McMillan Carolyn V, Bradley Clare, Gibney James, Russell-Jones David L, Sönksen Peter H
Department of Psychology, Royal Holloway, University of London, Egham, Surrey, UK.
J Eval Clin Pract. 2006 Oct;12(5):501-14. doi: 10.1111/j.1365-2753.2006.00659.x.
The objectives were (1) to report the preliminary development of the Hormone Deficiency-dependent Quality of Life (HDQoL) questionnaire, a new individualized questionnaire in which respondents rate personally applicable domains for importance and impact of hormonal deficiency and its treatment; (2) to evaluate the HDQoL's psychometric properties for adults with hypopituitarism including growth hormone deficiency (GHD).
Internal consistency reliability, aspects of validity, and sensitivity to change of the HDQoL were investigated in: (1) a cross-sectional survey of 157 adults with treated or untreated GHD; (2) a randomized, placebo-controlled study of 3 months' growth hormone (GH) withdrawal from 12 of 21 GH-treated adults.
Thirteen of the original 18 HDQoL domains were relevant and important for GH-deficient adults. The shorter 13-item HDQoL had excellent internal reliability (Cronbach's alpha coefficient = 0.914, n = 109), and was sensitive to sex differences (cross-sectional study): women perceived worse present QoL than men [t(149.8) = 2.33, P = 0.021]. The HDQoL was sensitive to change (GH-withdrawal study) with a significant between-group difference in change in domain scores for things I can do physically[t(16) = 2.47, P = 0.025, 2-tailed], patients withdrawn from GH reporting greater negative impact of hormone deficiency on this domain at end-point. Qualitative work resulted in the addition of seven new HDQoL domains, including energy and bodily pain.
The HDQoL, although at an early stage of development, proved useful in identifying expected changes following GH withdrawal. The extended 20-item version is recommended for further evaluation in assessing the impact of hypopituitarism on QoL.
（1）报告激素缺乏相关生活质量（HDQoL）问卷的初步编制情况，这是一种新的个体化问卷，受访者可对激素缺乏及其治疗对个人适用领域的重要性和影响进行评分；（2）评估HDQoL对包括生长激素缺乏（GHD）在内的垂体功能减退症成人患者的心理测量特性。
在以下研究中调查HDQoL的内部一致性信度、效度方面以及对变化的敏感性：（1）对157例接受或未接受治疗的GHD成人进行横断面调查；（2）对21例接受生长激素（GH）治疗的成人中的12例进行为期3个月的GH撤药随机、安慰剂对照研究。
最初18个HDQoL领域中的13个对GH缺乏的成人具有相关性和重要性。较短的13项HDQoL具有出色的内部信度（Cronbach's α系数 = 0.914，n = 109），并且对性别差异敏感（横断面研究）：女性认为当前生活质量比男性差[t(149.8) = 2.33，P = 0.021]。HDQoL对变化敏感（GH撤药研究），在“我身体能做之事”领域得分变化方面，组间存在显著差异[t(16) = 2.47，P = 0.025，双侧]，撤用GH的患者在终点时报告激素缺乏对该领域的负面影响更大。定性研究工作新增了7个HDQoL领域，包括精力和身体疼痛。
HDQoL尽管尚处于开发早期阶段，但已被证明有助于识别GH撤药后的预期变化。建议使用扩展的20项版本进一步评估垂体功能减退症对生活质量的影响。
