中国大陆版慢性肝病问卷的研制与应用：评估慢性乙型肝炎患者的健康相关生活质量
Development and Application of the Chinese (Mainland) Version of Chronic Liver Disease Questionnaire to Assess the Health-Related Quality of Life (HRQoL) in Patients with Chronic Hepatitis B.
作者信息
Liu Yanli, Zhang Sai, Zhao Yali, Du Juan, Jin Guanghui, Shao Shuang, Lu Xiaoqin
机构信息
Department of General Practice, School of General Practice & Continuing Education, Capital Medical University, Beijing 100069, China.
出版信息
PLoS One. 2016 Sep 15;11(9):e0162763. doi: 10.1371/journal.pone.0162763. eCollection 2016.
OBJECTIVE
To develop the Chinese (Mainland) version of Chronic Liver Disease Questionnaire (CLDQ) and use it to assess the health-related quality of life (HRQoL) of chronic hepatitis B (CHB) patients in China and identify the determinants of HRQoL.
METHODS
The Chinese (Mainland) CLDQ was developed by expert consultation, focus group interviews with patients, and pilot study. The final version of questionnaire was adopted to assess the HRQoL of chronic hepatitis B outpatients enrolled from two largest infectious hospitals in Beijing. Cronbach' s alpha was used to measure the internal consistency reliability. The construct validity was measured by factor analysis. T-test, one-way analysis of variance (ANOVA), and multi-variable linear regression were used to analyze the data.
RESULTS
Cronbach's alpha of the overall CLDQ is 0.935, ranging from 0.628 to o.881 among six subscales. Six factors were identified via factor analysis, including a new factor sleeping(SL). A total of 519 patients with CHB were included in the investigation with the final version of questionnaire, 405 of them were only with CHB, 53 with compensated cirrhosis, and 61 with decompensated cirrhosis. The CHB group scored the highest in the overall score of CLDQ (p<0.05). The score of worry (WO) domain was significantly lower in the compensated group than the CHB group (p<0.05). Decompensated cirrhosis patients scored lower than the CHB group in all CLDQ domains and the overall score (p<0.05). Stages of illness, gender, regular visits to specialized hospitals, and work status in last year were determinants of HRQoL.
CONCLUSION
The psychometric properties of the Chinese(Mainland) CLDQ is acceptable. The HRQoL of CHB patients deteriorated with disease progression. Advanced stages of CHB, female, long time absence from work after illness, and no job or retirement were determinants of poor HRQoL. Regular visits to specialized hospitals was a positive determinant of HRQoL.
目的
编制慢性肝病问卷（CLDQ）的中国（大陆）版，并使用其评估中国慢性乙型肝炎（CHB）患者的健康相关生活质量（HRQoL），并确定HRQoL的决定因素。
方法
通过专家咨询、患者焦点小组访谈和预试验编制中国（大陆）CLDQ。采用问卷最终版本评估来自北京两家最大传染病医院的慢性乙型肝炎门诊患者的HRQoL。采用Cronbach's α系数测量内部一致性信度。采用因子分析测量结构效度。采用t检验、单因素方差分析（ANOVA）和多变量线性回归分析数据。
结果
CLDQ总问卷的Cronbach's α系数为0.935，六个子量表的系数范围为0.628至0.881。通过因子分析确定了六个因素，包括一个新的因素睡眠（SL）。共有519例CHB患者纳入问卷最终版本的调查，其中仅CHB患者405例，代偿期肝硬化患者53例，失代偿期肝硬化患者61例。CHB组在CLDQ总分中得分最高（p<0.05）。代偿期组的担忧（WO）领域得分显著低于CHB组（p<0.05）。失代偿期肝硬化患者在所有CLDQ领域和总分中的得分均低于CHB组（p<0.05）。疾病分期、性别、定期到专科医院就诊以及去年的工作状态是HRQoL的决定因素。
结论
中国（大陆）CLDQ的心理测量学特性是可接受的。CHB患者的HRQoL随疾病进展而恶化。CHB晚期、女性、病后长期缺勤以及无工作或退休是HRQoL差的决定因素。定期到专科医院就诊是HRQoL的一个积极决定因素。
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