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上肢骨折儿童患者 QuickDASH 的结构效度和内部一致性。

The construct validity and internal consistency of QuickDASH in pediatric patients with upper extremity fractures.

机构信息

Department of Hand Surgery, Helsinki University Hospital and University of Helsink.

Department of Hand Surgery, Helsinki University Hospital and University of Helsinki.

出版信息

Acta Orthop. 2024 Apr 30;95:192-199. doi: 10.2340/17453674.2024.40181.

Abstract

BACKGROUND AND PURPOSE

Investigation of treatment options in the pediatric population necessitates the use of valid patient-reported outcome measures (PROMs). We aimed to assess the construct validity and internal consistency of the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) in the pediatric population with upper extremity fractures treated both operatively and conservatively.

PATIENTS AND METHODS

QuickDASH, along with several reference PROMs and objective outcome measures, was obtained from 148 5- to 18-year-old patients with a humeral medial epicondyle fracture or a fracture of the distal forearm in a cross-sectional setting with a single follow-up visit. Spearman's rank correlation and linear regression models were used to assess convergent validity, exploratory factor analysis (EFA) to assess structural validity, and Cronbach's alpha to investigate internal consistency.

RESULTS

The direction and magnitude of correlation showed by QuickDASH with reference outcome measures was consistent and demonstrated good convergent validity. EFA indicated a 3-factor model with poor fit indices and structural validity remained questionable. Construct validity was considered acceptable overall. QuickDASH demonstrated good internal consistency with an acceptable Cronbach's alpha (α = 0.75).

CONCLUSION

QuickDASH demonstrated acceptable construct validity and good internal consistency and is thus a valid instrument, with some limitations, to assess disability and quality of life in pediatric patients with upper extremity fractures.

摘要

背景与目的

在儿科人群中调查治疗选择需要使用有效的患者报告结局测量(PROM)。我们旨在评估在接受手术和保守治疗的上肢骨折的儿科人群中,快速上肢功能障碍(QuickDASH)量表的结构效度和内部一致性。

患者和方法

在横断面研究中,对 148 名 5 至 18 岁的肱骨内上髁骨折或前臂远端骨折患者进行了 QuickDASH 以及其他几种参考 PROM 和客观结局测量,单次随访。采用 Spearman 秩相关和线性回归模型评估了聚合效度,采用探索性因子分析(EFA)评估了结构效度,采用 Cronbach's alpha 评估了内部一致性。

结果

QuickDASH 与参考结局测量的相关性的方向和大小一致,表现出良好的聚合效度。EFA 表明存在一个 3 因素模型,但拟合指数较差,结构效度仍存在疑问。总体而言,结构效度被认为是可接受的。QuickDASH 表现出良好的内部一致性,Cronbach's alpha 为 0.75。

结论

QuickDASH 具有可接受的结构效度和良好的内部一致性,因此是一种有效的工具,具有一定的局限性,可用于评估上肢骨折儿科患者的残疾和生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39ca/11058482/4372aae4f154/ActaO-95-40181-g001.jpg

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