Traina Shana B, Colwell Hilary H, Crosby Ross D, Mathias Susan D
Janssen Global Services, LLC, Raritan, NJ, USA.
Health Outcomes Solutions, Winter Park, FL, USA.
Patient Relat Outcome Meas. 2015 Mar 26;6:103-15. doi: 10.2147/PROM.S79368. eCollection 2015.
The concept of diabetes-related health satisfaction encompasses issues specifically related to living with diabetes (eg, blood glucose, blood pressure levels, body weight). Health satisfaction is more specific than overall health-related quality of life because it considers disease-related factors, and is different from diabetes treatment satisfaction because it addresses issues not specifically related to treatment. Low levels of health satisfaction in people with type 2 diabetes mellitus (T2DM) may negatively affect self-care behaviors and treatment outcomes; however, there are currently no instruments available to assess health satisfaction in this population. This study assessed the measurement properties of a newly constructed, 14-item Current Health Satisfaction Questionnaire (CHES-Q) designed to assess diabetes-related health satisfaction and knowledge of the disease and important laboratory results.
In-depth interviews were conducted in 23 adults with T2DM to confirm the content and clarity of the CHES-Q. The revised instrument was administered to 1,015 individuals with T2DM, along with supplemental questionnaires, including the Short Form-36. All subjects completed the questionnaires again 3 to 7 days later. CHES-Q test-retest reliability, construct validity, and known-groups validity were evaluated.
In general, respondents found the CHES-Q to be clear and comprehensive. Test-retest reliability was generally acceptable for all items (≥0.70), except for three that fell just below the widely accepted cut-point of 0.70 (range 0.63-0.69). Convergent and divergent validity was demonstrated based on hypothesized correlations with the Short Form-36. Known-groups validity was confirmed for most CHES-Q items when respondents were split into groups known to differ clinically by body mass index, disease severity, or glycated hemoglobin.
Health satisfaction is a unique and important concept to consider when developing individualized strategies for managing T2DM because health satisfaction is a key element of patient-centered care. The CHES-Q allows for the pragmatic assessment of many aspects of diabetes-related health satisfaction in a single questionnaire.
糖尿病相关健康满意度的概念涵盖了与糖尿病生活相关的特定问题（如血糖、血压水平、体重）。健康满意度比总体健康相关生活质量更具针对性，因为它考虑了与疾病相关的因素，并且与糖尿病治疗满意度不同，因为它涉及的问题并非专门与治疗相关。2型糖尿病（T2DM）患者的健康满意度较低可能会对自我护理行为和治疗结果产生负面影响；然而，目前尚无用于评估该人群健康满意度的工具。本研究评估了新构建的、包含14个条目的当前健康满意度问卷（CHES-Q）的测量属性，该问卷旨在评估糖尿病相关健康满意度以及对疾病和重要实验室检查结果的了解情况。
对23名成年T2DM患者进行了深入访谈，以确认CHES-Q的内容和清晰度。将修订后的问卷发放给1015名T2DM患者，并同时发放包括简短健康调查问卷-36（Short Form-36）在内的补充问卷。所有受试者在3至7天后再次完成问卷。评估了CHES-Q的重测信度、结构效度和已知组效度。
总体而言，受访者认为CHES-Q清晰且全面。除了三个略低于广泛接受的0.70切点（范围为0.63 - 0.69）的条目外，所有条目的重测信度一般均可接受（≥0.70）。基于与简短健康调查问卷-36的假设相关性，证明了聚合效度和区分效度。当根据体重指数、疾病严重程度或糖化血红蛋白在临床上已知存在差异的分组对受访者进行划分时，大多数CHES-Q条目的已知组效度得到了证实。
在制定T2DM个体化管理策略时，健康满意度是一个独特且重要的概念需要考虑，因为健康满意度是以患者为中心的护理的关键要素。CHES-Q允许在单一问卷中对糖尿病相关健康满意度的多个方面进行实际评估。
