《图示化膝关节炎患者自我评估问卷》的制定

Design of Visualized Self-assessment Questionnaire for Patients with Knee Osteoarthritis

目的制定《图示化膝关节炎患者自我评估问卷》,旨在促进膝关节炎患者的自我评估,协助疾病的长期管理。方法检索Pub Med、中国知网等多个国内外文献数据库,参考现有关节炎评分量表及患者临床主诉,建立问卷的维度与条目池。邀请90名骨科医生对条目的可理解性、重要性、可行性等进行评分。召开共15名资深骨科专家参与的咨询会,基于骨科医生的评分排序结果优化问卷,并对77例膝关节炎患者进行预调查,征集对问卷的意见与反馈,再次召开专家咨询会,进一步优化问卷条目与图案,形成问卷初稿。结果问卷初始条目池包括疼痛、炎症及功能3个维度共38个条目。90名骨科医生问卷应答率100%,量表题干及使用意愿评分排名前75%的条目共26个。专家咨询会优化形成16个条目,经参考患者反馈意见后,修改为疼痛、炎症及功能3个维度14个条目的问卷初稿。结论《图示化膝关节疼痛患者自我评估问卷》是中国首个自主开发的膝关节炎评估问卷。其制定广泛基于骨科专家及患者意见,可行性高,是一种简便、全面、量化的膝关节炎患者自我评估问卷,具有较高的临床应用价值。

Objective To design a visualized self-assessment questionnaire for patients with knee osteoarthritis in order to facilitate patient self-assessment and long-term management of this condition. Methods Several databases including PubMed and China National Knowledge Infrastructure （CNKI） were searched for existing scales on osteoarthritis that reflect patients, complaints, based on which a pool of dimensions and items was generated. Ninety orthopedists were invited to rate the intelligibility, importance, and feasibility of these items. Then an expert consultation meeting consisting of 15 senior orthopedic specialists was convoked to optimize the questionnaire based on the rating results. A pilot investigation was conducted in 77 patients with knee osteoarthritis, from whom opinions and feedback were collected for further optimization of the items and graphs in a following expert consultation meeting to formulate the first draft of the questionnaire. Results The initial pool of items covered 38 items in 3 dimensions, namely, pain, inflammation, and function. The response rate of the 90 orthopedists was 100% , while 26 items were ranked within the top 7 5 % regarding items expression and usage intention. The number of items was streamlined to 16 after the first round of specialist consultation meeting, and further reduced to 14 items in the first draft on the basis of patient feedback, still in the 3 dimensions of pain, inflammation, and function. Conclusions The visualized self-assessment questionnaire for patients with knee osteoarthritis is the first independently developed knee osteoarthritis assessment scale in China. It is a simple, comprehensive, and quantitative self-assessment tool for patients with knee osteoarthritis based on expert and patient opinions, with high feasibility and clinical significance.