Martin Charles G, Rubenstein Edward B, Elting Linda S, Kim Young Jun, Osoba David
Department of General Internal Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
Cancer. 2003 Aug 1;98(3):645-55. doi: 10.1002/cncr.11540.
Chemotherapy-induced nausea and emesis (CINE) is one of the most dreaded side effects of cancer therapy. To investigate the influence of these symptoms on a patient's quality of life (QOL), a validated tool measuring many domains is needed.
A QOL questionnaire consisting of scales from the European Organization for Research and Treatment of Cancer QLQ-C30, the Morrow Assessment of Nausea and Emesis, the Osoba Nausea and Emesis Module, and new items specific to nausea, emesis, and retching was constructed and administered daily for 7-9 days to outpatients receiving emetogenic chemotherapy.
Test-retest and internal consistency reliabilities ranged from 0.44 to 0.84 and from 0.59 to 0.85, respectively. Item and scale correlations indicated good convergent and discriminant validity. Scales and items measuring similar factors (e.g., severity of emesis and severity of nausea) had strong correlations than did scales measuring dissimilar factors (e.g., cognitive functioning and physical functioning). The validity of known groups was demonstrated by significant differences (P < 0.01) in patients' QOL scores between days with no episodes of nausea, emesis, or retching, days with 1 or 2 episodes, and days with more than 3 episodes. Patients' QOL significantly decreased as the number of episodes per day increased (P < 0.001).
A CINE QOL questionnaire that successfully measures the short-term impact of nausea, emesis, and retching on patients receiving emetogenic chemotherapy has been developed, largely as a battery of preexisting questionnaires. The psychometric properties of the new questionnaire show adequate reliability and validity to warrant its use in clinical trials and outcomes studies. CINE adversely affects many domains within a patient's QOL.
化疗引起的恶心和呕吐（CINE）是癌症治疗中最令人恐惧的副作用之一。为了研究这些症状对患者生活质量（QOL）的影响，需要一种经过验证的、能测量多个领域的工具。
构建了一份生活质量问卷，该问卷包含来自欧洲癌症研究与治疗组织QLQ-C30量表、莫罗恶心和呕吐评估量表、奥索巴恶心和呕吐模块的量表，以及针对恶心、呕吐和干呕的新项目，并对接受致吐性化疗的门诊患者每天进行为期7 - 9天的问卷调查。
重测信度和内部一致性信度分别在0.44至0.84以及0.59至0.85之间。项目与量表的相关性表明具有良好的收敛效度和区分效度。测量相似因素（如呕吐严重程度和恶心严重程度）的量表和项目之间的相关性，比测量不同因素（如认知功能和身体功能）的量表之间的相关性更强。通过无恶心、呕吐或干呕发作的日子、有1或2次发作的日子以及发作超过3次的日子里患者生活质量得分的显著差异（P < 0.01），证明了已知组的效度。患者的生活质量随着每天发作次数的增加而显著下降（P < 0.001）。
已开发出一种CINE生活质量问卷，该问卷成功测量了恶心、呕吐和干呕对接受致吐性化疗患者的短期影响，主要是作为一系列现有问卷的组合。新问卷的心理测量特性显示出足够的信度和效度，足以保证其在临床试验和结果研究中的应用。CINE对患者生活质量的多个领域产生不利影响。
