Translation and psychometric evaluation of the Chinese version of functional digestive disorders quality of life questionnaire

Psychosocial quality-of-life correlates in functional gastrointestinal disorders

INTRODUCTION AND AIM

Functional gastrointestinal disorders (FGIDs) are complex illnesses characterized by gastrointestinal symptoms, with no underlying organic pathology. They are common, chronic, recurrent, and disabling disorders that significantly impair quality of life (QoL). The aim of the present cross-sectional analytical study was to assess QoL and its correlates in adult patients with FGIDs.

MATERIALS AND METHODS

A cross-sectional, observational, hospital-based study was conducted at the gastroenterology outpatient department of a tertiary care teaching hospital. The ROME IV diagnostic criteria were used to identify the FGIDs. Anxiety, depression, coping strategies, social support, and QoL were assessed by the hospital anxiety and depression scale, the coping strategies inventory, the multidimensional scale of perceived social support, and the functional digestive disorders quality-of-life questionnaire, respectively.

RESULTS

Of the 52 consecutive patients diagnosed with FGIDs, functional dyspepsia (51.92%) and irritable bowel syndrome (40.38%) were the most common. There were no significant associations between sociodemographic variables (age, sex, marital status, socioeconomic status, educational level, employment, occupation, dietary pattern) and QoL scores (all p values >0.05). Duration and social support were not significantly associated with QoL (all p values >0.05). In contrast, psychological variables, such as disengagement coping (r=-0.344, p=0.012), depression (r=-0.600, p=0.000), and anxiety (r=-0.590, p=0.000), were significantly correlated with QoL.

CONCLUSIONS

Despite advances in neurogastroenterology, patients continue to be disabled by FGIDs. Psychological factors, especially depression, significantly contribute to poor QoL in those patients and should be addressed in a holistic, multidisciplinary way. The biopsychosocial framework, as it applies to FGIDs, should lead to the inclusion of psychosocial assessments in the clinical management and research of those disorders.

Therapeutic massage/Tuina for treatment of functional dyspepsia: a systematic review and meta-analysis of randomized controlled trials

PURPOSE

A systematic review of randomized controlled trials (RCTs) was conducted to assess the potential effect of therapeutic massage/Tuina on functional dyspepsia (FD) patients.

METHOD

Twelve databases and three clinical trial registries were searched until December 2021, for RCTs that compared Tuina combined with or without conventional therapy versus conventional therapy in FD. We assessed the methodological quality of included trials by the Cochrane Risk of Bias tool, and graded the quality of the evidence. The data were presented as risk ratio (RR) or mean difference (MD) respectively with their 95% confidence interval (CI).

RESULTS

In total, 14 RCTs with 1128 FD participants were included. Compared with conventional therapy, Tuina showed significant beneficial effects on improving overall symptom (RR = 1.12, 95% CI 1.06 to 1.19, low certainty evidence), and early satiation (MD -0.44 scores, 95% CI -0.72 to -0.16, very low certainty evidence). Compared with conventional therapy, Tuina plus conventional therapy also significantly improved overall symptom (RR = 1.14, 95% CI 1.06-1.23, low certainty evidence), quality of life (MD 10.44 scores, 95% CI 7.65-13.23, low certainty evidence), and epigastric pain (MD -0.76 scores, 95% CI -1.11 to -0.41, low certainty evidence). No adverse events related to Tuina and cost-effectiveness were reported.

CONCLUSION

Low certainty evidence showed that Tuina significantly improved overall symptom of FD participants compared with conventional therapy. Low certainty evidence showed that Tuina plus conventional therapy obviously improved overall symptom and quality of life of FD participants compared with conventional therapy.

The Chinese Mandarin Version of the Esophageal-Atresia-Quality-of-Life Questionnaires for Children and Adolescents: Evaluation of Linguistic and Content Validity

BACKGROUND

After repair of esophageal atresia (EA), children risk digestive and respiratory morbidity, but knowledge of their health-related quality of life (HRQOL) in China is lacking. The EA-QOL questionnaires were developed in Sweden and Germany to evaluate condition-specific HRQOL in children with EA aged 2-7 and 8-17. This study aimed to evaluate the linguistic and content validity of the Chinese Mandarin version of the EA-QOL questionnaires.

METHODS

The procedure was conducted in compliance with international standards, including a forward-backward translation procedure, expert reviews, and cognitive debriefing interviews with 14 Chinese families of children with EA (parents of 8 children aged 2-7/6 children aged 8-17 and their parents).

RESULTS

Following forward-backward translation, minor issues were identified and solved. In interviews, all participants rated all EA-QOL items easy to understand, none expressed negative emotions about them and most described them comprehensive and relevant for EA. Leading from cognitive debriefing, three EA-QOL items in the questionnaire version for children aged 2-7 and three EA-QOL items in the questionnaire version for children aged 8-17 were modified in the Chinese language to improve cultural appropriateness and/or clarity.

CONCLUSION

The Chinese Mandarin version of the EA-QOL questionnaires achieved satisfactory linguistic and content validity. This can help increase focus of HRQOL in research and clinical practice of children with EA in China.

Interpretation of a Quantitative Diagnosis Model of Traditional Chinese Medicine Syndromes Based on Computer Adaptive Testing

Objectives

The aim of this study is to interpret a quantitative diagnosis model of traditional Chinese medicine (TCM) syndromes based on computer adaptive testing (CAT), from the perspective of both patients and clinicians.

Methods

In this cross-sectional study, patients with postprandial distress syndrome completed the CAT model of TCM syndromes and the Chinese version of the Quality of Life Questionnaire for Functional Digestive Disorders (Chin-FDDQL); the clinicians' diagnosis was concurrently recorded. The patients completed this questionnaire again after 14 ± 2 days. The kappa test and paired chi-square test were used to evaluate the consistency between the CAT model and clinical diagnosis. Minimal clinically important differences (MCID) of the Chin-FDDQL scores were used to assess clinical efficacy from the patients' perspective. Logistic regression was used to examine the association between changes in the CAT model syndrome domain scores and changes in clinical outcomes.

Results

Changes in the CAT model syndrome domain scores may affect the clinical outcomes of patients with the total scores of Chin-FDDQL (all P < 0.05). There was a correlation between changes in the CAT model syndrome domain scores and the patients' clinical outcomes. Different syndrome elements had different effects on various Chin-FDDQL domains, which was consistent with the theory of TCM.

Conclusions

This study proposes a method for the clinical interpretation of the CAT model of TCM syndromes, including evidence derived from the application. It may provide a reference for future interpretation of other CAT models.

Efficacy of modified Banxia Xiexin decoction in the management of Wei-Pi syndrome (postprandial distress syndrome): study protocol for a randomized, waitlist-controlled trial

BACKGROUND

Postprandial distress syndrome manifests as a feeling of fullness and early satiation that can significantly reduce the quality of life of the patients. In Chinese medicine (CM), the syndrome is traditionally regarded as the Wei-Pi syndrome, and Banxia Xiexin decoction (BXD) has been used in the empirical treatment of the same for a long time. The current study aims to evaluate the efficacy of modified BXD in the management of Wei-Pi syndrome.

METHODS/DESIGN

A randomized, waitlist-controlled trial will be conducted. A total of 84 patients with Wei-Pi syndrome will be randomized into the BXD or waitlist control group in a ratio of 1:1. The patients in the BXD group will receive the semi-individualized BXD on the basis of the syndrome differentiation in CM, for a duration of 3 weeks and will be under follow-up for further 3 weeks after the completion of therapy. Conversely, the patients in the waitlist control group will undergo the same intervention and follow-up after a 3-week waiting period. In the current study, the primary outcome will be the variation in the scores pertaining to the global scale of the Quality of Life Questionnaire for Functional Digestive Disorders after 3 weeks. The secondary outcomes include the variations in the scores pertaining to the Hospital Anxiety and Depression Scale and the EuroQoL 5-dimension 5-level Questionnaire and the results of the liver and kidney function tests.

DISCUSSION

This trial will assess the efficacy of modified BXD in improving the clinical symptoms and quality of life of the patients suffering from Wei-Pi syndrome.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04398888 . Registered on May 21, 2020.

Interpreting the Chinese version of quality of life questionnaire for functional digestive disorders

BACKGROUND AND AIM

The Chinese version quality of life questionnaire for functional digestive disorders (Chin-FDDQL) is a useful health assessment instrument for functional dyspepsia. This study aims to identify its score interpretation for clinical practice.

METHODS

Data of Chin-FDDQL from the functional dyspepsia patients (≥ 18 years) between November 2009 and April 2013 were enrolled in the 1st and 14th day. After baseline and responsiveness analysis, the single score interpretation and percentile ranks were established. The statistically reliable change was defined with effect size, standardized response mean, minimal detectable change, and others. Then the receiver operating characteristic curve analysis for health improvement was performed to define the clinically important change.

RESULTS

Two hundred two functional dyspepsia patients, 150 healthy participants, and 25 missing data were enrolled for analysis. Compared with the intake patients, the discharged and healthy persons have significant better health status in all domains (P < 0.001, expect discomfort in discharged people, P = 0.142), totally contrast to missing data. The reliability for single total intake and discharge were both ± 1. Based on score distribution, the 25th, 50th, and 75th percentile ranks were 49, 58, and 66 for intake scores and 59, 65, and 72 for discharge scores, respectively. The minimal detectable change and Reliable Change Index were 6 and 11 for total score. Receiver operating characteristic analyses supported that total score changes 4 or more represented minimal clinically important improvement.

CONCLUSIONS

The score interpretation system of the Chin-FDDQL could assist clinician's decision making during the therapy practice.

A Survey of Pharmacy Education in Thailand

OBJECTIVE

To explore the current status of pharmacy education in Thailand.

METHODS

The International Pharmaceutical Federation of the World Health Organization's (FIP-WHO) Global Survey of Pharmacy Schools was used for this study. The survey instrument was distributed to the deans of the 19 faculties (colleges) of pharmacy in Thailand.

RESULTS

More than half the colleges have been in existence less than 20 years, and the government owns 80% of them. There were 2 paths of admission to study pharmacy: direct admission and central admission system. The doctor of pharmacy (PharmD) programs can be divided into 4 types. Approximately 60% of all teaching staff holds a doctoral degree. Regarding the work balance among teaching staff, around 60% focus on teaching activities, 20% focus on research, and less than 20% focus on patient care services concurrent with real practice teaching. The proportion of student time dedicated to theory, practice, and research in PharmD programs is 51.5%, 46.7%, and 1.8%, respectively. Sites owned by the colleges or by others were used for student training. Colleges followed the Office of the National Education Standards' Internal Quality Assurance (IQA) and External Quality Assurance (EQA), and the Pharmacy Council's Quality Assessment (ONESQA).

CONCLUSION

This study provides a picture of the current status of curriculum, teaching staff, and students in pharmacy education in Thailand. The curriculum was adapted from the US PharmD program with the aim of meeting the country's needs and includes industrial pharmacy and public health tracks as well as clinical tracks. However, this transition in pharmacy education in Thailand needs to be monitored and evaluated.