便秘患者的生活质量问卷调查的开发与确认

作     者：Marquis P. De La Loge C. Dubois D. 郝筱倩 

作者机构：Mapi Values 15 Court Square Boston MA 02108 United States Dr. 

出 版 物：《世界核心医学期刊文摘（胃肠病学分册）》 (Core Journals in Gastroenterology)

年 卷 期：2005年第1卷第10期

页      面：52-53页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：便秘患者 生活质量问卷 慢性便秘 患者信息 严重度 肠蠕动 问卷调查 临床专家 指标评分 心理障碍 

摘      要：Objective. Chronic constipation is characterized by difficult, infrequent, or seemingly incomplete bowel movements. The Patient Assessment of Constipation Quality of Life (PACQOL) questionnaire was developed to address the need for a standardized, patient-reported outcomes measure to evaluate constipation over time. Material and methods. Items for the PAC-QOL were generated from the literature, clinical experts, and patients. Following principal components and multitrait analyses, 28 items were retained forming four subscales (worries and concerns, physical discomfort, psychosocial discomfort, and satisfaction) and an overall scale. Validation studies were conducted in the United States, Europe, Canada, and Australia, to evaluate the internal consistency reliability (Cronbach’s alpha), reproducibility (Intraclass Correlation Coefficients (ICCs)), validity (analysis of variance models), and responsiveness (effect size) of the PAC-QOL scales. Results. The PAC-QOL scales were internally consistent (Cronbach’s alpha 0.80) and reproducible (ICCs 0.70, except for the satisfaction subscale ICC = 0.66). PAC-QOL scale scores were significantly associated with abdominal pain (p 0.001) and constipation severity (p 0.05). Effect sizes in patients reporting improvements in constipation over a 6-week period were moderate to large, with subscale effect sizes ranging from 0.76 to 3.41 and the overall scale effect size = 1.77. Similar findings were observed in validation studies conducted in Europe, Canada, and Australia. Conclusions. The PAC-QOL is a brief but comprehensive assessment of the burden of constipation on patients’ everyday functioning and well-being. Multinational studies demonstrate that the PAC-QOL is internally consistent, reproducible, valid, and responsive to improvements over time.