Zhongguo quanke yixue (Jun 2023)
Research of the Measurement Properties of the Chinese Version of the Gastrointestinal Symptom Rating Scale for Patients with Gastrointestinal Diseases
Abstract
Background Gastrointestinal symptoms as a common clinical evaluation index require a universal evaluation tool, and the Gastrointestinal Symptom Rating Scale (GSRS) has been widely applicated in domestic studies. However, the versions used are not standardized Chinese versions and their measurement performance has not been reported yet. Objective To explore the measurement performance of the Chinese version of the GSRS, in order to provide an objective basis for expanding the application of the scale. Methods From October 2021 to March 2022, patients with irritable bowel syndrome (IBS), chronic enteritis and chronic gastritis who attended outpatient clinics of splenogastroenterology or gastroenterology in 45 hospitals (community health service centers), including Jilin Provincial People's Hospital and Beijing Changping District Urban Community Health Service Center, etc. The Chinese version of GSRS was used to evaluate the gastrointestinal symptoms of the included patients on treatment days 0, 3, 7 and 14. Reliability and validity analyses were conducted on the Chinese version of GSRS, and the paired Wilcoxon signed rank sum test was applied to compare the changes in the scores of patients before and after treatment. Additionally, effect size (ES), standardized response mean (SRM), and score change rate (CR) were used to assess the responsiveness of the scales. Results A total of 554 patients were included and followed up, including 127 patients (22.93%) with IBS, 244 (44.04%) patientswith chronic enteritis and 183 (33.03%) patients with chronic gastritis. The Cronbach's alpha coefficient for the Chinese version of GSRS was 0.896, the Guttman Split-half coefficient was 0.920, the Spearman-Brown coefficient was 0.926, the intraclass correlation coefficient (ICC) for the two retest results was 0.589, and the Spearman correlation coefficient was 0.662. The content validity index for each item ranged from 0.78 to 1.00. The content validity index (CVI) for the scale-level universal agreement was 0.73, and the average CVI was 0.96. Exploratory factor analysis extracted a total of three common factors with eigenvalues>1, and the rate of cumulative variance contribution is 60.721%.The validation factor analysis demonstrated that the data samples did not fit the initial model M0 well, and each fit index of model M1 is within the acceptable range after correction according to the modification indicator hints in the acceptable range: χ2/df<3.000, root mean square error of approximation (RMSEA) <0.800, and each fit index >0.900. The total Chinese version of GSRS scores of patients after 14 d of treatment are lower than the total Chinese version of GSRS scores before treatment (P<0.001), with ES=1.03, SRM=1.01, and CR=74.32%. Conclusion The Chinese version of GSRS has a high level of measurement performance with good reliability and responsiveness, which is suitable for measuring a general population with gastrointestinal symptoms and evaluating the treatment effectiveness of them.
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