中国头颈癌生命质量测定量表QLICP-HN信度效度分析

目的对中国版头颈癌生命质量测定量表（QLICP-HN）的信度与结构效度进行评价。方法采用因子分析和聚类分析对用QLICP-HN测定的133例头颈癌患者生命质量进行分析,对QLICP-HN量表信度与结构效度进行了评价。结果5个领域的重测信度均在0.90以上;各领域内部一致性信度的α值均在0.7以上;因子分析和聚类分析表明调查分析结果和理论构想基本吻合。结论QLICP-HN中文版具有较好的信度和结构效度,可用于中国头颈癌患者的生命质量测定。     

中国头颈癌生命质量测定量表QLICP-HN的研制与考评

[目的]研制中国版头颈癌生命质量测定量表QLICP-HN,并对其进行评价。[方法]通过提出量表条目形成条目池、确定条目的形式与回答选项、条目分析与筛选、预调查与量表考评、修改完善制定出中国版的头颈癌患者生命质量测量量表QLICP-HN,并通过133例头颈癌患者进行的生命质量测定对量表进行评价。[结果]5个领域的重测信度均在0.90以上;各领域内部一致性信度的α值均在0.7以上;各条目与其领域的相关系数r值均在0.6以上。该量表在入院治疗后4周就基本上可以反映生命质量的变化。[结论]QLICP-HN中文版具有较好的信度、效度和反应度,可用于中国头颈癌患者的生命质量测定。     

修订的糖尿病生命质量量表(A-DQOL)信度与效度初探

目的：通过对修订的专用糖尿病生命质量量表（Ａ－ＤＱＯＬ）信度和效度进行评价,旨在国内推广应用糖尿病生命质量评价的专用量表。方法：采用相关分析和因子分析对Ａ－ＤＱＯＬ的信度和效度进行评价。结果：Ａ－ＤＱＯＬ的重测信度为０．８２３６,折半信度为０．７９６３,克朗巴哈α系数为０．８６９９,θ系数为０．９０６０,Ω系数为０．９１６３;规定提取３个公因子,利用主因子因子分析法进行分析表明,Ａ－ＤＱＯＬ具有良     

阿尔茨海默病生命质量测评量表(QOL-AD)中文版信度和效度分析

目的 考察阿尔茨海默病生命质量测评量表QOL-AD中文版的信度和效度.方法 采用国际通用的量表翻译程序,将英文版QOL-AD翻译成中文.将QOL-AD中文版量表运用于太原市200例AD患者及其照料者,分析量表的可行性、效度和信度.结果 200例AD患者中195例完成了问卷,87例照料者全部完成了问卷,答卷的条目缺失率低于1％;QOL-AD得分(患者版)与ADL、SF-36(生理机能PF)、SF-36(生理职能RP)、GDS、SF-36(精神健康MH)、CBS的相关系数分别为-0.239、0.288、0.269、-0.211、0.290、0.227(P ＜0.01),QOL-AD得分(照料者版)与SF-36(生理职能RP)、SDS的相关系数分别为0.211、-0.266(P ＜0.05);MoCA得分低分组和其他组比较均有统计学意义(P＜0.05);MTMM矩阵单质多方法相关系数均有统计学意义(P＜0.05);量表总分的重测信度系数为0.835(P ＜0.01);QOL-AD(患者版)分半信度系数为0.674,QOL-AD(照料者版)分半信度系数为0.841;QOL-AD(患者版)的Cronbach系数为0.659,QOL-AD(照料者版)的Cronbach系数为0.869.结论 QOL-AD中文版具有较好的信度和效度,可以应用于中国阿尔茨海默病生命质量的研究.     

流动人口SF-12生命质量量表信度、效度评价

目的 评估SF-12生命质量量表用于评价流动人口生命质量时的信度和效度。方法 采用内部一致性信度评估SF-12生命质量量表的信度,采用集合效度、区分效度和结构效度评估SF-12量表的效度。结果 SF-12生命质量量表用于评价流动人口生命质量时的内部一致性信度cronbach'sα=0.84,各维度与总分的相关系数除了躯体活动功能(PF)=0.43,其余均>0.50;各维度的Cranach'sα系数均>0.70,且在删除相应维度后的Cronbach'sα系数均>0.70;8个维度的集合效度定标实验成功率均为100%,区分效度定标实验成功率均为100%;对量表的理论结构模型进行验证性因子分析,所得模型结构与原始假定一致,拟合指标结果为不规范拟合指数(NNFI)=0.95、比较拟合指数(CFI)=0.96、调整后的拟合优度指数(AGFI)=0.96、近似误差均方根(RMSEA)=0.06。结论 SF-12生命质量量表用于评价流动人口生命质量时具有较好的信度和效度。     

基于QLICP-HN(V2.0)量表的头颈癌患者生命质量影响因素及干预对策研究

[目的]分析头颈癌患者生命质量影响因素,为制定提高头颈癌患者生命质量的干预措施提供科学依据。[方法]收集云南省肿瘤医院133例头颈癌住院患者,采用t检验、方差分析等单因素分析以及多重线性回归法分析头颈癌患者生命质量的影响因素。[结果]单因素研究显示,不同性别、文化程度头颈癌患者生命质量差异有统计学意义(P≤0.05);不同年龄头颈癌生命质量在特异模块领域差异有统计学意义(P=0.025);家庭经济在共性模块得分上差异有统计学意义,家庭经济较好者生命质量较高。多重线性回归结果显示,性别均纳入了分别以共性模块、特异模块、总量表得分为因变量的3个回归模型;以共性模块、总量表得分为因变量的回归模型还将文化程度、医疗形式纳入了模型;以生命质量特异模块得分、总量表得分为因变量的回归模型中还纳入了手术情况。[结论]影响头颈癌患者生命质量的主要因素有性别、年龄、是否手术、家庭经济、文化程度、医疗形式、职业、婚姻、吸烟酗酒、抑郁症状,在后续进行头颈癌干预对策探讨时应着重考虑这几方面。     

SF-36量表应用于城市化居民生命质量评价的信度和效度分析

目的 评价SF-36量表用于城市化居民生命质量评价的信度和效度,为选择合适的健康测量工具提供参考。方法 采用多阶段整群系统抽样方法,使用SF-36量表进行入户调查,利用Spearman-Brown系数和Cronbach''s α 系数评价量表分半信度和内部一致性信度,集合效度实验和区分效度实验成功率评价量表集合效度和区分效度,采用相关分析和非参数检验以自评健康状况为标准进行标准关联效度分析,结构效度评价采用基于结构方程模型的验证性因子分析。结果 SF-36量表应用于城市化居民生命质量评价具有良好的分半信度(R=0.94)和内部一致性信度(除"躯体疼痛"和"精力"维度外,Cronbach''s α 系数为0.70~0.91),量表集合效度(定标成功率为88.57%)、区分效度(定标成功率为90.61%)和准则效度(γ_s=0.56,评分与自评健康状况相一致)良好,二阶验证性因子分析模型对数据拟合度较差(拟合优度指数为0.721,调整拟合优度指数为0.682,比较拟合指数为0.731,残差均方和平方根为0.084,近似误差均方为0.098),提示结构效度欠佳。结论 SF-36量表用于城市化居民生存质量评价具有良好的信度、集合效度、区分效度和标准关联效度,但结构效度欠佳,建议在实际应用中对相应条目进行调整。     

生存质量量表信度和效度的初步评价

按QWB量表修订框架,结合多种生理、心理、社会适应量表,精选26个问题条目重新编制NWS量表(NewWell-BeingScale)。经对福州市359例老年人生存质量的标准化研究,考核评价NWS量表的信度和效度。结果表明:该量表具备良好的信度,Cronbachα值高达0.8345;采用确定决断分值的内容效度考核,其误判比例＜30％;采用疾病等级为效标的实证效度考核,量表对疾病状态具有良好的甄别力;采用因子分析的结构效度考核,各问题条目可进行合理的归因与解释。NWS量表的信、效度均优于QWB量表,推荐使用。     

脑卒中PRO量表的信度效度分析

目的考察自行研制的用于临床疗效评价和新药临床试验的脑卒中患者报告的临床结局(PRO)评价量表的科学性。方法采用脑卒中PRO量表对595例样本(485例脑卒中患者、110例"健康人")进行自评量表式调查,对量表进行信度、效度和可行性的考核,并针对性别可能产生的量表选填差异进行项目功能差异分析。结果总量表的克朗巴赫系数为0.905。结构效度结果显示量表多维度的测量满足专业上的预期构想。项目功能差异(DIF)结果提示,仅PHD9和PSD3两个条目存在跨性别DIF。抽样调查脑卒中患者,量表回收率为99.2%,有效率为98.8%,平均作答时间为8.9分钟。结论本课题研制的脑卒中PRO量表具有较好的信度、效度、公平性和可行性。     

Performance and quality of life outcome in patients completing concomitant chemoradiotherapy protocols for head and neck cancer

This study evaluated post-treatment performance and quality of life (QOL) outcome in head and neck cancer (HNC) patients treated with organ preservat ion, intens ive chemoradiotherapy (FHX). Participants were 47 Stage II-IV HNC patients with no evidence of disease at least one year post-completion of organ preservation, concomitant FHX treatment. Patients were assessed via a semi-structured in-person interview, standardized measures of QOL (FACT-H, CES-D), performance (PSS-HN) and patients' perception of residual side effects. Disease, treatment and toxicity data were retrieved from medical charts and protocol records. The most salient performance impairment was inability to eat a normal solid food diet, with 50% of patients able to eat soft foods or take liquids only. This specific functional deficit was not related to global QOL, nor to specific quality of life dimensions. Dry mouth, the most frequent and severe residual effect, was not associated with outcome diet, depression or QOL. Residual pain, seen in only 15% of patients, appeared to influence both functional and QOL parameters as well as being a marker for other troublesome symptoms. Twenty-three per cent of patients were depressed; depression was associated with past problems related to alcohol abuse. Decreased QOL and increased depressive symptomatology were related to total number and severity of residual effects. The data highlight the importance of systematic study of QOL dimensions and caution against making assumptions about patients' experience of particular disease and treatment sequelae.     

A prospective investigation of dispositional optimism as a predictor of health-related quality of life in head and neck cancer patients

The aim of this study was to investigate the role of dispositional optimism (DO) as a predictor of health-related quality of life (HRQL) in a sample of upper aerodigestive tract cancer (UADT) patients. A prospective observational study design was used with a cohort of patients from one centre. DO was evaluated using a French version of the Life Orientation Test (the FLOT) translated and validated for this study. HRQL was evaluated using the EORTC QLQ-C30 prior to and 3 months following treatment. The association between FLOT ratings and HRQL was evaluated using linear multiple regression analysis and a two-way ANOVA with repeated measures. Baseline data were gathered on 101 subjects and follow-up data on 88 of these. The sample was dichotomized around the median FLOT score creating ‘optimist’ and ‘pessimist’ groups. Before treatment, optimists reported better role, cognitive and emotional function, less pain and fatigue and a better global rating of HRQL than did pessimists. Following treatment, optimists reported better role and cognitive functioning, less pain and better global HRQL than did pessimists. Pessimists reported a greater deterioration in the role domain following treatment than did optimists. At no point did pessimists rate HRQL better than optimists. The results suggest that optimism is associated with better HRQL in French UADT cancer patients. This revised version was published online in June 2006 with corrections to the Cover Date.     

Radiation related morbidities and their impact on quality of life in head and neck cancer patients receiving radical radiotherapy

Although 50-70% of head and neck cancer patients in India receive radiotherapy (RT), radiation-related acute and late morbidities and their impact on quality of life (QOL) are infrequently reported. Acute and late radiation morbidities and QOL were assessed in a prospective longitudinal study of 45 patients with head and neck cancers receiving radical RT to a dose of 7000 cGy in conventional fractionation. Grade II acute morbidities experienced by the largest percent of the sample during the course of RT pertained to the mucosa (66.4%), salivary gland (84%), and oesophagus (53%). These morbidities led to an increase in the symptom scores of appetite loss (76.46), fatigue (65.75) and pain (44.77). This increase in the symptom scores consequently led to a significant decline in physical, social and emotional functioning as well as global health status score during the course of RT (p < 0.001). Scores improved after 1 month of RT but did not reach the pre-RT value. Future studies may consider correlating QOL assessment to significant patient and disease related parameters such as performance status, weight loss, stage and site of disease.     

Temporal assessment of quality of life of head and neck cancer patients receiving radical radiotherapy

The study was undertaken to evaluate physical, psychological and functional aspects in quality of life (QoL) assessment prospectively in biopsy-proven head and neck cancer patients receiving radical radiotherapy. Fifty male patients were assessed using Karnofsky's Performance Status (KPS), Beck's Depression Inventory (BDI) and the Functional Living Index – Cancer (FLIC). Patient questionnaires were completed before radiotherapy, during 3–4 weeks of radiotherapy and 3 months after radiotherapy. Before the start of radiotherapy, KPS was 91±10.26, FLIC was 129.98±33.41 and BDI was 7.10±4.57. This indicated good performance and functional status with lower depression. In weeks 3–4 of radiotherapy, KPS (71.00±20.12) and FLIC (81.34±45.23) decreased, while BDI(16.56 ±9.01) increased, indicating impairment in QoL. Three months after radiotherapy, KPS (78.37±23.0), FLIC (119.51± 43.62) and BDI(9.02±7.81) improved but were not restored to pre-treatment levels. When patients were scheduled for radical radiotherapy, maximum deterioration in QoL was seen in weeks 3–4. This is the time when maximum supportive care and psychologic counselling is required.     

头颈癌核心基因筛选及其预后分析

目的 利用生物信息学方法,筛选与头颈癌发生发展相关的差异表达基因,并进行相关的预后分析,寻找头颈癌新的诊断标志物以及治疗靶点。方法 在GEO数据库中下载头颈癌相关数据集GSE83519,利用GEO2R分析其差异表达基因,并对其进行功能注释及通路富集分析。通过STRING网站与Cytohubba软件筛选核心基因。利用UALCAN在线网站筛选预后相关基因,并使用cBioPortal在线工具对预后相关基因在头颈癌中的基因突变进行分析。 结果 GEO2R分析结果显示,GSE83519筛选出371个差异表达基因,其中含240个上调基因和131个下调基因。功能富集分析结果表明,差异表达基因主要与对氧含量的反应,凋亡信号通路的负调控等有关。 通路富集分析表明差异表达基因主要涉及癌症通路,细胞凋亡通路等。Cytohubba软件筛选出25个核心基因,这些基因参与了结直肠癌,乳腺癌,食管癌等多个癌症的发生发展,其中CASP8、CXCL12、MMP9等基因已被证实与头颈癌发生风险相关。通过UALCAN网站发现四个核心基因IL6、CD28、HDAC1、ESR1与头颈癌的预后相关。cBioPortal分析结果显示,四个预后相关基因在头颈癌的发生发展中均存在基因突变。结论 本研究筛选出了四个与头颈癌预后相关的基因,这些基因在头颈癌中存在基因突变的现象,有望成为临床诊断及治疗的新靶点。     

头颈部肿瘤放疗中真菌感染的诊治

目的探讨头颈部肿瘤放疗中真菌感染的诊治疗效。方法回顾性分析14例头颈部肿瘤真菌感染病例的诊治过程及治疗方法。结果 8例患者均在接受治疗2~3 d后症状即有减轻、体温下降,7~10 d后症状基本消失,体温恢复正常,维持治疗1~3周后停药,随访2~6个月无复发;1例伴糖尿病、高血压者,在接受治疗的同时控制血糖、血压;2例在治疗前肝功能检查:谷丙转氨酶、谷草转氨酶均偏高,治疗后第2周后复查转氨酶有逐渐增高趋势,考虑患者临床上已基本痊愈,即予停药。结论真菌感染的治疗以抗真菌为主,可选用抗菌谱广、不良反应小的氟康唑、伊曲康唑等治疗。