Department of Anesthesiology and Intensive Care, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.
Klinik Bavaria, Kreischa, Germany.
Qual Life Res. 2023 Aug;32(8):2415-2423. doi: 10.1007/s11136-023-03403-3. Epub 2023 Mar 30.
Return to a normal state of living is a key patient-relevant outcome for sepsis survivors. The Reintegration to Normal Living Index (RNLI) assesses self-perceived participation in patients with chronic disease, but its psychometric properties have been analyzed neither for patients after sepsis nor in a German patient cohort. This study aims to analyze the psychometric properties of the German version of the RNLI in sepsis survivors.
In a prospective multicenter survey study, 287 sepsis survivors were interviewed 6 and 12 months after hospital discharge. Multiple-group categorical confirmatory factor analyses with three competing models were used to explore the factor structure of the RNLI. Concurrent validity was evaluated in relation to the EQ-5D-3L and the Barthel Index of Activities of Daily Living (ADL).
Regarding structural validity, all models showed an acceptable model fit. Because of high correlation between the latent variables in the two-factor models (up to r = 0.969) and for reason of parsimony, we opted for the common factor model to analyze the concurrent validity. Our analyses showed moderate positive correlations between RNLI score and ADL score (r ≥ 0.630), EQ-5D-3L visual analogue scale (r ≥ 0.656) and EQ-5D-3L utility score (r ≥ 0.548). The reliability assessed by McDonald's Omega was 0.94.
We found convincing evidence for good reliability, structural and concurrent validity of the RNLI in German sepsis survivors. We propose to use the RNLI in addition to generic health-related quality of life measures to assess the reintegration to normal living after sepsis.
恢复正常生活是脓毒症幸存者的一个关键患者相关结局。重返正常生活指数（RNLI）评估慢性疾病患者的自我感知参与度，但尚未对脓毒症后患者或德国患者队列进行其心理测量学特性分析。本研究旨在分析脓毒症幸存者中 RNLI 的德国版本的心理测量学特性。
在一项前瞻性多中心调查研究中，287 例脓毒症幸存者在出院后 6 个月和 12 个月接受了访谈。采用三种竞争模型的多组分类验证性因子分析来探讨 RNLI 的结构。同时评估与 EQ-5D-3L 和日常生活活动（ADL）的巴氏量表相关的效标效度。
在结构有效性方面，所有模型均显示出可接受的模型拟合度。由于两因素模型中潜在变量之间的相关性较高（高达 r=0.969），并且为了简约起见，我们选择共同因素模型来分析同时效度。我们的分析表明，RNLI 评分与 ADL 评分之间存在中度正相关（r≥0.630）、EQ-5D-3L 视觉模拟量表（r≥0.656）和 EQ-5D-3L 效用评分（r≥0.548）。麦当劳 omega 评估的可靠性为 0.94。
我们发现，德国脓毒症幸存者的 RNLI 具有令人信服的良好可靠性、结构和同时效度的证据。我们建议在使用通用健康相关生活质量措施评估脓毒症后重返正常生活时，同时使用 RNLI。
