Nicolucci A, Giorgino R, Cucinotta D, Zoppini G, Muggeo M, Squatrito S, Corsi A, Lostia S, Pappalardo L, Benaduce E, Girelli A, Galeone F, Maldonato A, Perriello G, Pata P, Marra G, Coronel G A
Dipartimento di Farmacologia Clinica e Epidemiologia, Consorzio Mario Negri Sud, S. Maria Imbaro, CH, Italy.
Diabetes Nutr Metab. 2004 Aug;17(4):235-43.
To validate the Italian version of the World Health Organization (WHO)-Well-Being Questionnaire (WBQ) and the WHO-Diabetes Treatment Satisfaction Questionnaire (DTSQ) in Type 1 and Type 2 diabetic patients.
The cultural adaptation of the questionnaires was performed by using standard forward/backward techniques. Internal consistency reliability was estimated by Cronbach's alpha coefficient. Construct validity was evaluated using the Short Form-36 (SF-36) Health Status Questionnaire. Finally, the discriminative properties of the questionnaires were evaluated relative to the patients' characteristics. The questionnaires were administered to a random sample of patients identified in twelve outpatient diabetes clinics.
Overall, 412 subjects were recruited, of whom 96 (23%) with Type 1 diabetes. Item-scale correlations were >0.40 for all the items. Cronbach's alpha coefficient was 0.86 for the WHO-DTSQ and ranged between 0.79 and 0.91 for the WHO-WBQ. High correlations were found between WHO-WBQ scales and the mental dimensions of the Short Form-36 (SF-36) questionnaire, but not between WHO-DTSQ and SF-36 scores. Women, obese subjects, those with longer diabetes duration and multiple complications showed a worse quality of life in all of the four areas of the WHO-WBQ. In Type 2 diabetic subjects, SF-36 scores, but not WHO-WBQ scores, were able to discriminate the population according to the treatment modalities. Lower levels of treatment satisfaction were related to female gender, longer diabetes duration, insulin treatment, presence of diabetes complications and HbA1c levels >7.0%. The flexibility of the treatement was perceived as a major problem even among patients treated with oral agents.
The WHO-DTSQ can be considered as a valuable instrument to be used internationally for the description of diabetes treatment satisfaction. The WHO-WBQ also shows adequate psychometric properties, but additional data are needed to clarify whether it is more sensitive than SF-36, the most widely used generic instrument.
在1型和2型糖尿病患者中验证世界卫生组织（WHO）幸福问卷（WBQ）和WHO糖尿病治疗满意度问卷（DTSQ）的意大利语版本。
采用标准的正向/反向技术对问卷进行文化调适。通过克朗巴哈α系数估计内部一致性信度。使用简明健康状况调查问卷（SF-36）评估结构效度。最后，根据患者特征评估问卷的区分特性。将问卷发放给在12家门诊糖尿病诊所中确定的患者随机样本。
总体而言，招募了412名受试者，其中96名（23%）为1型糖尿病患者。所有项目的项目-量表相关性均>0.40。WHO-DTSQ的克朗巴哈α系数为0.86，WHO-WBQ的克朗巴哈α系数在0.79至0.91之间。WHO-WBQ量表与SF-36问卷的心理维度之间存在高度相关性，但WHO-DTSQ与SF-36得分之间不存在相关性。女性、肥胖受试者、糖尿病病程较长且有多种并发症的患者在WHO-WBQ的所有四个领域中生活质量较差。在2型糖尿病患者中，SF-36得分而非WHO-WBQ得分能够根据治疗方式区分人群。较低的治疗满意度与女性性别、较长的糖尿病病程、胰岛素治疗、糖尿病并发症的存在以及糖化血红蛋白水平>7.0%有关。即使在口服药物治疗的患者中，治疗的灵活性也被视为一个主要问题。
WHO-DTSQ可被视为一种有价值的工具，可在国际上用于描述糖尿病治疗满意度。WHO-WBQ也显示出足够的心理测量特性，但需要更多数据来阐明它是否比最广泛使用的通用工具SF-36更敏感。
