QLQ-H&N35量表在鼻咽癌患者生存质量测评中的应用

 目的　对欧洲癌症研究组织（EORTC）头颈癌生存质量问卷（QLQ-H&N35）进行计量心理学考核,以考评量表是否适合于鼻咽癌患者生存质量的测评。方法　收集中山大学肿瘤防治中心的391例鼻咽癌患者的QLQ-H&N35和人口学资料,考核量表的信度、效度、区分度,条目进行项目反应理论（IRT）分析,考察个体分离指数（PSI）、条目阈值参数的排序,进行项目功能差异（DIF）分析。结果　除感觉问题外,各个领域的内部一致性信度和分半系数均大于0.7,所有领域的重测系数都大于0.7,因子分析的结果显示实际的数据跟理论模型一致。不同放疗阶段的患者在大部分领域得分的差异具有统计学意义。整个模型的PSI为0.90,大部分条目的阈值顺序均正常,所有条目在性别、年龄分组上没有一致性DIF和非一致性DIF。结论　QLQ-H&N35是一个具有良好的信度、效度、区分度和计量心理学特征的癌症量表,可操作性强,可用于鼻咽癌患者的生存质量评价。     

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。     

SF-36中文版健康状况调查表评价鼻咽癌疗后长期存活者适用性研究

目的 评价美国SF-36中文版健康状况调查表用于鼻咽癌疗后长期存活者的适用性.方法 85例鼻咽癌疗后长期存活者通过电话或信访方式完成评价,相关分析、信度分析和因子分析等统计方法用于评价SF-36中文版的信度和效度.结果 分半信度为0.92,各领域克朗巴赫系数α均>0.7,说明信度较好且各领域间有较好区分度.每个条目跟相关领域的相关系数都达到或接近0.5,并且各条目与所属领域相关系数均高于该条目与其他领域的相关系数,说明量表有较好的内容效度和区分效度.量表共提取6个主成分,基本反映了量表8个领域,累计方差贡献率为71.4%.8个领域提取2个公共因子,解释73.3%变异.SF-36中文版判别效度较好,能区分鼻咽癌患者和正常人群的生存质量.结论 SF-36中文版易于完成,具有较好的信度和效度,可应用于鼻咽癌疗后长期存活者生存质量的评价.     

鼻咽癌患者中SF-36量表的信度和效度的研究

目的：评价简明健康调查量表（36-items short form health survey,SF-36）在鼻咽癌患者生存质量应用中的信度和效度。方法：2007年1月21日～2月7日,统一受训的调查员使用SF-36对526例确诊的鼻咽癌患者进行自评量表式调查,并采用相关分析、信度分析和因子分析等统计方法分析量表的信度和效度。结果：SF-36具有较好的分半信度和内部信度;除活力（VT）和社会功能（SF）外（信度系数≥O．6）,各领域的内部信度系数均≥0．7。每务目跟相关领域的相关系数均〉0．53,而且高于该条目与其他领域的相关系数,说明SF36有良好的内容效度和区分效度。所有条目提取的7个主成分分布代表了各个领域,累计贡献达61．18％;8个领域得分提取2个公共因子,解释58．90％的变异。因子分析产生的结果与量表的理论结构假设基本一致。结论：SF-36有较好的信度和效度,可用于评价鼻咽癌患者的生存质量。     

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.     

肿瘤患者生命质量量表维文版测试效果评价

[目的]分析维文版EORTC QLQ-C30（V3）生命质量量表、维文版QLICP-GM（V1.0）量表的信度和效度。[方法]将EORTC QLQ-C30（V3）生命质量量表、我国自主研制的中文版QLICPGM（V1.0）量表进行翻译、回译及部分文化调适后分别产生维文量表,分别对497例在新疆维吾尔族自治区肿瘤医院住院确诊的恶性肿瘤患者进行问卷调查,分析量表的内部一致性、重测信度、内容效度、区分效度和结构效度等指标。[结果]QLICP-GM量表的内部一致性优于EORTC QLQ-C30量表,但重测信度不如EORTC QLQ-C30量表。QLICP-GM量表的内容效度、区分效度均优于EORTC QLQ-C30量表。[结论]维文版QLICP-GM量表具有良好的信度和效度,更适合应用于新疆公共卫生和其它医学领域。     

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。     

食管癌化疗患者生存质量测定量表中文版的研制与考评

目的:应用欧洲癌症研究与治疗组织(EORTC)开发的问卷表QLQ-OES18为蓝本来研制其中文版,并对其进行考评。方法:通过量表的翻译、回译和文化调适制定出中文版的QLQ-OES18,并通过考查133例食管癌患者的生存质量对量表进行评价。对EORTCQLQ-OES18中文版量表主要进行信度、效度和反应度三方面的考评,采用克朗巴赫系数考察内部一致性;计算各个领域及方面间相关系数来分析量表的内容效度;使用配对t检验进行第1、2次测定及第1、3次测定得分均数的比较,考察量表的区分效度。结果:EORTCQLQ-OES18显示出较好的可靠性和良好的鉴别能力,能显示出化疗带来的生存质量改变。各领域内部一致性的信度都在0.61以上;各条目与其领域的相关系数值在0.6以上。结论:QLQ-OES18显示出较好的心理测定学和临床有效性,可推荐其与核心量表QLQ-C30联用,用来评估化疗后食管癌患者的生存质量。     

宫颈癌患者生命质量评价量表的编制及测评

目的:编制一套适合测评中国宫颈癌患者的生命质量评价量表(quality of life scale for cervical cancer patients,QLS-CCP),并评价其信度和效度.方法:通过文献查阅法、访谈法和专家咨询等方法确定条目池,形成初始量表.采用变异度法、t检验法、相关系数法和逐步回归法对初始量表进行条目筛选,形成最终的测试量表;采用新编制的Q LS-CCP对136例子宫颈癌患者进行调查,并对其信度和效度进行评价.结果:最终QLS-CCP包含躯体功能、心理、社会及与疾病症状4个维度,共32个条目.量表的重测相关系数、Cronbach'α系数和分半信度系数分别为0.96、0.93和0.85.效标效度较好(rs=0.591,P=0.000).因子分析找到4个公因子,可以解释总变异的57.22％,显示量表的结构效度良好,量表结构与理论构想相符,具有较好的区分效度.结论:新编制的QLS-CCP具有良好的信度和效度,可用于中国宫颈癌患者生存质量的测评.     

食管癌化疗患者生存质量测定量表中文版的研制与考评

[目的]应用欧洲癌症研究与治疗组织(EORTC)开发的问卷表QLQ-OES18为蓝本来研制其中文版,并对其进行考评。[方法]通过对QLQ-OES18量表的翻译、回译和文化调适制定出中文版的QLQ-OES18,并通过133例食管癌患者的生存质量对量表进行评价,主要进行信度、效度和反应度三方面的考评,采用克朗巴赫系数考察内部一致性;计算各个领域及方面间相关系数来分析量表的内容效度;比较第1、2次测定及第1、3次测定得分均数,考察量表的区分效度。[结果]EORTCQLQ-OES18显示出较好的可靠性和良好的鉴别能力,能显示出化疗带来的生存质量改变。各领域内部一致性的信度都在0.61以上;各条目与其领域的相关系数值在0.6以上。[结论]QLQ-OES18显示出较好的心理测定学和临床有效性,可推荐其与核心量表QLQ-C30联用评估化疗后食管癌患者的生存质量。     

Validation of the simplified Chinese version of EORTC QLQ-C30 from the measurements of five types of inpatients with cancer

Background: European Organization for Research and Treatment quality of life (QOL) questionnaire (QLQ-C30) has been used frequently and many language versions have been developed, including the simplified Chinese version. It is important to study psychometric properties of the simplified Chinese version from the clinical standpoint.Patients and methods: The simplified Chinese version of the QLQ-C30 was used in a longitudinal study of 600 patients with five types of cancer: lung, breast, head and neck, colorectal, and stomach. The psychometric properties of the scale were evaluated by indicators of validity and reliability coefficients such as Cronbach's α and Pearson's correlation coefficient r, standardized response mean (SRM), correlational analysis, t-tests, and structural equation models.Results: Correlation and structural equation model analyses confirmed good construct validity with root mean square error of approximation 0.054, standardized root mean square residual 0.037, non-normed fit index 0.972, and comparative fit index 0.980. The α coefficients for all domains are >0.7 except for cognitive functioning (0.49). The test–retest reliability coefficients for most domains are >0.80 except for appetite loss (0.77) and diarrhea (0.75). The QOL score changes after treatments were of statistical significance with higher or moderate SRM in most domains.Conclusion: The simplified Chinese version of QLQ-C30 has good validity, reliability, and responsiveness and can be used to measure QOL for Chinese cancer patients.     

Psychometric properties of the simplified Chinese version of the EORTC QLQ-BR53 for measuring quality of life for breast cancer patients

A Simplified Chinese version of the EORTC QLQ-BR53 was evaluated using responses from 233 patients with breast cancer in China by assessing the construct and criterion-related validity, internal consistency and test–retest reliability, and responsiveness as measured by score changes of the scales. Internal consistency reliability measured by Cronbach’s coefficient α is greater than 0.75 for most multi-item scales except cognitive functioning (0.41) and breast symptoms (0.71). Test–retest reliability coefficients for all domains are greater than 0.80 with the exception of physical functioning (0.65), social functioning (0.75), appetite loss (0.75), diarrhea (0.72), and body image (0.72). Correlation and factor analysis among domains and items showed good construct validity for both QLQ-C30 and QLQ-BR23. Score changes over time were observed in most domains except emotional functioning, global health status/QOL, dyspnoea, constipation, diarrhea, financial difficulties, sexual functioning, sexual enjoyment, and breast symptoms. Therefore, the Simplified Chinese version of QLQ-BR53 shows reasonable validity, reliability, and responsiveness and can be used to measure QOL for Chinese patients with breast cancer.     

Development and validation of the system of quality of life instruments for cancer patients: lung cancer (QLICP-LU)

Using the structured group methods (nominal and focus group) and the theory in instrument development, the quality of life instrument for lung cancer (QLICP-LU) with Chinese cultural background was developed, and evaluated based on the data from a sample of 85 in-patients of lung cancer. Statistical methods used were correlation analysis, factor analysis and paired t-test, etc. The results showed that test-retest reliability of the overall scale was 0.78, and test-retest reliability and internal consistency alpha for most domains were higher than 0.70; correlation and factor analysis demonstrated good construct validity; criterion-related validity were confirmed given FACT-L and QLQ-LC43 (QLQ-C30 plus QLQ-LC13) as the criterions; statistically significant changes were found for each domain and the overall scale with standardized response mean SRM being greater than 0.80 except for the social function domain. We conclude that the QLICP-LU can be used to measure QOL for patients with lung cancer with better validity, reliability and responsiveness in China.     

Validation Study of a Quality of Life (QOL) Questionnaire for Usin Iran.

Introduction: Recently, it has been recognized that a more comprehensive assessment of the cancer patient is necessary and that the evaluation of outcomes must move beyond traditional biomedical endpoints to include assessments of the impact of disease and its treatment on patients' quality of life. The European Organization for Research and Treatment of Cancer has developed a 30-item quality of life questionnaire to obtain information about the impact of disease and treatment on the daily living of cancer patients. This questionnaire has been translated into many languages and used in various countries. However, version 3.0 has not yet been validated for use with Iranian patients. The aims of the present study were therefore to evaluate the reliability and validity of the new QLQ-C30 questionnaire. Method: We conducted a cross-sectional study on 132 random samples of breast cancer patients. Reliability was evaluated through the internal consistency of multi-item subscales. Pearson's correlations of an item with its own scale (corrected for overlap) and other scales were calculated to evaluated convergent and discriminant validity. Clinical validity was evaluated by known-group comparisons. All calculations were performed using SPSS.V.13 software. Results: In the reliability analysis, most scales fitted the criteria except the fatigue (Alpha 0.65), pain (Alpha 0.69) and nausea and vomiting scales (Alpha 0.66). Convergent validity was evidenced by item own subscale correlation above 0.40 for all multi-item subscales. Item discriminant validity was successful in all analyses except for item 4 of the physical functioning scale. Results of the group based analysis show significant differences in QLQ-C30 functioning and symptom scores, where patients with higher grade have the worst outcome(P<0.05). Conclusion: The Iranian version of EORTC QLQC30 is a reliable and valid QOL measure for cancer patients which indicates that it can be used in clinical and epidemiological cancer research.     

Psychometric Validation of the Malaysian Chinese Version of the EORTC QLQ-C30 in Colorectal Cancer Patients

Background and Aims: Colorectal cancer is the second most frequent cancer in Malaysia. We aimed to assess the validity and reliability of the Malaysian Chinese version of European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire core (QLQ-C30) in patients with colorectal cancer. Materials and Methods: Translated versions of the QLQ-C30 were obtained from the EORTC. A cross sectional study design was used to obtain data from patients receiving treatment at two teaching hospitals in Kuala Lumpur, Malaysia. The Malaysian Chinese version of QLQ-C30 was self administered in 96 patients while the Karnofsky Performance Scales (KPS) was generated by attending surgeons. Statistical analysis included reliability, convergent, discriminate validity, and known-groups comparisons. Statistical significance was based on p value ≤0.05. Results: The internal consistencies of the Malaysian Chinese version were acceptable [Cronbach’s alpha (α≥ 0.70)] in the global health status/overall quality of life (GHS/QOL), functioning scales except cognitive scale (α≤0.32) in all levels of analysis, and social/family functioning scale ( =0.63) in patients without a stoma. All questionnaire items fulfilled the criteria for convergent and discriminant validity except question number 5, with correlation with role (r = 0.62) and social/family (r = 0.41) functioning higher than with physical functioning scales (r = 0.34). The test-retest coefficients in the GHS/QOL, functioning scales and in most of the symptoms scales were moderate to high (r = 0.58 to 1.00). Patients with a stoma reported statistically significant lower physical functioning (p=0.015), social/family functioning (p=0.013), and higher constipation (p=0.010) and financial difficulty (p=0.037) compared to patients without stoma. There was no significant difference between patients with high and low KPS scores. Conclusions:Malaysian Chinese version of the QLQ-C30 is a valid and reliable measure of HRQOL in patients with colorectal cancer.     

Psychometric properties of the Chinese version of the FACT-L for measuring quality of life in patients with lung cancer

A Simplified Chinese version of the FACT-L was evaluated using responses from 181 patients with lung cancer in China by assessing the construct, discriminative and criterion-related validity, internal consistency, test-retest reliability, and responsiveness as measured by score changes of the scales. Correlation and factor analysis among domains and items showed good construct validity, correlation analysis of domain scores between FACT-L and Quality of Life Instruments for Cancer Patients-Lung cancer (QLICP-LU) displayed good criterion-related validity, and comparison of two age groups demonstrated discriminative validity. Test-retest reliability and Internal consistency coefficients for all domains were greater than 0.75 with the exception of the domain of additional concerns (alpha=0.56). Score changes over time were statistically significant in the overall scale and all domains: standardized response mean (SRM) for physical well-being is 1.56, social/ family well-being 0.70, emotional well-being 0.93, and functioning well-being 1.51. Therefore, the Simplified Chinese version of FACT-L can be used to measure quality of life (QOL) for Chinese patients with lung cancer with good validity, reliability, and responsiveness.