| Objective:The purpose of this study is divided into four parts,(1) to compile and translate 《Constitution in Chinese Medicine Questionnaire》into English, so it can be used on non-Asians;(2)to compile the health recommendation of constitution in Chinese medicine in English, so let foreign can know their constitution in Chinese medicine and how to keep in good health;(3) to evaluate the quality of the English version of 《Constitution in Chinese Medicine Questionnaire》;(4) to survey the Chinese Medicine body constitution of American and Canadian Caucasians and their health issues, in order to understand the distribution and influential factors;(5) to compare the difference between the survey results of American and Canadian Caucasians and general Chinese population, in order to understand the impacts from ethnics, geographic locations, life and diet routines on Chinese Medicine body constitution. It is a cross-cultural research.Methods:This study is based on and supported by国家重点基础研究发展计'(973Project)“中医原创思维与健康状态辨识方法体系研究”(2011-2015, subject number:2011CB505400). Research methods:(1) Translate 《Constitution in Chinese Medicine Questionnaire》 into English using the standardized procedures of "Cross-Cultural Foreign Language Scale." The translated 《Constitution in Chinese Medicine Questionnaire》 was used on60American and Canadian Caucasians as preliminary survey sample between February and April2011.(2) Based on the food culture, daily life customs and excerise habbits of foreigners, settle down the English version health recommendation of constitution in Chinese medicine. After approving by the experts, making an opion survey of the English version health recommendation of constitution in Chinese medicine on178American and Canadian Caucasians between April2011to June2011.(3) From April to October2011, cross-sectional survey was then conducted on404American and Canadian Caucasians who are15and above in hospitals, clinics, and schools in the PRC. The surveys were done in person using the English translated version to verify the effectiveness of the translation. The translation was further refined based on the preliminary survey result.(4) From October2011to January2012, cross-sectional survey was then conducted on542American and Canadian Caucasians who are15and above in hospitals, clinics, and schools in the PRC. Questionnaires used during the survey included the English version of ((Constitution in Chinese Medicine Questionnaire)), MOS SF-36, and basic health and body type questionnaire. Consents were received from all respondents before the survey. The statistic analyzes the distribution of the nine body constitutions (Balanced Constitution, Qi-deficient Constitution, Yang-deficient Constitution, Yin-deficient Constitution, Phlegm-dampness Constitution, Damp-heat Constitution, Stagnant Blood Constitution, Stagnant Qi Constitution, Inherited Special Constitution) of American and Canadian Caucasians. Logistic regression analysis was used to analyze the ethnic influence on body constitution.(5) Compare the result of previous study of general Chinese population to the result of studies conducted on American and Canadian Caucasians and analyzes the difference.Results:(1) Out of the60preliminary respondents,88.33%expressed that they understand fully of the English questionnaire. Based on the preliminary survey,44out of the60translated questions in the questionnaire were confirmed while the other16questions were further revised, amended and reverse translated. We, therefore, have the initial formation of the preliminary compiling of English version of ((Constitution in Chinese Medicine Questionnaire)).(2)The intelligibility of the respondents in the English version health recommendation of constitution in Chinese medicine is92.97%and85.39%consider it be ture of their daily life habbits,cultures and customs. The experts valued it on average scores7.6±0.55.(3) The acceptance rate of the English version of ((Constitution in Chinese Medicine Questionnaire)) is100%, while the completion rate is99%and the retest reliability is0.875(P0.001). The Spearman correlation coefficient of the9sub-scale (Balanced Constitution, Qi-deficient Constitution, Yang-deficient Constitution, Yin-deficient Constitution, Phlegm-dampness Constitution, Damp-heat Constitution, Stagnant Blood Constitution, Stagnant Qi Constitution, Inherited Special Constitution) is0.75-0.89; total scale split-half reliability of0.917; internal reliability is consistent, the overall Cronbach’s a coefficient is0.864while each sub-scale’s Cronbach’s a coefficient is between0.81-0.50which shows a good internal consistency. Pearson correlation coefficient is0.54(P<0.01) and has a positive correlation of0.54with balanced constitution and a negative correlation of0.46-0.28with unbalanced constitutions. Bartlett test of sphericity statistics X2=10510.61, P<0.001, therefore suitable for factor analysis. KMO=0.772, extract21common factors, the overall contribution rate is71.56%, while the sub-scale contribution rate ranges between70.18%-79.57%, indicating an excellent effectiveness and validity of the questionnaire.(4) Among the American and Canadian Caucasian respondents, balanced constitution accounted for43.5%, while the rest of the8unbalanced constitutions accounted for the rest of56.5%. The top3unbalanced constitutions are Yang-deficient Constitution, Inherited Special Constitution and Qi-deficient Constitution, each accounted for14.5%,9.3%, and8.2%. Body constitution varies by different gender, age, marital status, occupation, and education level. The ratio of the difference was significant (P<0.001). The statistical analysis of the distribution of the body constitution shows the correlation between each factor is different.(5) There is more balanced constitution founded among the American and Canadian Caucasian respondents than in the general Chinese population. There is also more Yang-deficient Constitution and Inherited Special Constitution founded among the American and Canadian Caucasian respondents than in the general Chinese population, while there are less other unbalanced constitutions founded among them.Conclusion:(1) The translation of ((Constitution in Chinese Medicine Questionnaire)) would require the participation of professionals with different culture background as it would need to be customized for different ethnic groups. This research translated the ((Constitution in Chinese Medicine Questionnaire)) into English which provided a tool to conduct large scale research among Caucasians.(2) The English version health recommendation of constitution in Chinese medicine can make foreigner understanding their own body constitution and know how to keep in good health in their daily life.(3) The retest reliability, split-half reliability rate and internal consistency reliability of the English version of the ((Constitution in Chinese Medicine Questionnaire)) are all excellent. Surface validity meets the requirements by expert assessment, content validity is good and standards correlation and structure correlation are all good. Segment is also effective.(4) There are different demographic features of the American and Canadian Caucasian respondents. Overall, the top two unbalanced constitutions are Yang-deficient Constitution and Inherited Special Constitution. Based on the study, we can conclude the factors that cause Yang-deficient Constitution would be disease, female, occasional exerciser, slim body and obesity, high sugar consumption and light dietary, divorced, age30-49years old, well educated, and family history of disease. The Yang-deficient Constitution population has a higher risk of physiological field damage, which damages the physiological function and overall health, therefore reduces the quality of life. We can also conclude the factors that cause Inherited Special Constitution would be female, suffering from the disease, occasional exerciser, slim body and obesity, divorced and other marital status, age30-49years old, lower educational level, blood type O, history of allergy, family history of disease, and alcohol consumption. The Inherited Special Constitution population has lower life quality in the physical domain, physiological function, general health, vitality, mental health and other health-related life quality.(5) The demographic constitution is very different from general Chinese population. This research can provide customized health guidance to different ethnic groups therefore improve their quality of life. |
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