QLQ-H＆N35量表在鼻咽癌患者生存质量测评中的应用

Assessment of psychological characteristics of EORTC QLQ-H＆N35 scale in nasopharyngeal carcinoma patients

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。

Objective To assess the psychological characteristics of EORTC QLQ-H＆N35 scale, and to explore whether QLQ-H＆N35 scale is suitable to measure the qulity of life （QOL） in nasopharyngeal carcinoma （NPC） patients. Methods The data of 391 NPC patients from Cancer Hospital of Sun Yat-Sen University was collected. Split-half reliability, Cronbach＇s α coefficient, content validity, construct validity, discriminant validity, and feasibility of QLQ-H＆N35 were performed. Person separation index （PSI）, the order of item threshold, and differential item functioning were analyzed. Results Cronbach s of coefficient and split-half reliability of QLQ-H＆N35 were higher than 0.7, except for sense parameter. All Test-retest coefficients of QLQ-H＆N35 weie higher than 0.7. The result of factor analysis showed that the data was consistent with the theoretical model. Most of the domain scores and dimension scores of patients with different radiotherapy stages were significantly different （P 〈 0.05）. PSI of the model was 0.90. Most of the order of item threshold were normal. All the items had no uniform or non-uniform DIF among different genders and age groups. Conclusion QLQ-H＆N35 scale is a reliable,operable, and valid disease-specific scale for the evaluation QOL in NPC patients.