Purpose

Symptoms of Multiple Sclerosis (MS) differentially impact upon quality of life (QoL) and a comprehensive measure is required for use in observational and interventional studies. This study examines the abbreviated World Health Organisation Quality of Life tool (WHOQOL-BREF) which was designed to be used as a broad measure of QoL across different cultures and diseases.

Methods

Data were collected from 3186 subjects as part of the TONiC study in MS and was examined with a systematic, iterative approach using Rasch analysis to investigate the internal construct validity of the WHOQOL-BREF.

Results

Mean age was 49.8 years (SD 11.8), disease duration was 11.2 years (SD 9.6) and 73.2% were female. Subjects represented all stages of MS with EDSS scores of 0–4, 4.5–6.5, 7–7.5 and ≥ 8 seen in 49.8%, 38.5%, 6.8% and 4.9% of patients, respectively. Using a super-item approach, it was possible to demonstrate fit to the assumptions of the Rasch model for 3 of the 4 domains of the WHOQOL-BREF (physical, psychological and environment) as well as a broad 24-item total score. In addition, item subsets derived from the stem of each question were shown to function as novel scales measuring impact and life satisfaction. We have provided transformation tables from ordinal raw scores to interval scales where data are complete.

Conclusions

The validation of multiple conceptual frameworks validates the WHOQOL-BREF as a powerful and flexible end-point for use in clinical trials and in testing conceptual models of factors influencing QoL in MS.

中文翻译：

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WHOQOL-BREF：对多发性硬化症患者内部结构有效性的现代心理测量评估。

目的

多发性硬化症 (MS) 的症状对生活质量 (QoL) 的影响不同，观察性和介入性研究需要采取综合措施。本研究考察了世界卫生组织生活质量工具（WHOQOL-BREF）的缩写，该工具旨在广泛衡量不同文化和疾病的生活质量。

方法

作为 MS TONiC 研究的一部分，从 3186 名受试者中收集了数据，并使用 Rasch 分析以系统、迭代的方法进行了检查，以调查 WHOQOL-BREF 的内部结构有效性。

结果

平均年龄为 49.8 岁 (SD 11.8)，病程为 11.2 年 (SD 9.6)，73.2% 为女性。受试者代表 MS 的所有阶段，EDSS 评分为 0-4、4.5-6.5、7-7.5 和 ≥ 8 的患者分别占 49.8%、38.5%、6.8% 和 4.9%。使用超级项目方法，可以证明 WHOQOL-BREF 4 个领域（身体、心理和环境）中的 3 个领域符合 Rasch 模型的假设，以及 24 个项目的总分。此外，从每个问题的主干得出的项目子集被证明可以作为衡量影响和生活满意度的新颖量表。我们提供了从序数原始分数到数据完整的区间尺度的转换表。

结论

多个概念框架的验证验证了 WHOQOL-BREF 作为一个强大而灵活的终点，可用于临床试验和测试影响 MS 生活质量因素的概念模型。