778740538, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Medicine & Nursing, Huzhou University, Huzhou, Zhejiang 313000, China), AuthorCompanyExt(id=1323941251795517756, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941250218459445, companyId=1323941251778740538, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=湖州师范学院医学院（护理学院），浙江　湖州　313000)])], figs=[ArticleFig(id=1323941253947195745, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941250218459445, language=EN, label=Figure 1, caption=Receiver operating characteristic curve for the McSCI-S, figureFileSmall=e0qZoiqcUfl7JRcCwl37SA==, figureFileBig=P5KS/xOm681LxTaiTjjAhw==, tableContent=null), ArticleFig(id=1323941254093996387, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941250218459445, language=CN, label=图1, caption=McSCI-S ROC曲线分析, figureFileSmall=e0qZoiqcUfl7JRcCwl37SA==, figureFileBig=P5KS/xOm681LxTaiTjjAhw==, tableContent=null), ArticleFig(id=1323941254270157156, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941250218459445, language=EN, label=Table 1, caption=

McSCI-S item parameters and mean information

, figureFileSmall=null, figureFileBig=null, tableContent=
条目ab1b2b3b4平均信息量
1.我的语言能力（包括理解能力、书面/口头表达能力）和说话能力出现困难1.5040.1041.0391.7672.5590.385*
2.我的记忆力出现明显的问题1.570-0.6700.1921.4082.8410.485*
3.我难以集中注意于不同的任务2.044-0.2960.4951.4032.5010.669
4.我难以解决家里日常生活中遇到的问题1.6050.0501.0972.0672.8600.449*
5.我难以记起自己把东西放在哪里了1.533-1.019-0.1591.4192.5360.476*
6.我（比以前）更加频繁地忘记日期1.942-0.4290.3681.3872.4580.629
7.我可能忘记正在和我说话的人的名字，即使我认识他/她1.9810.0150.7761.9222.6630.614
8.我难以复述刚听到的内容（比如电话号码、地址等）1.821-0.5690.2811.4342.3140.571
9.我会忘记两周前发生的事情细节1.529-0.7810.1121.3962.4430.456*
10.我不再像以前那样有条理了2.292-0.3840.4771.4612.5320.815
11.我很容易分心，以至于无法跟上对话或电影情节2.273-0.2430.5131.5202.4320.772
12.我写字或打字的速度（比以前）更慢了1.564-0.6080.3171.3162.6980.472*
13.我会忘记我近期打算要做的事情2.183-0.4140.3241.5272.5280.755
14.我常常不按计划行事（比预期的时间早或晚）2.432-0.0730.6411.6192.3260.812
15.我会忘记把车停在停车场的哪个位置了2.213-0.0230.5941.5492.6170.729
16.我难以提前制定计划并按计划执行2.491-0.0890.8121.6542.3670.853
17.我经常忘记年轻时在学校学到的基础知识1.202-1.068-0.1150.9912.1250.311*
18.有时候，我听不懂别人在说什么，哪怕我的听力没有问题2.771-0.1150.5921.5052.5211.029
19.我可能会撞到物体或人2.5680.1270.8882.0482.4880.854
20.我难以做出日常事务相关的决定（比如穿什么衣服，买什么东西）2.5320.1750.9181.8362.6400.872
21.别人告诉我，我会重复自己的话（比如，给他们讲同一件事或问同样的问题）2.7240.0260.6341.4362.1330.907
22.当我开车或走路回家时，我可能会开（走）过头，而且意识不到2.2530.0710.7391.9222.7230.746
23.我无法认出原本认识的名人（比如演员、歌手、电视角色）2.358-0.2960.5041.4732.4800.832
24.我难以处理家里的紧急情况（比如漏水，卧室里有蜘蛛、蟑螂和老鼠等）2.2570.0130.8471.8152.7780.770
25.我会忘记日常用品的名称（比如厨房用具，熟悉的家居用品）2.8820.3761.1081.9592.2860.924
26.我必须比以前更加努力，才能记住我所听到、读到或看到的东西1.999-0.4830.3021.2682.5280.668
27.即使我喜欢某件事，也无法集中注意力去完成3.044*0.0090.7111.6312.4071.136
28.我不能同时做两件事（比如一边洗碗一边和人说话，一边开车一边听收音机）2.3450.0840.8611.7902.3750.749
29.我（比以前）更加频繁地忘记今天是星期几2.558-0.2080.5341.3982.3390.904
30.我经常忘记如何使用最近刚学会的工具[比如电脑、（智能）手机]1.654-0.2980.5921.4542.3810.473*
31.我在地图上找不到朋友/亲戚的地址2.4460.1010.8191.5492.5320.821
32.我不能（像以前一样）玩好一些技巧性的游戏（比如桥牌、象棋、纸牌、麻将）或者做一些以前擅长的事情2.5810.1240.8701.6762.7060.914
33.说话的时候，我难以找到合适的词语（表达自己）2.431-0.3090.4671.7152.7780.902
34.我的笔迹发生了巨大的变化1.823-0.0090.9211.7772.7810.553
35.当我看老照片时，我无法认出一些以前认识的人2.5280.1260.8161.6222.3140.825
36.现在，有些东西我得读几遍才能理解2.224-0.4370.2551.2862.3720.763
37.我难以关注我周围发生的事情3.253*-0.0210.7851.5772.0821.173
38.我也许不能准确地临摹一幅画（比如树、房子等）2.037-0.2010.5731.3402.3400.638
39.我不再能完成简单的心算3.003*0.1560.8661.5382.0681.000
40.我有时会困惑如何去家里的某个房间（比如浴室、卧室、客厅）3.159*0.4511.0661.8722.6541.151
41.如果被打断，我无法从刚才被打断的地方继续谈话内容2.489-0.1980.4691.5082.3660.866
42.当我看到著名的地方或建筑物时，我可能认不出它们2.654-0.0180.7611.7042.5900.963
43.我难以给别人指路，因为我会搞混路线2.4410.0450.7811.5622.3230.799
44.我难以停止我刚开始做的事情2.9300.1370.9151.6862.3661.040
45.我会忘记至亲的名字或出生日期（比如孙辈、侄甥辈）2.4400.2070.8991.6932.3570.774
46.我难以使用我以前熟练使用的东西（例如电动剃须刀、微波炉、计算器）3.174*0.3391.0731.6572.5461.157
), ArticleFig(id=1323941254358237541, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1323941250218459445, language=CN, label=表1, caption=

McSCI-S项目参数及平均信息量

, figureFileSmall=null, figureFileBig=null, tableContent=
条目ab1b2b3b4平均信息量
1.我的语言能力（包括理解能力、书面/口头表达能力）和说话能力出现困难1.5040.1041.0391.7672.5590.385*
2.我的记忆力出现明显的问题1.570-0.6700.1921.4082.8410.485*
3.我难以集中注意于不同的任务2.044-0.2960.4951.4032.5010.669
4.我难以解决家里日常生活中遇到的问题1.6050.0501.0972.0672.8600.449*
5.我难以记起自己把东西放在哪里了1.533-1.019-0.1591.4192.5360.476*
6.我（比以前）更加频繁地忘记日期1.942-0.4290.3681.3872.4580.629
7.我可能忘记正在和我说话的人的名字，即使我认识他/她1.9810.0150.7761.9222.6630.614
8.我难以复述刚听到的内容（比如电话号码、地址等）1.821-0.5690.2811.4342.3140.571
9.我会忘记两周前发生的事情细节1.529-0.7810.1121.3962.4430.456*
10.我不再像以前那样有条理了2.292-0.3840.4771.4612.5320.815
11.我很容易分心，以至于无法跟上对话或电影情节2.273-0.2430.5131.5202.4320.772
12.我写字或打字的速度（比以前）更慢了1.564-0.6080.3171.3162.6980.472*
13.我会忘记我近期打算要做的事情2.183-0.4140.3241.5272.5280.755
14.我常常不按计划行事（比预期的时间早或晚）2.432-0.0730.6411.6192.3260.812
15.我会忘记把车停在停车场的哪个位置了2.213-0.0230.5941.5492.6170.729
16.我难以提前制定计划并按计划执行2.491-0.0890.8121.6542.3670.853
17.我经常忘记年轻时在学校学到的基础知识1.202-1.068-0.1150.9912.1250.311*
18.有时候，我听不懂别人在说什么，哪怕我的听力没有问题2.771-0.1150.5921.5052.5211.029
19.我可能会撞到物体或人2.5680.1270.8882.0482.4880.854
20.我难以做出日常事务相关的决定（比如穿什么衣服，买什么东西）2.5320.1750.9181.8362.6400.872
21.别人告诉我，我会重复自己的话（比如，给他们讲同一件事或问同样的问题）2.7240.0260.6341.4362.1330.907
22.当我开车或走路回家时，我可能会开（走）过头，而且意识不到2.2530.0710.7391.9222.7230.746
23.我无法认出原本认识的名人（比如演员、歌手、电视角色）2.358-0.2960.5041.4732.4800.832
24.我难以处理家里的紧急情况（比如漏水，卧室里有蜘蛛、蟑螂和老鼠等）2.2570.0130.8471.8152.7780.770
25.我会忘记日常用品的名称（比如厨房用具，熟悉的家居用品）2.8820.3761.1081.9592.2860.924
26.我必须比以前更加努力，才能记住我所听到、读到或看到的东西1.999-0.4830.3021.2682.5280.668
27.即使我喜欢某件事，也无法集中注意力去完成3.044*0.0090.7111.6312.4071.136
28.我不能同时做两件事（比如一边洗碗一边和人说话，一边开车一边听收音机）2.3450.0840.8611.7902.3750.749
29.我（比以前）更加频繁地忘记今天是星期几2.558-0.2080.5341.3982.3390.904
30.我经常忘记如何使用最近刚学会的工具[比如电脑、（智能）手机]1.654-0.2980.5921.4542.3810.473*
31.我在地图上找不到朋友/亲戚的地址2.4460.1010.8191.5492.5320.821
32.我不能（像以前一样）玩好一些技巧性的游戏（比如桥牌、象棋、纸牌、麻将）或者做一些以前擅长的事情2.5810.1240.8701.6762.7060.914
33.说话的时候，我难以找到合适的词语（表达自己）2.431-0.3090.4671.7152.7780.902
34.我的笔迹发生了巨大的变化1.823-0.0090.9211.7772.7810.553
35.当我看老照片时，我无法认出一些以前认识的人2.5280.1260.8161.6222.3140.825
36.现在，有些东西我得读几遍才能理解2.224-0.4370.2551.2862.3720.763
37.我难以关注我周围发生的事情3.253*-0.0210.7851.5772.0821.173
38.我也许不能准确地临摹一幅画（比如树、房子等）2.037-0.2010.5731.3402.3400.638
39.我不再能完成简单的心算3.003*0.1560.8661.5382.0681.000
40.我有时会困惑如何去家里的某个房间（比如浴室、卧室、客厅）3.159*0.4511.0661.8722.6541.151
41.如果被打断，我无法从刚才被打断的地方继续谈话内容2.489-0.1980.4691.5082.3660.866
42.当我看到著名的地方或建筑物时，我可能认不出它们2.654-0.0180.7611.7042.5900.963
43.我难以给别人指路，因为我会搞混路线2.4410.0450.7811.5622.3230.799
44.我难以停止我刚开始做的事情2.9300.1370.9151.6862.3661.040
45.我会忘记至亲的名字或出生日期（比如孙辈、侄甥辈）2.4400.2070.8991.6932.3570.774
46.我难以使用我以前熟练使用的东西（例如电动剃须刀、微波炉、计算器）3.174*0.3391.0731.6572.5461.157
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McCusker主观认知障碍自我报告量表的汉化及信效度检验
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陆冬燕 , 方娟 , 王俭苗 , 曹梅娟 , 张利兵
现代预防医学 | 流行病与统计方法 2025,52(23): 4257-4261
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现代预防医学 |流行病与统计方法 2025 , 52 (23) : 4257 -4261
McCusker主观认知障碍自我报告量表的汉化及信效度检验
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陆冬燕（1993—），女，硕士，讲师，研究方向：老年健康照护

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陆冬燕, 方娟, 王俭苗, 曹梅娟, 张利兵
作者信息
  • 湖州师范学院医学院（护理学院），浙江　湖州　313000
通讯作者:
张利兵，E-mail：
作者简介:

陆冬燕（1993—），女，硕士，讲师，研究方向：老年健康照护

Reliability and validity testing of the Chinese version of McCusker Subjective Cognitive Impairment Inventory-Self Report
Dong-yan LU, Juan FANG, Jian-miao WANG, Mei-juan CAO, Li-bing ZHANG
Affiliations
  • School of Medicine & Nursing, Huzhou University, Huzhou, Zhejiang 313000, China
出版时间: 2025-12-10 doi: 10.20043/j.cnki.MPM.202506158
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摘要
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目的

对McCusker主观认知障碍自我报告量表进行汉化和信效度检验。

方法

采用改良版Brislin模型，通过翻译、回译过程形成中文版McSCI-S量表。采用便利抽样法，对湖州市460名居民进行调查，基于项目反应理论和经典测量理论对量表进行信效度评价。

结果

中文版McSCI-S量表为单维度量表，共29个条目。该量表的内容效度指数为0.986。验证性因子分析显示模型拟合良好。效标关联系数为0.506。Cronbach α系数为0.970，重测信度为0.903。

结论

中文版McSCI-S量表信效度良好，可作为国内居民主观认知障碍的自我报告测评工具。

主观认知障碍  /  项目反应理论  /  经典测量理论  /  信度  /  效度
Objective

To translate McCusker Subjective Cognitive Impairment Inventory-Self Report (McSCI-S) into Chinese and to examine its reliability and validity.

Methods

The modified Brislin model was adopted to form the Chinese version of the McSCI-S scale through translation and back-translation processes. A convenience sampling method was used to investigate 460 residents from Huzhou. The reliability and validity of the scale were evaluated based on item response theory and classical test theory.

Results

The Chinese version of the McSCI-S was a unidimensional instrument comprising 29 items. The S-CVI/Ave was 0.986. Confirmatory factor analysis showed that the model fit was good. The criterion-related validity coefficient was 0.506.The total Cronbach’s α coefficient of the scale was 0.970, and the test-retest reliability was 0.903.

Conclusion

The Chinese version of the McSCI-S has good reliability and validity and can be used as a self-report instrument for assessing subjective cognitive impairment among residents in China.

Subjective cognitive impairment  /  Item response theory  /  Classical test theory  /  Reliability  /  Validity
陆冬燕, 方娟, 王俭苗, 曹梅娟, 张利兵. McCusker主观认知障碍自我报告量表的汉化及信效度检验. 现代预防医学, 2025 , 52 (23) : 4257 -4261 . DOI: 10.20043/j.cnki.MPM.202506158
Dong-yan LU, Juan FANG, Jian-miao WANG, Mei-juan CAO, Li-bing ZHANG. Reliability and validity testing of the Chinese version of McCusker Subjective Cognitive Impairment Inventory-Self Report[J]. Modern Preventive Medicine, 2025 , 52 (23) : 4257 -4261 . DOI: 10.20043/j.cnki.MPM.202506158
正文
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阿尔茨海默病是重大公共卫生问题[1]。主观认知下降（subjective cognitive decline，SCD）作为阿尔茨海默病临床前期的重要预警信号，其早期识别与评估具有重要价值[2]。SCD是指个体主观感觉到持续的认知减退，但在标准化认知测试中的表现仍处于正常范围[3]。但目前相关工具存在认知领域覆盖不全、敏感性不足等问题，制约了对SCD的精准识别[4]。2024年，Sohrabi等[5]开发了McCusker主观认知障碍自我报告量表（McCusker subjective cognitive impairment inventory-self report，McSCI-S），涵盖记忆力、语言能力、定向能力、注意/集中力、视觉构建能力和执行功能等六大核心认知领域。本研究综合运用项目反应理论（item response theory，IRT）和经典测量理论（classical test theory，CTT），对该量表进行检验，旨在为我国SCD的评估提供科学测评工具。
1　资料与方法
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1.1　原量表介绍
McSCI-S量表[5]为单维度量表，共46个条目。采用Likert 5 级评分，“几乎从不符合~几乎总是符合”依次计0～4分，分数越高，表示主观认知障碍越严重。Cronbach α系数为0.96，验证性因子分析显示模型拟合度良好。
1.2　McSCI-S的汉化
1.2.1　量表翻译
取得授权后，按照改良版Brislin模型[6]对量表进行汉化。由一名护理学硕士和一名具有海外访学经历的护理教师分别独立完成正译，形成中文版1和中文版2。研究团队通过比对和专家讨论，形成中文整合版。随后，请二名未接触原量表的医学博士独立将中文整合版回译成英文版1和英文版2。研究团队讨论修改后形成回译整合版。将中文整合版和回译整合版提交原作者审核，根据其意见进行修改，形成中文版McSCI-S量表。
1.2.2　量表的跨文化调试
邀请五名专家（包括神经心理学专家一名，老年护理专家二名和精神卫生护理专家二名）组成函询小组，对初始中文版量表在语言清晰度、文化适应性和内容相关性三个方面的表现进行评价。专家工作年限为8～20年；博士在三名，硕士二名。进行二轮专家咨询。
1.2.3　预调查
于2024年9月采用便利抽样法选取20名居民进行调查。纳排标准同正式调查。调查过程中，收集居民意见。
1.3　信效度检验
1.3.1　调查对象
采用便利抽样法，于2024年10—12月选取湖州市居民作为调查对象。纳入标准：（1）年龄≥39周岁（与原量表的实际应用人群保持一致[5]，重点考察中老年人群）；（2）对本研究知情，自愿参加。排除标准：（1）沟通障碍，无法完成调查；（2）自我或家属报告经医生诊断为轻度认知障碍或认知症（痴呆）。等级反应模型（graded response model，GRM）要求，样本量至少为250例[7]。基于探索性因子分析的样本量要求［条目数×（5～10倍）］。针对原量表46个条目，并考虑10%无效问卷，本研究确定最小样本量为253例。本研究经湖州师范学院医学伦理委员会批准（2023-HZKJJ-04），参与者均知情同意。
1.3.2　调查工具
（1）一般资料调查表：包括性别、年龄、文化程度、婚姻状况和居住情况；（2）中文版McSCI-S量表；（3）主观认知下降问卷（subjective cognitive decline questionnaire, SCD-Q9）：由Gifford等[8]编制，郝立晓等[9]汉化，包含整体记忆维度和日常活动能力维度，共9个条目。得分越高，提示主观认知下降程度越严重。Cronbach α系数为0.886。本研究选用SCD-Q9作为校标工具。
1.3.3　资料收集
由经培训的调查员一对一调查。调查前，向居民说明研究目的，并承诺匿名性和保密性。问卷现场收回，当天进行核查，剔除无效问卷。无效问卷判定标准为：（1）规律作答，如所有条目选择同一答案；（2）逻辑矛盾，如相似问题的回答存在矛盾；（3）信息缺失，如缺页或字迹无法辨认。共发放478份问卷，回收有效问卷460份，有效回收率为96.23%。选取30名居民间隔四周后进行重测[10]。
1.3.4　统计学方法
采用Epidata 3.1录入数据，采用SPSS 25.0、R语言中的mirt package和lordif package进行分析。首先，采用基于IRT的GRM，通过边际极大似然估计方法对模型参数进行估计。通过主成分分析确认是否满足单维性检验，若第一特征根与第二特征根的比值大于3，则满足单维性假设[11]。参数估计筛选指标：（1）区分度a：本研究选取a值介于0.3～3.0之间的条目[12]；（2）难度b：本研究选取b值介于-3～3之间的条目[13]；（3）项目平均信息量：一般认为平均信息量大于25/条目数的条目为良好，在25/条目数至16/条目数之间的条目则待改进，小于16/条目数的条目则判断为差[14]，本研究初始量表包含46个条目，删除信息量小于0.543的条目。使用lordif package对人口统计学变量进行项目功能差异（differential item functioning，DIF）评估，效应大小通过组间McFadden R2变化来评估，当R2>0.02时，表明该条存在DIF，予以删除[15]。基于CTT的条目筛选方法包括：（1）临界比值法：计算决断值（critical ratio，CR值），删除CR值小于3.000或P>0.05的条目；（2）积差相关法：计算每个条目与总分的积差相关系数（r值），r值小于0.4或P>0.05者，应予以删除；（3）同质性检验：计算删去某一项后的Cronbach α系数，若该系数增加，则考虑将其删除[16]。检验水准α=0.05。
2　结果
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2.1　量表翻译、跨文化调试及预调查结果
将翻译后的量表发给原作者审核，其修改意见为：将量表中的物品名称改成中国常见的物品；量表全称修改为“McCusker主观认知障碍自我报告量表”。跨文化调试过程，结合专家意见对量表进行以下修订：指导语中“注意到”改为“关注到” ；条目1中“语言能力”增加注释（包括理解能力、书面/口头表达能力）；条目6、条目12和条目29中增加“比以前”；条目11中“分心很快”改为“很容易分心”；条目32中“不再能”改为“不能像以前一样”。预调查中，调查对象均表示量表条目通俗易懂，故未予修改。
2.2　调查对象一般资料
本研究共纳入居民460人。其中，男性211人，女性249人；年龄（53.75±12.02）岁；小学及以下100人，初中123人，中专或高中74人，大学及以上163人；未婚17人，已婚418人，离婚12人，丧偶13人；独居32人，非独居428人。
2.3　条目筛选结果
2.3.1　IRT分析结果
2.3.1.1　单维性检验
因子分析结果显示，KMO值为0.977，Bartlett球形检验（χ2=16 412.776，P<0.01)），表明数据适合进行主成分分析。随后分析发现，第一因子的特征根为23.680，第二因子特征根为1.989，两者比值高达11.9，证明该量表具有单维性特征，适合进行IRT分析。
2.3.1.2　项目参数分析
分析发现，条目27、37、39、40和46的区分度超过3，其余各条目的区分度范围为1.202～2.930。所有条目的难度范围为-1.068～2.860，符合要求。所有条目的ICC曲线比较符合理想形状。量表总信息量峰值为74.020，量表总体的信息量较大。有8个条目的平均信息量小于0.543。见表1。
2.3.1.3　项目功能差异分析
结果显示条目30在年龄上存在DIF，条目7、19、20和34在文化程度上存在DIF。
2.3.2　CTT分析结果
（1）临界比值法：各条目的CR值为11.299～21.879（均P<0.05）；（2）积差相关法：相关系数均>0.4，在0.535～0.807之间（均P<0.05）；（3）同质性检验：各条目删除后的Cronbach α系数均未上升。
2.3.3　条目筛选情况汇总
结合上述二种理论的分析结果以及各认知领域条目内容的合理性，决定删除的条目序号为：1、2、4、5、7、9、12、17、19、20、27、30、34、37、39、40、46。至此，形成29个条目的中文版McSCI-S量表。
2.4　信效度检验
2.4.1　效度分析
2.4.1.1　内容效度
研究结果显示条目内容效度指数为0.800～1.000，量表内容效度指数为0.986。
2.4.1.2　结构效度
该量表为单维度量表，验证性因子分析结果显示：χ2/v=3.238，RMSEA=0.070，CFI=0.910，IFI=0.911，TLI=0.903，GFI=0.816，各项拟合指标接近适配值，提示模型拟合度可接受。
2.4.1.3　效标关联效度
修订后的McSCI-S得分与SCD-Q9得分的相关系数为0.506（P<0.05）。以SCD-Q9≥5分表示主观认知下降，绘制受试者工作特征（receiver operating characteristic，ROC）曲线，见图1。计算曲线下面积为0.806（95% CI：0.765～0.846），当McSCI-S得分为20.5时，约登指数为0.447，灵敏度为0.829，特异度为0.618。该值在保证较高敏感性的同时，也兼顾了特异性。
2.4.2　信度分析
量表的Cronbach α系数为0.970，重测信度为0.903。
3　讨论
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3.1　中文版McSCI-S汉化过程严谨
CTT主要从宏观层面对量表进行分析[13]。IRT注重微观评价，通过其信息参数筛选条目可提高测量精度[17]。本研究将两者结合进行量表修订。IRT分析显示，有五个条目的区分度过高，这些条目在主观认知下降较严重的人群较易发生，因此仅能区分部分个体，使量表精度受限。各条目的难度系数分布合理。有八个条目的平均信息量小，提示其测量标准误差较大。有五个条目存在DIF，这是多因素作用的结果。分析原因如下：年长群体较少接触现代电子科技产品，更可能认可条目30，该条目的作答可能受到科技产品使用经验的影响。不同文化程度居民对条目7的作答可能受其社交网络类型的影响。根据Cohn-Schwartz等[18]的研究，高文化程度群体更可能拥有多元化、较正式的社交网络（通常包含非亲属关系），更频繁使用全名和正式称谓，从而易出现对名字记忆问题的自我觉察。由于低文化程度群体更多从事体力劳动（如在工地、车间工作），环境本身存在更多碰撞风险，导致其更倾向于认可条目19。低文化程度群体的日常决策可能常由他人代劳，在面临决策时易感到困难，更易认可条目20。低文化群体书写较少，更倾向于认可条目34。CTT分析中，各条目临界比值法、积差相关法和同质性检验的结果均良好。
3.2　中文版McSCI-S具有较好的信效度
研究显示，条目内容效度指数为0.800～1.000，量表内容效度指数为0.986，表明内容效度良好。验证性因子分析结果表明中文版McSCI-S量表具有较好的结构效度。本研究选用SCD-Q9作为校标，显示中文版McSCI-S得分与SCD-Q9得分的相关系数为0.506，提示校标关联效度较好。量表的Cronbach α系数达到0.970，说明量表条目间具有高度一致性；间隔四周的重测相关系数为0.903，显示量表具有较好的稳定性。可见，中文版McSCI-S量表具有良好的信效度。
3.3　中文版McSCI-S具有较高的实用性
SCD患者发生认知障碍的风险是正常老年人的2.48倍[19]。早期识别和干预SCD，对延缓或逆转认知功能下降有重要意义。本研究确定中文版McSCI-S量表的临界值为大于等于20.5。由于缺乏金标准，其临界值有待进一步论证。汉化后中文版McSCI-S包含29个条目，内容表达符合中文习惯，同时也保持了原量表的认知域内容。研究[20]指出，与年龄相关的认知下降在大多数认知领域以相对统一的方式进行，这也是原量表设定为单维度结构的原因。尽管如此，该量表的不同认知域分数在应用中仍有参考价值。具体的认知域条目划分如下：语言能力（条目8、18、25、33、36），记忆力（条目13、15、21、23、26、35、42、45），注意力和集中力（条目3、11、41），执行功能（条目10、16、24、28、32、44），定向能力（条目6、14、22、29），视觉构建能力（条目31、38、43）。可基于该工具的测评结果，针对不同认知域的损伤情况开展训练干预[21]。
中文版McSCI-S的条目难度、区分度合理，信效度良好。该量表可用于自我报告主观认知障碍情况，有助于制定针对性干预方案，延缓或逆转认知功能下降。但本研究仍存在不足之处。一方面，本研究仅调查了湖州市居民，未来应扩大样本范围，以检验量表的广泛适用性。另一方面，本研究使用的是横断面数据，未来可开展纵向追踪，调查主观认知障碍随时间推移而发生的变化，进一步验证量表的适用性。
基金
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  • 浙江省教育厅一般科研项目(Y202454166)
  • 湖州市科技计划项目(2023GZ67)
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2025年第52卷第23期
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doi: 10.20043/j.cnki.MPM.202506158
  • 接收时间：2025-06-12
  • 首发时间：2026-11-02
  • 出版时间：2025-12-10
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  • 收稿日期：2025-06-12
基金
浙江省教育厅一般科研项目(Y202454166)
湖州市科技计划项目(2023GZ67)
作者信息
    湖州师范学院医学院（护理学院），浙江　湖州　313000

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红菇属 Russula 17 8.13
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