The Reliability And Validity Of The The 14-item Uremic Pruritus In Dialysis Patients Scale(Chinese Version Scale)

Objective Uremic pruritus is a common symptom in patients with end-stage renal disease,which seriously reduces the patient's quality of life and even increases the risk of death.The objective and accurate measurement of itching is conducive to further understanding of the characteristics of uremic pruritus and its physical and mental impact on patients,and has important clinical significance for the evaluation of the therapeutic effect of itching.At present,there are few tools used to measure uraemic pruritus in the world and none in China.This study introduced 14-item uremic pruritus in dialysis patients scale(14-Item UP-Dial Scale),in order to translate and evaluate the reliability and validity of 14-Item UP-Dial Scale,and assess its applicability in chinese patients.Methods With the consent of the original author,the 14-Item UP-Dial Scale was translated,back-translated and cultural adjusted to develop the Chinese version scale.The 791 dialysis patients from 5 different hospitals were selected as subjects.Visual analogue scale(VAS)has been widely used to measure the degree of pruritus,which has been fully verified clinically and has good reliability and validity,so it is taken as the criterion of this study.The data was analyzed by SPSS 24.0 software.Item analysis were conducted for evaluating item discrimination.Reliability was tested by Cronbach's a coefficient?test-retest reliability and correlation coefficient of each item and total score of the scale.Criterion related validity was tested by the correlation between the Chinese version scale and the VAS.Content validity of the scale was evaluated by content validity index(CVI).Construct validity was tested by exploratory factor analysis.Results After cultural adjusted,the Chinese version scale finally retained 14 questions.And we adjusted the meaning of some items.The scale is composed of 14 questions,which are divided into 3 dimensions:symptoms and signs(itch duration,itching degree,itching size,lesions from scratching,feel numb,crawling like ants or insects,and dry skin),sleep(difficulty to fall asleep,waking up during the night,interfere sleep quality),and social psychology(work/study,social interaction,mood,and any sexual difficulties).A total of 270 dialysis patients with uremic pruritus were screened out,and the incidence was about 34.1%.The questionnaire recovery rate was 100%.Among them,195(72.2%)patients were on hemodialysis,70(25.9%)patients on peritoneal dialysis,and 5(1.9%)patients on hemodialysis combined with peritoneal dialysis.In the item discrimination analysis,the results of t-test between the high group and low group were 5.570?19.172(p<0.01).The results were all higher than the standard value of 3.0,and all P<0.01,indicating a high degree of discrimination of items in the scale.The correlation coefficients between each item and the whole scale were 0.413?0.892(P<0.01).It shows that items of the scale have high homogeneity with the whole scale.The Cronbach's ? of the 3 subscales and the whole scale were 0.749,0.710,0.845 and 0.894 respectively,indicating that the reliability of the scale was ideal.The test-retest reliability coefficients of the 3 subscales and the whole scale were 0.968,0.951,0.977 and 0.976 respectively(P<0.01),indicating that the scale was highly stable and had excellent cross-time stability.The item-level content validity index(CVI)of item 5(feel numb)and item 14(any sexual difficulties)were both 0.83,and the remaining items were all 1.00.The average scale-level CVI was 0.98.Criterion related validity was 0.809(P<0.01).KMO test value was 0.907,and the Spherical Bartlett test ?2=1837.141(v=91,P<0.01).The result of exploratory factor analysis showed that three common factors explained 61.81%of the total variance.There are some differences between the items of the three common factors in this study and the original scale,but the core contents are basically the same.Therefore,the Chinese version of the 14-Item UP-Dial Scale is consistent with the original design concept and has good structural validity.Conclusion The Chinese version of 14-Item UP-Dial Scale was easy to understand and use.In addition,the Chinese version scale has good reliability and validity,which can be used to evaluate uremic pruritus in dialysis patients in China.