中文版慢性病治疗功能评估-疲劳量表在ITP患者中的应用及疲劳影响因素分析
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摘要
目的:评价中文版慢性病治疗功能评估-疲劳量表(FACIT-F量表)在原发免疫性血小板减少症(ITP)患者中的信效度,并分析患者疲劳程度的影响因素。方法:首先向量表授权机构提出申请,获取中文版FACIT-F量表。纳入206例成人ITP患者。采用中文版FACIT-F量表、健康调查简表(SF-36)进行患者自评,记录相关临床资料。计算中文版FACIT-F量表的Cronbach'α系数、重测信度和效标关联系数,运用多因素线性回归分析筛选患者疲劳程度的影响因素。结果:206例患者中男84例,女122例,中位年龄50(18～76)岁。中文版FACIT-F量表的Cronbach'α系数为0.934,重测信度为0.971,与SF-36量表中"活力"维度的效标关联系数为0.591(P<0.01)。多因素线性回归分析显示,女性(P=0.022)及血小板计数偏低(P=0.007)是ITP患者疲劳的独立危险因素。结论:中文版FACIT-F量表信效度良好,可作为国内ITP患者疲劳的评价工具。女性ITP患者可能更易受到疲劳困扰;提升血小板计数有助于改善疲劳状态。
Objective:To evaluate the reliability and validity of the Chinese version of functional assessment of chronic illness therapy-fatigue(FACIT-F)in patients with primary immune thrombocytopenia(ITP),and to analyze the possible factors that affect the severity of fatigue.Method:We applied to the scale authority to obtain the Chinese version of FACIT-F.A total of 206 eligible adult patients with ITP were enrolled in this study.The Chinese version of FACIT-F and the short form health survey(SF-36)were used for patient self-assessment.At the same time,we recorded the patients' relevant clinical data.The Cronbach's alpha coefficient,the test-retest reliability and the criterion correlation coefficient of the Chinese version of the FACIT-F scale were calculated,and the factors affecting the patients' fatigue were screened by multivariate linear regression analysis.Result:Among 206 patients with ITP,there were 84 males and 122 females,with a median age of 50(18-76)years.The Chinese version of the FACIT-F had a Cronbach'αof 0.934 and a test-retest reliability of 0.971,and the criterion validity with the "vitality" dimension of the SF-36 scale was 0.591(P<0.01).Multivariate linear regression analysis showed that women(P=0.022)and low platelet counts(P=0.007)were independent risk factors for fatigue in patients with ITP.Conclusion:The Chinese version of the FACIT-F has good reliability and validity and can be used as an evaluation tool for fatigue in domestic ITP patients.Women with ITP may be more susceptible to fatigue,and increasing platelet counts can help improve fatigue.
Objective:To evaluate the reliability and validity of the Chinese version of functional assessment of chronic illness therapy-fatigue(FACIT-F)in patients with primary immune thrombocytopenia(ITP),and to analyze the possible factors that affect the severity of fatigue.Method:We applied to the scale authority to obtain the Chinese version of FACIT-F.A total of 206 eligible adult patients with ITP were enrolled in this study.The Chinese version of FACIT-F and the short form health survey(SF-36)were used for patient self-assessment.At the same time,we recorded the patients' relevant clinical data.The Cronbach's alpha coefficient,the test-retest reliability and the criterion correlation coefficient of the Chinese version of the FACIT-F scale were calculated,and the factors affecting the patients' fatigue were screened by multivariate linear regression analysis.Result:Among 206 patients with ITP,there were 84 males and 122 females,with a median age of 50(18-76)years.The Chinese version of the FACIT-F had a Cronbach'αof 0.934 and a test-retest reliability of 0.971,and the criterion validity with the "vitality" dimension of the SF-36 scale was 0.591(P<0.01).Multivariate linear regression analysis showed that women(P=0.022)and low platelet counts(P=0.007)were independent risk factors for fatigue in patients with ITP.Conclusion:The Chinese version of the FACIT-F has good reliability and validity and can be used as an evaluation tool for fatigue in domestic ITP patients.Women with ITP may be more susceptible to fatigue,and increasing platelet counts can help improve fatigue.
引文
[1]侯明,秦平.成人原发免疫性血小板减少症诊治的中国专家共识(2016版)解读[J].临床血液学杂志,2016,29(7):523-527.
[2]Grace RF,Neunert C.Second-line therapies in immune thrombocytopenia[J].Hematology Am Soc Hematol Educ Program,2016,2016:698-706.
[3]李洋,吕明恩,郝亚停,等.成人原发免疫性血小板减少症患者疲劳症状及影响因素分析[J].中华血液学杂志,2017,38(5):384-389.
[4]Signorovitch J,Brainsky A,Grotzinger KM,et al.Validation of the FACIT-fatigue subscale,selected items from FACT-thrombocytopenia,and the SF-36v2in patients with chronic immune thrombocytopenia[J].Qual Life Res,2011,20:1737-1744.
[5]陈振萍,周泽平,杨丽,等.成人特发性血小板减少性紫癜患者生活质量研究[J].临床血液学杂志,2008,21(4):339-342.
[6]秦平,侯明.2012版成人原发免疫性血小板减少症诊治的中国专家共识解读[J].临床血液学杂志,2013,26(3):151-155.
[7]Newton JL,Reese JA,Watson SI,et al.Fatigue in adult patients with primary immune thrombocytopenia[J].Eur J Haematol,2011,86:420-429.
[8]Cuter DJ,Mathias SD,Rummel M,et al.Health-related quality of life in nonsplenectomized immune thrombocytopenia patients receiving romiplostim or medical standard of care[J].Am J Hematol,2012,87:558-561.
[9]Efficace F,Mandelli F,Fazi P,et al.Health-related quality of Life and burden of fatigue in patients with primary immune thrombocytopenia by phase of disease[J].Am J Hematol,2016,91:995-1001.
[10]王明镜,胡晓梅,邓中阳,等.免疫性血小板减少症的免疫机制研究进展[J].临床血液学杂志,2017,30(9):725-728.
[11]Mohandas H,Jaganathan SK,Mani MP,et al.Cancerrelated fatigue treatment:an overview[J].J Cancer Res Ther,2017,13(6):916-929.
[2]Grace RF,Neunert C.Second-line therapies in immune thrombocytopenia[J].Hematology Am Soc Hematol Educ Program,2016,2016:698-706.
[3]李洋,吕明恩,郝亚停,等.成人原发免疫性血小板减少症患者疲劳症状及影响因素分析[J].中华血液学杂志,2017,38(5):384-389.
[4]Signorovitch J,Brainsky A,Grotzinger KM,et al.Validation of the FACIT-fatigue subscale,selected items from FACT-thrombocytopenia,and the SF-36v2in patients with chronic immune thrombocytopenia[J].Qual Life Res,2011,20:1737-1744.
[5]陈振萍,周泽平,杨丽,等.成人特发性血小板减少性紫癜患者生活质量研究[J].临床血液学杂志,2008,21(4):339-342.
[6]秦平,侯明.2012版成人原发免疫性血小板减少症诊治的中国专家共识解读[J].临床血液学杂志,2013,26(3):151-155.
[7]Newton JL,Reese JA,Watson SI,et al.Fatigue in adult patients with primary immune thrombocytopenia[J].Eur J Haematol,2011,86:420-429.
[8]Cuter DJ,Mathias SD,Rummel M,et al.Health-related quality of life in nonsplenectomized immune thrombocytopenia patients receiving romiplostim or medical standard of care[J].Am J Hematol,2012,87:558-561.
[9]Efficace F,Mandelli F,Fazi P,et al.Health-related quality of Life and burden of fatigue in patients with primary immune thrombocytopenia by phase of disease[J].Am J Hematol,2016,91:995-1001.
[10]王明镜,胡晓梅,邓中阳,等.免疫性血小板减少症的免疫机制研究进展[J].临床血液学杂志,2017,30(9):725-728.
[11]Mohandas H,Jaganathan SK,Mani MP,et al.Cancerrelated fatigue treatment:an overview[J].J Cancer Res Ther,2017,13(6):916-929.