Szilasiová A, Macejová Z, Nagyová I, Kovarová M, Béresová A, Szilasiová J
II. interná klinika Lekárskej fakulty UPJS, Kosice, Slovenská republika.
Vnitr Lek. 2002 Jan;48(1):8-16.
BACKGROUND: Functional disability is one of the most important consequences of RA in the patient's daily life. The HAQ has been widely used in its self administered form for the assessment of disability. A sensitive and valid instrument is needed for a Slovak population with RA. OBJECTIVE: To evaluate reliability and validity of the Slovak version of the HAQ in patients with RA and to explore relationships between HAQ score and disease activity and to provide information concerning utilization of this instrument in clinical practice. METHODS: In preparing the Slovak version of the HAQ careful attention has been paid to the translation, in terms of linguistic and conceptual equivalence, in order to preserve the original purpose of the instrument. The wording of some items required adaptation to the current activities of daily living and Slovak lifestyle. The sample consisted of 160 RA-patients, out of which 135 were women and 25 were men. The inclusion criteria were the following: age from 20 to 70 years at the onset of the study, diagnosis of RA according to the ARA criteria. The exclusion criteria were the presence of another serious disease or very disabling RA (stage IV of the Steinbrocker's classification). To analyze the data t-test, correlations, one-way analysis of variance (ANOVA), and principal component analysis (PCA) available in the SPSS/PC+ statistical package were used. RESULTS: The Cronbach's coefficient of reliability alpha for the HAQ total scale was 0.94. The results of PCA showed that the 20 HAQ items loaded on four components for which the eigen values were greater than 1, accounting for 70% of overall interpersonal variability. Orthogonal varimax rotation of the principal components provided factor loadings reflecting the eight dimensions within the HAQ. Validity of the HAQ was examined further by means of known-groups technique. The HAQ was found to be sensitive to differentiate between the Steinbrocker's functional capacity groups, as well as between males and females. Moreover, significant correlations (p < or = 0.01) were found between the HAQ and the C-reactive protein, the ESR, the NHP-pain, the Ritchie articular index, the Steinbrocker's functional capacity (r = 0.31-0.62) and disease duration (p < or = 0.05, r = 0.17). CONCLUSION: The results of the current investigation provide support for reliability and construct validity of the Slovak version of the HAQ in patients with RA. The HAQ has sufficient discriminant ability. The index disability can be used as an criterion of severity of RA, as a criterion of effectiveness in therapeutical trials for patient stratification of the Slovak population with RA.
背景：功能残疾是类风湿关节炎（RA）对患者日常生活产生的最重要后果之一。健康评估问卷（HAQ）的自我管理形式已被广泛用于残疾评估。对于斯洛伐克的类风湿关节炎患者群体，需要一种敏感且有效的工具。 目的：评估斯洛伐克语版HAQ在类风湿关节炎患者中的信度和效度，探讨HAQ评分与疾病活动度之间的关系，并提供有关该工具在临床实践中应用的信息。 方法：在准备斯洛伐克语版HAQ时，在语言和概念对等方面对翻译给予了仔细关注，以保留该工具的原始目的。一些条目的措辞需要根据当前的日常生活活动和斯洛伐克生活方式进行调整。样本包括160名类风湿关节炎患者，其中135名女性，25名男性。纳入标准如下：研究开始时年龄在20至70岁之间；根据美国风湿病学会（ARA）标准诊断为类风湿关节炎。排除标准为存在另一种严重疾病或非常严重的类风湿关节炎（斯坦布鲁克分类的IV期）。使用SPSS/PC+统计软件包中的t检验、相关性分析、单因素方差分析（ANOVA）和主成分分析（PCA）来分析数据。 结果：HAQ总量表的Cronbach信度系数α为0.94。主成分分析结果表明，20个HAQ条目加载在四个特征值大于1的成分上，占总体人际变异性的70%。主成分的正交方差最大化旋转提供了反映HAQ内八个维度的因子载荷。通过已知组技术进一步检验了HAQ的效度。发现HAQ能够敏感地区分斯坦布鲁克功能能力组以及男性和女性。此外，还发现HAQ与C反应蛋白、红细胞沉降率（ESR）、诺丁汉健康量表疼痛分量表、里奇关节指数、斯坦布鲁克功能能力（r = 0.31 - 0.62）和病程（p≤0.05，r = 0.17）之间存在显著相关性（p≤0.01）。 结论：当前调查结果支持斯洛伐克语版HAQ在类风湿关节炎患者中的信度和结构效度。HAQ具有足够的判别能力。残疾指数可作为类风湿关节炎严重程度的标准，也可作为斯洛伐克类风湿关节炎患者群体分层治疗试验中疗效的标准。
Ann Acad Med Stetin. 2006
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