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直肠癌患者保肛手术后肠道功能障碍测量用低位前切除综合征评分中文版的验证

Validation of the Chinese version of the low anterior resection syndrome score for measuring bowel dysfunction after sphincter-preserving surgery among rectal cancer patients.

作者信息

Hou Xiao-ting, Pang Dong, Lu Qian, Yang Ping, Jin San-li, Zhou Yu-jie, Tian Shu-hong

机构信息

School of Nursing, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China.

School of Nursing, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China.

出版信息

Eur J Oncol Nurs. 2015 Oct;19(5):495-501. doi: 10.1016/j.ejon.2015.02.009. Epub 2015 Mar 23.

Abstract

PURPOSE

The low anterior resection syndrome (LARS) score is a simple and valid instrument for measuring bowel dysfunction after sphincter-preserving surgery (SPS) among rectal cancer patients. We aimed to translate the LARS score into Chinese, and to test its reliability and validity among Chinese rectal cancer patients.

METHODS

The LARS score was translated into Chinese by using internationally recognized forward- and back-translation procedures. In total, 102 patients completed the questionnaire; a subgroup of 20 patients answered the survey twice. The reliability was estimated through the test-retest reliability method. The convergent and discriminant validities were confirmed by measuring the relation of the LARS score with the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-CR29 domains, respectively, and testing its ability to differentiate among patients with different clinical characteristics.

RESULTS

The Spearman correlation coefficient of the LARS-scores at the two surveys was 0.86 (p < .001), and the linear-weighted kappa values of the five items of the LARS score were 0.38, 0.76, 0.79, 0.77, and 0.78, respectively. The LARS score showed significant correlations with all the assumptive domains of QLQ-C30 and QLQ-CR29, especially flatulence, fecal incontinence, and stool frequency (all p < .05). It could also detect differences between female and male patient groups (p = .033), patients who had/had not undergone radiation therapy (p = .007), those who had undergone surgery in the last <12.0 or ≥12.0 months (p = .002), and those with low or high tumor edge level (p = .017).

CONCLUSIONS

The Chinese version of the LARS score had good psychometric properties and can be used in clinical and research settings in the Chinese population.

摘要

目的

低位前切除综合征(LARS)评分是一种简单有效的工具,用于测量直肠癌患者保肛手术后的肠道功能障碍。我们旨在将LARS评分翻译成中文,并在中国直肠癌患者中测试其可靠性和有效性。

方法

采用国际认可的正向和反向翻译程序将LARS评分翻译成中文。共有102例患者完成了问卷;20例患者的亚组进行了两次调查。通过重测信度法评估可靠性。通过分别测量LARS评分与欧洲癌症研究与治疗组织(EORTC)QLQ-C30和QLQ-CR29领域的关系,并测试其区分不同临床特征患者的能力,来确认收敛效度和区分效度。

结果

两次调查中LARS评分的Spearman相关系数为0.86(p <.001),LARS评分五项的线性加权kappa值分别为0.38、0.76、0.79、0.77和0.78。LARS评分与QLQ-C30和QLQ-CR29的所有假设领域均有显著相关性,尤其是肠胃胀气、大便失禁和排便频率(均p <.05)。它还可以检测出女性和男性患者组之间的差异(p =.033)、接受/未接受放疗的患者之间的差异(p =.007)、在过去<12.0或≥12.0个月接受手术的患者之间的差异(p =.002)以及肿瘤边缘水平低或高的患者之间的差异(p =.017)。

结论

中文版LARS评分具有良好的心理测量学特性,可用于中国人群的临床和研究。

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