Development And Evaluation Of Quality Of Life Instruments For Patients With Chronic Pulmonary Heart Disease

Object To develop and evaluate the quality of life instrument for patients with chronic pulmonary heart disease (CPHD) .Method Based on systemetic research strategies of Quality of Life Instruments for Chronic Disease (QLICD) which emphasized on combination of general module and specific module, the development work was conducted by the programmed decision and associated with Chinese culture background in instruments development. The psychometric properties of instruments were evaluated. The statistic methods used in this research including statistic descriptions, Pearson Correlation, Exploratory Factor Analysis(EFA), Hierarchical Cluster Analysis and Paired-samples t Test, Chi-square Test, One-way ANOVA.Results(1) One 30-item general module (GM) for chronic diseases and one 21-item specific module for chronic pulmonary heart disease was formed. Then a 32 plus 21 items instrument for patients of chronic pulmonary heart disease, shortened as QLICD-CPHD was yielded by combination.(2) Validity: Because the item pools were nominated and several-rounds selected by persons who are strongly related with QOL study, reflecting the definition of health and QOL proposed by WHO and specific problems among patients of CPHD, the QLICD-CPHD have a considerable content validities. Most of the item scores in one domain had higher correlation with total domain score than other total domain score. The factor structures of CPHD was explored by using principle components analysis with varimax rotation. 10 principle components were extracted from the GM, which reflect facets of independence, eating and sleeping, vitality of PHD domain, anxious, depress emotion and self-awareness of PSD domain, and social support and ability of SOD domain, explaining 66.955% of the variance. 4 principle components which reflected content of psycho-social problems, symptoms of CPHD module, side effects were identified of CPHD and explaining 66.162% of the variance. The total scores of each domain of SF-36 were selected as criterions, the correlation coefficients between domain of GM and total scores of instrument and their criterions were greater than 0.5 excluded SOD. The two aspects above showed good validity of the instrument.(3) Reliability: The coefficients of internal consistency and split-half for physical functioning and psychological functioning domains and CPHD specific module was greater than 0.7. In addition, the results of test-retest reliability indicated that between first, second time point, all domains and total scores had no statistical significance, the correlation coefficients were greater than 0.75. The reliability of the instrument was not bad.(4) Responsiveness: The differences of each domain and total scores of the instruments between first time point and third one had statistical significance. The scale had the ability to detect clinical change due to treatment and then have good responsiveness.(5) About 15-20 minutes were spent for patients in completing instrument and the completed rate over 95% demonstrated that the good feasibility of the instrument.Conclusion The QLICD-CPHD was valid, reliable, and sensitive, and could be used to assess quality of life of patients and CPHD.