Krarup Anne L, Peterson Emma, Ringström Gisela, Törnblom Hans, Hjortswang Henrik, Simrén Magnus
*Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy †Centre for Person-Centered Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg ‡Department of Clinical and Experimental Medicine, Division of Gastroenterology and Hepatology, Linköping University §Department of Gastroenterology and Hepatology, UHL, County Council of Östergötland, Linköping, Sweden.
J Clin Gastroenterol. 2015 Aug;49(7):565-70. doi: 10.1097/MCG.0000000000000209.
To evaluate validity, reliability, and responsiveness of the Short Health Scale (SHS) in irritable bowel syndrome (IBS) patients.
Subjective health assessment is central when treating patients with IBS. The "Short Health Scale" is a quick 4-item questionnaire covering most aspects of subjective health that has been validated for inflammatory bowel disease.
To test validity, 451 patients with IBS (mean age, 38 y; 81% females) completed the SHS and questionnaires assessing IBS symptom severity (IBS-SSS), gastrointestinal (GI)-specific anxiety (VSI), and quality of life (IBSQOL). To evaluate reliability and responsiveness to changes, the questionnaires were repeated after 2 weeks in 18 patients, and after 12 weeks in 212 patients who had completed a patient-education program.
Validity was documented with (1) gradually increasing mean scores for all 4 SHS items with increasing IBS-SSS (P<0.0001), and (2) correlations between the 4 SHS items and the corresponding items from the other subjective health assessment tools [item 1 (symptom burden): ρ=0.67, item 2 (daily function): ρ=-0.44 to -0.46, item 3 (disease-related worry): ρ=-0.51 to 0.57, item 4 (general well-being): ρ=-0.34 to -0.46, P<0.0001]. Reliability was confirmed (Spearman ρ>0.7 and intraclass correlations >0.7). Responsiveness was good with responders to the patient-education program (IBS-SSS reduction ≥50 points) having significant reductions in 3 of the SHS items (P<0.05), and borderline change for the fourth SHS item (P=0.06).
SHS is a health measure that shows promising evidence of validity, reliability, and responsiveness in IBS patients. It is quickly completed and evaluated, which supports its usefulness in the busy clinical practice.
评估简易健康量表（SHS）在肠易激综合征（IBS）患者中的有效性、可靠性和反应性。
对IBS患者进行治疗时，主观健康评估至关重要。“简易健康量表”是一份包含4个条目的简短问卷，涵盖了主观健康的大多数方面，已在炎症性肠病中得到验证。
为测试有效性，451例IBS患者（平均年龄38岁；81%为女性）完成了SHS以及评估IBS症状严重程度（IBS-SSS）、胃肠道（GI）特异性焦虑（VSI）和生活质量（IBSQOL）的问卷。为评估可靠性和对变化的反应性，18例患者在2周后重复填写问卷，212例完成患者教育项目的患者在12周后重复填写问卷。
有效性表现为：（1）随着IBS-SSS增加，SHS所有4个条目的平均得分逐渐升高（P<0.0001）；（（2）SHS的4个条目与其他主观健康评估工具的相应条目之间存在相关性[条目1（症状负担）：ρ=0.67，条目2（日常功能）：ρ=-0.44至-0.46，条目3（疾病相关担忧）：ρ=-0.51至0.57，条目4（总体幸福感）：ρ=-0.34至-0.46，P<0.0001]。可靠性得到确认（Spearman ρ>0.7且组内相关性>0.7）。对患者教育项目有反应者（IBS-SSS降低≥50分）的反应性良好，SHS的4个条目中有3个显著降低（P<0.05），第4个SHS条目有临界变化（P=0.06）。
SHS是一种健康测量工具，在IBS患者中显示出有效性、可靠性和反应性的有力证据。它能快速完成和评估，这支持了其在繁忙临床实践中的实用性。
