Development of a questionnaire to assess vision problems under low luminance in age-related maculopathy
Development of a questionnaire to assess vision problems under low luminance in age-related maculopathy
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DOI：
10.1167/iovs.05-1222
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发表时间：
2006-02-01
影响因子：
4.4
通讯作者：
Kallies, K
中科院分区：
文献类型：
--
作者：
Owsley, C;McGwin, G;Kallies, K
目的.目的：设计一份用于老年性黄斑病变（ARM）研究的低亮度和夜间视力问题的调查问卷。调查问卷分为三个步骤：（1）通过重点人群的老年人与ARM和那些表现出正常的视网膜老化的问卷项目的内容进行了确定。讨论的题目是“夜间和低光照明下的视力”。“讨论被录音，转录，并进行内容分析，以确定患者表达的问题类别。（2）利用这些内容，通过电话向患有ARM或正常视网膜老化的人进行初步问卷调查。主成分分析确定的项目组，形成了内部一致性评价问卷的分量表，并实施了项目减少策略，以生成一个简短的问卷。（3）对低亮度问卷（LLQ）的结构效度、效标效度和重测信度进行了研究。32项LLQ有6个分量表（驾驶、极端照明、移动性、情绪困扰、一般昏暗照明和周边视觉），所有分量表都具有良好的内部一致性（Cronbach α>= 0.82）。LLQ分量表的评分与几乎所有国家眼科研究所视觉功能问卷（NEI VFQ）-25分量表中度相关，并且随着ARM疾病严重程度的增加，患者的值降低（表明更多的残疾）。视杆细胞介导的暗适应参数与LLQ子量表评分显著相关（r = 0.19 ~ 0.43，P < 0.03），视锥细胞介导的参数与LLQ子量表评分无关。所有分量表的重测信度范围为0.74 - 0.88（P < 0.0001），除了周边视力（0.46; P = 0.0003），几乎一半的受访者也表现出天花板效应。32个项目的LLQ，来自焦点小组的意见，由ARM的人的内容，具有良好的结构效度，与杆介导的视觉功能，和良好的重测信度的6个分量表中的5个分量表相关的分量表分数。LLQ最终可能有助于以患者为中心评价干预措施的结果，以预防ARM或阻止早期疾病的进展。
PURPOSE. To develop a questionnaire for assessing self-reported visual problems under low luminance and at night for use in studies on age-related maculopathy ( ARM).METHODS. The questionnaire was developed in three steps: ( 1) Content for questionnaire items was identified through focus groups of older adults with ARM and those exhibiting normal retinal aging. The topic for discussion was "vision at night and under low lighting." Discussion was audiotaped, transcribed, and subjected to content analysis to identify problem categories expressed by patients. ( 2) This content was used to develop a preliminary questionnaire administered by telephone to persons with ARM or normal retinal aging. Principal-components analysis identified groups of items that formed the questionnaire's subscales that were evaluated for internal consistency, and an item-reduction strategy was implemented to generate a briefer questionnaire. ( 3) Psychometric properties of the shortened Low-Luminance Questionnaire (LLQ) were determined, including construct validity, criterion validity, and test-retest reliability.RESULTS. The 32-item LLQ has six subscales ( driving, extreme lighting, mobility, emotional distress, general dim lighting, and peripheral vision), all with good internal consistency (Cronbach alpha >= 0.82). Scores on LLQ subscales correlated moderately with nearly all National Eye Institute Visual Function Questionnaire (NEI VFQ)-25 subscales and decreased in value ( indicating more disability) for patients with increasing ARM disease severity. Whereas rod-mediated parameters of dark adaptation were significantly associated with LLQ subscale scores (r = 0.19 - 0.43, all P < 0.03), cone-mediated parameters were not. Test-retest reliability ranged from 0.74 to 0.88 for all subscales ( P < 0.0001), except for peripheral vision (0.46; P = 0.0003), which also exhibited a ceiling effect in almost half of the respondents.CONCLUSIONS. The 32-item LLQ, derived from the content of focus group comments by persons with ARM, has good construct validity, subscale scores related to rod-mediated visual function, and good test-retest reliability for five of six subscales. The LLQ may ultimately be useful in patient-centered evaluation of the outcome of interventions to prevent ARM or to arrest progression of early disease.