UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy.
Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.
Front Public Health. 2024 Aug 16;12:1415334. doi: 10.3389/fpubh.2024.1415334. eCollection 2024.
The prevalence of anxiety and depression in patients diagnosed with Alopecia Areata (AA) is very high and this significant burden of psychological symptoms threatens the Health-Related Quality of Life (HRQoL) of affected patients. Indeed, AA often does not produce significant physical symptoms, but it nonetheless disrupts many areas of mental health. Clinical assessment of disease severity may not reliably predict patient's HRQoL, nor may it predict the patient's perception of illness. For this reason, considerable effort has been made to apply and develop measures that consider patient's perception and assess the HRQoL of individuals affected by AA. The aim of this multicentric study was to provide the Italian version of the Skindex-16AA and to evaluate its psychometric properties in a clinical sample of consecutive patients with moderate-to-severe AA.
This is a longitudinal, multicenter, observational study. Patients returned for follow-up visits at 4-, 12-, and 24-weeks. The analyses of the current work aimed to confirm the factorial structure of the Skindex-16AA. In the case of non-fit, an alternative structure for the model was proposed, using an Exploratory Graph Analysis and the Bayesian approach.
The sample was composed of 106 patients with AA. Alopecia Universalis was the most frequently diagnosed type of alopecia at all time points. The analyses on the Skindex-16AA revealed that a two-factor structure with eight items fit the data best (Bayesian Posterior Predictive Checking using 95% Confidence Interval for the Difference Between the Observed and the Replicated Chi-Square values = -6.246/56.395, Posterior Predictive -value = 0.06), and reported satisfactory psychometric properties (i.e., internal consistency and convergent validity).
The Skindex-8AA demonstrated optimal psychometric properties (i.e., convergent and construct validity, and test-retest reliability) measured in a sample of patients with AA, that may suggest that it is an appropriate tool to measure the HRQoL in AA patients. However, further studies are needed in order to confirm and tested other psychometric features of this tool.
患有斑秃（AA）的患者普遍存在较高的焦虑和抑郁发生率，这些严重的心理症状负担威胁着受影响患者的健康相关生活质量（HRQoL）。实际上，AA 通常不会产生明显的身体症状，但它仍然会扰乱心理健康的许多方面。疾病严重程度的临床评估可能无法可靠地预测患者的 HRQoL，也无法预测患者对疾病的感知。出于这个原因，人们已经付出了相当大的努力来应用和开发考虑患者感知并评估 AA 个体 HRQoL 的措施。本多中心研究的目的是提供 Skindex-16AA 的意大利语版本，并在中度至重度 AA 连续患者的临床样本中评估其心理测量特性。
这是一项纵向、多中心、观察性研究。患者在 4、12 和 24 周时返回进行随访。当前工作的分析旨在确认 Skindex-16AA 的因子结构。在不适合的情况下，使用探索性图形分析和贝叶斯方法提出了模型的替代结构。
该样本由 106 名 AA 患者组成。在所有时间点，全身性脱发是最常诊断的脱发类型。对 Skindex-16AA 的分析表明，具有八项条目的两因素结构最适合数据（使用 95%置信区间的贝叶斯后验预测检查观察到的和复制的卡方值之间的差异 = -6.246/56.395，后验预测值 = 0.06），并报告了令人满意的心理测量特性（即，内部一致性和收敛效度）。
在 AA 患者样本中，Skindex-8AA 表现出最佳的心理测量特性（即收敛和构念效度以及测试-重测信度），这表明它是衡量 AA 患者 HRQoL 的合适工具。然而，需要进一步的研究来确认和测试该工具的其他心理测量特征。
