title: Adaptation and validation of the "tolerability and quality of life" (TOOL) questionnaire in Chinese bipolar patients.
abstract: It is well known that the antipsychotic drugs impact the health-related quality of life (HRQoL) of the bipolar patients. The side effects had been assessed only from the doctors' perspective and neglected the patients' subjective feeling. The aim of the study is to validate the specific instrument "tolerability and quality of life" (TOOL) into Chinese to describe and grade the impact of antipsychotic drugs on HRQoL from patients' view.
  
  
  
  A psychometric study was conducted with euthymic bipolar disorder patients (N = 105) under antipsychotic treatment. The psychometric properties of the TOOL, including internal consistency, retest reliability, concurrent validity, content validity, discriminative validity, item analysis, confirmatory factor analysis and feasibility, were analyzed.
  
  
  
  The internal consistency and intraclass correlation coefficient (ICC) were adequate (Cronbach's alpha = 0.80 and ICC = 0.81). A confirmatory factor analysis (CFA) validated the one-factor model. Significant Spearman's rank correlations between the TOOL and both Bref QoL.BD (Brief version of Quality of Life in Bipolar Disorder) (r = -0.33, P < 0.01) and UKU (Udvalg for Kliniske Undersogelser side effects scale) (r = 0.13, P < 0.05) were found.
  
  
  
  Small sample size and no specific self-report instrument in Chinese to evaluate the criterion validity.
  
  
  
  TOOL appears to be a reliable and valid measure to assess the impact of adverse events of antipsychotic drugs on HRQoL from the patients' perspective.
authors.affiliation: School of Nursing, Southern Medical University, 1023 Sha Tai South Road, Bai Yun District, Guangzhou, 510515, Guangdong Province, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Xiao
authors.affiliation: School of Nursing, Southern Medical University, 1023 Sha Tai South Road, Bai Yun District, Guangzhou, 510515, Guangdong Province, China.
authors.forename: Yulin
authors.initials: Y
authors.lastname: Gao
authors.affiliation: School of Nursing, Southern Medical University, 1023 Sha Tai South Road, Bai Yun District, Guangzhou, 510515, Guangdong Province, China. xiaoxiao_871227@126.com.
authors.forename: Lili
authors.initials: L
authors.lastname: Zhang
authors.affiliation: School of Nursing, Southern Medical University, 1023 Sha Tai South Road, Bai Yun District, Guangzhou, 510515, Guangdong Province, China.
authors.forename: Peiyun
authors.initials: P
authors.lastname: Chen
authors.affiliation: School of Nursing, Southern Medical University, 1023 Sha Tai South Road, Bai Yun District, Guangzhou, 510515, Guangdong Province, China.
authors.forename: Xiaojia
authors.initials: X
authors.lastname: Sun
authors.affiliation: Nursing School of Central South University, 172 Tong Zi Po Street, Yue Lu District, Changsha, 410013, Hunan Province, China. tangsyuan@126.com.
authors.forename: Siyuan
authors.initials: S
authors.lastname: Tang
mesh_terms: D000328:Adult; D044466:Asian People; D001714:Bipolar Disorder / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D011594:Psychometrics / Q000379:methods*; D015203:Reproducibility of Results; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires
keywords: Antipsychotic treatment; Bipolar disorder; Quality of life; Reliability; Validity