关键词: 糖尿病足, 住院病人, 病人健康问卷抑郁自评量表, 信度, 效度

Abstract: Objective　To evaluate the reliability and validity of patient health questionnaire-9（PHQ-9） in inpatients with diabetic foot ulcers（DFU）.Methods　120 inpatients with DFU,who had received treatment in endocrinology department of one top three hospitals in Guangzhou from August 2014 to June 2015,were recruited in this study.We adopted self-designed general information questionnaire to collect the general data of patients;evaluated the depression situation of patients by PHQ-9 and tested the reliability and validity of the questionnaire,including content validity,construct validity,known-group validity,internal consistency reliability and test-retest reliability;verified the evaluated results of PHQ-9 by depression scale of Structured Clinical Interview（SCID） for American Diagnostic and Statistical Manual of Mental Disorders（4th Version）（DSM-IV）,and determined the diagnostic critical value of major depression.Results　PHQ-9 included 9 items totally,the content validity index（I-CVI） of each item was 1.00,1.00,1.00,0.83,1.00,1.00,0.83,1.00,1.00 respectively,and the content validity index of total scale（S-CVI） was 0.96.The average total score of PHQ-9 was（11.7±6.4）,the result of Pearson correlation analysis showed that there was a linear positive correlation between scores of each item and of the total scale（P<0.05）.We got two common factors,they were cognitive-emotion factor and somatic symptom factor,which could interpret 62.1% amount of variability of the scale jointly.Significant difference was found in cognitive-emotion dimension scores among patients with different genders,monthly incomes per person,self-care abilities,Wagner ranks,numerical rating scale scores（NRS） of DFU,and history or risk of limb/toe amputation（P<0.05）;and significant difference was found in somatic symptoms dimension scores among patients with different self-care abilities,NRS of DFU,history or risk of limb/toe amputation（P<0.05）.The Cronbach’s α coefficient of total scale,cognitive-emotion dimension and somatic symptom dimension was 0.88,0.86 and 0.70 respectively;the test-retest reliability coefficient was 0.87,0.89 and 0.83 respectively.The receiver operating characteristics（ROC） showed that there was significant difference in screening depression situation of DFU patients by PHQ-9〔area under the curve（AUC）=0.914,95%CI（0.862,0.967）,P<0.05）〕,the diagnostic critical value of major depression was 10,sensitivity was 0.928 and specificity was 0.804.Conclusion　The PHQ-9 application in DFU patients shows good reliability and validity.The diagnostic critical value of major depression was 10 with rather high sensitivity and specificity.The application of PHQ-9 in screening depression disorders for DFU inpatients was suggested.

Key words: Diabetic foot, Inpatients, Patient health questionnaire, Reliability, Validity