Vergara Mercedes, Sicilia Beatriz, Prieto Luis, Casellas Francesc, Ramos Alexis, Gomollón Fernando, Calvet Xavier
*Servei Aparell Digestiu, Corporació Sanitària Universitària Parc Tauli, Sabadell, Barcelona, Spain; †Departament de Medicina, Universitat Autònoma de Barcelona, Spain; ‡CIBERehd, Instituto de Salud Carlos III, Madrid, Spain; §Servicio de Aparato Digestivo, Complejo Asistencial de Burgos, Burgos, Spain; ‖Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom; ¶Servei d'Aparell Digestiu Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain; and **Servicio de AparatoDigestivo, Hospital Clínico Universitario de Zaragoza, Zaragoza, Spain.
Inflamm Bowel Dis. 2016 Apr;22(4):955-62. doi: 10.1097/MIB.0000000000000678.
The aim was to develop and validate a self-reported short Crohn's disease work disability questionnaire (sCDWDQ).
(1) Development of a shortened questionnaire-Patients' responses to the validation process (n = 108) of a previously developed, 16-item Spanish Crohn's disease work disability questionnaire (CDWDQ) were analyzed using the Rasch model for multiple response items. After this process, a 9-item sCDWDQ was obtained. (2) Validation phase-The validation assessed the questionnaire's convergent validity, discriminant validity, test-retest reproducibility, and internal consistency. Spearman rank correlation, t test, intra-class correlation and Cronbach's alpha were used for the analysis.
One hundred fifty-one patients were included in the validation phase. (1) Convergent validity was confirmed by correlations between the sCDWDQ and clinical activity (r = 0.66, P < 0.01), the short inflammatory bowel disease questionnaire IBDQ-9 (r = 0.74, P < 0.001), Euroqol-5D (r = 0.63, P < 0.01), the EuroQol-5D visual analog scale (r = 0.54, P < 0.01), and overall work impairment (r = 0.66, P < 0.01); (2) Discriminant validity-sCDWDQ scores were higher in patients with active disease (20.1 ± 6.3 versus 13.0 ± 3.8 inactive, P < 0.001), in those requiring previous sick leave (19.6 ± 6.9 versus no sick leave 14.2 ± 4.8, P < 0.01) and in those requiring hospitalization (20.0 ± 7.3 [n = 29] versus no hospitalization 14.1 ± 7.3 [n = 90], P < 0.01); (3) Internal consistency was also good (Cronbach's alpha = 0.92); and (4) Reproducibility-sCDWDQ measures obtained 2 weeks apart showed an excellent intraclass correlation coefficient of 0.92 (95% confidence interval, 0.90-0.94).
The self-reported sCDWDQ appears to be a simple, valid, and reliable tool for measuring work disability in Crohn's disease.
目的是开发并验证一份自我报告的克罗恩病工作残疾简短问卷（sCDWDQ）。
（1）简短问卷的开发——使用针对多项反应项目的拉施模型，分析患者对先前开发的16项西班牙文克罗恩病工作残疾问卷（CDWDQ）验证过程（n = 108）的回答。经过此过程，获得了一份9项的sCDWDQ。（2）验证阶段——验证评估了问卷的收敛效度、区分效度、重测信度和内部一致性。分析使用了斯皮尔曼等级相关性、t检验、组内相关性和克朗巴哈系数。
151名患者纳入验证阶段。（1）sCDWDQ与临床活动（r = 0.66，P < 0.01）、简短炎症性肠病问卷IBDQ - 9（r = 0.74，P < 0.001）、欧洲五维健康量表（r = 0.63，P < 0.01）、欧洲五维健康量表视觉模拟量表（r = 0.54，P < 0.01）以及总体工作障碍（r = 0.66，P < 0.01）之间的相关性证实了收敛效度；（2）区分效度——活动期疾病患者的sCDWDQ得分更高（活动期20.1±6.3，非活动期13.0±3.8，P < 0.001），需要先前病假的患者更高（19.6±6.9，无病假14.2±4.8，P < 0.01），需要住院的患者更高（20.0±7.3 [n = 29]，未住院14.1±7.3 [n = 90]，P < 0.01）；（3）内部一致性也良好（克朗巴哈系数 = 0.92）；（4）重测信度——间隔2周获得的sCDWDQ测量结果显示组内相关系数极佳，为0.92（95%置信区间，0.90 - 0.94）。
自我报告的sCDWDQ似乎是一种用于测量克罗恩病工作残疾的简单、有效且可靠的工具。
