多発性硬化症セルフマネジメント尺度日本語版の開発

Development of a Japanese Version of the Multiple Sclerosis Self-Management Scale-Revised

要旨

　目的：米国で開発された多発性硬化症セルフマネジメント尺度（MSSM-R）の日本語版を作成し，日本語版尺度の信頼性と妥当性を検証する．

　方法：逆翻訳の手順を踏んで日本語版尺度を作成し予備調査を実施後，MS患者524名に対して本調査を実施した．信頼性を安定性および内的整合性で検討し，妥当性を併存妥当性および構成概念妥当性で検討した．

　結果：本調査実施2週間後の再テスト法による安定性はICC（1, 2）で0.93であった．MSSM-R日本語版尺度全体でクロンバックα係数0.85であった．また，外的基準との相関はr = 0.64であった．探索的因子分析の結果，1項目を除き原版と同様の因子構造となり，MSSM-R日本語版の適合度はGFI = 0.84，AGFI = 0.80，CFI = 0.83，RMSEA = 0.08であった．

　結論：MSSM-R日本語版は尺度全体としての信頼性と妥当性を確認でき，本尺度は使用可能な尺度と考えられた．ただし，1項目のみ原版と因子が異なるため，下位尺度で国際比較をする際には注意を要する．

　Objective: This study aims to develop a Japanese version of the multiple sclerosis self-management scale-revised (MSSM-R) developed in the United States and test its reliability and validity.

　Methods: A back-translation procedure was used to develop the Japanese version of the scale, a preliminary survey was conducted, and the primary survey was administered to 524 patients with multiple sclerosis. Reliability was examined for stability and internal consistency, and validity was examined for concurrent validity and construct validity.

　Result: The ICC for the stability of the test-retest conducted 2 weeks after the primary survey was 0.93. Overall, the Cronbach's α for the Japanese version of the MSSM-R was 0.85. The correlation coefficient with the external criteria scale was r = 0.64. An exploratory factor analysis revealed that the factor structure of the Japanese version of the MSSM-R was similar to that of the original version except for one item. The Japanese version of the MSSM-R had a goodness of fit of GFI = 0.84, AGFI = 0.80, CFI = 0.83, and RMSEA = 0.08.

　Conclusion: The overall reliability and validity of the Japanese version of the MSSM-R were confirmed, and this scale was deemed usable. However, as only one item in the international comparison differs from the original version in terms of factors, international comparisons of subscales should be approached with caution.