CaReQoL哮喘的验证：一项监测重症难治性哮喘成年患者肺康复感知效果的患者报告结果指标
2023/02/01
摘要
背景：CaReQoL哮喘回顾性评估重症哮喘患者肺康复的护理相关生活质量结果。问卷包括五个领域（身体功能；社会功能；应对哮喘；哮喘知识；药物）。
目的：通过与其他健康指标（AQLQ、ACQ和FEV1）的比较，研究CaReQoL哮喘的结构和标准有效性，以及其反应性和最小重要变化（MIC）。
方法：83名患有重症难治性哮喘的成人在瑞士或荷兰的三级哮喘中心进行为期12周的个性化多学科肺康复计划后，于6个月和12个月填写了CaReQoL哮喘问卷。通过测试与AQLQ、ACQ和FEV1评分变化相关的预定义假设来评估结构效度和响应性。使用全球感知效应（GPE）评估标准效度和MIC。进行了因子分析、克隆巴赫系数、Spearman相关性、配对t检验和Student Newman-Keuls检验。
结果：问卷领域的克隆巴赫系数在0.82至0.95之间。良好的结构效度和反应性；84%的评估相关性证实了预定义的假设，并反映了弱相关性和中到强相关性。还确定了良好的标准效度，康复后6个月，CaReQol评分在GPE水平之间的区别优于其他健康指标。总得分的MIC估计为0.84。
结论：这些研究结果表明，CaReQoL哮喘是一种有效的、响应性强的工具，并显示出它是一种综合的、量身定制的问卷，用于评估和监测重症难治性哮喘患者的肺康复结果。为了进一步证实CaReQoL哮喘的可靠性和有效性，以及监测重症哮喘患者的肺康复结果，建议除了使用其他疾病专用仪器外，还使用CaReQoL哮喘。
Validation of the CaReQoL asthma: a patient reported outcome measure for monitoring the perceived effects of pulmonary rehabilitation in adult patients with severe refractory asthma
Linda Springvloet, Mattanja Triemstra, Bart Knottnerus, Marlon Rolink, Harry Heijerman, Dolf de Boer
Abstract
Background: The CaReQoL Asthma assesses the care-related quality of life outcomes of pulmonary rehabilitation retrospectively in patients with severe asthma. The questionnaire comprises five domains (physical functioning; social functioning; coping with asthma; knowledge about asthma; medication).
Aim: To investigate construct and criterion validity of the CaReQoL Asthma, as well as its responsiveness and minimal important change (MIC), in comparison with other health measures (AQLQ, ACQ and FEV1).
Methods: Eighty three adults with severe refractory asthma filled out the CaReQoL Asthma at 6 and 12 months after a 12-week personalized multidisciplinary pulmonary rehabilitation program in a tertiary asthma centre, either in Switzerland or The Netherlands. Construct validity and responsiveness were assessed by testing pre-defined hypotheses about associations with changes in AQLQ, ACQ and FEV1 scores. Criterion validity and MIC was assessed using Global Perceived Effect (GPE). Factor analyses, Cronbach's alpha, Spearman's correlations, paired t-tests and Student-Newman-Keuls tests were performed.
Results: Cronbach's alphas of the questionnaire domains ranged from 0.82 to 0.95. Good construct validity and responsiveness were found; 84% of the assessed correlations confirm pre-defined hypotheses and reflect both weak and moderate to strong correlations. Good criterion validity was also identified, with CaReQol scores discriminating better than other health measures between levels of GPE at 6 months post-rehabilitation. The MIC for the total score was estimated at 0.84.
Conclusion: These study results suggest that the CaReQoL Asthma is a valid and responsive instrument and shows to be a comprehensive and tailored questionnaire for evaluating and monitoring outcomes of pulmonary rehabilitation in patients with severe refractory asthma. In order to further substantiate the reliability and validity of the CaReQoL Asthma, as well as to monitor outcomes of pulmonary rehabilitation in patients with severe asthma, it is recommended to use the CaReQoL Asthma in addition to other disease specific instruments.
背景：CaReQoL哮喘回顾性评估重症哮喘患者肺康复的护理相关生活质量结果。问卷包括五个领域（身体功能；社会功能；应对哮喘；哮喘知识；药物）。
目的：通过与其他健康指标（AQLQ、ACQ和FEV1）的比较，研究CaReQoL哮喘的结构和标准有效性，以及其反应性和最小重要变化（MIC）。
方法：83名患有重症难治性哮喘的成人在瑞士或荷兰的三级哮喘中心进行为期12周的个性化多学科肺康复计划后，于6个月和12个月填写了CaReQoL哮喘问卷。通过测试与AQLQ、ACQ和FEV1评分变化相关的预定义假设来评估结构效度和响应性。使用全球感知效应（GPE）评估标准效度和MIC。进行了因子分析、克隆巴赫系数、Spearman相关性、配对t检验和Student Newman-Keuls检验。
结果：问卷领域的克隆巴赫系数在0.82至0.95之间。良好的结构效度和反应性；84%的评估相关性证实了预定义的假设，并反映了弱相关性和中到强相关性。还确定了良好的标准效度，康复后6个月，CaReQol评分在GPE水平之间的区别优于其他健康指标。总得分的MIC估计为0.84。
结论：这些研究结果表明，CaReQoL哮喘是一种有效的、响应性强的工具，并显示出它是一种综合的、量身定制的问卷，用于评估和监测重症难治性哮喘患者的肺康复结果。为了进一步证实CaReQoL哮喘的可靠性和有效性，以及监测重症哮喘患者的肺康复结果，建议除了使用其他疾病专用仪器外，还使用CaReQoL哮喘。
(中日友好医院呼吸与危重症医学科 顾宪民 摘译 林江涛 审校)
(Respir Res. 2023 Jan 13;24(1):14. doi: 10.1186/s12931-022-02281-6.)
(Respir Res. 2023 Jan 13;24(1):14. doi: 10.1186/s12931-022-02281-6.)
Validation of the CaReQoL asthma: a patient reported outcome measure for monitoring the perceived effects of pulmonary rehabilitation in adult patients with severe refractory asthma
Linda Springvloet, Mattanja Triemstra, Bart Knottnerus, Marlon Rolink, Harry Heijerman, Dolf de Boer
Abstract
Background: The CaReQoL Asthma assesses the care-related quality of life outcomes of pulmonary rehabilitation retrospectively in patients with severe asthma. The questionnaire comprises five domains (physical functioning; social functioning; coping with asthma; knowledge about asthma; medication).
Aim: To investigate construct and criterion validity of the CaReQoL Asthma, as well as its responsiveness and minimal important change (MIC), in comparison with other health measures (AQLQ, ACQ and FEV1).
Methods: Eighty three adults with severe refractory asthma filled out the CaReQoL Asthma at 6 and 12 months after a 12-week personalized multidisciplinary pulmonary rehabilitation program in a tertiary asthma centre, either in Switzerland or The Netherlands. Construct validity and responsiveness were assessed by testing pre-defined hypotheses about associations with changes in AQLQ, ACQ and FEV1 scores. Criterion validity and MIC was assessed using Global Perceived Effect (GPE). Factor analyses, Cronbach's alpha, Spearman's correlations, paired t-tests and Student-Newman-Keuls tests were performed.
Results: Cronbach's alphas of the questionnaire domains ranged from 0.82 to 0.95. Good construct validity and responsiveness were found; 84% of the assessed correlations confirm pre-defined hypotheses and reflect both weak and moderate to strong correlations. Good criterion validity was also identified, with CaReQol scores discriminating better than other health measures between levels of GPE at 6 months post-rehabilitation. The MIC for the total score was estimated at 0.84.
Conclusion: These study results suggest that the CaReQoL Asthma is a valid and responsive instrument and shows to be a comprehensive and tailored questionnaire for evaluating and monitoring outcomes of pulmonary rehabilitation in patients with severe refractory asthma. In order to further substantiate the reliability and validity of the CaReQoL Asthma, as well as to monitor outcomes of pulmonary rehabilitation in patients with severe asthma, it is recommended to use the CaReQoL Asthma in addition to other disease specific instruments.
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成人哮喘患者脉冲振荡法的最小临床重要差异
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哮喘临床实践中一种检测小气道功能障碍的工具研发
