Development and evaluation of the quality of life instrument in chronic liver disease patients with minimal hepatic encephalopathy
Article first published online: 1 DEC 2008
© 2008 The Authors. Journal compilation © 2008 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd
Journal of Gastroenterology and Hepatology
Volume 24, Issue 3, pages 408–415, March 2009
How to Cite
Zhou, Y.-q., Chen, S.-y., Jiang, L.-d., Guo, C.-y., Shen, Z.-y., Huang, P.-x. and Wang, J.-y. (2009), Development and evaluation of the quality of life instrument in chronic liver disease patients with minimal hepatic encephalopathy. Journal of Gastroenterology and Hepatology, 24: 408–415. doi: 10.1111/j.1440-1746.2008.05678.x
- Issue published online: 23 MAR 2009
- Article first published online: 1 DEC 2008
- Accepted for publication 12 August 2008.
- liver disease;
- minimal hepatic encephalopathy;
- quality of life
Objectives: The objective was to develop a valid and reliable health-related quality of life (HRQOL) assessment tool to measure the functional and health status of patients with minimal hepatic encephalopathy (mHE).
Methods: Items potentially affecting the HRQOL of these patients were identified, based on the responses from 53 patients with minimal hepatic encephalopathy, from seven liver experts, four epidemiologists and from a PubMed search of the literature. Results were explored using factor analysis and redundant questions were eliminated. The final stated questionnaire was used in 178 patients with mHE to evaluate its reliability and validity.
Results: Thirty-five items proved to be important for 32 respondents in the item reduction sample. The final instrument included five domains (30 items) which were shown as follows: physical functioning (8 items), psychological well-being (7 items), symptoms/side effects (7 items), social functioning (4 items) and general-health (4 items). An inter-item correlation for each of the five domains ranged from 0.220 to 0.776, with a mean of 0.280. Cronbach's alpha for above five domains was 0.8775, 0.8446, 0.8360, 0.7087 and 0.7016 respectively. The test-retest coefficients for the five domains were 0.94, 0.93, 0.96, 0.82 and 0.83 respectively. Factor analysis showed preservation of five components structure. Cumulative variance of principal components was 63.12%. Patients with more advanced disease seemed to have more impairment of their well-being, especially in the symptoms/side effects domain.
Conclusions: The instrument is short, easy to administer and is of good validity and reliability in patients with mHE.