Tangtrakulwanich Boonsin, Wiwatwongwana Sutti, Chongsuvivatwong Virasakdi, Geater Alan F
Department of Orthopaedic Surgery and Physical Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
J Med Assoc Thai. 2006 Sep;89(9):1454-9.
Short-form 36 (SF-36) and Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) are common instruments for measuring quality of life (QoL) in patients with knee osteoarthritis. The goal of the present study was to compare the performance of both instruments in evaluating QoL in patients with knee osteoarthritis as diagnosed by the American College of Rheumatology (ACR) criteria. Treatment included nonsteroidal anti-inflammatory drugs and patient education for 6 weeks. Face-to-face interview by an orthopaedist was done at baseline and after treatment, including collection of demographic data and use of both SF-36 and WOMAC questionnaires. Evaluation of instrument performance included reliability, validity, and responsiveness measures. Reliability was tested by analysis of internal consistency using Cronbach's alpha at baseline and after treatment. Construct validity was computed by determining the correlation between each domain of SF-36 and WOMAC (Pearson's test). Responsiveness was compared between baseline and after treatment of both SF-36 and WOMAC in each domain using the paired t test. Fifty-two patients (8 men, 48 women) with a mean age of 58.4 years were included in the present study. About 75% of subjects had less than secondary education levels and most were from agricultural communities. Sixty-four percent had mild grade knee osteoarthritis. The internal consistency of WOMAC revealed good levels of reliability, both at baseline and after treatment, in all dimensions. The reliability of SF-36 was relatively low, especially in the role physical and bodily pain dimensions (Cronbach's alpha < 0.700). Construct validity between each dimension in SF-36 and WOMAC demonstrated coefficients ranging from -0.05 to -0.409. Both WOMAC and SF-36 showed good responsiveness when comparing scores before and after treatment in all domains. In conclusion, both the Thai version WOMAC and SF-36 were valid, reliable, and sensitive to change in evaluating QoL in Thai patients with knee osteoarthritis.
简明健康状况调查问卷（SF - 36）和西安大略和麦克马斯特大学骨关节炎指数（WOMAC）是用于测量膝关节骨关节炎患者生活质量（QoL）的常用工具。本研究的目的是比较这两种工具在评估根据美国风湿病学会（ACR）标准诊断的膝关节骨关节炎患者生活质量方面的表现。治疗包括使用非甾体抗炎药并进行为期6周的患者教育。在基线和治疗后由骨科医生进行面对面访谈，包括收集人口统计学数据以及使用SF - 36和WOMAC问卷。对工具性能的评估包括可靠性、有效性和反应性测量。通过在基线和治疗后使用Cronbach's alpha分析内部一致性来测试可靠性。通过确定SF - 36和WOMAC各领域之间的相关性（Pearson检验）来计算结构效度。使用配对t检验比较SF - 36和WOMAC在每个领域基线和治疗后的反应性。本研究纳入了52例患者（8例男性，48例女性），平均年龄58.4岁。约75%的受试者教育程度低于中学水平，且大多数来自农业社区。64%的患者患有轻度膝关节骨关节炎。WOMAC的内部一致性在基线和治疗后在所有维度上均显示出良好的可靠性水平。SF - 36的可靠性相对较低，尤其是在身体功能和身体疼痛维度（Cronbach's alpha < 0.700）。SF - 36和WOMAC各维度之间的结构效度系数范围为 - 0.05至 - 0.409。在比较所有领域治疗前后的得分时，WOMAC和SF - 36均显示出良好的反应性。总之，泰语版的WOMAC和SF - 36在评估泰国膝关节骨关节炎患者的生活质量方面都是有效、可靠且对变化敏感的。
