Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Oxford, Oxford, UK.
BMJ Open. 2017 Nov 3;7(11):e019235. doi: 10.1136/bmjopen-2017-019235.
The aim of this study was to validate a new generic patient-reported outcome measure, the Long-Term Conditions Questionnaire (LTCQ), among a diverse sample of health and social care users in England.
Cross-sectional validation survey. Data were collected through postal surveys (February 2016-January 2017). The sample included a healthcare cohort of patients recruited through primary care practices, and a social care cohort recruited through local government bodies that provide social care services.
1211 participants (24% confirmed social care recipients) took part in the study. Healthcare participants were recruited on the basis of having one of 11 specified long-term conditions (LTCs), and social care participants were recruited on the basis of receiving social care support for at least one LTC. The sample exhibited high multimorbidity, with 93% reporting two or more LTCs and 43% reporting a mental health condition.
The LTCQ's construct validity was tested with reference to the EQ-5D (5-level version), the Self-Efficacy for Managing Chronic Disease scale, an Activities of Daily Living scale and the Bayliss burden of morbidity scale.
Low levels of missing data for each item indicate acceptability of the LTCQ across the sample. The LTCQ exhibits high internal consistency (Cronbach's α=0.95) across the scale's 20 items and excellent test-retest reliability (intraclass correlation coefficient=0.94, 95% CI 0.93 to 0.95). Associations between the LTCQ and all reference measures were moderate to strong and in the expected directions, indicating convergent construct validity.
This study provides evidence for the reliability and validity of the LTCQ, which has potential for use in both health and social care settings. The LTCQ could meet a need for holistic outcome measurement that goes beyond symptoms and physical function, complementing existing measures to capture fully what it means to live well with LTCs.
本研究旨在验证一种新的通用患者报告结局测量工具——长期疾病问卷（LTCQ）在英格兰不同健康和社会照护使用者样本中的有效性。
横断面验证调查。数据通过邮寄调查（2016 年 2 月至 2017 年 1 月）收集。样本包括通过初级保健诊所招募的医疗保健队列和通过提供社会照护服务的地方政府机构招募的社会照护队列。
1211 名参与者（24%为确认的社会照护受助人）参与了研究。医疗保健参与者是根据以下 11 种特定的长期疾病（LTCs）之一招募的，社会照护参与者是根据至少一种 LTC 接受社会照护支持招募的。该样本表现出高度的多种合并症，93%的人报告有两种或两种以上的 LTCs，43%的人报告有心理健康状况。
LTCQ 的结构有效性通过与 EQ-5D（5 级版本）、慢性疾病管理自我效能感量表、日常生活活动量表和 Bayliss 发病负担量表进行比较来测试。
该研究提供了 LTCQ 的可靠性和有效性证据，该问卷在健康和社会照护环境中都具有应用潜力。LTCQ 在整个量表的 20 个项目中具有较高的内部一致性（Cronbach's α=0.95）和极好的重测信度（组内相关系数=0.94，95%CI 0.93 至 0.95）。LTCQ 与所有参考测量之间的关联为中度至高度，且方向与预期一致，表明具有收敛结构有效性。
