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欧洲癌症研究与治疗组织化疗所致周围神经病变问卷(QLQ-CIPN20)的心理测量学特性评估。

Evaluation of the psychometric properties of the EORTC chemotherapy-induced peripheral neuropathy questionnaire (QLQ-CIPN20).

作者信息

Kieffer Jacobien M, Postma Tjeerd J, van de Poll-Franse Lonneke, Mols Floortje, Heimans Jan J, Cavaletti Guido, Aaronson Neil K

机构信息

Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.

Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands.

出版信息

Qual Life Res. 2017 Nov;26(11):2999-3010. doi: 10.1007/s11136-017-1626-1. Epub 2017 Jun 20.

Abstract

PURPOSE

To investigate the scale structure and psychometrics of the EORTC chemotherapy-induced peripheral neuropathy module (QLQ-CIPN20).

METHODS

Using confirmatory factor analyses (CFA), we tested two hypothesized scale structure models of the QLQ-CIPN20 in 473 patients with non-small cell lung cancer, 281 patients with heterogeneous cancer diagnoses, and 500 patients with colorectal cancer. We also modeled the two hypothesized models as bi-factor models. These included a general factor, in addition to the specific domain factors. Additional models were investigated with exploratory factor analysis (EFA). Known groups validity was evaluated where justified.

RESULTS

CFA could not confirm the two hypothesized models (Model 1: CFI < 0.926; TLI < 0.914; RMSEA > 0.077 and Model 2: CFI < 0.906; TLI < 0.887; RMSEA > 0.105) in any of the three samples. Including a general factor to these two hypothesized models to produce a bi-factor model also did not yield satisfactory results. Using EFA, we identified four different factor structures in the three samples that were unstable due to cross loadings of the items. When scoring the QLQ-CIPN20 as a simple, additive checklist evidence was found for known groups validity in the first two samples based on Common Toxicity Criteria (CTC-AE), and in the third sample based on exposure to CIPN-inducing chemotherapy.

CONCLUSIONS

Neither CFA nor EFA yielded support for a stable subscale structure for the QLQ-CIPN20. Scoring the questionnaire as a simple additive checklist results in acceptable validity.

摘要

目的

研究欧洲癌症研究与治疗组织(EORTC)化疗所致周围神经病变模块(QLQ-CIPN20)的量表结构和心理测量学特性。

方法

我们采用验证性因子分析(CFA),在473例非小细胞肺癌患者、281例癌症诊断各异的患者以及500例结直肠癌患者中,对QLQ-CIPN20的两种假设量表结构模型进行了测试。我们还将这两种假设模型构建为双因子模型。除特定领域因子外,这些模型还包括一个一般因子。另外采用探索性因子分析(EFA)研究了其他模型。在合理的情况下评估已知组效度。

结果

在三个样本中的任何一个中,CFA均无法证实这两种假设模型(模型1:CFI < 0.926;TLI < 0.914;RMSEA > 0.077;模型2:CFI < 0.906;TLI < 0.887;RMSEA > 0.105)。在这两种假设模型中纳入一个一般因子以构建双因子模型也未产生令人满意的结果。使用EFA,我们在三个样本中识别出四种不同的因子结构,这些结构因项目的交叉载荷而不稳定。当将QLQ-CIPN20作为一个简单的累加清单进行评分时,在前两个样本中基于常见毒性标准(CTC-AE),在第三个样本中基于接触诱导CIPN的化疗,发现了已知组效度的证据。

结论

CFA和EFA均未支持QLQ-CIPN20具有稳定的子量表结构。将该问卷作为一个简单的累加清单进行评分可得到可接受的效度。

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