MEASUREMENT OF HEALTH-STATUS IN CHILDREN WITH JUVENILE RHEUMATOID-ARTHRITIS
MEASUREMENT OF HEALTH-STATUS IN CHILDREN WITH JUVENILE RHEUMATOID-ARTHRITIS
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DOI：
10.1002/art.1780371209
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发表时间：
1994-12-01
影响因子：
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通讯作者：
GOLDSMITH, DP
中科院分区：
文献类型：
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作者：
SINGH, G;ATHREYA, BH;GOLDSMITH, DP
目标。开发和验证一种自我或父母管理的仪器，用于测量幼年类风湿性关节炎（JRA）儿童的功能状态。我们对斯坦福健康评估问卷（HAQ）进行了调整，使其适用于1-19岁的儿童，增加了几个新问题，使每个功能领域至少有一个问题与所有年龄的儿童相关。由20名卫生专业人员和22名健康儿童的家长对该工具的表面效度进行了评估。72例JRA患者（平均年龄9.1岁，发病类型全身性16例，多关节型21例，少关节型35例）的家长接受问卷调查。该仪器具有良好的内部信度（Cronbach's alpha = 0.94），平均项目间相关系数为0.6。残疾指数（所有功能区域得分的平均值）与Steinbrocker功能类别（Kendall's tau b = 0.77, P < 0.0001）、涉及关节数（Kendall's tau b = 0.67, P < 0.0001）和晨僵（Kendall's tau b = 0.54, P < 0.0001）具有强相关性，证明了趋同效度。父母问卷的残疾指数得分与年龄较大的儿童（0 ~ 8岁）的残疾指数得分之间的Spearman相关系数为0.84 (n = 29; P < 0.001)，说明父母可以准确地为孩子报告。以2周为间隔进行的重测信度研究显示，两次测量的残疾指数得分几乎相同（0.96对0.96；配对t检验P > 0.9； Spearman相关系数= 0.8,P < 0.002）。儿童HAQ是一种有效的、可靠的、灵敏的测量JRA儿童功能状态的工具，只需不到10分钟即可完成。
Objective. To develop and validate a self- or parent-administered instrument for measuring functional status in children with juvenile rheumatoid arthritis (JRA).Methods. We adapted the Stanford Health Assessment Questionnaire (HAQ) for use in children ages 1-19 years, by adding several new questions, such that for each functional area, there was at least 1 question relevant to children of all ages. The face validity of the instrument was evaluated by a group of 20 health professionals and parents of 22 healthy children. The questionnaire was then administered to parents of 72 JRA patients (mean age 9.1 years, onset type systemic in 16, polyarticular in 21, pauciarticular in 35).Results. The instrument showed excellent internal reliability (Cronbach's alpha = 0.94), with a mean inter-item correlation of 0.6. The convergent validity was demonstrated by strong correlations of the Disability Index (average of scores on all functional areas) with Steinbrocker functional class (Kendall's tau b = 0.77, P < 0.0001), number of involved joints (Kendall's tau b = 0.67, P < 0.0001), and morning stiffness (Kendall's tau b = 0.54, P < 0.0001). Spearman's correlation coefficient between Disability Index scores from questionnaires administered to parents and those from questionnaires administered to older children (>8 years) was 0.84 (n = 29; P < 0.001), showing that parents can accurately report for their children. The test-retest reliability, studied at a 2-week interval, revealed virtually identical Disability Index scores measured on the 2 occasions (0.96 versus 0.96; P > 0.9 by paired t-test; Spearman's correlation coefficient = 0.8, P < 0.002).Conclusion. The Childhood HAQ, which takes less than 10 minutes to complete, is a valid, reliable, and sensitive instrument for measuring functional status in children with JRA.