Clinical Epidemiology Unit, Oncological Network, Prevention and Research Institute-ISPRO, Florence, Italy.
Centro Studi e Ricerca Synthesis, Associazione Promozione Sociale Sul Sentiero, Florence, Italy.
Hepatol Commun. 2023 Jan 27;7(2):e0007. doi: 10.1097/HC9.0000000000000007. eCollection 2023 Feb 1.
Patients with chronic liver disease face debilitating complications in their daily living and constantly report several types of unmet needs, but there is a paucity of validated questionnaires to assess these needs. In this study, we present the development of the Needs Evaluation Questionnaire for Liver Diseases (NEQ-LD) for the assessment of unmet needs in patients with chronic liver disease. Two hundred eighty-six outpatients with chronic liver diseases from a single tertiary referral center completed the NEQ-LD and related validity measures. Item response theory analyses were performed and demonstrated the strong psychometric properties of the questionnaire. Differential item functioning analyses showed that the scale functions equally across groups differing for age, sex, and presence of cirrhosis, suggesting the large applicability of the NEQ-LD for the assessment of unmet needs and between-group comparisons. Criterion validity measures provided evidence that unmet needs were positively associated with measures of depression and anxiety and negatively associated with measures of subjective well-being and physical and mental health. Unmet needs were expressed by a high percentage of patients, especially in the areas of information and dialogue with clinicians. One third of the sample reported material needs. Most of the items describing unmet needs were reported more frequently by patients with cirrhosis. Conclusion: We developed a reliable, valid, and largely employable instrument that can promote patient-centered care and facilitate support services in Hepatology.
患有慢性肝病的患者在日常生活中面临着严重的并发症，并经常报告存在多种未满足的需求，但目前缺乏经过验证的问卷来评估这些需求。在这项研究中，我们开发了用于评估慢性肝病患者未满足需求的肝病需求评估问卷（NEQ-LD）。来自一家三级转诊中心的 286 名慢性肝病门诊患者完成了 NEQ-LD 和相关有效性测量。项目反应理论分析表明该问卷具有很强的心理测量学特性。差异项目功能分析表明，该量表在年龄、性别和肝硬化存在方面存在差异的组中具有相同的功能，这表明 NEQ-LD 具有广泛的适用性，可用于评估未满足的需求和组间比较。标准有效性测量提供的证据表明，未满足的需求与抑郁和焦虑的测量呈正相关，与主观幸福感以及身体和心理健康的测量呈负相关。有很高比例的患者表达了未满足的需求，尤其是在与临床医生的信息和对话方面。三分之一的样本报告了物质需求。描述未满足需求的大多数项目更多地被肝硬化患者报告。结论：我们开发了一种可靠、有效的、广泛适用的工具，可促进以患者为中心的护理，并为肝病学中的支持服务提供便利。
