口干问卷中文版对鼻咽癌放疗患者评价效度和信度调查

目的 评价口干问卷中文版(XQ-C)对鼻咽癌放疗患者的效度和信度。方法 根据国际生命质量评价项目的标准程序进行XQ-C的制作,对不同放疗阶段的鼻咽癌患者进行问卷调查,对问卷结果进行效度和信度检验,内容效度采用专家评价法,结构效度采用探索性因子分析,区分效度采用非参数检验,信度检验采用克朗巴赫系数(Cronbach′s α)和分半信度进行内部一致性评价。结果回收有效问卷212份,内容效度I-CVI均≥0.80,S-CVI/Ave=0.97,Kendall′s W一致性检验P=0.701;探索性因子分析显示XQ-C为单一维度量表;不同放疗阶段患者的量表评分不同即区分效度良好;信度检验示Cronbach′s α系数=0.951,Guttman分半信度系数为0.940。方法 中文版口干问卷具有良好的效度和信度,可推广用于我国鼻咽癌患者放疗后口腔干燥症的临床诊疗和研究中。     

肿瘤患者“营养认知-食欲-功能”量表的编制及信效度分析

目的开发综合营养认知、食欲及机体功能等评价进行营养风险筛查的量表,并进行信效度验证。 方法 在文献回顾、患者访谈及项目组讨论的基础上确定量表维度、形成条目池,经过德尔斐专家咨询形成原始量表。选取首都医科大学附属北京世纪坛医院104例肿瘤患者进行调查,检验量表的信效度。 结果 最终形成的肿瘤患者营养认知-食欲-功能（nutrition belief-appetite-function, BAF）评估量表包括营养认知、食欲和功能指标3个维度,共13个条目。项目分析时发现各条目和总分的相关系数均＞0.3,各条目的决断值均达到预设标准,故不考虑删除条目。本量表的分半信度为0.750,各维度的分半信度为0.590～0.847;量表的Cronbachs α系数为0.806,各维度的Cronbachs α系数为0.631～0.866,营养认知和功能维度的系数未达到理想状态;量表的重测信度为0.784,各维度的重测信度为0.588～0.721。量表效度分析方面,各维度与总量表间得分的相关系数为0.539～0.890,均有显著性;结构性因子分析提取2个公因子,累计方差贡献率为56.36%,删除2个条目后得到营养认知和食欲及功能相关的两个维度;量表总分及各维度得分均与NRS 2002的显著正相关。 结论 编制的肿瘤患者BAF评估量表具有较好的信效度,可有效评估肿瘤患者的营养风险。     

恶性肿瘤患者安宁疗护知识问卷的编制及信效度检验

目的：编制恶性肿瘤患者安宁疗护知识问卷,并检测其信效度。方法：参考安宁疗护实践指南及相关文献形成最初版肿瘤患者安宁疗护知识问卷,采取德尔菲两轮专家咨询法,邀请15名专家对问卷的内容效度进行检验,并选取170名肿瘤患者对问卷的信效度进行检验。结果：该问卷的 Cronbanch’s α系数为 0.895,重测信度系数为0.820,内容效度指数I-CVI波动在0.818~1.00,S-CVI为0.910,结构效度KMO值为0.843,Bartlett’s 球形检验结果为P≤0.001,共提取2个公因子,解释变量量为70.036% ,最终保留12个条目。结论：本研究编制的恶性肿瘤患者安宁疗护知识问卷具有较好的信效度,适合评估肿瘤患者对安宁疗护知识的掌握情况。     

鼻咽癌患者生存质量量表的效度信度评价

目的:对研发的鼻咽癌(NPC)患者生存质量量表(QOL-NPC)进行信度和效度评价.方法:2007-01-21-2007-02-07,统一受训的调查员对433例确诊的、接受放疗的NPC患者进行调查,并采用相关分析、信度分析、因子分析和结构方程模型等统计方法进行分析.结果:QOL-NPC量表具有较好的分半信度和内部信度;除社会领域外(信度系数为0.628),各领域的内部信度系数均>0.8.每条目跟所属领域的相关系数>0.547,均有统计学意义,大于该条目与其他领域的相关系数,说明QOL-NPC量表有良好的内容效度.所有条目提取的6个主成分分布代表了各个领域,累计贡献达57.04%;结构方程模型拟和效果好,各条目和相关领域关系与量表的理论结构假设基本一致,结构效度较好.不同性别、不同放疗阶段患者的PS领域得分差异有统计学意义(t=2.10,P=0.037;F=3.34,P=0.019),不同收入人群的PH、PS、SE领域得分差异有统计学意义.P<0.05.结论:QOL-NPC量表有较好的信度和效度,可用于评价正在或者已经接受放疗NPC患者的生存质量.     

鼻咽癌患者生存质量QOL-RTI/H&N测评信度效度考核

目的:对QOL-RTI/H&N量表进行信度效度考核,以考评量表是否适合于鼻咽癌患者生存质量的测评。方法:收集中山大学肿瘤医院416例鼻咽癌患者的QOL-RTI/H&N和人口学资料,采用Cronbach’sα、相关分析、信度分析、证实性因子分析和方差分析考核量表的信度(α信度、分半信度和重测信度)、效度(结构效度)和区分度。结果:所有方面的Cronbach’sα系数和分半系数均>0.6,所有方面的重测系数均>0.7。总体模型的证实性因子分析显示,正规拟合指数、非正规拟合指数以及比较拟合指数都等于1,近似误差均方根RMSEA为0.000,95%RMSEA为(0.000;0.078)。不同放疗阶段的患者在所有方面的得分差异均有统计学意义(P<0.05),正在接受放疗患者的生存质量普遍较低。结论:QOL-RTI/H&N量表具有良好的信度、效度和区分度,可操作性强,可用于鼻咽癌患者的生存质量评价。     

肿瘤患者食欲的评价及药物干预

食欲下降是肿瘤患者常见症状,可导致营养摄入不足,使患者出现全血细胞减少、体重下降、脂肪组织和骨骼 肌减少、生活质量下降等问题,不利于抗肿瘤治疗措施的实施。准确评估厌食症的过程,无论对研究还是临床管理都极为 重要,科学的食欲评价方法和技术不仅是营养工作者客观评价食欲的工具 , 也是进一步认识和预测营养不良的基础。本文 通过回顾国内外发表的肿瘤患者食欲评价及癌性厌食的相关文献,综述目前肿瘤患者食欲的评估方法及常用治疗药物,但 尚无一致认可的肿瘤患者食欲评估工具,常用方法包括：询问法、视觉模拟测量、厌食 / 恶液质治疗的功能评估、肿瘤患 者食欲症状问卷、简单营养食欲评估问卷及口头评价量表等,且各有侧重。尽管临床上可通过药物干预改善肿瘤患者的厌 食状况并增加体重,但仍需权衡药物的相关副作用,以期有效帮助肿瘤患者改善食欲,并使其获益最大。     

中文版莱斯特咳嗽问卷的改良及验证

背景与目的 患者行肺部手术后常常出现咳嗽,目前尚缺乏专门评估术后咳嗽的工具.本研究对中文版莱斯特咳嗽问卷(Leicester Cough Questionnaire in Mandarin-Chinese,LCQ-MC)改良并进行验证,探讨其临床应用价值.方法 2015年9月-2016年12月四川大学华西医院胸外科单个医疗组共250例行胸腔镜肺部手术的患者参与调查,其中121例患者完成LCQ-MC,129例患者完成简化LCQ-MC,并进行信度和效度检验.结果 新问卷保留LCQ-MC的框架与评分方式,由生理、心理和社会3个维度,共12个条目构成.量表内容效度良好,内容效度指数达到0.83;与日间咳嗽症状积分对比标准效度高(r=-0.578,P<0.001),与夜间咳嗽症状积分和健康调查简表总分(Chinese version of the Medical Outcome Study 36-item Short-Form Healthy Survey,SF-36)对比标准效度中等(r=-0.358,P=0.004;r=0.346,P=0.030),与医院焦虑与抑郁评分总分(Hospital Anxiety and Depression Scale,HADS)对比标准效度较弱(r=-0.241,P=0.046);内部一致性良好,克朗巴赫α系数在0.71-0.84之间;1周后重测信度良好(n=30,r=0.81-0.95).结论 简化版中文版莱斯特咳嗽问卷有良好的信度和效度,可应用于临床.     

肿瘤患者食欲评价和调节的专家共识

食欲下降是肿瘤患者常见症状，癌性厌食/恶液质综合征在晚期肿瘤患者中发病率较高。肿瘤患者因营养摄入不足，会出现全血细胞减少、体重下降、脂肪组织和骨骼肌减少，导致患者免疫力降低，治疗耐受性下降，治疗机会减少，并发症增加，不利于抗肿瘤治疗措施的实施。准确评估癌性厌食的过程，无论对研究还是临床救治都极为重要，科学的食欲评价方法和技术不仅是营养工作者客观评价食欲的工具，也是进一步认识和预测营养不良的基础，对改善肿瘤患者营养不良具有积极意义。本共识根据国内外现有研究证据，对该领域的研究结果进行系统总结。从肿瘤、营养与食欲的关系出发，分析癌性厌食的发生发展机制，总结不同情况下肿瘤患者的食欲评价方法，并给出专家推荐意见。结合我国膳食现状和特点，从临床、营养、护理、中医的角度提出调节食欲的方法，科学规范癌性厌食管理策略，以便临床医师、临床营养专业人员、护士等医疗保健人员应用，更好地为肿瘤患者服务。     

癌症患者生命质量测定量表体系共性模块的研制(二):信度与效度分析

背景与目的:我们已经开发了癌症患者生命质量测定量表体系共性模块(quality of life instruments for cancer patients-general module,QLICP-GM),但其心理测量学特性有待考评.本研究拟考评QLICP-GM的信度与效度.方法:用QLICP-GM对600例肺癌、乳腺癌、大肠癌、胃癌和头颈癌患者的生命质量进行测定和评价,用相关分析、配对t检验、等效检验、结构方程模型等统计学方法分析QLICP-GM的信度和效度;同时与FACT-G量表测定和评价结果比较,分析QLICP-GM的效标效度.结果:QLICP-GM各领域及总量表的重测信度均在0.85以上,除社会功能外各领域内部一致性信度α值均在0.70以上,总量表的α值和分半信度分别为0.88和0.93;相关分析与结构方程模型分析显示量表有较好的结构效度:与FACT-G的相关分析显示有较好的效标关联效度.结论:QLICPGM具有较好的信度和效度,可用于癌症患者生命质量测定.     

肿瘤患者食欲下降的营养诊疗专家共识

由于肿瘤本身及手术、放化疗等治疗因素影响,肿瘤患者常出现食欲下降。食欲下降导致的营养摄入不足易引起营养不良和恶液质,可使肿瘤患者对抗肿瘤治疗的耐受性及疗效降低、生活质量下降,严重影响患者生存预后。在病程中准确评估患者食欲,结合营养筛查与评估,尽早发现患者营养风险并给予个体化的营养治疗,有利于改善患者食欲与营养状况、预防或延缓病程进展、提高治疗耐受性,对于改善患者的预后及生活质量具有积极意义。为规范肿瘤患者食欲下降的营养诊疗,提高救治效果,本共识根据国内外现有研究成果,综合有关专家意见和临床经验,阐述了肿瘤患者食欲下降的定义与发生机制,提供了厌食/恶液质评价量表、肿瘤患者食欲症状问卷、食欲刻度尺等食欲评价工具,并且给出了肿瘤患者食欲下降的营养治疗建议。希望本共识的发布可以提高临床医护人员及临床营养(医)师对于肿瘤患者食欲下降的识别、评估和营养治疗水平,使患者临床获益。     

Reliability and Validity of the Malay Version of a Modified Smoking Self-Efficacy Questionnaire among Bruneian Secondary Students

Introduction: The 12-items Smoking Self-Efficacy Questionnaire (SEQ-12) has been shown to be a valid and reliable instrument to assess confidence in one’s ability to refrain from smoking. However, although such measures have been validated worldwide, most of them have not been culturally and linguistically adapted for use among Malay communities. The objective of this study was therefore to modify the SEQ-12 according to the Bruneian context for cultural adaptation for use among Bruneian adolescents, and assess the validity and reliability of the Malay translated version among secondary students. Methods: The original English version of the SEQ-12 was modified according to Bruneian context, translated and back-translated into and from the Malay language. The Malay version was then pre-tested and finally distributed to 40 purposively selected students in two secondary schools in Bandar Seri Begawan, Brunei Darussalam. Reliability was determined using Cronbach’s alpha for internal consistency, while to assess the construct validity, an exploratory principle component factor analysis with varimax rotation was applied. Test-retest reliability was assessed with the students and tested using the intraclass correlation coefficient (ICC). Results: In total, 31 students participated with the initial questionnaire and the test-retest reliability. Exploratory factor analysis revealed two factors, representing two constructs as in the original questionnaire. Cronbach’s alpha co-efficients for the first and second factors were 0.87 and 0.92, respectively. The test-retest reliability test showed an ICC of 0.98 (95%CI: 0.96, 0.99). Conclusions: The Malay version of the M-SEQ-12 is a valid and reliable scale, with potential applications in both research and clinical settings. It is a useful instrument for measuring self-efficacy regarding avoidance of smoking among Bruneian secondary students. Further analysis is necessary to assess the concurrent validity of the M-SEQ-12.     

Reliability and Validity of the Malay Version of the Breast-Impact of Treatment Scale (MVBITS) in Breast Cancer Womenundergoing Chemotherapy

Background: Body image dissatisfaction among breast cancer survivors has been associated with psychologicalstress resultant from breast cancer and resultant surgery. This study aimed to examine the psychometric propertiesof the Malay Version of the Breast-Impact of Treatment Scale (MVBITS) and to investigate the associations ofretained factors with the Hospital Anxiety and Depression Scale (HADS) and the Rosenberg Self-Esteem Scale(RSES). Materials and Methods: The MVBITS was ‘forward–backward’ translated from English to Malay andthen administered to 70 female breast cancer patients who came to the Oncology Clinic of University MalayaMedical Centre, Kuala Lumpur, Malaysia to undergo chemotherapy. Principal component analysis (PCA)with varimax rotation was performed to explore the factor structure of the MVBITS. Associations of retainedfactors were estimated with reference to Spearman correlation coefficients. Results: The internal consistencyreliability of MVBITS was good (Cronbach’s alpha 0.945) and showed temporal stability over a 3-week period.Principal component analysis suggested two factors termed as ‘Intrusion’ and ‘Avoidance’ domains. Thesefactors explained 70.3% of the variance. Factor 1 comprised the effects of breast cancer treatment on theemotion and thought, while Factor 2 informed attempts to limit exposure of the body to self or others. The Factor1 of MVBITS was positively correlated with total, depression and anxiety sub-scores of HADS. Factor 2 waspositively correlated with total and anxiety sub-scores of HADS. MVBITS was also positively correlated withthe RSES scores. Conclusions: The results showed that the Malay Version of Breast-Impact of Treatment Scalepossesses satisfactory psychometric properties suggesting that this instrument is appropriate for assessment ofbody change stress among female breast cancer patients in Malaysia.     

Reliability and Validity of Turkish Version of the Caregiver Quality of Life Index Cancer Scale

Background: Measuring effects of cancer on family caregivers is important to develop methods which canimprove their quality of life (QOL) . Nevertheless, up to now, only a few tools have been developed to be usedin this group. Among those, the Caregiver Quality of Life Index-Cancer Scale (CQOLC) has met minimumpsychometric criteria in different populations in spite of conflicting results. The present study was conducted toevaluate reliability and validity of CQOLC among Turkish cancer family caregivers. Materials and Methods:The CQOLC was administered to 120 caregivers, along with Beck Depression Inventory (BDI), MedicalOutcomes Study MOS 36- Item Short Form Health Survey (SF-36), State–Trait Anxiety Inventory (STAI), andMultidimensional Scale of Perceived Social Support (MSPSS). Internal consistency and test-retest stability wereused to investigate reliability. Construct validity was examined by using known group method, convergent, anddivergent validity. For the known group method, we hypothesized that CQOLC scores would differ betweendepressed and non-depressed subjects. We investigated convergent validity by correlating scores for CQOLCwith scores for other similar measures including SF-36 and STAI. The MSPSS was completed at the same timeas CQOLC to provide divergent validity. Results: The values for internal consistency and test-retest correlationwere 0.88 and 0.96, respectively. The CQOLC discriminated those who were depressed from those who werenot. Convergent validity supported strong correlations between CQOLC scores and two main component scores(PCS, MCS) in SF-36 although there was a weak correlation between CQOLC and STAI scores. Regardingdivergent validity, the correlation between CQOLC and MSPSS was in the low range, as expected. Conclusions:The Turkish CQOLC is a reliable and valid tool and it can be utilized to determine QOL of family caregivers.     

Psychometric Evaluation of the FACT Colorectal Cancer Symptom Index (FCSI‐9): Reliability,Validity, Responsiveness,and Clinical Meaningfulness

Background.

Patient-reported outcomes (PROs) are essential for evaluating treatment effects on health-related quality of life and symptoms from the patient''s perspective. This study sought to evaluate the psychometric properties of the nine-item Functional Assessment of Cancer Therapy/National Comprehensive Cancer Network Colorectal Cancer Symptom Index (FCSI-9) in a metastatic colorectal cancer (mCRC) population.

Methods.

The FCSI-9 and EQ-5D were administered every 2–4 weeks to mCRC subjects in a phase III clinical trial. Three hundred ninety-one mCRC subjects completed the questionnaires at baseline and at least one follow-up assessment. Internal consistency reliability, test–retest reliability, construct validity, known groups validity, responsiveness, and the minimum important difference (MID) of the FCSI-9 were evaluated.

Results.

The internal consistency and test–retest reliability of the FCSI-9 were acceptable (0.81 and 0.76, respectively). Construct validity was supported based on moderate correlations with the EQ-5D. Known groups validity was evaluated by examining the FCSI-9 scores of subjects categorized by their Eastern Cooperative Oncology Group performance status (PS) score. Subjects with better PS scores reported significantly higher FCSI-9 scores than those with lower PS scores at both baseline and week 8. Responsiveness, as measured by Guyatt''s statistic, was 0.77 from baseline to week 8 and 0.60 from week 4 to week 12. Considering all data together, the MID of the FCSI-9 is estimated to be in the range of 1.5–3.0 points.

Conclusion.

Results provide preliminary evidence of the reliability, validity, and responsiveness of the FCSI-9.     

Reliability and Validity of an Assessment of Usual Phytoestrogen Consumption (United States)

Objective To evaluate the reliability and validity of a food-frequency questionnaire (FFQ) and database designed to quantify phytoestrogen consumption. Methods This study included 195 members of the California Teachers Study (CTS) cohort who, over a 10-month period, completed four 24-h dietary recalls, a pre- and post-study FFQ, and provided two 24-h urine specimens. Participants (n=106) in a parallel study (and 18 women who dropped out of the long-term study) completed a single recall and FFQ, and provided one 24-h urine specimen. Urinary phytoestrogens were determined using liquid chromatography–mass spectrometry. Reliability and validity were evaluated using Shrout–Fleiss intraclass correlations and energy-adjusted deattenuated Pearson correlations, respectively. Results Correlations reflecting the reproducibility of the FFQ phytoestrogen assessment ranged from 0.67 to 0.81. Validity correlations (FFQ compared to dietary recalls) ranged from 0.67 to 0.79 for the major phytoestrogenic compounds (i.e., daidzein, genistein, and secoisolariciresinol) and 0.43 to 0.54 for the less common compounds. Compared to urinary levels, validity correlations ranged from 0.41 to 0.55 for the isoflavones and 0.16 to 0.21 for total lignans. Conclusion Our isoflavone assessment is reproducible, valid, and an excellent tool for evaluating the relationship with disease risk in non-Asian populations. Further research is needed before these tools can accurately be used to assess lignan consumption. All work was performed at the Northern California Cancer Center with the exception of the laboratory analyses which were performed at the University of Alabama, Birmingham.     

Validity and Reliability of Health Belief Model Questionnaire for Promoting Breast Self-examination and Screening Mammogram for Early Cancer Detection

Background: Early detection of breast cancer is essential in improving overall women’s health. The researchers sought to develop a comprehensive measure that combined the basic components of the health belief model (HBM) with a focus on breast self-examination (BSE) and screening mammogram amongst women.Methods: Questionnaire items were developed following a review of relevant literature of HBM on BSE and screening mammogram. The sampling frame for the study was Malaysian women aged 35 to 70 years old, living in Kuantan, Pahang and able to read or write in Bahasa Malaysia or English. As such, 103 women were randomly selected to participate in the study. Tests of validity using exploratory factor analysis (EFA) and reliability were subsequently performed to determine the psychometric properties of the questionnaire. Results: The EFA revealed nine factors (self-efficacy of mammogram, perceived barriers of BSE and mammogram, perceived susceptibility of breast cancer, perceived severity of breast cancer, cues to action for mammogram screening, perceived benefits of BSE, health motivation, perceived benefits of mammogram and self-efficacy of BSE) containing 54 items that jointly accounted for 74.2% of the observed variance. All nine factors have good internal consistency with Cronbach’s alpha ≥ 0.8. Fifty-four items remained in the final questionnaire after deleting 13 problematic items. The scale also showed good convergent and discriminant validity.Conclusion: The findings showed that the designed questionnaire was a valid and reliable instrument for the study involving women in Kuantan, Pahang. The instrument can help to assess women’s beliefs on BSE adoption and mammogram screening in health care practice and research.     

Reliability and validity of the Childhood Cancer Survivor Study Neurocognitive Questionnaire

BACKGROUND.

Up to 40% of childhood cancer survivors may experience neurocognitive impairment in 1 or more specific domains. As such, regular monitoring has been recommended for patients exposed to cranial irradiation and/or antimetabolite chemotherapy. This study reports the results of a questionnaire developed to identify those survivors who may be experiencing neurocognitive problems.

METHODS.

Participants for this study were 7121 members of the Childhood Cancer Survivor Study cohort (6739 survivors and 382 siblings). These participants completed a new neurocognitive questionnaire designed to assess functions commonly affected by cancer therapy, as well as a standard measure of emotional functioning. A measure of cognitive and emotional functioning was also completed on a subset of the patients roughly 7 years before the current questionnaire. Responses to the questionnaires among subgroups of survivors were then analyzed to examine the reliability and validity of the new neurocognitive questionnaire.

RESULTS.

Four reliable factors were identified that assessed task efficiency, emotional regulation, organization, and memory skills. These neurocognitive factors accurately discriminated survivors who were at “high risk” for neurocognitive dysfunction, because of neurologic abnormalities or a history of intensive focal cranial irradiation, from healthy “low‐risk” survivors and siblings.

CONCLUSIONS.

The questionnaire demonstrated excellent reliability, as well as construct and discriminative validity. It appears to be a practical and efficient tool for monitoring neurocognitive outcomes in adult survivors of pediatric cancer. Cancer 2008. © 2008 American Cancer Society.