Lee Shin-Seok, Park Mi-Jeong, Yoon Hyun-Jeong, Park Yong-Wook, Park In-Hyae, Park Kyeong-Soo
Department of Rheumatology, Chonnam National University Medical School, Hak-Dong 5, Dong-Ku, Gwangju 501-746, South Korea.
Clin Rheumatol. 2006 May;25(3):353-7. doi: 10.1007/s10067-005-0049-5. Epub 2005 Nov 5.
Although the Health Assessment Questionnaire (HAQ) and the Modified Health Assessment Questionnaire are useful tools for assessing and monitoring patients with rheumatic diseases, they have a "floor effect" and do not fully reflect the psychological status of patients. Recently, the Multidimensional Health Assessment Questionnaire (MDHAQ) was developed to overcome these shortcomings. We translated the MDHAQ into the Korean language and evaluated its reliability and validity for use with Korean-speaking patients with rheumatoid arthritis (RA). The questionnaire was translated into the Korean language by three translators, who were aware of its objectives, and it was translated back into the English language by three different translators. One question was modified to reflect Korean culture, and imperial measures were changed to metric measures because most Koreans use the metric system. The Korean MDHAQ was administered to 136 patients with RA who were attending the outpatient rheumatology clinic at the Chonnam National University Hospital (Gwangju, South Korea). Test-retest reliability was assessed in 101 patients after 1 week. To assess criterion validity, we compared MDHAQ scores with HAQ scores and the American College of Rheumatology (ACR) functional class. To test construct validity, the MDHAQ was compared to ACR core criteria (tender and swollen joint count, pain, patient's global assessment, physician's global assessment, erythrocyte sedimentation rate, and C-reactive protein), the Beck Depression Inventory (BDI), and the State-Trait Anxiety Inventory (STAI). The test-retest reliability was analyzed by computing kappa statistics, which ranged from 0.60 to 0.76. Cronbach's alpha coefficient ranged from 0.892 to 0.938. The MDHAQ was significantly correlated with the HAQ and ACR functional class (all p<0.001). The correlations between the MDHAQ scores and the ACR core set, BDI, and STAI were all high and statistically significant. The Korean version of the MDHAQ is a reliable, valid tool for assessing Korean patients with RA.
尽管健康评估问卷(HAQ)和改良健康评估问卷是评估和监测风湿性疾病患者的有用工具,但它们存在“地板效应”,不能完全反映患者的心理状态。最近,为克服这些缺点开发了多维健康评估问卷(MDHAQ)。我们将MDHAQ翻译成韩语,并评估其在说韩语的类风湿关节炎(RA)患者中的信度和效度。问卷由三名了解其目的的翻译人员翻译成韩语,然后由另外三名不同的翻译人员再翻译回英语。修改了一个问题以反映韩国文化,并将英制单位改为公制单位,因为大多数韩国人使用公制。韩国版MDHAQ应用于136名在韩国光州全南国立大学医院门诊风湿病诊所就诊的RA患者。对101名患者在1周后进行重测信度评估。为评估效标效度,我们将MDHAQ得分与HAQ得分以及美国风湿病学会(ACR)功能分级进行比较。为检验结构效度,将MDHAQ与ACR核心标准(压痛和肿胀关节计数、疼痛、患者整体评估、医生整体评估、红细胞沉降率和C反应蛋白)、贝克抑郁量表(BDI)以及状态-特质焦虑量表(STAI)进行比较。通过计算kappa统计量分析重测信度,范围为0.60至0.76。克朗巴哈α系数范围为0.892至0.938。MDHAQ与HAQ和ACR功能分级显著相关(所有p<0.001)。MDHAQ得分与ACR核心指标、BDI和STAI之间的相关性均很高且具有统计学意义。韩国版MDHAQ是评估韩国RA患者的可靠、有效的工具。