| Objective: (1) According to cross-cultural adaptation process of scales, translation and revision of quality of life in Alzheimer's disease (QOL-AD) were conducted to develop Chinese version of quality of life in Alzheimer's disease; (2) Chinese version of quality of life in Alzheimer's disease was assessed for reliability and validity among patients with Alzheimer's disease in Taiyuan, Shanxi. The final scale was aimed more widely used in clinical evaluation; (3) Chinese version of QOL-AD was used to investigate status and related factors of quality of life among patients with Alzheimer's disease in Taiyuan, Shanxi.Methods: (1) Brislin Model of Translation was used for QOL-AD forward translation, back translation and cross-cultural adaptation process to develop Chinese version of QOL-AD. (2) By stratified cluster sampling in Taiyuan city, 200 patients with Alzheimer's disease were selected from 3 upper first-class hospitals and 3 large communities. Item distribution, coefficient of variation, t-test, and correlation analysis were used for item analysis and selection. (3) Content validity, criterion validity and discriminant validity were used for validity evaluation. Test-retest reliability, split-half reliability and internal consistency were used for reliability assessment. (4) Cognition effect on validity and reliability was evaluated based on cognitive groups comparison. (5) Scores of QOL-AD (patient version) and those of QOL-AD (caregiver's version) were compared by paired t test. (6) QOL-AD Chinese version was used to investigate patients with Alzheimer's disease in Taiyuan city and related factors about quality of life were determined by univariate and multivariate analysis.Results: (1) Through Brislin Model of Translation and item selection, QOL-AD Chinese version included 13 items. (2) Validity assessment results:①content validity: This translated scale was re-assessed by several specialists and showed good content.②criterion validity: Correlation coefficients for QOL-AD (patient) and ADL, SF-36 PF, SF-36 RP, GDS, SF-36 MH, SDS, SAS, and CBS were -0.239, 0.288, 0.269, -0.211, 0.290, 0.185, 0.194, and 0.227, respectively. Correlation coefficients for QOL-AD (caregiver) and ADL, SF-36 PF, SF-36 RP, GDS, SF-36 MH, SDS, SAS, and CBS were -0.179, 0.129, 0.211, 0.135, 0.107, -0.266, -0.164, and -0.142, respectively.③discriminant validity: There were statistically significant differences between scores of total QOL-AD for low Moca and high Moca groups. (3) Reliability test results:①test-retest reliability: Intra-class correlation coefficient (ICC) for total score of QOL- AD Chinese version was 0.835.②split-half reliability: Reliability index for total score of QOL- AD patient version and caregiver version were 0.674 and 0.841.③internal consistency: Chronbach's ? coefficients for total score of QOL- AD patient version and caregiver version were 0.659 and 0.869. Corralation coefficients between each item and total for QOL- AD patient version were 0.285-0.590 and 0.231-0.815 for caregiver version; Corralation coefficients between each item and item 13 for QOL- AD patient version were -0.470-0.860 and -0.095-0.155 for caregiver version; (4) cognitive function effect on QOL-AD: Correlations between QOL-AD and criterions were more acceptable for moderate to high cognitive function group of patient version than for low and low to moderate cognitive function groups of caregiver version; Split-half reliability and Chronbach's ? coefficients were high for moderate to high and high cognitive function groups of patient version and all cognitive function groups of caregivert version except high cognitive function group. (5) status of quality of life among patients with Alzheimer's disease: Total score of QOL-AD was 28.78±4.29 (mean±SD) with range of 14.00-39.00 and 55.35±8.26 (mean±SD) with range of 25.00-75.00 for hundred-mark system. Scores of QOL-AD (caregivers version) were statistically higher than those of QOL-AD (patient version). (6) Univariate analysis showed that for total score of QOL-AD, retired work, drinking tea, restricted diet, hearing, eyesight, doing housework, public activities, hobbies, sports activities, and recreational activities were the significant factors. Multiple linear regression analysis showed that marriage relationship, restricted diet, drinking tea, public activities, doing housework, and character were predictive factors.Conclusion: Translation and revision of quality of life in Alzheimer's disease (QOL-AD) are conducted to develop Chinese version of quality of life in Alzheimer's disease. Reliability and validity assessment show that content validity, criterion validity, discriminant validity, test-retest reliability, split-half reliability, and internal consistency have achieved psychometric requirements. QOL-AD (patient) is possibly not suitable to severe cognition impaired patients compared with QOL-AD (caregiver). Caregiver reported QOL-AD is slightly higher than patient reported QOL-AD. Quality of life in patients with Alzheimer's disease is poor and has many related factors. Strategies to improve quality of life of patients with Alzheimer's disease could be developed based on this. |
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