Quality of life of HIV-infected patients: Psychometric properties and validation of the German version of the MQOL-HIV

Objective: to determine the psychometric properties of the recently developed German version of the Multidimensional Quality of Life Questionnaire for HIV/AIDS (MQOL-HIV) and to test its performance in a sample of HIV-infected patients. Methods: Two-hundred and seven outpatients with HIV/AIDS were interviewed with the German version of the MQOL-HIV; 109 patients were interviewed a second time approximately 2 weeks later. Patients also completed the Beck Depression Inventory (BDI) and the World Health Organization Disability Assessment Schedule II (WHODAS II). Results: The German version of the MQOL-HIV showed satisfactory internal consistency (r: 0.74–0.85, sexual functioning: r = 0.61) and test–retest reliability in most subscales (r: 0.74–0.89, medical care: r = 0.67). Convergent validity with WHODAS II and BDI was satisfactory for most domains. Exploratory factor analysis yielded a seven-factor solution with separate factors for physical, emotional, cognitive, social and financial aspects, sexual functioning and medical care. CD4 count and source of infection were associated with most QOL domains, whereas age and gender showed no major impact on QOL. High rates of missing values were seen in the partnership domain and substantial ceiling effects in the area of medical care. Conclusions: Overall the German version of the MQOL-HIV showed satisfactory reliability and validity. However, the domains of partnership, sexuality and medical care should generally receive more emphasis in future research on QOL assessment in patients with HIV/AIDS and the MQOL-HIV may be improved in these domains.     

Validation of the Chinese version of the Schizophrenia Quality of Life Scale Revision 4 (SQLS-R4) in Taiwanese patients with schizophrenia

We tested the reliability, sensitivity, and validity of a Chinese translation of the Schizophrenia Quality of Life Scale Revision 4 (SQLS-R4). One hundred Taiwanese individuals with schizophrenia were recruited. The internal consistency reliability was satisfactory for both the psychosocial and vitality domains (Cronbach’s α = 0.92, 0.84). The test–retest reliability was also high (psychosocial: ICC = 0.84, vitality: ICC = 0.84) for those individuals whose psychological conditions remained stable between the two-week interval. However, the responsiveness coefficient for those with considerable changes in psychological conditions ranged from very small to moderate, suggesting either low responsiveness for the vitality domain or a complex relationship between the change of psychological conditions and quality of life, and the need to estimate responsiveness more conclusively in a future intervention study. The convergent validity was supported by moderate-to-large correlations between domains measuring related constructs of the SQLS-R4 and SF-36 (r = −0.65 to −0.67). Overall, the results of this study provide preliminary evidence for the reliability and validity of the SQLS-R4 used in Taiwanese individuals with schizophrenia. This study provides a common ground for international researchers to understand quality of life in Taiwanese patients with schizophrenia.     

Development and psychometric tests of the Chinese-version Low Vision Quality of Life Questionnaire

Background/Aims:To develop and assess the psychometric validity of a Chinese language Vision Health related quality-of-life (VRQoL) measurement instrument for the Chinese visually impaired.Methods: The Low Vision Quality of Life Questionnaire (LVQOL) was translated and adapted into the Chinese-version Low Vision Quality of Life Questionnaire (CLVQOL). The CLVQOL was completed by 100 randomly selected people with low vision (primary group) and 100 people with normal vision (control group). Ninety-four participants from the primary group completed the CLVQOL a second time 2 weeks later (test–retest group). The internal consistency reliability, test–retest reliability, item-internal consistency, item-discrimination validity, construct validity and discriminatory power of the CLVQOL were calculated.Results: The review committee agreed that the CLVQOL replicated the meaning of the LVQOL and was sensitive to cultural differences. The Cronbach’s α coefficient and the split-half coefficient for the four scales and total CLVQOL scales were 0.75–0.97. The test–retest reliability as estimated by the intraclass correlations coefficient was 0.69–0.95. Item-internal consistency was >0.4 and item-discrimination validity was generally <0.40. The Varimax rotation factor analysis of the CLVQOL identified four principal factors. the quality-of-life rating of four subscales and the total score of the CLVQOL of the primary group were lower than those of the Control group, both in hospital-based subjects and community-based subjects.Conclusion: The CLVQOL Chinese is a culturally specific vision-related quality-of-life measure instrument. It satisfies conventional psychometric criteria, discriminates visually healthy populations from low vision patients and may be valuable in screening the local community as well as for use in clinical practice or research.     

Psychometric Assessment of the Multidimensional Quality of Life Questionnaire for Persons with HIV/AIDS (MQOL-HIV) in a Sample of HIV-Infected Women

Since the late 1980s, several HIV-specific quality of life instruments have been developed; however, little testing has been done in terms of their validity and reliability for HIV-infected women. The purpose of this study was to test the content validity, concurrent validity, internal consistency, and test-retest reliability of the Multidimensional Quality of Life Questionnaire for Persons with HIV/AIDS (MQOL-HIV) in a sample of 85 HIV-infected women. The MQOL-HIV is a 40-item scale comprised of 10 dimensions. Most of the items and all of the domains were determined content valid but revision of some of the items and domains is recommended. Concurrent validity was measured between the MQOL-HIV and the MOS-HIV and ranged from 0.51-0.81 between similar domains. Of the 10 domains and the entire instrument, 7 had a Cronbach's alpha over 0.70 (range 0.43-0.92). Eight domains and the entire instrument achieved test-retest correlation coefficients over 0.70 (range 0.60-0.96). Although some revision may make the scale more content-valid for HIV-infected women, given due care in the interpretation of results, the MQOL-HIV can be used with female populations in its current form.     

Quality of Life of Women with Urinary Incontinence: Cross-cultural Performance of 15 Language Versions of the I-QOL

Urinary incontinence (UI) has substantial and important impacts on health-related quality of life. The purpose of this research is to report the psychometric performance of 15 different language versions of the Incontinence-specific Quality of Life (I-QOL)measure, a patient-reported outcome measure specific to stress, urge and mixed urinary incontinence. The multi-national dataset consisted of data from four clinical trials for stress incontinent females and from two additional population studies, enrolling women with stress, urge and mixed UI. All enrolled patients completed the I-QOL and comparative measures at baseline. The clinical trial populations had multiple administrations up to 12 weeks, and the two population studies included a shorter retest. Country-specific psychometric testing for validity, reliability, and responsiveness followed standardized procedures. Confirmatory factor analyses were performed to assess the I-QOL subscales. The I-QOL measurement model was confirmed as three subscales. Summary and subscale scores for the 15 versions were internally consistent (alpha values = 0.91–0.96) and reproducible (ICC = 0.72–0.97). Using changes in the independent measures of incontinence episode frequency standardized response means were predominantly strong (ranged 0.71–1.05) across 13 versions (out of 15) in association with these measures and effect sizes. These additional language versions of the I-QOL instrument demonstrate psychometric properties similar to the original version. The I-QOL has shown good results in both community studies and clinical trials with varying types and severity of urinary incontinence. It is a reliable and valid measure of HRQOL, suitable for use in a variety of international settings.     

糖尿病特异性生存质量量表的信度与效度初探

目的通过对引进的中文版糖尿病特异性生存质量量表(CN-ADDQOL)的信度和效度进行评价,旨在为糖尿病患者生存质量的测评提供敏感、有效的工具。方法对697例糖尿病患者采用相关分析和结构方程模型对CN-ADDQOL的信度和效度进行评价。结果CN-ADDQOL的Cronbachα系数为0.941,表明量表具有很好的内部一致性;CN-ADDQOL19个条目的因子载荷均有统计学意义(P<0.05),且绝大部分条目的因子载荷值均在0.4以上,说明量表具有较好的结构效度。结论CN-ADDQOL具有较好的信度和效度,值得推广应用。     

An evaluation of psychometric properties of the client's questionnaire of the Wisconsin Quality of Life Index-Canadian version (CaW-QLI)

Psychometric properties of Client's questionnaire from the Canadian version of the Wisconsin Quality of Life-Index (CaW-QLI) were assessed with two groups, 89 English (E) and 94 French (F) individuals with schizophrenia or schizoaffective disorder. Sub-samples of 40E and 36F were re-interviewed within a 2-week period. Spearman correlations-SC between each domain and CaW-QLI global Score ranged from 0.39 to 0.76, while inter-domain correlations were low, confirming the multidimensional properties of the scale. Cronbach's (internal consistency) were 0.78(E) and 0.70(F) for the CaW-QLI global scores and, from 0.45 to 0.88 among seven of eight domains. Test–retest (Concordance Correlation Coefficient-CCC) ranged from 0.36 to 0.80 among the domains, and from 0.80(E) and 0.85(F) between CaW-QLI global scores. Regarding convergent validity, SC between CaW-QLI global score and Spitzer's QOL-Index were 0.72(E) and 0.58(F). As hypothesized, there were higher correlations between CaW-QLI global scores (E and F) and SF-36 scales related to mental health than those related to physical health. Minor changes in the scoring are proposed to enhance face and content validity.     

老年人生活质量调查表的信度和效度研究

目的 探讨老年人生活质量调查表在老年人群中应用的信度、效度和可行性。方法 以问卷访谈的形式调查1055名老年人，用分半信度、内部一致性、判别效度和结构效度等指标对调查表进行评判。结果 该调查表具有良好的内部一致性，11项健康相关内容的Cronbach’a系数均≥0．7。调查表的分半信度较好，用三种方法获得的Pearson相关系数均≥0．5。判别效度和结构效度令人满意。因子分析产生4个因子，能解释总方差的57．92％，且各项目在相应因子上有较满意的因子载荷量(≥0．4)。结论 老年人生活质量调查表基本适用于我国老年人的生活质量评价。     

绝经期生存质量量表中文版本的临床应用与评价

目的　引入绝经期生存质量量表 (MENQOL) ,并测定其信度、效度和反应度。方法将MENQOL译成中文并回译 ,30例预调查后 ,对 4 0 9例确诊为更年期综合征的患者进行问卷调查 ,采用描述性分析 ,推断性分析等方法 ,测评量表的信度、效度、反应度。结果　因子分析得出 7个公因子 ,累积贡献率为 5 9.4 76 % ,与各维度的相关系数比较 ,表明中文版可产生 4个维度 ,包括 (血管舒缩症状、心理状态、生理状态、性生活 ) ,与英文版本的 4个维度相同 ;重测 4个维度的相关系数分别为0 .80 6、0 .80 4、0 .94 1、0 .94 0 ;量表 4个维度的克朗巴赫系数分别为 0 .72 5 8、0 .82 34、0 .84 75和 0 .86 4 1;量表能敏感地反应治疗前后生存质量的变化。结论　MENQOL中文译本经初测效度、信度和反应度比较满意 ,适合中国更年期妇女的生存质量评测。     

Quality of life and parkinson's disease: Translation and validation of the US Parkinson's Disease Questionnaire (PDQ-39)

Parkinson's disease is a common progressive neurodegenerative disorder affecting an estimated 4 million people worldwide. A number of general health status measures exist but few fully capture the subjective evaluation of life quality associated with Parkinson's disease. We report here the results of: (1) translating the British PDQ-39 into a US version, (2) validity and reliability of the new US PDQ-39 questionnaire, and (3) parallel validation analyses following the method published in the development of the British version of the PDQ-39. Data were collected by postal survey on 150 patients recruited from neurology clinics in the Seattle area. A short, generic health status measure (SF-36) was used to test convergent validity, and a three-day test–retest assessed the reliability of the PDQ-39. The US version of the PDQ-39 demonstrated acceptable internal consistency ( = 0.51 to 0.96) and proved to be reproducible (0.86 to 0.96). Subscales of the PDQ-39 showed convergence with like scales of the SF-36 and was able to discriminate between levels of symptom severity.     

Is Psychometric Scoring of the McNew Quality of Life After Myocardial Infarction Questionnaire Superior to the Clinimetric Scoring? A Comparison of the Two Approaches

Objective: ‘Clinimetric’ and ‘psychometric’ approaches are currently used to develop health related quality of life questionnaires. The Quality of Life after Myocardial Infarction questionnaire (QLMI) was originally developed using ‘clinimetric’ criteria; it was subsequently modified (McNew QLMI) and a new domain structure was defined using factor analysis. The objective of this study was to compare the measurement properties of the McNew QLMI scores when both approaches for scoring are used. Methods: The McNew QLMI and SF-36 were administered to patients 2 weeks and 2 months after myocardial infarction. Two sets of scores for the McNew QLMI were computed using the original ‘clinimetric’ and the subsequent ‘psychometrically’ derived scoring systems. Reliability statistics for the two sets of domains were compared and construct validity was assessed by establishing a priori hypotheses on the expected correlation between each score and the dimensions of the SF-36. Results: Both sets of scores had similar reliability (Cronbach’s α between 0.64 and 0.93) and responsiveness (SRMs between 0.17 and 0.87) while validity was better for the ‘clinimetric’ set of scores (concordance between observed and expected correlations was moderate for the ‘clinimetric’ scores and fair for the ‘psychometric’ scores). Conclusion: Since overall measurement properties of the ‘clinimetrically’ scored McNew QLMI are better than the ‘psychometrically’ scored version, we suggest that either the original ‘clinimetric’ system is used or that an improved ‘psychometric’ version is developed.     

Validity and reliability of Pediatric Quality of Life Inventory for 2- to 4-year-old and 5- to 7-year-old Turkish children

Objective In this study, we attempted to examine the reliability and validity of the Pediatric Quality of Life Inventory (PedsQL^TM 4.0) for 2- to 4-year-old and 5- to 7-year-old Turkish children. Method Parents of 223 children in the 2- to 4-year-old age group and 198 children in the 5- to 7-year-old age group and their parents were enrolled in the study. Children were grouped as healthy, those with acute health conditions, and those with chronic health conditions. Results Internal consistency reliability alpha coefficients (Cronbach’s coefficient alpha) of the PedsQL^TM 4.0’s total scale score for the parent proxy reports of 2- to 4-year-old children and 5- to 7-year-old age groups and for the child’ s self-report of the 5- to 7-year-old age group were 0.85, 0.86, and 0.80, respectively. Most subscale scores were acceptable for group comparisons. For all items in the child self-report and parent proxy report, item internal consistency was found to be more than 0, 40. Children with chronic health conditions scored less than healthy children and the children with acute health conditions in parent proxy reports. However, in the child self-reports of the 5- to 7-year-old group, there was no significant statistical difference in the scores between the groups. Generally, there was a low–medium inverse correlation between the total scale scores (and most subscale scores) and the indicators of morbidity and illness burden. The correlation between the child self-report and the parent proxy reports were significant direct but low correlations. No significant difference was observed in subscale scores between genders except in the school functioning scores in parent reports of healthy children 2–4 years of age and the acute health condition group of 5–7 years of age. School functioning scores of boys were significantly lower than for girls. Conclusion The parent proxy reports of the Turkish translation of the PedsQL^TM 4.0 may be used in research for group comparisons for 2- to 7-year-old Turkish children.     

Psychometric properties of the initial Brazilian version of the CHQ-PF50 applied to the caregivers of children and adolescents with cerebral palsy

Goals To evaluate the psychometric properties of the initial Brazilian version of the Child Health Questionnaire(CHQ-PF50) in children and adolescents with cerebral palsy(CP). Methods The caregivers of 5- to 18-year-old children and adolescents with CP answered the self-administered CHQ-PF50 questionnaire. Data quality, reliability and validity were studied. The Gross Motor Function Measure was used to assess physical function. Results Ninety-six caregivers answered the questionnaire. Patient age ranged from 5 to 17.9 years (mean: 9.3 years). Missing data rate was low. Floor effect occurred in 3 scales and was substantial for quadriplegia group (63.6–77.3%). Ceiling effect occurred in 9 scales. Reliability was adequate for all scales except for the general health perception scale (Cronbach alpha coefficient = 0.24). The validity was adequate in general, but the role/social limitations-emotional behavioral scale was not satisfactory for discriminant and divergent validity. Conclusion The initial Brazilian version of the CHQ-PF50 showed, in general, adequate psychometric properties for application in patients with CP. Although floor and ceiling effects are expected in heterogeneous group as a limitation inherent to generic assessment instruments, they must be carefully considered in further studies. The general health perception and role/social limitations-emotional behavioral scale must be further reviewed for this population.     

简体中文版皮肤病生活质量指标信度和效度初探

目的 评价简体中文版皮肤病生活质量指标(DLQI)量表的信度和效度。方法 对就诊皮肤科门诊的236例患者进行DLQI量表的测量,并计算其分值,用可靠性分析和因子分析进行评估。结果 DLQI量表克伦巴赫系数为0.87,折半信度为0.85,各维度之间相关性较高为0.4024～0.6569,因子分析发现单因素能够代表DLQI量表的大多数因子。结论 DLQI量表为简单有效的皮肤病生活质量测评工具,且具有较好的信度和效度。     

Psychometric Properties of the DUKE Health Profile-adolescent Version (DHP-A): A Generic Instrument for Adolescents

Purpose: Quality of life in general population of adolescents has been scarcely documented. The study was aimed at evaluating the psychometric properties of the DUKE Health Profile-Adolescent version (DHP-A), an adaptation from the adult version.Material and method: Feasibility and construct validity were assessed in a sample of 618 adolescents from school settings. Test–retest reliability was assessed in another sample of 100 adolescents at 2 weeks interval. Construct validity was assessed in groups by gender, age and existence of a health problem.Results: The DHP-A, a short instrument of HRQOL, easy to administer, proved its ability to discriminate between boys and girls, with or without a health problem, for all of health and dysfunction dimensions (p < 0.05). Its reliability is also acceptable for three health dimensions and anxiety, depression (ICC = 0.68–0.72), moderate for social, perceived health, self-esteem and pain (ICC = 0.43–0.59), and debatable for disability (ICC = 0.22) (single item). Conclusion: The initial testing of the adolescent version (DHP-A) indicates that the psychometric properties are acceptable and will provide a useful tool for the assessment of health status in adolescents. Three single-item dimensions (perceived health, pain and disability) should be interpreted with caution.     

广东开平、博罗农村老年人生活质量调查

为了解广东农村老年人生活质量现状，用多级，分层随机抽样方法，对开平，博罗两地１００８例农村老年人进行了生活质量调查，结果：９６．６４％的老年人具生活自理能力（ＡＤＬ量表评分）７８．０％的老年人具独立性生活能力（ＩＡＤＬ量表评分）；健康自评３６．３１％的老年人良好；５２．８％中等，１０．４２％差，５６．０５％的老年人有慢性病史，居一，二位的是关系炎，慢性头痛，对目前医疗条件满意的占３８．８％，一般占     

Revision and Psychometric Testing of the City of Hope Quality of Life–Ostomy Questionnaire

PURPOSE: Ostomies may be performed for bowel or urinary diversion, and occur in both cancer and non-cancer patients. Impact on physical, psychological, social and spiritual well-being is not unexpected, but has been minimally described in the literature. The City of Hope Quality of Life (COH-QOL)-Ostomy Questionnaire is an adult patient self-report instrument designed to assess quality of life. This report focuses on the revision and psychometric testing of this questionnaire. PATIENTS AND METHODS: The revised COH-QOL-Ostomy Questionnaire involved in-depth patient interviews and expert panel review. The format consisted of a 13-item disease and demographic section, a 34-item forced-choice section, and a 41-item linear analogue scaled section. A mailed survey to California members of the United Ostomy Association resulted in a 62% response rate (n = 1513). Factor analysis was conducted to refine the instrument. Construct validity involved testing a number of hypotheses identifying contrasting groups. RESULTS: Factor analysis confirmed the conceptual framework. Reliability of subscales ranged from 0.77 to 0.90. The questionnaire discriminated between subpopulations with specific concerns. CONCLUSIONS: Overall, the analyses provide evidence for the validity and reliability of the COH-QOL-Ostomy Questionnaire as a comprehensive, multidimensional self-report questionnaire for measuring quality of life in patients with intestinal ostomies.     

修订的糖尿病生命质量量表(A-DQOL)信度与效度初探

目的：通过对修订的专用糖尿病生命质量量表（Ａ－ＤＱＯＬ）信度和效度进行评价,旨在国内推广应用糖尿病生命质量评价的专用量表。方法：采用相关分析和因子分析对Ａ－ＤＱＯＬ的信度和效度进行评价。结果：Ａ－ＤＱＯＬ的重测信度为０．８２３６,折半信度为０．７９６３,克朗巴哈α系数为０．８６９９,θ系数为０．９０６０,Ω系数为０．９１６３;规定提取３个公因子,利用主因子因子分析法进行分析表明,Ａ－ＤＱＯＬ具有良     

慢性病对成都农村社区老年人生命质量的影响

采用自己设计的问卷，对成都市龙泉镇２４５２名６０岁及以上老年人的生命质量和慢性病患病情况进行了询问调查，结果表明农村老年人的慢性病患病率（６１４．２‰）较高，近１／３患有两种或两种以上的疾病；从患病频度看，影响农村老年人健康前几位慢性病为呼吸系病、消化系病、循环系病、肌肉骨骼系病和五官疾病；单因素和多因素分析表明，对生命质量影响较大的慢性病依次为精神疾病、循环系病、五官疾病、外伤、肿瘤和神经系病。因此从生命质量和疾病频度角度出发确定的疾病重要性不同，提示确定疾病重要性需要考虑生命质量。     

Depressed Mood and Social Support as Predictors of Quality of Life in Women Receiving Home Health Care

We examined relationships among depressed mood, social support and quality of life in 58 medically ill low-income women 40 years and older receiving home health care. Analyses showed a negative relation ship between depressed mood and quality of life (p’s ≤ 0.05). Positive relationships were found between number of people avail able for support and two of three quality of life domains as well as sat is faction with support and all three domains (p’s ≤ 0.05). Results also provided preliminary support that belonging to a church is related to emotional well-being (p = 0.039) and among those belonging to a church, recent increased activity was related to social/family well-being (p = 0.004). Mediational analyses revealed a cycle of depressed mood, dissatisfaction with social support, and loss of social support providers underlying the poor quality of life of many participants. This high lights the need to address the relation ship between depression and social support when treating patients with chronic illness.