长期病症问卷（LTCQ）的 Rasch 分析及短式问卷（LTCQ-8）的开发。
Rasch analysis of the long-term conditions questionnaire (LTCQ) and development of a short-form (LTCQ-8).
机构信息
Personal Social Services Research Unit, School of Social Policy, Sociology, and Social Research, University of Kent, Canterbury, Kent, CT2 7NF, UK.
Health Services Research Unit, The University of Oxford, Richard Doll Building, Old Road Campus, Roosevelt Drive, Headington, Oxford, OX3 7LF, UK.
出版信息
Health Qual Life Outcomes. 2020 Nov 30;18(1):375. doi: 10.1186/s12955-020-01626-3.
BACKGROUND
The aim of the current study was to evaluate the structural validity of the 20-item long-term conditions questionnaire (LTCQ) and to explore a potential short-form version of the scale using Rasch analysis.
METHODS
Data were collected through postal surveys (February 2016-January 2017) from a sample of 1,211 participants diagnosed with at least one long-term condition (LTC). Identified participants were invited through either local authorities for a social care cohort (n = 294) or primary care practices for a health care cohort (n = 917). Participants were mailed a survey, including the LTCQ, demographic questions, a comorbidities measure, and other validated outcome measures. Respondents were invited to complete a follow-up survey including the LTCQ for assessment of reproducibility.
RESULTS
The main assumptions of the Rasch model from the LTCQ were fulfilled, although infit and outfit indices indicated some items showed misfit. Misfitted items, items that did not have a preceding set or showed some local dependence were removed one at a time, with the remaining candidate items to form an 8-item short version, the LTCQ-8. The Rasch model for the LTCQ-8 explained 64% variance and had a reliability estimate greater than 0.80. Several items in the LTCQ showed uniform differential item function (DIF) in relation to the number of reported LTCs, age, cohort and type of LTCs, but fewer items exhibited DIF in the LTCQ-8. Spearman's rho correlations between the LTCQ and the LTCQ-8 were strong across the total sample and various subgroups. Correlations between the LTCQ-8 and all reference measures were moderate to strong, and comparable to correlations found between the LTCQ and these measures.
CONCLUSIONS
The LTCQ measures a unidimensional construct, and it is therefore acceptable to use a summed total score. The LTCQ-8 also met the assumption of unidimensionality and had comparable construct validity with the LTCQ. Additional validation is required in an independent sample.
背景
本研究旨在评估 20 项长期疾病问卷（LTCQ）的结构效度，并通过 Rasch 分析探讨该量表的潜在短式版本。
方法
该研究于 2016 年 2 月至 2017 年 1 月通过邮寄问卷的方式收集了至少患有一种长期疾病（LTC）的 1211 名参与者的数据。通过地方当局邀请参加社会护理队列的参与者（n=294）或通过初级保健实践邀请参加卫生保健队列的参与者（n=917）。参与者收到了一份包括 LTCQ、人口统计学问题、合并症测量和其他经过验证的结果测量在内的调查。调查邀请他们完成一份包括 LTCQ 的随访调查，以评估其可重复性。
结果
LTCQ 的 Rasch 模型的主要假设得到满足，尽管 infit 和 outfit 指数表明有些项目存在拟合不良。一次删除一个不拟合的项目、没有前序设置或显示出局部依赖的项目，剩余的候选项目形成了一个 8 项短式，即 LTCQ-8。LTCQ-8 的 Rasch 模型解释了 64%的方差，可靠性估计值大于 0.80。LTCQ 的几个项目在与报告的 LTC 数量、年龄、队列和 LTC 类型相关时显示出均匀的差异项目功能（DIF），但 LTCQ-8 中显示 DIF 的项目较少。在整个样本和各种亚组中，LTCQ 和 LTCQ-8 之间的 Spearman rho 相关性很强。LTCQ-8 与所有参考测量之间的相关性均为中等至强，与 LTCQ 与这些测量之间的相关性相当。
结论
LTCQ 测量了一个单一维度的结构，因此可以接受使用总和总分。LTCQ-8 也满足单一维度的假设，与 LTCQ 具有可比的结构效度。需要在独立样本中进行进一步验证。
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