Hagell Peter, Whalley Diane, McKenna Stephen P, Lindvall Olle
Section of Restorative Neurology, Department of Clinical Neuroscience, University Hospital, Lund, Sweden.
Mov Disord. 2003 Jul;18(7):773-83. doi: 10.1002/mds.10438.
We assessed the feasibility and psychometric properties of two commonly used health status questionnaires in Parkinson's disease (PD): the generic Nottingham Health Profile (NHP) and the disease-specific 39-item Parkinson's disease Questionnaire (PDQ-39), from a cross-sectional postal survey of PD patients (N = 81), using traditional and Rasch measurement methodologies. Overall response rate was 88%. Both questionnaires were found feasible, although the NHP performed less well. The PDQ-39 had fewer floor effects and was better able to separate respondents into distinct groups than the NHP, whereas the latter exhibited less ambiguous dimensionality and better targeting of respondents with non-extreme scores. Reliability and validity indices were similar, and potential differential item functioning by age and gender groups was found for both questionnaires. PDQ-39 response alternatives indicated ambiguity. With few exceptions, questionnaire scales were unable to meet recommended standards fully. While preliminary, this study illustrates the need for thorough evaluation of outcome measures and has implications beyond the questionnaires used here. Although promising, both questionnaires warrant further developmental work and stronger support of measurement validity before they could be considered fully suitable for valid use in PD, in particular in earlier stages of the disease.
我们采用传统和拉施测量方法，对81名帕金森病（PD）患者进行了横断面邮寄调查，评估了帕金森病中两种常用健康状况问卷的可行性和心理测量特性：通用的诺丁汉健康量表（NHP）和特定疾病的39项帕金森病问卷（PDQ-39）。总体回复率为88%。尽管NHP表现稍逊，但两种问卷都被认为可行。与NHP相比，PDQ-39的地板效应较少，能更好地将受访者分为不同组，而NHP的维度模糊性较小，对非极端分数受访者的针对性更好。两种问卷的信度和效度指标相似，且在年龄和性别组中均发现了潜在的项目功能差异。PDQ-39的回答选项存在模糊性。除少数例外，问卷量表无法完全达到推荐标准。虽然这只是初步研究，但它说明了对结果测量进行全面评估的必要性，其影响范围超出了本文所使用的问卷。尽管前景乐观，但在被认为完全适用于帕金森病（尤其是疾病早期）的有效使用之前，这两种问卷都需要进一步开展开发工作并获得更强有力的测量效度支持。
