Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China.
Department of Cardiology, Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases, Beijing, China.
BMC Geriatr. 2024 Sep 7;24(1):743. doi: 10.1186/s12877-024-05304-7.
This study aimed to develop a Quality of Life (QOL) assessment scale for older patients with Neuro-co-Cardiological Diseases (NCCD) and to evaluate the reliability and validity of the scale.
The study participants were derived from the Elderly Individuals with NCCD Registered Cohort Study (EINCCDRCS), a multicenter registry of patients with NCCD. The preliminary testing of the questionnaire was conducted among 10 older individuals aged 65 years and older who had NCCD and were recruited from the registry. Other patients who met the inclusion criteria participated in the field testing. After verifying the unidimensionality, local independence, and monotonicity assumptions of the scale, we employed the Rasch model within Item Response Theory framework to assess the quality of the scale through methods including internal consistency, criterion validity, Wright map, and item functioning differential. Subsequently, we assessed the construct validity of the scale by combining exploratory factor analysis with confirmatory factor analysis.
Based on well-validated scales such as the short-form WHOQOL-OLD, HeartQOL, IQCODE, and SF-36, an original Neuro-co-Cardiological Diseases Quality of Life scale (NCCDQOL) was developed. 196 individuals from the EINCCDRCS were included in the study, with 10 participating in the preliminary testing and 186 in the field testing. Based on the results of the preliminary testing, the original questionnaire was refined through item deletion and adjustment, resulting in an 11-item NCCDQOL questionnaire. The Rasch analysis of the field testing data led to the removal of 21 misfitting individuals. The NCCDQOL demonstrated a four-category structure, achieved by combining two response categories. This structure aligned with the assumptions of unidimensionality, local independence, and monotonicity. The NCCDQOL also exhibited good validity and reliability.
The revised NCCDQOL questionnaire demonstrated good reliability and validity in the Rasch model, indicating promising potential for clinical application.
本研究旨在为患有神经心脑疾病（NCCD）的老年患者开发生活质量（QOL）评估量表，并评估该量表的信度和效度。
研究参与者来自多中心神经心脑疾病登记研究（EINCCDRCS）中的老年 NCCD 患者注册队列研究，该研究共纳入 10 名年龄在 65 岁及以上、患有 NCCD 的患者。对符合纳入标准的其他患者进行现场测试。在验证了量表的单维性、局部独立性和单调性假设后，我们使用项目反应理论框架内的 Rasch 模型通过内部一致性、效标效度、Wright 图谱和项目功能差异等方法评估量表质量。随后，我们通过探索性因子分析和验证性因子分析相结合来评估量表的结构效度。
在经过验证的量表（如 WHOQOL-OLD 短表、心脏生活质量量表、智力衰退量表和 SF-36）的基础上，我们开发了一个原始的神经心脑疾病生活质量量表（NCCDQOL）。该量表纳入了 EINCCDRCS 中的 196 名患者，其中 10 名患者参与了初步测试，186 名患者参与了现场测试。基于初步测试结果，通过删除和调整项目对原始问卷进行了修订，得到一个包含 11 个项目的 NCCDQOL 问卷。现场测试数据的 Rasch 分析导致 21 名拟合不良的个体被剔除。NCCDQOL 表现出四分类结构，通过将两个反应类别结合起来实现。该结构符合单维性、局部独立性和单调性的假设。NCCDQOL 还具有良好的有效性和可靠性。
修订后的 NCCDQOL 问卷在 Rasch 模型中表现出良好的信度和效度，表明其在临床应用方面具有广阔的前景。
