Lee Eun Hyun, Tahk Seong Jai, Shin Jun Han, Lee Young Whee, Song Rhayun
Graduate School of Public Health, Ajou University, Korea.
Taehan Kanho Hakhoe Chi. 2007 Apr;37(3):313-23. doi: 10.4040/jkan.2007.37.3.313.
Health-related quality of life (HRQOL) in patients with cardiovascular disease in Korea has rarely been studied, mostly due to the lack of a psychometrically validated disease-specific instrument. The purpose of this study was to develop and validate a cardiovascular specific-HRQOL questionnaire (CD-QOL).
The CD-QOL was developed and validated as follows; item generation, pilot study, and psychometric tests. Patients were recruited from three-university hospitals. The patients were asked to complete the preliminary questionnaire comprising the content-validated items, SF-36, and CES-D. The NYHA and KASI classifications were used to classify the functional performance of the patients. The data was analyzed using correlation, factor analysis, multidimensional scaling, multitrait/multi-item matrix, ANOVA, and Cronbach's alpha.
Preliminarily, thirty-nine items were generated. Factor analysisextracted a five-factor solution with a total of twenty-two items. One item was deleted based upon the MDS. The remaining items were moderately correlated with the subscales of the SF-36 and associated with depression measured with the CES-D. The mean scores of patients in NYHA and KASI class I were significantly higher than those in NYHA and KASI class II or/and III, which suggested patients with better functional performance were likely to have a better HRQOL. Cronbach's alphas of the total and subscales were all greater than 0.70.
The CD-QOL is a easily applicable instrument with excellent psychometric properties of content, criterion, factorial, convergent, and known-groups validity, and internal consistency reliability in Korean patients with cardiovascular disease.
韩国心血管疾病患者的健康相关生活质量(HRQOL)很少被研究,主要原因是缺乏经过心理测量学验证的疾病特异性工具。本研究的目的是开发并验证一份心血管疾病特异性HRQOL问卷(CD-QOL)。
CD-QOL的开发和验证过程如下:项目生成、预试验和心理测量测试。患者从三所大学医院招募。要求患者完成包含内容效度验证项目、SF-36和CES-D的初步问卷。采用纽约心脏协会(NYHA)和韩国心功能分级(KASI)对患者的功能状态进行分类。使用相关性分析、因子分析、多维标度法、多特质/多项目矩阵、方差分析和克朗巴赫α系数对数据进行分析。
初步生成了39个项目。因子分析提取了一个包含22个项目的五因子解决方案。根据多维标度法删除了一个项目。其余项目与SF-36的子量表中度相关,并与CES-D测量的抑郁相关。NYHA和KASI I级患者的平均得分显著高于NYHA和KASI II级或/和III级患者,这表明功能状态较好的患者可能具有更好的HRQOL。总量表和子量表的克朗巴赫α系数均大于0.70。
CD-QOL是一种易于应用的工具,在韩国心血管疾病患者中具有良好的内容效度、标准效度、因子效度、收敛效度、已知组效度和内部一致性信度等心理测量学特性。