Cross-cultural adaptation and clinical application of Meniere's disease outcomes questionnaire
-
摘要: 目的 引入英文版梅尼埃病结局问卷(MDOQ)，系统汉化评价其信效度，并进行临床应用，测量梅尼埃病患者生活质量。方法 采用Brislin模型对量表进行翻译，形成中文版MDOQ-C。对101例梅尼埃病患者进行MDOQ-C信效度调查，分析条目鉴别度、信度、效标效度和结构效度。采用MDOQ-C对272例患者进行生活质量测量，分析梅尼埃病患者生活质量影响因素。结果 MDOQ-C各条目CR值均超过3.00，信度分析示量表Cronbach's α系数为0.88，折半信度Spearman-Brown系数为0.90，效标效度分析示MDOQ-C与头晕残障量表的Pearson相关系数r为0.80(P < 0.01)，探索性因子分析示MDOQ-C共有3个因子，累积方差贡献率为60.503%，条目构成与原量表不同。采用MDOQ-C测得梅尼埃病患者生活质量平均得分为(52.94±13.87)分，生活质量影响因素主要有年龄、婚姻状况、工作情况、耳鸣和眩晕发作次数。结论 中文版MDOQ-C信效度良好，条目构成与原量表不同，经条目重构后可作为评价梅尼埃病患者生活质量的有效工具。通过临床初步应用，明确了梅尼埃病患者生活质量的影响因素，为优化临床管理策略提供了参考。Abstract: Objective To cross-culturally adapt the Meniere's Disease Outcomes Questionnaire(MDOQ) into Chinese language, to evaluate its reliability and validity, and to apply in clinical.Methods The MDOQ was translated according to the Brislin model. Cross-cultural adaption was done by expert discussion and pilot study. The MDOQ was applied to 101 patients to test its reliability and validity. The quality of life(QOL) of 272 patients was measured by MDOQ-C, analyzing the influence factors of QOL of patients with Meniere's disease.Results The CR value of each item of MDOQ-C exceeded 3.00, the Cronbach's α coefficient was 0.88, and the Spearman Brown coefficient was 0.90. The Pearson correlation coefficient of MDOQ-C and the DHI was 0.803(P < 0.01). Three factors were extracted by factor analysis, which could explain 60.503% of the total variance. The dimension composition was different from the original scale. The average QOL score of Meniere's disease patients was 52.94±13.87. The main influence factors were age, marital status, work status, with tinnitus and the number of vertigo attacks.Conclusion The MDOQ-C is reliable and valid. After dimension reconstruction, MDOQ-C can be used to evaluate the QOL of patients with Meniere's disease. Through the preliminary clinical application, the influence factors of quality of life of patients with Meniere's disease were identified, thus providing reference for optimizing clinical management strategies.
-
Key words:
- Meniere's disease /
- quality of life /
- reliability /
- validity /
- influence factor
-
-
表 1 中文版MDOQ-C
条目 中文版MDOQ-C 1 总的来说，梅尼埃病对你生活的影响有多大？ 2 梅尼埃病对你出行(工作、娱乐休闲方面)的限制有多大？(例如：旅行、度假、看电影等) 3 听力下降对你的影响有多大？ 4 因为梅尼埃病你多久到医院就诊一次？ 5 你对治愈梅尼埃病有多大的信心？ 6 你觉得你的身体健康状况如何？ 7 在做日常生活事务(洗澡、做家务等)时你觉得有多大的困难？ 8 最近6个月是否有眩晕发作？如果有的话，影响有多大？ 9 是否有耳鸣？ 10 你日常记忆东西有困难吗？ 11 你走直线有困难吗？ 12 集中注意力对你来说有困难吗？(例如：阅读、在电脑上进行工作等) 13 你是否感觉到情绪低落？ 14 梅尼埃病两次发作期间，失衡/不稳的情况有多严重？ 15 日常活动(购物、社交、外出就餐、锻炼等)受影响的频率有多大？ 16 梅尼埃病发作时，失衡/不稳的情况有多严重？ 17 梅尼埃病会影响你的工作/学习吗？(工作/学习表现、病假、休假、离职/退学等方面) 18 梅尼埃病大约多久发作一次？ 19 你觉得梅尼埃病最严重的一次发作时情况有多糟糕？ 
下载: 导出CSV
表 2 中文版MDOQ-C旋转后的因子载荷(n=101)
条目 因子1 因子2 因子3 16 梅尼埃病发作时，失衡/不稳的情况有多严重？ 0.875 19 你觉得梅尼埃病最严重的一次发作时情况有多糟糕？ 0.860 18 梅尼埃病大约多久发作一次？ 0.845 8 最近6个月是否有眩晕发作？如果有的话，影响有多大？ 0.810 4 因为梅尼埃病你多久到医院就诊一次？ 0.614 5 你对治愈梅尼埃病有多大的信心？ 0.690 3 听力下降对你的影响有多大？ 0.666 6 你觉得你的身体健康状况如何？ 0.622 13 你是否感觉到情绪低落？ 0.610 12 集中注意力对你来说有困难吗？(例如：阅读、在电脑上进行工作等) 0.598 10 你日常记忆东西有困难吗？ 0.594 9 是否有耳鸣？ 0.570 7 在做日常生活事务(洗澡、做家务等)时你觉得有多大的困难？ 0.788 11 你走直线有困难吗？ 0.763 15 日常活动(购物、社交、外出就餐、锻炼等)受影响的频率有多大？ 0.749 2 梅尼埃病对你出行(工作、娱乐休闲方面)的限制有多大？(例如：旅行、度假、看电影等) 0.720 14 梅尼埃病两次发作期间，失衡/不稳的情况有多严重？ 0.602 17 梅尼埃病会影响你的工作/学习吗？(工作/学习表现、病假、休假、离职/退学等方面) 0.524
下载: 导出CSV
表 3 梅尼埃病患者生活质量影响因素分析
X±S 项目 例数
(n=272)MDOQ-C P值 年龄/岁 0.000a) 18~44 75 58.48±12.37 45~64 138 51.07±13.83 >65 59 50.29±14.01 婚姻状况 0.000b) 未婚 67 59.12±10.73 已婚 205 50.92±14.19 工作情况 0.002a) 在职 156 55.34±13.79 退休 110 49.85±13.59 离职 6 47.33±8.64 耳鸣情况 0.000b) 无耳鸣 24 63.37±12.00 有耳鸣 248 51.93±13.64 听力下降侧别 0.798a) 右耳 110 53.59±14.40 左耳 142 52.41±13.51 双耳 20 53.15±13.90 听力变化特征 0.275a) 突然下降 28 48.82±14.83 逐渐下降 131 53.48±15.02 波动性下降 113 53.32±12.07 病史/年 0.085a) < 1 11 43.27±9.26 1~9 220 53.59±13.87 10~19 29 53.10±14.70 ≥20 12 49.42±12.82 眩晕发作次数 0.000a) < 9 199 55.67±13.49 10~50 70 45.86±12.19 >50 3 37.00±6.00 注：a)Kruskal-Wallis检验; b)Mann-Whitney U检验。
下载: 导出CSV
-
[1] Kurz A, Auinger A, Arnoldner C. Long-term vertigo control after cochlear implantation in patients with end-stage Menière's disease: A retrospective questionnaire-based cross-sectional study[J]. Wien Klin Wochenschr, 2020, 132(17/18): 521-525.
[2] Ballard DP, Sukato DC, Timashpolsky A, et al. Quality-of-Life Outcomes following Surgical Treatment of Ménière's Disease: A Systematic Review and Meta-analysis[J]. Otolaryngol Head Neck Surg, 2019, 160(2): 232-238. doi: 10.1177/0194599818803612
[3] Convert C, Franco-Vidal V, Bebear JP, et al. Outcome-based assessment of endolymphatic sac decompression for Ménière's disease using the Ménière's disease outcome questionnaire: a review of 90 patients[J]. Otol Neurotol, 2006, 27(5): 687-696. doi: 10.1097/01.mao.0000227661.52760.f1
[4] Jones PS, Lee JW, Phillips LR, et al. An adaptation of Brislin's translation model for cross-cultural research[J]. Nurs Res, 2001, 50(5): 300-304. doi: 10.1097/00006199-200109000-00008
[5] 赵志雅, 徐鸿彬, 卢祖洵, 等. 精神文化对居民就医选择的影响综述[J]. 中国社会医学杂志, 2022, 39(2): 191-195.
[6] 晏子逸. 常态化疫情防控下互联网医疗面临的机遇与挑战[J]. 中国国情国力, 2022, 2: 43-47. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGQG202202012.htm
[7] 张季蕾, 马鑫, 苏林, 等. 走路不稳门诊患者131例双侧前庭病患病率调查[J]. 临床耳鼻咽喉头颈外科杂志, 2021, 35(2): 116-119. https://www.cnki.com.cn/Article/CJFDTOTAL-LCEH202102007.htm
[8] 杨学平, 何茹. 耳鸣患者异常心理状态的诊治研究进展[J]. 中国医学创新, 2021, 18(9): 176-180. doi: 10.3969/j.issn.1674-4985.2021.09.044
[9] 孙慧颖, 冯国栋, 高志强. 影响慢性主观性耳鸣严重程度的关键因素分析: 基于复杂网络分析的研究[J]. 临床耳鼻咽喉头颈外科杂志, 2021, 35(7): 586-592. https://www.cnki.com.cn/Article/CJFDTOTAL-LCEH202107003.htm
[10] Tang D, Li H, Chen L. Advances in Understanding, Diagnosis, and Treatment of Tinnitus[J]. Adv Exp Med Biol, 2019, 1130: 109-128.
[11] Henkens K, Henkens K, Schippers J. Active ageing in Europe: the role of organisations[J]. International Journal of Manpower, 2012, 33(6): 604-611. doi: 10.1108/01437721211261840
[12] Bowling A, Iliffe S. Psychological approach to successful ageing predicts future quality of life in older adults[J]. Health Qual Life Outcomes, 2011, 9: 13. doi: 10.1186/1477-7525-9-13
[13] Lorem GF, Schirmer H, Emaus N. Health Impact Index. Development and Validation of a Methodsfor Classifying Comorbid Disease Measured against Self-Reported Health[J]. PLoS One, 2016, 11(2): e0148830.
[14] 任亚晴, 王林娥, 李菁, 等. 术后前庭康复训练对梅尼埃病患者生活质量的效果研究[J]. 中国中西医结合耳鼻咽喉科杂志, 2021, 29(4): 263-266. https://www.cnki.com.cn/Article/CJFDTOTAL-XYJH202104006.htm
[15] 王志平, 张义, 许尧生. 应用眩晕残障量表筛查与评估眩晕患者生活质量[J]. 现代仪器与医疗, 2017, 23(6): 30-31, 34.
[16] 许静飞, 严庆丰. 健康教育干预对梅尼埃病患者疗效及生活质量的影响[J]. 中国现代医生, 2014, 52(29): 83-86. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDYS201429028.htm
[17] Szirmai Á, Maihoub S, Molnár A, et al. [Effect of the stapedius and tensor tympani muscles tenotomy on the quality of life of patients suffering from Ménière's disease][J]. Orv Hetil, 2020, 161(5): 177-182.
[18] 崔彦儒, 郑艳秋. 探讨前庭功能训练对梅尼埃病患者Berg评分及生活质量的影响[J]. 中国听力语言康复科学杂志, 2021, 19(2): 109-112. https://www.cnki.com.cn/Article/CJFDTOTAL-TLKF202102011.htm
[19] Liu JL, Liu JG, Chen XB, et al. The benefits of betahistine or vestibular rehabilitation(Tetrax biofeedback)on the quality of life and fall risk in patients with Ménière's disease[J]. J Laryngol Otol, 2020, 134(12): 1073-1076.
[20] Anderson JP, Harris JP. Impact of Ménière's disease on quality of life[J]. Otol Neurotol, 2001, 22(6): 888-894.
[21] Stephens D, Pyykk I, Levo H, et al. Positive experiences and quality of life in Ménière's disorder[J]. Int J Audiol, 2010, 49(11): 839-843.
[22] 李翠娟, 李卡莉, 胡廷保. 梅尼埃病病人生活质量与影响因素调查研究[J]. 护理研究, 2015, 29(13): 1571-1574. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ201513013.htm
[23] Söderman AC, Bagger-Sjöbäck D, Bergenius J, et al. Factors influencing quality of life in patients with Ménière's disease, identified by a multidimensional approach[J]. Otol Neurotol, 2002, 23(6): 941-948.
[24] Cohen H, Ewell LR, Jenkins HA. Disability in Meniére's disease[J]. Arch Otolaryngol Head Neck Surg, 1995, 121(1): 29-33.
[25] Arroll M, Dancey CP, Attree EA, et al. People with symptoms of Ménière's disease: the relationship between illness intrusiveness, illness uncertainty, dizziness handicap, and depression[J]. Otol Neurotol, 2012, 33(5): 816-823.
-