Romaine Jacquelyn, Peach George, Thompson Matt, Hinchliffe Robert J, Bradley Clare
Health Psychology Research Unit, Orchard Building, Royal Holloway, University of London, Egham, Surrey, TW20 0EX, UK.
St George's Vascular Institute, St George's Healthcare NHS Trust, London, UK.
J Patient Rep Outcomes. 2019 May 16;3(1):29. doi: 10.1186/s41687-019-0119-0.
To evaluate the psychometric properties of three new condition-specific questionnaires designed to assess outcomes amongst patients under pre-operative surveillance for a small abdominal aortic aneurysm (AAA) or who have undergone aneurysm repair. These tools are the Aneurysm-Dependent Quality of Life measure (AneurysmDQoL), the Aneurysm Symptom Rating Questionnaire (AneurysmSRQ) and the Aneurysm Treatment Satisfaction Questionnaire (AneurysmTSQ).
The questionnaires were sent to 297 patients with abdominal aortic aneurysm (AAA) or who had undergone AAA repair (using open or endovascular technique) sampled from five UK NHS Trusts. Exploratory Factor Analysis was used to examine factor structure together with reliability analysis. A subset of 65 patients completed the questionnaires a second time four months later. One hundred and ninety-seven patients (178 men; 18 women) provided data for analysis (69% response rate): mean age was 75 years (range 60-95). Nineteen were under pre-operative surveillance for AAA and 178 had undergone AAA repair (70 open repair; 104 endovascular repair; 4 uncertain). Exploratory Factor Analysis of the AneurysmDQoL and the AneurysmTSQ each demonstrated a one-factor structure. The AneurysmSRQ demonstrated a six-factor structure (emotional, weight loss, lower limb, cognitive, general malaise and gastrointestinal symptoms) and a one-factor composite symptom scale. All scales have clean factor structures: item loadings above 0.40, no cross-loadings, and no factors with fewer than three items. Internal consistency reliability was excellent (α = 0.869-0.959) and test-retest reliability good (Intraclass correlation coefficient = 0.70-0.88).
The three new questionnaires have a clear structure and strong reliability and are now ready for use in clinical trials and routine practice, which will allow evaluation of responsiveness to change.
评估三种新的特定病情调查问卷的心理测量特性，这些问卷旨在评估接受小腹主动脉瘤（AAA）术前监测或已接受动脉瘤修复的患者的预后。这些工具分别是动脉瘤相关生活质量量表（AneurysmDQoL）、动脉瘤症状评分问卷（AneurysmSRQ）和动脉瘤治疗满意度问卷（AneurysmTSQ）。
问卷被发送给从英国五个国民健康服务信托基金抽取的297例腹主动脉瘤（AAA）患者或已接受AAA修复（采用开放或血管内技术）的患者。探索性因子分析用于检验因子结构并进行可靠性分析。65例患者的一个子集在四个月后再次填写了问卷。197例患者（178例男性；18例女性）提供了分析数据（回复率69%）：平均年龄为75岁（范围60 - 95岁）。19例患者正在接受AAA术前监测，178例患者已接受AAA修复（70例开放修复；104例血管内修复；4例情况不明）。AneurysmDQoL和AneurysmTSQ的探索性因子分析均显示单因子结构。AneurysmSRQ显示六因子结构（情绪、体重减轻、下肢、认知、全身不适和胃肠道症状）和单因子综合症状量表。所有量表均具有清晰的因子结构：项目载荷高于0.40，无交叉载荷，且因子项目数不少于三个。内部一致性信度极佳（α = 0.869 - 0.959），重测信度良好（组内相关系数 = 0.70 - 0.88）。
这三种新问卷结构清晰、可靠性强，现已准备好在临床试验和常规实践中使用，这将有助于评估对变化的反应性。
