Thorpe Carolyn T, Devellis Robert F, Lewis Megan A, Blalock Susan J, Hogan Susan L, Devellis Brenda M
Veteran's Affairs Medical Center, Durham, North Carolina, USA.
Arthritis Rheum. 2007 Oct 15;57(7):1296-302. doi: 10.1002/art.23017.
To develop a measure of illness self-management for adults living with antineutrophil cytoplasmic antibody (ANCA)-associated small-vessel vasculitis (ANCA-SVV) and to gather evidence of its reliability and validity.
Development of the Vasculitis Self-Management Scale (VSMS) was guided by previous research on self-management in other chronically ill populations, a review of the current treatment literature for ANCA-SVV, interviews with patients, and consultation with experts. A total of 205 patients living with ANCA-SVV or a closely related condition then completed the VSMS, along with measures of sociodemographic and clinical variables, social desirability bias, and general adherence to medical recommendations, using a self-administered mailed questionnaire. A principal components analysis was conducted on the VSMS items. Internal consistency reliability and construct validity of the resulting subscales were assessed. Forty-four patients completed the VSMS a second time, for the purpose of assessing test-retest reliability.
Analyses suggested an 8-factor solution. The final VSMS consisted of 43 items representing these 8 behavioral domains. Correlations among the 8 domains were null to modest in magnitude. The internal consistency reliability of the 8 subscales ranged from minimally acceptable (alpha = 0.67) to excellent (alpha = 0.94), and correlations between subscale scores at time 1 and time 2 suggested good temporal stability. Preliminary evidence for validity was mixed.
These findings suggest that the VSMS is a promising method for assessing illness self-management in adults with ANCA-SVV. More research exploring the validity of the measure is warranted.
为抗中性粒细胞胞浆抗体（ANCA）相关小血管炎（ANCA-SVV）成年患者开发一种疾病自我管理测量工具，并收集其可靠性和有效性的证据。
血管炎自我管理量表（VSMS）的开发以前期其他慢性病患者自我管理的研究、对ANCA-SVV当前治疗文献的综述、患者访谈以及专家咨询为指导。然后，205例患有ANCA-SVV或密切相关疾病的患者使用自行邮寄的问卷完成了VSMS，以及社会人口统计学和临床变量、社会期望偏差和对医疗建议的总体依从性测量。对VSMS项目进行主成分分析。评估所得子量表的内部一致性信度和结构效度。44例患者再次完成VSMS，以评估重测信度。
分析提出了一个八因素解决方案。最终的VSMS由代表这8个行为领域的43个项目组成。8个领域之间的相关性在零到中等程度之间。8个子量表的内部一致性信度范围从勉强可接受（α=0.67）到优秀（α=0.94），第1次和第2次测量时子量表得分之间的相关性表明具有良好的时间稳定性。有效性的初步证据不一。
这些发现表明，VSMS是评估ANCA-SVV成年患者疾病自我管理的一种有前景的方法。有必要进行更多研究以探索该测量工具的有效性。
