Development Of The Chinese Version Of The Short Health Scale For Patients With Inflammatory Bowel Disease

Objective To introduce and revise the short health scale for patients with inflammatory bowel disease developed by Dr.Henrik et al.and conduct its psychological properties tests and preliminary test its applicability in our country so as to provide a short and simple tool for evaluating the health related quality of life and the influences of various therapeutic and nursing interventions on health-related quality of life for patients with inflammatory bowel disease.Method According to the general procedures of revising and psychological testing of scales,six experts(including two bilingual experts and four inflammatory bowel disease experts)were invited to translate and back translate the English translation version of the scale after got approval from the original author.A Chinese translation version of the short health scale was formed.Ten patients with inflammatory bowel disease(including 5 patients with Crohn’s disease and 5 patients with ulcerative colitis)of different disease types,gender,age,education level and severity of disease were included for pre-testing.These patients were consulted for their views and opinions of the questionnaire after filling out the forms.Revisions were made based on that and the Chinese version of draft short health scale was formed.Then patients with inflammatory bowel disease who met the inclusion criteria were invited to fill in a general information questionnaire,the 22-item IBD quality-of-life questionnaire,the rating form of IBD patient concerns and the Chinese version of draft short health scale.Meanwhile,a physician was asked to evaluate the patient’s disease activity index.A retest was conducted 2 weeks to 1 month after the first completion.The SPSS 19.0 statistical software was used for analysis of the reliability,validity,discriminant ability and sensitivity to change of the Chinese version of the draft short health scale so as to develop a Chinese version suitable for use in China.Results A total of 154 patients with inflammatory bowel disease(including 102 patients with Crohn’s disease,52 patients with ulcerative colitis)was invited to participate in the survey,and 102 patients completed the survey a second time.The overall reliability of the Chinese version of the short health scale was high,with an internal consistency alpha coefficient of 0.887 for Crohn’s disease and 0.914 for ulcerative colitis,and intraclass correlation coefficiency greater than 0.7 for both patients with Crohn’s disease and ulcerative colitis in all items,suggesting a good test-retest reliability.The Chinese version of the short health scale had a good face validity.The results of construct validity analysis showed that the correlation analysis of the four questions of the Chinese version of the short health scale with similar dimensions of the 22-item IBD quality-of-life questionnaire and the rating form of IBD patient concerns were significantly higher than other dimensions,and they were medium correlated with disease activity index,indicating the scale had good construct validity.The participants were divided into active and remission groups based on the disease activity index.Independent samples Mann-Whitney U test showed that there was significant difference(P<0.05)between active and remission groups of patients with both Crohn’s disease and ulcerative colitis except general feeling of well-being in Crohn’s disease patients,which indicating the questionnaire has a relatively good discriminant ability.For respondents whose disease activity index changed equal or more than 1,a correlated sample Mann-Whitney U test was performed,and the results failed to show significant difference between the two occasions for all dimensions for both patients with Crohn’s disease and ulcerative colitis(P>0.05),indicating that the scale was not sensitive to change.Conclusion The Chinese version of the short health scale is generally feasible for evaluating the quality of life for patients with inflammatory bowel disease in our country.The reliability,validity,discriminant ability of the scale are all relatively satisfactory and the sensitive to change need to be tested further.The scale could be preliminary applied to evaluate the health-related quality of life in patients with inflammatory bowel disease in clinic to guide the clinical treatment and nursing work.