Division of Nursing Science, Department of Medicine and Health Sciences, Linkping University, UHL, County Council of stergtland, Linkping, Sweden.
Health Qual Life Outcomes. 2012 Apr 30;10:44. doi: 10.1186/1477-7525-10-44.
Arrhythmias can appear with a variety of symptoms, all from vague to pronounced and handicapping symptoms. Therefore, patient-reported outcomes (PROs) concerning symptom burden are important to assess and take into consideration in the care and treatment of patients with arrhythmias. The main purpose was to develop and validate a disease-specific questionnaire evaluating symptom burden in patients with different forms of arrhythmias.
A literature review was conducted and arrhythmia patients were interviewed. Identified symptoms were evaluated by an expert panel consisting of cardiologists and nurses working daily with arrhythmia patients. SF-36 and Symptoms Checklist (SCL) were used in the validation of the new questionnaire Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia (ASTA). Homogeneity was evaluated with Spearman's correlations and Cronbach's alpha coefficient (α) was used to evaluate internal consistency. Construct validity was evaluated using item-total correlations and convergent and discriminant validity. For this, Spearman's correlations were calculated between the ASTA symptom scale, SCL and SF-36. Concurrent validity was validated by Spearman's correlations between the ASTA symptom scale and SCL.
The correlations between the different items in the ASTA symptom scale showed generally sufficient homogeneity. Cronbach's coefficient was found to be satisfactory (α = 0.80; lower bound 95% CI for α = 0.76). Construct validity was supported by item-total correlations where all items in the symptom scale were sufficiently correlated (≥0.3). Convergent and discriminant validity was supported by the higher correlations to the arrhythmia-specific SCL compared to the generic SF-36. Concurrent validity was evaluated and there were sufficiently, but not extremely strong correlations found between the ASTA symptom scale and SCL.
The nine items of the ASTA symptom scale were found to have good psychometric properties in patients with different forms of arrhythmias. Arrhythmia patients suffer from both frequent and disabling symptoms. The validated ASTA questionnaire can be an important contribution to PROs regarding symptom burden in arrhythmia patients.
心律失常可能表现出多种症状，从模糊到明显和致残症状都有。因此，评估心律失常患者的症状负担并在其护理和治疗中加以考虑，患者报告的结局（PRO）是很重要的。主要目的是开发和验证一种专门评估不同类型心律失常患者症状负担的疾病特异性问卷。
进行了文献回顾，并对心律失常患者进行了访谈。由心脏病专家和每天与心律失常患者一起工作的护士组成的专家小组对确定的症状进行了评估。SF-36 和症状清单（SCL）用于验证新的心动过速和心律失常专用问卷（ASTA）。使用 Spearman 相关系数评估同质性，使用 Cronbach'α 系数（α）评估内部一致性。使用项目总分相关性和收敛有效性和判别有效性评估结构有效性。为此，计算了 ASTA 症状量表、SCL 和 SF-36 之间的项目-总分相关性。使用 Spearman 相关系数验证了 ASTA 症状量表与 SCL 之间的同时有效性。
ASTA 症状量表中不同项目之间的相关性通常具有足够的同质性。Cronbach'α 系数令人满意（α=0.80；α 的下限 95%置信区间为 0.76）。结构有效性通过症状量表中所有项目的项目-总分相关性得到支持，所有项目相关性均足够（≥0.3）。通过与心律失常特异性 SCL 的更高相关性而不是通用 SF-36 的相关性支持收敛有效性和判别有效性。同时有效性进行了评估，在 ASTA 症状量表和 SCL 之间发现了足够但不是极强的相关性。
在患有不同类型心律失常的患者中，ASTA 症状量表的九个项目具有良好的心理测量学特性。心律失常患者经常出现且症状致残。验证后的 ASTA 问卷可以为心律失常患者的症状负担的 PRO 做出重要贡献。
