Consultation Liaison Psychiatry, Renal Unit, Centre for Population mental Health Research, Liverpool Hospital, Locked Bag 7103, Liverpool BC, NSW 1871, Australia.
Clin J Am Soc Nephrol. 2010 Jul;5(7):1249-54. doi: 10.2215/CJN.08361109. Epub 2010 May 24.
Kidney disease-related loss is clinically significant in patients with ESRD and is related to depression and quality of life. The Kidney Disease Loss Scale (KDLS) was recently developed for long-term dialysis patients as a means of studying loss and applying it to clinical practice; however, its validity and usability in the other developmental stages of ESRD-predialysis and early dialysis-remain unknown. This study examined the validity and reliability of the KDLS in the long-term dialysis, early dialysis, and predialysis populations.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Four groups of participants were recruited from four large university teaching hospitals in the Sydney metropolitan area. Participants were long-term dialysis (n=151), early dialysis (n=163), and predialysis (n=111) patients. An additional independent group of dialysis (n=50) patients were recruited to measure the test-retest reliability. Multisample confirmatory factor analysis and correlational analysis were used.
Results demonstrated good internal consistency and test-retest reliability for KDLS. Multisample confirmatory factor analysis indicated that the factor structure of KDLS was invariant across samples and thus supported its construct validity. The convergent and discriminant validities of KDLS were supported by its correlations with scales that measure health-related quality of life, depression, and positive affect in the expected directions and magnitudes. The KDLS was sensitive to the developmental stages of ESRD.
These findings demonstrated that the concept of loss exists in dialysis patients. The KDLS is a reliable measure of loss in ESRD and valid in the developmental stages of ESRD.
肾衰竭患者的肾脏疾病相关丧失具有重要的临床意义，与抑郁和生活质量有关。肾脏疾病丧失量表（KDLS）是最近为长期透析患者开发的一种研究丧失的工具，并将其应用于临床实践；然而，其在透析前和早期透析的其他发展阶段的有效性和可用性尚不清楚。本研究旨在检验 KDLS 在长期透析、早期透析和透析前人群中的有效性和可靠性。
设计、设置、参与者和测量：从悉尼大都市区的四家大型大学教学医院招募了四组参与者。参与者包括长期透析组（n=151）、早期透析组（n=163）和透析前组（n=111）。还招募了一组独立的透析组（n=50）患者来测量测试-重测信度。采用多样本验证性因子分析和相关分析。
结果表明 KDLS 具有良好的内部一致性和测试-重测信度。多样本验证性因子分析表明，KDLS 的因子结构在各样本中是不变的，因此支持其结构效度。KDLS 与衡量健康相关生活质量、抑郁和积极情绪的量表之间的相关性表明其具有较好的聚合和区分效度。KDLS 对肾衰竭的发展阶段具有敏感性。
这些发现表明，丧失的概念存在于透析患者中。KDLS 是肾衰竭患者丧失的可靠测量工具，在肾衰竭的发展阶段具有有效性。
