Reliability and Validity Analysis of a Standard Instrument of Diagnosis and Assessment for Spleen Qi Deficiency Pattern in Chronic Dyspepsia Patients

Jihye Kim; Juyeon Kim; Jinsung Kim; Keun Ho Kim; Kim, Jihye; Kim, Juyeon; Kim, Jinsung; Kim, Keun Ho

doi:10.13048/jkm.15017

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

Original Article

The Journal of Korean Oriental Medicine 2015; 36(3): 23-34.

DOI: https://doi.org/10.13048/jkm.15017

Reliability and Validity Analysis of a Standard Instrument of Diagnosis and Assessment for Spleen Qi Deficiency Pattern in Chronic Dyspepsia Patients

Jihye Kim¹, Juyeon Kim², Jinsung Kim², Keun Ho Kim¹

¹KM Fundamental Research Division, Korea Institute of Oriental Medicine

²Dept. of Gastroenterology, College of Korean Medicine, Kyung-Hee University

Correspondence to: 김근호(Keun Ho Kim), 대전광역시 유성구 유성대로 1672 한국한의학연구원 한의기반연구부, Tel: +82-42-868-9365, Fax: +82-42-868-9480, E-mail: rkim70@kiom.re.kr

Received June 24, 2015 Revised September 24, 2015 Accepted September 24, 2015

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.

Keywords: Spleen Qi deficiency, pattern identification, chronic dyspepsia, questionnaire

Fig. 1.

Flow chart of clinical study

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)
Meal	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)
Figure	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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