title: Development and evaluation of the quality of life instrument in chronic liver disease patients with minimal hepatic encephalopathy.
abstract: OBJECTIVE
  The objective was to develop a valid and reliable health-related quality of life (HRQOL) assessment tool to measure the functional and health status of patients with minimal hepatic encephalopathy (mHE).
  
  
  METHODS
  Items potentially affecting the HRQOL of these patients were identified, based on the responses from 53 patients with minimal hepatic encephalopathy, from seven liver experts, four epidemiologists and from a PubMed search of the literature. Results were explored using factor analysis and redundant questions were eliminated. The final stated questionnaire was used in 178 patients with mHE to evaluate its reliability and validity.
  
  
  RESULTS
  Thirty-five items proved to be important for 32 respondents in the item reduction sample. The final instrument included five domains (30 items) which were shown as follows: physical functioning (8 items), psychological well-being (7 items), symptoms/side effects (7 items), social functioning (4 items) and general-health (4 items). An inter-item correlation for each of the five domains ranged from 0.220 to 0.776, with a mean of 0.280. Cronbach's alpha for above five domains was 0.8775, 0.8446, 0.8360, 0.7087 and 0.7016 respectively. The test-retest coefficients for the five domains were 0.94, 0.93, 0.96, 0.82 and 0.83 respectively. Factor analysis showed preservation of five components structure. Cumulative variance of principal components was 63.12%. Patients with more advanced disease seemed to have more impairment of their well-being, especially in the symptoms/side effects domain.
  
  
  CONCLUSIONS
  The instrument is short, easy to administer and is of good validity and reliability in patients with mHE.
authors.affiliation: Department of Digestion, Tenth People's Hospital, Tong Ji University, Zhabei District, Shanghai, China. yqzh02@163.com
authors.forename: Ying-qun
authors.initials: YQ
authors.lastname: Zhou
authors.forename: Shi-yao
authors.initials: SY
authors.lastname: Chen
authors.forename: Lin-di
authors.initials: LD
authors.lastname: Jiang
authors.forename: Chuan-yong
authors.initials: CY
authors.lastname: Guo
authors.forename: Zhen-yu
authors.initials: ZY
authors.lastname: Shen
authors.forename: Pei-xing
authors.initials: PX
authors.lastname: Huang
authors.forename: Ji-yao
authors.initials: JY
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D002681:China; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004569:Electroencephalography; D005163:Factor Analysis, Statistical; D005260:Female; D006305:Health Status Indicators; D006501:Hepatic Encephalopathy / Q000209:etiology* / Q000523:psychology; D006801:Humans; D008107:Liver Diseases / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011594:Psychometrics; D011788:Quality of Life; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires