| Object to develop and evaluate two quality of life instruments that could be administered to patients with hypertension and coronary heart disease (CHD). Method based on system research strategy of Quality of Life Instruments for Chronic Disease (QLICD), which emphasize combination of general model with specific ones, the development work was conducted by the programmed decision associated with domestic culture background. Methods of Literature review, individual interviews and focus group discussions were used during the course of instruments development. The psychometric properties of instruments were evaluated. The statistic method used in this research included some statistic descriptions, Pearson correlation, factor analysis, cluster analysis and paired t student test.Result (1) a 32-item general module (GM) for chronic diseases and a 17-item specific one for hypertension as well as a 16-item specific one for CHD were formed. Then a 32 plus 17 items instrument for patients with hypertension, shortened as QLICD-HY(V 1.0) , and a 32 plus 16 items instrument for patients with CHD, shortened as QLICD-CHD (V 1.0) were yielded by combination. There are three domains in GM: 10-item for physical functioning (PH), 12-item for psychological functioning (PS) and 10-item for social functioning (SO). (2) Because the item pools were nominated and several-rounds selected by persons who are strongly related with QOL study , reflecting the definition of health and QOL proposed by WHO and specific problems among patients with hypertension and CHD, the QLICD-HY and QLICD-CHD have a considerable content validities. Most of the Item scores within domains had higher correlation with domain score than others. The factor structure of GM and HY (hypertension specific model) as well as CHD were explored by using principle components analysis, with varimax rotation. 8 principle components were extracted in the GM , which reflect facets of independence, eat and sleep, vitality in PH domain, anxious and depress emotionin PS domain, and social support and ability in SO domain, explaining 62.4% of the variance;6 principle components which reflected content of mental-social problems .symptoms .medicine and treatment side effect were identified in HY and explained 65.44% variance; there are 5 principle components in CHD model, covering facets of symptoms, sense of security, trouble feelings, adaptation and coping .explaining 62.4% of the variance. The result of item-domain correlations and factor analysis build evidences of structure validity. Because of no gold standard, we temporarily selected the second item of SF-36 as criteria, the coefficients between total scores and criterion are moderate. The three aspects above showed good validity of the two instruments. (3) The coefficients of internal consistency and split-half for three domains in GM and two specific models are high, in addition, the results of test-retest reliability indicate that between first two time point .domains and total scores of two instrument(excepted for SO domain of hypertension) .have no statistical significances, the correlation coefficient were also high. So we can say that the reliability of the two instruments are not bad. (4) nearly all domains and total scores differences between first time point and third one had statistical significant (expect for SO domain in both instruments), so the two measurements have the ability to detect clinically change due to treatment and then have good responsiveness. (5)Taking an average of 15 minutes or less to complete each instrument and a complete rate over 90% demonstrated the good feasibility of the two instruments.Conclusion The QLICD-HY and the QLICD-CHD were valid, reliable, and sensitive, they could be used to assess quality of life among patients with hypertension and CHD. |
PDF Full Text Request