Wendel Christopher S, Grant Marcia, Herrinton Lisa, Temple Larissa K F, Hornbrook Mark C, McMullen Carmit K, Bulkley Joanna E, Altschuler Andrea, Krouse Robert S
University of Arizona College of Medicine, Tucson, AZ, USA,
Qual Life Res. 2014 Dec;23(10):2831-40. doi: 10.1007/s11136-014-0724-6. Epub 2014 Jun 3.
Examination of reliability and validity of a specialized health-related quality of life questionnaire for rectal cancer (RC) survivors (≥5 years post-diagnosis).
We mailed 1,063 Kaiser Permanente (KP) RC survivors (313 ostomy and 750 anastomosis) a questionnaire containing the Modified City of Hope Quality of Life-Ostomy (mCOH-QOL-O), SF-12v2, Duke-UNC Functional Social Support Questionnaire (FSSQ), and Memorial Sloan-Kettering Cancer Center Bowel Function Index (BFI). We adapted certain BFI items for use by subjects with intestinal ostomies. We evaluated reliability for all instruments with inter-item correlations and Cronbach's alpha. We assessed construct validity only for the BFI in the ostomy group, because such use has not been reported.
The overall response rate was 60.5 % (577 respondents/953 eligible). Compared with non-responders, participants were on average 2 years younger and more likely non-Hispanic white, resided in educationally non-deprived areas, and had KP membership through a group. The mCOH-QOL-O, SF-12, and FSSQ were found to be highly reliable for RC survivors. In the ostomy group, BFI Urgency/Soilage and Dietary subscales were found to be reliable, but Frequency was not. Factor analysis supported the construct of Urgency/Soilage and Dietary subscales in the ostomy group, although one item had a moderate correlation with all three factors. The BFI also demonstrated good concurrent validity with other instruments in the ostomy group.
With possible exception of the BFI Frequency subscale in populations with ostomies, components of our survey can be used for the entire population of RC survivors, no matter whether they received anastomosis or ostomy.
检验一份专门针对直肠癌（RC）幸存者（诊断后≥5年）的健康相关生活质量问卷的信效度。
我们向1063名凯撒医疗集团（KP）的RC幸存者（313名造口术患者和750名吻合术患者）邮寄了一份问卷，其中包含改良版希望之城造口生活质量量表（mCOH-QOL-O）、SF-12v2、杜克大学-北卡罗来纳大学功能性社会支持问卷（FSSQ）以及纪念斯隆凯特琳癌症中心肠道功能指数（BFI）。我们对某些BFI项目进行了调整，以便肠道造口术患者使用。我们通过项目间相关性和克朗巴哈系数评估了所有量表的信度。由于此前未报道过BFI在造口术组中的此类应用，因此我们仅评估了造口术组中BFI的结构效度。
总体回复率为60.5%（577名受访者/953名符合条件者）。与未回复者相比，参与者平均年轻2岁，更有可能是非西班牙裔白人，居住在教育资源不匮乏的地区，并且是通过团体加入凯撒医疗集团的。结果发现，mCOH-QOL-O、SF-12和FSSQ对RC幸存者具有高度信度。在造口术组中，发现BFI的急迫/粪便污染和饮食分量表具有信度，但频率分量表不具有信度。因子分析支持了造口术组中急迫/粪便污染和饮食分量表的结构，尽管有一个项目与所有三个因子的相关性中等。BFI在造口术组中与其他量表也显示出良好的同时效度。
除了造口人群中BFI频率分量表可能存在的问题外，我们调查中的各个部分可用于整个RC幸存者群体，无论他们接受的是吻合术还是造口术。
