Evaluation And Application Of A Chinese Version Of The Intermittent Exotropia Questionnaire(CIXTQ)

Objective: To evaluate the Chinese-version Intermittent Exotropia Questionnaire(CIX TQ) performance in terms of feasibility,reliability and validity.To explore theinfluence factors of health-related quality of life (HRQOL) concerns in children withintermittent exotropia (XT),in order to Provide the Comprehensive evaluation of theirHRQOL and the reference therapy.Methods:A Chinese Version of the Intermittent Exotropia Questionnaire (CIXTQ)was accomplished after translation and cultural adjustment from the English Version ofIXTQ. In order to evaluate the reliability, validity and feasibility of the CIXTQ，62cases of intermittent exotropia children with their one parent and64cases of normalcontrols was recruited. We evaluated the feasibility of the CIXTQ using acceptance rate,completion rate and completion time.The Cronbach’s α coefficient was used to test theinternal consistency,test-retest reliability to the stability and split-half reliability to theconsistency across index.We evaluated the validity by means of content validity,contract validity and discriminating validity.Results: This process resulted in a final questionnaire containing3subscales,whichare the Proxy IXTQ(Social and psychology dimensions,12items),Parent IXTQ(threedimensions of function, appearance and operation,a total of17items) and ChildIXTQ(Social and psychology dimensions,12items).For each questionnaire item,a5-point Likert scale was used for responses:never (score100),rarely(score75),sometimes(score50), often(score25)and always(score0). Recovery rate of the Scalewas100%, and the completion rate was98%. All subjects completed the questionnairein an average of12minutes (8-15min), which showed a good acceptability andfeasibility of the CIXTQ.The Cronbach’s α coefficient of3subscales were between0.805~0882,the reliability coefficient were between0.833~0.864, split-halfcoefficient were between0.773~0.814, which showed a good reliability of the total scale.The Content Validity Index of all the items(I-CVI)was greater than0.83（5/6）,Content validity index of the3scales (S-CVI)were between0.96~0.98,provingthat CIXTQ had a good content validity.Construct validity was appraised by factoranalysis and4,5,4principal factors were extracted from the the3subscales (ProxyIXTQ,Parent IXTQ,Child IXTQ).The total cumulative variances were72.41%、67.88%、69.13%.Children with intermittent exotropia and their parents had significantlylower scores on the Child IXTQ than the controls（p<0.001）.Patients and their parentswho chose surgical treatment had significantly lower scores on3subscales than thatchose Non-operative treatment（p＜0.05）.Compared with different strabismus anglegroups （＜40△vs≥40△）, the differences between the groups were statisticallysignificant (P<0.01). Children with greater strabismus angle and their parents had lowerscores. No significant differences in scores were found between patient by gender andage for either the3subscales or the CIXTQ as a whole(P>0.05).Conclusion:1.The CIXTQ presented satisfactory reliability,validity and a goodfeasibility in our study.It is suggested that the questionnaire could be applied in qualityevaluation of Chinese children with intermittent exotropia,which Provide the basis forthe choice of treatment and surgical timing.2.The quality of life of Children withIntermittent exotropia significantly lower than the control group, and the main factorscomes from its visual function and worry, not from the attitude of others.3. Childrenwith Intermittent exotropia and their parents who choose surgical treatment scoredsignificantly lower than that choose conservative treatment.4. Parents of Children withintermittent exotropia has even lower quality of life, mainly because of their worryabout their child’s eyesight.