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使用新的儿科 PROMIS 疼痛和身体体验测量工具评估镰状细胞病患儿的状况。

Use of the new pediatric PROMIS measures of pain and physical experiences for children with sickle cell disease.

机构信息

Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.

Children's Hospital of Wisconsin, Milwaukee, Wisconsin.

出版信息

Pediatr Blood Cancer. 2019 May;66(5):e27633. doi: 10.1002/pbc.27633. Epub 2019 Jan 28.

Abstract

BACKGROUND

There are new pediatric domains to measure patients' pain and physical experiences in the Patient-Reported Outcomes Measurement Information System (PROMIS). The objective of this study was to establish the psychometric properties of these domains for children with sickle cell disease (SCD).

PROCEDURE

We conducted a cross-sectional analysis of PROMIS assessments of children with SCD recruited from a pediatric tertiary care clinic. Validity of the new PROMIS domains was determined by comparing scores between known groups and describing their correlations with previously validated PROMIS measures. Cronbach's alpha and item response theory (IRT) reliability were used to assess internal consistency reliability. Agreement between parent-proxy and child self-report was determined for all domains.

RESULTS

Our study included 164 subjects, of whom 117 were eligible to self-report. The mean T-scores for physical stress experience, strength impact, pain behavior, and pain quality sensory scores were significantly different between children who used pain medications in the prior week and those who did not. There were also differences in T-scores across children reporting mild, moderate, and severe pain on the pain intensity scale. All measures had Cronbach's alpha and IRT reliability > 0.80. The percentage of agreement between child and parent-proxy PROMIS domains ranged from 36% to 60% depending on the domain.

CONCLUSIONS

The new PROMIS domains of physical stress experience, strength impact, pain behavior, and pain quality sensory domains are valid and reliable for children with SCD. The low-moderate agreement between parent-proxy and child self-report scores support the complementary information provided by the two perspectives.

摘要

背景

在患者报告结局测量信息系统(PROMIS)中有新的儿科领域用于测量患者的疼痛和身体体验。本研究的目的是为镰状细胞病(SCD)患儿建立这些领域的心理测量学特性。

过程

我们对从儿科三级保健诊所招募的 SCD 患儿进行了 PROMIS 评估的横断面分析。通过比较已知组之间的分数并描述它们与先前验证的 PROMIS 测量的相关性来确定新的 PROMIS 领域的有效性。Cronbach's alpha 和项目反应理论(IRT)可靠性用于评估内部一致性可靠性。所有领域均评估了父母代理和儿童自我报告之间的一致性。

结果

我们的研究包括 164 名受试者,其中 117 名有资格进行自我报告。在过去一周使用止痛药的儿童和未使用止痛药的儿童之间,身体应激体验、力量影响、疼痛行为和疼痛质量感觉得分的 T 分数存在显著差异。在报告疼痛强度量表上有轻度、中度和重度疼痛的儿童之间,T 分数也存在差异。所有测量方法的 Cronbach's alpha 和 IRT 可靠性均>0.80。儿童和父母代理 PROMIS 领域之间的一致性百分比因领域而异,范围从 36%到 60%。

结论

身体应激体验、力量影响、疼痛行为和疼痛质量感觉领域的新 PROMIS 领域对 SCD 患儿是有效且可靠的。父母代理和儿童自我报告评分之间的低中度一致性支持两个角度提供的补充信息。

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