6533b7cffe1ef96bd1259ae9
RESEARCH PRODUCT
Confirmatory factor analysis of the Patient Assessment of Constipation-Symptoms (PAC-SYM) among patients with chronic constipation.
Neri LConway PmBasilisco GAltomare DfAnnese VBadiali DBasilisco GBassotti GBattaglia EBazzocchi GBellini MBendia EBenini LBiscaglia GBiviano IBocchini RBonfrate LBonventre SBossa FBrandimarte GCannizzaro RCicala MCipolletta LClara VCogliandro RComandini GCorazziari ECrotta SRosario CuomoD'alba LDe Giorgi FDel Piano MDi Fonzo MDi Mario FrancescoDi Stefano MD'onofrio VEfthymakis KFiore PFortuna MFries WGaetani EGaleazzi FGasbarrini AGeccherle' AGiangregorio FGirardi LGrassini MGroppo MGuarnieri GIovino PLo Cascio MLolli RLuzza FMacarri GMarino MMiraglia SMonastra SNeri LNeri McNeri MNoris RaOrselli SPassaretti SPaviotti APazzi PPilotto APortincasa PRanaldo NRavelli PRogai FSablich RSavarino VSpinzi GStanghellini VTammaro LTorresan FUsai Satta PValle C.subject
AdultMalemedicine.medical_specialtyAbdominal painConstipationConstipation severityChronic constipation; Chronic non-organic constipation; Constipation severity; Quality of life; Adult; Chronic Disease; Constipation; Female; Humans; Male; Middle Aged; Patient Care; Quality of Life; Reproducibility of Results; Surveys and Questionnaires; Factor Analysis Statistical; Public Health Environmental and Occupational Health; Medicine (all)Reproducibility of ResultChronic constipation; Chronic non-organic constipation; Constipation severity; Quality of life; Adult; Chronic Disease; Constipation; Female; Humans; Male; Middle Aged; Patient Care; Quality of Life; Reproducibility of Results; Surveys and Questionnaires; Factor Analysis Statistical; Public Health Environmental and Occupational HealthQuality of lifeInternal medicineSurveys and QuestionnairesmedicineCriterion validitySurveys and QuestionnaireHumansChronic constipationSettore MED/12 - Gastroenterologiabusiness.industryChronic constipationMinimal clinically important differenceMedicine (all)Environmental and Occupational HealthSettore MED/09 - MEDICINA INTERNAPublic Health Environmental and Occupational HealthReproducibility of ResultsStatisticalMiddle Agedmedicine.diseaseConfirmatory factor analysisSettore MED/18 - Chirurgia GeneraleChronic DiseasePhysical therapyQuality of LifeFunctional constipationChronic constipation; Chronic non-organic constipation; Constipation severity; Quality of life; Public Health Environmental and Occupational HealthChronic constipation; Chronic non-organic constipation; Constipation severity; Quality of life; Adult; Chronic Disease; Constipation; Female; Humans; Male; Middle Aged; Patient Care; Quality of Life; Reproducibility of Results; Surveys and Questionnaires; Factor Analysis StatisticalFemalePublic HealthChronic non-organic constipationPatient Caremedicine.symptombusinessFactor Analysis StatisticalFactor AnalysisConstipationHumandescription
Background and aim: PAC-SYM is widely adopted to asses constipation severity. However, it has been validated in a small sample, few items have been included based on expert opinion and not on empirical grounds, and its factor structure has never been replicated. We aimed at evaluating the psychometric properties of PAC-SYM in patients with chronic constipation. Methods: We enrolled 2,203 outpatients with chronic constipation in two waves. We used wave I sample to test the psychometric properties of the PAC-SYM and wave II sample to cross-validate its factor structure, to assess criterion validity, responsiveness to clinical change, and its minimal clinically important difference. Results: Only a minority of patients reported any rectal tearing (38 %). Deletion of such item leads to a 11-item version (M:PAC-SYM). The remaining items in the rectal domain were moderately correlated with the stool domain. Exploratory factor analysis and confirmatory factor analysis revealed a bifactor structure with two subscales (stool and abdominal symptoms) and a general severity factor. The M:PAC-SYM demonstrated excellent reliability, moderate correlation with SF-12 and treatment satisfaction (r = 0.28–0.45), discrimination across Rome III criteria for functional constipation and abdominal pain, and responsiveness to clinical change (β = −0.49; ω 2 = 0.25). M:PAC-SYM minimal clinically important difference was 0.24. Conclusion: Our analysis shows that the rectal domain may not represent a relevant cluster of symptoms for patients with chronic constipation. We developed a modified version of the PAC-SYM which might better represent symptom severity of most patients seeking care in gastroenterology referral centers
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2015-01-01 | Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation |