Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 2-50 Corbett Hall, Edmonton, AB, T6G 2G4, Canada,
Qual Life Res. 2014 Apr;23(3):805-13. doi: 10.1007/s11136-013-0531-5. Epub 2013 Oct 1.
The objective of this study is to evaluate the longitudinal construct validity of the Health Utilities Index Mark 2 (HUI2) and Health Utilities Index Mark 3 (HUI3) using a convergent/divergent validity approach in patients recovering from hip fracture, with the Functional Independence Measure (FIM) as the comparator.
A total of 278 patients with a primary diagnosis of hip fracture were interviewed 3-5 days after surgery and then at 1 and 6 months using the HUI2, HUI3 and the FIM and a Likert-type rating of hip pain. A priori hypotheses were formulated. Convergent and divergent correlations between HUI2, HUI3 and FIM change scores for the baseline to 1-month and baseline to 6-month intervals were examined.
Overall HUI2 detected continued gain in health-related quality of life between 1 and 6 months after fracture, as the change increased from 0.20 to 0.29 units. The correlation between change in the overall HUI2 score and total FIM score was moderate (r = 0.50) over the 6-month interval, but larger than the observed correlation over the 1-month interval (r = 0.36). The correlation between change in overall HUI3 score and total FIM over the 1-month interval was small (r = 0.32), and the correlation between change in overall HUI3 score and total FIM was moderate (r = 0.37) over the 6-month interval. All hypotheses for the divergent correlations were supported.
Weaker correlations were reported for change over 1 month as compared to change over the 6 months after fracture. Findings supported the longitudinal construct validity of the overall HUI2 and HUI3 for the assessment of recovery following hip fracture, particularly for change over the 6 months following fracture.
本研究旨在通过与功能独立性测量（FIM）进行对比，采用收敛/发散有效性方法，评估髋部骨折患者在康复过程中健康效用指数标记 2 版（HUI2）和健康效用指数标记 3 版（HUI3）的纵向结构有效性。
共有 278 名原发性髋部骨折患者在手术后 3-5 天、1 个月和 6 个月时接受 HUI2、HUI3 和 FIM 采访，并采用 Likert 型髋痛评分。制定了先验假设。考察了基线至 1 个月和基线至 6 个月间隔内 HUI2、HUI3 和 FIM 变化评分之间的收敛和发散相关性。
总体而言，HUI2 在骨折后 1-6 个月期间检测到健康相关生活质量的持续改善，因为变化从 0.20 增加到 0.29 单位。在 6 个月的间隔内，总体 HUI2 评分与总 FIM 评分之间的相关性为中度（r=0.50），但大于 1 个月间隔内的观察相关性（r=0.36）。在 1 个月的间隔内，总体 HUI3 评分与总 FIM 之间的变化相关性较小（r=0.32），而在 6 个月的间隔内，总体 HUI3 评分与总 FIM 之间的相关性为中度（r=0.37）。所有发散相关性的假设均得到支持。
与骨折后 6 个月的变化相比，报告了 1 个月的变化的相关性较弱。研究结果支持 HUI2 和 HUI3 的整体纵向结构有效性，用于评估髋部骨折后的恢复情况，特别是在骨折后 6 个月的变化。
