Psychometric properties of the Chinese version of the Amblyopia and Strabismus Questionnaire (ASQE)

Health and Quality of Life Outcomes

Yan Wu²  Yang Liu³  Xiaolei Wang³  Zonghua Wang²  Min Li¹  Wei Bian³ 

[1] School of Psychology, Third Military Medical University, Chongqing 400038, China;School of Nursing, Third Military Medical University, Chongqing 400038, China;Key Lab of visual Damage and Regeneration & Restoration of Chongqing, Chongqing 400038, China

关键词: Psychometric properties;    Chinese version;    Quality of life;    The Strabismus and Amblyopia Questionnaire;   

Others  :  1219171
DOI  :  10.1186/s12955-015-0269-6

 received in 2014-07-20, accepted in 2015-05-19,  发布年份 2015

【 摘 要 】

Background

Strabismus and amblyopia are known to cause visual dysfunction, self-image disorders, difficulty in seeking employment and social and emotional barriers. These factors can have a serious and detrimental effect upon the patients’ health-related quality of life (HRQOL). Presently, a condition-specific questionnaire is not available for assessing the HRQOL in Chinese patients. This study developed a Chinese version of the Amblyopia and Strabismus Questionnaire (ASQE) and tested its reliability and validity in Chinese adult strabismus patients.

Methods

Chinese strabismus adults, adults with normal vision and patients with a variety of other eye diseases completed the Chinese version of the ASQE. Reliability was established by Cronbach’s alpha and test-retest. Validity was evaluated by content, construct, criterion-related, convergent and discriminative validities.

Results

A total of 202 adult strabismus patients with or without amblyopia, 100 visually normal adults, and 100 patients with other eye diseases (excluding strabismus and amblyopia) participated in this study. Using principal components analysis, six domains were extracted, with a content validity of 0.91. Four items were deleted giving final total of 22 items in the questionnaire. The total score of the ASQE was significantly correlated to the Adult Strabismus Questionnaire (AS-20) (r = 0.642, P < 0.01). The median scores for the adult strabismus patients were significantly lower (worse HRQOL) compared with visually normal adults (66.32 vs. 92.71; P < 0.001) and patients with other eye diseases (66.32 vs. 79.50; P < 0.001) thus demonstrating good discriminative validity for the questionnaire. The Cronbach’s alpha coefficient for internal consistent reliability was 0.887 and the test-retest reliability was 0.946. The mean total score of the ASQE was 65.85 (SD = 15.32) and the domain ‘social contact and appearance’ recorded the lowest mean score 43.78 (SD = 13.92) in strabismus patients.

Conclusions

The revised 22-item Chinese version of the ASQE showed good psychometric properties. It is suggested that this questionnaire provides a potentially useful measurement tool in clinical or research programs involving Chinese strabismus patients with or without associated amblyopia.

【 授权许可】

   
2015 Bian et al.

【 参考文献 】

• [1]Beauchamp GR, Black BC, Coats DK, Enzenauer RW, Hutchinson AK, Saunders RA, Simon JW, Stager DR, Wilson ME, Zobal-Ratner J, Felius J. The Management of Strabismus in Adults—III. The Effects on Disability. J Am Assoc Pediatr Ophthalmol Strabismus. 2005; 9:455-459.
• [2]Durnian JM, Owen ME, Baddon AC, Noonan CP, Marsh IB. The psychosocial effects of strabismus: Effect of patient demographics on the AS-20 score. J Am Assoc Pediatr Ophthalmol Strabismus. 2010; 14:469-471.
• [3]Nelson BA, Gunton KB, Lasker JN, Nelson LB, Drohan LA. The psychosocial aspects of strabismus in teenagers and adults and the impact of surgical correction. J Am Assoc Pediatr Ophthalmol Strabismus. 2008; 12:72-76.
• [4]Williams C, Harrad R. Amblyopia: Contemporary Clinical Issues. Strabismus. 2006; 14:43-50.
• [5]Coats DK, Paysse EA, Towler AJ, Dipboye RL. Impact of large angle horizontal strabismus on ability to obtain employment. Ophthalmology. 2000; 107:402-405.
• [6]Lukman H, Kiat JE, Ganesan A, Chua WL, Khor KL, Choong YF. Strabismus-related prejudice in 5-6-year-old children. Br J Ophthalmol. 2010; 94:1348-1351.
• [7]Menon V, Saha J, Tandon R, Mehta M, Khokhar S. Study of the psychosocial aspects of strabismus. J Pediatr Ophthalmol Strabismus. 2002; 39:203-208.
• [8]Olitsky SE, Sudesh S, Graziano A, Hamblen J, Brooks SE, Shaha SH. The negative psychosocial impact of strabismus in adults. J AAPOS. 1999; 3:209-211.
• [9]Hatt SR, Leske DA, Liebermann L, Holmes JM. Changes in Health-Related Quality of Life 1 Year Following Strabismus Surgery. Am J Ophthalmol. 2012; 153:614-619.
• [10]Mangione CM, Lee PP, Gutierrez PR, Spritzer K, Berry S, Hays RD. Development of the 25-item National Eye Institute Visual Function Questionnaire. Arch Ophthalmol. 2001; 119:1050-1058.
• [11]Wolffsohn JS, Cochrane AL. Design of the low vision quality-of-life questionnaire (LVQOL) and measuring the outcome of low-vision rehabilitation. Am J Ophthalmol. 2000; 130:793-802.
• [12]Mangione CM, Phillips RS, Seddon JM, Lawrence MG, Cook EF, Dailey R, Goldman L. Development of the 'Activities of Daily Vision Scale'. A measure of visual functional status. Med Care. 1992; 30:1111-1126.
• [13]Cole SR, Beck RW, Moke PS, Celano MP, Drews CD, Repka MX, Holmes JM, Birch EE, Kraker RT, Kip KE. The amblyopia treatment index. J Am Assoc Pediatr Ophthalmol Strabismus. 2001; 5:250-254.
• [14]Felius J, Beauchamp GR, Stager DR, Van De Graaf ES, Simonsz HJ. The Amblyopia and Strabismus Questionnaire: English Translation, Validation, and Subscales. Am J Ophthalmol. 2007; 143:305-310.
• [15]van de Graaf ES, Felius J, van Kempen-du SH, Looman CW, Passchier J, Kelderman H, Simonsz HJ. Construct validation of the Amblyopia and Strabismus Questionnaire (A&SQ) by factor analysis. Graefes Arch Clin Exp Ophthalmol. 2009; 247:1263-1268.
• [16]van de Graaf ES, van der Sterre GW, Polling JR, van Kempen H, Simonsz B, Simonsz HJ. Amblyopia & Strabismus Questionnaire: design and initial validation. Strabismus. 2004; 12:181-193.
• [17]van de Graaf ES, van der Sterre GW, van Kempen-du SH, Simonsz B, Looman CW, Simonsz HJ. Amblyopia and Strabismus Questionnaire (A&SQ): clinical validation in a historic cohort. Graefes Arch Clin Exp Ophthalmol. 2007; 245:1589-1595.
• [18]Bujak MC, Leung AK, Kisilevsky M, Margolin E. Monovision correction for small-angle diplopia. Am J Ophthalmol. 2012; 154:586-592.
• [19]Zong-Hua Wang WB, Hui Ren, Rosemary Frey, Ling-Fei Tang, Xian-Yuan Wang1: Development and application of the Chinese version of the adult strabismus quality of life questionnaire (AS-20): a cross-sectional study. Health Qual Life Outcomes. 2013;11:180.
• [20]Garyfallos G, Karastergiou A, Adamopoulou A, Moutzoukis C, Alagiozidou E, Mala D, Garyfallos A. Greek version of the General Health Questionnaire: accuracy of translation and validity. Acta Psychiatr Scand. 1991; 84:371-378.
• [21]Lynn MR. Determination and quantification of content validity. Nurs Res. 1986; 35:382-385.
• [22]Polit D, Beck C. Nursing Research: Principles and methods. 2004.
• [23]Pallant J. SPSS survival manual: A step by step guide to data analysis using SPSS. McGraw-Hill Education: Open University Press; 2010.
• [24]Marcon GB, Pittino R. The Italian version of the Amblyopia and Strabismus Questionnaire: translation, validation, and reliability. Strabismus. 2014; 22:100-110.
• [25]Yu H, Yang X, Ye T, Chen J, Zhang F, Yu X. Development and evaluation of a Chinese version of the Adult Strabismus Questionnaire (AS-20). Ophthalmic Epidemiol. 2013; 20:239-247.
• [26]Kong D, Wang F, Ma L-X, Yun-Yan W, Guo L, Lv F-f. Investigating the quality of life in adult strabismus patients. Nurs Manag. 2014; 14:339-340.
• [27]Chang H, Holt G. A chinese perspective on face as inter-relational concern. 1994.
• [28]Marella M, Pesudovs K, Keeffe JE, O'Connor PM, Rees G, Lamoureux EL. The psychometric validity of the NEI VFQ-25 for use in a low-vision population. Invest Ophthalmol Vis Sci. 2010; 51:2878-2884.
• [29]Baker JD. The value of adult strabismus correction to the patient. J Am Assoc Pediatr Ophthalmol Strabismus. 2002; 6:136-140.
• [30]Bez Y, Coşkun E, Erol K, Cingu AK, Eren Z, Topçuoğlu V, Özertürk Y. Adult strabismus and social phobia: A case-controlled study. J Am Assoc Pediatr Ophthalmol Strabismus. 2009; 13:249-252.
• [31]Jackson S, Harrad RA, Morris M, Rumsey N. The psychosocial benefits of corrective surgery for adults with strabismus. Br J Ophthalmol. 2006; 90:883-888.