| Objective: To evaluate the reliability and validity of chronic liver disease questionnaire(CLDQ), we surveyed the patients with chronic liver disease and the health individuals with the questionnaire. At the same time, we evaluated the quality of life among patients with chronic hepatitis C in order to acknowledge that of the patients in different demographic characteristics.Methods: Patients with chronic liver disease and health individuals were tested using the chronic liver disease questionnaire(CLDQ), EuroQol-5 Dimensions(EQ-5D) and the socio-demographic characteristic questionnaire in a cross-sectional study. The data of our survey includes general information(age, gender, marital status, education, occupation, other chronic diseases, family medical history, smoking, alcohol consumption and duration of illness, etc.), quality of life associated with CLDQ and EQ-5D were collected. Data were typed-in using Epidata version 3.2 and analyzed using SPSS(Statistical package for social sciences)for windows, version 16.0. Statistical description of the data were expressed as constituent ratio, mean and standard deviation; Statistical analysis were performed by t- test, analysis of variance, correlation analysis, exploratory factor analysis and multiple linear regression.Results: In this study, a total of 453 completed questionnaires, which including the 67 people are normal population, accounting for 14.79% of the total; 56 patients with hepatitis B, 12.36% of the total; 314 people with hepatitis C group, accounting for 69.32% of the total; Cirrhosis group of 16 people, 3.53% of the total.The degree of internal uniformity among the items was expressed by Cronbach’s α coefficient. The overall Cronbach’s α coefficient of the total scale was 0.956, all dimensions were above 0.7, which indicated the scale had a good internal uniformity. The test-retest reliability of the total scale was 0.916, almost all dimensions were above 0.8 except emotion and anxiety dimension were 0.7 to 0.8, which indicated that the scale showed good test-retest reliability. Split-half reliability of the total scale was 0.920 and almost all the dimensions were above 0.8 except the systemic symptoms dimension is between 0.7 and 0.8, which demonstrated that the scale had good split-half reliability.In terms of validity, the degree of content validity between each item and its domain was expressed by correlation coefficients, all the correlation coefficients were greater than 0.6(P<0.001), which demonstrated that the scale had a good content validity. We got 6 principal components according to the exploratory factor analysis among the scale which was consistent with the original scale, which indicated that the scale had a good construct validity. After the multiple compairison, there was significant difference of quality of life scores in each dimension and total scale between different health status(P<0.05), which demonstrated that the scale had good discriminate validity. Comparing the scores of EQ-5D to CLDQ,almost all correlations were above 0.8 except EQ-VAS and abdominal symptoms had a low correlation(r = 0.49), showed that CLDQ and EQ-5D scale were similar in criterion-related validity.The total score of CLDQ among patients with chronic hepatitis C was 5.42±1.24, Abdominal symptoms was 5.73±1.50, Fatigue was 5.16±1.66, Systemic symptoms was 5.24±1.35, Activity was 5.43±1.62, Emotional function was 5.37±1.40, Worry was 5.75±1.45. There was no differences of quality of life scores in patients with chronic hepatitis C in different age, marital status, education, occupation, smoking and drinking aspect(P>0.05). Regarding to gender variable, in addition to the difference of emotional dimension and systemic symptoms between males and females had no significant difference(P= 0.011 and 0.018), the abdominal symptoms and activities were in the edge of significant difference(P = 0.081 and 0.051), and the other dimensions had no significant difference(P>0.05). As for other chronic diseases, quality of life in other dimensions had significant difference(P<0.05) except abdominal symptoms, drowsiness and anxiety. In the aspect of family history of chronic liver disease, in addition to activities and emotional dimension, there were differences of quality of life scores in other dimensions(P<0.05). Meanwhile, in terms of duration of illness, quality of life scores in the three groups of patients in all dimensions had significant difference(P<0.05).The social factors that have an impact on the quality of life in patients with chronic hepatitis C were screened by multiple stepwise regressions. And it was found gender, family history, and whether suffering from other chronic diseases influences quality of life of chronic hepatitis C patients.Conclusion:1. Chronic liver disease questionnaire(CLDQ) scale has good feasibility, reliability and validity, which can be taken as a good scale and evaluation tool for the quality of life of the patients with chronic hepatitis C.2. There are no statistical differences of age, marital status, education, occupation, smoking and drinking on the quality of life scores in patients with chronic hepatitis C, while it shows differences on gender, other chronic diseases, family history and duration of illness, which indicating that we should focus on women, other chronic diseases and family history of patients in the prevention and treatment of chronic hepatitis C. |
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