Objective: To explore the validity of the Chinese version of tinnitus handicap inventory (THI-CM) using confirmatory factor analysis. Methods: A cross-sectional study was carried out. The patients who complained of tinnitus and visited the Department of Otolaryngology, Head and Neck Surgery at West China Hospital of Sichuan University from March 15 to June 28, 2023 were included. All participants underwent pure tone audiometry and acoustic impedance testing before filling out THI-CM, and the results were subjected to confirmatory factor analysis. Results: A cross-sectional study was carried out. A total of 300 patients aged (47±13) years participated in this study. There were 175 females (58.3%) and 125 males (41.7%). The confirmatory factor analysis showed that χ2/df was 1.597<3.00, root mean square error of approximation (RMSEA) was 0.039<0.05, and standardized root mean square residual (SRMR) was 0.091>0.08. The incremental fit index (IFI), Tucker-Lewis index (TLI), comparative fit index (CFI), and goodness of fit index (GFI) were 0.960, 0.954, 0.960, and 0.902, respectively. The overall model fitted well. Except for one item with a load of 0.493, the load values of the other items were between 0.553 and 0.771. The composite reliability (CR) values of the three dimensions of the scale were between 0.769 and 0.901 (all CR>0.7). The average variance extracted (AVE) values ranged from 0.403 to 0.505 (all AVE<0.7), indicating poor convergent validity of the scale. The square value of AVE in each dimension of the scale was smaller than the correlation coefficient between factors, indicating poor discriminant validity of the scale. Conclusions: The THI-CM has good structural validity, which can be used as an effective tool to evaluate the overall severity of tinnitus. However, its convergent validity and discriminant validity are poor.
目的： 使用验证性因子分析探讨中文版耳鸣残疾量表（THI-CM）的有效性。 方法： 横断面研究。纳入2023年3月15日至6月28日于四川大学华西医院耳鼻咽喉头颈外科就诊的主诉为耳鸣的患者，受试者完成纯音测听、声导抗，填写THI-CM，对填写结果进行验证性因子分析。 结果： 共纳入300例耳鸣患者，其中男125例（41.7%），女175例（58.3%），年龄（47±13）岁。验证性因子分析结果显示，卡方与自由度比值（χ2/df）为1.597<3.00，渐进残差均方根（RMSEA）为0.039<0.05，标准化残差均方根（SRMR）为0.091>0.08，增值适配指数（IFI）、非规范适配指数（TLI）、比较适配指数（CFI）、拟合优度指数（GFI）分别为0.960、0.954、0.960、0.902，均>0.90；除SRMR外，其余指标均达评价标准，模型总体拟合良好；除了“当你有压力的时候耳鸣是否会加重？”载荷为0.493<0.5外，其余条目载荷值为0.553~0.771；量表3个维度组合信度（CR）值0.769~0.901，均>0.7；平均方差抽取量（AVE）值0.403~0.505，均<0.7；量表各维度AVE平方值均小于因子间相关系数。 结论： THI-CM具有较好的结构效度，可以作为评估耳鸣总体严重程度的有效工具，但收敛效度和区分效度较差。.