Department of Health Technology Assessment, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Population Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, Tehran, Iran.
Int Wound J. 2023 Mar;20(3):822-830. doi: 10.1111/iwj.13929. Epub 2022 Aug 17.
Foot ulcer in diabetic patients could often result in significantly impaired quality of life. This study aimed to translate and validate the DFS-SF in Iran. The DFS-SF was translated into Persian, and then its validity and reliability were tested in 262 patients with DFUs. Content validity was evaluated using content validity ratio (CVR) and content validity index (CVI), and criterion validity was assessed through Spearman's correlation between dimensions of the DFS-SF and the EQ-5D-5L. Construct validity was measured using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and convergent-discriminant validity was examined by calculating the average variance extracted (AVE) and composite reliability (CR). Cronbach's alpha and intraclass correlation coefficient (ICC) were calculated to evaluate the reliability of the measure. CVR ≥0.66 and CVI = 0.81 were calculated. Spearman's correlation ranged from 0.23 to 0.78 across all dimensions. The results of EFA showed that all six dimensions of the DFS-SF had an eigenvalue more than 1; accounting for 68.88% of the total variance. CFA confirmed the DFS-SF as a six-dimension structure with good fit indices of χ2/df = 2.15 < 5, RMSEA = 0.06 < 0.08, CFI = 0.91 ≥ 0.90, TLI = 0.90 ≥ 0.90, and RMR = 0.04, as well as with adequate fit indices of GFI = 0.84 ≤ 0.90, NFI = 0.86 ≤ 0.90. Estimates of ≥0.50 for AVE were not observed in two of the six dimensions and CR ≥0.70 was obtained for all dimensions. The reliability was calculated with a Cronbach's alpha of 0.89 and ICC >0.69 for all dimensions. Our findings confirmed the validity and reliability of the Persian DFS-SF; therefore, it can be used to assess QoL in patients with DFSs in clinical and research settings in Iran.
糖尿病患者的足部溃疡往往会导致生活质量显著下降。本研究旨在将 DFS-SF 翻译成波斯语,并在 262 例糖尿病足溃疡患者中测试其有效性和可靠性。内容效度采用内容效度比(CVR)和内容效度指数(CVI)进行评估,各维度的 DFS-SF 与 EQ-5D-5L 之间的相关性采用 Spearman 相关分析进行标准效度评估。结构效度采用探索性因子分析(EFA)和验证性因子分析(CFA)进行测量,收敛判别效度通过计算平均方差提取(AVE)和综合可靠性(CR)进行检验。采用 Cronbach's alpha 和组内相关系数(ICC)评估测量的可靠性。CVR≥0.66,CVI=0.81。Spearman 相关系数在所有维度的范围为 0.23-0.78。EFA 的结果表明,DFS-SF 的所有六个维度的特征值均大于 1;占总方差的 68.88%。CFA 证实 DFS-SF 为六维结构,具有良好的拟合指数,χ2/df=2.15<5,RMSEA=0.06<0.08,CFI=0.91≥0.90,TLI=0.90≥0.90,RMR=0.04,以及适当的拟合指数,GFI=0.84≤0.90,NFI=0.86≤0.90。六个维度中有两个维度的 AVE 估计值大于 0.50,所有维度的 CR 均大于 0.70。所有维度的 Cronbach's alpha 为 0.89,ICC>0.69。我们的研究结果证实了波斯语 DFS-SF 的有效性和可靠性;因此,它可以在伊朗的临床和研究环境中用于评估 DFS 患者的生活质量。