| Objective To develop and validate the Quality of Life Instruments for Chronic Diseases-Pulmonary Tuberculosis (QLICD-PT). In addition, the preliminary analysis about quality of life in patients with pulmonary tuberculosis and its influence factors was carried out, with minimal clinically important difference (MCID) being established.Methods The General Module of the system of Quality of Life Instruments for Chronic Diseases (QLICD-GM) has been developed. In accordance with the research idea of combination of the General Module and Specific ones, on the basis of the literature review and cultural characteristics of China, the Quality of Life Instruments for Chronic Diseases-Pulmonary Tuberculosis (QLICD-PT) was developed using the instruments developing program decision-making procedures. The psychometrics of the scale was also carried out including instruments' validity, reliability, and responsibility to change. Regard to preliminary applications of QLICD-PT, the influence factors to pulmonary tuberculosis patients' quality of life was analyzed. The relation between pulmonary tuberculosis patients' family care index and social support scores and quality of life, and comparisons of pulmonary tuberculosis patients' quality of life score changes before treatment, two months after treatment and six months after treatment were studied. Also the minimal clinically important differences (MCID) for each domain of QLICD-PT were estimated. The statistical methods used throughout the course of the study include statistical description, correlation analysis, paired T-test, factor analysis, multiple linear regression analysis etc. Results1. The QLICD-PT for patients with pulmonary tuberculosis was developed with the general module (29entries) combining with the pulmonary tuberculosis specific module (12entries).2.Evaluation about quality of life instrument for patients with pulmonary Tuberculosis QLICD-PT:①reliability: QLICD-PT Chronbach'a coefficients in various domains are greater than0.7; split-half reliabilities of all domains are greater than0.6, total instruments' split-half reliability is0.824. It can be considered that the reliability of QLICD-PT is good.②validity: pulmonary tuberculosis specific domain score is basically consistent with the theoretical structure proposed in advance by clinical experts after factor analysis. And the correlation coefficients of each item and its relevant domain are relatively large; the correlation coefficients of each item and its irrelevant domain are small. Correlation coefficients of QLICD-GM and eight relevant domains of SF-36are0.44～0.57, exception of lower correlation coefficients of emotional role and general module. So it has good validity.③responsibility to change:the scores of each domain before treatment and two month later from the treatment are statistically significant by paired T-tests, it can be said that the responsibility to change of QLICD-PT is relatively good.3. Preliminary application of QLICD-PT:①the factors that affecting pulmonary tuberculosis patients' quality of life are mainly education and career.②Family care index and social support score were positively correlated with pulmonary tuberculosis patients' quality of life scores, the correlation coefficient with QLICD-PT of the Social domain is higher than the correlation coefficients in other domain.③The possible influence factors on quality of life of gender, nationality, marital status, and different treatment time of pulmonary tuberculosis patients were analyzed by repeated measurement ANOVA respectively. The results showed that pulmonary tuberculosis patients' quality of life scores rise gradually as treatment time.④MCID of domain PHD, PSD, SOD, CGD, SPD, and TOT developed with anchor-based method are12.82,16.14,15.61,15.88,13.64and16.79respectively. MCID of domain PHD, PSD, SOD, CGD, SPD, and TOT developed with distribution-based approach are8.50,7.38, 10.40,10.34,10.52and10.73respectively.Conclusion Quality of life instrument for patients with pulmonary Tuberculosis (QLICD-PT) has good reliability, validity and responsibility to change, which can be used for evaluating pulmonary tuberculosis patients' quality of life. The factors affecting pulmonary tuberculosis patients' quality of life are mainly education and career. Pulmonary tuberculosis patients with more family care and social support have higher quality of life; pulmonary tuberculosis patients' quality of life could be improved after the treatment. The result derived from anchor-based approach in this study are for reference only, the MCID results are subject to approach to distribution-based approach, the final results for MCID of PHD, PSD, SOD, CGD, SPD and TOT are respectively8.50,7.38,10.40,10.34,10.52and10.73. |
PDF Full Text Request