| Background:Chronic constipation (CC) is characterized by long-term symptoms of difficult infrequent or seemingly incomplete bowel movements. The preva1ence of CC varies from 1.9 to 27.2 percent in European country, with the accelerated pace of modern life, eating habits, and social-psychological factors and the incidence of CC increases year by year. Studies suggested that CC correlated with cardiovascular and cerebrovascular diseases,dementia and colorectal cancer, which will have effects on health-related quality of life (HRQoL) , then the studies on CC have attracted more and more attention.Many research suggested that physiological and psychological dysfunction often coexist in patients with constipation, so subjective instrument of psychosocial factors like HRQoL in chronic illness is becoming an increasingly important endpoint to researchers and clinicians. HRQoL is a concept which re?ects the physical, social and emotional attitudes and behaviours of individuals as they relate to their prior and current health state. Patient Assessment of Constipation quality of life questionnaire (PAC-QOL ) is brief and comprehensive developed as a disease-specific instrument to measure HRQoL of CC patients . It achieved good psychometric properties and reproducible in several countries. However, there has not been any verification of the Chinese version and it has not been widely used in China.The aim of this study was to assess further the psychometric properties of the Chinese version of the PAC-QOL, and to investigate the status of the quality of life influencing factors among patients with constipation which can establish the effective psychological and behavioral interventions to improve the quality of life.Objectives:1. To assess further the psychometric properties of the Chinese version of the PAC-QOL.2. To investigate the level and influencing factors of quality of life on CC patients evaluated by the Chinese version of the PAC-QOL.Materials and Methods:1. 188 CC patients were tested by the Chinese version of the PAC-QOL and the Chinese version of the MOS 36-item short form healthy survey (SF-36) and 30 of them repeated two weeks later, 42 of them received biofeedback treatment, to evaluate the feasibility, reliability, validity, and responsiveness of the Chinese version of PAC-QOL.2. 163 CC patients were tested by the Chinese version of the PAC-QOL, a structured questionnaire for general data of patients such as demographic and clinical evaluation, Zung'self-rating anxiety scales (SAS) and self-rating depressive scales (SDS) for psychological condition, social support rating scales to investigate the social support level, then alaysis influencing factors of quality of life on CC patients.Results:1. The recovery rate of the Chinese version of PAC-QOL was 100%,with a response rate as 95.7%,it was understandable for patients and the completion of the PAC-QOL took 10.7 minutes on average.2. The Chinese version of PAC-QOL scales had acceptable internal consistency and test-retest reliability, with a Cronbach's alpha of 0.75-0.93 and ICC of 0.68-0.89, except for the physical discomfort subscale (Cronbach's alpha=0.68, ICC=0.68).3. Content validity index (CVI) was 0.84; there was acceptable concurrent validity with correlations between the Chinese version of PAC-QOL and the Chinese Mandarin version of the Short Form-36 health survey (CM:SF-36)(r=0.561),confirmation factor analysis revealed a four factor solution accounting for 57.3% of the total variance; it can discriminate the quality of life between severity and non-severity CC patients.4. The scores of the four subscales and the total evaluation were all decreased after biofeedback treatment (P<0.01).5. The quality of life in CC patients was significantly lower than those in controls(P<0.01), the influencing factors on quality of life of CC patients were bowel symptoms, anxiety status and depression status, levels of social support.Conclusions:The Chinese version of PAC-QOL is a valid and reliable disease-specific instrument in evaluating the quality of life in CC patients, the quality of life should he emphasized in the design and implementation of intervention program and the nursing intervention can be implemented according to the related factors.
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