Mueser Kim T, Kim Min, Addington Jean, McGurk Susan R, Pratt Sarah I, Addington Donald E
Center for Psychiatric Rehabilitation, Departments of Occupational Therapy, Psychology, and Psychiatry, Boston University, Boston, MA, USA.
Center for Psychiatric Rehabilitation, Boston University, Boston, MA, USA.
Schizophr Res. 2017 Mar;181:117-123. doi: 10.1016/j.schres.2016.10.018. Epub 2016 Oct 15.
The Quality of Life Scale (QLS) is a frequently used semistructured interview for the assessment of functional outcomes in schizophrenia. Despite the use of the QLS for over 30years, the original 4-factor structure of the instrument (Interpersonal Relations, Instrumental Role, Intrapsychic Foundations, and Common Objects and Activities) has not been rigorously examined. Exploratory factor analyses (EFAs) and confirmatory factor analyses (CFAs) were used to evaluate the factor structure of the QLS in two independent datasets, including a mixed diagnostic sample of multi-episode participants (N=247), and a sample of individuals with a first episode of psychosis (N=337). A CFA with the first dataset indicated a poor fit for the 4-factor model of the QLS. Subsequent EFAs on this dataset led to a more promising 3-factor solution including 16/21 of the QLS items, which were similar to the first 3 of 4 factors originally proposed for the QLS. CFAs on the same dataset indicated that the 3-factor model for the QLS-Revised (QLS-R) fit the data well. This factor structure was evaluated with the second dataset using CFA and was also found to be fit the data well. The results support the robustness of the 3-factor model of the QLS-R in schizophrenia and mixed diagnostic samples. Future research should evaluate the validity of the 3-factor model of the QLS-R, and consider the merits of changing the name of the Intrapsychic Foundations factor to Motivation.
生活质量量表(QLS)是一种常用于评估精神分裂症功能结局的半结构化访谈工具。尽管QLS已使用了30多年,但该工具最初的四因素结构(人际关系、工具性角色、内心基础以及常见物体和活动)尚未得到严格检验。探索性因素分析(EFA)和验证性因素分析(CFA)被用于评估两个独立数据集中QLS的因素结构,其中一个是多发作参与者的混合诊断样本(N = 247),另一个是首次发作精神病患者的样本(N = 337)。对第一个数据集进行的CFA表明QLS的四因素模型拟合不佳。随后对该数据集进行的EFA得出了一个更有前景的三因素解决方案,包含QLS的21个项目中的16个,这与最初为QLS提出的四个因素中的前三个相似。对同一数据集进行的CFA表明,修订后的QLS(QLS-R)的三因素模型与数据拟合良好。使用CFA对第二个数据集评估了这种因素结构,发现其也与数据拟合良好。结果支持了QLS-R的三因素模型在精神分裂症和混合诊断样本中的稳健性。未来的研究应评估QLS-R三因素模型的有效性,并考虑将内心基础因素更名为动机的优点。