Camilleri-Brennan John, Ruta Danny A, Steele Robert J C
University Department of Surgery and Molecular Oncology, Level 6, Ninewells Hospital and Medical School, Dundee DD1 9SY, Scotland, UK.
World J Surg. 2002 Nov;26(11):1354-9. doi: 10.1007/s00268-002-6360-2. Epub 2002 Sep 26.
The objective of this study was to assess the validity and responsiveness of a new quality of life instrument, the Patient Generated Index (PGI), in patients with rectal cancer. Thirty-three patients with rectal cancer were administered the PGI, the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaires QLQ-C30 and QLQ-CR38, and the Medical Outcomes Study short form SF-36 questionnaire preoperatively and at 3 months postoperatively. The PGI was assessed in this group of patients for validity and responsiveness. PGI scores achieved significant correlations with a number of domains on the three quality of life (QOL) questionnaires. Stepwise regression analysis showed that 91.3% of the variation in PGI scores could be explained by three health-related QOL variables alone: pain, role limitations due to physical problems, and a global rating of health and QOL. The mean PGI score showed significant improvement 3 months following surgery. The PGI was found to be more responsive to change than the SF-36, the QLQ-C30, or the QLQ-CR38 items except the micturition item. The PGI assesses the extent to which the expectations of patients suffering from rectal cancer are matched by reality; and it satisfies the criteria of validity and responsiveness of this instrument for this cancer. Further studies are needed to determine its psychometric properties in other areas of surgery and oncology. If these studies support our findings, we believe that patient-centered measures such as the PGI may provide a meaningful assessment of the outcome of surgery for patients with cancer.
本研究的目的是评估一种新的生活质量工具——患者生成指数（PGI）在直肠癌患者中的有效性和反应性。33例直肠癌患者在术前及术后3个月接受了PGI、欧洲癌症研究与治疗组织（EORTC）生活质量问卷QLQ-C30和QLQ-CR38以及医学结局研究简表SF-36问卷的评估。对该组患者的PGI进行有效性和反应性评估。PGI评分与三份生活质量（QOL）问卷中的多个领域显著相关。逐步回归分析表明，PGI评分中91.3%的变异仅可由三个与健康相关的QOL变量解释：疼痛、身体问题导致的角色限制以及健康和QOL的总体评分。术后3个月，PGI平均评分显示出显著改善。结果发现，除排尿项目外，PGI对变化的反应比SF-36、QLQ-C30或QLQ-CR38项目更敏感。PGI评估了直肠癌患者的期望与现实相符的程度；并且它满足了该工具对这种癌症的有效性和反应性标准。需要进一步研究以确定其在其他外科手术和肿瘤学领域的心理测量特性。如果这些研究支持我们的发现，我们相信诸如PGI这样以患者为中心的测量方法可能会为癌症患者的手术结果提供有意义的评估。
