基于EQ-5D量表的子宫颈癌患者生命质量评价

目的:测算子宫颈癌患者生命质量,为临床实践中子宫颈癌治疗方案的选择和子宫颈癌患者生命质量的提高提供参考依据。方法:选取276名子宫颈癌患者为研究对象,所有病例均经病理学确诊。采用欧洲五维度健康量表(EQ-5D)评价子宫颈癌患者生命质量。结果:子宫颈癌CIN2及以下患者量表指数(Index)评分为(0.916 5±0.013 3)分、视觉模拟尺度(VAS)评分为(86.23±11.13)分,接近正常女性人群评分。但随着子宫颈癌病理和临床分期的提高,Index评分逐渐降低,分别由0.916 5分降至0.872 3分和由0.913 8分降至0.868 9分;VAS评分亦逐渐降低,分别由83.09分降至64.97分和86.23分降至65.37分。不同的治疗方法后子宫颈癌患者的生命质量亦有差异。Index得分由低到高依次为:子宫颈癌根治术+化疗、单纯化疗、子宫颈癌根治术、子宫全切术、子宫颈锥切术。VAS得分由低到高依次为:子宫颈癌根治术+化疗、子宫颈癌根治术、单纯化疗、子宫全切术、子宫颈锥切术。除子宫颈癌根治术与单纯化疗略有交叉外,其他治疗方案得分顺序相同。结论:随着子宫颈癌患者病情的加重,生命质量不断降低,提示子宫颈癌早期诊断和治疗可以显著改善子宫颈癌患者的生命质量。实施不同治疗方案的子宫颈癌患者的生命质量不同,提示患者生命质量也应作为临床实践中治疗方案的选择依据。     

欧洲生命质量量表EQ-5D的应用研究进展

作为一种新型的健康测评工具,生命质量正受到越来越多的关注。欧洲生命质量量表EQ-5D作为生命质量的评定量表之一,也以其独特的优势在国际上获得了较为广泛的应用。本文通过对文献的学习与回顾,综述EQ-5D在当前国际上的应用研究进展,为今后在国内更好地开展EQ-5D的相关研究提供参考与借鉴。     

基于EQ-5D量表分析老年人高血压患者健康相关生命质量及其影响因素

目的 探讨老年人高血压患者的健康相关生命质量(health-related quality of life, HRQoL)状况及影响因素,为提高老年人高血压患者HRQoL提供针对性建议。方法 采用多阶段分层整群随机抽样的方法对广州、苏州和青岛的社区老年高血压患者进行问卷调查。单因素分析使用Wilcoxon秩和检验和Kruskal-Wallis H检验,多因素分析使用Tobit回归模型。结果 老年人高血压患者健康效用值为0.847(0.569,1.000),在EQ-5D量表的5个维度中的疼痛或不舒服(40.5%)存在的问题最突出。Tobit回归模型结果显示,婚姻状况(已婚：β=0.127,P=0.005<0.05;丧偶：β=-0.069,P=0.003<0.05)和外出频率(1次/d:β=0.106,P<0.001;1次/周：β=0.204,P<0.001;更长时间：β=0.312,P<0.001;不确定：β=-0.423,P<0.001)是影响高血压老年人健康相关生命质量的因素。结论 老年人高血压患者生命质量低于普通人群,政府及相关部门可根据主要因素...     

基于EQ-5D量表的深圳市居民健康相关生命质量研究

目的 了解深圳市居民的健康相关生命质量情况,并对其健康相关影响因素进行分析.方法 运用欧洲的五维健康量表(EQ-5D)对深圳市居民的健康状况进行测评,采用描述性分析、多元回归分析等对健康相关影响因素进行分析.结果 被调查居民的主要健康问题是疼痛/不适、焦虑/抑郁,这两维度有困难的比例分别为5.53％、2.14％;EQ-VAS评分平均为84.31±10.81分,年龄、就业状况、文化程度、是否饮酒、两周病伤情况和慢性病患病均是居民健康相关生命质量的独立影响因素.结论 关注高年龄、低文化程度、嗜酒和无业人群的健康,加强慢性病的防治管理是提高深圳市居民健康相关生命质量的关键.     

欧洲EQ-5D量表用于杭州市余杭区慢性淋巴丝虫病生命质量调查

目的:采用欧洲EQ-5D量表评价慢性淋巴丝虫病人生命质量。方法:对杭州市余杭区276例慢性丝虫病人进行自评量表式调查,内容包括一般情况问卷调查和EQ-5D量表测量。结果:目标人群中EQ-5D指数平均得分为0.77±0.13,单因素方差分析显示,不同性别、年龄、婚姻、工作状况、家庭年收入的目标人群在EQ-5D得分上差异具有统计学意义(P<0.01)。EQ-5D5个维度测量,问题报告率主要在疼痛/不舒服(47.8%)、日常活动(报告率44.9%)、行动(43.8%)3个维度出现较高。多元logistic逐步回归分析,疼痛/不舒服维度影响因素主要为性别、婚姻状况。日常活动维度为性别、年龄、婚姻状况。行动维度影响因素为家庭收入。焦虑/抑郁维度影响因素为婚姻状况。自我照顾维度影响因素为年龄、家庭年收入。结论:在目标人群中女性、老年人、丧偶、文盲、低经济收入状况的患者生命质量较次,是关怀照料工作的重点对象,干预的重点内容则应放在减轻病人病痛和提高病人日常活动及行动能力方面。     

EQ-5D量表附加维度及应用述评

欧洲五维健康量表(EQ-5D)已成为世界上应用最为广泛的量表之一,为进一步提高EQ-5D量表在某些状况下的敏感度,附加维度(bolt-on dimension)的概念应运而生.文章系统介绍了EQ-5D附加维度的概念、产生背景、研究现状,并梳理目前研究的主要问题,对其研究前景进行展望,以期为国内学者开展相关研究提供参考.     

海南省2型糖尿病患者生命质量评价与分析

目的 探讨海南省2型糖尿病患者生命质量及其影响因素,为有效提高糖尿病患者生命质量和制定防治策略提供参考依据。方法 本研究采用多阶段分层随机抽样,均衡地理、经济等情况选取海南省4个市县的糖尿病患者作为研究对象,使用二元logistic回归分析EQ-5D-5L量表中不同维度出现问题的影响因素,用Tobit回归分析海南省2型糖尿病患者生命质量的影响因素。结果 EQ-5D-5L中健康效用值中位数为0.907(0.782,1)。生命质量的五个维度中“疼痛或不舒服”(52.0%)和“焦虑或沮丧”(46.7%)维度存在问题占比较高。Tobit回归表明,年龄(β=-0.042,P<0.05)、婚姻状态(β=-0.030,P<0.01)、文化程度(β=0.039,P<0.01)、医保类型(β=0.071,P<0.01)、BMI值(β=0.049,P<0.01)、病程(β=-0.003,P<0.05)、疾病危害知晓情况(β=-0.075,P<0.000)、是否患有慢性肾脏疾病(β=0.076,P<0.05)、是否患有心力衰竭(β=0.132,P<0.0...     

社区居家老年人社会经济地位与生命质量的关系研究-基于EQ-5D量表

目的：基于EQ-5D量表了解社区居家老年人生命质量情况,研究老年人社会经济地位与老年人生命质量的关系,为当地老年人的健康管理提供帮助。方法：采用多阶段分层整群随机抽样法对青岛、广州和苏州三地的社区居家老年人开展研究调查,采用Wilcoxon秩和检验和Kruskal-Wallis H检验分析老年人一般情况的健康效应值差异,通过Tobit回归模型分析老年人社会经济地位与生命质量的关系。结果：共有1254名社区居家老年人纳入调查。社区居家老年人的健康效用值为0.887(0.696,0.961)。年龄、文化程度、婚姻状况、月均收入、职业、社会经济地位与社区居家老年人的健康效应值差异具有统计学意义(P<0.05)。Tobit回归结果显示,社区居家老年人的社会经济地位对生命质量有影响(P<0.05)。结论：社区居家老年人的社会经济地位与生命质量之间存在影响关系,建议相关负责单位根据老年人不同的社会经济地位因素,采取针对性措施,以改善老年人的健康状况,提高老年人的生命质量。     

2型糖尿病患者自我管理行为量表的改良及其信效度检验

目的将引入国内的糖尿病自我管理行为量表修订版(SDSCA)进行重新编译,并对其进行信效度检验,为评价糖尿病患者的健康教育效果提供准确的测量工具。方法按方便取样的方法,对符合纳入标准的2型糖尿病患者113例进行问卷调查。结果量表整体的Cronbach’sα为0.84,其中饮食、运动、血糖监测、糖尿病足四个分量表的Cronbach’sα值在0.71～0.93,均大于0.70,具有较好的同质性;采用因子分析法,共提取因子5个,累计贡献率为86.11%。结论重新编译后的SDSCA量表(中文版)具有较好的信度、效度,可作为病情发展不同阶段的2型糖尿病患者自我管理行为的评估工具。     

深圳市2型糖尿病及合并症患者健康相关生命质量研究

目的 分析深圳市糖尿病人群健康相关生命质量及其影响因素。方法 于2021年9—12月对深圳市罗湖区各大医院及社区卫生中心展开调研,最终确定634名18～92岁的2型糖尿病患者为研究对象。采用欧洲质量-5维度-5水平健康量表（European quality-5 dimension-5 levels questionnaire,EQ-5D-5L）、视觉检查评分（visual analogue scale,VAS）测算患者健康效用值。利用t检验及方差分析进行单因素检验,Tobit回归探究影响因素。结果 本研究人群平均EQ-5D-5L效用值为0.888±0.205,VAS得分为（76.471±17.682）分。此外,研究测算了糖尿病合并其他疾病患者的效用值,高血压为0.873±0.014,高血脂为0.886±0.012,心力衰竭为0.792±0.083,心肌梗死为0.887±0.083,中风为0.569±0.070,冠心病心绞痛为0.765±0.067,慢性胃肠道疾病为0.840±0.036,生殖器疾病为0.847±0.043,视网膜病变为0.809±0.041,肾衰竭为0.699±0.11...     

Construct validity of the RAND-12 and Health Utilities Index Mark 2 and 3 in type 2 diabetes

OBJECTIVE: To assess the cross-sectional construct validity of the RAND-12 and the Health Utilities Index Mark 2 (HUI2) and Mark 3 (HUI3) in type 2 diabetes. METHODS: Parametric tests were used to test for differences in HRQL scores between known groups with type 2 diabetes, defined in terms of treatment intensity, duration of diabetes and glycemic control. RESULTS: The PHC of the RAND-12 was significantly lower for individuals treated with insulin (40.28 +/- 10.97) than diet alone (45.18 +/- 12.02, p < 0.01), as was the MHC (42.83 +/- 10.75 vs. 46.87 +/- 10.89, p < 0.05). MHC (43.56 +/- 10.20 vs. 46.18 +/- 9.94, p < 0.05) and PHC (41.04 +/- 10.64 vs. 45.62 +/- 10.48, p < 0.001) were both lower for those with longer duration of diabetes. Overall HUI3 scores were lower in individuals above the median duration of diabetes (5.0 years) as compared to those with a shorter duration (0.60 +/- 0.29 vs. 0.67 +/- 0.29, p < 0.01) and for individuals whose diabetes was managed using insulin compared to diet alone (0.59 +/- 0.30 vs. 0.69 +/- 0.30, p < 0.05). Disease severity was associated with impairment on the ambulation, dexterity and pain attributes of the HUI3. Similar results were found for the HUI2. Overall HUI2 scores were highest for individuals managed with diet alone compared to those managed with insulin. Disease severity was associated with the mobility and self-care attributes of the HUI2. No relationship was found between any of the measures of HRQL and glycemic control. CONCLUSIONS: Scores for individuals presumed to have more severe or advanced disease were significantly lower for many comparisons using the RAND-12, HUI2 and HUI3. The results of this study contribute evidence of construct validity of the HUI2, HUI3 and RAND-12 in type 2 diabetes.     

糖尿病患健康促进量表信度和效度评价

目的 评价糖尿病患健康促进量表（T2DHPS）的信度和效度,为该量表在中国大陆人群的推广使用提供科学依据。方法 于2015年5月-2016年4月采用连续定点抽样方法在山西省长治医学院2家直属附属医院抽取180例2型糖尿病患者进行T2DHPS量表面访调查;采用Cronbach's α系数和分半信度评估量表的信度,采用探索性因子分析、区分效度和集合效度评估量表的效度。结果 T2DHPS量表的总体Cronbach's α系数为0.943,分半信度为0.935;运动行为、风险规避行为、压力处置行为、生命欣赏行为、健康责任行为、健康饮食行为6个维度的Cronbach's α系数分别为0.931、0.832、0.838、0.887、0.819、0.842,分半信度分别为0.897、0.741、0.802、0.765、0.669、0.707,量表具有较好的信度;探索性因子分析结果显示,T2DHPS量表符合预设的6个因子结构,累计方差贡献率为70.266%;T2DHPS量表运动行为、风险规避行为、压力处置行为、生命欣赏行为、健康责任行为、健康饮食行为6个维度的平均分分别为（16.0±7.6）、（17.5±6.6）、（14.7±5.4）、（11.2±3.6）、（8.6±3.8）、（9.7±3.5）分,集合效度均高于区分效度,量表具有较好的效度。结论 T2DHPS量表在中国大陆人群中的信度和效度指标均符合心理测量学的要求,可适用于中国糖尿病患者健康促进效果的评估。     

生存质量表评价2型糖尿病患者的信度、效度

目的探讨世界卫生组织生存质量测定量表简表(WHOQOL-BEFF)2型糖尿病患者生存质量评价中的信度与效度。方法采用WHOQOL—BEFF和糖尿病人生存质量特异性量表(DSQL)对210名2型糖尿病患者进行问卷调查。用SPSS软件进行信度、效度分析。结果WHOQOL—BEFF用于评价2型糖尿病患者生存质量的分半信度为0．843,效标效度为0．72,具有较好的信度与效度。且与糖尿病生存质量特异性量表(DSQL)相关程度较低。结论WHOQOL-BEFF与DSQL配合使用可兼顾普适性与特异性,综合评价患者生存质量。     

健康教育对2型糖尿病患者生存质量影响的研究

目的 了解影响2型糖尿病患者生存质量的因素和健康教育效果,为制定2型糖尿病患者的医院健康教育提供科学的依据.方法 将115人随机分成健康教育组和对照组,采用《糖尿病患者生存质量特异性量表》和相关的因素调查进行问卷调查,并进行两组之间的T检验和逐步回归分析.结果 健康教育组患者的生存质量较对照组有明显的提高,健康知识也有了明显的提高,相关行为和生理指标没有明显变化.健康教育、文化程度、并发症、体质指数、年龄和性别等因素影响生存质量.结论 应该加强对2型糖尿病患者的医院健康教育,同时要更加重视那些文化水平低的女性患者的健康教育.     

Development of a preliminary diabetes dietary satisfaction and outcomes measure for patients with type 2 diabetes

Adopting dietary lifestyle changes for diabetes management is often difficult for patients; yet the health-related quality of life (HRQOL) outcomes of dietary management for the patient are not extensively developed in the HRQOL assessments now widely used in diabetes research. This study developed a preliminary instrument, the diabetes dietary satisfaction and outcomes measure, to assess outcomes of individuals' experiences in following a meal plan for the treatment of type 2 diabetes. A theoretical framework and preliminary focus group data guided the design of a 47-item questionnaire, administered to 239 patients with type 2 diabetes. Medical file data was obtained on 180 of these patients. Fifty-four percent of respondents were women, with mean age of 64 +/- 12 years and diabetes duration of 10 +/- 8 years. Scores for the satisfaction and other outcome measures discriminated between patient groups by age, gender, medication use, depression diagnosis, meal plan status, and employment status. Significant correlations also occurred with diet adherence, number of co-morbidities, and glycemic control as measured by glycolated hemoglobin (HbA1c). Future research with additional patient samples is needed to refine the measure for use in diabetes education programs.     

An assessment of the discriminative ability of the EQ-5D<Subscript>index</Subscript>, SF-6D,and EQ VAS,using sociodemographic factors and clinical conditions

OBJECTIVE: To assess whether three health-related quality-of-life (HRQL) measures (the EQ-5D(index), SF-6D, and EQ VAS) can discriminate between the HRQL of different groups of individuals. METHODS: In one UK general practice a cross-sectional survey requested information on six sociodemographic factors, 10 clinical conditions, and the three HRQL measures. Regression analyses were used to assess whether there was a significant difference in HRQL between groups with different sociodemographic factors and those with and without clinical conditions. RESULTS: One thousand eight hundred and sixty-five questionnaires were returned. There was a significant difference between the HRQL of the majority of different groups according to each HRQL measure. However, not all of the measures could discriminate between groups of different ethnicity, gender, or smoking status, or those with and without asthma, stroke, cancer or diabetes. CONCLUSION: The HRQL of the majority of different groups could be discriminated between by the EQ-5D(index), SF-6D, and EQ VAS.     

2型糖尿病患者实施综合护理干预效果研究

目的探讨2型糖尿病患者实施综合护理的干预效果。方法将160例2型糖尿病患者随机分对照组和干预组,各80例,对照组采用传统的护理方式,而干预组采用综合护理干预模式,比较两组患者的治疗依从性、血糖情况及生活质量等指标。结果干预组干预后的坚持运动、按时服药、合理膳食、坚持血糖监测等治疗依从性均明显好于对照组（P〈0.01）;干预组干预后的空腹血糖、餐后2 h血糖、糖化血红蛋白均明显低于对照组（P〈0.01）;干预组干预后的躯体功能、心理功能、社会功能、物质生活等维度得分均明显高于对照组（P〈0.01）。结论 2型糖尿病患者实施综合护理干预后,可明显提高患者治疗依从性,改善血糖情况及提高生活质量。     

Cross-cultural adaptation and validation of the Korean version of the EQ-5D in patients with rheumatic diseases

Objectives: This study aimed to determine the cross-cultural adaptation and validation of the Korean version of the EQ-5D in rheumatic conditions. Methods: Translation, back-translation and cognitive debriefing were performed according to the EuroQol groups guidelines. For validity, 508 patients were recruited and administered the EQ-5D, Short-Form 36 and condition-specific measures. Construct validity and sensitivity were evaluated by testing a-priori hypotheses. For reliability, another 57 patients repeated the EQ-5D at 1-week interval, and intra-class correlations (ICC) and kappa statistics were estimated. For responsiveness, another 60 patients repeated it at 12-week interval within the context of clinical trial, and standardized response mean(SRM) were calculated. Results: The cross-cultural adaptation produced no major modifications in the scale. The associations of the EQ-5D with the generic- and condition-specific measures were observed as expected in hypotheses the higher: EQ-5D_index and EQ-5D_VAS scores, the better health status by generic- or condition-specific measures, and the better functional class. The ICCs were 0.751 and 0.767, respectively, and kappa ranged from 0.455 to 0.772. The SRM were 0.649 and 0.410, respectively. Conclusion: The Korean EQ-5D exhibits good validity and sensitivity in various rheumatic conditions. Although its reliability and responsiveness were not excellent, it seems acceptable if condition-specific measures are applied together.