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慢性关节炎患儿的健康状况:不同测量方法与家长代理报告质量的关系

Health of children with chronic arthritis: relationship of different measures and the quality of parent proxy reporting.

作者信息

Brunner Hermine I, Klein-Gitelman Marisa S, Miller Michael J, Trombley Michael, Baldwin Nicole, Kress Angela, Johnson Anne L, Barron Andrea C, Griffin Thomas A, Passo Murray H, Lovell Daniel J

机构信息

Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45229-3039, USA.

出版信息

Arthritis Rheum. 2004 Oct 15;51(5):763-73. doi: 10.1002/art.20689.

Abstract

OBJECTIVE

To examine the strength of the association between different measures of health-related quality of life (HRQOL), disability, pain, and well-being in children with chronic arthritis. To evaluate whether HRQOL scores vary as a function of disability status beyond chance. To assess the quality of the parent proxy report for HRQOL as compared with disability, pain, and well-being.

METHODS

Measures of HRQOL (visual analog scale [VAS] of health, Pediatric Quality of Life Inventory [PedsQL], Juvenile Arthritis Quality of Life Questionnaire (JAQQ), and modified standard gamble technique [SG]), disability (Childhood Health Assessment Questionnaire), VAS of pain, and VAS of well-being (VAS-well) were completed by the parents (n = 119) and patients > or =8 years (SG: > or =12 years).

RESULTS

HRQOL was highest when measured by the SG, whose utilities were no more than weakly correlated with any of the other outcomes. The values of all other HRQOL measures were at least moderately correlated with each other and with the VAS-well. Irrespective of the measure used, disability was associated with significantly decreased HRQOL. There was fair to good agreement and moderate consistency of the HRQOL ratings (SG: fair consistency) between patients and parents with marked differences between health domains.

CONCLUSION

HRQOL measured by the PedsQL, JAQQ, and VAS are moderately to highly correlated with each other in children with chronic arthritis. The children's HRQOL significantly decreases with increasing disability. Despite more pronounced differences for some health domains, parents are moderate to good proxy reporters of HRQOL, disability, and well-being of children with chronic arthritis.

摘要

目的

研究慢性关节炎患儿不同健康相关生活质量(HRQOL)测量指标、残疾、疼痛及幸福感之间关联的强度。评估HRQOL评分是否因残疾状态而随机变化。评估与残疾、疼痛及幸福感相比,家长代理报告的HRQOL质量。

方法

家长(n = 119)及8岁及以上患儿(SG:12岁及以上)完成HRQOL测量指标(健康视觉模拟量表[VAS]、儿童生活质量量表[PedsQL]、青少年关节炎生活质量问卷[JAQQ]及改良标准博弈技术[SG])、残疾(儿童健康评估问卷)、疼痛VAS及幸福感VAS(VAS-幸福感)。

结果

用SG测量时HRQOL最高,其效用与其他任何结果的相关性都不超过弱相关。所有其他HRQOL测量指标的值彼此之间以及与VAS-幸福感至少呈中度相关。无论使用何种测量指标,残疾都与HRQOL显著降低相关。患者与家长之间HRQOL评分(SG:一致性一般)的一致性良好至中等,健康领域之间存在明显差异。

结论

在慢性关节炎患儿中,用PedsQL、JAQQ和VAS测量的HRQOL彼此之间呈中度至高度相关。患儿的HRQOL随残疾程度增加而显著降低。尽管某些健康领域存在更明显的差异,但家长对慢性关节炎患儿的HRQOL、残疾及幸福感的代理报告为中等至良好。

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