| Objective To develop a chronic hepatitis-specific quality of life (QOL) instrument for Chinese and evaluate the reliability, validity, responsibility.To explore the factors of QOL by anlasing objective indicators.Methods Combining geneal module with specific module,the scale was developed by the programmed decision and combining with Chinese culture; and interviewing,discussing,analyzing and combining with practice.Reliability,validity and responsiveness were evaluated by measuring 108 cases of chronic hepatitis patients.Chronic the factors of QOL were analyzed by the objective indicators.The statistic methods were as follows, statistic descriptions, Peason correlation, Paired-samples t Test, factor analysis,one-way ANOVA, Multivariate Regression.Results (1) The 23-items specific module for chronic hepatitis and 36-item general module for chronic disease was screened and combined as the 59-items instrument for chronic hepatitis patients.(2) QLICD-CH Reliability:Cronbach's Alpha of each domain exceeded 0.7,the split-half of each domain was also above 0.6, Test-retest reliability of the scale, as assessed with the intraclass correlation coefficient was above 0.90, Excepet form Physical domain,Psychological domain, the other domains'score had no statistical differences.(3) QLICD-CH Validity:Because the item pool were discussed by panels and liver expert and it could reflect the definition of health related QOL proposed by WHO.the item-to-its domain correlations were more highly than that of other domains.The factor structure of the instrument were explored by using principle components with varimax rotation. In the general module of instrument,nine principe components which reflected contents of physical domain,psychological domain and social domain were extracted and the cumulative variance was 67.20%.In the special module, four principe components which reflected contents of symptom facet,drug side effect facet and psychological effect facet were extracted and the cumulative variance was 62.55%.. In the absence of gold standard,SF-36 was chosen as the criterion.The correlation coefficients of each domain and total score between QLICD-CH and SF-36 were fairly high. The results above showed that the instrument had good validity.(4) QLICD-CH Responsiveness:the results indicated that the differeces of physical domain,specific module domain,general module domain and total scores of instrument had statistical significance between the first time and the third time,while the differeces of psychological domain,social domain had no statistical significance. So the scale had good responsiveness.(5) QLICD-CH Feasibility:Most patients could understand the meaning of the instrument well and spent 15～30 minutes on complenting the instrument. The recovery of the scale was 96%, while the integrity of scale was 93%, So the scale had good clinical feasibility.(6) QLICD-CH Influencing factor analysis:Linear correlation analysis showed that the correlation coefficient was less than o.4 between clinical objective indicators and all domians'scores.The multivariate regression analysis showed that age,gender,family economy, total bilirubin entered the different regression equation.These were the main influencing factors of chronic hepatitis patients' QOL,Conclusions The QLICD-CH is valid, reliable, sensitive and can assess quality of life in patients with chronic hepatitis. The scale's score have no the close linear correlation with objiective indicators.
|
PDF Full Text Request