Smith J J, Guest M G, Greenhalgh R M, Davies A H
Department of Vascular Surgery, Imperial College of Science Technology and Medicine, Charing Cross Hospital, London, UK.
J Vasc Surg. 2000 Apr;31(4):642-9. doi: 10.1067/mva.2000.104103.
This prospective study aimed to validate a newly designed specific measure of quality of life for patients with venous ulcers.
The study was set in a London teaching hospital and surrounding community clinics. Items for the questionnaire were selected by means of patient interviews, a literature review, and expert opinion. The questionnaire and the Short Form 36-item (SF-36) Health Survey were given to a prospective consecutive cohort of 98 patients with proven venous ulcers that were diagnosed by means of clinical and color duplex examination. Fifty-eight of the patients were women (60%), and the median age of patients was 76 years. The questionnaire was assessed for reliability, validity, and responsiveness.
The ulcer-specific questionnaire showed good reliability, as assessed by means of the internal consistency (Cronbach alpha = 0.93) and test-retest analysis (r = 0.84). Factor analysis identified four important health factors: social function, domestic activities, cosmesis, and emotional status. Validity was demonstrated by means of a high correlation with all eight domains of the SF-36 general health measure (r > 0.55, P <.001). Responsiveness was demonstrated by means of a significant reduction in the score on the ulcer questionnaire as ulcers healed at 6 and 11 weeks (P <.05).
Good evidence exists that a clinically derived measure for patients with venous ulcers has validity to measure the quality of life.
这项前瞻性研究旨在验证一种新设计的针对静脉性溃疡患者的生活质量特定测量方法。
该研究在伦敦一家教学医院及周边社区诊所开展。通过患者访谈、文献综述和专家意见来选择问卷项目。向一个由98例经临床和彩色双功超声检查确诊为静脉性溃疡的连续前瞻性队列患者发放问卷和36项简表(SF - 36)健康调查。其中58例患者为女性(60%),患者的中位年龄为76岁。对问卷进行了信度、效度和反应度评估。
通过内部一致性(Cronbach α = 0.93)和重测分析(r = 0.84)评估,溃疡特异性问卷显示出良好的信度。因子分析确定了四个重要的健康因素:社会功能、家庭活动、美容和情绪状态。与SF - 36一般健康测量的所有八个领域高度相关(r > 0.55,P <.001),证明了效度。随着溃疡在6周和11周愈合,溃疡问卷得分显著降低(P <.05),证明了反应度。
有充分证据表明,一种针对静脉性溃疡患者的临床衍生测量方法对于测量生活质量是有效的。