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一种用于测量深静脉血栓形成(DVT)患者健康相关生活质量的工具:深静脉血栓形成生活质量(DVTQOL)问卷的编制与验证

An instrument for measuring health-related quality of life in patients with Deep Venous Thrombosis (DVT): development and validation of Deep Venous Thrombosis Quality of Life (DVTQOL) questionnaire.

作者信息

Hedner Ewa, Carlsson Jonas, Kulich Károly R, Stigendal Lennart, Ingelgård Anders, Wiklund Ingela

机构信息

Experimental Medicine, AstraZeneca, R&D, SE-431 83 Mölndal, Sweden.

出版信息

Health Qual Life Outcomes. 2004 Jun 23;2:30. doi: 10.1186/1477-7525-2-30.

Abstract

BACKGROUND

Few studies have evaluated patient-reported outcomes in connection with a primary event of deep venous thrombosis, partly due to a lack of disease-specific measures. The aim here was to develop a disease-specific health-related quality of life (HRQL) measure, the deep venous thrombosis quality of life questionnaire (DVTQOL), for patients with recent exposition and treatment of proximal deep venous thrombosis.

METHODS

A total of 121 consecutive outpatients (50 % males; mean age 61.2 +/- 14 years) treated with warfarin (Waran) for symptomatic proximal deep venous thrombosis were included in the study. Patients completed the SF-36, EQ-5D and the pilot version of the DVTQOL.

RESULTS

Items having: high ceiling and floor effect, items with lower factor loadings than 0.50 and items loading in several factors were removed from the pilot version of DVTQOL. In addition, overlapping and redundant items identified by the Rasch analysis were excluded. The final DVTQOL questionnaire consists of 29 items composing six dimensions depicting problems with: emotional distress; symptoms (e.g. pain, swollen ankles, cramp, bruising); limitation in physical activity; hassle with coagulation monitoring; sleep disturbance; and dietary problems. The internal consistency reliability was high (alpha value ranged from 0.79 to 0.93). The relevant domains of the SF-36 and EQ-5D significantly correlated with DVTQOL, thereby confirming its construct validity.

CONCLUSIONS

The DVTQOL is a short and user-friendly instrument with good reliability and validity. Its test-retest reliability and responsiveness to change in clinical trials, however, must be explored.

摘要

背景

很少有研究评估与深静脉血栓形成原发性事件相关的患者报告结局,部分原因是缺乏针对该疾病的测量方法。本研究的目的是为近期发生并接受治疗的近端深静脉血栓形成患者开发一种针对该疾病的健康相关生活质量(HRQL)测量工具,即深静脉血栓形成生活质量问卷(DVTQOL)。

方法

本研究纳入了121例连续的门诊患者(50%为男性;平均年龄61.2±14岁),这些患者因有症状的近端深静脉血栓形成接受华法林(Waran)治疗。患者完成了SF-36、EQ-5D以及DVTQOL的预试验版本。

结果

具有高天花板效应和地板效应的条目、因子载荷低于0.50的条目以及在多个因子中载荷的条目从DVTQOL预试验版本中删除。此外,通过Rasch分析确定的重叠和冗余条目也被排除。最终的DVTQOL问卷由29个条目组成,分为六个维度,描述了以下问题:情绪困扰;症状(如疼痛、脚踝肿胀、抽筋、瘀伤);身体活动受限;凝血监测麻烦;睡眠障碍;以及饮食问题。内部一致性信度较高(α值范围为0.79至0.93)。SF-36和EQ-5D的相关领域与DVTQOL显著相关,从而证实了其结构效度。

结论

DVTQOL是一种简短且用户友好的工具,具有良好的信度和效度。然而,其重测信度以及在临床试验中对变化的反应性仍有待探索。

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