Alvarado-Martel Dácil, Ruiz Fernández M Angeles, Cuadrado Vigaray Maribel, Carrillo Armando, Boronat Mauro, Expósito Montesdeoca Ana, Nattero Chávez Lía, Pozuelo Sánchez Maite, López Quevedo Pino, Santana Suárez Ana D, Hillman Natalia, Subias David, Martin Vaquero Pilar, Sáez de Ibarra Lourdes, Mauricio Didac, de Pablos-Velasco Pedro, Nóvoa Francisco J, Wägner Ana M
Department of Endocrinology and Nutrition, Complejo Hospitalario Univesitario Insular Materno-Infantil de Gran CanariaLas Palmas de Gran Canaria, Spain.
Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran CanariaLas Palmas de Gran Canaria, Spain.
Front Psychol. 2017 May 31;8:904. doi: 10.3389/fpsyg.2017.00904. eCollection 2017.
This study describes the development of a new questionnaire to measure health-related quality of life (HRQoL) in patients with type 1 diabetes (the ViDa1 questionnaire) and provides information on its psychometric properties. For its development, open interviews with patients took place and topics relevant to patients' HRQoL were identified and items were generated. Qualitative analysis of items, expert review, and refinement of the questionnaire followed. A pilot study ( = 150) was conducted to explore the underlying structure of the 40-item ViDa1 questionnaire. A Principal Component Analysis (PCA) was performed and six of the items that did not load on any of the factors were eliminated. The results supported a four-dimensional structure for ViDa1, the dimensions being Interference of diabetes in everyday life, Self-care, Well-being, and Worry about the disease. Subsequently, the PCA was repeated in a larger sample ( = 578) with the reduced 34-item version of the questionnaire, and a Confirmatory Factor Analysis (CFA) was performed ( = 428). Overall fit indices obtained presented adequate values which supported the four-factor model initially proposed [([Formula: see text] 2601.93) ( < 0.001); Root Mean Square Error of Approximation = 0.060 (CI = 0.056 -0.064)]. As regards reliability, the four dimensions of the ViDa1 demonstrated good internal consistency, with Cronbach's alphas ranging between 0.71 and 0.86. Evidence of convergent-discriminant validity in the form of high correlations with another specific HRQoL questionnaire for diabetes and low correlations with other constructs such as self-efficacy, anxiety, and depression were presented. The ViDa1 also discriminated between different aspects of clinical interest such as type of insulin treatment, presence of chronic complications, and glycemic control, temporal stability, and sensitivity to change after an intervention. In conclusion, the ViDa1 questionnaire presents adequate psychometric properties and may represent a good alternative for the evaluation of HRQoL in type 1 diabetes.
本研究描述了一种用于测量1型糖尿病患者健康相关生活质量(HRQoL)的新问卷(ViDa1问卷)的开发过程,并提供了其心理测量特性的相关信息。在开发过程中,对患者进行了开放式访谈,确定了与患者HRQoL相关的主题并生成了条目。随后对条目进行了定性分析、专家评审以及问卷完善。开展了一项预试验(n = 150)以探索包含40个条目的ViDa1问卷的潜在结构。进行了主成分分析(PCA),并剔除了未在任何因子上负荷的6个条目。结果支持ViDa1具有四维结构,维度分别为糖尿病对日常生活的干扰、自我护理、幸福感以及对疾病的担忧。随后,在一个更大的样本(n = 578)中使用精简后的34个条目版本的问卷重复进行PCA,并进行了验证性因子分析(CFA)(n = 428)。获得的整体拟合指数呈现出合适的值,支持最初提出的四因子模型[(χ² = 2601.93)(p < 0.001);近似均方根误差 = 0.060(95%CI = 0.056 - 0.064)]。在信度方面,ViDa1的四个维度显示出良好的内部一致性,克朗巴哈系数在0.71至0.86之间。以与另一份特定的糖尿病HRQoL问卷高度相关以及与自我效能、焦虑和抑郁等其他构念低度相关的形式呈现了聚合区分效度的证据。ViDa1还区分了不同的临床关注方面,如胰岛素治疗类型、慢性并发症的存在、血糖控制、时间稳定性以及干预后的变化敏感性。总之,ViDa1问卷具有合适的心理测量特性,可能是评估1型糖尿病患者HRQoL的一个良好选择。