Shaw M, Talley N J, Adlis S, Beebe T, Tomshine P, Healey M
Health Research Center, Park Nicollet Clinic, Institute for Research and Education, HealthSystem, Minneapolis, Minnesota 55416, USA.
Aliment Pharmacol Ther. 1998 Nov;12(11):1067-78. doi: 10.1046/j.1365-2036.1998.00399.x.
The absence of valid and reliable health status measures for functional gastrointestinal illness has limited research and patient care for this common group of disorders. A self-report survey has been developed.
Initial development focused on extensive pre-testing of patients, primary care physicians and gastroenterologists. The disease-specific portion included the Rome criteria for dyspepsia subgroups and the Manning and Rome criteria for irritable bowel syndrome. The Short Form-36 was added. Psychometric analyses included techniques of multitrait scaling, scale internal consistency and criterion validation.
Six hundred and ninety patients presenting to their primary care physician for treatment of heartburn, abdominal pain or discomfort completed the 98 question survey. The disease-specific portion revealed five components including reflux, dysmotility, a two-domain bowel dysfunction complex, and a pain index. Internal consistency measures demonstrated good to excellent reliability. Scaling successes were observed on multitrait scaling. The disease-specific portion was reduced to 34 questions. Criterion validity was demonstrated with the correlation of the disease-specific questions to the SF-36.
The psychometric analyses lend credence to the concept of stomach and bowel symptom subgrouping as proposed by expert consensus. The psychometric properties of the five summated disease-specific scales compare favourably with standardized health status measures.
功能性胃肠病缺乏有效且可靠的健康状况测量方法，限制了对这一常见疾病群体的研究和患者护理。现已开发出一项自我报告调查。
最初的开发重点是对患者、初级保健医生和胃肠病学家进行广泛的预测试。特定疾病部分包括消化不良亚组的罗马标准以及肠易激综合征的曼宁和罗马标准。增加了简短健康调查问卷（Short Form-36）。心理测量分析包括多特质量表技术、量表内部一致性和标准效度验证。
690名因烧心、腹痛或不适前往初级保健医生处就诊的患者完成了这项包含98个问题的调查。特定疾病部分显示出五个组成部分，包括反流、动力障碍、双域肠道功能障碍复合体和疼痛指数。内部一致性测量显示出良好到极佳的可靠性。在多特质量表上观察到量表构建成功。特定疾病部分减少到34个问题。通过特定疾病问题与简短健康调查问卷（SF-36）的相关性证明了标准效度。
心理测量分析支持了专家共识提出的胃肠症状亚组分类概念。五个合计的特定疾病量表的心理测量特性与标准化健康状况测量方法相比具有优势。
