Schwartz Monica Maria, Ljosaa Tone Marte, Pukstad Brita Solveig, Utvær Britt Karin
Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.
Surgical Department, Namsos Hospital, Nord-Trøndelag Health Trust, Namsos, Norway.
Int Wound J. 2025 Jun;22(6):e70697. doi: 10.1111/iwj.70697.
The objective of this study was to test the validity, reliability and dimensionality of the Norwegian version of the Cardiff Wound Impact Schedule (CWIS), a measure for wound-specific health-related quality of life. The Norwegian CWIS and a 36-item short form health survey (SF-36) were completed by 204 patients with hard-to-heal wounds on the lower extremity. The questionnaires were filled in at three time points over 8-14 weeks (T0, T1, T2). The Patients Global Impression of Change (PGIC) was completed at T1 and T2. Demographic and clinical data were collected at T0 and T2. The three-factor model of the CWIS showed an acceptable fit to the observed data, and the dimensionality was clear as long as two correlated error terms were accepted and four items were removed (χ = 426.64, p = 0.000, df = 204, χ/df = 2.09, RMSEA = 0.074, SRMR = 0.066, CFI = 0.900, TLI = 0.880). Correlation analyses showed significant associations between the CWIS and SF-36 (0.350**-0.766**), PGIC (-0.277**), wound size (-0.156**), general wound pain intensity (-0.371**) and pain intensity at wound change (-0.240**); all aligned with the expected directions. The intraclass correlations indicated good to excellent test-retest reliability (0.724**-0.951**). The internal consistency ranged from acceptable to excellent (α = 0.78-0.89, ρc = 0.79-0.89). While the questionnaires' ability to detect wound-related change was low, it was adequate for differentiating between healed and non-healed ulcers. The Norwegian version of the CWIS demonstrated good reliability and construct validity, making it suitable for evaluating HRQoL in patients with hard-to-heal wounds. However, some modifications were made to achieve an acceptable model fit.
本研究的目的是检验挪威版卡迪夫伤口影响量表（CWIS）的有效性、可靠性和维度，该量表用于评估特定伤口的健康相关生活质量。204例下肢难愈合伤口患者完成了挪威版CWIS和一份36项简短健康调查问卷（SF - 36）。问卷在8 - 14周内的三个时间点（T0、T1、T2）填写。患者整体变化印象（PGIC）在T1和T2完成。在T0和T2收集人口统计学和临床数据。CWIS的三因素模型对观察数据显示出可接受的拟合度，只要接受两个相关误差项并删除四个项目，维度就清晰（χ = 426.64，p = 0.000，df = 204，χ/df = 2.09，RMSEA = 0.074，SRMR = 0.066，CFI = 0.900，TLI = 0.880）。相关性分析显示，CWIS与SF - 36（0.350** - 0.766**）、PGIC（ - 0.277**）、伤口大小（ - 0.156**）、一般伤口疼痛强度（ - 0.371**）和伤口换药时的疼痛强度（ - 0.240**）之间存在显著关联；均与预期方向一致。组内相关性表明重测信度良好至优秀（0.724** - 0.951**）。内部一致性从可接受至优秀（α = 0.78 - 0.89，ρc = 0.79 - 0.89）。虽然问卷检测伤口相关变化的能力较低，但足以区分愈合和未愈合的溃疡。挪威版CWIS显示出良好的可靠性和结构效度，使其适用于评估难愈合伤口患者的健康相关生活质量。然而，为了获得可接受的模型拟合度进行了一些修改。
