MacNew Heart Disease Health-Related Quality of Life Questionnaireの日本語版の作成と信頼性・妥当性の検討

Development of a Japanese Version of the MacNew Heart Disease Health-Related Quality of Life Questionnaire

要旨

　わが国においては心不全に特異的なQOL尺度が存在しないため，海外で多用されている心不全特異的QOL尺度の日本語版を作成し，その信頼性と妥当性を検討した．

　日本語版作成のプロセスは原著者の指示に従い，翻訳は医療者と非医療者によるチームによって行われ，A県内の3医療機関の外来に通院する慢性心不全患者204人を対象に，調査を行った．結果は，理論的関連があると考えられるSF-36およびHospital Anxiety and Depression Scaleのすべての下位尺度間において有意な相関を示し，基準関連妥当性が確認された．また，因子分析により原版と同じ3因子構造が確認され，心機能の分類(NYHA)によるMacNew平均得点の比較から，重症者では軽度・中等度の患者よりもQOL得点が5％水準で有意に低くなることが明らかとなり，構成概念妥当性が確認された．さらに，すべてのCronbach α係数は0.7以上であり，十分な内的整合性をもつことが確認された．よって，19項目のMacNew日本語版「MacNew心疾患健康関連QOL尺度(日本語版)」の信頼性および妥当性が確認された．

Abstract

　Aim：The purpose of this study is to develop a Japanese version of the MacNew Heart Disease Health-Related Quality of Life Questionnaire (MacNew) because there are few available heart disease-specific scales in Japan.

　Methods：Firstly, research team members carried out repeated translation and back translation. After that, a Japanese version of MacNew was used to measure the health-related quality of life of 204 Japanese outpatients with chronic heart failure.Factor analysis,Pearson correlation coefficients, and internal consistency were used to verify validity and reliability of the scale.

　Results：As a result of the statistical analysis, the same three dimensions as in the original version of MacNew were identified for the 19 questionnaire items. Moreover the analysis showed a significant correlation between the Japanese version of MacNew and two other existent scales having the same concept, Medical Outcome Study Short-Form 36-Item Health Survey and the Hospital Anxiety and Depression Scale. Additionally, construct validity was confirmed by comparative mean score between level of New York Heart Association which was one of the clinical indicators of heart disease. Also, regarding the internal consistency, the coefficient value of Cronbach alpha for the total scores of the three dimensions of the Japanese version of MacNew was more than 0.7, which was verification of reliability.

　Conclusion：In conclusion, the Japanese version of MacNew with 3 dimensions consisting of 19 items was developed and its validity and reliability were confirmed.