目的 构建哮喘患儿家长报告结局概念模型,初步探索哮喘患儿家长报告结局量表结构,为量表的进一步编制提供基础。方法 回顾文献,结合专家咨询和目标人群访谈构建哮喘患儿家长报告结局的概念模型、量表初始维度和条目池。根据30名哮喘儿童家长的测试结果和5名专家的评价意见,对条目进行初步筛选和修改,形成包含72个条目的初始问卷。通过对212名哮喘儿童家长的调查,采用经典测量理论对初始问卷条目进行筛选,结合平行分析、探索性因子分析和专家意见,确定哮喘患儿家长报告结局量表的结构。结果 构建出了包含4个一级指标、8个二级指标的哮喘患儿家长报告结局概念模型。在此基础上,编制了包含72个条目的初始问卷并实施现场调查,经过条目筛选、平行分析和探索性因子分析提取出了5个公因子,累积方差贡献率为51.6%,5个公因子分别反映患儿身体状况、心理状况、日常活动、行为限制和家庭影响。结论 提取出的5个公因子均涵盖在所构建的概念模型内,能够解释哮喘对儿童的影响。哮喘患儿家长报告量表应以身体状况、心理状况、日常活动、行为限制和家庭影响5个维度进行编制。
Abstract
Objectives To develop a conceptual model for childhood asthma patient reported outcomes reported by parents, and to explore the structure of patient reported outcomes scale preliminarily, in order to provide basis for the compilation and evaluation of the scale.Methods A conceptual model, initial dimensions and items pool were developed by literature review combined with expert consultation and target group interview methods. The items were preliminarily screened and revised according to the test results of 30 parents of asthmatic children and the evaluation opinions of 5 experts, and then an initial questionnaire containing 72 items was formed. Totally 212 parents of asthmatic children were investigated, and the items of initial questionnaire were screened by using the classical test theory methods, combined with parallel analysis, exploratory factor analysis methods and expert advice, finally the structure of childhood asthma patient reported outcomes scale reported by parents was identified.Results A four primary indicators and eight secondary indicators conceptual model was constructed. Based on that, an initial questionnaire containing 72 items was compiled and a field investigation was carried out. The items screening, parallel analysis and exploratory factor analysis showed that five common factors were extracted, and the cumulative variance contribution rate was 51.6%. The five common factors reflected children′s physical condition, psychological status, daily activities, behavior restrictions and family influence.Conclusions The extracted five common factors were covered in the conceptual model and could explain the impact of asthma on children. The scale of childhood asthma patient reports outcomes reported by parents should be compiled in 5 dimensions, including physical condition, psychological state, daily activities, behavior restrictions and family influence.
关键词
儿童哮喘 /
患者报告结局 /
概念模型 /
量表结构
Key words
childhood asthma /
patient reported outcomes /
conceptual model /
scale structure
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 刘传合,洪建国,尚云晓,等.中国16城市儿童哮喘患病率20年对比研究[J].中国实用儿科杂志,2015,30(8):596-600.
[2] Wong GWK,Kwon N,Hong JG,et al.Pediatric asthma control in Asia:Phase 2 of the Asthma Insights and Reality in Asia-Pacific (AIRIAP 2) survey[J].Allergy,2013,68(4):524-530.
[3] 中华医学会儿科学分会呼吸学组,中华儿科杂志编辑委员会.儿童支气管哮喘诊断与防治指南(2016年版)[J].中华儿科杂志,2016,54(3):167-181.
[4] 孔明,卞冉,张厚粲.平行分析在探索性因素分析中的应用[J].心理科学,2007,30(4):924-925.
[5] 茅范贞,韩耀风,方亚.量表条目的统计学筛选方法研究进展[J].现代预防医学,2015,42(1):1-3.
[6] Varma R,Richman EA,Ferris FL,et al.Use of patient-reported outcomes in medical product development:A report from the 2009 NEI/FDA clinical trial endpoints symposium [J].Invest Ophthalmol Vis Sci,2010,51(12):6095-6103.
[7] National Institutes of Health.Introduction to PROMIS.[EB/OL].http://www.healthmeasures.net/explore-measurement-systems/promis/intro-to-promis.
[8] Hullmann SE,Ryan JL,Ramsey RR,et al.Measures of general pediatric quality of life:Child Health Questionnaire (CHQ), DISABKIDS Chronic Generic Measure (DCGM), KINDL-R, Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scales, and Quality of My Life Questionnaire (QoML) [J].Arthritis Care Res(Hoboken),2011,63(Suppl 1):420-430.
[9] 张映芬,冯丽芬,陈若青,等.儿童生存质量量表PedsQLTM 3.0哮喘模块中文版父母报告的信度效度分析[J].中山大学学报:医学科学版,2010,31(5):710-714.
[10] 卢奕云,田琪,郝元涛,等.儿童生存质量测定量表PedsQL 4.0中文版的信度和效度分析[J].中山大学学报:医学科学版,2008,29(3):328-331.
基金
国家自然科学基金(81773540);陕西省社发攻关项目(2017SF-005)