Abstract
BackgroundThe impact of strabismus on visual function, self-image, self-esteem, and social interactions decrease health-related quality of life (HRQoL).The purpose of this study was to evaluate and refine the adult strabismus quality of life questionnaire (AS-20) by using Rasch analysis among Chinese adult patients with strabismus.MethodsWe evaluated the fitness of the AS-20 with Rasch model in Chinese population by assessing unidimensionality, infit and outfit, person and item separation index and reliability, response ordering, targeting and differential item functioning (DIF).ResultsThe overall AS-20 did not demonstrate unidimensional; however, it was achieved separately in the two Rasch-revised subscales: the psychosocial subscale (11 items) and the function subscale (9 items). The features of good targeting, optimal item infit and outfit, and no notable local dependence were found for each of the subscales. The rating scale was appropriate for the psychosocial subscale but a reduction to four response categories was required for the function subscale. No significant DIF were revealed for any demographic and clinical factors (e.g., age, gender, and strabismus types).ConclusionThe AS-20 was demonstrated by Rasch analysis to be a rigorous instrument for measuring health-related quality of life in Chinese strabismus patents if some revisions were made regarding the subscale construct and response options.
Highlights
Adult strabismus, with an estimated prevalence of 4% [1], is often accompanied by ocular misalignment, blurred vision, diplopia, and eyestrain
We evaluated the fitness of the adult strabismus-20 (AS-20) with Rasch model in Chinese population by assessing unidimensionality, infit and outfit, person and item separation index and reliability, response ordering, targeting and differential item functioning (DIF)
Rasch model provides a deeper insight into the underlying features, such as unidimensionality, items fit and targeting, and response ordering. These are essential for an instrument to make meaningful comparisons of latent trait between different groups, or to compare across time [15]. Given these advantages of Rasch model, this study aims to investigate the psychometric properties of the AS-20 by using Rasch analysis among adult strabismus patients in the context of Chinese culture
Summary
With an estimated prevalence of 4% [1], is often accompanied by ocular misalignment, blurred vision, diplopia, and eyestrain. Previous studies showed that adult strabismus patients have suffered from anxiety and depression, low self-esteem, lack of confidence, limited job opportunities and difficulties with interpersonal relationships [2,3,4]. They are likely to avoid social contacts, abandon outdoor activities, and develop mannerisms to hide the defects. The impact of strabismus on visual function, self-image, self-esteem, and social interactions decrease health-related quality of life (HRQoL).The purpose of this study was to evaluate and refine the adult strabismus quality of life questionnaire (AS-20) by using Rasch analysis among Chinese adult patients with strabismus.
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