Price Patricia, Harding Keith
Wound Healing Research Unit, University of Wales College of Medicine, Heath Park, Cardiff, UK.
Int Wound J. 2004 Apr;1(1):10-7. doi: 10.1111/j.1742-481x.2004.00007.x.
The purpose of this study was to develop and validate a questionnaire to measure the impact of chronic wounds (leg ulcers and diabetic foot ulcers) on patient health-related quality of life (HRQoL) and identify areas of patient concern. The Cardiff Wound Impact Schedule (CWIS) was created following a three-stage process. Stage 1 included a focus group (n=10) and a series of semi-structured interviews (n=13) to generate items for the questionnaire. Stage 2 involved piloting the 28-item questionnaire on 124 patients (64.5% with leg ulceration and 35.5% with diabetic foot ulceration): data from this stage were analysed using factor analysis. The reliability, validity and reproducibility of the resulting scale were assessed in Stage 3, a 3-month follow-up study of 135 patients in which patients completed the CWIS and the SF-36. Factor analysis identified three domains of HRQoL: physical symptoms and daily living, social life and well-being. There were no significant differences in scores across the wound types. Internal consistency was good (alpha=0.77-0.96) as was reproducibility (P<0.001). The CWIS was able to discriminate between those with healed ulcers and active ulcers (P<0.01). Construct validity was demonstrated by strong correlations between related items on CWIS and SF-36 (P<0.01-P<0.0001). The data suggest that CWIS has high internal consistency and the ability to discriminate between health states and good reproducibility. CWIS is a valid tool for studying the impact of chronic wounds of the lower leg on HRQoL. CWIS allows clinicians to identify items of patient concern, which can then be used to negotiate options of care most suited to individual patients.
本研究的目的是开发并验证一份问卷，以衡量慢性伤口（腿部溃疡和糖尿病足溃疡）对患者健康相关生活质量（HRQoL）的影响，并确定患者关注的领域。卡迪夫伤口影响量表（CWIS）是经过三个阶段的过程创建的。第一阶段包括一个焦点小组（n = 10）和一系列半结构化访谈（n = 13），以生成问卷项目。第二阶段涉及在124名患者（64.5%患有腿部溃疡，35.5%患有糖尿病足溃疡）中试用这份包含28个条目的问卷：使用因子分析对该阶段的数据进行分析。在第三阶段对135名患者进行了为期3个月的随访研究，评估了所得量表的信度、效度和可重复性，在此阶段患者完成了CWIS和SF-36。因子分析确定了HRQoL的三个领域：身体症状与日常生活、社交生活与幸福感。不同伤口类型的得分没有显著差异。内部一致性良好（α = 0.77 - 0.96），可重复性也良好（P < 0.001）。CWIS能够区分溃疡已愈合和仍处于活动期的患者（P < 0.01）。CWIS与SF-36相关项目之间的强相关性证明了结构效度（P < 0.01 - P < 0.0001）。数据表明，CWIS具有较高的内部一致性、区分健康状态的能力以及良好的可重复性。CWIS是研究小腿慢性伤口对HRQoL影响的有效工具。CWIS使临床医生能够识别患者关注的项目，进而用于协商最适合个体患者的护理方案。
