Supplementary Material for: Psychometric Properties of a Modified KINDL-R Questionnaire for Adolescents and Adults, and Construction of a Brief Version, the KINDL-A(dult)B(rief) Questionnaire, KINDL-AB

<b><i>Background/Aims:</i></b> The generic quality of life KINDL-R ­questionnaire is validated for use in children/adolescents ≤16 years. The aim of this cross-sectional investigation was to modify the KINDL-R questionnaire for use in adults and to validate its psychometric properties. <b><i>Methods:</i></b> Five items of the KINDL-R questionnaire were adapted and the newly developed KINDL-A(dult) questionnaire administered to 255 patients with hereditary and acquired bleeding disorders (mean age 53 years). Its internal consistency and convergent and divergent construct validity were investigated and confirmatory factor analysis was used to evaluate the latent factor structure. <b><i>Results:</i></b> The KINDL-A questionnaire showed satisfactory reliability, varying construct validity, but inconclusive factor structure. The KINDL-AB(rief) was developed by removing half of the items and combining 2 sub-axes. This led to factor loadings between 0.62 and 0.91 and increased overall fit (Goodness of fit &gt; 0.8 and Root Mean Square Error of Approximation, RMSEA, &lt; 0.08). Results were validated in 966 healthy blood donors (mean age 38 years). In this group, the KINDL-AB questionnaire showed factor loadings between 0.43 and 0.77, Goodness of fit &gt; 0.95 and RMSEA &lt; 0.05. <b><i>Conclusions:</i></b> The new KINDL-AB suggests sufficient to good psychometric properties in adult patients with hereditary and acquired bleeding disorders.

**背景与研究目的**：通用生活质量评定问卷KINDL-R（KINDL-R）已通过效度验证，适用于16岁及以下的儿童与青少年。本横断面调查（cross-sectional investigation）旨在将KINDL-R问卷适配至成人使用，并验证其心理测量学特性（psychometric properties）。**研究方法**：对KINDL-R问卷的5个条目进行了适配修订，将新开发的成人版KINDL-A问卷施测于255名患有遗传性及获得性出血性疾病的患者（平均年龄53岁）。本研究考察了该问卷的内部一致性、会聚效度与区分效度，并采用验证性因子分析（Confirmatory Factor Analysis）评估其潜在因子结构。**研究结果**：KINDL-A问卷表现出令人满意的信度，以及尚可的建构效度，但因子结构尚未明确。研究团队通过删减半数条目并合并2个亚维度，开发出简版KINDL-AB问卷。该调整使因子载荷介于0.62至0.91之间，整体拟合优度（Goodness of fit）得到提升（拟合优度>0.8，近似误差均方根（Root Mean Square Error of Approximation, RMSEA）<0.08）。上述结果在966名健康献血者（平均年龄38岁）队列中得到验证。在该队列中，KINDL-AB问卷的因子载荷介于0.43至0.77之间，拟合优度>0.95，RMSEA<0.05。**研究结论**：新型简版KINDL-AB问卷在遗传性及获得性出血性疾病成年患者群体中，展现出足以达到良好水平的心理测量学特性。