Department of Surgery, Kantonsspital Graubünden, Loëstrasse 170, 7000 Chur, Switzerland.
Br J Surg. 2011 Jan;98(1):148-55. doi: 10.1002/bjs.7236. Epub 2010 Sep 2.
Patient-oriented questionnaires are indispensable in the assessment of surgical outcome. The psychometric properties of a brief multidimensional instrument were examined in patients with inguinal hernia undergoing surgery.
Fifty-one patients (mean(s.d.) age 50·6(17·4) years; 48 men) participated. The following questionnaire properties were assessed for the Core Outcome Measures Index adapted for patients with hernia (COMI-hernia) and the EuroQol: practicability, floor and ceiling effects, test-retest reliability (over 2 weeks), construct validity (by comparison with other relevant scales) and responsiveness 9 months after surgery as standardized response mean (SRM).
The questionnaires were easy to implement and well accepted by the patients. Ceiling effects at baseline were 2 per cent for the COMI-hernia, 8 per cent for EuroQol-visual analogue scale (EQ-VAS) and 35 per cent for EuroQol-Five Dimensions (EQ-5D); no instrument showed floor effects. The reproducibility of individual COMI-hernia items was good, with test-retest differences within one grade ranging from 41 of 45 for 'social/work disability' to 44 of 45 for 'general quality of life'. The intraclass correlation coefficients were moderately high for COMI-hernia (0·74) and EQ-VAS (0·77), but low for EQ-5D (0·43). COMI-hernia scores correlated in the expected manner with related scales (r = 0·42-0·72, P < 0·050). COMI-hernia was the most responsive instrument (SRM 1·42).
The COMI-hernia and EQ-VAS general health scale represent reliable, valid and sensitive tools for assessing multidimensional outcome in patients with inguinal hernia undergoing surgical treatment.
以患者为导向的问卷在评估手术结果方面不可或缺。本研究旨在评估一种简短多维工具的心理测量特性，该工具用于评估接受手术治疗的腹股沟疝患者。
51 名患者（平均（标准差）年龄 50.6（17.4）岁；48 名男性）参与了研究。评估了改良后的核心结局测量指标（COMI-hernia）和欧洲五维健康量表（EQ-5D）的以下问卷特性：实用性、天花板和地板效应、两周内的重测信度、结构有效性（与其他相关量表比较）和 9 个月后的反应度（以标准化反应均数表示）。
问卷易于实施，且患者接受度良好。COMI-hernia 在基线时的天花板效应为 2%，EQ-VAS 为 8%，EQ-5D 为 35%；无仪器显示地板效应。COMI-hernia 各个项目的可重复性较好，两次测试之间的差异在一个等级内，范围从“社会/工作障碍”的 41 分至 45 分，到“一般生活质量”的 44 分至 45 分。COMI-hernia 的组内相关系数为 0.74，EQ-VAS 为 0.77，而 EQ-5D 为 0.43，均为中度高。COMI-hernia 评分与相关量表呈预期相关（r = 0.42-0.72，P < 0.050）。COMI-hernia 是最敏感的工具（SRM 1.42）。
COMI-hernia 和 EQ-VAS 一般健康量表是评估接受手术治疗的腹股沟疝患者多维结局的可靠、有效和敏感的工具。
