Development of an 18-Item Measure of Symptom Burden in Patients With Glaucoma From the Collaborative Initial Glaucoma Treatment Study's Symptom and Health Problem Checklist
Development of an 18-Item Measure of Symptom Burden in Patients With Glaucoma From the Collaborative Initial Glaucoma Treatment Study's Symptom and Health Problem Checklist
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DOI：
10.1001/jamaophthalmol.2017.4574
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发表时间：
2017-12-01
影响因子：
8.1
通讯作者：
Janz, Nancy K.
中科院分区：
文献类型：
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作者：
Musch, David C.;Tarver, Michelle E.;Janz, Nancy K.
目的在协作性初始青光眼治疗研究(CIGTS)症状和健康问题检查表(SHPC)的基础上开发一种简明的青光眼症状测量工具，并评估其心理测量学特性。设计、设置和参与者本测量开发研究评估了从CIGTS参与者那里获得的43个条目的SHPC的因素结构。这607名参与者是在美国的14个临床中心登记的，他们新诊断为开角型青光眼。与视野检查的平均偏差为-5.5(4.3)分贝。数据收集自1993年10月至1997年4月。主要结果和测量SHPC的因素结构，所产生的18项问卷(SHPC-18)的验证性因素分析，SHPC-18的信度，以及SHPC-18的2个症状子量表(局部眼和视功能)与视野严重程度和25个条目的国家眼研究所视觉功能问卷(NEI-VFQ25)的相关性。结果607名被试(入学时平均年龄57.5[10.9]岁)，334名(55.0%)男性，273名(45.0%)女性；231人(38.1%)是非裔美国人。探索性因素分析和纵向生长模型记录了局部眼和视功能症状子量表。局部眼子量表和视功能子量表的平均加权内部一致性的Cronbach a值分别为0.83和0.89，并随着时间的推移保持稳定。各分量表得分与NEI-VFQ25总分呈显著正相关(r分别为-0.41和-0.59)，与各分量表得分均呈显著正相关(P<；0.01)。重度青光眼患者基线时的平均(SD)得分高于轻度青光眼患者(4.68[6.62]vs 3.07[5.60])和视功能(8.44[11.45]vs 4.42[8.94]；P<；0.05)SHPC-18子量表。接受小梁切除术的参与者报告的任何局部眼部症状的频率高于接受局部药物治疗的参与者(例如，在12个月时，269人中有153人(56.9%)对276人中的11人(40.9%)；P<；.001)。结论这些结果表明，SHPC-18是一种可靠的、响应性的、心理测量学良好的测量患者报告的青光眼相关症状的工具。该方法对治疗有反应，并能区分青光眼的严重程度。这一较短版本的原始SHPC测量可能在临床和研究环境中有用，以更好地了解青光眼症状对患者日常生活的影响。
IMPORTANCE Administration of a brief questionnaire to evaluate glaucoma symptoms would lend useful information for patient care.OBJECTIVES To develop a shortened glaucoma symptom measure based on the Collaborative Initial Glaucoma Treatment Study (CIGTS) Symptom and Health Problem Checklist (SHPC) and evaluate its psychometric properties.DESIGN, SETTING, AND PARTICIPANTS This measure development study evaluated the factor structure of the 43-item SHPC that was obtained from CIGTS participants at baseline and every 6 months thereafter. These 607 participants were enrolled at 14 clinical centers in the United States and had newly diagnosed open-angle glaucoma. Their mean deviation (SD) from visual field testing was -5.5 (4.3) dB. Data were collected from October 1993 through April 1997.MAIN OUTCOMES AND MEASURES The factor structure of the SHPC, confirmatory factor analysis of the resulting 18-item questionnaire (SHPC-18), the reliability of the SHPC-18, and associations of the 2 symptom subscales (Local Eye and Visual Function) of the SHPC-18 with visual field severity and 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ25) subscales.RESULTS Among the 607 participants (mean [SD] age at enrollment, 57.5 [10.9] years), 334 (55.0%) were men and 273 (45.0%) were women; 231 (38.1%) were African American. Exploratory factor analysis and longitudinal growth modeling documented Local Eye and Visual Function symptom subscales. Cronbach a values for mean weighted internal consistency were 0.83 and 0.89 for the Local Eye and Visual Function subscales, respectively, and remained stable over time. Scores on each subscale significantly correlated with the NEI-VFQ25 total score (r = -0.41 and r = -0.59, respectively) and with all subscale scores (P < .01). Participants with more severe glaucoma had higher (worse) mean (SD) scores than those with mild glaucoma at baseline on the Local Eye (4.68 [6.62] vs 3.07 [5.60]) and Visual Function (8.44 [11.45] vs 4.42 [8.94]; P < .05) SHPC-18 subscales. Participants who underwent trabeculectomy reported a higher frequency of any Local Eye symptoms than those treated with topical medications (eg, at 12 months, 153 of 269 [56.9%] vs 11 of 276 [40.9%]; P < .001).CONCLUSIONS AND RELEVANCE These results suggest that the SHPC-18 is a reliable, responsive, and psychometrically sound measure of patient-reported, glaucoma-related symptoms. The measure is responsive to treatment and discriminates the severity of glaucoma. This shorter version of the original SHPC measure may be useful in clinical and research settings to better understand the influence of glaucoma symptoms on patients' daily life.