School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, New South Wales, Australia.
Taizhou No.4 Renmin Hospital, Department of Rheumatology, Taizhou, Jiangsu, China.
Int J Rheum Dis. 2017 Dec;20(12):1987-1992. doi: 10.1111/1756-185X.12831. Epub 2016 Mar 1.
To validate the psychometric properties of the Chinese Health Assessment Questionnaire (HAQ) for use in rheumatoid arthritis (RA) patients in China.
The psychometric properties of the HAQ were validated by interviewing subjects with a questionnaire battery containing the HAQ, EQ-5D, and Short Form 12 (SF-12). Reliability was assessed by Cronbach's alpha, construct validity by assessing a priori hypotheses, and discriminative validity by discriminating subjects in different groups, respectively. To assess the applicability of HAQ in different regions, subgroup analyses were conducted for south and north China, respectively.
Questionnaires were administered to a consecutive sample of 133 RA patients. Cronbach's alpha showed a strong reliability among all the items. In particular, the internal reliability was higher when excluding the items about the use of aids and devices: 0.987 when excluding versus 0.963 when including. Construct validity was supported by achieving both of the a priori hypotheses based on correlations between the HAQ scores and scales of EQ-5D and SF-12. Overall, HAQ scores were important inferential factors for Global Functional Status in RA, which indicated good discriminative validity. The validation results are generally consistent between subgroups from north and south China.
The Chinese HAQ demonstrated good acceptability and psychometric properties in RA patients from China. Two possible improvements for better use and interpretation of the patient-reported outcomes of RA patients in China could be to cross-culturally adapt the items about the use of aids and devices and joint use of mental health measurements together with HAQ in future studies.
验证中文版健康评估问卷（HAQ）在中国大陆地区类风湿关节炎（RA）患者中的心理计量学特性。
通过问卷调查的方式对包含 HAQ、EQ-5D 和 SF-12 的问卷组合对受试者进行访谈，验证 HAQ 的心理计量学特性。采用 Cronbach's alpha 评估信度，通过检验预先假设评估结构效度，通过区分不同组别的受试者评估判别效度。为评估 HAQ 在不同地区的适用性，分别对中国南方和北方进行亚组分析。
共对 133 例 RA 患者进行了连续抽样问卷调查。所有项目的 Cronbach's alpha 均显示出较强的可靠性。特别是当排除关于辅助器具使用的项目时，内部可靠性更高：排除时为 0.987，包括时为 0.963。基于 HAQ 评分与 EQ-5D 和 SF-12 量表之间的相关性，达到了两个预先假设，从而支持了结构效度。总体而言，HAQ 评分对于 RA 的全球功能状况是重要的推断因素，表明具有良好的判别效度。南北亚组的验证结果基本一致。
中文版 HAQ 在中国大陆地区 RA 患者中具有良好的可接受性和心理计量学特性。为了更好地使用和解释中国 RA 患者的患者报告结局，未来的研究可能需要对关于辅助器具使用的项目进行跨文化适应，并将心理健康测量与 HAQ 联合使用。
