癌症患者生命质量测定量表体系QLICP(V1.0)及其与欧洲QLQ和美国FACT量表的比较

杨铮 全鹏 罗家洪 孟琼 李高峰 寸英丽 万崇华
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Abstract

Objective To compare the differences and similarities among the system of quality of life instruments for cancer patients (QLICP) V1.0, the quality of life questionnaire (QLQ) from European Organization for Research and Treatment of Cancer (EORTC) and Functional Assessment of Cancer Therapy (FACT) from Center on Outcomes, Research and Education (CORE) of America. Methods Based on literatures and our measuring data from patients at hospitals, the constructs, characteristics and psychometrics of the systems above were analyzed and compared. Internal consistency reliability was assessed using Cronbach α coefficient for each domain, and test-retest reliability through calculating the Pearson correlation coefficient r between the first and second assessments as well as intra-class correlation (ICC). Construct validity was evaluated by Pearson correlation coefficient r (item-domains correlations) and factor analysis. 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-treatment with standardized response mean (SRM). Results The instruments of three systems were of different outstanding characteristics with all psychometrics meeting requirements. Measurements for 12 types of cancers showed that the internal consistency reliability Cronbach α coefficient for the overall scale of QLICP (V1.0) was 0.67-0.92, and for FACT was 0.79-0.98. The test-retest reliability (r or ICC) for the overall scale of QLICP (V1.0) was 0.61-0.99, and for FACT was 0.60-0.98. The SRM for the overall scale of QLICP (V1.0) was 0.25-1.28, and for FACT was 0.11-0.83. However, the QLICP was of better construct (clear hierarchical structure with items→facets→domains→overall) and Chinese culture. Conclusion The instruments of three systems can be used as the instruments to assess quality of life for patients with cancer with selections basing on different settings. Key words: Quality of life; Neoplasms; Behavior rating scale; Quality of life instruments for cancer patients
癌症患者生命质量测定量表体系QLICP(V1.0)及其与欧洲QLQ和美国FACT量表的比较
目的比较癌症患者生活质量评估系统(QLICP) V1.0版、欧洲癌症研究与治疗组织(EORTC)的生活质量问卷(QLQ)和美国结局、研究与教育中心(CORE)的癌症治疗功能评估(FACT)的异同。方法根据文献资料和我们在医院对患者的测量数据,对上述系统的结构、特点和心理测量学进行分析和比较。采用各域的Cronbach α系数评估内部一致性信度,并通过计算第一次和第二次评估之间的Pearson相关系数r以及类内相关(ICC)来评估重测信度。构念效度以Pearson相关系数r(项目域相关系数)及因子分析评估。通过两种工具对应域的相关性来评估标准相关效度。通过标准化反应均值(SRM)比较治疗前和治疗后的平均差异来评估反应性。结果三个系统的仪器各有突出特点,心理测量指标均达到要求。12种癌症的测量结果表明,QLICP (V1.0)总体量表的内部一致性信度Cronbach α系数为0.67 ~ 0.92,FACT量表的内部一致性信度Cronbach α系数为0.79 ~ 0.98。QLICP (V1.0)总体量表的重测信度(r或ICC)为0.61 ~ 0.99,FACT量表的重测信度(r或ICC)为0.60 ~ 0.98。QLICP (V1.0)整体量表的SRM为0.25 ~ 1.28,FACT量表的SRM为0.11 ~ 0.83。而QLICP具有较好的结构(层次结构清晰,项目→层面→领域→整体)和中国文化。结论三个系统的仪器均可作为评估肿瘤患者生活质量的仪器,可根据不同的环境进行选择。关键词:生活质量;肿瘤;行为评定量表;癌症患者的生活质量仪器
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