DEVELOPMENT OF THE QUALITY-OF-LIFE IN EPILEPSY INVENTORY
DEVELOPMENT OF THE QUALITY-OF-LIFE IN EPILEPSY INVENTORY
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DOI：
10.1111/j.1528-1157.1995.tb00467.x
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发表时间：
1995-11-01
期刊：
影响因子：
5.6
通讯作者：
HAYS, RD
中科院分区：
文献类型：
--
作者：
DEVINSKY, O;VICKREY, BG;HAYS, RD
我们开发了一种测量癫痫患者健康相关生活质量（HRQOL）的工具。从兰德公司的36项健康调查（通用核心），9个额外的通用项目，48个癫痫为目标的项目，和6个其他项目有关的态度癫痫和自尊的99个项目的清单。我们对25个癫痫中心的304名癫痫成年人进行了99项清单。患者和患者指定的代理人完成了库存，并在1-91天后重新测试。这些数据的多性状尺度分析导致保留86个项目分布在17个多项目规模（克朗巴赫的α范围从0.78到0.92）。因素分析的17个多项量表产生了四个基本的健康方面：癫痫目标的尺寸，认知因素，心理健康和身体健康。所有量表的显著患者代理相关性以及神经心理学测试与自我报告的情感和认知功能之间的相关性（所有p值< 0.05）支持了结构效度。HRQOL量表的4个因子评分与神经毒性、全身毒性和医疗保健利用之间存在显著负相关（除了心理健康因子与医疗保健利用之间的相关性;所有p值均< 0.05）。与癫痫发作频率高的患者相比，前一年无癫痫发作的患者的总体评分、4个因子评分中的3个评分和17个量表评分中的8个评分的HRQOL更好。相对有效性分析表明，癫痫的目标因素和它的四个组成部分的规模比规模挖掘身体健康，心理健康，认知功能更敏感的癫痫发作频率和类型的严重程度患者的分类。这些横断面数据支持癫痫HRQOL测量的可靠性和有效性。在通用核心中添加癫痫靶向补充剂改善了对癫痫严重程度的敏感性。现场测试中包含的86个项目由另外3个项目补充，以形成癫痫生活质量（QOLIE-89）清单。
We developed an instrument to measure health-related quality of life (HRQOL) in epilepsy. A 99-item inventory was constructed from the RAND 36-Item Health Survey (generic core), with 9 additional generic items, 48 epilepsy-targeted items, and 6 other items concerning attitudes toward epilepsy and self-esteem. We administered the 99-item inventory to 304 adults with epilepsy at 25 epilepsy centers. Patients and patient-designated proxies completed the inventory and were retested 1-91 days later. A multitrait scaling analysis of these data led to retention of 86 items distributed in 17 multiitem scales (Cronbach's alpha ranged from 0.78 to 0.92). Factor analysis of the 17 multiitem scales yielded four underlying dimensions of health: an epilepsy-targeted dimension, a cognitive factor, mental health, and physical health. Construct validity was supported by significant patient-proxy correlations for all scales and correlations between neuropsychologic tests and self-reported emotional and cognitive function (all p values < 0.05). There were significant negative correlations between the four factor scores derived from the HRQOL scales and neurotoxicity, systemic toxicity, and health care utilization (except for the correlation between mental health factor and health care utilization; all p values < 0.05). Patients who were seizure-free in the preceding year reported better HRQOL for the overall score, three of the four factor scores, and 8 of the 17 scale scores than did patients with a high frequency of seizures. Relative validity analysis showed that the epilepsy-targeted factor and three of its four component scales were more sensitive to categorization of patients by severity of seizure frequency and type than scales tapping physical health, mental health, or cognitive function. These cross-sectional data support the reliability and validity of this measure of HRQOL in epilepsy. The addition of an epilepsy-targeted supplement to the generic core improved the sensitivity to severity of epilepsy. The 86 items included in the field testing were supplemented by three additional items to form the Quality of Life in Epilepsy (QOLIE-89) inventory.