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基于项目反应理论测量高血压患者的生活质量。

Measuring the quality of life in hypertension according to Item Response Theory.

作者信息

Borges José Wicto Pereira, Moreira Thereza Maria Magalhães, Schmitt Jeovani, Andrade Dalton Francisco de, Barbetta Pedro Alberto, Souza Ana Célia Caetano de, Lima Daniele Braz da Silva, Carvalho Irialda Saboia

机构信息

Programa de Pós-Graduação em Saúde e Comunidade. Universidade Federal do Piauí. Floriano, PI, Brasil.

Programa de Pós-Graduação em Cuidados Clínicos em Enfermagem e Saúde. Programa de Pós-Graduação em Saúde Coletiva. Centro de Ciências da Saúde. Universidade Estadual do Ceará. Fortaleza, CE, Brasil.

出版信息

Rev Saude Publica. 2017 May 4;51:45. doi: 10.1590/S1518-8787.2017051006845.

Abstract

OBJECTIVE

To analyze the Miniquestionário de Qualidade de Vida em Hipertensão Arterial (MINICHAL - Mini-questionnaire of Quality of Life in Hypertension) using the Item Response Theory.

METHODS

This is an analytical study conducted with 712 persons with hypertension treated in thirteen primary health care units of Fortaleza, State of Ceará, Brazil, in 2015. The steps of the analysis by the Item Response Theory were: evaluation of dimensionality, estimation of parameters of items, and construction of scale. The study of dimensionality was carried out on the polychoric correlation matrix and confirmatory factor analysis. To estimate the item parameters, we used the Gradual Response Model of Samejima. The analyses were conducted using the free software R with the aid of psych and mirt.

RESULTS

The analysis has allowed the visualization of item parameters and their individual contributions in the measurement of the latent trait, generating more information and allowing the construction of a scale with an interpretative model that demonstrates the evolution of the worsening of the quality of life in five levels. Regarding the item parameters, the items related to the somatic state have had a good performance, as they have presented better power to discriminate individuals with worse quality of life. The items related to mental state have been those which contributed with less psychometric data in the MINICHAL.

CONCLUSIONS

We conclude that the instrument is suitable for the identification of the worsening of the quality of life in hypertension. The analysis of the MINICHAL using the Item Response Theory has allowed us to identify new sides of this instrument that have not yet been addressed in previous studies.

OBJETIVO

Analisar o Miniquestionário de Qualidade de Vida em Hipertensão Arterial (MINICHAL) por meio da Teoria da Resposta ao Item.

MÉTODOS: Estudo analítico realizado com 712 pessoas com hipertensão arterial atendidas em 13 unidades de atenção primária em saúde de Fortaleza, CE, em 2015. As etapas da análise pela Teoria da Resposta ao Item foram: avaliação da dimensionalidade, estimação dos parâmetros dos itens e construção da escala. O estudo da dimensionalidade foi realizado sobre a matriz de correlação policórica e análise fatorial confirmatória. Para a estimação dos parâmetros dos itens, foi utilizado o Modelo de Resposta Gradual de Samejima. As análises foram conduzidas no software livre R com o auxílio dos pacotes psych e mirt.

RESULTADOS

A análise permitiu a visualização dos parâmetros dos itens e suas contribuições individuais na mensuração do traço latente, gerando mais informação, permitindo a construção de uma escala com um modelo interpretativo que demonstra a evolução da piora da qualidade de vida em cinco níveis. Quanto aos parâmetros dos itens, houve bom desempenho daqueles referentes ao estado somático, pois apresentaram melhor poder de discriminar os indivíduos com pior qualidade de vida. Os itens relacionados ao estado mental foram os que contribuíram com menor quantidade de informação psicométrica no MINICHAL.

CONCLUSÕES: Conclui-se que o instrumento é indicado para a identificação da deterioração da qualidade de vida em hipertensão arterial. A análise do MINICHAL pela Teoria da Resposta ao Item permitiu identificar novas facetas desse instrumento ainda não abordadas em estudos anteriores.

摘要

目的

运用项目反应理论分析高血压生活质量简易问卷(MINICHAL)。

方法

这是一项分析性研究,于2015年对巴西塞阿拉州福塔雷萨市13个初级卫生保健单位收治的712例高血压患者进行。项目反应理论分析步骤包括:维度评估、项目参数估计和量表构建。维度研究基于多相关矩阵和验证性因子分析进行。为估计项目参数,我们使用了Samejima的渐进反应模型。分析借助免费软件R并在psych和mirt包的帮助下进行。

结果

该分析使项目参数及其在潜在特质测量中的个体贡献得以可视化,产生了更多信息,从而能够构建一个具有解释模型的量表,该模型展示了生活质量恶化在五个水平上的演变。关于项目参数,与躯体状态相关的项目表现良好,因为它们在区分生活质量较差的个体方面具有更好的能力。与精神状态相关的项目在MINICHAL中提供的心理测量数据较少。

结论

我们得出结论,该工具适用于识别高血压患者生活质量的恶化情况。运用项目反应理论对MINICHAL进行分析,使我们能够识别该工具此前研究中尚未涉及的新方面。

目的

通过项目反应理论分析高血压生活质量简易问卷(MINICHAL)。

方法

2015年在巴西塞阿拉州福塔雷萨市的13个初级卫生保健单位对712例高血压患者进行了分析性研究。项目反应理论分析的步骤为:维度评估、项目参数估计和量表构建。维度研究是在多相关矩阵和验证性因子分析的基础上进行的。为估计项目参数,使用了Samejima的渐进反应模型。分析在免费软件R中借助psych和mirt包进行。

结果

该分析使项目参数及其在潜在特质测量中的个体贡献得以显现,产生了更多信息,从而能够构建一个具有解释模型的量表,该模型展示了生活质量在五个水平上恶化的演变情况。就项目参数而言,与躯体状态相关的项目表现良好,因为它们在区分生活质量较差的个体方面具有更强的能力。与精神状态相关的项目在MINICHAL中提供的心理测量数据较少。

结论

得出结论,该工具适用于识别高血压患者生活质量的恶化。通过项目反应理论对MINICHAL进行分析,使我们能够识别该工具此前研究中尚未涉及的新层面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f42/5433789/86940eb70841/0034-8910-rsp-S1518-87872017051006845-gf01.jpg

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