开发一种用于慢性心力衰竭患者的疲劳和呼吸困难的患者报告结局测量工具（OxFAB）。

The development of a patient reported outcome measure for fatigue and breathlessness for patients with chronic heart failure (OxFAB).

机构信息

Oxford University Hospitals NHS Foundation Trust Headley Way, Oxford, OX3 9DU, UK; NIHR Oxford Biomedical Research Centre, Clinical Informatics Research Office Room 4503, Corridor B, Level 4, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK.

出版信息

Heart Lung. 2023 Mar-Apr;58:116-124. doi: 10.1016/j.hrtlng.2022.11.018. Epub 2022 Dec 6.

DOI:10.1016/j.hrtlng.2022.11.018

PMID:36493523

Abstract

BACKGROUND

Fatigue and breathlessness are the two most common and distressing symptoms for patients with chronic heart failure. They affect a patient's quality of life and ability to undertake activities of daily living. Currently there are no symptom specific measures for fatigue and breathlessness available or developed and validated for use with this patient group and no questionnaire that incorporates both symptoms into one measure.

OBJECTIVE

To develop a patient-reported outcome measure for patients with chronic heart failure for their fatigue and breathlessness symptoms.

METHODS

A three-staged, approach was used. In stage One in-depth qualitative patient-interviews on factors of fatigue and breathlessness in chronic heart failure were undertaken to provide question themes. Items from these interviews were generated and pilot questionnaires developed and tested. In Stage Two, exploratory factor analysis with item reduction and final testing of the questionnaire was performed. Stage Three involved validation testing.

RESULTS

In Stage One, issues raised in interviews (n = 25) were used to generate items. Pilot questionnaires were developed and tested. Items were refined in the context of cognitive debrief interviews (n = 7) for possible inclusion in the final measure. Final testing of questionnaire properties with item reduction was carried out in Stage Two (n = 112). Validity and reliability were assessed in Stage Three (n = 96). Psychometric testing showed positive results, in internal consistency (Cronbach's alpha ranging from 0.8 to 0.94) and test-retest (no difference in means), content validity and relevance to patients.

CONCLUSIONS

This questionnaire could be useful in the assessment of fatigue and breathlessness in patients living with chronic heart failure.

摘要

背景

疲劳和呼吸困难是慢性心力衰竭患者最常见和最痛苦的两种症状。它们影响患者的生活质量和日常生活活动能力。目前，针对这一患者群体，尚无专门针对疲劳和呼吸困难的症状特异性措施，也没有开发和验证用于该患者群体的问卷，将这两种症状纳入单一措施的问卷也没有。

目的

为慢性心力衰竭患者开发一种针对其疲劳和呼吸困难症状的患者报告结局测量工具。

方法

采用三阶段方法。在第一阶段，对慢性心力衰竭患者的疲劳和呼吸困难因素进行深入的定性访谈，以提供问题主题。从这些访谈中生成项目，并开发和测试初步问卷。在第二阶段，进行探索性因子分析，对项目进行简化，并对问卷进行最终测试。第三阶段涉及验证性测试。

结果

在第一阶段，访谈中提出的问题（n=25）被用于生成项目。开发并测试了初步问卷。在认知访谈（n=7）的背景下，对可能包含在最终测量中的项目进行了精炼。在第二阶段（n=112），对问卷进行了项目简化后的进一步测试。在第三阶段（n=96）评估了有效性和可靠性。心理测量学测试结果显示，内部一致性良好（Cronbach's alpha 范围为 0.8 至 0.94），重测无差异（均值无差异），内容有效性和与患者的相关性良好。