De Vrieze Tessa, Vos Lore, Gebruers Nick, De Groef An, Dams Lore, Van der Gucht Elien, Nevelsteen Ines, Devoogdt Nele
1 Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Research Group for Rehabilitation in Internal Disorders, Leuven, Belgium.
2 Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, MOVANT, Antwerp, Belgium.
Lymphat Res Biol. 2019 Jun;17(3):347-355. doi: 10.1089/lrb.2018.0025. Epub 2019 Feb 12.
Lymphedema is associated with significant physical and psychosocial problems. The Lymphedema Functioning, Disability and Health questionnaire for upper limb lymphedema is a valid and reliable tool quantifying the amount of problems in functioning in patients with breast cancer-related lymphedema. Patients suggested a revision of the scoring system to facilitate completion of the questionnaire. Therefore, adjustment of the questionnaire was carried out by implementing a numeric rating scale instead of the existing visual analog scale. Purpose of this study was to investigate reliability and validity of the revised Lymph-ICF, called the Lymph-ICF-UL. Reliability and validity of the Lymph-ICF-UL were examined in 56 participants with upper limb lymphedema. Intraclass correlation coefficients for test-retest reliability ranged from 0.79 to 0.95. Cronbach's alpha coefficients for internal consistency were higher than 0.80. Face and content validity were very good because the scoring system was clear for all participants (100%), questions were understandable for all participants (100%), and all complaints due to arm lymphedema were mentioned by 98% of the participants. Construct validity was good. Convergent validity was established since four out of five expected domains of the Lymph-ICF-UL showed a moderate correlation with expected domains of the 36-Item Short-Form Health Survey questionnaire. There was good divergent validity because seven out of nine hypotheses assessing divergent validity were accepted. The Lymph-ICF-UL is a reliable and valid questionnaire using a simplified and clearer scoring procedure to assess impairments in function, activity limitations, and participation restrictions of patients with breast cancer-related arm lymphedema.
淋巴水肿与严重的身体和心理社会问题相关。上肢淋巴水肿的淋巴水肿功能、残疾和健康问卷是一种有效且可靠的工具，可量化乳腺癌相关淋巴水肿患者的功能问题数量。患者建议修订评分系统以方便问卷的填写。因此，通过采用数字评分量表而非现有的视觉模拟量表对问卷进行了调整。本研究的目的是调查修订后的淋巴国际功能、残疾和健康分类量表（Lymph-ICF），即Lymph-ICF-UL的信度和效度。在56名上肢淋巴水肿患者中对Lymph-ICF-UL的信度和效度进行了检验。重测信度的组内相关系数范围为0.79至0.95。内部一致性的克朗巴哈α系数高于0.80。表面效度和内容效度非常好，因为评分系统对所有参与者都很清晰（100%），问题对所有参与者都易懂（100%），并且98%的参与者提到了手臂淋巴水肿引起的所有不适。结构效度良好。由于Lymph-ICF-UL的五个预期领域中有四个与36项简短健康调查问卷的预期领域显示出中度相关性，因此建立了收敛效度。由于评估区分效度的九个假设中有七个被接受，所以有良好的区分效度。Lymph-ICF-UL是一种可靠且有效的问卷，它采用了简化且更清晰的评分程序来评估乳腺癌相关手臂淋巴水肿患者的功能损害、活动受限和参与限制。
