癌症患者生命质量测定量表体系的测量学特性与应用

目的对癌症患者生命质量测定量表体系QLICP(V1.0)中已研制的头颈癌、脑癌、肺癌、乳腺癌、食管癌、胃癌、大肠癌、肝癌、宫颈癌、卵巢癌、白血病及淋巴瘤12种癌症量表的构成、测量学特性(信度、效度、反应度)及应用情况等进行报告与评价。方法通过对相应肿瘤患者进行生命质量测定得到的实测数据,采用计算总量表及各个领域的Cronbach'sα系数和重测相关系数来评价量表的内部一致性信度和重测信度;校标效度用两个量表间的相关系数反映;反应度通过比较治疗前后各领域生命质量的得分均数,并计算各领域标准化反应均数SRM值来考评。通过量表使用协议及文献检索等方式了解12种癌症患者生命质量测定量表的应用情况。结果12种癌症患者生命质量测定量表均有较好的结构(5个领域11~15个侧面),有较好的信度(总量表的内部一致性α系数为0.67~0.92、重测信度r为0.61~0.99)、较好的效度(与效标相关系数为0.28~0.89)和一定反应度(SRM为0.25~1.28),且被广泛用于临床上相应癌症患者的生命质量的测定及相关研究。结论QLICP(V1.0)系列结构合理,层次清晰(条目→侧面→领域→总量表),测量学特性均符合要求,具有很好的推广应用价值。

Psychometric properties and applications of the system of quality of life instruments for cancer patients

Objective To present briefly introductions and evaluations on the constructs,psychometric properties(reliability,validity,reactivity etc.)and applications of the system of Quality of Life Instruments for Cancer Patients QLICP(V1.0)including 12 kinds of scales for patients with head and neck cancer,brain cancer,lung cancer,breast cancer,esophageal cancer,gastric cancer,colorectal cancer,liver cancer,cervical cancer,ovarian cancer,leukemia and lymphoma.Methods Based on our measuring data from relevant patients at hospitals,the constructs,characteristics and psychometrics of the system above were analyzed and presented.Internal consistency reliability for each domain and the overall scale was assessed using Cronbach's alpha coefficient,and test-retest reliability through calculating the Pearson correlation coefficient between the first and second assessments.The criterion-related validity was evaluated by correlating corresponding domains of two instruments.Responsiveness was assessed through comparing the mean difference between the pre-treatment and post-treatments with standardized response mean(SRM).The use agreements and literature reviews of this system were used to understand the applications of 12 kinds measurement scales.Results The quality of life scales for 12 kinds of cancer patients of the system QLICP(V1.0)have good construct(5 domains,11-15 facets),reliability,validity and a certain degree of responsiveness.The internal consistency reliability Cronbach's α coefficients for the overall scale of QLICP in different cancers was from 0.67 to 0.92,and the test-retest reliability(correlation coefficient)was from 0.61 to 0.99.The criterion-related validity(correlation coefficient)was for the overall scale of QLICP in different cancers was from 0.28 to 0.89,and the responsiveness SRM was from 0.25 to 1.28.And also they were widely used in clinical practice and relevant studies for the corresponding cancers.Conclusion The system QLICP(V1.0)is of outstanding characteristics with all psychometrics meeting requirements and better construct(clear hierarchical structure with items→facets→domains→overall),and can be used widely in clinical practice further.