Ferrer-Márquez Manuel, Espínola-Cortés Natalia, Reina-Duarte Angel, Granero-Molina José, Fernández-Sola Cayetano, Hernández-Padilla José Manuel
1 Departamento de Cirugía Colorectal, Servicio de Cirugía General y Digestiva, Hospital Torrecárdenas, Almería, Spain 2 Nursing, Physiotherapy, and Medicine Department, Faculty of Health Sciences, University of Almeria, Almería, Spain 3 Faculty of Health Sciences, Universidad Autónoma de Chile, Temuco, Chile 4 Adult, Child, and Midwifery Department, School of Health and Education, Middlesex University, London, United Kingdom.
Dis Colon Rectum. 2017 Oct;60(10):1083-1091. doi: 10.1097/DCR.0000000000000877.
Quality of life is often considered when deciding and evaluating the treatment strategy for patients diagnosed with anal fistula.
The purpose of this study was to develop and psychometrically test the Quality of Life in Patients with Anal Fistula Questionnaire.
This was an observational cross-sectional study for the development and validation of a psychometric tool.
The study was conducted at a general hospital in the southeast of Spain.
A convenience sample included 54 patients diagnosed with anal fistula.
The reliability of the tool was assessed through its internal consistency (Cronbach α) and temporal stability (Spearman correlation coefficient (r) between test-retest). The content validity index of the items and the scale was calculated. Correlation analysis and an ordinal regression analysis between the developed tool and the Short Form 12 Health Survey examined its concurrent validity. Principal component analysis and known-group analysis using the Kruskal-Wallis test examined its construct validity.
The reliability of the developed questionnaire was very high (α = 0.908; r = 0.861; p < 0.01). Its content validity was excellent (all-item content validity index = 0.79-1.00; scale validity index = 0.92). Evidence of its concurrent validity included strong correlation between the developed tool and Short Form 12 Health Survey (r = 0.734; p < 0.001), and participant scores on the developed tool explained ≈46.2% of the between-subject variation for the participant scores on Short Form 12 Health Survey (Nagelkerke R = 0.462). Confirming its construct validity, principal component analysis revealed that 2 factors explained 81.63% of the total variance found. Known-group analysis evidenced the ability of the questionnaire to detect expected differences in patients presenting with different symptomatology.
The major limitations of this study were the use of a small sample of Spanish-speaking patients, not including patients in the initial development of the questionnaire, and developing the scoring system using a summation method.
The Quality of Life in Patients with Anal Fistula Questionnaire has proven to be a valid, reliable, and concise tool that could contribute to the evaluation of quality of life among patients with an anal fistula. See Video Abstract at http://links.lww.com/DCR/A368.
在决定和评估肛瘘患者的治疗策略时，通常会考虑生活质量。
本研究的目的是开发并对肛瘘患者生活质量问卷进行心理测量学测试。
这是一项用于开发和验证心理测量工具的观察性横断面研究。
该研究在西班牙东南部的一家综合医院进行。
一个便利样本包括54名被诊断为肛瘘的患者。
通过内部一致性（Cronbach α）和时间稳定性（重测之间的Spearman相关系数（r））评估工具的可靠性。计算项目和量表的内容效度指数。在开发的工具与简短健康调查12项量表之间进行相关分析和有序回归分析，以检验其同时效度。使用主成分分析和已知组分析（Kruskal-Wallis检验）检验其结构效度。
开发的问卷可靠性非常高（α = 0.908；r = 0.861；p < 0.01）。其内容效度极佳（所有项目内容效度指数 = 0.79 - 1.00；量表效度指数 = 0.92）。其同时效度的证据包括开发的工具与简短健康调查12项量表之间的强相关性（r = 0.734；p < 0.001），并且参与者在开发工具上的得分解释了简短健康调查12项量表中参与者得分的约46.2%的受试者间变异（Nagelkerke R = 0.462）。主成分分析证实了其结构效度，该分析显示2个因素解释了发现的总方差的81.63%。已知组分析证明了该问卷能够检测出具有不同症状的患者的预期差异。
本研究的主要局限性是使用了一小部分讲西班牙语的患者样本，在问卷最初开发时未纳入患者，以及使用求和方法开发评分系统。
肛瘘患者生活质量问卷已被证明是一个有效、可靠且简洁的工具，可有助于评估肛瘘患者的生活质量。见视频摘要：http://links.lww.com/DCR/A368 。
