中文版頭痛失能量表之翻譯與心理計量檢驗

Translation and Psychometric Evaluation of Headache Disability Inventory-Chinese Version

頭痛是最常見的神經系統疾患，發作時可能嚴重影響工作、社交活動與日常活動。為了瞭解頭痛對病患生活的影響、評估頭痛失能狀態並進行不同文化的比較，需進行國際通用的頭痛失能症狀量表的翻譯與信效度檢定。本研究旨在針對「頭痛失能量表」（Headache Disability Inventory, HDI）進行量表中文版之翻譯與信效度檢定。採橫斷式研究設計，應用Jacobson等人提出的HDI，將量表翻譯成中文版本，再邀請專家評估內容效度；最後，招募北部某醫學中心140位有頭痛情形的臨床醫療人員，填寫此問卷中文版及偏頭痛失能評估表（Migraine Disability Assessment Scale, MIDAS），確認內在一致性信度、建構效度與校標關聯效度。「頭痛失能量表」中文版展現良好的信效度，包含：（1）專家內容效度在內容合適性與用詞明確性之CVI各達0.96與0.94；（2）內在一致性信度（Cronbach’s a 達0.95）；（3）建構效度結果為CFI=0.94, IFI=0.94, NNFI=0.93, SRMR=0.07，大多數的因素負荷量在0.60以上；（4）校標關聯效度，以中文版的「偏頭痛失能評估表（MIDAS）」，相關係數為r=0.34, p<0.001及「疼痛視覺類比量表」，相關係數為r=0.36, p<0.001，作為效度標準。「頭痛失能量表」中文版具有良好的信、效度，可快速又有效地評估習慣使用繁體中文的頭痛患者的失能情形，以協助制定適當的健康計劃。

Headache is the most prevalent neurological disorder worldwide. Headache disorders impact patients’ work, social activities, and daily activities. To better understand the impacts of headaches, and how these might differ from one country or culture to another, reliable and valid measures are needed in different languages. To address this need, here we (1) translated the Headache Disability Inventory into a Chinese version (HDI-C), and (2) examined the psychometric properties of the measure. The purpose of this study was to validate the Chinese version of the Headache Disability Inventory (HDI). The study adopted a cross-sectional design. First, forward translation approach was used to develop the HDI Chinese version. Second, experts were invited to validate the content of the draft scale. Finally, we enrolled 140 clinical health professionals with a history of headaches in a medical center in northern Taiwan to complete the HDI-C, along with Migraine Disability Assessment Scale (MIDAS). We then evaluated the internal consistency, criterion validity, average variance extracted. The HDI-C scales demonstrated good reliability and validity, including (1) content validity (0.96 and 0.94 for appropriateness and clarity, respectively), (2) internal consistency (Cronbach’a=5), (3) construct validity (CFI = 0.94, IFI = 0.94, NNFI = 0.93, SRMR = 0.07), all factor loadings higher than 0.60, and (4) criterion validity (positive correlations between HDI-C and MIDAS [r = 0.34, p < 0.001] and Visual Analogue Scale for headache [r = 0.36, p < 0.001], respectively). The HDI-C exhibited good reliability and validity among individuals with headaches who speak traditional Chinese language. The availability of HDI-C will assist the evaluation of headache patients to make prompt and appropriate health plans.