FLIC、SF-36和QOL-LC量表在肝癌患者生活质量测定中的应用比较

目的比较癌症患者生活功能指标量表(FLIC)、健康调查简表(SF-36)和肝癌患者生活质量测定量表(QOL-LC)在肝癌患者生活质量测定中的应用效果。方法以2010～2011年选定的调查医院肝癌住院患者105例为研究对象,采用FLIC、SF-36和QOL-LC量表分别进行3次纵向测定,计算和比较各量表的信度、效度和反应度。结果 QOL-LC的效度、信度比FLIC和SF-36量表好;在反应度方面,QOL-LC及FLIC量表均显示躯体功能与总生命质量的变化差异有统计学意义(QOL-LC:t=5.08;P=0.000;t=3.16;P=0.002;FLIC:t=4.02;P=0.000;t=2.21;P=0.030)。SF-36量表除一般健康状况和心理健康两个领域外,其余领域的治疗前后得分变化均有统计学意义(躯体功能t=5.94;P=0.000;躯体角色t=3.07;P=0.003;身体疼痛t=3.21;P=0.002;生命力t=3.22;P=0.002;社会角色t=2.60;P=0.012;情绪角色t=3.28;P=0.002)。结论 QOL-LC是测定肝癌患者生活质量的特异量表,在评估肝癌患者生活质量时是首选,而SF-36和FLIC量表能反映肝癌患者生命质量的共性部分,在缺少特异性量表的情况下,可用于测评肝癌患者的生活质量。

Comparisons among FLIC, SF-36 and QOL-LC in Measuring Quality of Life of Patients with Liver Cancer

Objective To compare the application effects of three psychometric instruments including SF-36, FLIC and QOL-LC in measuring the quality of life of patients with liver cancer. Methods A total of 105 in-patients with liver cancer selected from 2010 to 2011 were included. The quality of life was measured by FLIC, SF-36 and QOL-LC, respectively, and the reliability, validity and responsiveness were calculated and analyzed. Results The reliability and validity of QOL-LC were better than those of SF-36 and FLIC. Both QOL-LC and FLIC showed significant differences in responsiveness based on the changes of physical function and overall quality of life （QOL-LC： t=5.08, P=0.000, t=3.16, P=0.002; FLIC： t=4.02, P=0.000, t=2.21, P=0.030）. Except for general health and mental health, the other domains of SF-36 showed significant differences in changes after treatment （physical function： t=5.94, P=O.O00; physical role： t=3.07, P=0.003; body pain： t=3.21, P=O.002; vital- ity： t=3.22, P=0.002; social role： t=2.60, P=0.012; emotional role： t=3.28, P=0.002）. Conclusion QOL-LC is a specific scale for liver cancer, and it should be used preferentially. SF-36 and FLIC can measure the general state of quality of life and can be used in patients with liver cancer when specific scale is not available.