中文版SF-36用于评价亚急性脑卒中患者生存质量的信度和效度

目的:检测中文版健康调查简表SF-36(the medical outcomes study 36-item short-form,SF-36)用于中国亚急性期脑卒中后遗症人群的生存质量评估的信度和效度情况。方法:选取福建中医药大学附属康复医院、复旦大学附属华山医院、暨南大学附属第一医院、广东省中医院和新疆维吾尔自治区中医院五家合作单位,共377例(女性35.73%,平均年龄60.95±10岁)脑卒中后遗症患者,在完成第一次评估后的6—7天,随机选取75例患者进行SF-36重测。量表的信度分析采用内部一致性和重测信度,效度分析采用内容效度和结构效度检验。结果:(1)中文版SF-36量表内部一致性Cronbachα系数为0.801(0.761—0.807);量表重测信度ICC为0.731(0.672—0.884)(2)对量表的8项内容的得分进行探索性因子分析,共抽取了3个公因子,总体方差解释力为67.3%。结论:中文版SF-36量表在评估我国亚急性期脑卒中患者具有良好的信度和效度,是一个可靠、有效的适用于临床脑卒中患者生存质量的测量工具。     

中文版SF-36量表在心力衰竭患者生存质量评价中的应用研究

目的　探讨中文版SF 3 6量表在慢性心力衰竭患者健康相关生存质量 (HRQOL)评价中的可行性。方法　采用中文版SF 3 6量表对 12 8例心衰患者的HRQOL进行评价。结果　 (1)心衰患者HRQOL各维度的得分随心功能分级增加逐步下降 ,均显著低于我国一般人群 (均P <0 .0 1)。对于不同左室舒张末期直径及运动耐量的患者来说 ,只有部分维度的比较差异有统计学意义 ,而不同左室射血分数组患者间各维度的比较差异并无统计学意义。 (2 )相关分析提示 ,各影响因素仅对部分维度呈中、低度相关 ,多元回归分析发现 ,临床病情对患者HRQOL的影响作用比常见的一些人口学指标更为重要 ,但所有因素对各维度变异的解释作用仅为 2 1.5 %～ 41.8% ,对心衰患者HRQOL综合评分、生理健康内容评分及心理健康内容评分变异的解释作用分别为 5 0 .2 % ,2 7.6% ,42 .7%。结论　 (1)心衰患者的HRQOL较一般人群已出现明显下降。 (2 )常见的一些人口学资料及临床病情共同用于解释患者HRQOL下降的意义有限 ,导致患者HRQOL下降最为主要的因素目前尚不清楚。     

SF-36量表在糖尿病患者生存质量测量中的应用

糖尿病患者生存质量(qualityoflife,QOL)测量常用SF-36量表,就其性能使用、构造、内容、使用方法作了介绍,并分析了影响糖尿病患者QOL的影响因素。     

应用SF-36量表评价血液病患者的生存质量调查

目的分析影响血液病患者生存质量的主要因素。方法采用横向调查研究方法对64例住院治疗血液病患者实施问卷调查,找出影响血液病患者生存质量的主要因素。结果血液病患者的生存质量较我国正常人群显著下降。主要影响因素为年龄、文化程度、合并症及ADL分级。结论血液病患者的生存质量普遍较低,通过控制影响因素有助于改善生存质量。     

偏头痛类型及性别对患者生活质量影响的调查研究

目的探讨偏头痛类型、性别对偏头痛患者生活质量的影响。方法选取门诊偏头痛患者84例,根据偏头痛类型分为先兆型偏头痛(16例)和无先兆型偏头痛(68例)2个亚组;根据性别分为男性(36例)和女性(48例)2组。采用生活质量综合评定问卷-74(GQOLI-74)对入选对象进行测试。结果①先兆型偏头痛组与无先兆型偏头痛组比较,仅生活质量总体评价评分的平均值差异有统计学意义,分别为(42.63±13.63)分vs(51.25±13.16)分(P<0.05),先兆型偏头痛组GQOLI-74总分的平均值较无先兆型偏头痛组低,但差异无统计学意义,分别为(58.81±10.94)分vs(61.46±8.37)分(P>0.05);②女性偏头痛组与男性偏头痛组相比,仅在躯体不适感(42.29±15.15)分vs(48.56±12.85)分、认知功能(53.52±18.86)分vs(64.42±16.84)分和工作与学习(57.33±12.98)分vs(64.61±12.74)分,差异有统计学意义(均P<0.05),女性组GQOLI-74总分的平均值(59.69±9.54)分vs(62.64±7.79)分,但差异无统计学意义(P>0.05)。结论偏头痛患者的生活质量较差。先兆型偏头痛患者的生活质量较无先兆型偏头痛患者生活质量差,但差异无统计学意义。偏头痛患者中,女性生活质量较男性更差,突出表现在躯体不适感、认知功能和工作与学习方面。     

梅州市糖尿病患者生存质量调查

目的探讨梅州市糖尿病(DM)患者生存质量。方法采用糖尿病(DM)患者生存质量(QOL)特异性量表。于2000年6月～2001年12月对梅州城区四间医院确诊的DM患者进行问卷调查,共收集有效样本230例。结果DM患者QOL明显下降:其中心理/精神的影响最大,其次为对生理功能的影响,对社会关系的影响,治疗对患者的影响,而且生理功能改变越明显者,其他3项影响也越大。结论通过健康教育行为干预使病人心理适应,乐于接受治疗,缓解疾病症状,延缓并发症的发生,减少治疗过程中的负面影响,以改善其QOL。     

SF-36量表测量伤残人员生存质量的信度与效度

目的 评价SF-36量表在测量地震伤残人员生存质量中的信度和效度.方法 利用自填法及访谈相结合的方式调查201例绵竹市某镇地震伤残人员,用重测信度和Cronbach's a系数分析SF-36信度;因子分析方法分析效度.结果 SF-36各领域的重测信度分别为:生理功能(PF)0.78、生理问题对功能的限制(RP)0.85...     

缺血性脑卒中后焦虑与SF-36生存质量的关系

目的：探讨缺血性卒中后焦虑与SF-36生存质量的关系。方法：符合研究标准的急性期缺血性脑卒中患者170例,经汉密顿焦虑量表（HAMA）评分后分为无焦虑组72例和焦虑组98例,均运用健康状况调查问卷（SF-36）对患者生存质量进行评价。结果：在SF-36的8个维度中,焦虑组患者精力,情绪角色,社会功能,总体健康的评分明显低于无焦虑组（P〈0．05,0．01）。HAMA总分与精力、情绪角色、社会功能、总体健康维度评分具有显著相关性（P〈0．05．0．01）。结论：缺血性脑卒中后焦虑患者生存质量明显下降,其焦虑与SF-36生存质量密切相关。     

梅州市糖尿病患者生存质量调查

目的：探讨梅州市糖尿病（DM）患生存质量。方法：采用糖尿病（DM）患生存质量（DOL）特异必量表。于2000年6月-2001年12月对梅州城区四间医院确诊的DM患进行问卷调查，共收集有效样本230例。结果：DM患QOL明显下降，其中心理／精神的影响最大，其次为对生理功能的影响，对社会关系的影响，治疗对患的影响，而且生理 明显，其他3项影响也越大。结论：通过健康教育行为干预使病人心理适应，乐于接受治疗，缓解疾病症状，延缓并发症的发生，减少治疗过程中的负面质量，以改善其QOL。     

SF-36量表评价Graves病患者生存质量信度和效度的研究

目的评价SF-36量表测定Graves病患者生存质量的信度和效度。方法应用SF-36量表对113例Graves病患者的生存质量进行测评,并从中随机抽取20例于2周后复测,对测定结果进行效度和信度分析。结果量表总体Cronbachα系数为0．775,各个维度的Cronbachα系数的范围为0．571—0．868;评价分半信度的Spearman—Brown系数为0．946;重测信度中两次测量的Pearson相关系数为0．87;用因子分析法对量表进行结构效度的评价,得到的两个公因子共解释了59．71％的方差。标准效度中患者健康自评总分与量表总分的相关系数r为0．726。结论SF-36量表评价Graves病患者生存质量的信效度较高,可应用于此病生存质量的测评。     

乙醇依赖病人配偶生活质量调查

目的了解乙醇依赖病人配偶的生活质量状况。方法应用生活质量综合评定问卷（GQOLI）对36例乙醇依赖病人配偶及36例健康对照者进行调查。结果乙醇依赖病人配偶GQOLI总分及躯体功能、心理功能、社会功能、物质生活4个维度评分均低于正常对照组（t=2.4~8.7,P〈0.05、0.01）,其中以心理健康、躯体健康对生活质量的影响较大。结论乙醇依赖病人的配偶生活质量较差,在乙醇依赖病人的治疗过程中应注意其配偶心身健康的干预。     

SF-36在慢性软组织疼痛患者中的信度和效度初步评价

目的探讨中文版36条健康状况简明调查问卷（SF-36）在慢性软组织疼痛患者健康生存质量评价中的信度和效度。 方法采用中文版SF-36和医院结局疼痛用量表（MOSPM）,同时对210例慢性软组织疼痛患者进行问卷调查,以后者为效度标准,其中有57例（27.1%)患者进行了二次测评。收集资料输入SPSS软件包,采用Spearman相关分析,进行内部一致性、复测信度和效标效度的评价。 结果SF-36量表具有良好的内部一致性和重测信度,8个维度的Cronbachs α系数均&rt;0.7,重测信度的组内相关系数除SF为0.336（P<0.05）外,其他7个维度均在0.44~0.66之间（P<0.01）;在效度评价中,SF-36的8个维度与MOSPM的大部分条目及总分均显著相关,相关系数在－0.145~－0.630之间（P<0.05,P<0.01）。 结论SF-36在慢性软组织疼痛患者人群健康相关生存质量评价中应用,具有较好的信度和效度。     

69例癌痛患者的生活质量评价

作者对６９例癌症合并疼痛的患者进行了生活质量问卷调查，其中包括身体、心理和社会人际关系等三方面的因素。男性４９例，女性２０例，均为明确诊断的中、晚期癌症患者。结果：累度疼痛对患者的生活质量影响较小，而中、重度疼痛对患者的生活质量影响明显增大；疼痛时时≤６月的患者生活质量於分与〉６月的患者生活质量评分比较有明显差异；镇痛治疗有效者生活质量有改善，与治疗无效者比较有非常显著性差异。结论：１．疼痛是癌症     

预防性治疗对偏头痛患者生活质量的影响

目的:观察预防性治疗对偏头痛患者生活质量的影响。方法:对符合入选标准的36例偏头痛病人在正规预防性治疗的同时进行生活质量量表SF-36随访6个月。结果:36例患者中无1例观察期间因副作用换药,治疗前后头痛发作频率分别为9.16/月和2.4/月,SF-36评价的四个维度如健康状况、体力角色、躯体疼痛和心理健康均有显著性改善。结论:预防性治疗可以改善偏头痛患者的健康相关生活质量。SF-36可作为偏头痛预防性治疗的评价指标之一。     

房室结消融联合起搏治疗的永久性房颤患者生存质量的SF-36测评

目的：探讨中文版SF-36健康调查问卷在房室结消融联合起搏（ABL＋PM）治疗永久性房颤患者后生存质量评估中的作用.方法：采用中文版简明健康调查问卷SF-36对19名永久性房颤患者治疗前及治疗后6个月进行问卷调查,评估患者生存质量.同时治疗前后分别行心脏超声检测患者心功能.量表采用标准分法进行评分、统计分析.结果：治疗前后比较,永久性房颤患者经ALB＋PM治疗后,患者心功能及SF-36量表各项指标除躯体疼痛（P＞0.05）外,均与治疗前相比较明显改善（P＜0.01）.生存质量总分值与心功能各项线性回归分析结果表明：生存质量总分值与心功能各项均有相关性.结论：ABL＋PM是治疗永久性房颤的有效方法,中文版简明健康调查问卷SF-36可以作为评定该方法治疗永久性房颤患者生存质量的一个重要指标.     

The factor structure of the SF-36 in Parkinson's disease

Rationale, aims and objectives  The concept of quality of life (QoL) has emerged as an important psychological dimension in individuals experiencing Parkinson's disease (PD). The current study sought to determine the factor structure of the Medical Outcomes Study Short-Form 36 (SF-36) version 2 in patients with PD in order to evaluate how this measure might best be used to assess QoL in this clinical population.
Method  Confirmatory factor analyses were conducted on self-report SF-36 data from 339 individuals diagnosed with PD. Six structural models of the SF-36 were evaluated against the participants' data.
Results  The underlying factor structure of the SF-36 in PD was observed to be inconsistent with the assumed measurement model of SF-36 but consistent with contemporary theoretical models of the instrument.
Conclusions  The use of the SF-36 in individuals with PD can be recommended when eight subscales are used and reported. Evidence to support the use of the instrument as a two-subscale measure of physical health and mental health components was not found.     

EFFECT OF VESTIBULAR REHABILITATION ON CHANGE IN HEALTH-RELATED QUALITY OF LIFE IN PATIENTS WITH DIZZINESS AND BALANCE PROBLEMS AFTER TRAUMATIC BRAIN INJURY: A RANDOMIZED CONTROLLED TRIAL

ObjectiveSecondary analysis, testing the effect on change in health-related quality of life of group-based vestibular rehabilitation in patients with mild-moderate traumatic brain injury, dizziness and balance problems.DesignA single-blind randomized controlled trial.SubjectsA total of 65 patients aged 16–60 years with a Rivermead Post-concussion Symptoms Questionnaire dizziness score ≥2, and DizzinessHandicap Inventory score >15 points. Data collection was performed at baseline 3.5 (standard deviation (SD) 2.1) months post-injury, end of intervention, and 4.4 (SD 1.0) months after baseline.MethodsQuality of Life after Brain Injury was the main outcome. Independent variables were demographic and injury variables, Hospital Anxiety and Depression Scale, changes on the Rivermead Post-concussion Symptoms Questionnaire (RPQ3 physical and RPQ13 psychological/cognitive), and Vertigo Symptom Scale-Short Form.ResultsMean age of participants was 39.4 years (SD 13.0); 70.3% women. Predictors of change inthe Quality of Life after Brain Injury were receiving the vestibular rehabilitation (p =0.049), baseline psychological distress (p =0.020), and changein RPQ3 physical (p =0.047) and RPQ13 psychological/cognitive (p =0.047). Adjusted R2 was 0.399,F=6.13, p < 0.001.ConclusionThere was an effect in favour of the intervention group in improvement in health-related quality of life. Changes on the Rivermead Post-concussion Symptoms Questionnaire were also associated with change on the Quality of Life after Brain Injury.LAY ABSTRACTThis paper is the first to present results of a vestibular rehabilitation intervention study on changes in health-related quality of life in patients with dizziness and balance problems after mild-to-moderate traumatic brain injury. The intervention group received exercises and guidance aimed at self-efficacy and how to cope with their dizziness and balance problems. In addition, both the intervention and control groups received treatment as usual, comprising multidisciplinary rehabilitation at a university hospital. The main result was measured as change on the Quality of Life after Brain Injury questionnaire. Post-concussion symptoms, vertigo and psychological distress were also measured. The study showed that the group receiving the vestibular rehabilitation intervention underwent more improvement in health-related quality of life than the group receiving usual treatment alone. Other factors that influenced the improvement in quality of life were psychological distress at the start of the study and fewer post-concussion symptoms.Key words: quality of life, traumatic brain injury, dizziness, randomized controlled trial, psychological distress, patientreported outcome measure

Sustaining a traumatic brain injury (TBI) affects patients’ functioning and health-related quality of life (HRQL) (1). TBI is defined as an alteration in brain function, or other evidence of brain pathology, caused by an external force (2). Research shows that HRQL is often reduced after a TBI, independent of the severity of the injury (3). Problems in cognitive, emotional, or physical functioning are associated with HRQL after TBI (4). Systematic reviews emphasize the multifactorial aetiology of post-concussion syndrome/symptoms (PCS), and that pre- and post-injury mental health are predictors of post-injury functioning after mild TBI (5, 6). Furthermore, both psychological and physical post-concussion symptoms, including dizziness, show significant correlation with the physical and mental aspects of HRQL (7).Dizziness is a subjective experience that is often described as vertigo and balance problems, or lightheadedness and disorientation (8). The aetiology of dizziness after a TBI can be caused by injuries in the vestibular system (9, 10), or have a non-vestibular origin (10). Zeldovich et al. found that 46% of patients with mild or moderate TBI and persistent PCS experienced dizziness post-injury and, at 6 months post-injury, dizziness was reported by approximately 30% of patients with complicated mild TBI (4). After 1 year, dizziness was reported in 25% of patients (11). Challenges caused by dizziness may hamper return to physical activities and work and increase the patients’ perception of post-concussion symptom pressure (12). There is, however, a lack of intervention studies on dizziness and balance problems after TBI (13). We have shown previously that self-reported dizzinessrelated disability, measured by the Dizziness Handicap Inventory (DHI), is associated with vertigo symptoms, balance problems, and psychological distress (14). These findings showed that a group-based adjusted programme for vestibular rehabilitation (VR) had an immediate, but not long-term, effect on dizzinessrelated disability (15). However, to our knowledge, there are no studies into how HRQL is affected in the subgroup of the TBI population having dizziness and balance problems.The current study reports results for HRQL from a randomized controlled trial (RCT) that tested the efficacy of an individually modified, group-based VR intervention designed specifically for reducing dizziness and balance problems after TBI (15, 16). It is not known how HRQL change was in this subgroup of patients with TBI, and whether injury-related factors and changes in post-injury functioning had an effect on change in HRQL reported on a TBI-specific outcome measure. Hence, the main objectives of this secondary analysis of a RCT was to test the effect on changes in HRQL of a group-based VR programme in addition to routine multidisciplinary rehabilitation on patients with mild-to-moderate TBI and dizziness and balance problems. Secondarily, the current study aimed to describe the HRQL over time. It was hypothesized that mental health at baseline, improved persistent PCS and functioning, and reduced dizziness would have significant positive effects on changes in HRQL, and that the intervention group would show significantly more improvement in HRQL than the control group.