Perneger Thomas V, Leski Michel, Chopard-Stoermann Catherine, Martin Pierre-Yves
Division of Nephrology, Quality Care Unit, Geneva University Hospitals, CH-1211 Geneva 14, Switzerland.
J Nephrol. 2003 Mar-Apr;16(2):252-9.
We compared three ways of assessing health status in chronic hemodialysis patients: generic questionnaire compared with population norms, disease-specific questionnaire, and open questions.
Hemodialysis patients (n=83) treated in Geneva canton, Switzerland, answered the Kidney Disease Quality of Life (KDQOL-SF) questionnaire, which combines 12 disease-specific scales with the generic Short-Form 36 (SF36) health survey, and open questions about the most disturbing and most positive aspects of having end-stage renal disease. SF36 scores were compared with those of the general population, and generic health scales were correlated with dialysis-specific scales.
Hemodialysis patients had significantly lower scores than general population controls on 7 of 8 SF36 scales, especially physical functioning (-1.2 standard deviation (SD) units, p<0.001) and general health (-1.2 SD, p<0.001), but their mental health was similar (-0.2 SD, p=0.13). All 12 KDQOL dialysis-specific scores correlated significantly with the SF36 mental summary score, but only 6 correlated significantly with the SF36 physical summary score. Open comments suggested that dialysis itself is the chief problem confronting dialysis patients, but also that the predicament of end-stage renal disease may have a positive impact on the lives of some patients.
While physical problems are the biggest difference between dialysis patients and controls, disease-specific scales and open comments highlighted the importance of psychosocial and treatment-related problems among hemodialysis patients. Generic and disease-specific questionnaires, and open comments provide different information about the health status of dialysis patients.
我们比较了评估慢性血液透析患者健康状况的三种方法：与人群常模比较的通用问卷、疾病特异性问卷和开放式问题。
在瑞士日内瓦州接受治疗的血液透析患者（n = 83）回答了肾脏病生活质量（KDQOL-SF）问卷，该问卷将12个疾病特异性量表与通用的简短形式36（SF36）健康调查相结合，并就终末期肾病最困扰和最积极的方面提出开放式问题。将SF36评分与普通人群的评分进行比较，并将通用健康量表与透析特异性量表进行相关性分析。
血液透析患者在8个SF36量表中的7个上的得分显著低于普通人群对照组，尤其是身体功能（-1.2标准差（SD）单位，p < 0.001）和总体健康（-1.2 SD，p < 0.001），但他们的心理健康状况相似（-0.2 SD，p = 0.13）。所有12个KDQOL透析特异性评分均与SF36心理综合评分显著相关，但只有6个与SF36身体综合评分显著相关。开放式评论表明，透析本身是透析患者面临的主要问题，但终末期肾病的困境也可能对一些患者的生活产生积极影响。
虽然身体问题是透析患者与对照组之间最大的差异，但疾病特异性量表和开放式评论突出了血液透析患者心理社会和治疗相关问题的重要性。通用问卷、疾病特异性问卷和开放式评论提供了关于透析患者健康状况的不同信息。
