The validity and reliability of the Swedish version of the Satisfaction with appearance scale for individuals with systemic sclerosis.

Malin Mattsson, Roger Hesselstrand, Karin Gunnarsson, Elisabet Dyrsmeds, Monica Holmner, Annica Nordin, Carina Boström
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Abstract

Background: Systemic sclerosis (SSc) can lead to visible changes in appearance which could generate concerns among patients. Thus, valid questionnaires that capture these concerns are valuable to identify and communicate appearance concerns.

Objective: To determine aspects of the validity and reliability of the Swedish version of the Satisfaction with Appearance scale for individuals with SSc (SWAP-Swe in SSc).

Methods: Content validity was assessed by interviews. In a cross-sectional design, construct validity was evaluated by comparing the self-reported questionnaire SWAP-Swe in SSc to the Scleroderma Health Assessment Questionnaire (SSc HAQ), Patient Health Questionnaire-8 (PHQ-8), RAND-36, modified Rodnan skin score (mRSS), disease duration and age using Spearman's rank correlations (rs ). Internal consistency was evaluated by Cronbach's alpha coefficient and corrected item-to-total correlations. Test-retest reliability was investigated using the intraclass correlation coefficient (ICC).

Results: Eleven patients and 10 health professionals participated in the assessment of content validity. For the other aspects of validity and reliability 134 patients (median age 62 years, women 81%, limited cutaneous SSc 75%) participated. Overall, the content validity was satisfactory. The SWAP-Swe in SSc correlated with SSc HAQ (HAQ-DI rs  = 0.50, visual analogue scales rs  = 0.24-0.41), PHQ-8 (rs  = 0.46), RAND-36 (rs  = -0.21 to -0.47), mRSS (rs  = 0.28), disease duration (rs  = -0.01) and age (rs  = -0.15). The Cronbach's alpha coefficient was 0.92, corrected item-to-total correlations ⩾ 0.45 and the ICC 0.82.

Conclusion: The SWAP-Swe in SSc showed satisfactory content validity, sufficient and good internal consistency and sufficient test-retest reliability. It was more strongly associated with self-reported questionnaires than with physician-assessed skin involvement and age, indicating that appearance concerns in SSc seem to be multidimensional as earlier reported. Our study contributes with a thorough investigation of validity and reliability including aspects that have not been investigated before. However, evaluation of more validity aspects of the SWAP-Swe in SSc is suggested.

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瑞典版系统性硬化症患者外貌满意度量表的效度与信度。
背景:系统性硬化症(SSc)可导致明显的外观变化,这可能引起患者的关注。因此,捕获这些关注点的有效问卷对于识别和交流外观关注点是有价值的。目的:确定瑞典版外貌满意度量表对SSc患者的效度和信度(SSc中的SWAP-Swe)。方法:采用访谈法评估内容效度。在横断面设计中,采用Spearman秩相关(rs),将SSc中的自我报告问卷SWAP-Swe与硬皮病健康评估问卷(SSc HAQ)、患者健康问卷-8 (PHQ-8)、RAND-36、改良罗南皮肤评分(mRSS)、疾病持续时间和年龄进行比较,评估结构效度。内部一致性通过Cronbach's alpha系数和校正的项目-总相关性来评估。采用类内相关系数(ICC)研究重测信度。结果:11名患者和10名卫生专业人员参与了内容效度评估。在效度和信度的其他方面,134例患者(中位年龄62岁,女性81%,有限皮肤SSc 75%)参与。总体而言,内容效度令人满意。SSc的SWAP-Swe与SSc的HAQ (HAQ- di rs = 0.50,视觉模拟量表rs = 0.24 ~ 0.41)、PHQ-8 (rs = 0.46)、RAND-36 (rs = -0.21 ~ -0.47)、mRSS (rs = 0.28)、病程(rs = -0.01)和年龄(rs = -0.15)相关。Cronbach的alpha系数为0.92,校正的项目与总相关性大于或等于0.45,ICC为0.82。结论:SSc的SWAP-Swe量表具有满意的内容效度、充分且良好的内部一致性和足够的重测信度。与医生评估的皮肤受损伤和年龄相比,它与自我报告的调查问卷的相关性更强,这表明SSc中对外表的关注似乎是多方面的,正如之前报道的那样。我们的研究有助于对效度和信度进行彻底的调查,包括以前没有调查过的方面。然而,建议在SSc中对SWAP-Swe的效度进行更多的评估。
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