San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court, San Diego, CA, 92120, USA.
VA San Diego Healthcare System, San Diego, CA, USA.
Qual Life Res. 2023 Aug;32(8):2195-2208. doi: 10.1007/s11136-023-03380-7. Epub 2023 Mar 16.
Celiac disease and its treatment negatively impact quality of life, indicating potential need for measurement of disease-specific quality of life domains to inform interdisciplinary intervention. The Celiac Disease Quality of Life Survey (CD-QOL) has been used in clinical research; however, its factor structure has not been confirmed and psychometric properties have not been evaluated in English-speaking adults in the U.S.
(1) Confirm the factor structure of the 20-item English CD-QOL; (2) assess psychometric properties including internal consistency reliability, convergent validity, known groups validity, and incremental validity.
453 adults with self-reported Celiac disease (M = 40.57; 88% female; 92% White) completed the CD-QOL and validated measures of generic health-related quality of life (SF-36), gluten-free diet adherence (CDAT), anxiety and depression symptoms (PROMIS), and physical symptoms (CSI) as part of the iCureCeliac patient-powered research network.
Confirmatory factor analysis found superior fit for a bifactor structure with one general factor and four group factors. Ancillary bifactor analyses suggest the CD-QOL can be considered primarily unidimensional. Total and three subscale scores demonstrated acceptable internal consistency reliability. Convergent and known groups validity were supported. The CD-QOL demonstrated some incremental validity over the SF-36.
The English CD-QOL can be used as a measure of disease-specific quality of life among adults with Celiac disease in the U.S. Compared to generic instruments, the CD-QOL appears to better capture specific cognitive and affective aspects of living with Celiac disease. Use of a total score is recommended. Its utility as a screening and outcome measurement tool in clinical settings should be examined.
乳糜泻及其治疗会对生活质量产生负面影响，这表明需要测量特定于疾病的生活质量领域，以提供信息来进行跨学科干预。乳糜泻生活质量调查（CD-QOL）已用于临床研究；然而，其因子结构尚未在美国英语使用者中得到证实，其心理测量学特性也尚未得到评估。
（1）确认 20 项英语 CD-QOL 的因子结构；（2）评估心理测量学特性，包括内部一致性信度、收敛有效性、已知群体有效性和增量有效性。
453 名自我报告患有乳糜泻的成年人（M=40.57；88%为女性；92%为白人）完成了 CD-QOL 和经过验证的通用健康相关生活质量量表（SF-36）、无麸质饮食依从性量表（CDAT）、焦虑和抑郁症状量表（PROMIS）以及身体症状量表（CSI）的测量，这些测量是 iCureCeliac 患者驱动的研究网络的一部分。
验证性因子分析发现，具有一个总因子和四个分组因子的双因素结构具有更好的拟合度。辅助双因素分析表明，CD-QOL 可以被认为主要是单维的。总分和三个子量表的得分表现出可接受的内部一致性信度。收敛性和已知群体有效性得到了支持。与 SF-36 相比，CD-QOL 显示出一些增量有效性。
英语 CD-QOL 可用于衡量美国乳糜泻成年人的疾病特异性生活质量。与通用工具相比，CD-QOL 似乎更能捕捉到患有乳糜泻的特定认知和情感方面。建议使用总分。应在临床环境中检查其作为筛查和结果测量工具的效用。
