Kelly Laura, Fitzpatrick Ray, Kurinczuk Jennifer J, Rivero-Arias Oliver, Alderdice Fiona
Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Harris Manchester College, University of Oxford, Oxford, UK.
Patient Relat Outcome Meas. 2022 Oct 19;13:221-228. doi: 10.2147/PROM.S376070. eCollection 2022.
The aim of this study was to validate a generic patient-reported outcome measure, the Long-Term Conditions Questionnaire (LTCQ), among pregnant and postpartum women living with a pre-existing long-term condition (LTC).
Cognitive interviews were conducted with women who were currently pregnant or had given birth within the past year and living with a pre-existing LTC (n=11) and with healthcare professionals working in maternal care (n=11) to explore the acceptability of LTCQ items. An online survey was subsequently administered among women who were pregnant or had given birth within the past year and living with a pre-existing LTC (n=718). Tests of validity were performed including assessing correlations between the LTCQ and reference measures, the Well-being in Pregnancy (WiP) Questionnaire and the EuroQol EQ-5D-5L. Internal consistency was assessed using the Cronbach's alpha statistic.
All LTCQ items were considered relevant and appropriate for use with women who were pregnant or had given birth within the past year. The most commonly reported LTC among the online survey sample (n=718) was a mental health condition (n=350, 48.7%) followed by joint, bone and connective tissues (n= 212, 29.5%) and gastrointestinal (n=143, 19.9%) condition. Data indicated LTCQ scores behaved in a predictable pattern, demonstrating poorer scores for women reporting a greater number of LTCs; mean (SD) scores, one LTC= 61.86 (17.8), two LTCs= 55.29 (16.0), three LTCs= 49.84 (15.52) and four LTCs= 44.94 (12.2). Poorer scores were also reported for women living with at least one mental health condition compared to those reporting no mental health condition, mean score = 66.18 (SD 16.7) v 48.64 (SD 13.3), p<0.001 respectively. As anticipated, LTCQ scores demonstrated significant correlations in the expected direction with both the EQ-5D-5L and WiP scores. For all LTCQ items, the Cronbach's alpha statistic was 0.93.
Data presented here indicate that the LTCQ, which assesses living well with one or more LTC, is suitable for use among pregnant and postpartum women, from both the woman's perspective and from the perspectives of maternity healthcare professionals. Use of the LTCQ would facilitate the identification of unmet needs within this high-risk cohort and support the exploration of how LTCs may affect women throughout the pregnancy and post-natal period. Understanding unmet needs within this cohort of women provides an opportunity to link up specialist care within maternity services and enhance personalised care.
本研究的目的是在患有既往长期疾病（LTC）的孕妇和产后妇女中验证一种通用的患者报告结局指标——长期疾病问卷（LTCQ）。
对目前怀孕或在过去一年内分娩且患有既往LTC的女性（n = 11）以及从事孕产妇护理工作的医疗保健专业人员（n = 11）进行认知访谈，以探讨LTCQ项目的可接受性。随后，对目前怀孕或在过去一年内分娩且患有既往LTC的女性（n = 718）进行了在线调查。进行了效度测试，包括评估LTCQ与参考指标（妊娠幸福感（WiP）问卷和欧洲五维度健康量表EQ - 5D - 5L）之间的相关性。使用克朗巴哈系数统计量评估内部一致性。
所有LTCQ项目都被认为与目前怀孕或在过去一年内分娩的女性相关且适用。在线调查样本（n = 718）中最常报告患有LTC的是心理健康状况（n = 350，48.7%），其次是关节、骨骼和结缔组织疾病（n = 212，29.5%）以及胃肠道疾病（n = 143，19.9%）。数据表明，LTCQ得分呈现出可预测的模式，报告LTC数量较多的女性得分较低；平均（标准差）得分，一种LTC = 61.86（17.8），两种LTC = 55.29（16.0），三种LTC = 49.84（15.52），四种LTC = 44.94（12.2）。与未报告任何心理健康状况的女性相比，至少患有一种心理健康状况的女性得分也较低，平均得分分别为66.18（标准差16.7）和48.64（标准差13.3），p < 0.001。正如预期的那样，LTCQ得分与EQ - 5D - 5L和WiP得分在预期方向上呈现出显著相关性。对于所有LTCQ项目，克朗巴哈系数统计量为0.93。
此处呈现的数据表明，评估患有一种或多种LTC时生活状况的LTCQ，从女性自身以及孕产妇保健专业人员的角度来看，都适用于孕妇和产后妇女。使用LTCQ将有助于识别这一高危人群中未满足的需求，并支持探索LTC在整个孕期和产后对女性的影响。了解这一女性群体中未满足的需求为在孕产妇服务中联系专科护理并加强个性化护理提供了机会。
