哮喘联盟

   摘要
   背景：目前还没有针对特定疾病的用来描述印度哮喘患者的健康相关生活质量（HRQoL）的工具。然而，世界卫生组织生活质量调查问卷的缩写（WHOQOL-简表），一个通用的印地文HRQoL量表已经在印度制定并得到验证。
   目的：旨在评估成人哮喘患者使用WHOQOL-简表的情况，并检测对本工具可能的修改以提高其心理测试的充分性。
   方法： 67例哮喘患者完成WHOQOL-简表。使用罗序分析观察四个领域（生理、心理、社会关系和环境）的心理表现。研究观察每个领域的数据整体拟合情况（模型预期）、相应类别的排序情况、项目是否存在不同的功能、针对患者能力的单个项目的适宜情况和达到项目目标的难易情况。研究对不适宜项目进行项目缺失和成绩复查，以改善整体功能。
   结果：WHOQOL-简表数据的整体拟合是适当的。项目3（疼痛防止工作）显示一个大的正拟合残值（提示与单维度假设冲突），从而导致物理领域较差的结构效度。没有任何项目表现出不同的项目功能。十个项目存在无序的阈值。通过放弃项目3和复查16项结构类别的成绩对WHOQOL-简表进行修改。修改后量表的所有域具有较好的结构效度、所有项目具有有序的阈值、项目中具有针对个人的良好的目标。
   结论：WHOQOL-简表用于描述研究中哮喘患者的HRQoL不充分。然而，通过罗序分析修改，已证实量表较原来的量表更好。
 

（林江涛 审校）
NPJ Prim Care Respir Med. 2014 Jun 12;24:14001. doi: 10.1038/npjpcrm.2014.1.


 

Abbreviated World Health Organization Quality of Life questionnaire (WHOQOL-Bref) in north Indian patients with bronchial asthma: an evaluation using Rasch analysis.
 

Aggarwal AN, Agarwal R, Gupta D.
 

ABSTRACT
BACKGROUND:There is no disease-specific instrument to describe health-related quality of life (HRQoL) in Indian patients with asthma. However, an abbreviated World Health Organization Quality of Life questionnaire (WHOQOL-Bref), a generic Hindi HRQoL measure, has been developed and validated in India.Aims:To evaluate the WHOQOL-Bref in adult patients with asthma and to test possible modifications to the instrument to improve its psychometric adequacy.
METHODS:Sixty-seven patients with asthma completed the WHOQOL-Bref. Rasch analysis was used to explore the psychometric performance of the four domains (physical, psychological, social relationships and environment) of the scale. Overall fit of data to model expectations, appropriate category ordering, presence of differential item functioning, individual item fit and targeting of item difficulty to patient ability were explored for each domain. Item deletion and rescoring were applied to misfitting items to improve overall performance.
RESULTS:The overall fit of the WHOQOL-Bref data was adequate. Item 3 (pain prevents doing work) displayed a large positive fit residual value (indicating violation of unidimensionality), resulting in poor construct validity for the physical domain. No item exhibited differential item functioning. Ten items had disordered thresholds. The WHOQOL-Bref was modified by dropping item 3 and rescoring category structures of 16 items. The modified scale had good construct validity for all domains, ordered thresholds for all items and good targeting of items to persons.
CONCLUSIONS:The WHOQOL-Bref performed inadequately in describing HRQoL in the asthma patients studied. However, when modified by Rasch analysis, the scale proved better than the original scale.
 

NPJ Prim Care Respir Med. 2014 Jun 12;24:14001. doi: 10.1038/npjpcrm.2014.1.