1.北京中医药大学管理学院,北京市房山区良乡高教园区阳光南大街,102488
2.深圳北京中医药大学研究院
3.广东省中医院珠海医院
yanbo0722@sina.com
收稿:2023-07-06,
修回:2024-07-26,
纸质出版:2024-12-02
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龙利群,朱燕波,史会梅等.中医体质量表的纵向测量等值性研究[J].中医杂志,2024,65(23):2427-2433.
LONG Liqun,ZHU Yanbo,SHI Huimei,et al.Longitudinal Measurement Invariance of Constitution in Chinese Medicine Questionnaire[J].Journal of Traditional Chinese Medicine,2024,65(23):2427-2433.
龙利群,朱燕波,史会梅等.中医体质量表的纵向测量等值性研究[J].中医杂志,2024,65(23):2427-2433. DOI: 10.13288/j.11-2166/r.2024.23.008.
LONG Liqun,ZHU Yanbo,SHI Huimei,et al.Longitudinal Measurement Invariance of Constitution in Chinese Medicine Questionnaire[J].Journal of Traditional Chinese Medicine,2024,65(23):2427-2433. DOI: 10.13288/j.11-2166/r.2024.23.008.
目的
2
检验标准化中医体质量表在中国成年人群中跨时间的测量等值性,为该量表的跨时间效应分析提供依据。
方法
2
纳入自愿接受26周中医体质综合干预的509例成人中医体质量表9个亚量表测评数据(3个时间点:干预前、干预13周、干预26周)。进行单组验证性因素分析以建立模型拟合良好的单组基线模型,进而使用嵌套模型即多组验证性因素分析拟合模型的纵向测量等值性,依次是形态等值、弱等值、强等值、严格等值,采用相对拟合指数(CFI)、近似均方根误差(RMSEA)、标准化残差均方根(SRMR)作为模型拟合指标进行分析。
结果
2
单组验证性因素分析证明中医体质量表9个亚量表在3个时间点均拟合良好(CFI:0.933~0.992,RMSEA:0.027~0.080,SRMR:0.022~0.045)。多组验证性因素分析显示,气郁质和特禀质2个亚量表跨时间的形态等值、弱等值、强等值、严格等值均成立(ΔCFI<0.01,ΔRMSEA<0.01);痰湿质亚量表跨时间的形态等值、弱等值、强等值、部分严格等值成立(ΔCFI<0.01,ΔRMSEA<0.01);平和质、气虚质、阳虚质、阴虚质、湿热质、血瘀质6个亚量表跨时间的形态等值、弱等值、部分强等值、部分严格等值成立(ΔCFI<0.01,ΔRMSEA<0.01)。
结论
2
中医体质量表在3个时间点上至少满足弱等值,可应用于不同时间点是否具有相同的单位或含义的研究。痰湿质、气郁质和特禀质亚量表强等值成立,满足均数跨时间比较;平和质、气虚质、阳虚质、阴虚质、湿热质、血瘀质亚量表满足部分强等值和部分严格等值,可部分解释均数跨时间比较的差异性。
Objective
2
To explore the longitudinal measurement invariance of standardized Constitution in Chinese Medicine Questionnaire (CCMQ) among Chinese adult populations, and to provide evidence for the longitudinal effect analysis of this questionnaire.
Methods
2
A total of 509 adults who voluntarily received 26 weeks of comprehensive traditional Chinese medicine (TCM) constitution fitness intervention were included (3 time points: before intervention, 13 weeks intervention, and 26 weeks intervention), evaluated by CCMQ with 9 subscales. A single-group confirmatory factor analysis was performed to establish a single-group baseline model with a well-fitting model, and then nested models, that is multiple groups of confirmatory factors analysis, are used to analyze the longitudinal measurement invariance, followed by configural invariance, metric invariance, scalar invariance, and strict invariance. Comparative Fit Index (CFI), Root Mean Square Error of Approximation (RMSEA), and Standardized Root Mean Square Residual (SRMR) were used as model fit indicators for the analysis.
Results
2
The single-group confirmatory factors analysis proved that the 9 subscales of CCMQ fit well at the three time points (CFI: 0.933~0.992, RMSEA: 0.027~0.080, SRMR: 0.022~0.045). The multiple-group confirmatory factors analysis showed that the configural, metric, scalar, and strict invariance across time of
qi
-stagnation and special diathesis constitution were established (ΔCFI<0.01, ΔRMSEA<0.01); the configural, metric, scalar, and partial strict invariance across time of phlegm-dampness constitution subscale were established (ΔCFI<0.01, ΔRMSEA<0.01); the configural, metric, partial scalar and partial strict invariance of 6 subscales, including gentleness,
qi
-deficiency,
yang
-deficiency,
yin
-deficiency, dampness-heat, and blood-stasis constitutions, were all established (ΔCFI<0.01, ΔRMSEA<0.01).
Conclusion
2
The CCMQ met at least metric invariance at 3 time points, which can be applied to the study of whether different time points have the same unit or meaning. The measurement invariance of the 3 subscales of phlegm-dampness,
qi
-stagnation and special diathesis, special diathesis have longitudinal measurement invariance, so the mean comparison over time could be made; while the 6 subscales of gentleness,
qi
-deficiency,
yang
-deficiency,
yin
-deficiency, dampness-heat, and blood-stasis constitutions meet partial scalar and partial strict invariance, which could be explained partially for the difference in the comparison of the mean over time.
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