Centre for Socioeconomic Research, Cardiff School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Redwood Building, King Edward VII Avenue, Cardiff CF10 3NB, UK.
Health Qual Life Outcomes. 2013 May 8;11:78. doi: 10.1186/1477-7525-11-78.
Chronic diseases may influence patients taking major life changing decisions (MLCDs) concerning for example education, career, relationships, having children and retirement. A validated measure is needed to evaluate the impact of chronic diseases on MLCDs, improving assessment of their life-long burden. The aims of this study were to develop a validated questionnaire, the "Major Life Changing Decision Profile" (MLCDP) and to evaluate its psychometric properties.
50 interviews with dermatology patients and 258 questionnaires, completed by cardiology, rheumatology, nephrology, diabetes and respiratory disorder patients, were analysed for qualitative data using Nvivo8 software. Content validation was carried out by a panel of experts. The first version of the MLCDP was completed by 210 patients and an iterative process of multiple Exploratory Factor Analyses and item prevalence was used to guide item reduction. Face validity and practicability was assessed by patients.
48 MLCDs were selected from analysis of the transcripts and questionnaires for the first version of the MLCDP, and reduced to 45 by combination of similar themes. There was a high intraclass correlation coefficient (0.7) between the 13 members of the content validation panel. Four more items were deleted leaving a 41-item MLCDP that was completed by 210 patients. The most frequently recorded MLCDs were decisions to change eating habits (71.4%), to change smoking/drinking alcohol habits (58.5%) and not to travel or go for holidays abroad (50.9%).Factor analysis suggested item number reduction from 41 to 34, to 29, then 23 items. However after taking into account item prevalence data as well as factor analysis results, 32 items were retained. The 32-item MLCDP has five domains education (3 items), job/career (9), family/relationships (5), social (10) and physical (5). The MLCDP score is expressed as the absolute number of decisions that have been affected.
The 32-item (5 domains) MLCDP has been developed as an easy to complete generic tool for use in clinical practice and for quality of life and epidemiological research. Further validation is required.
慢性病可能会影响患者做出重大生活改变决策（MLCD），例如教育、职业、人际关系、生育和退休。需要一种经过验证的衡量标准来评估慢性病对 MLCD 的影响，以提高对其终身负担的评估。本研究的目的是开发一种经过验证的问卷，即“重大生活改变决策概况”（MLCDP），并评估其心理测量特性。
对皮肤科患者进行了 50 次访谈，并对心血管疾病、风湿病、肾病、糖尿病和呼吸系统疾病患者进行了 258 次问卷调查，使用 Nvivo8 软件对定性数据进行分析。内容验证由专家组进行。MLCDP 的第一版由 210 名患者完成，并通过多次探索性因素分析和项目流行率的迭代过程来指导项目减少。患者评估了表面效度和实用性。
从转录本和问卷分析中选择了 48 个 MLCD，用于 MLCDP 的第一版，并通过组合相似主题将其减少到 45 个。内容验证小组成员之间的组内相关系数为 0.7。又删除了 4 个项目，得到了一个由 41 个项目组成的 MLCDP，由 210 名患者完成。记录最多的 MLCD 是改变饮食习惯（71.4%）、改变吸烟/饮酒习惯（58.5%）和不旅行或不前往国外度假（50.9%）。因素分析表明，项目数量从 41 项减少到 34 项，再减少到 29 项，然后减少到 23 项。然而，在考虑到项目流行率数据以及因素分析结果后，保留了 32 个项目。32 项 MLCDP 有五个领域：教育（3 项）、工作/职业（9 项）、家庭/人际关系（5 项）、社会（10 项）和身体（5 项）。MLCDP 得分表示受影响的决策数量。
已经开发出 32 项（5 个领域）的 MLCDP，作为一种易于完成的通用工具，可用于临床实践以及生活质量和流行病学研究。需要进一步验证。
