在常规医院环境中测量慢性阻塞性肺疾病患者的健康相关生活质量：可行性与感知价值
Measuring health-related quality of life in patients with chronic obstructive pulmonary disease in a routine hospital setting: feasibility and perceived value.
作者信息
Bendtsen Preben, Leijon Matti, Sofie Sommer Ann, Kristenson Margareta
机构信息
Department of Health and Society, Linköping University, Sweden.
出版信息
Health Qual Life Outcomes. 2003 Apr 11;1:5. doi: 10.1186/1477-7525-1-5.
BACKGROUND
Assessment of health-related quality of life is so far mainly used in specific research settings and not widely accepted in the routine care of patients. Lack of trust in accuracy and reliability and lack of knowledge concerning the questionnaires used, methods, terminology, are just some of the perceived barriers for a more widespread dissemination of these instruments into routine health care. The present study was undertaken in order to test the feasibility of a computerised system for collecting and analysing health-related quality of life in a routine clinical setting and to examine the thoughts and attitudes among physicians concerning the value of these measurements.
METHODS
Seventy-four patients with chronic pulmonary lung disease were asked to assess their health-related quality of life with a computerised version of the SF-36 questionnaire before a regular the visit to a physician. The results were immediately available for the physician during the consultation for comparison of information given by the patients and the physician's evaluation of the patients overall health status. A focus group interview with the physicians was performed before and after the implementation of routine measurements of health-related quality of life.
RESULTS
The systematic assessment concept worked satisfactorily. All patients approached agreed to participate and completed the assessment on the touch screen computer. A weak correlation was found between patients' self-rated health and pulmonary function and between physicians' evaluation and pulmonary function. The physicians appreciated the SF-36 assessments and the value of the patients' perspective although only a few could pinpoint new clinical decisions based upon this new information.
CONCLUSION
Physicians' clinical evaluation and patients' self-rating of health status offer unique and important information that are complementary.
背景
迄今为止，健康相关生活质量评估主要用于特定研究环境，在患者的常规护理中尚未得到广泛接受。对准确性和可靠性缺乏信任，以及对所使用的问卷、方法、术语缺乏了解，只是这些工具更广泛地应用于常规医疗保健的一些公认障碍。本研究旨在测试一种计算机系统在常规临床环境中收集和分析健康相关生活质量的可行性，并考察医生对这些测量价值的看法和态度。
方法
74例慢性肺病患者在定期就诊前，被要求使用SF-36问卷的计算机版本评估其健康相关生活质量。在会诊期间，医生可立即获得结果，以便比较患者提供的信息和医生对患者总体健康状况的评估。在实施健康相关生活质量的常规测量前后，对医生进行了焦点小组访谈。
结果
系统评估概念运行良好。所有接触到的患者都同意参与并在触摸屏计算机上完成了评估。患者的自评健康与肺功能之间以及医生的评估与肺功能之间存在弱相关性。医生认可SF-36评估以及患者观点的价值，尽管只有少数医生能够根据这些新信息确定新的临床决策。
结论
医生的临床评估和患者对健康状况的自评提供了独特且重要的互补信息。
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