Development of a Korean Hyperthyroidism-Specific Health Status Scale

  • Soongyo YEOUM Department of Nursing, Seoil University, Seoul, South Korea
  • Sunah PARK Department of Nursing, Gangneung-Wonju National University, Wonju, South Korea
Keywords: Health status; Hyperthyroidism; Reliability; Scale; Validity


Abstract Background: The aims of this study were to develop a hyperthyroidism-specific health status scale of Korea (K-HHSS) and to verify its validity and reliability. Methods: A methodological study was performed with hyperthyroid patients to assess the following properties: content validity, item analysis, Cronbach’s α, intraclass correlation coefficients, and confirmatory factor analysis. The data were obtained from 80 patients with hyperthyroidism given medical care at C university hospital in Seoul in 2017. Results: The construct validity was supported by the item-analysis correlations ranging between 0.31 and 0.82. The internal consistency reliability was from 0.70 to 0.85, and the scale’s stability was confirmed by intraclass correlation coefficients between 0.57 and 0.97. Construct reliability was 0.81 and the average variance extracted (AVE) was 0.72. These inclusion criteria resulted in the selection of 30 items in 7 categories. Conclusion: This scale will be useful as a limited health-measuring index for the nursing assessment of patients with hyperthyroidism in Korea.    


1. National Cancer Informational Center. (2015). [cited 24 Dec. 2015.]
2. National Health Insurance Service. (2015). [cited 12 Oct. 2015].
3. Seo GH, Kim SW, Chung JH (2013). In-cidence & prevalence of hyperthyroid-ism and preference for therapeutic modalities in Korea. J Korean Thyroid Assoc, 6(1):56-63.
4. Bulow PI, Knudsen N, Jorgensen T et al (2002). Large differences in incidences of overt hyper-and hypothyroidism as-sociated with a small difference in io-dine intake: a prospective comparative register-based population survey. J Clin Endocrinol Metab, 87(10): 4462-4469.
5. Empson M, Flood VM, Eastman CJ, Mitchell P (2007). Prevalence of thy-roid disease in an older Australian population. Intern Med J, 37(7): 448-455.
6. Jo B. H. Clinical Thyroidology. Seoul, Korea: Medical Book; 2005.
7. Iglesias P, Diez JJ (2009). Thyroid dys-function and kidney disease. Eur J En-docrinol, 160(4): 503-515.
8. Siu CW, Yeung CY, Lau CP et al (2007). Incidence, clinical characteristics and outcome of congestive heart failure as the initial presentation in patients with primary hyperthyroidism. Heart, 93(4): 483-487.
9. Boelaert K, Franklyn JA (2005). Thyroid hormone in health and disease. J Endo-crinol, 187(1): 1-15.
10. Demet MM, Ozemen B, Deveci A et al (2002). Depression and anxiety in hy-perthyroidism. Arch Med Res, 33(6): 552-556.
11. Numbenjapon N, Costin G, Gilsanz V, Pitukeheewanont P (2007). Low cor-tical bone density measures by com-puted tomography in children and adolescents with untreated hyperthy-roidism. J Pediatr, 150(5): 517-530.
12. Tan ZS, Beiser A, Vasan RS et al (2008). Thyroid function and the risk of Alz-heimer disease: The Framingham study. Arch Intern Med, 168(14): 1514-1520.
13. Fahrenfort JJ, Wilterdink AM, Van der Veen EA (2000). Long-term residual complaints and psychosocial sequelae after remission of hyperthyroidism. Psychoneuroendocrinology, 25(2): 201-211.
14. Terwee CB, Gerding MN, Dekker FW et al (1998). Development of a disease-specific quality of life questionnaire for patients with Graves' ophthalmo-pathy: the GO-QOL. Br J Ophthalmol, 82(7): 773-779.
15. Klein I, Trzepacz PT, Roberts M, Levey GS (1988). Symptom rating scale for assessing hyperthyroidism. Arch Med Res, 148(2): 387-390.
16. Panita L, Kittisak S, Ajanee M, Chaiyasit W (2006). Clinical manifestations of primary hyperthyroidism in the elderly patients at the out-patient clinic of Srinagarind hospital. J Med Assoc Thai, 89(2): 178-181.
17. Watt T, Groenvold M, Rasmussen AK et al (2006). Quality of life in patients with benign thyroid disorders. Eur J Endocrinol, 154(4): 501-510.
18. Kim JH (2012). Thyroid dysfunction. J Korean Thyroid Assoc, 5(2): 94-98.
19. Bianchi GP, Zaccheroni V, Solaroli E et al (2004). Health-related quality of life in patients with thyroid disorders. Qual Life Res, 13(4): 45-54.
20. Irwin K, Kaie O (2001). Thyroid hor-mone and the cardiovascular system. N Engl J Med, 344(7): 501-509.
21. Park JJ, Sullivan TJ, Mortimer RH et al (2004). Assessing quality of life in Australian patients with Graves’ oph-thalmopathy. Br J Ophthalmol, 88(1): 75-78.
22. Lee UO, Im NY, Park HA (1998). Nurs-ing, public health research and statistical analysis. Soomoonsa. Seoul.
23. Nunnally JC, Bernstein IH (1994). Psy-chometric Theory. 3rd ed:. McGraw Hill. New York.
24. Hur MH, Yang KS (2001). Multivariate data analysis. SPSS Academy Pub Co. Seoul
25. Han SY, Nam JM, Myoung SM, Song KJ (2010). A Comparison of sample size requirements for intraclass correlation coefficient (ICC). KJAS, 23: 497-510.
26. Osman F, Franklyn JA, Holder RL et al (2007). Cardiovascular manifestations of hyperthyroidism before and after anti-thyroid therapy: a matched case-control study. J Am Coll Cardiol, 49(1): 71-81.
How to Cite
YEOUM S, PARK S. Development of a Korean Hyperthyroidism-Specific Health Status Scale. Iran J Public Health. 48(5):873-881.
Original Article(s)