Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, 50200, Thailand.
Pharmacoepidemiology and Statistics Clinic, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, 50200, Thailand.
Br J Dermatol. 2017 Jun;176(6):1516-1524. doi: 10.1111/bjd.15268. Epub 2017 May 2.
Dialysis patients with uraemic pruritus (UP) have significantly impaired quality of life. To assess the therapeutic effect of UP treatments, a well-validated comprehensive and multidimensional instrument needed to be established.
To develop and validate a multidimensional scale assessing UP in patients on dialysis: the Uraemic Pruritus in Dialysis Patients (UP-Dial).
The development and validation of the UP-Dial instrument were conducted in four phases: (i) item generation, (ii) development of a pilot questionnaire, (iii) refinement of the questionnaire with patient recruitment and (iv) psychometric validation. Participants completed the UP-Dial, the visual analogue scale (VAS) of UP, the Dermatology Life Quality Index (DLQI), the Kidney Disease Quality of Life-36 (KDQOL-36), the Pittsburgh Sleep Quality Index (PSQI) and the Beck Depression Inventory (BDI) between 15 May 2012 and 30 November 2015.
The 27-item pilot UP-Dial was generated, with 168 participants completing the pilot scale. After factor analysis was performed, the final 14-item UP-Dial encompassed three domains: signs and symptoms, psychosocial, and sleep. Face and content validity were satisfied through the item generation process and expert review. Psychometric analysis demonstrated that the UP-Dial had good convergent and discriminant validity. The UP-Dial was significantly correlated [Spearman rank coefficient, 95% confidence interval (CI)] with the VAS-UP (0·76, 0·69-0·83), DLQI (0·78, 0·71-0·85), KDQOL-36 (-0·86, -0·91 to -0·81), PSQI (0·85, 0·80-0·89) and BDI (0·70, 0·61-0·79). The UP-Dial revealed excellent internal consistency (Cronbach's α 0·90, 95% CI 0·87-0·92) and reproducibility (intraclass correlation 0·95, 95% CI 0·90-0·98).
The UP-Dial is valid and reliable for assessing UP among patients on dialysis. Future research should focus on the cross-cultural adaptation and translation of the scale to other languages.
患有尿毒症瘙痒（UP）的透析患者生活质量明显受损。为了评估 UP 治疗的疗效，需要建立一种经过良好验证的全面和多维的工具。
开发和验证一种用于评估透析患者 UP 的多维量表：透析患者尿毒症瘙痒量表（UP-Dial）。
该 UP-Dial 仪器的开发和验证分为四个阶段：（i）项目生成，（ii）试点问卷的开发，（iii）通过患者招募对问卷进行改进，（iv）心理测量验证。参与者在 2012 年 5 月 15 日至 2015 年 11 月 30 日之间完成了 UP-Dial、UP 的视觉模拟量表（VAS）、皮肤病生活质量指数（DLQI）、肾脏病生活质量-36（KDQOL-36）、匹兹堡睡眠质量指数（PSQI）和贝克抑郁量表（BDI）。
生成了包含 27 个项目的试点 UP-Dial，有 168 名参与者完成了试点量表。经过因子分析后，最终的 14 项 UP-Dial 涵盖了三个领域：体征和症状、心理社会和睡眠。通过项目生成过程和专家审查满足了表面和内容效度。心理测量分析表明，UP-Dial 具有良好的聚合和区分效度。UP-Dial 与 VAS-UP（Spearman 秩系数，95%置信区间（CI））显著相关[0·76，0·69-0·83]、DLQI（0·78，0·71-0·85）、KDQOL-36（-0·86，-0·91 至-0·81）、PSQI（0·85，0·80-0·89）和 BDI（0·70，0·61-0·79）。UP-Dial 显示出极好的内部一致性（Cronbach's α 0·90，95%CI 0·87-0·92）和再现性（组内相关系数 0·95，95%CI 0·90-0·98）。
UP-Dial 可有效可靠地评估透析患者的 UP。未来的研究应集中于对其他语言的跨文化适应性和翻译。
