Development and Validation of the Coronary Heart Disease Scale Among the System of Quality of Life Instruments for Chronic Diseases QLICD-CHD (V2.0) Based on Classical Test Theory and Generalizability Theory

Abstract

Liyuan Qiao,1,2,* Shulin Ding,2,* Wanrui Ma,1 Chuanzhi Xu,3 Xiaoqing Zhang,3 Yuxi Liu,1,2 Chonghua Wan1,2 1The First Dongguan Affiliated Hospital of Guangdong Medical University, Dongguan, people’s republic of china; 2Key Laboratory for Quality of Life and Psychological Assessment and Intervention, School of Humanities and Management, Guangdong Medical University, Dongguan, people’s republic of china; 3School of Public Health, Kunming Medical University, Kunming, people’s republic of china*These authors contributed equally to this workCorrespondence: Yuxi Liu; Chonghua Wan, Email [email protected]; [email protected]: Coronary heart disease (CHD) is a common and frequent disease with a long and incurable course, and the quality of life of patients is severely reduced. This study was to develop and validate a quality of life scale for patients with CHD based on the Chinese context.Methods: The scale QLICD-CHD (V2.0) was developed based on the QLICD-CHD (V1.0), using a programmed decision procedures. Based on the data measuring QoL 3 times before and after treatments from 189 patients with CHD, the psychometric properties of the scale were evaluated with respect to validity, reliability and responsiveness employing correlation analysis, multi-trait scaling analysis, structural equation modeling, t-test and also G-study and D-study of generalizability theory analysis. The SF-36 scale was used as the criterion to evaluate the criterion-related validity. Paired t tests were conducted to evaluate the responsiveness on each domain/facet as well as the total of the scale, with Standardized Response Mean (SRM) being calculated.Results: The QLICD-CHD (V2.0) has been developed with 42 items in 4 domains. The Cronbach’s α of the general module, the specific module and the total scale were 0.91, 0.92 and 0.91 respectively. The overall score and the test-retest reliability coefficients in all domains are higher than 0.60, except for the specific module. Correlation and factor analysis confirmed good construct validity and criterion-related validity. After treatments, the overall score and score of all domains have statistically significant changes (P< 0.01). The SRM of domain-level score ranges from 0.27 to 0.50. Generalizability Theory further confirm the reliability of the scale through more accurate variance component studies.Conclusion: The QLICD-CHD (V2.0) could be used as a useful instrument in assessing QoL for patients with CHD, with good psychometric properties.Keywords: quality of life, classical test theory, standardized response mean, psychometric properties, generalizability theory

Keywords

• quality of life
• classical test theory，standardized response mean
• psychometric properties
• generalizability theory