| Objective To revise the form of Visual Function index-14 from Unite states and introduce to China in Chinese revision, Meanwhile its reliability, validity and acceptability was evaluated to provide evidence to explore the suitable tool of visual function evaluation.Method 440 patients who had been diagnosed with age-related cataract and 12 eye experts and 80 health people were selected as subjects. All patients were diagnosis based on the national standard to diagnose the age-related cataract. The ages of the patients were between 40-70 years old and the levels of all patients'education were finishing primary school at least. Among them 200 patients were selected as subjects to amend of VF-14, and 240-patients and 80 health people served as VF-14 evaluation. The profession title of eye experts was above associate chief physician and with clinical experience more than 10 years. They were proficient in English, and one of them who had the experience of studying in U.S.A. took part in translation and amendment of VF.According to the rules of form introduction, VF-14 in Chinese version was formed through the translation, back translation and comparison by the ophthalmologists. After seeking the comments and suggestions from 9 ophthalmologists and 200 patients, the script is amended according the cultural flexibility and the revised Chinese version of VF-14 form is finally formulated.The questionnaire was applied to collected information from 240 age-related cataract patients for evaluating Chinese version of VF-14 including general background of the subjects; conditions of eye examination, evaluation material to the Chinese amendment of VF-14 Scale, evaluation of VF–QoL, condition of self-evaluation, and evaluation of information acceptability. Among them 80 patients are evaluated twice by two different investigators within one day and another 80 patients are checked with eyesight, VFQ01, self-evaluation and Chinese amendment of VF-14 one day before the operation and one month after operation, 80 health people are checked with eyesight, VFQ01, self-evaluation and Chinese amendment of VF-14.All the questionnaires were collected to set an Excel database after double data check. The data were analyzed by SPSS13.0 statistic software and the credibility, validity, and acceptability of the form were evaluated by"t"test, Cronbach'α, ICC value, relativity analysis, and factor analysis. The indices of the evaluation included credibility evaluation, such as re-test credibility, inner-consistency credibility, inter-investigator credibility, and dichotomy credibility; validity evaluation included content validity, structure validity, criterion-related validity, and discrimination validity. Acceptability evaluation included the credibility of answering the scale, completeness of the scale, the time used in answering the Chinese amendment of VF-14.Result1. The translation of the formIn accordance with the concepts of semantic and concept equivalence, the translation of the form was done by two ophthalmologists separately. The combination of the two translations formed the first Chinese version VF-14 form and then the first version was back-translated by another ophthalmologist. The back-translated version and the first Chinese edition were compared and corrected back until they match each other. Then the finally the VF-14 form Chinese version is formulated.2. Opinions separately form ophthalmologists and age-related cataract patients were collected about the amendment of VF-14 form Chinese edition. The experts suggested that under the background of current Chinese economical and social life, VF-14 Chinese form reflects largely the content of sight related tests with clear expression and suitable difficulty to the subjects. All the experts thought that the item 8 entertainment (bingo, domino, and poker) and item 10 sports (bowling, handball, tennis or golf) were not suitable to Chinese situation and should be replaced as popular activities in China such as mah-jong, poker, Chinese chess, badminton, table tennis, basketball, and gate ball. 95% of experts suggested that item 13 and 14 and the item related to driving were not suitable in Chinese situation. All the patients believe that all the items were easy to understand in clear expression. Items 1-12 were suitable in China while items 13 and 14 were not. After considering the opinions of experts and patients, the VF-14 Chinese version was finally formulated.3. Credibility of VF-14 Chinese version:①re-test credibility: the value range of two scoring of the scale and the score of ICC was between 0.814～0.976 ( P<0.05) , which indicates a good credibility.②inner-consistency credibility: the coefficient of the form is 0.196, which indicateed a high inner-consistency;③inter-investigator credibility: the value range of all the items and total score of ICC was between 0.854～0.996 (P<0.05), which indicated a high inner-investigator credibility.④dichotomy credibility: the coefficient of dichotomy credibility in VF-14 form Chinese version was 0.817 ( P<0.05) ,which indicated a good dichotomy credibility.4. Validity of VF-14 form in Chinese edition.①content validity: experts agreed unanimously that the items in VF-14 form Chinese version included both the sight function of cataract patients for basic living need and the higher living need;②Structure validity: The factor analysis results showed that there were four main factors which accounted for the variance of 88.70% in total. Factor loading of every item was showed that one factor was major. Of them the first main factor included entertainment, sports activities, cooking, etc, which reflect the entries in the patients with three-dimensional visual function. The second main factor included reading the instruction with the small print, reading newspaper, doing fine work, filling out the forms, etc which reflect the patients obtained reflect. The third main factor included seeing the stairs and kerbstone , and all kinds of identification cards, watching TV, etc, which reflect the situation of patients'visual adaption. The fourth main factor included reading general words, recognizing Truman, etc, which reflect the subjective items with visual of patients. This consistent with the constructed theory and indicated the well structure validity.③criterion-related validity: The form of survival quality was applied before and after operation to make relevance analysis with the score from VF-14 form Chinese version. the relevant coefficients were 0.55 and 0.67 separately (p<0.01). The sight evaluation score before and after the operation was got and made relevance analysis with the score from VF-14 form Chinese amended version and the relevant coefficients were -0.63 and -0.72 repectively ( p<0.01). The relationship between the improvement of sight reported by the patients and the score from VF-14 form Chinese amended version was made and relevant coefficients were 0.65 and 0.76 separately, p<0.01.④discriminant validity: there were the significant difference between VFQOL, sight, self-evaluation before and after operation, which indicates that the score from VF-14 form Chinese amended version had a good validity in distinguishing the conditions of patients'eyesight. there were the significant difference between VFQOL, sight, self-evaluation patient and health people, which indicates that the score from VF-14 form Chinese amended version had a good validity in distinguishing the conditions of patients'and health people eyesight.5. Acceptability①Through the investigation on 300 patients, 85.4 % of patients thought that their evaluation is relatively reliable. Moreover 14.6 percent of them thought absolutely reliable.②The rate of completion of the VF reached 100 %.③Of all the investigations, the shortest time to complete the VF was 5 minutes, and the longest time was 10 minutes. It indicated that the VF-14 for in Chinese version could be accepted by age-related cataract patients.Conclusion The final VF-14 form Chinese version was finished through scientific and strict research. Study showed that it was with good reliability, validity and strong acceptability. It adapts to the meet of our economy, culture and life background. It can be used as the tool to evaluate the visual function of the ophthalmology patient. |
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