Holmes W C, Shea J A
Division of General Internal Medicine and the Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia 19104-6021, USA.
Med Care. 1998 Feb;36(2):138-54. doi: 10.1097/00005650-199802000-00004.
The objectives of this study were to identify quality-of-life concerns, as reported by human immunodeficiency virus (HIV) seropositive individuals, and to develop a measure to assess these concerns.
The HIV/acquired immunodeficiency syndrome (AIDS)-targeted measure was developed in two linked studies. In study one, group discussions with 42 HIV seropositive individuals were used to generate item content for the new measure. In study two, 201 HIV seropositive individuals were cross-sectionally studied to identify dimensions and to reduce the number of items of the quality of life questionnaire resulting from study one.
Study one subjects (76% male; 66% white; 55% gay/bisexual) identified concerns captured by 76 items. Factor analysis indicated that responses of study two subjects (78% male; 42% white; 55% gay/bisexual) could be summarized by nine dimensions. Overall function, sexual function, disclosure worries, health worries, financial worries, HIV mastery, life satisfaction, medication concerns, and provider trust dimensions were refined by removing items using methods to maximize internal consistency and to minimize item redundancy. No substantial ceiling/floor effects existed, except for the provider trust dimension (43% received the highest score possible). All internal consistency coefficients were > or = 0.70, except those for the HIV mastery (0.57) and medication concerns (0.51) dimensions, as well as the sexual function dimension (0.56) in the non-AIDS subsample. Multitrait/multiitem assessment indicated scaling success rates that were high (> or = 91%) for eight of nine dimensions (HIV mastery revealed a lower but modest success rate of 79%). Validity assessments, using self-reported HIV disease severity and sociodemographic variables, indicated expected relationships for all dimensions.
Five dimensions of the new HIV/AIDS-targeted quality of life instrument (overall function, disclosure worries, health worries, financial worries, and life satisfaction) exhibited good psychometric properties, including low ceiling/floor effects, good internal consistency, and evidence for construct validity.
本研究的目的是确定人类免疫缺陷病毒（HIV）血清反应阳性个体所报告的生活质量问题，并开发一种测量方法来评估这些问题。
针对HIV/获得性免疫缺陷综合征（AIDS）的测量方法是在两项相关研究中开发的。在研究一中，与42名HIV血清反应阳性个体进行小组讨论，以生成新测量方法的项目内容。在研究二中，对201名HIV血清反应阳性个体进行横断面研究，以确定维度并减少研究一所得生活质量问卷的项目数量。
研究一的受试者（76%为男性；66%为白人；55%为男同性恋者/双性恋者）确定了76个项目所涵盖的问题。因子分析表明，研究二的受试者（78%为男性；42%为白人；55%为男同性恋者/双性恋者）的回答可归纳为九个维度。通过使用最大化内部一致性和最小化项目冗余的方法去除项目，对总体功能、性功能、披露担忧、健康担忧、财务担忧、HIV掌控、生活满意度、药物治疗担忧和对医疗服务提供者的信任等维度进行了优化。除了对医疗服务提供者的信任维度（43%的人获得了可能的最高分）外，不存在明显的天花板/地板效应。所有内部一致性系数均≥0.70，但HIV掌控维度（0.57）、药物治疗担忧维度（0.51）以及非艾滋病亚样本中的性功能维度（0.56）除外。多特质/多项目评估表明，九个维度中有八个维度的量表成功率较高（≥91%）（HIV掌控维度的成功率较低，但也有适度的79%）。使用自我报告的HIV疾病严重程度和社会人口学变量进行的效度评估表明，所有维度均呈现出预期的关系。
新的针对HIV/AIDS的生活质量工具的五个维度（总体功能、披露担忧、健康担忧、财务担忧和生活满意度）表现出良好的心理测量特性，包括低天花板/地板效应、良好的内部一致性以及结构效度的证据。
