使用通用生活质量问卷评估痴呆症患者的生活质量：杜克健康状况调查表。

Evaluation of the quality of life in dementia with a generic quality of life questionnaire: the Duke Health Profile.

作者信息

Novella J, Ankri J, Morrone I, Guillemin F, Jolly D, Jochum C, Ploton L, Blanchard F

机构信息

Department of Internal Medicine and Gerontology, Hôpital Sébastopol, Reims, France.

出版信息

Dement Geriatr Cogn Disord. 2001 Mar-Apr;12(2):158-66. doi: 10.1159/000051251.

DOI:10.1159/000051251

PMID:11173890

Abstract

OBJECTIVE

The study was designed to determine the acceptability, feasibility and validity of measuring quality of life in a representative sample of dementia patients with a generic instrument, the Duke Health Profile.

METHOD

The French version of the Duke Health Profile was administered to 148 subjects with a mental disorder according to the DSM-III-R diagnostic criteria. The feasibility and acceptability of employing the instrument were determined by the refusal rate, the type of administration, and the percentage and distribution of missing data. Reliability was determined with Cronbach's alpha coefficient. Instrument reproducibility was assessed with the intraclass correlation coefficient for test-retest values. Internal construct validity was determined by factor analysis. Discriminant capacity was determined by comparing the average scores on each measure among patients with and without an additional chronic pathology. The measurements obtained were compared by source of information (patient, family proxy and care provider proxy).

RESULTS

The feasibility and acceptability of the instrument was good. Only 2% of the patients refused to complete the questionnaire. Help from the interviewer was necessary in 79% of the cases. The average completion time was 10.6 min. Missing data exist in only 3.5% of the cases on average, except among patients with severe dementia (Mini Mental State Examination <10). For reliability, internal consistency was acceptable (Cronbach's coefficient alpha = 0.5--0.7) when the self-esteem (0.23) and social health (0.26) concepts were eliminated. Reproducibility as measured by test-retest scores was moderate to good (intraclass correlation coefficient r = 0.53--0.80), except for anxiety (0.48) and perceived health (0.45). Severity of dementia mainly affected the feasibility, acceptability and reproducibility of the instrument. The family proxy seemed to agree more with the patient than did the care provider proxy.

CONCLUSION

Quality of life can be measured in patients with dementia, but special tools need to be developed for severe dementia.

摘要

目的

本研究旨在确定使用通用工具杜克健康状况量表在痴呆患者代表性样本中测量生活质量的可接受性、可行性和有效性。

方法

根据《精神疾病诊断与统计手册》第三版修订版（DSM-III-R）诊断标准，对148名患有精神障碍的受试者进行了杜克健康状况量表的法语版测试。通过拒绝率、施测类型以及缺失数据的百分比和分布情况来确定使用该工具的可行性和可接受性。使用克朗巴赫α系数来确定信度。通过组内相关系数来评估工具重测值的再现性。通过因子分析确定内部结构效度。通过比较有无其他慢性疾病的患者在各项测量上的平均得分来确定判别能力。所获得的测量结果按信息来源（患者、家属代理和护理人员代理）进行比较。

结果

该工具的可行性和可接受性良好。只有2%的患者拒绝完成问卷。79%的情况下需要访谈者协助。平均完成时间为10.6分钟。平均只有3.5%的病例存在缺失数据，重度痴呆患者（简易精神状态检查表评分<10）除外。在排除自尊（0.23）和社会健康（0.26）概念后，信度方面内部一致性尚可接受（克朗巴赫系数α=0.5 - 0.7）。重测分数衡量的再现性为中等至良好（组内相关系数r = 0.53 - 0.80），焦虑（0.48）和感知健康（0.45）除外。痴呆的严重程度主要影响该工具的可行性、可接受性和再现性。家属代理似乎比护理人员代理更认同患者的情况。