Centre for Health Sciences Research, University of Salford, Frederick Road Campus, Brian Blatchford Building PO.50, Salford, M6 6PU, UK.
Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.
BMC Musculoskelet Disord. 2020 Jul 30;21(1):505. doi: 10.1186/s12891-020-03409-9.
The Valued Life Activities Scale (VLAs) measures difficulty in daily activities and social participation. With various versions involving a different number of items, we have linguistically and culturally adopted the full VLAs (33-items) and psychometrically tested it in adults with rheumatic and musculoskeletal diseases in the United Kingdom.
Participants with Rheumatoid Arthritis, Ankylosing Spondylitis, Chronic Pain/ Fibromyalgia, Chronic Hand/ Upper Limb Conditions, Osteoarthritis, Systemic Lupus, Systemic Sclerosis and Primary Sjogren's Syndrome were recruited from out-patient clinics in National Health Service Hospitals, General Practice and patient organisations in the UK. Phase1 involved linguistic and cultural adaptation: forward translation to British English; synthesis; expert panel review and cognitive debriefing interviews. In Phase2 participants completed postal questionnaires to assess internal construct validity using (i) Confirmatory Factor Analysis (CFA) (ii) Mokken scaling and (iii) Rasch model.
Responders (n = 1544) had mean age of 59 years (SD13.3) and 77.2% women. A CFA failed to support a total score from the 33-items (Chi Square 3552:df 464: p < 0.0001). Mokken scaling indicated a strong non-parametric association between items. Fit to the Rasch model indicated that the VLAs was characterised by multidimensionality and item misfit, which may have been influenced by clusters of residual item correlations. An item banking approach resolved a 25-item calibrated set whose application could accommodate the 'does not apply to me' response option.
The UK version of the VLAs failed to satisfy classical and modern psychometric standards for complete item sets. However, as the scale is not usually applied in complete format, an item bank approach calibrated 25 items with fit to the Rasch model. Suitable Computer Adaptive Testing (CAT) software could implement the item set, giving patients the choice of whether an item applies to them, or not.
价值生活活动量表（VLAs）测量日常活动和社会参与的难度。该量表有多种版本，包含不同数量的项目，我们采用了完整的 VLAs（33 项），并在英国的风湿和肌肉骨骼疾病患者中进行了语言学和文化适应性测试。
在英国，从国家卫生服务医院、普通诊所和患者组织招募类风湿关节炎、强直性脊柱炎、慢性疼痛/纤维肌痛、慢性手部/上肢疾病、骨关节炎、系统性红斑狼疮、系统性硬化症和原发性干燥综合征患者。第一阶段涉及语言和文化适应：正向翻译成英国英语；综合；专家小组审查和认知审查访谈。在第二阶段，参与者通过（i）验证性因子分析（CFA）、（ii）Mokken 分级和（iii）Rasch 模型完成邮寄问卷，以评估内部结构有效性。
应答者（n=1544）的平均年龄为 59 岁（SD13.3），77.2%为女性。CFA 不支持 33 项总分（卡方值 3552：df 464：p<0.0001）。Mokken 分级表明项目之间存在很强的非参数关联。Rasch 模型拟合表明，VLAs 具有多维性和项目不拟合特征，这可能受到残余项目相关性聚类的影响。项目银行方法解决了 25 项校准项目集的问题，该方法可以适应“不适用我”的应答选项。
英国版 VLAs 未能满足完整项目集的经典和现代心理测量标准。然而，由于该量表通常不是以完整形式应用，因此采用项目银行方法校准 25 项符合 Rasch 模型的项目。合适的计算机自适应测试（CAT）软件可以实现项目集，让患者选择是否有项目适用于他们。
