偏头痛患者群体样本中头痛疾病严重程度测量方法的可靠性。

Reliability of an illness severity measure for headache in a population sample of migraine sufferers.

作者信息

Stewart W F, Lipton R B, Simon D, Von Korff M, Liberman J

机构信息

Department of Epidemiology, Johns Hopkins School of Hygiene and Public Health, USA.

出版信息

Cephalalgia. 1998 Jan;18(1):44-51. doi: 10.1046/j.1468-2982.1998.1801044.x.

DOI:10.1046/j.1468-2982.1998.1801044.x

PMID:9601624

Abstract

OBJECTIVES

To examine the reliability and related measurement properties of an illness severity measure for headache derived from responses to a 16-item self-administered questionnaire, the Headache Impact Questionnaire (HImQ), and to determine if there is support for combining measures of pain and disability into a single scaled measure of severity.

METHODS

A population-based sample of migraine headache sufferers completed the HImQ twice, an average of 38 days apart. The HImQ included questions about number of headaches in the last 3 months, headache duration, last headache, pain intensity (two questions), need for bedrest (two questions), disability in specific domains of activity (seven questions about interference with ability to work, do household chores, and engage in non-work activity), and symptoms (two questions).

RESULTS

Test-retest correlations of individual questions ranged from 0.65 to 0.93. In principal components analysis, a single factor with significant loading emerged. One measure of pain intensity (average pain score from 0 to 10) and items related to disability (i.e., missed days due to headache, and reduced effectiveness because of headache) in defined activity domains (work for pay, housework, nonwork activities) had the greatest weights on this single factor, supporting prior work on combining measures of pain and disability into a single scale. The HImQ score was derived as the sum of average pain intensity and total lost time in each of the three domains of activity, expressed as lost days. The latter was derived as the sum of actual missed days in each activity domain and reduced effectiveness day equivalents in each activity with a headache. The test-retest correlation was 0.77 for all eligible subjects and 0.85 when one influential outlier was removed. Cronbach's alpha was 0.83.

CONCLUSIONS

The HImQ score, based on eight items, is a highly reliable and internally consistent measure of headache severity.

摘要

目的

通过对一份16项自填式问卷（头痛影响问卷，HImQ）的回答来检验一种头痛疾病严重程度测量方法的可靠性及相关测量属性，并确定是否支持将疼痛和残疾测量合并为一个单一的严重程度量表。

方法

以人群为基础的偏头痛患者样本完成了两次HImQ，平均间隔38天。HImQ包括以下问题：过去3个月的头痛次数、头痛持续时间、上次头痛情况、疼痛强度（两个问题）、卧床休息需求（两个问题）、特定活动领域的残疾情况（关于干扰工作能力、做家务和从事非工作活动能力的七个问题）以及症状（两个问题）。

结果

各个问题的重测相关性在0.65至0.93之间。在主成分分析中，出现了一个具有显著载荷的单一因素。一种疼痛强度测量方法（0至10的平均疼痛评分）以及与残疾相关的项目（即因头痛错过的天数以及因头痛导致效率降低）在特定活动领域（有偿工作、家务、非工作活动）对这个单一因素的权重最大，这支持了之前将疼痛和残疾测量合并为一个单一量表的研究工作。HImQ得分是通过平均疼痛强度与三个活动领域中每个领域的总损失时间之和得出的，总损失时间以损失天数表示。后者是通过每个活动领域实际错过的天数之和以及每个有头痛的活动中效率降低天数的等效值得出的。所有符合条件的受试者的重测相关性为0.77，去除一个有影响力的异常值后为0.85。克朗巴哈系数为0.83。