Chung K C, Pillsbury M S, Walters M R, Hayward R A
Department of Surgery, University of Michigan Medical Center, Ann Arbor 48109-0340, USA.
J Hand Surg Am. 1998 Jul;23(4):575-87. doi: 10.1016/S0363-5023(98)80042-7.
In this study, psychometric principles were used to develop an outcomes questionnaire capable of measuring health state domains important to patients with hand disorders. These domains were hypothesized to include (1) overall hand function, (2) activities of daily living (ADL), (3) pain, (4) work performance, (5) aesthetics, and (6) patient satisfaction with hand function. An initial pool of 100 questions was pilot-tested for clarity in 20 patients; following factor analysis, the number of questions was reduced to a 37-item Michigan Hand Outcomes Questionnaire (MHQ). The MHQ, along with the Short Form-12, a generic health status outcomes questionnaire, was then administered to 200 consecutive patients at a university-based hand surgery clinic and was subjected to reliability and validity testing. The mean time required to complete the questionnaire was 10 minutes (range, 7-20 minutes). Factor analysis supported the 6 hypothesized scales. Test-retest reliability using Spearman's correlation demonstrated substantial agreement, ranging from 0.81 for the aesthetics scale to 0.97 for the ADL scale. In testing for internal consistency, Cronbach's alphas ranged from 0.86 for the pain scale to 0.97 for the ADL scale (values >0.7 for Cronbach's alpha are considered a good internal consistency). Correlation between scales gave evidence of construct validity. In comparing similar scales in the MHQ and the Short Form-12, a moderate correlation (range, 0.54-0.79) for the ADL, work performance, and pain scales was found. In evaluating the discriminate validity of the aesthetics scale, a significant difference (p = .0012) was found between the aesthetics scores for patients with carpal tunnel syndrome and patients with rheumatoid arthritis. The MHQ is a reliable and valid instrument for measuring hand outcomes. It can be used in a clinic setting with minimal burden to patients. The questions in the MHQ have undergone rigorous psychometric testing, and the MHQ is a promising instrument for evaluation of outcomes following hand surgery.
在本研究中，运用心理测量学原理开发了一份结果调查问卷，该问卷能够测量对手部疾病患者而言重要的健康状态领域。这些领域被假设包括：（1）手部整体功能，（2）日常生活活动（ADL），（3）疼痛，（4）工作表现，（5）美观程度，以及（6）患者对手部功能的满意度。最初有100个问题的题库在20名患者中进行了清晰度的预测试；经过因子分析后，问题数量减少至一份包含37个条目的密歇根手部结果调查问卷（MHQ）。随后，MHQ与一份通用健康状况结果调查问卷简明健康状况调查简表-12一起，被发放给一家大学附属手部外科诊所的200名连续就诊患者，并进行了信度和效度测试。完成问卷所需的平均时间为10分钟（范围为7 - 20分钟）。因子分析支持了6个假设的量表。使用斯皮尔曼相关性进行的重测信度显示出高度一致性，美观程度量表为0.81，ADL量表为0.97。在内部一致性测试中，克朗巴哈系数范围从疼痛量表的0.86到ADL量表的0.97（克朗巴哈系数>0.7被认为具有良好的内部一致性）。量表之间的相关性证明了结构效度。在比较MHQ和简明健康状况调查简表-12中的相似量表时，发现ADL、工作表现和疼痛量表存在中等程度的相关性（范围为0.54 - 0.79）。在评估美观程度量表的区分效度时，发现腕管综合征患者和类风湿性关节炎患者的美观程度得分存在显著差异（p = 0.0
