直肠癌术后患者生活质量量表初步编制与评估

The development of the quality of life questionnaire for postoperative rectal cancer patients

目的编制和检验适合国情、符合直肠癌术后患者生活质量的评定工具。方法形成条目库并进行条目和因素分析以选取合适条目构成多维度量表,然后选择70例直肠癌术后患者,对量表进行信度和反应度检验。结果经筛选和测试形成包括一般症状、手术反应、功能3个分量表,后者又包括躯体功能、角色功能、情绪功能(焦虑和抑郁)、认知功能和社会功能5个功能子量表,以及经济困难、工作和生活期望和总体健康状况共37项条目的自评量表(QLQ-PRC-37)。功能子量表因子分析显示因子数与量表的理论结构一致,同时具有较好的可信度、区分效度及一定的效标效度。结论本量表通过信度和效度检验,可作为直肠癌术后患者生活质量评定工具。

Objective To develop and validate a means-suitable for measuring the quality of life in Chinese postoperative rectal cancer patients. Methods A pool of items were selected from hterature review,interviews with patients and experts in oncology and psychology. Then the preliminary questionnaire was administered to 70 patients. Items reduction was done by item analysis to weight the critical ratio-CR value. Factor analysis was performed to identify domains. These domains were assessed for reliability and validity. Results The 37-item self-administered questionnaire called QLQ-PRC-37 was developed. The questionnaire comprised 3 domains：general symptom,function assessment and postoperative reaction as well as 4 single items ： future perspectives, economy problem, general health and general quality of life. Domain scores were reproducible after 7 days （ r = 0.739 - 0.951 ） and were internally reliable （ Cronbach α = 0. 6785 - 0. 9472）. In an exploratory principal axes factor analysis for function assessment,82.021% of the common variance was explained by 6 factors that correlated with the initial domains. Patients with high anterior resection responded with higher scores than those with low anterior resection, and patients with abdominoperineal resection and stoma experienced the lowest results. Conclusions QLQ-PRC-37 is valuable in the measurement of quality of life in the postoperative rectal cancer patients.