中文版接纳与承诺疗法综合评估量表在鼻咽癌患者中的信效度：一项横断面研究

文献信息

中文摘要

目的： 接纳与承诺疗法（ACT）在肿瘤学中的应用日益增多，提示心理灵活性可能是癌症患者治疗、康复和幸福感的关键因素。中文版接纳与承诺疗法综合评估量表（CompACT-C）在乳腺癌患者中被发现具有可接受的信度和效度；然而，其心理测量学特性尚未在鼻咽癌（NPC）患者中得到验证。
方法： 采用便利抽样法，从中国广东省一家三级甲等医院招募确诊为鼻咽癌的参与者。患者提供一般人口学资料，并完成CompACT-C和接纳与行动问卷第二版（AAQ-II）。基于CompACT-C原始三因子结构，采用验证性因子分析检验其结构效度，并评估其内部一致性和2周重测信度。通过分析CompACT-C与AAQ-II之间的相关性确定聚合效度。
结果： 共有310名鼻咽癌患者（年龄：47.88 ± 11.45岁）完成问卷并纳入数据分析。大多数患者（75.2%）为男性。CompACT-C的三因子结构最初显示模型拟合较差（RMSEA = 0.073，CFI = 0.766，SRMR = 0.109）。在删除条目OE5、OE8和OE9并对条目OE7进行修改（从“经验开放性”维度重新分配到“行为觉察”维度）后，拟合得到改善[结构方程模型结果：χ2 = 338.999，df = 167，NC（χ2/df）= 2.030，RMSEA = 0.048，CFI = 0.918，TLI = 0.906，SRMR = 0.071]。在该鼻咽癌患者样本中，该量表表现出令人满意的内部一致性（Cronbach's α = 0.780）以及与AAQ-II的聚合效度（r = -0.570，p < 0.001）。
结论： CompACT-C在评估鼻咽癌患者心理灵活性方面表现出可接受的信度和效度，支持其作为未来研究中的评估工具使用。

英文摘要

OBJECTIVES: The increasing application of Acceptance and Commitment Therapy (ACT) in oncology suggests that psychological flexibility may be a crucial factor in the treatment of individuals with cancer, rehabilitation and well-being. The Chinese version of the Comprehensive Assessment of Acceptance and Commitment Therapy Processes (CompACT-C) was found to have acceptable reliability and validity among individuals with breast cancer; however, its psychometric properties have not been verified among individuals with nasopharyngeal carcinoma (NPC).
METHODS: Convenience sampling was used to recruit participants diagnosed with NPC from a Grade III Level A hospital in Guangdong Province, China. The patients provided general demographic data and completed the CompACT-C and the Acceptance and Action Questionnaire-II (AAQ-II). The construct validity of the CompACT-C was tested using confirmatory factor analysis based on its original three-factor structure, and its internal consistency and 2-week test-retest reliability were evaluated. Convergent validity was determined by analyzing the correlation between the CompACT-C and AAQ-II.
RESULTS: A total of 310 individuals with NPC (age: 47.88 ± 11.45 years) completed the questionnaire and were included in the data analysis. The majority of patients (75.2%) were male. The three-factor structure of the CompACT-C initially showed a poor model fit (RMSEA = 0.073, CFI = 0.766, SRMR = 0.109). After removing items OE5, OE8, and OE9 and modifying item OE7 (reassignment from the "Openness to Experience" to the "Behavioural Awareness" dimension), the fit improved [structural equation modeling results: χ2 = 338.999, df = 167, NC (χ2/df) = 2.030, RMSEA = 0.048, CFI = 0.918, TLI = 0.906, SRMR = 0.071]. The scale demonstrated satisfactory internal consistency (Cronbach's α = 0.780) and convergent validity with the AAQ-II (r = -0.570, p < 0.001) in this sample of individuals with NPC.
CONCLUSIONS: The CompACT-C demonstrated acceptable reliability and validity for assessing psychological flexibility in individuals with NPC, supporting its use as an assessment instrument in future research.