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DOI: 10.1055/s-2004-812835
Validation of the Inflammatory Bowel Disease Questionnaire IBDQ-D, German Version, for Patients with Ileal Pouch Anal Anastomosis for Ulcerative Colitis[*]
Validierung der deutschen Version des Inflammatory Bowel Disease Questionnaire IBDQ-D für Patienten mit Colitis ulcerosa und ileoanalem PouchPublikationsverlauf
Manuscript received: 19. July 03
Accepted after revision: 27. October 03
Publikationsdatum:
13. Februar 2004 (online)
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Zusammenfassung
Zielsetzung: Der Inflammatory Bowel Disease Questionnaire (IBDQ) ist das Standardinstrument zur Erfassung der gesundheitsbezogenen Lebensqualität (HRQOL) von Patienten mit chronisch entzündlichen Darmerkrankungen (CED). Die deutsche Version des IBDQ wurde bisher nicht für Patienten mit ileoanalem Pouch (IPAA) bei Colitis ulcerosa (CU) validiert.
Methoden: 61 Patienten mit CU (Alter 52,7 ± 13,9 Jahre; 47 % weiblich, 53 % männlich) und IPAA füllten die deutsche Version des Inflammatory Bowel Disease Questionnaire (IBDQ-D), den Fragebogen zum Gesundheitszustand (SF-36), die deutsche Version der Krankenhaus Angst- und Depressions-Skala (HADS-D) und den Gießener Beschwerdebogen (GBB 24) zur Bestimmung der Akzeptanz (Anzahl beantworteter Items), Reliabilität (Cronbachs α der Subskalen) und konvergenten Validität (Korrelation mit anderen Fragebogen) aus. Die Augenscheinvalidität des IBDQ-D wurde durch ein Panel von Ärzten und Patienten beurteilt. 37 Patienten wurden endoskopiert, um die diskriminative Validität des IBDQ-D im Vergleich von Patienten mit und ohne Pouchitis bestimmen zu können.
Ergebnisse: Mit 97,7 % beantworteter Items war die Akzeptanz exzellent. Das Cronbachs α der Subskalen lag zwischen 0,71 und 0,93. Die mangelnde Berücksichtigung extraintestinaler Symptome wurde von den Patienten kritisiert. Die Korrelationen mit vergleichbaren Subskalen der Validierungsinstrumente lagen zwischen 0,41 und 0,76. Patienten mit klinischer Pouchitis gaben in allen Subskalen des IBDQ-D eine schlechtere HRQOL an als Patienten ohne klinische Pouchitis (p < 0,001).
Schlussfolgerung: Der IBDQ-D weist eine gute Reliabilität sowie konvergente und diskriminative Validität, jedoch eine eingeschränkte Augenschein- und Konstruktvalidität bei Patienten mit IPAA und CU auf.
Abstract
Background and aims: The inflammatory bowel disease questionnaire (IBDQ) is the standard instrument for assessment of health-related quality of life (HRQOL) in patients with inflammatory bowel diseases. It has not been validated for patients with ileal pouch anal anastomosis (IPAA) and ulcerative colitis (UC).
Methods: To determine acceptance (percentage of completed items), reliability (Cronbach’s α of the IBDQ-D subscales) and convergent validity (correlations of the IBDQ subscales with the questionnaires used for validation) 61 patients with UC (age 52.7 ± 13.9 years; 47 % female, 53 % male) and IPAA completed the German (Competence Network IBD) version of the Inflammatory Bowel Disease Questionnaire (IBDQ-D), the Short Form Health Survey (SF-36) the Hospital Anxiety and Depression Scale German Version (HADS-D) and the Giessener Symptom List (GBB 24). Face validity was assessed by a physicians’ and patients’ panel. All 37 patients underwent endoscopy making it possible to differentiate between patients with and without pouchitis (discriminant validity).
Results: With 97.7 % completed items the acceptance was high. Cronbach’s α value for the subscales ranged from 0.71 to 0.93. Missing items covering extraintestinal manifestations of IBD were criticized by patients. The correlation coefficients with comparable subscales of other instruments ranged between 0.41 and 0.76. Patients with clinical pouchitis scored significantly lower in all subscales than patients without pouchitis (p < 0.001).
Conclusion: The IBDQ-D has good acceptance, reliability, convergent and discriminant validity, but limited face and construct validity in patients with IPAA and UC.
Schlüsselwörter
Deutsche Version Inflammatory Bowel Disease Questionnaire IBDQ-D - Colitis ulcerosa - Ileoanaler Pouch - Validierung - Kompetenznetz Chronisch entzündliche Darmerkrankungen
Key words
German version inflammatory bowel disease questionnaire IBDQ-D - ulcerative colitis - ileal pouch anal anastomosis - validation - competence network inflammatory bowel Disease
1 * This investigation is part of the Competence Network IBD, supported by the German Ministry of Education and Research (BMBF D 20.00 415).
References
1 * This investigation is part of the Competence Network IBD, supported by the German Ministry of Education and Research (BMBF D 20.00 415).
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Winfried Häuser, MD
Department of Internal Medicine I, Klinikum Saarbrücken gGmbH
Winterberg 1
66119 Saarbrücken
eMail: whaeuser@klinikum-saarbruecken.de