间歇性外斜视生存质量评估量表的应用研究

Utilization of Quality-of-life assessment Questionnaires for Intermittent Exotropia in China

目的 评价中文版间歇性外斜视生存质量评估量表（CIXTQ）的信度与效度.方法 横断面研究.将Hatt等研制的英文版间歇性外斜视生存质量评估量表（IXTQ）翻译成中文.CIXTQ包括3部分：儿童量表[包括5～7岁和8～17岁2种,用于儿童评估自身的健康相关生存质量（HRQoL）]、家长代理量表（用于家长评估儿童的HRQoL）和家长量表（包括功能、社会心理和手术3个维度,用于家长评估自身的HRQoL）.对175例间歇性外斜视（IXT）儿童（IXT组）和151例眼位健康儿童（对照组）及其家长采用CIXTQ进行调查.以克朗巴赫α系数和分半信度评估CIXTQ的内部一致性信度;以Kappa系数评估CIXTQ的重测信度;以平均量表水平内容效度指数（S-CVI/Ave）评价CIXTQ的内容效度;以主成分分析法评估CIXTQ家长量表的结构效度;采用独立样本t检验比较IXT组与对照组的CIXTQ得分,以评估CIXTQ的区分效度.结果 各年龄段CIXTQ儿童量表、家长代理量表、家长量表总量表及其3个维度的克朗巴赫α系数为0.80～0.96;分半信度为0.66～0.96,除5～7岁年龄段家长代理量表外,其余分半信度均高于0.70;重测信度的kappa系数为0.57～0.94.各量表的S-CVI/Ave为0.97 ～0.99.各年龄段家长量表经主成分分析法所提取的综合变量均可归纳为功能、社会心理和手术3个维度.IXT组CIXTQ得分（8.0±12.5～81.6±15.1）明显低于对照组（83.1± 11.3～99.6± 1.2）,差异具有统计学意义（t=-50.36～-6.93,P＜0.01）.结论 CIXTQ具有良好的信度和效度,可用于我国IXT患儿及其家长的HRQoL评估.

Objective To evaluate the reliability and validity of Chinese version of Quality-of-life assessment Questionnaires for Intermittent Exotropia （CIXTQ）.Methods Cross-sectional study.The original English version of the IXTQ was translated into Chinese.The final Chinese version of the IXTQ （CIXTQ） consists of 3 parts：the 12-item child CIXTQ （for children ≥5 and〈8 years old and ≥8 and〈18 years old,respectively,to assess their health quality of life （HRQoL））,the 12-item proxy CIXTQ （for parents to assess children＇s HRQoL）,and the 17-item parent CIXTQ （containing functional,psychosocial,and surgery subscales;for parents to assess their HRQoL）.175 IXT children and 151 control children along with one of their parents were recruited to answer the CIXTQ.Cronbach＇s α coefficient and split-half reliability were used to test the internal consistency reliability of the CIXTQ.Kappa coefficient was used to assess the test-retest reliability.Scale-level content validity index/average （S-CVI/Ave） was used to evaluate the content validity of the CIXTQ.Principal component analysis （PCA） was used to verify the construct validity of the parent CIXTQ.Comparison of different CIXTQ scores in IXT patients with controls was conducted by independent-samples t test to evaluate the discriminate validity of the CIXTQ.Results For all scales and subscales of the CIXTQ in different age groups,the Cronbach＇s α ranged from 0.804 to 0.963;the split-half reliability ranged from 0.658 to 0.963 and was higher than 0.7 except for the proxy CIXTQ for children aged ≥5 and〈8 years old;the test-retest reliability ranged from 0.569 to 0.94 4.The S-CVI/Ave of the child,proxy and parent CIXTQ was 0.988,0.988 and 0.966,respectively.Principal factors identified by PCA for the parent CIXTQ could be regrouped into the originally described 3 subscales which was functional,social psychology and surgery in different age groups.The mean scores of all the scales and subscales among IXT children and their parents （8.0±12.5-81.6 ± 15.1） were significantly lower than these among control children and their parents （83.1±11.3-99.6± 1.2） （t values range from-50.36 to-6.93,P〈0.001）.Conclusions The CIXTQ are useful tools to evaluate the influence of IXT on HRQoL among Chinese children and their parents.