Perrin James M, Kuhlthau Karen, Chughtai Aziz, Romm Diane, Kirschner Barbara S, Ferry George D, Cohen Stanley A, Gold Benjamin D, Heyman Melvin B, Baldassano Robert N, Winter Harland S
Department of Pediatrics, MassGeneral Hospital for Children, Boston, USA.
J Pediatr Gastroenterol Nutr. 2008 Feb;46(2):164-71. doi: 10.1097/MPG.0b013e31812f7f4e.
To extend development of a pediatric inflammatory bowel disease (IBD) health-related quality of life (HRQoL) measure by determining its factor structure and associations of factors with generic HRQoL measures and clinical variables.
Cross-sectional survey of children and adolescents ages 8 years to 18 years and their parents attending any of 6 US IBD centers, recruited from either existing registry of age-eligible subjects or visits to participating centers. The survey included generic (Pediatric Quality of Life Inventory) and IBD-specific (Impact Questionnaire) quality of life measures, disease activity, and other clinical indicators. We carried out factor analysis of Impact responses, comparing resulting factors with results on the generic HRQoL and the clinical measures.
We included 220 subjects (161 with Crohn disease and 59 with ulcerative colitis). Initial confirmatory factor analysis did not support the 6 proposed Impact domains. Exploratory factor analysis indicated 4 factors with good to excellent reliability for IBD responses: general well-being and symptoms, emotional functioning, social interactions, and body image. Two items did not load well on any factor. The 4 factors correlated well with the Pediatric Quality of Life Inventory and subscales. Children with higher disease activity scores and other indicators of clinical activity reported lower HRQoL.
This study provides further characteristics of a HRQoL measure specific to pediatric IBD and indicates ways to score the measure based on the resulting factor structure. The measure correlates appropriately with generic HRQoL measures and clinical severity indicators.
通过确定其因子结构以及因子与一般健康相关生活质量（HRQoL）指标和临床变量之间的关联，扩展一种小儿炎症性肠病（IBD）健康相关生活质量测量方法的开发。
对年龄在8岁至18岁的儿童和青少年及其父母进行横断面调查，这些儿童和青少年来自美国6个IBD中心中的任何一个，他们是从符合年龄条件的受试者现有登记册或参与中心的就诊者中招募而来的。该调查包括一般（儿童生活质量量表）和IBD特异性（影响问卷）生活质量测量、疾病活动度及其他临床指标。我们对影响问卷的回答进行了因子分析，并将所得因子与一般HRQoL结果及临床测量结果进行比较。
我们纳入了220名受试者（161例克罗恩病患者和59例溃疡性结肠炎患者）。初始验证性因子分析不支持所提出的6个影响领域。探索性因子分析表明，IBD回答中有4个因子具有良好至优秀的信度：总体幸福感和症状、情绪功能、社会交往及身体形象。有两个项目在任何因子上的载荷都不佳。这4个因子与儿童生活质量量表及其子量表相关性良好。疾病活动度得分较高及有其他临床活动指标的儿童报告的HRQoL较低。
本研究提供了小儿IBD特异性HRQoL测量方法的进一步特征，并指出了基于所得因子结构对该测量方法进行评分的方法。该测量方法与一般HRQoL测量方法及临床严重程度指标具有适当的相关性。
