Basic information of respondents. A total of 186 patients with cervical cancer were investigated in this study. Among them, there were 132 males and 71 females, with an average age of 41.42 19.42. There were 100 patients (49.26%) with age < 40 years old, 155 patients (83.2%) with Han nationality, and 194 patients (95.56%) with education level of high school or technical secondary school or below. Other categories are the most in occupations, mainly students and retired people, Primary school and junior high school education accounted for 72.9%.
G findings of analysis based on GT.The value on the diagonal of each effect is the variance component estimation in the corresponding field. According to Table 6, the variance components of the subjects in the four fields are 0.22, 0.49, 0.22 and 0.20 respectively, The variance components of entries are 0.20, 0.35, 0.72 and 0.19. The variance components of subjects and items were 0.84, 0.63, 1.59 and 1.46, respectively. Except for social function, the variance components of subjects are larger than the variance components of items, which shows that the quality of items is better.
Table 6
Variance and covariance component matrix of effect
Effects
|
Physiological function
|
Mental functioning
|
Social function
|
Specific modules
|
People(p)
|
0.22
|
0.71
|
0.52
|
0.87
|
|
0.23
|
0.49
|
0.78
|
0.62
|
|
0.11
|
0.26
|
0.22
|
0.52
|
|
0.18
|
0.19
|
0.11
|
0.20
|
Item(i)
|
0.20
|
|
|
|
|
|
0.35
|
|
|
|
|
|
0.72
|
|
|
|
|
|
0.19
|
People*Item(p*i)
|
0.84
|
|
|
|
|
|
0.63
|
|
|
|
|
|
1.59
|
|
|
|
|
|
1.46
|
D Results of the analysis . (1) generalization coefficient and reliability index: The generalization coefficients of the four fields are all greater than 0.50, Except for social function, the reliability index of other fields is above 0.50, The relative and absolute error variance of each field is less than 0.30, which shows that the reliability of the four fields is good and the measurement results of the scale are more accurate, shown in Table 7.
Table 7
Research results based on multivariate generalization theory D
(2) Contribution ratio of each field to the whole total score: According to the contribution ratio of each field, the proportion of psychological function and specific module is higher than that of other fields, which shows that these two fields occupy a more important position in the analysis of patients' quality of life by the overall scale. The contribution rate of absolute error variance of four fields shows that the absolute error of specific module is the smallest, which indicates that the items in this field are of better quality. Generally speaking, the global total score contribution ratio of the four fields is more appropriate, which can achieve the goal of measuring patients' quality of life, seen in Table 8.
Table 8
Comparison between the proportion of entries and the contribution rate of variance in various fields
|
Physiological function
|
Mental functioning
|
Social functioning
|
Specific modules
|
Entries
|
9
|
11
|
8
|
15
|
Ration of score(%)
|
20.93
|
25.58
|
18.61
|
34.89
|
Total variance contribution rate across the fields(%)
|
19.05
|
35.83
|
15.14
|
29.97
|
Absolute error variance contribution rate (%)
|
1.88
|
10.25
|
3.47
|
4.92
|
Relative error variance contribution rate (%)
|
8.98
|
40.07
|
18.65
|
14.10
|
Halve and double the number of entries to explore the change of generalization coefficient and reliability index. It can be seen from Table 9 that the number of original items (43 items in the total table), except for social functions, the reliability index of other fields is greater than 0.50, When the number of items is halved (the total table is 23 items), only the reliability index of psychological function is greater than 0.50, When the number of items is double (86 items in the total table), the reliability index of each field is 0.60 ~ 0.92. With the increase of the number of entries, G and φ of each field increase in turn, seen in Table 9.
Table 9
Generalization coefficient and reliability index of different items
Fields
|
Items
|
Generalization coefficient (G)
|
Reliability index (Ф)
|
Halve
|
Origin
|
Double
|
Halve
|
Origin
|
Double
|
Halve
|
Origin
|
Double
|
Physiological function (PHD)
|
5
|
9
|
18
|
0.42
|
0.70
|
0.82
|
0.37
|
0.57
|
0.72
|
Mental functioning(PSD)
|
6
|
11
|
22
|
0.65
|
0.90
|
0.95
|
0.55
|
0.85
|
0.92
|
Social functioning(SOD)
|
4
|
8
|
16
|
0.46
|
0.53
|
0.69
|
0.37
|
0.43
|
0.60
|
Specific modules(SPD)
|
8
|
15
|
30
|
0.50
|
0.67
|
0.81
|
0.38
|
0.55
|
0.71
|
Estimated values of parameters for each item of the specific module based on IRT. In IRT study, the value of discrimination is between 0 and 2, and when the discrimination is less than 0.30, it can be considered that the discrimination of this item is low, The value of difficulty Bi is generally considered to be between-3 and 3, and B1 ~ B4 increases monotonously. If Bi <-3, it means that the item is too easy, and if Bi > 3, it means that the item is very difficult. According to the results, the discrimination degree of specific module of QLICD-NS (V2.0) scale is 0.82, and the discrimination degree of each item is better, The difficulty B3 and B4 of TNS7 are greater than 3, and the difficulty of TNS8 is less than 3. The difficulty setting of these two items is unreasonable, and the difficulty coefficients of other items are between-3 and 3 and increase monotonously. It can be considered that the difficulty of items in the specific module of QLICD-NS (V2.0) scale is suitable, seen in Table 10.
Table 10
Differentiation and difficulty of items in the specific module of QLICD-NS (V2.0) scale
The entry number
|
Differentiation A(SE)
|
B1(SE)
|
B2(SE)
|
B3(SE)
|
B4(SE)
|
TNS1
|
0.82(0.02)
|
-2.58(0.34)
|
-1.26(0.25)
|
-0.94(0.25)
|
-0.54(0.23)
|
TNS2
|
0.82(0.02)
|
-1.89(0.29)
|
-0.93(0.25)
|
-0.09(0.24)
|
0.25(0.24)
|
TNS3
|
0.82(0.02)
|
-3.25(0.43)
|
-2.68(0.36)
|
-1.89(0.29)
|
-1.55(0.26)
|
TNS4
|
0.82(0.02)
|
1.08(0.26)
|
1.93(0.29)
|
2.72(0.35)
|
2.97(0.49)
|
TNS5
|
0.82(0.02)
|
-3.83(0.51)
|
-2.75(0.35)
|
-2.13(0.31)
|
-1.60(0.27)
|
TNS6
|
0.82(0.02)
|
-0.72(0.25)
|
1.11(0.25)
|
2.41(0.44)
|
2.88(0.72)
|
TNS7
|
0.82(0.02)
|
0.04(0.23)
|
1.88(0.27)
|
4.34(0.62)
|
4.78(0.72)
|
TNS8
|
0.82(0.02)
|
-6.93(1.64)
|
-4.68(0.68)
|
-4.48(0.63)
|
-3.87(0.52)
|
TNS9
|
0.82(0.02)
|
-2.30(0.42)
|
-1.26(0.28)
|
-0.24(0.25)
|
0.40(0.24)
|
TNS10
|
0.82(0.02)
|
-2.36(0.44)
|
-2.03(0.31)
|
-1.33(0.27)
|
-1.06(0.26)
|
TNS11
|
0.82(0.02)
|
-2.47(0.45)
|
-2.12(0.32)
|
-1.30(0.27)
|
-0.97(0.26)
|
TNS12
|
0.82(0.02)
|
-1.10(0.25)
|
0.10(0.23)
|
0.62(0.24)
|
1.01(0.25)
|
TNS13
|
0.82(0.02)
|
-2.30(0.33)
|
-1.36(0.26)
|
-0.32(0.25)
|
0.36(0.24)
|
TNS14
|
0.82(0.02)
|
-3.30(0.41)
|
-1.71(0.28)
|
0.58(0.24)
|
2.03(0.31)
|
TNS15
|
0.82(0.02)
|
-2.30(0.33)
|
0.33(0.24)
|
2.65(0.36)
|
2.89(0.80)
|
Estimated value of information amount of each item of specific module based on IRT. For the estimation of item information quantity, 5 is usually taken as the overall information quantity standard of the scale, and 5/k is taken as the average information quantity standard of each item (K is the number of items), which can meet both the internal consistency requirements and the test-retest reliability requirements. There are 43 items in QLICD-NS (V2.0) scale, so the information content standard of a single item is 0.12. The results show that the information content of TNS5 and TNS8 is less than 0.12, and the items need to be improved. The average information content of other items reaches the standard of 0.12, which can be considered as good quality items, seen in Table 11.
Table 11
Information content of each item in the specific module of QLICD-NS (V2.0) scale
Code
|
|
Average information content
|
-2
|
-1
|
0
|
1
|
2
|
TNS1
|
0.20
|
0.20
|
0.17
|
0.12
|
0.07
|
0.15
|
TNS2
|
0.19
|
0.21
|
0.20
|
0.16
|
0.11
|
0.17
|
TNS3
|
0.20
|
0.17
|
0.12
|
0.07
|
0.03
|
0.12
|
TNS4
|
0.05
|
0.09
|
0.14
|
0.19
|
0.21
|
0.14
|
TNS5
|
0.20
|
0.17
|
0.11
|
0.06
|
0.03
|
0.11
|
TNS6
|
0.13
|
0.19
|
0.20
|
0.20
|
0.20
|
0.18
|
TNS7
|
0.09
|
0.14
|
0.19
|
0.20
|
0.20
|
0.16
|
TNS8
|
0.10
|
0.05
|
0.03
|
0.01
|
0.01
|
0.04
|
TNS9
|
0.20
|
0.21
|
0.20
|
0.17
|
0.11
|
0.18
|
TNS10
|
0.21
|
0.19
|
0.14
|
0.09
|
0.05
|
0.14
|
TNS11
|
0.21
|
0.19
|
0.15
|
0.10
|
0.05
|
0.14
|
TNS12
|
0.15
|
0.19
|
0.21
|
0.19
|
0.15
|
0.18
|
TNS13
|
0.20
|
0.21
|
0.20
|
0.18
|
0.11
|
0.18
|
TNS14
|
0.20
|
0.20
|
0.20
|
0.20
|
0.19
|
0.20
|
TNS15
|
0.19
|
0.19
|
0.20
|
0.20
|
0.20
|
0.20
|