解释问题与患者健康问卷说明书的解释问题
Margarita Panayiotou1, Josip Razum2,3, Gudrun Eisele4
1Manchester Institute of Education, University of Manchester, Manchester, United Kingdom.
JAMA psychiatry
|December 17, 2025
概括
患者健康问卷 (PHQ) 的有效性受到质疑,因为说明被广泛误解. 许多参与者不明白是否报告症状频率或烦,这会影响抑郁症评估的准确性.
科学领域:
- 心理评估 心理评估
- 心理健康研究方法的方法论.
背景情况:
- 患者健康问卷 (PHQ) 版本 (PHQ-2,PHQ-8,PHQ-9) 在研究和临床环境中广泛用于抑郁症评估.
- 对于PHQ仪器的有效性存在担忧,特别是响应是否反映症状的频率或症状令人困扰的程度.
研究的目的:
- 调查参与者如何解释PHQ的指令,这些指令旨在根据烦来衡量症状严重程度.
- 评估参与者在完成PHQ时是否关注症状频率或烦.
主要方法:
- 利用了来自普通人口样本 (亚马逊机械土耳其人,n=503) 和中度至重度抑郁症的临床样本 (OPTIMA研究,n=349) 的数据.
- 评估了参与者对PHQ-8指令的解释,使用三个完成后的问题,包括一个假设的场景和自我报告的解释基础 (频率与烦).
- 在2022年至2023年期间收集的数据.
主要成果:
- 两个样本中的绝大多数参与者误解了PHQ指令,只有54.7% (MTurk) 和15.5% (OPTIMA) 正确地理解了假设场景中的"被打扰"方面.
- 较少的参与者报告说,他们的PHQ反应是基于症状的烦 (21.3%MTurk,11.7%OPTIMA) 或打算在未来这样做 (22.3%MTurk,9.9%OPTIMA).
- 发现PHQ-8的有效性根据参与者对其说明的解释而有所不同.
结论:
- 在社区和临床样本中发现了PHQ指令的广泛误解.
- 这些发现引发了对PHQ在研究目的和临床决策中的有效性严重的担忧.
- 修改PHQ指令或评估方法可能是必要的,以确保精确的抑郁测量.
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