Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America.
Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America.
Gynecol Oncol. 2019 Mar;152(3):492-500. doi: 10.1016/j.ygyno.2018.11.004.
Using patient-reported outcomes (PROs) in perioperative care is increasingly common. We report the development, validation, and application of an MD Anderson Symptom Inventory version for use in patients undergoing surgery for gynecologic cancer or benign conditions (MDASI-PeriOp-GYN).
Our process included: (1) generating PeriOp-GYN-specific candidate items from qualitative interviews with patients, followed by input from an expert panel; (2) dropping items that lacked independent clinical relevance; (3) validating psychometric properties (reliability, validity) of the resulting MDASI-PeriOp-GYN; and (4) conducting cognitive debriefing interviews with patients to confirm ease of comprehension, relevance, and acceptability.
Qualitative interviews with 40 patients generated 9 new PeriOp-GYN symptom items (bloating, abdominal cramping, constipation, hot flashes, dizziness, grogginess/confusion, urinary pain, difficulty urinating, and diarrhea) that, along with the core MDASI items, formed the new MDASI-PeriOp-GYN. A total of 150 patients (minimally invasive surgery (MIS) = 69, open surgery = 81) participated in the validation study; 121 patients also provided retest data. Cronbach alphas were 0.89 for symptoms and 0.86 for interference. Test-retest reliability was 0.88 for all symptom severity items. Known-group validity was supported by the detection of significant differences in symptom and interference levels by performance status (P < 0.01) and for all symptoms by surgery type (P < 0.01). Cognitive debriefing with 20 of the 150 patients demonstrated that the MDASI-PeriOp-GYN is an easy-to-use and understandable tool.
The MDASI-PeriOp-GYN is a valid, reliable, concise tool for measuring symptom severity and functional interference in patients undergoing gynecologic surgery and can be useful in assessing postoperative symptom burden via PROs.
在围手术期护理中使用患者报告的结局（PROs）越来越普遍。我们报告了 MD Anderson 症状量表用于妇科癌症或良性疾病患者（MDASI-PerOp-GYN）的开发、验证和应用。
我们的过程包括：（1）从患者的定性访谈中生成特定于 PerOp-GYN 的候选项目，然后由专家小组提供意见；（2）删除缺乏独立临床相关性的项目；（3）验证 MDASI-PerOp-GYN 的心理测量学特性（信度、效度）；（4）对患者进行认知性访谈，以确认理解、相关性和可接受性。
对 40 名患者进行的定性访谈产生了 9 个新的 PerOp-GYN 症状项目（腹胀、腹部痉挛、便秘、热潮红、头晕、昏昏欲睡/困惑、尿痛、排尿困难和腹泻），这些项目与核心 MDASI 项目一起构成了新的 MDASI-PerOp-GYN。共有 150 名患者（微创手术（MIS）= 69 名，开放手术= 81 名）参加了验证研究；121 名患者还提供了复测数据。症状和干扰的 Cronbach 阿尔法系数分别为 0.89 和 0.86。所有症状严重程度项目的重测信度为 0.88。基于表现状态（P<0.01）和手术类型（P<0.01），检测到症状和干扰水平的显著差异，支持已知组的有效性。对 150 名患者中的 20 名进行认知性访谈表明，MDASI-PerOp-GYN 是一种易于使用和理解的工具。
MDASI-PerOp-GYN 是一种有效、可靠、简洁的工具，可用于测量妇科手术患者的症状严重程度和功能干扰，可通过 PROs 评估术后症状负担。
