Gauffin Jarno, Hankama Tiina, Kautiainen Hannu, Arkela-Kautiainen Marja, Hannonen Pekka, Haanpää Maija
ORTON Rehabilitation Centre, Tenholantie 10, 00280 Helsinki, Finland.
Department of Medicine, Central Finland Central Hospital, Keskussairaalantie 19, 40620 Jyväskylä, Finland.
Scand J Pain. 2012 Jan 1;3(1):15-20. doi: 10.1016/j.sjpain.2011.10.004.
Background and purpose Fibromyalgia (FM) is a chronic pain syndrome, which affects up to 5% of the general population. The aetiology of FM is unclear. The lack of specific diagnostic laboratory tests or imaging options combined with the severe burden on both patients and society caused by the FM syndrome demands the development of valid instruments able to measure the current health status of the FM patients. The Fibromyalgia Impact Questionnaire (FIQ) is the most widely used of these instruments. Our objective was to translate the Fibromyalgia Impact Questionnaire (FIQ) into Finnish and evaluate its validity in Finnish speaking FM patients. Methods FIQ was translated by two bilingual researchers into the Finnish version (Finn-FIQ) and linked to the categories of International Classification of Functioning, Disability and Health (ICF). Finn-FIQ was administered to 162 patients who had prior fibromyalgia diagnoses M79.0 according to ICD-10 year 2006 version. They also filled in the Health Assessment Questionnaire (HAQ), the Rand 36-item Health Survey (RAND-36), the Beck Depression Inventory IA (BDIIA), the Chronic Pain Acceptance Questionnaire (CPAQ), the International Physical Activity Questionnaire Short Form (IPAQ), and they assessed their general well-being on a 0-100 mm visual analogue scale while attending a clinical check-up visit. Internal consistency was estimated according to Cronbach's alpha internal consistency. An exploratory factor analysis was performed to identify related items and to show construct validity. Correlation coefficients were calculated by the Spearman method. Results From the 162 participants 153 were female and 9 male, 119 (73%) had an active job or were students, 21 (13%) were unemployed, 16 (10%) were retired and 6 (4%) were on sick leave. The mean age was 47 years. The internal consistency value (95% CI) was 0.90 for the overall Finn-FIQ. The factor analysis performed for construct analysis showed that Finn-FIQ was loaded on 4 factors. These factors were loaded on components of ICF and explained 69% of total variance. Significant correlations were obtained between patients own assessments of general well-being and Finn-FIQ total score (r = 0.64 [95% CI 0.53-0.73]) and also between Finn-FIQ total score and HAQ total score (r = 0.56 [95% CI 0.44-0.66]). Finn-FIQ questions had significant correlations with RAND-36 domains. Conclusion Finn-FIQ is a valid and feasible instrument to mirror the functioning of FM patients according to its internal consistency, correlation to general well-being, convergent validity and response rate. It covers the main components of the ICF framework hence reflecting the whole spectrum of functioning. Implications In our study Finn-FIQ was proven as a valid instrument with Finnish speaking FM patients. Original FIQ and other validated translations have already confirmed their place in fibromyalgia research. After this study Finnish fibromyalgia research can be included in those using the best-known instrument in validated form and native language. Current study showed also Finn-FIQ's ability to measure functioning of the FM patients, and it had good applicability among Finnish speaking patients. Therefore it can be recommended also for monitoring individual FM patients and their functioning for example during different treatment trials.
背景与目的
纤维肌痛(FM)是一种慢性疼痛综合征,影响着高达5%的普通人群。FM的病因尚不清楚。由于缺乏特异性诊断实验室检查或影像学检查方法,且FM综合征给患者和社会带来沉重负担,因此需要开发能够测量FM患者当前健康状况的有效工具。纤维肌痛影响问卷(FIQ)是这些工具中使用最广泛的。我们的目的是将纤维肌痛影响问卷(FIQ)翻译成芬兰语,并评估其在讲芬兰语的FM患者中的有效性。
方法
FIQ由两位双语研究人员翻译成芬兰语版本(Finn-FIQ),并与国际功能、残疾和健康分类(ICF)的类别相关联。Finn-FIQ应用于162例根据2006年版ICD-10确诊为M79.0型纤维肌痛的患者。他们还填写了健康评估问卷(HAQ)、兰德36项健康调查(RAND-36)、贝克抑郁量表IA(BDIIA)、慢性疼痛接受问卷(CPAQ)、国际体力活动问卷简表(IPAQ),并在临床检查就诊时用0-100mm视觉模拟量表评估他们的总体幸福感。根据克朗巴赫α内部一致性估计内部一致性。进行探索性因素分析以识别相关项目并显示结构效度。相关系数采用斯皮尔曼方法计算。
结果
162名参与者中,153名女性,9名男性,119名(73%)有工作或为学生,21名(13%)失业,16名(10%)退休,6名(4%)病假。平均年龄47岁。Finn-FIQ总体的内部一致性值(95%CI)为0.90。为进行结构分析而进行的因素分析表明,Finn-FIQ加载在4个因素上。这些因素加载在ICF的组成部分上,解释了总方差的69%。患者自身对总体幸福感的评估与Finn-FIQ总分之间存在显著相关性(r = 0.64 [95%CI 0.53 - 0.73]),Finn-FIQ总分与HAQ总分之间也存在显著相关性(r = 0.56 [95%CI 0.44 - 0.66])。Finn-FIQ问题与RAND-36领域存在显著相关性。
结论
根据其内部一致性、与总体幸福感的相关性、收敛效度和应答率,Finn-FIQ是反映FM患者功能的有效且可行的工具。它涵盖了ICF框架的主要组成部分,从而反映了功能的全谱。
意义
在我们的研究中,Finn-FIQ被证明是用于讲芬兰语的FM患者的有效工具。原始FIQ和其他经过验证的翻译版本已在纤维肌痛研究中确立了地位。本研究之后,芬兰的纤维肌痛研究可以纳入使用经过验证的形式和母语的最知名工具的研究之中。当前研究还显示了Finn-FIQ测量FM患者功能的能力,并且它在讲芬兰语的患者中具有良好的适用性。因此,它也可推荐用于监测个体FM患者及其功能,例如在不同的治疗试验期间。