Tones Megan J, Moss Nathan D
Queensland University of Technology, Victoria Park Road, Kelvin Grove, 4059, QLD, Australia.
Scoliosis. 2007 Oct 15;2:14. doi: 10.1186/1748-7161-2-14.
Body image and HRQL are significant issues for patients with scoliosis due to cosmetic deformity, physical and psychological symptoms, and treatment factors. A selective review of scoliosis literature revealed that self report measures of body image and HRQL share unreliable correlations with radiographic measures and clinician recommendations for surgery. However, current body image and HRQL measures do not indicate which aspects of scoliosis deformity are the most distressing for patients. The WRVAS is an instrument designed to evaluate patient self assessment of deformity, and may show some promise in identifying aspects of deformity most troubling to patients. Previous research on adolescents with scoliosis supports the use of the WRVAS as a clinical tool, as the instrument shares strong correlations with radiographic measures and quality of life instruments. There has been limited use of this instrument on adult populations.
The WRVAS and the SF-36v2, a HRQL measure, were administered to 71 adults with scoliosis, along with a form to report age and gender. Preliminary validation analyses were performed on the WRVAS (floor and ceiling effects, internal consistency and collinearity, correlations with the SF-36v2, and multiple regression with the WRVAS total score as the predictor, and SF-36v2 scores as outcomes).
The psychometric properties of the WRVAS were acceptable. Older participants perceived their deformities as more severe than younger participants. More severe deformities were associated with lower scores on the Physical Component Summary Score of the SF-36v2. Total WRVAS score also predicted Physical Component Summary scores.
The results of the current study indicate that the WRVAS is a reliable tool to use with adult patients, and that patient self assessment of deformity shared a relationship with physical rather than psychological aspects of HRQL. The current and previous studies concur that revision of the WRVAS is necessary to more accurately represent the diversity of scoliosis deformities. Ability to identify disturbing aspects of deformity could potentially be improved by evaluating each WRVAS items against indicators of pain, physical/psychosocial function, and self image from previous measures such as the SRS, SF-36 or BSSQ-deformity.
由于外观畸形、身体和心理症状以及治疗因素，身体形象和健康相关生活质量（HRQL）是脊柱侧弯患者的重要问题。对脊柱侧弯文献的选择性回顾显示，身体形象和HRQL的自我报告测量与影像学测量以及临床医生的手术建议之间存在不可靠的相关性。然而，目前的身体形象和HRQL测量并未表明脊柱侧弯畸形的哪些方面对患者最困扰。WRVAS是一种旨在评估患者对畸形自我评估的工具，在识别患者最困扰的畸形方面可能显示出一定前景。先前对青少年脊柱侧弯患者的研究支持将WRVAS用作临床工具，因为该工具与影像学测量和生活质量工具具有很强的相关性。该工具在成年人群中的使用有限。
对71名成年脊柱侧弯患者进行了WRVAS和HRQL测量工具SF - 36v2的测试，并发放了一份报告年龄和性别的表格。对WRVAS进行了初步验证分析（地板效应和天花板效应、内部一致性和共线性、与SF - 36v2的相关性，以及以WRVAS总分作为预测指标、SF - 36v2分数作为结果的多元回归分析）。
WRVAS的心理测量特性是可接受的。年龄较大的参与者认为他们的畸形比年轻参与者更严重。更严重的畸形与SF - 36v2身体成分总结得分较低相关。WRVAS总分也可预测身体成分总结得分。
本研究结果表明，WRVAS是用于成年患者的可靠工具，并且患者对畸形的自我评估与HRQL的身体而非心理方面相关。当前和先前的研究一致认为，有必要对WRVAS进行修订，以更准确地反映脊柱侧弯畸形的多样性。通过根据先前测量（如SRS、SF - 36或BSSQ - 畸形）中的疼痛、身体/心理社会功能和自我形象指标评估每个WRVAS项目，可能会提高识别畸形困扰方面的能力。
