Liu Yu-Wen, Guo Shu-Jia, Li Jia-Ni, Zhang Yu-Ting, Ouyang Wei-Jie, Wang Yu-Qian, Huang Cai-Hong, Liao Yi, Hu Jiaoyue, Liu Zuguo
Xiamen University Affiliated Xiamen Eye Center; Fujian Provincial Key Laboratory of Ophthalmology and Visual Science; Fujian Engineering and Research Center of Eye Regenerative Medicine; Eye Institute of Xiamen University; School of Medicine, Xiamen University, Xiamen 361005, Fujian Province, China.
Department of Ophthalmology, Xiang'an Hospital of Xiamen University, Xiamen 361005, Fujian Province, China.
Int J Ophthalmol. 2024 Sep 18;17(9):1614-1620. doi: 10.18240/ijo.2024.09.06. eCollection 2024.
To psychometrically validate the Chinese version of the dry eye-related quality-of-life score questionnaire (DEQS-CHN) among Chinese patients with dry eye.
This study involved 231 participants, including 191 with dry eye disease (DED) comprising the dry eye disease group, and 40 healthy participants forming the control group. Participants were required to complete the DEQS-CHN, and Chinese dry eye questionnaire and undergo clinical tests including the fluorescein breakup time (FBUT), corneal fluorescein staining (CFS), and Schirmer I test. To assess the internal consistency and retest reliability, Cronbach's and the intraclass correlation coefficient (ICC) were employed. Content validity was assessed by item-level content validity index (ICV) and an average scale-level content validity index (S-CVI/Ave). Construct validity was assessed by confirmatory factor analysis. The concurrent validity was assessed by calculating correlations between DEQS-CHN and Chinese dry eye questionnaire. Discriminative validity was evaluated through non-parametric tests, with receiver operating characteristic (ROC) curve serving as conclusive indicators of the questionnaire's distinguishing capability.
The Cronbach's coefficients for frequency and degree of ocular symptoms, impact on daily life, and summary score were 0.736, 0.704, 0.811, 0.818, 0.861, and 0.860, respectively, and the ICC were 0.611, 0.677, 0.715, 0.769, 0.711, and 0.779, respectively. All I-CVI scores ranged from 0.833 to 1.000, with an S-CVI/Ave of 0.956. Confirmatory factor analysis results exhibited a well-fitting model consistent with the original questionnaire [ /=2.653, incremental fit index (IFI)=0.924, comparative fit index (CFI)=0.924, Tucker-Lewis index (TLI)=0.909, and root mean square error of approximation (RMSEA)=0.065]. There was a moderate positive correlation between the DEQS-CHN and the Chinese dry eye questionnaire ( =0.588). The dry eye group demonstrated significantly higher scores compared to the control group, and the area under the curve (AUC) value was 0.8092.
The DEQS-CHN has been demonstrated as a valid and reliable instrument for assessing the impact of dry eye disease on the quality of life among Chinese individuals with DED.
对干眼相关生活质量评分问卷中文版（DEQS-CHN）在中国干眼患者中进行心理测量学验证。
本研究纳入231名参与者，其中包括191名干眼疾病（DED）患者组成干眼疾病组，以及40名健康参与者组成对照组。参与者需完成DEQS-CHN、中国干眼问卷，并接受包括荧光素泪膜破裂时间（FBUT）、角膜荧光素染色（CFS）和Schirmer I试验在内的临床检查。为评估内部一致性和重测信度，采用Cronbach's 系数和组内相关系数（ICC）。通过项目水平内容效度指数（ICV）和平均量表水平内容效度指数（S-CVI/Ave）评估内容效度。通过验证性因子分析评估结构效度。通过计算DEQS-CHN与中国干眼问卷之间的相关性评估同时效度。通过非参数检验评估区分效度，以受试者工作特征（ROC）曲线作为问卷区分能力的决定性指标。
眼部症状频率和程度、对日常生活的影响以及总分的Cronbach's 系数分别为0.736、0.704、0.811、0.818、0.861和0.860，ICC分别为0.611、0.677、0.715、0.769、0.711和0.779。所有I-CVI分数范围为0.833至1.000，S-CVI/Ave为0.956。验证性因子分析结果显示模型拟合良好，与原始问卷一致[ /=2.653，增值拟合指数（IFI）=0.924，比较拟合指数（CFI）=0.924，塔克-刘易斯指数（TLI）=0.909，近似均方根误差（RMSEA）=0.065]。DEQS-CHN与中国干眼问卷之间存在中度正相关（ =0.588）。干眼组的得分显著高于对照组，曲线下面积（AUC）值为0.8092。
DEQS-CHN已被证明是评估干眼疾病对中国DED患者生活质量影响的有效且可靠的工具。
