Doward Lynda, Wilburn Jeanette, McKenna Stephen P, Leicester Roger, Epstein Owen, Hedley Vicki, Korala Sanjeeva, Twiss James, Jones Deborah, Geraint Mike
Galen Research Ltd, Manchester, UK.
Department of Endoscopy, St George's Hospital, London, UK.
Frontline Gastroenterol. 2013 Apr;4(2):112-119. doi: 10.1136/flgastro-2012-100278. Epub 2013 Jan 15.
Acceptability and tolerability of bowel cleansers influence whether patients are able to complete the prescribed dose and, consequently, the quality of the cleansing achieved. No standardised means of assessing patients' experience of using bowel cleansing is currently available. The aim of the study was to develop the Bowel Cleansing Impact Review (BOCLIR) to assess patient response to bowel cleansing products.
Content was derived from qualitative interviews. Face and content validity were assessed via cognitive-debriefing interviews. Finally, patients completed the BOCLIR and a demographic questionnaire. Item response theory (Rasch analysis) was employed for item reduction and assessment of unidimensionality. Internal consistency and construct validity were also assessed.
Analysis of 40 interviews resulted in the production of three scales; patient satisfaction, symptomatic impact and activity limitations. Scales were designed to be used alone or together. 19 debriefing interviews demonstrated BOCLIR acceptability, relevance and ease of completion. The validation survey involved 166 patients (52% male, mean (SD) age 54.3 (15.2) years). After misfitting and redundant items were removed all scales fit the Rasch model confirming their unidimensionality. Cronbach's α-coefficients were high (0.77-0.94) indicating good internal consistency. Scores on the BOCLIR were related to patients' willingness to use the product in future and ease of drinking the full preparation (p<0.01 for each scale).
The BOCLIR is a new measure consisting of three unidimensional scales (satisfaction, symptoms and activity limitations) with good psychometric and scaling properties. The BOCLIR will allow accurate assessment of patients' response to bowel cleansing preparations.
肠道清洁剂的可接受性和耐受性会影响患者是否能够完成规定剂量，进而影响清洁效果的质量。目前尚无标准化的方法来评估患者使用肠道清洁产品的体验。本研究的目的是开发肠道清洁影响评估量表（BOCLIR），以评估患者对肠道清洁产品的反应。
内容源自定性访谈。通过认知反馈访谈评估表面效度和内容效度。最后，患者完成BOCLIR和一份人口统计学问卷。采用项目反应理论（拉施分析）进行项目删减和单维性评估。还评估了内部一致性和结构效度。
对40次访谈的分析产生了三个量表：患者满意度、症状影响和活动受限。这些量表既可以单独使用，也可以一起使用。19次反馈访谈证明了BOCLIR的可接受性、相关性和易完成性。验证性调查涉及166名患者（男性占52%，平均（标准差）年龄54.3（15.2）岁）。去除不匹配和冗余项目后，所有量表均符合拉施模型，证实了它们的单维性。克朗巴赫α系数较高（0.77 - 0.94），表明内部一致性良好。BOCLIR得分与患者未来使用该产品的意愿以及饮用完整制剂的难易程度相关（每个量表p<0.01）。
BOCLIR是一种新的测量工具，由三个单维量表（满意度、症状和活动受限）组成，具有良好的心理测量和量表特性。BOCLIR将能够准确评估患者对肠道清洁制剂的反应。
