基于健康测量工具的共识标准对癌症复发恐惧评估工具的系统评价

doi:10.12114/j.issn.1007-9572.2022.0810

摘要/Abstract

摘要： 背景目前国内外可用于评估癌症复发恐惧的量表种类较多，且主要为自我报告量表，但有关此类量表测量学属性的系统评价研究较为缺乏，为评估工具的选择带来了困难。目的系统评价癌症患者癌症复发恐惧评估工具的测量学属性及研究的方法学质量，为医护人员选择更合适的评估工具提供参考。方法在PubMed、Embase、Web of Science、CINAHL、中国知网、维普网、万方数据知识服务平台、中国生物医学文献数据库中检索与癌症复发恐惧量表测量学属性评价相关的研究，检索时限为建库至2022-09-10。由2名研究者各自进行资料数据提取。同时采用基于健康测量工具的共识标准（COSMIN）系统评价指南对纳入评估工具进行评价，最终形成推荐意见。结果共纳入24篇文献，涉及6个癌症复发恐惧工具：恐惧癌症复发量表（FCRI）、癌症患者恐惧疾病进展量表（FOPQ）、7条目癌症复发恐惧量表（FCR-7）、癌症复发恐惧单项量表（FCR-1）、癌症担忧量表（CWS）、幸存者担忧评估问卷（ASC）。就量表的测量特性质量而言，除FCR-1和FCR-7内容效度为"不充分"，CWS为"未报告"以外，其余量表为"不确定"；除ASC量表结构效度为"充分"，FCR-1为"未报告"以外，其余量表均为模糊；内部一致性中，FCR-1为"不确定"，ASC量表为"不充分"以外，其余量表均为"充分"；稳定性方面，FCR-1及CWS为"不确定"，ASC为"未报告"，其他量表为"充分"；效标效度方面，ASC量表为"未报告"以外，其余量表均为"不充分"；跨文化效度方面，FCRI及ASC为"不确定"，其余量表为"未报告"。FCRI、FOPQ、FCR-7、FCR-1、CWS均为B级推荐，ASC为C级推荐。结论 FCRI的各个测量学属性得到了较为全面地评价，具有较好的信效度，可暂时被推荐使用，但其他测量学特性仍有待验证。

关键词: 肿瘤, 复发恐惧, 测量学属性, 系统评价, 评估工具, COSMIN指南

Abstract: Background There is a wide variety of scales that can be used to assess fear of cancer recurrence both domestically and internationally. Currently, the fear of cancer recurrence can be assessed by multiple domestic and foreign scales, most of which are self-report scales. However, it remains difficult to select assessment tools due to the lack of the systematic reviews of the measurement characteristics of such scales.Objective To systematically review the measurement characteristics and methodological quality of fear of cancer recurrence assessment tools in cancer patients, so as to provide reference for healthcare staff to select more appropriate assessment tools.Methods The search was performed in PubMed, Embase, Web of Science, CINAHL, CNKI, VIP, Wanfang Data, and China Biomedical Literature Database from the inception to September 10, 2022 for the measurement characteristic of fear of cancer recurrence assessment tools. Data were extracted independently by two researchers and the included assessment tools was evaluated by the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) system, to derive the final recommendations.Results A total of 24 studies were included, involving 6 fear of cancer recurrence assessment tools, including the Fear of Cancer Recurrence Inventory (FCRI) , Fear of Progression Questionnaire (FOPQ) , 7-item Fear of Cancer Recurrence Scale (FCR-7) , 1-item Fear of Cancer Recurrence (FCR-1) , Cancer Worry Scale (CWS) , and Assessment of Survivor Concerns (ASC) . In terms of the quality of measurement characteristics, the content validity of the scales were "uncertain" except for FCR-1 ("inadequate") , FCR-7 ("inadequate") and CWS ("not reported") , the construct validity of the scales were "uncertain" except for FCR-1 ("not reported") , the internal consistency of the scales were "adequate" except for FCR-1 ("uncertain") and ASC ("inadequate") , the stability of the scales were "uncertain" except for FCR-1 ("uncertain") and ASC ("not reported") . the criterion validity were "inadequate" except for ASC ("not reported") , the cross-cultural validity of the scales were "not reported" except for FCRI ("uncertain") and ASC ("uncertain") . In the end, FCRI, FOPQ, FCR-7, FCR-1, and CWS were considered as level B recommendation, and ASC was considered as level C recommendation.Conclusion Each measurement characteristic of FCRI has been evaluated more comprehensively with good reliability and validity, which can be temporarily recommended. However, other measurement characteristics still need to be verified.

Key words: Neoplasms, Fear of recurrence, Measurement characteristics, Systematic review, Assessment instruments, COSMIN guideline

张露露,陈欢,罗欢,等. 基于健康测量工具的共识标准对癌症复发恐惧评估工具的系统评价[J]. 中国全科医学, 2023, 26(17): 2138-2146. DOI: 10.12114/j.issn.1007-9572.2022.0810.
ZHANG Lulu,CHEN Huan,LUO Huan, et al. Fear of Cancer Recurrence Assessment Tools Based on COSMIN: a Systematic Review[J]. Chinese General Practice, 2023, 26(17): 2138-2146. DOI: 10.12114/j.issn.1007-9572.2022.0810.

图/表 5

参考文献 40

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#1	"fear of cancer recurrence" [Title/Abstract] OR "fear of cancer^*" [Title/Abstract] OR "FCR" [Title/Abstract]
#2	（instrumentation[sh] OR methods[sh] OR "Comparative Study" [pt] OR "psychometrics" [MeSH] OR psychometr[tiab] OR clinimetr[tw] OR clinometr[tw] OR "Outcome Assessment，Health Care" [MeSH] OR "outcome assessment" [tiab] OR "outcome measure" [tw] OR "observer variation" [MeSH] OR "observer variation" [tiab] OR "Health Status Indicators" [Mesh] OR "reproducibility of results" [MeSH] OR reproducib[tiab] OR "discriminant analysis" [MeSH] OR reliab[tiab] OR unreliab[tiab] OR valid[tiab] OR "coefficient of variation" [tiab] OR coefficient[tiab] OR homogeneity[tiab] OR homogeneous[tiab] OR "internal consistency" [tiab] OR（cronbach[tiab] AND（alpha[tiab] OR alphas[tiab]））OR（item[tiab] AND（correlation[tiab] OR selection[tiab] OR reduction[tiab]））OR agreement[tw] OR precision[tw] OR imprecision[tw] OR "precise values" [tw] OR test-retest[tiab] OR（test[tiab] AND retest[tiab]）OR（reliab[tiab] AND（test[tiab] OR retest[tiab]））OR stability[tiab] OR interrater[tiab] OR inter-rater[tiab] OR intrarater[tiab] OR intra-rater[tiab] OR intertester[tiab] OR inter-tester[tiab] OR intratester[tiab] OR intra-tester[tiab] OR interobserver[tiab] OR inter-observer[tiab] OR intraobserver[tiab] OR intra-observer[tiab] OR intertechnician[tiab] OR inter-technician[tiab] OR intratechnician[tiab] OR intra-technician[tiab] OR interexaminer[tiab] OR inter-examiner[tiab] OR intraexaminer[tiab] OR intra-examiner[tiab] OR interassay[tiab] OR inter-assay[tiab] OR intraassay[tiab] OR intra-assay[tiab] OR interindividual[tiab] OR inter-individual[tiab] OR intraindividual[tiab] OR intra-individual[tiab] OR interparticipant[tiab] OR inter-participant[tiab] OR intraparticipant[tiab] OR intra-participant[tiab] OR kappa[tiab] OR kappa's[tiab] OR kappas[tiab] OR repeatab[tw] OR（（replicab[tw] OR repeated[tw]）AND（measure[tw] OR measures[tw] OR findings[tw] OR result[tw] OR results[tw] OR test[tw] OR tests[tw]））OR generaliza[tiab] OR generalisa[tiab] OR concordance[tiab] OR（intraclass[tiab] AND correlation[tiab]）OR discriminative[tiab] OR "known group" [tiab] OR "factor analysis" [tiab] OR "factor analyses" [tiab] OR "factor structure" [tiab] OR "factor structures" [tiab] OR dimension[tiab] OR subscale[tiab] OR（multitrait[tiab] AND scaling[tiab] AND（analysis[tiab] OR analyses[tiab]））OR "item discriminant" [tiab] OR "interscale correlation" [tiab] OR error[tiab] OR errors[tiab] OR "individual variability"[tiab] OR "interval variability" [tiab] OR "rate variability" [tiab] OR（variability[tiab] AND（analysis[tiab] OR values[tiab]））OR（uncertainty[tiab] AND（measurement[tiab] OR measuring[tiab]））OR "standard error of measurement" [tiab] OR sensitiv[tiab] OR responsive[tiab] OR（limit[tiab] AND detection[tiab]）OR "minimal detectable concentration" [tiab] OR interpretab[tiab] OR（（minimal[tiab] OR minimally[tiab] OR clinical[tiab] OR clinically[tiab]）AND（important[tiab] OR significant[tiab] OR detectable[tiab]）AND（change[tiab] OR difference[tiab]））OR（small*[tiab] AND（real[tiab] OR detectable[tiab]）AND（change[tiab] OR difference[tiab]））OR "meaningful change" [tiab] OR "ceiling effect" [tiab] OR "floor effect" [tiab] OR "Item response model" [tiab] OR IRT[tiab] OR Rasch[tiab] OR "Differential item functioning" [tiab] OR DIF[tiab] OR "computer adaptive testing" [tiab] OR "item bank" [tiab] OR "cross-cultural equivalence" [tiab]）
#3	#1 AND #2

#1	"fear of cancer recurrence" [Title/Abstract] OR "fear of cancer^*" [Title/Abstract] OR "FCR" [Title/Abstract]
#2	（instrumentation[sh] OR methods[sh] OR "Comparative Study" [pt] OR "psychometrics" [MeSH] OR psychometr[tiab] OR clinimetr[tw] OR clinometr[tw] OR "Outcome Assessment，Health Care" [MeSH] OR "outcome assessment" [tiab] OR "outcome measure" [tw] OR "observer variation" [MeSH] OR "observer variation" [tiab] OR "Health Status Indicators" [Mesh] OR "reproducibility of results" [MeSH] OR reproducib[tiab] OR "discriminant analysis" [MeSH] OR reliab[tiab] OR unreliab[tiab] OR valid[tiab] OR "coefficient of variation" [tiab] OR coefficient[tiab] OR homogeneity[tiab] OR homogeneous[tiab] OR "internal consistency" [tiab] OR（cronbach[tiab] AND（alpha[tiab] OR alphas[tiab]））OR（item[tiab] AND（correlation[tiab] OR selection[tiab] OR reduction[tiab]））OR agreement[tw] OR precision[tw] OR imprecision[tw] OR "precise values" [tw] OR test-retest[tiab] OR（test[tiab] AND retest[tiab]）OR（reliab[tiab] AND（test[tiab] OR retest[tiab]））OR stability[tiab] OR interrater[tiab] OR inter-rater[tiab] OR intrarater[tiab] OR intra-rater[tiab] OR intertester[tiab] OR inter-tester[tiab] OR intratester[tiab] OR intra-tester[tiab] OR interobserver[tiab] OR inter-observer[tiab] OR intraobserver[tiab] OR intra-observer[tiab] OR intertechnician[tiab] OR inter-technician[tiab] OR intratechnician[tiab] OR intra-technician[tiab] OR interexaminer[tiab] OR inter-examiner[tiab] OR intraexaminer[tiab] OR intra-examiner[tiab] OR interassay[tiab] OR inter-assay[tiab] OR intraassay[tiab] OR intra-assay[tiab] OR interindividual[tiab] OR inter-individual[tiab] OR intraindividual[tiab] OR intra-individual[tiab] OR interparticipant[tiab] OR inter-participant[tiab] OR intraparticipant[tiab] OR intra-participant[tiab] OR kappa[tiab] OR kappa's[tiab] OR kappas[tiab] OR repeatab[tw] OR（（replicab[tw] OR repeated[tw]）AND（measure[tw] OR measures[tw] OR findings[tw] OR result[tw] OR results[tw] OR test[tw] OR tests[tw]））OR generaliza[tiab] OR generalisa[tiab] OR concordance[tiab] OR（intraclass[tiab] AND correlation[tiab]）OR discriminative[tiab] OR "known group" [tiab] OR "factor analysis" [tiab] OR "factor analyses" [tiab] OR "factor structure" [tiab] OR "factor structures" [tiab] OR dimension[tiab] OR subscale[tiab] OR（multitrait[tiab] AND scaling[tiab] AND（analysis[tiab] OR analyses[tiab]））OR "item discriminant" [tiab] OR "interscale correlation" [tiab] OR error[tiab] OR errors[tiab] OR "individual variability"[tiab] OR "interval variability" [tiab] OR "rate variability" [tiab] OR（variability[tiab] AND（analysis[tiab] OR values[tiab]））OR（uncertainty[tiab] AND（measurement[tiab] OR measuring[tiab]））OR "standard error of measurement" [tiab] OR sensitiv[tiab] OR responsive[tiab] OR（limit[tiab] AND detection[tiab]）OR "minimal detectable concentration" [tiab] OR interpretab[tiab] OR（（minimal[tiab] OR minimally[tiab] OR clinical[tiab] OR clinically[tiab]）AND（important[tiab] OR significant[tiab] OR detectable[tiab]）AND（change[tiab] OR difference[tiab]））OR（small*[tiab] AND（real[tiab] OR detectable[tiab]）AND（change[tiab] OR difference[tiab]））OR "meaningful change" [tiab] OR "ceiling effect" [tiab] OR "floor effect" [tiab] OR "Item response model" [tiab] OR IRT[tiab] OR Rasch[tiab] OR "Differential item functioning" [tiab] OR DIF[tiab] OR "computer adaptive testing" [tiab] OR "item bank" [tiab] OR "cross-cultural equivalence" [tiab]）
#3	#1 AND #2

第一作者	发表年份（年）	评估工具	研究地区	样本量（例）	条目数/维度数（个）	对象来源	评分方法	完成时间（min）	重测时间
PENG^[14]	2019	FCRI	中国	207	9/1	乳腺癌	Likert 5级	NR	NR
XU^[15]	2022	FCRI-C	中国	326	42/7	滤泡型淋巴癌	Likert 5级	NR	1周
宿婷^[16]	2018	FCRI	中国	240	42/7	不同类型癌症	Likert 5级	NR	2周
YOUSSEF^[17]	2021	FOP-Q-RS	德国	1 002	12/1	不同类型癌症	Likert 5级	NR	NR
SIMARD^[18]	2009	FCRI	加拿大	232	42/7	不同类型癌症	Likert 5级	NR	1个月
EYRENCI ^[19]	2018	FCRI	土耳其	219	24/5	不同类型癌症	Likert 5级	30	NR
JAKOBSEN^[20]	2018	FCRI	丹麦	78	42/7	妇科癌症	Likert 5级	NR	2周
LEBEL^[21]	2016	FCRI	英国	350	42/7	不同类型癌症	Likert 5级	NR	1个月
LIU^[22]	2020	FCRI	新加坡	331	42/7	不同类型癌症	Likert 5级	NR	NR
SHIN^[23]	2017	K-FCRI	韩国	444	42/7	不同类型癌症	Likert 5级	NR	NR
VAN HELMONDT^[24]	2017	FCRI-NL	荷兰	255	42/7	淋巴癌和肺癌	Likert 5级	NR	2周
HERSCHBACH ^[25]	2005	FOPQ	德国	411	43/5	癌症及慢性病	Likert 5级	20~40	1周
黄燕萍^[26]	2022	FOPQ	中国	269	43/5	血液系统肿瘤	Likert 5级	10~20	1周
HINZ^[27]	2015	FOP-Q-12	德国	2 059	12/1	不同类型癌症	Likert 5级	NR	NR
吴奇云^[28]	2015	FOP-Q-SF	中国	678	12/2	肝癌	Likert 5级	NR	NR
蔡建平^[29]	2018	FOP-Q-SF	中国	237	12/2	乳腺癌	Likert 5级	NR	NR
CHENG^[30]	2022	FOP-Q-SF	中国	311	12/2	不同类型癌症	Likert 5级	NR	2周
HUMPHRIS^[31]	2018	FCR-7	英国	425	7/1	结肠直肠癌	1~6条目Likert 5级，第7条目Likert 10级	NR	NR
张永福^[32]	2019	FCRQ	中国	571	7/1	不同类型癌症	1~6条目Likert 5级，第7条目Likert 10级	NR	1个月
CUSTERS^[33]	2018	CWS	荷兰	194	8/1	乳腺癌	Likert4级	NR	NR
RUDY^[34]	2020	FCR-1	加拿大	69	1/1	妇科癌症	0~100分	NR	1周
CHIRICO^[35]	2022	CWS	意大利	108	8/1	乳腺癌	Likert 4级	NR	1个月
LEE^[36]	2020	FCR7-C	中国	160	7/1	肺癌	1~6条目Likert 5级，第7条目Likert 10级	NR	NR
GOTAY^[37]	2007	ASC（修订）	美国	753	5/2	不同类型癌症	Likert 4级	NR	NR

第一作者	发表年份（年）	评估工具	研究地区	样本量（例）	条目数/维度数（个）	对象来源	评分方法	完成时间（min）	重测时间
PENG^[14]	2019	FCRI	中国	207	9/1	乳腺癌	Likert 5级	NR	NR
XU^[15]	2022	FCRI-C	中国	326	42/7	滤泡型淋巴癌	Likert 5级	NR	1周
宿婷^[16]	2018	FCRI	中国	240	42/7	不同类型癌症	Likert 5级	NR	2周
YOUSSEF^[17]	2021	FOP-Q-RS	德国	1 002	12/1	不同类型癌症	Likert 5级	NR	NR
SIMARD^[18]	2009	FCRI	加拿大	232	42/7	不同类型癌症	Likert 5级	NR	1个月
EYRENCI ^[19]	2018	FCRI	土耳其	219	24/5	不同类型癌症	Likert 5级	30	NR
JAKOBSEN^[20]	2018	FCRI	丹麦	78	42/7	妇科癌症	Likert 5级	NR	2周
LEBEL^[21]	2016	FCRI	英国	350	42/7	不同类型癌症	Likert 5级	NR	1个月
LIU^[22]	2020	FCRI	新加坡	331	42/7	不同类型癌症	Likert 5级	NR	NR
SHIN^[23]	2017	K-FCRI	韩国	444	42/7	不同类型癌症	Likert 5级	NR	NR
VAN HELMONDT^[24]	2017	FCRI-NL	荷兰	255	42/7	淋巴癌和肺癌	Likert 5级	NR	2周
HERSCHBACH ^[25]	2005	FOPQ	德国	411	43/5	癌症及慢性病	Likert 5级	20~40	1周
黄燕萍^[26]	2022	FOPQ	中国	269	43/5	血液系统肿瘤	Likert 5级	10~20	1周
HINZ^[27]	2015	FOP-Q-12	德国	2 059	12/1	不同类型癌症	Likert 5级	NR	NR
吴奇云^[28]	2015	FOP-Q-SF	中国	678	12/2	肝癌	Likert 5级	NR	NR
蔡建平^[29]	2018	FOP-Q-SF	中国	237	12/2	乳腺癌	Likert 5级	NR	NR
CHENG^[30]	2022	FOP-Q-SF	中国	311	12/2	不同类型癌症	Likert 5级	NR	2周
HUMPHRIS^[31]	2018	FCR-7	英国	425	7/1	结肠直肠癌	1~6条目Likert 5级，第7条目Likert 10级	NR	NR
张永福^[32]	2019	FCRQ	中国	571	7/1	不同类型癌症	1~6条目Likert 5级，第7条目Likert 10级	NR	1个月
CUSTERS^[33]	2018	CWS	荷兰	194	8/1	乳腺癌	Likert4级	NR	NR
RUDY^[34]	2020	FCR-1	加拿大	69	1/1	妇科癌症	0~100分	NR	1周
CHIRICO^[35]	2022	CWS	意大利	108	8/1	乳腺癌	Likert 4级	NR	1个月
LEE^[36]	2020	FCR7-C	中国	160	7/1	肺癌	1~6条目Likert 5级，第7条目Likert 10级	NR	NR
GOTAY^[37]	2007	ASC（修订）	美国	753	5/2	不同类型癌症	Likert 4级	NR	NR

第一作者	评估工具	内容效度			结构效度		内部一致性		稳定性		跨文化效度		效标效度
第一作者	评估工具	相关性	全面性	理解性	指标	评价结果	Cronbach's α系数	评价结果	ICC	评价结果	指标	评价结果	相关性/AUC	评价结果
PENG^[14]	FCRI	NR	NR	NR	NR	NR	NR	NR	NR	NR	NR	NR	0.77~0.88（HADS）	I/-
XU^[15]	FCRI-C	D^a，b/?	D^a，b/?	D^b/?	CFA：7个因子CFI=0.91	V/?	0.78-0.97	V/+	0.82~0.87	D/+	DIF分析	V/?	0.77 （PHQ-9评分）	I/-
宿婷^[16]	FCRI-CV	D^a，b/+	D^a，b/?	D^b/?	CFA：7个因子CFI=0.96	A/+	0.71~0.90	V/+	NR	D/?	NR	NR	NR	NR
YOUSSEF^[17]	FOP-Q-RS	A^a/?	A^a/?	NR	CFA：1个因子CFI=0.82	V/？	NR	D/？	NR	NR	NR	NR	（GAD-7）	I/-
SIMARD^[18]	FCRI	D^a，b/+	D^a，b/+	D^b/+	EFA：7个因子	A/？	0.75~0.95	V/+	NR	D/？	NR	NR	NR	NR
EYRENCI^[19]	FCRI	D^a，b/?	D^a/?	D^b/?	CFA：5个因子CFI=0.92	A/？	0.80~0.88	V/+	NR	A/+	NR	NR	NR	NR
JAKOBSEN^[20]	FCRI	D^a，b/+	D^a，b/?	D^b/?	NR	I/-	NR	NR	0.84	D/+	NR	NR	NR	NR
LEBEL ^[21]	FCRI	D^a，b/+	D^a，b/?	D^b/?	CFA：7个因子CFI>0.95	V/+	0.71~0.94	V/+	NR	D/?	MGCFA	I/？	NR	NR
LIU^[22]	FCRI	NR	NR	NR	CFA：7个因子CFI=0.91	V/?	0.70~0.87	V/+	NR	D/?	NR	NR	（FOPQ）	I/-
SHIN^[23]	K-FCRI	D^a，b/+	D^a，b/+	D^b/?	CFA：7个因子CFI=0.90	V/?	0.77~0.87	V/+	0.90	D/+	MGCFA	I/？	NR	NR
VAN HELMONDT^[24]	FCRI-NL	D^b/？	NR	D^b/?	CFA：7个因子	A/?	>0.8	V/+	0.84	V/?	NR	NR	NR	NR
HERSCHBACH^[25]	FOPQ	A^a，b/+	A^a，b/+	D^b/+	EFA：5个因子	I/+	0.70~0.95	V/+	NR	D/?	NR	NR	NR	NR
黄燕萍^[26]	FOPQ	D^a，b/?	D^a，b/?	D^b/?	CFA：5个因子	A/？	0.81~0.94	V/+	NR	NR	NR	NR	NR	NR
HINZ^[27]	FOP-Q-12	D^a，b/?	D^a，b/?	D^b/?	CFA：1个因子CFI=0.88	V/？	0.90	V/+	NR	NR	NR	NR	NR	NR
吴奇云^[28]	FOP-Q-SF	D^b/?	D^b/?	D^b/?	EFA和CFA：2个因子CFI=0.90	V/？	0.82/0.81	V/+	NR	NR	NR	NR	NR	NR
蔡建平^[29]	FOP-Q-SF	NR	NR	NR	EFA：2个因子	A/？	0.83/0.84	V/+	NR	NR	NR	NR	NR	NR
CHENG^[30]	FOP-Q-SF	NR	NR	NR	EFA：2个因子CFI=0.95	A/+	0.92	A/+	NR	NR	NR	NR	NR	NR
HUMPHRIS^[31]	FCR7	NR	NR	NR	EFA：1个因子	V/+	0.92	V/+	NR	D/+	NR	NR	NR	NR
张永福^[32]	FCRQ	D^a/？	D^a，b/?	D^b/?	EFA：7个因子	A/?	0.86	V/?	NR	NR	NR	NR	0.52~0.75 （FOP-Q-SF、PHQ、GAD）	I/-
CUSTERS^[33]	CWS	NR	NR	NR	EFA：8个因子	A/?	0.71~0.82	V/+	NR	NR	NR	NR	0.83~0.93（CAS）	I/-
RUDY^[34]	FCR-1	D^a，b/-	D^a，b/-	D^a，b/-	NR	NR	NR	D/?	NR	D/?	NR	NR	0.85（FCRI）	I/-
CHIRICO^[35]	CWS	NR	NR	NR	EFA：8个因子	A/？	>0.90	V/+	NR	D/?	NR	NR	0.87（CAS）	I/-
LEE^[36]	FCR7-C	D^a，b/?	D^a，b/?	D^b/?	CFA：1个因子	V/+	NR	D/+	NR	NR	NR	NR	NR	NR
GOTAY^[37]	ASC（修订）	D^b/-	D^b/?	D^b/?	EFA：2个因子CFI=0.99	V/+	0.93/0.63	V/-	NR	NR	NR	NR	NR	NR