2型糖尿病患者的EQ-5D量表结构效度分析

A construct validity analysis and application of EQ-5D among type 2 diabetes patients

目的分析2型糖尿病患者的EQ-5D结构效度,以进一步认识和应用。方法资料来自于2010年全国23个省(市)的103个临床试验中心调查资料,对象为9872例15岁及以上的口服降糖药物的2型糖尿病患者。采用验证性因子分析进行结构效度分析,并用PA-OV递归模型(Path analysis with observed variables)来探索生活质量影响因素。结果量表5个维度可以提取出2个公因子,分别命名为"主动生活质量"和"感知生活质量"。行动、平常活动和自我照顾三维度在"主动生活质量"上因子载荷分别为0.82、0.84和0.88,而疼痛、不舒服在"感知生活质量"上因子载荷分别为0.71和0.56,自我照顾存在跨因子现象。主动和感知生活质量2个初阶因子在"整体生活质量"上的因子载荷分别为0.66和0.88。一阶和二阶验证性因子分析模型适配度均较好,模型稳定。结论验证性因子分析能较好地评价EQ-5D结构效度,并能应用于2型糖尿病患者生活质量影响因素的探索。

Objective To analyze the construct validity of European Quality of Life （QoL） - 5 Dimensions （EQ -5D） among type 2 diabetes patients for its further understanding and application. Methods Data from a nationwide multi - center clinical survey in 2010 was used. A total number of 9872 type 2 diabetes patients over 15 years old and taking Oral Antidiabetic Drugs（OAD） were investigated. Confirmatory factor analysis （CFA） was applied to test construct validity and Path Analysis with Observed Variable （ PA - OV） was used to explore the influencing factors. Results Two common factors were extracted from 5 dimensions and named as Initiative QoLtand Perception QoL＇respectively. Factor loading of mobility, usual activities and self - care on Initiative QoL＇was 0. 82, 0. 84 and 0.88 respectively, and the factor loading of pain and anxiety on Perception QoL was 0. 71 and 0. 56 respectively. However, self- care dimension covered two factors. Factor loading of Initiative QoL and Perception QoL on Whole QoL was 0. 66 and 0. 88 respectively. Model of first - stage and second - order CFA both had well fitness and stability. Conclusion CFA could well evaluate construct validity of EQ - 5 D and can be applied to explore influencing factors of Qol among type 2 diabetes patients.