Structural Equation Modeling of the Relationship between Disease Activity and Health-related Quality of Life Variables in Crohn’s Disease
(English)Manuscript (preprint) (Other academic)
Objective. Disease activity (DA) and health-related quality of life (HRQL) are two major endpoints in outcome assessment of Crohn’s disease (CD). A health concept model of the relationship between DA and HRQL encompassing five dimensions (biological variables, symptoms, function, worries, and general well-being) in inflammatory bowel disease (IBD) has been postulated previously, forming the basis of the IBD HRQL instrument, the Short Health Scale (SHS). This study evaluates the model, using structural equation modeling technique (SEM) on DA and HRQL data from a cohort of CD patients.
Methods. The relationships of the five dimensions represented by 14 health measures of 283 CD patients were analyzed by confirmatory factor analysis and SEM, using SPSS AMOS v18.0.
Results. All parameter estimates proved significant, and the goodness-of-fit indices were good (χ2=104.2, df=69, p=0.004, CFI=0.986, RMSEA=0.043). A revision of the structural pathway, in which well-being precedes worries, was suggested from empirical data.
Conclusion. The postulated health concept model proved to be a valid and plausible approximation of the relationship between disease activity and subjective health perception in CD. The results support the use of the SHS for subjective health assessment in CD.
Crohn’s disease; inflammatory bowel disease; health-related quality of life; disease activity; structural equation modeling
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-66242OAI: oai:DiVA.org:liu-66242DiVA: diva2:402693