School of Humanities and Management, Guangdong Medical College, Dongguan 523808, China.
Health Qual Life Outcomes. 2014 Jun 4;12:82. doi: 10.1186/1477-7525-12-82.
Quality of life (QOL) for patients with coronary heart disease (CHD) is now concerned worldwide with the specific instruments being seldom and no one developed by the modular approach.
This paper is aimed to develop the CHD scale of the system of Quality of Life Instruments for Chronic Diseases (QLICD-CHD) by the modular approach and validate it by both classical test theory and Generalizability Theory.
The QLICD-CHD was developed based on programmed decision procedures with multiple nominal and focus group discussions, in-depth interview, pre-testing and quantitative statistical procedures. 146 inpatients with CHD were used to provide the data measuring QOL three times before and after treatments. The psychometric properties of the scale were evaluated with respect to validity, reliability and responsiveness employing correlation analysis, factor analyses, multi-trait scaling analysis, t-tests and also G studies and D studies of Genralizability Theory analysis.
Multi-trait scaling analysis, correlation and factor analyses confirmed good construct validity and criterion-related validity when using SF-36 as a criterion. The internal consistency α and test-retest reliability coefficients (Pearson r and Intra-class correlations ICC) for the overall instrument and all domains were higher than 0.70 and 0.80 respectively; The overall and all domains except for social domain had statistically significant changes after treatments with moderate effect size SRM (standardized response mea) ranging from 0.32 to 0.67. G-coefficients and index of dependability (Ф coefficients) confirmed the reliability of the scale further with more exact variance components.
The QLICD-CHD has good validity, reliability, and moderate responsiveness and some highlights, and can be used as the quality of life instrument for patients with CHD. However, in order to obtain better reliability, the numbers of items for social domain should be increased or the items' quality, not quantity, should be improved.
目前全球都关注冠心病患者的生活质量（QOL），但专门的工具却很少，且尚无采用模块化方法开发的工具。
本研究旨在采用模块化方法开发系统的生活质量工具（QLICD-CHD）中的冠心病量表，并通过经典测试理论和概化理论对其进行验证。
根据程序决策程序，结合多项名义和焦点小组讨论、深入访谈、预测试和定量统计程序，开发了 QLICD-CHD。采用相关分析、因子分析、多特质评分分析、t 检验以及概化理论的 G 研究和 D 研究，对量表的心理测量学特性进行了评估，包括效度、信度和反应度。
多特质评分分析、相关和因子分析均证实，使用 SF-36 作为标准时，量表具有良好的结构效度和效标关联效度。整体工具和所有领域的内部一致性α和测试-重测信度系数（Pearson r 和组内相关 ICC）均高于 0.70 和 0.80；整体和除社会领域外的所有领域在治疗后均有统计学意义的变化，且具有中等效应量 SRM（标准化反应均值），范围从 0.32 到 0.67。G 系数和可靠性指数（Ф 系数）进一步证实了量表的可靠性，具有更准确的方差分量。
QLICD-CHD 具有良好的效度、信度和适度的反应性，有一些亮点，可以作为冠心病患者的生活质量工具。然而，为了获得更好的可靠性，社会领域的项目数量应增加，或者应提高项目的质量，而不是数量。
