Walton David M, MacDermid Joy C, Pulickal Mathew, Rollack Amber, Veitch Jennifer
School of Physical Therapy, Western University, London Ontario, Canada.
School of Physical Therapy, McMaster University, Hamilton Ontario, Canada ; Clinical Research Lab, Hand and Upper Limb Centre, St. Joseph's Hospital, London Ontario, Canada.
Open Orthop J. 2014 Sep 30;8:316-25. doi: 10.2174/1874325001408010316. eCollection 2014.
There is a need for a generic patient-reported outcome (PRO) that is patient-centric and offers sound properties for measuring the process and state of recovery from musculoskeletal trauma. This study describes the construction and initial validation of a new tool for this purpose.
A prototype tool was constructed through input of academic and clinical experts and patient representatives. After evaluation of individual items, a 9-item Satisfaction and Recovery Index (SRI) was subject to psychometric evaluation drawn from classical test theory. Subjects were recruited through online and clinical populations, from those reporting pain or disability from musculoskeletal trauma. The full sample (N = 129) completed the prototype tool and a corresponding region-specific disability measure. A subsample (N = 46) also completed the Short-Form 12 version 2 (SF12vs). Of that, a second subsample (N = 29) repeated all measures 3 months later.
A single factor 'health-related satisfaction' was extracted that explained 71.1% of scale variance, Cronbach's alpha = 0.95. A priori hypotheses for cross-sectional correlations with region-specific disability measures and the generic Short-form 12 component scores were supported. The SRI tool was equally responsive to change, and able to discriminate between recovered/non-recovered subjects, at a level similar to that of the region-specific measures and generally better than the SF-12 subscales.
The new SRI tool, as a measure of health-related satisfaction, shows promise in this initial evaluation of its properties. It is generic, patient-centered, and shows overall measurement properties similar to that of region-specific measures while allowing the potential benefit of comparison between clinical conditions. Despite early promising results, additional properties need to be explored before the tool can be endorsed for routine clinical use.
需要一种以患者为中心的通用患者报告结局(PRO),该结局应具备良好的属性,用于衡量肌肉骨骼创伤后的恢复过程和状态。本研究描述了为此目的构建的一种新工具及其初步验证。
通过学术和临床专家以及患者代表的意见构建了一个原型工具。在对各个项目进行评估后,一个包含9个项目的满意度与恢复指数(SRI)接受了基于经典测试理论的心理测量学评估。通过在线和临床人群招募受试者,这些受试者均报告有肌肉骨骼创伤引起的疼痛或残疾。完整样本(N = 129)完成了原型工具以及相应的特定区域残疾测量。一个子样本(N = 46)还完成了简明健康调查简表第2版(SF12v2)。其中,第二个子样本(N = 29)在3个月后重复了所有测量。
提取了一个单一因素“与健康相关的满意度”,该因素解释了量表方差的71.1%,Cronbach's alpha系数为0.95。与特定区域残疾测量和通用简明健康调查简表分量表得分的横断面相关性的先验假设得到了支持。SRI工具对变化的反应同样灵敏,并且能够区分恢复/未恢复的受试者,其水平与特定区域测量相似,总体上优于SF - 12分量表。
新的SRI工具作为一种与健康相关满意度的测量方法,在其属性的初步评估中显示出前景。它是通用的、以患者为中心的,并且总体测量属性与特定区域测量相似,同时具有在不同临床情况之间进行比较的潜在优势。尽管早期结果令人鼓舞,但在该工具被认可用于常规临床使用之前,还需要探索其他属性。