哈萨克语版鼻窦炎结局测试-22（SNOT-22）在慢性鼻窦炎伴鼻息肉患者中的跨文化适应与初步心理测量学评价

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中文摘要

背景/目的： 慢性鼻窦炎伴鼻息肉（CRSwNP）与健康相关生活质量的显著损害相关。鼻窦炎结局测试-22（SNOT-22）是慢性鼻窦炎中最广泛使用的患者报告结局测量工具之一。据我们所知，此前尚无关于哈萨克语版SNOT-22心理测量学评价的已发表报告。本研究旨在对哈萨克语版SNOT-22进行跨文化适应，并在CRSwNP成人中评价其部分测量学特性。方法：这项前瞻性单中心研究纳入151名参与者：101例CRSwNP患者（维生素D补充组，n=50；标准治疗组，n=51）和50名健康志愿者。两个患者组均接受内镜鼻窦手术并接受局部糖皮质激素治疗；仅维生素D补充组按照预设方案接受辅助性维生素D。跨文化适应按照ISPOR推荐进行。所考察的测量学特性包括内部一致性、已知组效度、反应性以及与Lund-Kennedy内镜评分的探索性关联。未评估重测信度和结构效度。结果：CRSwNP患者的基线SNOT-22评分显著高于健康志愿者（p<0.001），尽管该已知组比较的解释受到组间年龄和性别显著不平衡的限制。在具有完整条目水平数据的合并目标CRSwNP样本中（n=99），Cronbach's alpha为0.921。亚组系数在维生素D补充组为0.901，在标准治疗组为0.934，而健康志愿者中的系数为0.891。一个月后，两个患者组的SNOT-22评分均显著下降（均p<0.001），支持该工具检测随时间变化的能力。与Lund-Kennedy评分的基线相关性非常弱且无统计学意义；仅在治疗后观察到更强的相关性。结论：哈萨克语版SNOT-22显示出有希望的初步测量学特性，包括高内部一致性、区分患者与健康志愿者的能力以及检测纵向评分变化的能力。然而，由于未评估重测信度、测量误差和结构效度，且聚合效度的证据有限，心理测量学评价仍不完整。需要在更大规模、人口学特征均衡的样本中进一步验证。

英文摘要

Background/Objectives: Chronic rhinosinusitis with nasal polyps (CRSwNP) is associated with substantial impairment of the health-related quality of life. The Sino-Nasal Outcome Test-22 (SNOT-22) is one of the most widely used patient-reported outcome measures in chronic rhinosinusitis. To our knowledge, no published psychometric evaluation of a Kazakh-language SNOT-22 has previously been reported. The aim of this study was to perform the cross-cultural adaptation and evaluate selected measurement properties of the Kazakh-language SNOT-22 in adults with CRSwNP. Methods: This prospective single-center study included 151 participants: 101 patients with CRSwNP (vitamin D supplementation group, n = 50; standard-treatment group, n = 51) and 50 healthy volunteers. Both patient groups underwent endoscopic sinus surgery and received topical glucocorticosteroids; adjunctive vitamin D was administered only in the vitamin D supplementation group according to the prespecified protocol. Cross-cultural adaptation was conducted according to ISPOR recommendations. The selected measurement properties examined were internal consistency, known-group validity, responsiveness, and exploratory associations with Lund-Kennedy endoscopic scores. Test-retest reliability and structural validity were not assessed. Results: Baseline SNOT-22 scores were substantially higher in patients with CRSwNP than in healthy volunteers (p < 0.001), although the interpretation of this known-group comparison is limited by significant age and sex imbalance between groups. In the combined target CRSwNP sample with complete item-level data (n = 99), Cronbach's alpha was 0.921. Subgroup coefficients were 0.901 in the vitamin D supplementation group and 0.934 in the standard-treatment group, while the coefficient in healthy volunteers was 0.891. After one month, SNOT-22 scores decreased substantially in both patient groups (both p < 0.001), supporting the instrument's ability to detect change over time. Baseline correlations with Lund-Kennedy scores were very weak and non-significant; stronger correlations were observed only after treatment. Conclusions: The Kazakh-language SNOT-22 showed promising initial measurement properties, including high internal consistency and the ability to distinguish patients from healthy volunteers and to detect longitudinal score changes. However, the psychometric evaluation remains incomplete because test-retest reliability, measurement error, and structural validity were not assessed, and evidence for convergent validity was limited. Further validation in larger, demographically balanced samples is required.