Conijn A P, Santema T B K, Bipat S, Koelemay M J W, de Haan R J
Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands; Department of Radiology, Academic Medical Centre, Amsterdam, The Netherlands.
Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands.
Eur J Vasc Endovasc Surg. 2017 Mar;53(3):412-418. doi: 10.1016/j.ejvs.2016.12.015. Epub 2017 Jan 4.
Although commonly used to measure health related quality of life in patients with lower limb ischaemia, the measurement properties of the VascuQol and its assumed underlying health dimensions have not been studied in depth. The objective of this study was therefore to evaluate aspects of reliability and validity of the Dutch version of the VascuQol in patients with intermittent claudication (IC) and critical limb ischaemia (CLI).
Two datasets containing 195 patients with IC and 150 patients with CLI were used. Face validity of the VascuQol was examined in interviews with patients and a survey among health professionals. Homogeneity and structural validity of the VascuQol were assessed using Cronbach's α coefficients and explanatory factor analysis. Furthermore, convergent validity and known group validity were assessed.
During the face validity interviews, three items were indicated as less relevant. Homogeneity analysis showed that the α coefficient of the VascuQol was .93, while the symptoms and social domains had α coefficients below the threshold of .70. The original five domains of the VascuQol could not be reproduced. Instead, factor analysis yielded a three factor solution. Moderate correlations were found for the activities, social and emotional VascuQol domains and matching health domains of other patient reported outcome measures (PROMs). Lower convergent correlations were observed for the pain domain and the sumscore of the VascuQol. The VascuQol was able to distinguish between patients' level of HRQL in relation to their disease severity (IC versus CLI patients).
There is room for improvement of the VascuQol questionnaire. Further clinimetric studies should be performed to strengthen clinically relevant findings based on this instrument.
尽管血管生活质量量表（VascuQol）常用于测量下肢缺血患者的健康相关生活质量，但其测量特性及其假定的潜在健康维度尚未得到深入研究。因此，本研究的目的是评估荷兰版VascuQol在间歇性跛行（IC）和严重肢体缺血（CLI）患者中的信度和效度。
使用了两个数据集，其中包含195例IC患者和150例CLI患者。通过与患者访谈和对卫生专业人员进行调查来检验VascuQol的表面效度。使用克朗巴赫α系数和解释性因子分析评估VascuQol的同质性和结构效度。此外，还评估了收敛效度和已知组效度。
在表面效度访谈中，有三个项目被认为相关性较低。同质性分析表明，VascuQol的α系数为0.93，而症状和社会领域的α系数低于0.70的阈值。VascuQol最初的五个领域无法重现。相反，因子分析得出了一个三因子解决方案。在活动、社会和情感VascuQol领域与其他患者报告结局测量（PROMs）的匹配健康领域之间发现了中等程度的相关性。在疼痛领域和VascuQol总分方面观察到较低的收敛相关性。VascuQol能够区分患者与疾病严重程度相关的健康相关生活质量水平（IC患者与CLI患者）。
VascuQol问卷有改进的空间。应进行进一步的临床测量学研究，以加强基于该工具的临床相关发现。
