University of Victoria
HIV remains to be a major public issue today. According to the Chinese Center for Disease Control and Prevention (CDC), China had 1.05 million people living with HIV/AIDs (PLWHA) and 351,000 cumulative reported deaths by the end of 2020. The widespread application of the highly active antiretroviral therapy (HAART) has made HIV infection a manageable chronic health condition, enabling PLWHA to live a longer life. However, longer life expectancy is not equal to better life well-being. Alongside physical discomforts, PLWHA also struggle with depression, anxiety, and HIV-related discrimination. Degeneration of physical and social function that comes with aging means that older patients can face more specific and complex problems with HIV/AIDS. To date, no true instrument has been developed to measure the health outcome of elderly PLWHA. Therefore, to better understand how HIV/AIDS influences older patients in China, this study developed and tested preliminary measurement properties of a new patient-reported outcome—the EPRO-HIV—measure for Chinese elderly PLWHA.
The study had two main findings:
- The EPRO-HIV was found to have acceptable reliability and validity for evaluating health status of Chinese elderly PLWHA.
- On the scores of the EPRO-HIV, there were significant differences between demographic and clinical subgroups.
The psychometric property of responsiveness will be further examined. Meanwhile, the minimally important differences of the EPRO-HIV will be estimated in future studies to help explain the clinical meaning of the scale scores.
A total of 600 patients were recruited at the baseline. Of the 485 patients who completed the follow-up investigation, 483 were included in the validation sample. Item reduction based on the CTT kept 33 items, and then the IRT analysis based on the graded response model (GRM) led to the definition of five domains (physical symptom, mental status, illness perception, family relationship, and treatment), thereby giving rise to the final scale of EPRO-HIV containing 25 items. The Cronbach’s alpha coefficient, McDonald’s ω coefficient, and composite reliability of each domain were all higher than 0.85. Most domains met the test-retest reliability standard except for the physical symptom domain (ICC=0.64). CFA supported the structural validity of the final scale, and the model fit index (/df=2.54, CFI=0.94, TLI=0.93, SRMR=0.06, RMSEA=0.06) satisfied the criterion. The correlations between dimensions of EPRO-HIV and MOS-HIV met hypotheses in general.
Abstract will be presented virtually in the Thursday Afternoon Poster Presentations: Slot 5 on 20 October, 3:05 pm – 3:20 pm.
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