“中国心血管病人生活质量评定问卷”及其常模的测定

背景：2008年就我会制定的＂中国心血管病人生活质量评定问卷＂（CQQC）,与常用的健康调查简表（SF-36）对600例高血压、冠心病、心衰患者进行了比较调查,结果与SF-36的信度（Cronbach′α=0.76）相比,CQQC的信度更好（Cronbach’α=0.91）,二者的效度有较好的相关性（r=0.674,P〈0.01）。目的：公布CQQC,报告CQQC测定的正常人,高血压、冠心病、充血性心力衰竭（CHF）患者的常模,并分析其影响因素。方法：采用整群随机抽样的方法,对地跨全国各大区的20个城市29所医院的,包括正常人,高血压、冠心病、心衰患者的8267名对象的生活质量进行测试,建立全国常模,并比较性别、年龄、运动、心理状态、教育、家庭以及医疗条件所致的影响。结果：这次CQQC常模测定：（1）正常人平均得分为（93.93±26.53）分;（2）高血压患者平均得分为（76.61±25.84）,高血压3级患者生活质量（68.15±21.85）得分,明显低于其他级患者（P〈0.01）;（3）冠心病患者的平均得分为（63.46±21.4）,其中不稳定型心绞痛患者的生活质量得分（55.38±18.68）最差（P〈0.01）;（4）CHF患者的的平均得分为（40.51±17.16）,显著低于高血压和和冠心病患者（P〈0.01）;（5）影响因素：①性别、年龄：所有人的总体得分为（71.19±27.66）分,男性得分非常显著高于女性（P〈0.001）,正常人生活质量男性得分（96.54±28.15）,显著多于女性（89.99±23.35）,P〈0.001;正常人随着年龄增加,得分逐渐减少（P〈0.001）,除≥70岁组,其他各年龄组男性得分显著高于女性（P〈0.05～〈0.001）;高血压、冠心病、心衰三组除部分亚组（如单纯收缩期高血压,高血压3级,隐匿性冠心病,稳定性心绞痛）外,男性得分均显著高于女性（P〈0.05～〈0.001）;②运动：参加运动者的得分（78.72±25.49）非常显著高于未参加运动者（60.78±27.16,P〈0.001）;③心理：心理健康者的得分（86.53±23.22）非常显著高于心理有障碍者（52.64±20.26,P〈0.001）;④其他：受教育程度越高,得分越高;家庭成员为1个人的得分明显低于2人和≥3人家庭的得分（P〈0.001）。结论：本研究样本量大,数据可靠;中国心血管病人生活质量评定问卷能反映年龄、性别、疾病、运动、心理、家庭、受教育程度对生活质量的影响,条目简短明了,可操作性好,值得推广。

China questionnaire of quality of life in patients with cardiovascular diseases and its mensuration of national norm

Background: The compared survey between"China questionnaire of quality of life in patients with cardiovascular diseases(CQQC)"and the 36-item short form health survey(SF-36)in 600 cases of patients with hypertension,coronary artery disease and heart failure was performed in 2008,the result show that compared with reliability of SF-36(Cronbach’α=0.76),the reliability of CQQC was better(Cronbach’α=0.91),validity of CQQC was correlated with that of SF-36(r=0.674,P<0.01).Objective: To measure the national norm of Chinese questionnaire of quality of life in patients with cardiovascular diseases(CQQC) according patients with hypertension,coronary artery disease(CAD),and congestive heart failure(CHF)and to analyze the influence of gender,exercise,psychology,education,number of family member and medical cost.Methods:The CQQC was used to evaluate 8267 subjects(contain normal person and patients with hypertension,CAD,and CHF)in 29 hospitals of 20 cities across every greater area of China.The data were compared in gender,age,education,number of family member and medical cost.Results:(1)The mean score(national norms)of normal person was(93.93±26.53);(2)The score of hypertension patients was(76.61±25.84),the score of hypertension stage 3 group(68.15±21.85)was least compared with other stages(P<0.01);(3)The score of CAD patients was(63.46±21.4),the score of unstable angina group(55.38±18.68)was least compared with other types in CAD patients(P<0.01);(4)The score of CHF patients was(40.51±17.16),it was least compared with hypertension and CAD patients(P<0.01);(5)Influence factor:①Sex,age: The mean score was(71.19±27.66)for 8267 persons,the score of male persons was significantly higher than that of female(P<0.001);in normal persons the score of male persons(96.54±28.15)was significantly higher than that of female(89.99±23.35),P<0.001;along with age increased,the score decreased(P<0.001);except ≥70 ages group,the score of male persons was higher than that of female(P<0.05~<0.001);②Exercise: The score of patients participating exercise was significantly higher than that of no participating exercise [(78.72±25.49)vs.(52.64±20.26),P<0.001];③Psychology: The score of patients with healthy psychology was significantly higher than that of with psychology disorder [(86.53±23.22)vs.(68.91±20.44),P=0.001];④Other: patients with better education,and more than 1 family members had better scores(P<0.001).Conclusion:The sample size is large and the datum is reliable for China questionnaire of quality of life in patients with cardiovascular diseases.It can reflect influence of age,sex,disease,exercise,psychology,family,education background and its item is brief,clear,and maneuverability is good,so it may well be spread.