测量亲密伴侣暴力对健康相关生活质量的影响：一项定性焦点小组研究。
Measuring the effect of intimate partner violence on health-related quality of life: a qualitative focus group study.
作者信息
Wittenberg Eve, Joshi Manisha, Thomas Kristie A, McCloskey Laura A
机构信息
Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA.
出版信息
Health Qual Life Outcomes. 2007 Dec 19;5:67. doi: 10.1186/1477-7525-5-67.
BACKGROUND
Health related quality of life (HRQOL) can be measured by a wide range of instruments, many of which have been designed for specific conditions or uses. "Preference-based" measures assess the value individuals place on health, and are included in economic evaluations of treatments and interventions (such as cost effectiveness analysis). As economic evaluation becomes more common, it is important to assess the applicability of preference-based health related quality of life (HRQOL) measures to public health issues. This study investigated the usefulness of such instruments in the context of intimate partner violence (IPV), a public health concern that that can seriously affect quality of life.
METHODS
The study consisted of focus groups with abused women to determine the aspects of life affected by IPV, and an analysis of existing HRQOL measures. Eight focus groups (n = 40) were conducted in which participants discussed the domains of health affected by IPV. Results were content analyzed and compared with the domains of health included in four commonly-used, preference-based HRQOL measures.
RESULTS
The average focus group participant was 43 years old, unemployed, African American, with 3 children. Domains of health reported to be affected by IPV included physical functioning, emotional and psychological functioning, social functioning and children's functioning. Psychological health was the most severely affected domain. The Short Form 36, the Health Utilities Index, the EuroQol 5D, and the Quality of Well-being Scale were found to vary in the degree to which they include domains of health important in IPV. Psychological health is included to a limited extent, and the spill-over effect of a condition on other family members, including children, is not included at all.
CONCLUSION
Emotional and psychological health plays an important role in the overall HRQOL of abused women but is relatively underemphasized in preference-based HRQOL measures. This may lead to an underestimation of the impact of partner violence on HRQOL when using these measures and in economic evaluations that rely thereon. Holistic measurement approaches or expanded measures that capture the far-reaching effects of IPV on HRQOL may be needed to accurately measure the effect of this condition on women's health.
背景
健康相关生活质量（HRQOL）可通过多种工具进行测量，其中许多工具是针对特定情况或用途设计的。“基于偏好”的测量方法评估个体对健康的重视程度，并被纳入治疗和干预措施的经济评估中（如成本效益分析）。随着经济评估变得越来越普遍，评估基于偏好的健康相关生活质量（HRQOL）测量方法对公共卫生问题的适用性很重要。本研究调查了此类工具在亲密伴侣暴力（IPV）背景下的有用性，IPV是一个会严重影响生活质量的公共卫生问题。
方法
该研究包括与受虐妇女进行焦点小组讨论以确定受IPV影响的生活方面，以及对现有HRQOL测量方法的分析。开展了八个焦点小组（n = 40），参与者在小组中讨论了受IPV影响的健康领域。对结果进行内容分析，并与四种常用的、基于偏好的HRQOL测量方法所包含的健康领域进行比较。
结果
焦点小组参与者的平均年龄为43岁，失业，非裔美国人，育有3个孩子。据报告，受IPV影响的健康领域包括身体功能、情绪和心理功能、社会功能以及儿童功能。心理健康是受影响最严重的领域。研究发现，简短健康调查问卷（Short Form 36）、健康效用指数（Health Utilities Index）、欧洲五维健康量表（EuroQol 5D）和幸福感量表（Quality of Well-being Scale）在纳入IPV中重要健康领域的程度上存在差异。心理健康仅在有限程度上被纳入，而且一种状况对包括儿童在内的其他家庭成员的溢出效应完全未被纳入。
结论
情绪和心理健康在受虐妇女的整体HRQOL中起着重要作用，但在基于偏好的HRQOL测量方法中相对未得到充分重视。这可能导致在使用这些测量方法以及依赖这些方法的经济评估中，低估伴侣暴力对HRQOL的影响。可能需要采用整体测量方法或扩展测量方法来捕捉IPV对HRQOL的深远影响，以便准确测量这种状况对妇女健康的影响。
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