title: Psychometric properties of the Chinese version of the Amblyopia and Strabismus Questionnaire (ASQE).
abstract: 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.
authors.affiliation: Southwest Hospital/Southwest Eye Hospital, Third Military Medical University, Chongqing, 400038, China. 664091353@qq.com.|Key Lab of visual Damage and Regeneration & Restoration of Chongqing, Chongqing, 400038, China. 664091353@qq.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Bian
authors.affiliation: School of Psychology, Third Military Medical University, Chongqing, 400038, China. limin52267@tmmu.edu.cn.
authors.forename: Min
authors.initials: M
authors.lastname: Li
authors.affiliation: School of Nursing, Third Military Medical University, Chongqing, 400038, China. 948542236@qq.com.
authors.forename: Zonghua
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Southwest Hospital/Southwest Eye Hospital, Third Military Medical University, Chongqing, 400038, China. 2894248144@qq.com.|Key Lab of visual Damage and Regeneration & Restoration of Chongqing, Chongqing, 400038, China. 2894248144@qq.com.
authors.forename: Xiaolei
authors.initials: X
authors.lastname: Wang
authors.affiliation: Southwest Hospital/Southwest Eye Hospital, Third Military Medical University, Chongqing, 400038, China. 214041600@qq.com.|Key Lab of visual Damage and Regeneration & Restoration of Chongqing, Chongqing, 400038, China. 214041600@qq.com.
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Southwest Hospital/Southwest Eye Hospital, Third Military Medical University, Chongqing, 400038, China. hwuy2001@sina.com.|School of Nursing, Third Military Medical University, Chongqing, 400038, China. hwuy2001@sina.com.
authors.forename: Yan
authors.initials: Y
authors.lastname: Wu
mesh_terms: D000328:Adult; D000550:Amblyopia / Q000523:psychology*; D044466:Asian People / Q000706:statistics & numerical data; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D025341:Principal Component Analysis; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results; D013285:Strabismus / Q000523:psychology*; D011795:Surveys and Questionnaires / Q000592:standards*