Eaton T, Young P, Fergusson W, Garrett J E, Kolbe J
Respiratory Services, Green Lane Hospital, Auckland, New Zealand.
Qual Life Res. 2005 Apr;14(3):575-85. doi: 10.1007/s11136-004-0624-2.
The negative impact of chronic obstructive pulmonary disease (COPD) on health-related quality of life (HRQL) is substantial. Measurement of HRQL is increasingly advocated in clinical practice; traditional outcome measures such as lung function are poorly responsive. However many HRQL tools are not user-friendly in the clinic setting. Hence HRQL is often neglected. The Dartmouth Cooperative Functional Assessment Charts (COOP) have the requisite attributes of a tool suitable for routine clinical practice: they are simple, reliable, quick and easy to perform and score and well accepted. We aimed to determine the reliability, validity and responsiveness of the COOP in patients with significant COPD. HRQL was assessed during a prospective, randomised, placebo-controlled, double-blind, 12 week cross-over interventional study of ambulatory oxygen in patients (n = 50) with COPD. Test-retest reliability of the COOP domains was only modest however it was measured over a 2 month period. Significant correlations ranging between 0.4 and 0.8 were observed between all comparable domains of the COOP and the Medical Outcomes Study 36-item Short-form Health Survey, Chronic Respiratory Questionnaire (CRQ) and Hospital Anxiety and Depression (HAD) scale. Following ambulatory oxygen significant improvements were noted in all CRQ and HAD domains. Several domains of the generic SF-36 (role emotional, social functioning, role-physical) showed significant improvements. Comparable domains of the COOP (social activities, feelings) also showed significant improvements. The COOP change in health domain improved very significantly. The COOP is a simple, reliable HRQL tool which proved valid and responsive in our study population of COPD patients and may have a valuable role in routine clinical practice.
慢性阻塞性肺疾病(COPD)对健康相关生活质量(HRQL)的负面影响很大。在临床实践中,越来越提倡对HRQL进行测量;而诸如肺功能等传统结局指标的反应性较差。然而,许多HRQL工具在临床环境中并不便于使用。因此,HRQL常常被忽视。达特茅斯协作功能评估表(COOP)具备适合常规临床实践的工具所需的属性:它们简单、可靠、快速且易于实施和评分,并且易于接受。我们旨在确定COOP在重度COPD患者中的可靠性、有效性和反应性。在一项针对50例COPD患者进行的前瞻性、随机、安慰剂对照、双盲、为期12周的门诊吸氧交叉干预研究中,对HRQL进行了评估。COOP各领域的重测信度仅为中等,不过这是在2个月的时间段内测量的。在COOP的所有可比领域与医学结局研究36项简短健康调查、慢性呼吸问卷(CRQ)以及医院焦虑抑郁(HAD)量表之间,观察到了0.4至0.8之间的显著相关性。在门诊吸氧后,所有CRQ和HAD领域均有显著改善。通用SF - 36的几个领域(角色情感、社会功能、角色 - 身体)也有显著改善。COOP的可比领域(社交活动、感受)也有显著改善。COOP健康领域的变化有非常显著的改善。COOP是一种简单、可靠的HRQL工具,在我们的COPD患者研究人群中被证明是有效且有反应性的,并且可能在常规临床实践中发挥重要作用。