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测量先天性巨结肠或肛门直肠畸形患儿生活质量的挑战。

The challenge of measuring quality of life in children with Hirschsprung's disease or anorectal malformation.

机构信息

Department of Pediatric surgery, University Hospital, Nantes, France; EA 4275 "Biostatistics, Pharmacoepidemiology and Subjective Measures in Health Sciences", Faculties of Medicine and Pharmaceutical Sciences, University of Nantes, Nantes, France.

出版信息

J Pediatr Surg. 2013 Oct;48(10):2118-27. doi: 10.1016/j.jpedsurg.2013.03.071.

Abstract

PURPOSE

The aim of the present study was to assess, after adaptation to French, the only specific quality of life (QoL) instrument for children with Hirschsprung's disease or anorectal malformation, the Hirschsprung's disease/Anorectal Malformation Quality of Life questionnaire (HAQL), in order to get a standardized QoL evaluation instrument that could further be used to help health care improvement.

METHODS

The study was conducted in three teaching hospitals, including the French reference center for anorectal and pelvic malformations. After adaptation to French, QoL questionnaires were sent to the children and proxies. The questionnaire was mailed to 280 families. Psychometrics properties of the questionnaires (validity and reliability) were analysed from 120 proxy and 96 child questionnaires.

RESULTS

The HAQL with the original structure was not acceptable. Exploratory steps led to a clinically pertinent structure that had acceptable fit and good validity and reliability properties. The final structure pools physical symptoms (continence, discomfort) and psychosocial dimensions (general well-being, social and emotional functioning) of QoL.

CONCLUSION

The final structure, despite the disadvantage of being a new structure, allows assessment of QoL in this population and has the advantage of being shorter and validated on the clinical postoperative questionnaire from the Krickenbeck international consensus.

摘要

目的

本研究旨在评估唯一针对先天性巨结肠症或肛门直肠畸形儿童的特定生活质量(QoL)工具——先天性巨结肠症/肛门直肠畸形生活质量问卷(HAQL),在适应法语后,以便获得标准化的 QoL 评估工具,进一步用于改善医疗保健。

方法

该研究在三所教学医院进行,包括法国肛门直肠和骨盆畸形参考中心。适应法语后,将 QoL 问卷发送给儿童及其代理人。问卷寄给了 280 个家庭。从 120 份代理和 96 份儿童问卷中分析了问卷的心理测量学特性(有效性和可靠性)。

结果

HAQL 的原始结构不可接受。探索性步骤导致了一种具有临床相关性的结构,具有可接受的拟合度和良好的有效性和可靠性特性。最终结构汇集了 QoL 的身体症状(控便、不适)和心理社会维度(整体幸福感、社会和情感功能)。

结论

尽管最终结构的缺点是一个新的结构,但它允许评估该人群的 QoL,并且具有优势,即比 Krickenbeck 国际共识的临床术后问卷更短且经过验证。

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