SymTrak 的可靠性和有效性，一种用于监测患有多种慢性疾病的老年人症状的多领域工具。
Reliability and Validity of SymTrak, a Multi-Domain Tool for Monitoring Symptoms of Older Adults with Multiple Chronic Conditions.
机构信息
School of Medicine, Indiana University, Indianapolis, IN, USA.
School of Public Health, Indiana University, Indianapolis, IN, USA.
出版信息
J Gen Intern Med. 2019 Jun;34(6):908-914. doi: 10.1007/s11606-018-4780-4. Epub 2019 Apr 18.
BACKGROUND
A reliable and valid clinically practical multi-domain self-report and caregiver-report tool is needed for tracking actionable symptoms in primary care for elderly patients with multiple chronic conditions (MCCs).
OBJECTIVE
Assess internal consistency reliability, test-retest reliability, construct validity, and sensitivity to change for SymTrak.
DESIGN AND PARTICIPANTS
Among 600 (200 patient-caregiver dyads, 200 patients without an identified caregiver) participants, SymTrak was telephone interviewer-administered at baseline and 3-month follow-up, and at 24 h post-baseline for assessing test-retest reliability in a random subsample of 180 (60 dyads, 60 individual patients) participants.
MAIN MEASURES
Demographic questions, SymTrak, Health Utility Index Mark 3 (HUI3).
KEY RESULTS
Exploratory factor analysis indicated a single dominant dimension for SymTrak items for both patients and caregivers. Coefficient alpha and 24-h test-retest reliability, respectively, were high for the 23-item SymTrak total score for both patient-reported (0.85; 0.87) and caregiver-reported (0.86; 0.91) scores. Construct validity was supported by monotone decreasing relationships between the mean of SymTrak total scores across the poor-to-excellent categories of physical and emotional general health, and by high correlations with HUI3 overall utility score, even after adjusting for demographic covariates (standardized linear regression coefficient = - 0.84 for patients; - 0.70 for caregivers). Three-month change in the SymTrak total score was sensitive to detecting criterion standard 3-month reliable change categories (Improved, Stable, Declined) in HUI3-based health-related quality of life, especially for caregiver-reported scores.
CONCLUSIONS
SymTrak demonstrates good internal consistency and test-retest reliability, construct validity, and sensitivity to change over a 3-month period, supporting its use for monitoring symptoms for older adults with MCCs.
背景
在初级保健中，需要一种可靠且有效的、针对多种慢性疾病（MCC）患者的、具有临床实用性的多领域自我报告和照顾者报告工具，以跟踪可操作的症状。
目的
评估 SymTrak 的内部一致性信度、重测信度、结构效度和变化敏感性。
设计和参与者
在 600 名（200 对患者-照顾者，200 名无指定照顾者的患者）参与者中，SymTrak 在基线和 3 个月随访时通过电话访谈者进行管理，并在 180 名（60 对患者-照顾者，60 名个体患者）随机亚组的 24 小时内进行基线后评估，以评估重测信度。
主要措施
人口统计学问题、SymTrak、健康效用指数标记 3 版（HUI3）。
主要结果
探索性因子分析表明，对于患者和照顾者的 SymTrak 项目，均存在单一主导维度。对于患者报告（0.85；0.87）和照顾者报告（0.86；0.91）的 23 项 SymTrak 总分，系数α和 24 小时重测信度均较高。SymTrak 总分在身体和情绪一般健康的从差到优的类别中呈单调递减关系，与 HUI3 整体效用评分高度相关，这支持了结构效度，即使在调整了人口统计学协变量后（患者的标准化线性回归系数为-0.84；照顾者为-0.70）。SymTrak 总分在 3 个月内的变化对基于 HUI3 的健康相关生活质量的 3 个月可靠变化类别（改善、稳定、下降）具有敏感性，尤其是对于照顾者报告的分数。
结论
SymTrak 在 3 个月内表现出良好的内部一致性和重测信度、结构效度和变化敏感性，支持其用于监测患有多种慢性疾病的老年人的症状。
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