儿童甲状腺癌术后健康相关生活质量量表的开发及评估

Development and evaluation of the children′s postoperative health-related quality of life scale for thyroid cancer

目的编制儿童甲状腺癌术后健康相关生活质量量表并检验其信效度。方法通过文献检索、焦点小组会议以及预调查形成量表初稿, 并招募2023年1月—12月就诊于首都医科大学附属北京儿童医院的116例甲状腺癌患儿(测试对象76例, 外部验证集40例)对量表进行作答, 以测试量表的信效度, 筛选量表题目并将题目进行分类, 形成多个维度的最终量表。结果儿童甲状腺癌术后健康相关生活质量量表(Health-Related Quality of Life, HRQoL)包含5个维度, 29个题目。探索性因子分析显示5个因子累积方差解释率为64.343%。验证性因子分析显示本量表的题目与维度间存在相关性, 量表的收敛效度一般, 区分效度良好。效标效度显示本量表各项题目与效标之间存在相关性。项目—维度相关系数显示各维度中的题目具有良好区分度。量表总的Cronbach′s α系数为0.930, 折半信度为0.843, 初次测试后2周、1个月和3个月的重测信度为0.936、0.922和0.910。结论本项目开发的儿童甲状腺癌术后HRQoL具有良好的信效度, 可用于评估甲状腺癌术后患儿的健康相关生活质量。

Objective To develop the children′s postoperative health-related quality of life scale for thyroid cancer and to test its reliability and validity.Methods The first draft of the scale was developed through literature search,focus group meetings,and a pre-survey,and 116 children(76 for testing and 40 for external validation)with thyroid cancer attending Beijing Children′s Hospital of Capital Medical University were selected to answer the scale,to screen and categorize the questions and to form the final scale with multiple dimensions.Results The children′s postoperative health-related quality of life scale for thyroid cancer contained 5 dimensions and 29 questions.Exploratory factor analysis showed that the cumulative variance explained by the 5 factors was 64.343%.Confirmatory factor analysis showed correlations between the questions and dimensions of this scale,fair convergent validity for the scale,and good discriminant validity.The validity of the validity scale showed that there was a existing correlation between the questions and the validity scale of this scale.The item-dimension correlation coefficients showed that the questions in each dimension were well differentiated.The total Cronbach′sαcoefficient of the scale was 0.930,the folded half reliability was 0.843,and retest reliabilities at 2 weeks,1 month,and 3 months after the initial test were respectively 0.936,0.922,and 0.910.ConclusionThe developed children′s postoperative health-related quality of life scale for thyroid cancer has good reliability and validity and can be used to assess the health-related quality of life of children after thyroid cancer surgery.