Franks Peter J, Moffatt Christine J, Doherty Debra C, Williams Anne F, Jeffs Eunice, Mortimer Peter S
Centre for Research & Implementation of Clinical Practice, Faculty of Health & Human Sciences, Thames Valley University, London, United Kingdom.
Wound Repair Regen. 2006 Mar-Apr;14(2):110-8. doi: 10.1111/j.1743-6109.2006.00099.x.
The purpose of this study was to examine the use of a number of tools in the evaluation of health-related quality of life in patients with lower limb lymphedema, and to determine the consequences of cancer history and concurrent leg ulceration. Patients in one health trust having lower limb lymphedema were identified and interviewed at entry and after 24 weeks. The short form-36 (SF-36), modified Barthel scale, McGill short form pain questionnaire, and Euroqol were administered at both time points. Of the 164 (median age=76.9 years, 70.7% women) patients who comprised the study population, 15.2% had a history of cancer and 30.4% had coexisting current leg ulceration. Internal consistencies were high for all scales (Cronbach's alpha >0.80). There were high ceiling effects for a number of SF-36 scores, and high floor effects in these and the McGill short form pain questionnaire, scales. Despite these limitations, there was strong evidence that treatment led to significant improvements in six of eight scores of the SF-36, three of three scores of the McGill short form pain questionnaire and the modified Barthel scale (all p<0.05). The improvement in physical functioning was significantly greater for patients who entered the study with a leg ulcer (mean different=9.1, 95% confidence interval 2.1-16.1, p=0.011). Patients treated with compression bandaging had significantly greater improvements for physical functioning (10.2) than those treated with compression hosiery (-1.5) or no treatment (-2.0), p=0.001. Of the tools assessed, the SF-36, appears to be the most appropriate for use in this patient group.
本研究的目的是探讨多种工具在评估下肢淋巴水肿患者健康相关生活质量中的应用，并确定癌症病史和并发腿部溃疡的影响。在一个医疗信托机构中识别出患有下肢淋巴水肿的患者，并在入组时和24周后进行访谈。在两个时间点均使用了简明健康调查问卷（SF-36）、改良巴氏量表、麦吉尔疼痛问卷简表和欧洲五维度健康量表。在构成研究人群的164名患者（中位年龄 = 76.9岁，70.7%为女性）中，15.2%有癌症病史，30.4%存在当前并发的腿部溃疡。所有量表的内部一致性都很高（Cronbach's α>0.80）。SF-36的多个分数存在较高的天花板效应，这些量表以及麦吉尔疼痛问卷简表存在较高的地板效应。尽管有这些局限性，但有强有力的证据表明，治疗使SF-36的八个分数中的六个、麦吉尔疼痛问卷简表的三个分数以及改良巴氏量表有显著改善（所有p<0.05）。对于入组时患有腿部溃疡的患者，身体功能的改善显著更大（平均差异 = 9.1，95%置信区间2.1 - 16.1，p = 0.011）。接受加压绷带治疗的患者在身体功能方面的改善（10.2）明显大于接受加压袜治疗（-1.5）或未接受治疗（-2.0）的患者，p = 0.001。在所评估的工具中，SF-36似乎最适合用于该患者群体。
