Franks Peter J, McCullagh Lynn, Moffatt Christine J
Centre for Research and Implementation of Clinical Practice, Faculty of Health and Human Sciences, Thames Valley University, London, UK.
Ostomy Wound Manage. 2003 Feb;49(2):26-37.
Clinician awareness of the importance of recognizing, assessing, and ultimately addressing the negative impact of chronic wounds on patient quality of life is increasing. One hundred, eighteen (118) patients (average age 78 years) participated in a study to evaluate the use of the Medical Outcomes Short Form-36 for assessing the health-related quality of life of patients with chronic leg ulceration. Most patients (104, 88%) were treated at home by community nurses. A medical history was obtained and patients completed the Short Form-36 questionnaire at baseline and after 12 weeks of receiving standard ulcer care. Published normative data were used to ascertain the effect of leg ulcers on health-related quality of life. Short Form-36 responsiveness was determined by comparing baseline and 12-week scores. Results suggest that the questionnaire is reliable for five of eight Short Form-36 domains (alpha > 0.8), with the remainder alpha > 0.7. Compared to age-sex adjusted published normative scores, patients with leg ulcers had significantly lower mean scores in the following domains: role-emotional (d = 28.6, P <0.001), social functioning (d = 22.8, P <0.001), role-functioning (d = 20.8, P <0.001), role-physical (d = 20.7, P <0.001), and bodily pain (d = 12.3, P <0.001). Short Form-36 scores barely changed between baseline and the 12-week assessment, but bodily pain improved in the 31 patients whose ulcers healed during that time (d = 14.6, P = 0.006; SRM = 0.60). Pain did not improve in patients whose ulcers remained open (d = -2.1, P = 0.45). Compared to patients whose ulcers did not heal, patients with healed ulcers experienced greater improvements in the following domains: body pain (d = 16.8, P = 0.003), mental health (d = 9.4, P = 0.013), role-physical (d = 19.7, P = 0.06), role-emotional (d = 17.2, P = 0.12), and vitality (d = 9.0, P = 0.052). The results of this study suggest that leg ulcers reduce patient quality of life and that the Short Form-36 can be used to ascertain their impact
临床医生逐渐意识到，认识、评估并最终解决慢性伤口对患者生活质量的负面影响至关重要。118名患者（平均年龄78岁）参与了一项研究，以评估使用医学结局简表36（Medical Outcomes Short Form-36，SF-36）来评估慢性腿部溃疡患者的健康相关生活质量。大多数患者（104名，88%）由社区护士在家中进行治疗。研究获取了患者的病史，并让患者在基线时以及接受标准溃疡护理12周后完成SF-36问卷。利用已发表的规范数据来确定腿部溃疡对健康相关生活质量的影响。通过比较基线和12周时的得分来确定SF-36的反应性。结果表明，该问卷在SF-36的八个领域中的五个领域是可靠的（α>0.8），其余领域α>0.7。与年龄和性别调整后的已发表规范得分相比，腿部溃疡患者在以下领域的平均得分显著更低：角色情感（d = 28.6，P <0.001）、社会功能（d = 22.8，P <0.001）、角色功能（d = 20.8，P <0.001）、角色身体（d = 20.7，P <0.001）和身体疼痛（d = 12.3，P <0.001）。SF-36得分在基线和12周评估之间几乎没有变化，但在那段时间溃疡愈合的31名患者中，身体疼痛有所改善（d = 14.6，P = 0.006；标准化反应均值（SRM）= 0.60）。溃疡仍未愈合的患者疼痛没有改善（d = -2.1，P = 0.45）。与溃疡未愈合的患者相比，溃疡愈合的患者在以下领域有更大改善：身体疼痛（d = 16.8，P = 0.003）、心理健康（d = 9.4，P = 0.013）、角色身体（d = 19.7，P = 0.06）、角色情感（d = 17.2，P = 0.12）和活力（d = 9.0，P = 0.052）。这项研究的结果表明，腿部溃疡会降低患者的生活质量，并且SF-36可用于确定其影响
