Diseño y validación de un cuestionario de salud en pacientes con urolitiasis tratados mediante litotricia extracorpórea por ondas de choque (LEOC).

espanolOBJETIVO: Estudiar la esfera psicosocial de los pacientes que se someten a algun tratamiento permite tener mas informacion sobre la repercusion del mismo y puede ayudar a la eleccion de un tratamiento adecuado y personalizado. Debido a la ausencia de instrumentos especificos actualmente, el objetivo es disenar y validar un cuestionario de salud en pacientes tratados con LEOC. MATERIAL Y METODOS: Se realizo en 6 fases utilizando una muestra de 50 pacientes tratados con LEOC en 2015 en nuestro centro, a los que entrevistamos por via telefonica. En la fase 1 se propusieron items a partir de revision bibliografica. En la fase 2 se eliminaron los que puntuaban por debajo de 7 segun la valoracion de 0-10 sobre los items efectuada por especialistas en la materia. En la fase 3 se asignaron valores de 1 a 5 a cada item y se eliminaron aquellos cuya correlacion corregida fuera mayor de 0,2 y cuya potencia discriminante con U-Mann Whitney no fuera significativa (p>0,05). En la fase 4 se comprobo la fiabilidad del cuestionario con dos indices (alfa de Cronbach y dos mitades de Guttman). En la fase 5 se realizo el analisis factorial con rotacion Varimax para el calculo de la validez de constructo. Finalmente, en la fase 6 se tipificaron de las puntuaciones para establecer valores de referencia. RESULTADOS: 50 pacientes (32 hombres, 18 mujeres). Mediana edad 59 anos (27-79). Fase 1: 35 items propuestos. Fase 2: 9 items eliminados. Distribucion de cuestionario con 26 items. Fase 3: 18 items eliminados. Cuestionario final constituido por 8 items. Fase 4: valores de fiabilidad del cuestionario (alfa de Cronbach 0,44 e indice por tecnica de dos mitades de Guttman 0,323). Fase 5: analisis factorial hallando 4 factores con 2 items cada uno (antecedentes, repercusion del cuadro agudo, post-tratamiento, calidad de vida) capaces de explicar el 71,19% de la varianza. Fase 6: mediana puntuacion 50:17(minimo-maximo 9-25), P25:14 y P75:20. CONCLUSIONES: El trabajo realizado ha proporcionado un nuevo instrumento de evaluacion de salud tras tratamiento con LEOC con valores de fiabilidad y validez adecuados. Seran necesarios futuros estudios para contrastar su verdadera utilidad clinica. EnglishOBJECTIVES: Studying the psychosocial sphere of patients who undergo any treatment allows to have more information about its repercussion and can help the choice of an appropriate and personalized treatment. Due to the absence of specific instruments at present, the objective is to design and validate a health questionnaire regarding the treatment received with ESWL. METHODS: It was carried out in 6 phases using a sample of 50 patients treated with ESWL in 2015 in our center, whom we interviewed by telephone. In phase 1 the items were proposed based on bibliographic review, in phase 2 those that scored below 7 were eliminated according to the evaluation from 0 to 10 on the items made by specialists. In phase 3, values of 1 to 5 were assigned to each item and those with corrected correlation more than 0.2 and not significant (p>0.05) discriminant power with U-Mann Whitney were eliminated. In phase 4 the reliability of the questionnaire was checked with two indexes (Cronbach’s alpha and two Guttman’s halves). In phase 5, the factor analysis with Varimax rotation was performed to calculate the construct validity and in stage 6, the scores were analyzed to establish reference values. RESULTS: 50 patients (32 men, 18 women). Median age 59 years (27-79). In phase 1, 35 items were proposed, 9 of which were eliminated in phase 2. The initial questionnaire with 26 items was distributed, with 18 being eliminated in phase 3. The final questionnaire was formed with 8 items. In phase 4 the results of Cronbach’s alpha and Guttman’s two halves index were 0.44 and 0.323 respectively. In phase 5 after factor analysis, we found 4 factors with 2 items each (background, impact of the acute picture, post-treatment, quality of life) able to explain 71.19% of the variance. The median scores of the scale, extreme values and quartiles studied in phase 6 were respectively: P50: 17 (minimum-maximum 9-25), P25: 14 and P75: 20. CONCLUSIONS: The study carried out has provided a new instrument for assessing satisfaction after treatment with ESWL with adequate reliability and validity values. Future studies will be necessary to contrast its true clinical usefulness.