Korean Journal of Family Medicine (가정의학회지)

The Korean Academy of Family Medicine (대한가정의학회)
권호 표지

Validity and Reliability of the Korean Version of AIMS2 in Patients with Osteoarthritis

한국형 AIMS2의 타당도와 신뢰도

Lee, Jae-Ho;Shin, Ho-Cheol;Kim, Cheol-Hwan;Yang, Yun-Jun;Won, Chang- Won;Cho, Kyung-Hwan;Cho, Belong;Jeong, Hwa-Jae;Bin, Seong-Il;Park, Eun-Sook
이재호;신호철;김철환;양윤준;원장원;조경환;조비룡;정화재;빈성일;박은숙

  • Published : 20030000
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Abstract

Background : The second version of the Arthritis Impact Measurement Scales (AIMS2) is an improvement on an evaluation instrument that was developed to measure patient outcome in the rheumatic diseases. The goal of this study was to validate a translated version of the revised and expanded Arthritis Impact Measurement Scales (AIMS2) to be used by Korean patients with osteoarthritis (OA) of the knee. Methods : The AIMS2 was translated into Korean according to a recommended translation guideline. The Korean version of AIMS2 (K-AIMS2) was administered to a cohort of 239 outpatients with symptomatic OA of the knee who attended 7 participating University Hospitals in Seoul, Ilsan and Taejon. Forty eight patients readministered the K-AIMS2, 7 days after the first visit, to evaluate the instrument's test-retest reliability. After 6 weeks of NS AIDs therapy, 79 subjects were asked to complete a second survey of the questionnaire. Results : The internal consistency reliability of each scale score, as estimated by Cronbach's alpha coefficient, was high and indicated that the components of the scale measured the same construct. The items were all correlated with each other, but there was no redundancy; this indicated that each domain addressed a somewhat different aspect of functional disability. The test-retest reliability equalled or exceeded 0.86 for 12 scales. Factor analysis provided a three-factor health status model explaining 58.2% of the variance. The upper limb function scales formed the first factor. Psycho-social scale were loaded on the second factor. Arthritis pain together with physical scales for mobility level and walking and bending were loaded on the third factor (the lower limb function). The scale for support from family and friends was not loaded on any factors. These results demonstrate that the physical health status scales of the K-AIMS2 are valid, as shown by the significant, moderate to high correlations between the K-AIMS2 subscales and the majority of the clinical measures. Conclusion : Our data suggest that, like the original questionnaire, the Korean version of AIMS2 is a reliable, consistent and valid instrument for measuring health status and physical functioning in patients with OA of the knee.

연구배경 : 건강관련 삶의 질(Health Related Quality of Life; HRQoL) 측정은 관절염 환자의 치료를 포괄적으로 평가할 수 있는 중요한 방법이다. AIMS (Arthritis Impact Measurement Scale)는 류마티스 환자의 HRQoL을 평가하기 위해 특이적으로 고안된 첫 번째 도구였다. AIMS2는 이를 수정, 보완, 확대시킨 포괄적인 도구로서 외국에서는 널리 이용되고 있지만, 국내에서는 현재까지 권장되는 지침에 따른 번역이나 타당도 검증이 이루어진 적이 없다. 방법 : 권장되는 지침에 따라서 AIMS2를 번역, 역 번역하였고, 저자 및 위원회 검토, 예비조사를 거쳐 한국형 AIMS2 (K-AIMS2)를 개발하였다. 2001년 10월부터 12월까지 7개 대학병원 외래(가정의학과 5, 정형외과 2)를 방문한 골관절염 초진환자 239명을 대상으로 1차 조사하였다. 48명에 대해서는 1주 후 재조사를 실시하였다. 비스테로이드성 소염제(NSAIDs)를 처방 받은 환자 중 79명에 대해서는 6주 후 2차 조사를 하였다. 1차 조사에는 K-AIMS2, K-WOMAC (Korean version of Western Ontario McMaster University), CMCHS (Catholic Medical Center Health Survey) 등이 포함되었다. 자료분석을 위해서 pairted t 검증, 요인분석, 상관분석 등을 시행하였고, 조사-재조사 신뢰도 검증을 위해 급내 상관계수를 산출하였다. 결과 : 연구 대상자의 평균 연령은 61.6 (±9.1)세였으며, 여성이 197 (82.4%)명으로 다수를 차지했다. 관절염 지속기간은 평균 6.2 (±6.5)년이었다. K-AIMS2 작성시간은 평균 28.3 (±10.8)분이었다. 내용 이해정도는, '보통이다'가 157 (66.5%)명으로 가장 많았다. 두 척도(이동성과 긴장정도)를 제외한 10개 척도에서, 문항-척도 상관성은 0.4 이상, Cronbach's alpha 계수는 0.70 이상을 나타냈고, 개별 척도의 문항들이 하나의 인자에 적재함을 입증하였다. 조사-재조사 신뢰도에서는 12개 척도 모두에서 급내 상관계수가 0.86 이상으로 나타났다. '일' 척도를 제외한 11개 척도에 대한 요인분석에서 K-AIMS2는 3요인(상지기능, 정신사회적 기능, 하지기능 및 관절염 통증)에 적재하였고, 분산의 58.2%를 설명하였다. K-AIMS2의 하지기능 척도들은 K-WOMAC의 신체적 기능 및 통증, 환자 및 의사의 전반적 평가, 그리고 CMCHS의 신체적 기능 및 신체통증 등의 척도와 강한 상관관계를 보였으며, K-AIMS2의 관절염 통증 척도는 K-WOMAC의 하부척도 3개, 환자 및 의사의 전반적 평가, CMCHS의 '신체적 기능', '정서적 기능', '전반적 건강' 척도와 강한 상관관계를 보였다(Pearson's r＞0.4). 6주 후 평가한 민감도에서 '관절염 통증'(Standardized Response Mean 0.86) 등에서 민감한 개선을 보였다. 결론 : 한국형 AIMS2 (K-AIMS2)는 그 신뢰도와 타당도가 전반적으로 우수하였다. 따라서, 골관절염 치료의 임상평가에 유용하게 쓰일 수 있을 것으로 기대한다.

Keywords

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