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癌症患者生活质量测量工具系统通用模块的开发与验证

Development and validation of the general module of the system of quality of life instruments for cancer patients.

作者信息

Wan Chonghua, Yang Zheng, Meng Qiong, Feng Changyong, Wang Hongyue, Tang Xuelang, Zhang Caizhen, Lu Yubo, Luo Jionghong, Zhang Xiaqing

机构信息

School of Public Health, Kunming Medical College, Kunming 650031, Yunnan, China.

出版信息

Int J Cancer. 2008 Jan 1;122(1):190-6. doi: 10.1002/ijc.23036.

Abstract

Based on World Health Organization (WHO)'s definition of Quality of Life (QOL) and programmed decision procedures, we developed a general module of the System of Quality of Life Instruments for Cancer Patients (QLICP-GM) utilizing focus group discussions, pilot tests of 448 cases and field tests of 600 cases of 5 different cancer patients. The number of items in the final version was reduced to 32 from a 78-item pool. The psychometric properties of the scale were evaluated by indicators such as validity and reliability coefficients, SRM, and statistical methods of correlational analysis, t tests, and structural equation modeling. Correlational and structural equation model analyses indicate good construct validity with RMSEA 0.086, NNFI 0.947 and CFI 0.961. Good criterion-related validity was found when FACT-G was used as the criterion. The test-retest reliability for all domains and the overall scale is above 0.85; the internal consistency alpha for each domain is higher than 0.70 except of the social function; alpha and the split-half reliability of the overall scale is 0.88 and 0.93, respectively. The pre-post changes of QOL scores are of statistical significances in 3 domains of physical function, psychological function, common symptoms and side effects, and the overall instrument, with standardized response mean ranging from 0.16 to 0.67. Equivalence tests showed nonequivalence on quality of life score changes of these domains and the overall instrument. Our study shows that the QLICP-GM has good validity, reliability, responsiveness, and can be used as the general module for cancer patients in China.

摘要

基于世界卫生组织(WHO)对生活质量(QOL)的定义和程序化决策程序,我们通过焦点小组讨论、448例患者的预试验以及5种不同癌症患者的600例现场试验,开发了癌症患者生活质量量表系统通用模块(QLICP-GM)。最终版本的条目数量从78条缩减至32条。通过效度和信度系数、SRM等指标以及相关分析、t检验和结构方程建模等统计方法对量表的心理测量学特性进行了评估。相关分析和结构方程模型分析表明,该量表具有良好的结构效度,RMSEA为0.086,NNFI为0.947,CFI为0.961。以FACT-G为标准时,发现具有良好的效标关联效度。所有领域和总量表的重测信度均高于0.85;除社会功能外,各领域的内部一致性α系数均高于0.70;总量表的α系数和分半信度分别为0.88和0.93。生活质量得分在身体功能、心理功能、常见症状和副作用这3个领域以及总量表的前后变化具有统计学意义,标准化反应均值范围为0.16至0.67。等效性检验表明,这些领域和总量表在生活质量得分变化方面存在不等效性。我们的研究表明,QLICP-GM具有良好的效度、信度和反应度,可作为中国癌症患者的通用模块。

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