Goldstein Stuart L, Graham Nicole, Warady Bradley A, Seikaly Mouin, McDonald Ruth, Burwinkle Tasha M, Limbers Christine A, Varni James W
Baylor College of Medicine, Houston, TX, USA.
Am J Kidney Dis. 2008 Feb;51(2):285-97. doi: 10.1053/j.ajkd.2007.09.021.
Minimal data exist to describe health-related quality of life in children with end-stage renal disease (ESRD).
Cross-sectional study.
SETTING & PARTICIPANTS: 193 children aged 5 to 18 years with ESRD and 190 parents of children aged 2 to 18 years with ESRD at 4 pediatric nephrology centers across the United States.
OUTCOMES & MEASUREMENTS: Generic and disease-specific health-related quality of life. The Pediatric Quality of Life Inventory version 4.0 (PedsQL 4.0) Generic Core Scales encompass: (1) Physical Functioning (8 items), (2) Emotional Functioning (5 items), (3) Social Functioning (5 items), and (4) School Functioning (5 items). The PedsQL 3.0 ESRD Module encompasses: (1) General Fatigue (4 items), (2) About My Kidney Disease (5 items), (3) Treatment Problems (4 items), (4) Family and Peer Interaction (3 items), (5) Worry (10 items), (6) Perceived Physical Appearance (3 items), and (7) Communication (5 items).
Internal consistency reliability for the PedsQL 4.0 Generic Core Scales and the PedsQL 3.0 ESRD Module was acceptable for both parent-proxy report and child self-report, with the exception of 1 parent-proxy report and 3 child self-report scales on the ESRD Module. The PedsQL Generic Core Scales differentiated between healthy children and children with ESRD, supporting discriminant validity. Intercorrelations between the PedsQL Generic Core Scales and the ESRD Module were in the medium to large range, supporting construct validity. A confirmatory factor analysis further supported construct validity of the ESRD Module.
Test-retest reliability was not conducted, limited generalizability may exist given the age distribution of the children included, and imperfect agreement between child and parent-proxy reports.
Results support the feasibility, reliability, and validity of the PedsQL 4.0 Generic Core Scales in children with ESRD and provide initial support for the PedsQL 3.0 ESRD Module, although additional validation testing is warranted.
描述终末期肾病(ESRD)患儿健康相关生活质量的数据极少。
横断面研究。
美国4家儿科肾脏病中心的193名5至18岁的ESRD患儿以及190名2至18岁ESRD患儿的父母。
一般及疾病特异性健康相关生活质量。儿童生活质量量表第4版(PedsQL 4.0)一般核心量表包括:(1)身体功能(8项),(2)情绪功能(5项),(3)社会功能(5项),以及(4)学校功能(5项)。PedsQL 3.0 ESRD模块包括:(1)全身疲劳(4项),(2)关于我的肾病(5项),(3)治疗问题(4项),(4)家庭和同伴互动(3项),(5)担忧(10项),(6)感知身体外观(3项),以及(7)沟通(5项)。
PedsQL 4.0一般核心量表和PedsQL 3.0 ESRD模块的内部一致性信度对于父母代理报告和儿童自评报告均为可接受,ESRD模块中有1份父母代理报告和3份儿童自评量表除外。PedsQL一般核心量表能够区分健康儿童和ESRD患儿,支持判别效度。PedsQL一般核心量表与ESRD模块之间的相互关联处于中等到较大范围,支持结构效度。验证性因素分析进一步支持了ESRD模块的结构效度。
未进行重测信度检验,鉴于所纳入儿童的年龄分布,可能存在普遍适用性有限的问题,并且儿童与父母代理报告之间的一致性不完善。
结果支持PedsQL 4.0一般核心量表在ESRD患儿中的可行性、信度和效度,并为PedsQL 3.0 ESRD模块提供了初步支持,不过仍需进行额外的验证测试。