Objective To understand the status of family well-being of university and high school students in Guangdong Province,and to analyze the factors affecting students'family well-being.Methods Using cluster sampling,students enrolled in two universities and six high schools in Guangdong Province were collected,and quartile regression was used to analyze the factors affecting the family well-being of these students.Results A valid sample of 4987 cases was obtained with the percentage of students who clearly feel happy being 73.5%.The quantile regression results showed that:gender(Q10,Q25,Q50,Q75),household registration(Q75,Q90),grade level(Q25,Q75),father's occupation(Q75),mother's occupation(Q75),father's education(Q90),freedom to develop hobbies and interests(Q10,Q50,Q75),freedom to make decisions(Q25,Q75),family members'transposition of thinking(Q75),parental interference(Q10,Q25,Q50,Q75),freedom to organize time(Q75,Q90),parental harshness(Q75),parental constraints(Q75),family closeness,family caring level,family atmosphere,and family solidarity are all related to family well-being among university and high school students.Among them,the family well-being are positively related to family closeness,family care,family atmosphere and family solidarity,and negatively related to parental interference.Conclusion Family well-being is relatively high among university and high school students in Guangdong Province.In order to enhance students'well-being,we should increase the degree of intimacy among family members to create a relaxing,happy and warm family atmosphere,and at the same time,parents should moderately reduce the amount of interference in their children's affairs.

Objective:To analyze and evaluate the items of the general module of multidimensional health measurement instruments system for elderly patients with chronic disease (MHIEC-GM)(V1.0) based on classical test theory (CTT) and item response theory (IRT).Methods:A self-administered survey of 2 375 elderly patients with chronic diseases was conducted using the MHIEC-GM(V1.0) scale. The quality of items was analyzed using the variability method, correlation coefficient method, factor analysis method, and Cronbach's α coefficient method based on CTT. The difficulty coefficient, differentiation coefficient, and information content of items were analyzed using the IRT analysis software MULTILOG 7.03.Results:The CTT results showed that the standard deviations of all nine items were greater than 0.9. The results of the correlation coefficient method, the factor analysis method and the Cronbach′s α coefficient method showed that except for the GMI9 item, the correlation coefficients between the other items and the total scale were all greater than 0.5, and the factor loads were all greater than 0.5, and the Cronbach′s α coefficients after the deletion of the items were all less than 0.763. Based on the results of the four analysis methods, except for the GMI9 item, all the other items had good characteristics. The IRT results showed that the information contents of all items were >0.333 (5/15) except for the GMI4, GMI6, and GMI8, and the differentiation coefficient of each item was 1.44. The items that difficulty coefficient met the [-4, 4] inclusion criteria were the GMI2, GMI3, GMI5, GMI7 and GMI9, showing a monotonically increasing trend with increasing difficulty level. The items of GMI1, GMI4, GMI6, and GMI8 needed further improvement.Conclusion:Most of items of the MHIEC-GM(V1.0) scale have good psychometric properties, but some items need to be further revised and validated according to the characteristics of chronic diseases in the elderly.

Objective To evaluate the performance of the Quality of Life Instrument for Chronic Dis-ease Nephrotic Syndrome [QLICD-NS(V2.0)] in patients with nephrotic syndrome.Methods A total of 203 patients with nephrotic syndrome (NS) diagnosed in the Department of Nephrology,Affiliated Hospital of Guangdong Medical University from March 2021 to November 2021 were selected for QLICD-NS(V2.0) eval-uation,and the evaluation methods were generalization theory (GT) and item response theory (IRT).The dif-ficulty,discrimination coefficient and information amount of each item were obtained by using Multilog 7.0 software to analyze the grade response model (GRM) of IRT.Results The results of GT showed that the contribution ratio of the global total score in the four domains of QLICD-NS(V2.0) scale was evenly distribu-ted,and the generalization coefficient of the four domains was greater than 0.50.Except for social function,the variance component of the participants in the other three domains were greater than the item variance compo-nent,and the reliability index of each domain was greater than 0.50.The results of IRT showed that the dis-crimination degree of QLICD-NS(V2.0) scale was 0.82.Except for items TNS7 and TNS8,the difficulty coef-ficients of the other items ranged from -3 to 3 and increase monotonically.Conclusion The QLICD-NS (V2.0) scale has good reliability in physiological function and psychological function,and is acceptable in so-cial field and special function.The QLICD-NS(V2.0) scale developed in this study has good performance.

Objective To analyze and evaluate the items of the QLICD-CPHD(V2.0)scale for chronic pulmonary heart disease using classical test theory(CTT)and item response theory(IRT).Methods 184 patients with chronic pulmonary heart disease were investigated by QLICD-CPHD(V2.0)scale.The items of the QLICD-CPHD(V2.0)scale was evaluated by some statistical methods based on CTT including correlation coefficient method,variance method,factor analysis method and Cronbach's α coefficient method.Meanwhile,Samejima hierarchical response model of item response theory was utilized to calculate the difficulty,information and differentiation coefficient content of each item in the scale.Results CTT results showed that 7 items failed meet at least three or more statistical requirements,including 6 items in the general module and 1 item in the disease specific module.IRT results showed that the range of item differentiation was 1.18～1.44,which was suitable.The difficulty coefficient increases monotonously with the increase of the difficulty level(B1→B4),and some items exceed the standard value range.The average information amount of each item ranges from 0.185～0.576.Conclusion By CTT and IRT analysis,most items of the QLICD-CPHD(V2.0)scale have good performance and good differentiation,but a few items still need further revision.

ObjectiveTo analyze the quality of life and related factors in patients with depression， and to provide evidence for formulating the corresponding measures to improve the patients' quality of life. MethodsA total of 117 inpatients who met the International Classification of Diseases， tenth edition（ICD-10） for depression were selected in Central People's Hospital of Zhanjiang， Affiliated Hospital of Guangdong Medical University and Guangdong 999 Brain Hospital from November 19， 2018 to September 7， 2019. The values of patients' clinical objective indicators consisted of routine blood test， routine urine examination， blood biochemical tests and blood gas analysis were collected by reviewing their medical records， and all subjects were assessed using Quality of Life Instruments for Chronic Diseases-Depression V2.0 ［QLICD-DE（V2.0）］. Simple correlation analysis was used to explore the correlation between the QLICD-DE （V2.0） scores and various clinical objective indicators， and multiple linear regression was adopted to further screen factors affecting quality of life of patients with depression. ResultsSimple correlation analysis suggested that QLICD-DE （V2.0） total score was positively correlated with total protein and platelet distribution width in patients with depression （r=0.198， 0.281， P<0.05 or 0.01）， and negatively correlated with hematocrit （r=-0.300， P<0.01）. Multiple linear regression analysis showed that albumin-to-globulin ratio and treatment compliance （B=-19.836， -3.711， P<0.05 or 0.01） were influential factors for physical function. Platelet distribution width （B=2.706， P<0.01） was an influential factor for psychological function. Bilirubin （B=-6.375， P<0.05） was an influential factor for social function. Platelet distribution width （B=2.101， P<0.05） was an influencing factor for specific module. The albumin-to-globulin ratio and platelet distribution width （B=-10.653， 2.114， P<0.05 or 0.01） were influencing factors for total score of QLICD-DE （V2.0）. ConclusionTreatment compliance and clinical objective indicators platelet distribution width， bilirubin and albumin-to-globulin ratio may be the influencing factors of quality of life in patients with depression.

Objective:To understand the reliability and validity of quality of life instruments for cancer patients-brain neoplasm [QLICP-BN (V1.0)], a self-developed quality of life scale for cancer patients.Methods:The quality of life of 112 patients with brain neoplasms in Yunnan Cancer Hospital from March 2012 to November 2013 was measured. The general data questionnaire and QLICP-BN (V1.0) were used for data collection. The reliability, validity and responsiveness of the scale were tested, and then the metric characteristics of the scale were evaluated.Results:The split-half reliability of the total score of the scale was 0.95, the Cronbach αcoefficient was 0.92, and the test-retest correlation coefficient rwas 0.78. After extracting common factors by the principal component method and rotating with the maximum variance, the specific module obtained three principal components, and the cumulative variance contribution rate was 64.18%. The score of specific module was 75.30±17.44 before treatment and 78.91±12.20 after treatment ( t=-2.481, P=0.015). The total score of scale before treatment was 65.26±12.29, and that after treatment was 69.62±10.41, with a statistically significant difference ( t=-4.492, P<0.001). The total responsiveness of the scale was 0.456, showing moderate responsiveness. Conclusion:QLICP-BN (V1.0) has good reliability, validity and a certain degree of responsiveness. It can be used as a measurement tool for the quality of life of patients with brain neoplasms in China.

Objective To study patient delay and the influencing factors of the elderly patients with pulmonary tuberculosis（PTB），so as to provide evidence for developing effective prevention and control strategies. Methods Derived the information from PTB management information system in 2010-2019 of the tuberculosis patients who were aged 60 years or older in Huai'an City, described and analyzed the influencing factors of patient delay. Results The median time of PTB patients delay in Huaian was 21 day, while the rate was 65.91%. Multivariate logistic regression analysis results showed that compared with permanent residents, city dwellers, the first diagnosis unit specialized hospital, and the patient source referral, the patient delay risks of the floating residents（OR = 2.942 , 95% CI: 2.461-3.518）, the country dwellers（OR = 1.528,95% CI :1.377-1.697）, the first diagnosis unit general hospital（OR = 1.203,95% CI: 1.087-1.333）, and the patient source recommendation （OR = 2.395,95% CI: 1.960-2.928）were higher, Compared with the peasants（OR = 0.315 , 95% CI : 0.213-0.512）, new patients（OR = 0.812 , 95% CI : 0.689-0.974） and sputum smear positive patients（OR = 0.866 , 95% CI : 0.780-0.962）, the patient delay risks of the non-peasants, recurrent patients, and sputum negative patients were lower. Conclusion The patient delay of the elderly patients with pulmonary tuberculosis（PTB）in Huaian was serious, the influencing factors of patient delay were type of household registration, current residence, occupation, type of first-time unit, source of patient , classification of treatment, and the sputum test results.

Objective:To develop the minimal clinically important difference (MCID) of Quality of Life Instruments for Cancer Patients-Leukemia (QLICP-LE) (V2.0).Methods:The quality of life of 101 patients with leukemia in First Affiliated Hospital of Kunming Medical University and First People′s Hospital of Yunnan Province from October 2011 to May 2012 were measured. The QLICP-LE (V2.0) was used for data collection, and the MCID for the overall score and scores of various domains of QLICP-LE (V2.0) were established by using the distribution-based approach including indexes of effect size, standard error of measurement (SEM), reliable change index, standardized response mean and responsiveness statistic, and the recommended values of MCID were determined through the consensus method.Results:The MCID formulated by the above five indexes were as follows: the total scale 1.4-9.3, physical functional domain 1.6-15.6, psychological functional domain 2.9-15.6, social functional domain 2.2-18.0, common symptoms and side-effects domain 1.7-17.1, common module 1.8-10.0, and the specific module 1.1-12.1. Through the expert consensus method, it was recommended to use the MCID results calculated by 1.96SEM: the total scale was 4, physical domain was 8, psychological domain was 8, social domain was 9, common symptoms and side-effects domain was 9, common module was 4, and the specific module was 6.Conclusion:Each index of distribution-based approach has its own advantages and disadvantages, which can be selected based on actual conditions. There is clinical significance when the score change of QLICP-LE (V2.0) of leukemia patients after treatment exceeds its MCID.

Objective:To present briefly introductions and evaluations on the constructs, psychometric properties (reliability, validity, reactivity etc.) and applications of the system of Quality of Life Instruments for Cancer Patients QLICP(V1.0) including 12 kinds of scales for patients with head and neck cancer, brain cancer, lung cancer, breast cancer, esophageal cancer, gastric cancer, colorectal cancer, liver cancer, cervical cancer, ovarian cancer, leukemia and lymphoma.Methods:Based on our measuring data from relevant patients at hospitals, the constructs, characteristics and psychometrics of the system above were analyzed and presented. Internal consistency reliability for each domain and the overall scale was assessed using Cronbach's alpha coefficient, and test-retest reliability through calculating the Pearson correlation coefficient between the first and second assessments. The criterion-related validity was evaluated by correlating corresponding domains of two instruments. Responsiveness was assessed through comparing the mean difference between the pre-treatment and post-treatments with standardized response mean (SRM). The use agreements and literature reviews of this system were used to understand the applications of 12 kinds measurement scales.Results:The quality of life scales for 12 kinds of cancer patients of the system QLICP(V1.0) have good construct( 5 domains, 11-15 facets), reliability, validity and a certain degree of responsiveness. The internal consistency reliability Cronbach's α coefficients for the overall scale of QLICP in different cancers was from 0.67 to 0.92, and the test-retest reliability (correlation coefficient) was from 0.61 to 0.99. The criterion-related validity (correlation coefficient) was for the overall scale of QLICP in different cancers was from 0.28 to 0.89, and the responsiveness SRM was from 0.25 to 1.28. And also they were widely used in clinical practice and relevant studies for the corresponding cancers.Conclusion:The system QLICP(V1.0) is of outstanding characteristics with all psychometrics meeting requirements and better construct (clear hierarchical structure with items→ facets→ domains→ overall ), and can be used widely in clinical practice further.

Objective: To compare the differences and similarities among the system of quality of life instruments for cancer patients (QLICP) V1.0, the quality of life questionnaire (QLQ) from European Organization for Research and Treatment of Cancer (EORTC) and Functional Assessment of Cancer Therapy (FACT) from Center on Outcomes, Research and Education (CORE) of America. Methods: Based on literatures and our measuring data from patients at hospitals, the constructs, characteristics and psychometrics of the systems above were analyzed and compared. Internal consistency reliability was assessed using Cronbach α coefficient for each domain, and test-retest reliability through calculating the Pearson correlation coefficient r between the first and second assessments as well as intra-class correlation (ICC). Construct validity was evaluated by Pearson correlation coefficient r (item-domains correlations) and factor analysis. The criterion-related validity was evaluated by correlating corresponding domains of two instruments. Responsiveness was assessed through comparing the mean difference between the pre-treatment and post-treatment with standardized response mean (SRM). Results: The instruments of three systems were of different outstanding characteristics with all psychometrics meeting requirements. Measurements for 12 types of cancers showed that the internal consistency reliability Cronbach α coefficient for the overall scale of QLICP (V1.0) was 0.67-0.92, and for FACT was 0.79-0.98. The test-retest reliability (r or ICC) for the overall scale of QLICP (V1.0) was 0.61-0.99, and for FACT was 0.60-0.98. The SRM for the overall scale of QLICP (V1.0) was 0.25-1.28, and for FACT was 0.11-0.83. However, the QLICP was of better construct (clear hierarchical structure with items→facets→domains→overall) and Chinese culture. Conclusion The instruments of three systems can be used as the instruments to assess quality of life for patients with cancer with selections basing on different settings.