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JKM > Volume 36(3); 2015 > Article
Kim, Kim, Kim, and Kim: Reliability and Validity Analysis of a Standard Instrument of Diagnosis and Assessment for Spleen Qi Deficiency Pattern in Chronic Dyspepsia Patients

Abstract

Objectives:

This study is aimed at assessing the reliability of a standard instrument of diagnosis and assessment for Spleen Qi deficiency pattern questionnaire (SQDQ) and examining the validity of the SQDQ by comparing the pattern identification scores of different groups.

Methods:

We conducted a survey of 72 participants (60 patients with chronic dyspepsia and 12 healthy subjects) using self-reported questionnaire. Participants were given written consent and this study was performed under the permission of institutional review board of Kyung-Hee university Korean medicine hospital.

Results:

The reliability and the validity of the questionnaire were inspected. Internal consistency of the SQDQ was excellent. Construct validity analyzed by exploratory factor analysis produced 4 factors, which were selected from eigenvalues that are greater than 1.0. The factor 1, 2, 3 and 4 showed ‘fatigue’, ‘meal’, ‘diagnosis’ and ‘figure’ respectively. For most of SQDQs’ items, there were significant differences observed between the Spleen Qi and the non-Spleen Qi groups. However, the ‘emaciation’, ‘tongue diagnosis’ and ‘pulse diagnosis’ showed no significant differences.

Conclusions:

The SQDQ restructured in this study may provide a fundamental questionnaire and a further study is required for a more advanced, standardized and statistically proven questionnaire.

Fig. 1.
Flow chart of clinical study
jkm-36-3-23f1.tif
Table 1.
Demographic Characteristics of Patients with Chronic Dyspepsia and Controls (N=72)
Controls (n=12) Chronic dyspepsia patients (n=60) p-value
Age 42.6 ± 14.9 40.0 ± 12.7 0.535
Height 162.0 ± 7.5 160.0 ± 7.8 0.995
Weight 60.0 ± 7.5 59.8 ± 10.1 0.936
Table 2.
Internal Consistency of Spleen Qi Deficiency Pattern Questionnaire (N=60)
Cronbach’s α 95% C.I.
Original questionnaire 0.808 0.735–0.868
Restructure Questionnaire 0.827 0.760–0.881

Restructure questionnaire was excluded the pulse diagnosis item and tongue diagnosis item from original questionnaire.

Table 3.
Rotated Component Matrix (N=60)
Items Component

Factor 1 Factor 2 Factor 3 Factor 4
Q03 .735 .298 −.102 −.105
Q05 .572 .207 −.285 .191
Q06 .827 .078 .125 .119
Q08 .684 −.008 .372 .185
Q04 .206 .872 −.076 .090
Q09 .127 .876 .040 .102
Q02 .303 .190 .531 .328
Q10 −.169 −.089 .751 −.067
Q11 .121 −.025 .727 −.242
Q01 .016 .000 −.183 .782
Q07 .166 .161 .020 .693

Eigenvalue 2.240 1.735 1.661 1.377

% Variance explained 20.359 36.135 51.235 63.748

Extraction method : Principal component analysis

Rotation method : Varimax

Table 4.
Factor Analysis Results of Spleen Qi Deficiency Pattern Questionnaire (N=60)
Index Items Symptoms
Fatigue Q03 Tiredness of extremities (肢体倦怠)
Q05 Sallow complexion (面色萎黄)
Q06 Shortness of breath and reluctance to speak (少氣懶言)
Q08 Lethargy (神疲)

Meal Q04 Inability to eat (納少)
Q09 Reduced appetite (食欲减退)

Diagnosis Q02 Abdominal distension after eating (腹胀食後尤甚)
Q10 Weak pulse (脈緩弱)
Q11 Pale tongue and white fur (舌淡苔白)

Figure Q01 Loose stool (大便溏薄)
Q07 Emaciation (消瘦)
Table 5.
Rotated Component Matrix about 9 items (N=60)
Items Component

Factor 1 Factor 2 Factor 3
Q06 .807 .165 .088
Q08 .793 .004 .092
Q03 .659 .395 −.157
Q02 .531 .051 .209
Q05 .381 .378 .268
Q04 .121 .888 .106
Q09 .104 .852 .083
Q01 .006 .033 .798
Q07 .203 .152 .692

Eigenvalue 2.208 1.868 1.289

% Variance explained 24.539 45.293 59.615

Extraction method : Principal component analysis

Rotation method : Varimax

Table 6.
Comparison of Spleen Qi Deficiency Pattern Questionnaire Scores on Controls and Chronic Dyspepsia Patients (N=72)
Controls (n=12) Chronic dyspepsia patients (n=60) p-value
Q01 1.50 ± 1.00 1.83 ± 0.96 0.279
Q02 0.25 ± 0.45 2.40 ± 0.87 0.000**
Q03 0.92 ± 0.51 2.18 ± 0.89 0.000**
Q04 0.25 ± 0.45 1.67 ± 1.12 0.000**
Q05 0.75 ± 0.75 1.83 ± 1.12 0.002**
Q06 0.42 ± 0.67 1.47 ± 1.03 0.001**
Q07 0.50 ± 0.52 1.03 ± 1.03 0.084
Q08 1.00 ± 0.85 2.22 ± 0.87 0.000**
Q09 0.25 ± 0.45 1.57 ± 1.02 0.000**
Q10 1.17 ± 1.19 2.57 ± 0.98 0.000**
Q11 1.33 ± 0.99 2.37 ± 1.13 0.004**

Total score 17.68 ± 7.34 48.67 ± 12.58 0.000**
Table 7.
Comparison of Spleen Qi Deficiency Pattern Questionnaire Scores on Spleen Qi deficiency and non-Spleen Qi deficiency groups (N=60)
Spleen Qi deficiency (n=41) Non-Spleen Qi deficiency (n=19) p-value
Q01 2.00 ± 0.92 1.47 ± 0.96 0.047*
Q02 2.68 ± 0.69 1.79 ± 0.92 0.000**
Q03 2.51 ± 0.75 1.47 ± 0.77 0.000**
Q04 1.98 ± 1.13 1.00 ± 0.75 0.001**
Q05 2.29 ± 0.96 0.84 ± 0.77 0.000**
Q06 1.83 ± 0.97 0.68 ± 0.67 0.000**
Q07 1.20 ± 1.08 0.68 ± 0.82 0.072
Q08 2.54 ± 0.71 1.53 ± 0.77 0.000**
Q09 1.90 ± 0.97 0.84 ± 0.69 0.000**
Q10 2.49 ± 0.93 2.74 ± 1.10 0.365
Q11 2.41 ± 1.10 2.26 ± 1.24 0.634

Total score 55.42 ± 8.01 34.12 ± 6.98 0.000**

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