Psychometric validation of a constipation symptom assessment questionnaire
Psychometric validation of a constipation symptom assessment questionnaire
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DOI：
10.1080/003655299750025327
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发表时间：
1999-09-01
影响因子：
1.9
通讯作者：
Miner, P
中科院分区：
文献类型：
--
作者：
Frank, L;Kleinman, L;Miner, P
背景：便秘的临床治疗因缺乏症状评估的金标准而变得复杂。便秘症状评估工具，PAC-SYM，开发，以解决病人的角度对疾病。工具内容基于文献综述和焦点小组的结果。方法：216例患者在9个地点参加了为期6周的PAC-SYM的心理测量评估。最终的工具包含12个项目，分配到3个分量表：粪便症状，直肠症状和腹部症状。对这一最终工具的心理测量特性进行了评估。结果：最终工具的内部一致性和重测信度较高（Cronbach的α = 0.89;组内相关= 0.75）。受试者和研究者便秘严重程度评分的相关性（r分别为0.68和0.72; P < 0.0001）支持了并行有效性。得分与生活质量测量工具中度相关。治疗应答者与无应答者的比较显示，该仪器能够根据临床严重程度区分各组（t =-6.12，P < 0.0001）。随着时间的推移，反应者的评分显着变化，表明仪器的反应性。结论：PAC-SYM具有内部一致性，在稳定条件下可重现，有效，对变化有反应，并提供了评估便秘治疗有效性的综合方法。
Background: Clinical management of constipation is complicated by the lack of a gold standard for evaluation of symptoms. A constipation symptom assessment instrument, the PAC-SYM, was developed to address the patient perspective on the disorder. Instrument content was based on literature review and results of focus groups. Methods: Two hundred and sixteen patients at nine sites participated in a 6-week psychometric evaluation of the PAC-SYM. The final instrument contained 12 items assigned to 3 subscales: stool symptoms, rectal symptoms, and abdominal symptoms. The psychometric properties of this final instrument were assessed. Results: Internal consistency and test-retest reliability of the final instrument was high (Cronbach's alpha = 0.89; intraclass correlation = 0.75). Concurrent validity was supported by the correlation with both subject and investigator constipation severity ratings (r = 0.68 and 0.72, respectively; P < 0.0001). Scores were moderately correlated with instruments measuring quality of life. Comparison of treatment responders with nonresponders showed the ability of the instrument to differentiate between groups on the basis of clinical severity (t = -6.12, P < 0.0001). Scores changed significantly over time among responders, indicating instrument responsiveness. Conclusions: The PAC-SYM is internally consistent, reproducible under stable conditions, valid, and responsive to change and provides a comprehensive means to assess the effectiveness of treatment for constipation.