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一项健康状况测量指标在评估胆囊切除短期预后中的有效性证据。

Evidence for validity of a health status measure in assessing short term outcomes of cholecystectomy.

作者信息

Bardsley M J, Venables C W, Watson J, Goodfellow J, Wright P D

机构信息

Kings Edward's Hospital Fund, Bayswater, London.

出版信息

Qual Health Care. 1992 Mar;1(1):10-4. doi: 10.1136/qshc.1.1.10.

Abstract

OBJECTIVE

To assess the validity of the Nottingham health profile (NHP) as an indicator of short term outcome of cholecystectomy.

DESIGN

Prospective assessment of outcome.

SETTING

One teaching hospital. Patients--161 consecutive patients admitted for cholecystectomy between January 1989 and September 1990.

MAIN MEASURES

Patients' reported symptoms and self assessed NHP scores before cholecystectomy and at follow up at three and 12 months (76 patients); assessment before admission (19).

RESULTS

Complete data were obtained preoperatively and at three months' follow up from 154 patients; seven did not respond to the follow up questionnaire. 76/84(90%) patients in the study 12 months or more answered the 12 month follow up questionnaire; eight did not respond. Significant changes in score before and at three months after the operation were observed for four of the six dimensions: energy (35.34 v 19.53, p < 0.0001), pain (27.38 v 9.8, p < 0.0001), sleep (26.99 v 17.51, p = 0.0002), and emotional reactions (16.12 v 7.56, p = 0.001). The mean scores for 76 patients followed up at three and 12 months showed little subsequent change. Scores in readmitted patients were all significantly higher, suggesting poor health. Patients with five reported symptoms had significantly worse scores for all dimensions. Scores were similar before cholecystectomy whether the questionnaire was completed before or after admission.

CONCLUSION

The NHP is an appropriate tool for monitoring changes in health after cholecystectomy.

摘要

目的

评估诺丁汉健康量表(NHP)作为胆囊切除术短期预后指标的有效性。

设计

对预后进行前瞻性评估。

地点

一家教学医院。患者——1989年1月至1990年9月期间连续收治的161例接受胆囊切除术的患者。

主要测量指标

患者报告的症状以及胆囊切除术前、术后3个月和12个月随访时(76例患者)自我评估的NHP评分;入院前评估(19例)。

结果

154例患者术前及术后3个月获得了完整数据;7例未回复随访问卷。研究中12个月及以上的84例患者中有76例(90%)回复了12个月随访问卷;8例未回复。六个维度中的四个维度在术前和术后3个月时评分有显著变化:精力(35.34对19.53,p<0.0001)、疼痛(27.38对9.8,p<0.0001)、睡眠(26.99对17.51,p = 0.0002)和情绪反应(16.12对7.56,p = 0.001)。76例患者在3个月和12个月随访时的平均评分随后变化不大。再次入院患者的评分均显著更高,表明健康状况较差。报告有五种症状的患者在所有维度上的评分都显著更差。无论问卷是在入院前还是入院后完成,胆囊切除术前的评分相似。

结论

NHP是监测胆囊切除术后健康状况变化的合适工具。

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