McNamara Catherine T, Parry Gareth, Netson Rebecca, Nuzzi Laura C, Labow Brian I
From the Adolescent Breast Clinic, Boston Children's Hospital and Harvard Medical School, Boston, Mass.
Department of Plastic and Oral Surgery, Boston Children's Hospital and Harvard Medical School, Boston, Mass.
Plast Reconstr Surg Glob Open. 2023 Jun 15;11(6):e5075. doi: 10.1097/GOX.0000000000005075. eCollection 2023 Jun.
Health-related quality of life improvements after reduction mammaplasty have been reported by patients. Although instruments exist for adults, a validated outcomes survey is not available for adolescents. This study aims to validate the Short-Form 36 (SF-36) for adolescents undergoing reduction mammaplasty.
Patients aged 12-21 years were prospectively recruited between 2008 and 2021 to unaffected or macromastia cohorts. Patients completed four baseline surveys: SF-36, Rosenberg Self-esteem Scale, Breast-related Symptoms Questionnaire, and Eating Attitudes Test. Surveys were repeated at 6 and 12 months postoperatively (macromastia cohort), and at 6 and 12 months from baseline (unaffected cohort). Content, construct, and longitudinal validity were assessed.
A total of 258 patients with macromastia (median age: 17.5 years), and 128 unaffected patients (median age: 17.0 years) were included. Content validity was established, and construct validity was fulfilled: internal consistency was confirmed for all domains (Cronbach alpha >0.7); convergent validity was satisfied through expected correlations between the SF-36 and Rosenberg Self-esteem Scale, Breast-related Symptoms Questionnaire, and Eating Attitudes Test, and known-groups validity was established through significantly lower mean scores in all SF-36 domains in the macromastia cohort compared with unaffected patients. Longitudinal validity was established by significant improvements in domain scores from baseline to 6 and 12 months postoperatively in patients with macromastia ( < 0.05, all).
The SF-36 is a valid instrument for adolescents undergoing reduction mammaplasty. Although other instruments have been used for older patients, we recommend the SF-36 when assessing health-related quality of life changes in younger populations.
患者报告了缩乳术后与健康相关的生活质量改善情况。虽然有针对成年人的工具,但尚无经过验证的青少年结局调查问卷。本研究旨在验证缩乳术青少年版简明健康状况调查问卷(SF-36)的有效性。
2008年至2021年间,前瞻性招募了12至21岁的患者,分为未受影响组或巨乳症组。患者完成了四项基线调查:SF-36、罗森伯格自尊量表、乳房相关症状问卷和饮食态度测试。术后6个月和12个月(巨乳症组)以及基线后6个月和12个月(未受影响组)重复进行调查。评估内容效度、结构效度和纵向效度。
共纳入258例巨乳症患者(中位年龄:17.5岁)和128例未受影响患者(中位年龄:17.0岁)。建立了内容效度,并满足了结构效度:所有领域的内部一致性得到确认(克朗巴哈α系数>0.7);通过SF-36与罗森伯格自尊量表、乳房相关症状问卷和饮食态度测试之间的预期相关性满足了收敛效度,并且通过巨乳症组与未受影响患者相比所有SF-36领域的平均得分显著更低建立了已知组效度。巨乳症患者术后从基线到6个月和12个月领域得分显著改善,从而建立了纵向效度(所有P<0.05)。
SF-36是评估缩乳术青少年患者的有效工具。虽然其他工具已用于年龄较大的患者,但我们建议在评估年轻人群与健康相关的生活质量变化时使用SF-36。