首个用于评估心力衰竭患者生活质量的伊朗问卷（IHF-QoL）的开发与验证
Development and Validation of the First Iranian Questionnaire to Assess Quality of Life in Patients With Heart Failure: IHF-QoL.
作者信息
Naderi Nasim, Bakhshandeh Hooman, Amin Ahmad, Taghavi Sepideh, Dadashi Masoumeh, Maleki Majid
机构信息
Cardiac Electrophysiology Research Center, Rajaie Cardiovascular Medical and Research Center, Tehran University of Medical Sciences, Tehran, IR Iran.
Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Tehran University of Medical Sciences, Tehran, IR Iran.
出版信息
Res Cardiovasc Med. 2012 Nov;1(1):10-6. doi: 10.5812/cardiovascmed.4186. Epub 2012 Nov 1.
BACKGROUND
In its Constitution of 1948, WHO defined health as "a state of complete physical, mental, and social well-being, and not merely the absence of disease and infirmity" . In 1994, the Agency for Health Care Policy and Research published clinical practice guidelines recommending providers to routinely evaluate patients' HRQoL (Health Related Quality of Life) and use their assessment to modify and guide patient care.
OBJECTIVES
to create a valid, sensitive, disease-specific Persian health status quality of life questionnaire for patients with chronic heart failure in Iran.
MATERIALS AND METHODS
Considering the existing relevant inventories and scientific literature, the authors designed the first draft of questionnaire which was modified and validated, using expert opinions and finalized in a session of expert panel. The questionnaire was processed among 130 patients with heart failure. Construct validity evaluated by principle component factor analysis, and promax method was used for factor rotation. MacNew quality of life questionnaire was selected to assess convergence validity, and the agreements were measured in 60 patients. Discriminant validity was also assessed. Thirty patients were followed for 3 months and responsiveness of questionnaire was measured. Cronbach's alpha, item analysis, and Intra-class correlation coefficients (ICCs) were used to investigate reliability of questionnaire. SPSS 15 for Windows was applied for statistical analysis.
RESULTS
Principle component factor analysis revealed 4 main components. Sub-group analysis suggested that IHF-QoL questionnaire demonstrated an acceptable discriminant validity. High conformity between this inventory and MacNew questionnaire revealed an appropriate convergence validity. Cronbach's alpha (α) for the overall questionnaire was equal to 0.922. Intra-class correlation coefficients (ICCs) for all components were significant (from. 708 to. 883; all P values < 0.001). Patients fallow-up revealed an acceptable responsiveness of our questionnaire.
CONCLUSIONS
IHF-QoL questionnaire is a valid and reliable inventory. It can be applied in daily clinical practice and in the clinical research context.
背景
世界卫生组织在其1948年的章程中将健康定义为“一种身体、心理和社会的完全良好状态，而不仅仅是没有疾病和虚弱”。1994年，医疗保健政策与研究机构发布了临床实践指南，建议医疗服务提供者定期评估患者的健康相关生活质量（HRQoL），并利用评估结果来调整和指导患者护理。
目的
为伊朗慢性心力衰竭患者创建一份有效、敏感、针对特定疾病的波斯语健康状况生活质量问卷。
材料与方法
考虑到现有的相关量表和科学文献，作者设计了问卷初稿，通过专家意见进行修改和验证，并在专家小组会议上最终确定。该问卷在130名心力衰竭患者中进行了测试。通过主成分因子分析评估结构效度，并使用斜交旋转法进行因子旋转。选择MacNew生活质量问卷来评估收敛效度，并在60名患者中测量一致性。还评估了区分效度。对30名患者进行了3个月的随访，并测量了问卷的反应度。使用Cronbach's α系数、项目分析和组内相关系数（ICC）来研究问卷的信度。使用SPSS 15 for Windows进行统计分析。
结果
主成分因子分析揭示了4个主要成分。亚组分析表明，IHF-QoL问卷显示出可接受的区分效度。该量表与MacNew问卷之间的高度一致性表明具有适当的收敛效度。整个问卷的Cronbach's α系数（α）等于0.922。所有成分的组内相关系数（ICC）均具有显著性（从0.708到0.883；所有P值<0.001）。患者随访显示我们的问卷具有可接受的反应度。
结论
IHF-QoL问卷是一份有效且可靠的量表。它可应用于日常临床实践和临床研究。
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