中文版IND—VFQ-33在白内障人群中的应用与评价

Assessment of a Chinese version of the 33-item Indian Vision Functioning Questionnaire revised for use in a Chinese cataract population

目的研制中文版印度视功能量表（IND-VFQ—CN-33），评价其在中国白内障人群中的测量特性，并初步分析白内障患者术前生活质量的影响因素。方法横断面调查研究。对IND—VFO-33量表进行标准的翻译、回译和跨文化调试后，选取在温州医科大学附属眼视光医院确诊的白内障住院患者293例进行调查，其中45例患者用于评估2名调查者信度。通过Cronbach’s α系数分析量表的内部一致性；Pearson相关分析评估评定者间信度；内容效度指数评估内容效度；探索性因子分析评估结构效度，评价量表的适用性、项目区分度及信度、效度。通过独立样本t检验分析不同性别、年龄、文化程度条件下生活质量的差异，并通过单因素方差分析不同双眼远视力情况下生活质量的差异。结果中文版IND—VFQ-CN-33项目区分度好。内部一致性和评定者间信度较高，总表的Cronbach’s α系数为0．93。量表水平内容效度指数为0．84；结构效度的探索性因子分析提取出8个公因子，累积方差贡献率为67．62％。男性患者的心理评估子表得分高（t=-3．27，P〈0．05），文盲患者的视功能子表（t=-3．03，P〈0．05）和心理评估子表（t=-3．45．P〈0．05）得分高。单因素方差分析发现不同双眼远视力组间差异均有统计学意义（F=3．66～24．37，P〈0．05）。结论IND—VFQ-CN-33在中国白内障术前人群中适用性好，具有较优的测量特性，可用于中国白内障术前人群的生活质量评估研究。白内障男性患者的心理方面生活质量下降较女性更加显著，文盲患者的视功能和心理方面生活质量下降较非文盲患者更加显著。

Objective There were three objectives in this study： （1）To develop a Chinese version of the 33-item Indian Vision Functioning Questionnaire. （2）To assess the applicability, item discrimination, reliability, and validity of the developed Chinese questionnaire in a Chinese cataract population. （3）To compare the vision-related quality of life （VRQoL） within different demographics of the study population. Methods In this cross-sectional investigation,language translation, back translation, and cross-cultural adaptation were used to revise the IND-VFQ-33 and create the Chinese Vision Functioning Questionnaire （IND-VFQ-CN-33）. A total of 293 cataract in-patients waiting for surgery were interviewed by a single scorer, and 45 of them were independently interviewed again by another scorer. The IND-VFQ-CN-33 was tested for applicability, item discrimination, reliability, and validity based on internal consistency, inter-scorer reliability, content validity, and format validity. An independent samples t-test was used to compare the VRQoL of patients of different genders, ages, and educational levels. All patients were diveded into four vision groups according to their binocular distance visual acuity, a one-way analysis of variance was used to correlate quality of life with binocular distance visual acuity. Results The 1ND-VFQ-CN-33 demonstrated excellent applicability and item discrimination. There was good internal consistency （Cronbach＇s α=0.93） and excellent inter-scorer reliability. The scale-level content validity index value was 0.84. Eight common factors were extracted by exploratory factor analysis and explained 67.62% of the variance. Male patients scored higher on the psychosocial impact scale （t=-3.27, P〈0.05）, indicating reduced levels of psychosocial interactions. And illiterate patients scored higher on both the general functioning scale （t=-3.03, P〈0.05） and the psychosocial impact scale （t=-3.45, P〈0.05）, indicating worse general functioning skills and psychosocial level. There were significant differences between the three scale scores among the four vision groups （F=3.66-24.37, P〈0.05）. Conclusion The IND-VFQ-CN-33 is suitable for evaluating VRQoL in Chinese cataract patients waiting for surgery. It shows good applicability, item discrimination, reliability, and validity. The psychosocial effects of cataracts are greater in male and illiterate patients. General functioning skills are more impaired in illiterate patients. VRQoL is influenced differently at different vision levels.