Nagpal Jitender, Kumar Arvind, Kakar Sonia, Bhartia Abhishek
Sitaram Bhartia Institute of Science and Research, B-16, Qutab Institutional Area, New Delhi-110016, India.
J Assoc Physicians India. 2010 May;58:295-304.
To develop a reliable and valid quality of life questionnaire for Indian patients with diabetes.
A draft of 75 questions was prepared on the basis of expert opinion, focus group discussions, review of existing literature and detailed semi-structured interviews of patients with diabetes with the intention of including all aspects of diabetes-specific and quality of life considered relevant by patients and care providers to enable constrict validity. A Stage 2 questionnaire was then prepared with 13 domains and 54 items (questions) after expert panel review for obvious irrelevance and duplication of issues. It was administered to 150 participants visiting a diabetes center at New Delhi. Factor analysis was done using principal component method with varimax rotation. Reliability analysis was done by calculating Cronbach's Alpha. For evaluating concordant validity the questionnaire was co-administered with DQL-CTQ to 30 participants. The discriminant validity of the questionnaire was tested using 't' test for metabolic control, co-morbidities, insulin use and gender.
Using principal component method 8 domains were identified on the basis of an apriori hypothesis and the scree plot. These 8 domains explained 49.9% of the total variation. 34 items (questions) were selected to represent these domains on the basis of extraction communality, factor loading, inter-item and item-total correlations. The final questionnaire has an Overall Cronbach's Alpha value of 0.894 (subscale- 0.55 to 0.85) showing high internal consistency. The questionnaire showed good concordance (product moment correlation 0.724; p = 0.001; subscale correlation - 0.457 to 0.779) with the DQL-CTQ. The overall standardized questionnaire score showed good responsiveness to metabolic control and co-morbidities establishing discriminant validity.
The final version of questionnaire with 8 domains and 34 items is a reliable and valid tool for assessment of quality of life of Indian patients with diabetes.
为印度糖尿病患者开发一份可靠且有效的生活质量问卷。
基于专家意见、焦点小组讨论、对现有文献的回顾以及对糖尿病患者进行详细的半结构化访谈，编制了一份包含75个问题的初稿，旨在涵盖患者和医护人员认为与糖尿病及生活质量相关的所有方面，以确保结构效度。在专家小组对明显不相关和重复的问题进行审查后，编制了第二阶段问卷，该问卷包含13个领域和54个项目（问题）。将其发放给150名前往新德里一家糖尿病中心就诊的参与者。使用主成分分析法和方差最大化旋转进行因子分析。通过计算克朗巴哈系数进行信度分析。为评估一致性效度，将该问卷与糖尿病生活质量简明问卷（DQL-CTQ）共同发放给30名参与者。使用“t”检验对代谢控制、合并症、胰岛素使用情况和性别进行测试，以检验该问卷的区分效度。
基于先验假设和碎石图，使用主成分分析法确定了8个领域。这8个领域解释了总变异的49.9%。根据提取共同度、因子载荷、项目间相关性和项目与总分相关性，选择了34个项目（问题）来代表这些领域。最终问卷的总体克朗巴哈系数值为0.894（子量表为0.55至0.85），显示出较高的内部一致性。该问卷与DQL-CTQ显示出良好的一致性（积差相关系数为0.724；p = 0.001；子量表相关性为 - 0.457至0.779）。总体标准化问卷得分对代谢控制和合并症显示出良好的反应性，确立了区分效度。
最终版包含8个领域和34个项目的问卷是评估印度糖尿病患者生活质量的可靠且有效的工具。
