老年日间医院患者个体化生活质量测量方法的验证
Validation of an individualised quality of life measure in older day hospital patients.
作者信息
Witham Miles D, Fulton Roberta L, Wilson Lucy, Leslie Carolyn A, McMurdo Marion E T
机构信息
Section of Ageing and Health, University of Dundee, Ninewells Hospital, Dundee DD1 9SY, UK.
出版信息
Health Qual Life Outcomes. 2008 Apr 18;6:27. doi: 10.1186/1477-7525-6-27.
BACKGROUND
To test the ease of use, reliability, responsiveness and construct validity of the Patient Generated Index, an individualised quality of life score, in older people attending a Medicine for Older People Day Hospital.
METHODS
Prospective longitudinal study in patients attending a specialist Medicine for Older People Day Hospital in Scotland. The Patient Generated Index was administered at baseline, one week later, and at the end of Day Hospital attendance. Functional Limitations Profile, Hospital Anxiety and Depression Score, Barthel index and global subjective impressions of change were also collected and compared with baseline scores and change in Patient Generated Index scores. Reliability was assessed using intraclass correlation coefficients in subjects reporting no change in global quality of life; responsiveness was assessed using effect size and Guyatt coefficients in subjects reporting change in global quality of life. External validity was assessed via correlation with measures of physical function, comorbid disease and psychological state.
RESULTS
75 patients were enrolled, mean age 81 years. Mean completion time was 5.0 minutes at baseline. Reliability was moderate (intraclass correlation coefficient 0.72) but there were weak and inconsistent responses to change (effect sizes 0.02 to 0.15; Guyatt responsiveness coefficient 0.29). Patient Generated Index scores correlated with Functional Limitation Profile scores (r = 0.51, p < 0.001), baseline anxiety score (r = -0.25, P = 0.039) and baseline depression score (r = -0.37, P = 0.002) but displayed only weak, non-significant correlation with number of comorbid diseases (r = -0.22, P = 0.07), number of medications (r = -0.21, P = 0.08) and Barthel score (r = 0.09, p = 0.45).
CONCLUSION
The Patient Generated Index appears moderately reliable and easy to complete, but is poorly responsive to change, limiting its usefulness in clinical practice or research.
背景
为了测试患者生成指数（一种个性化生活质量评分）在老年医学日间医院老年患者中的易用性、可靠性、反应性和结构效度。
方法
对苏格兰一家老年医学专科日间医院的患者进行前瞻性纵向研究。在基线、一周后以及日间医院就诊结束时对患者生成指数进行评估。还收集了功能受限概况、医院焦虑抑郁量表评分、巴氏指数以及对变化的总体主观印象，并与基线评分和患者生成指数评分的变化进行比较。在报告总体生活质量无变化的受试者中，使用组内相关系数评估可靠性；在报告总体生活质量有变化的受试者中，使用效应量和盖亚特系数评估反应性。通过与身体功能、共病疾病和心理状态的测量指标进行相关性分析来评估外部效度。
结果
共纳入75例患者，平均年龄81岁。基线时平均完成时间为5.0分钟。可靠性中等（组内相关系数为0.72），但对变化的反应较弱且不一致（效应量为0.02至0.15；盖亚特反应性系数为0.29）。患者生成指数评分与功能受限概况评分（r = 0.51，p < 0.001）、基线焦虑评分（r = -0.25，P = 0.039）和基线抑郁评分（r = -0.37，P = 0.002）相关，但与共病疾病数量（r = -0.22，P = 0.07）、用药数量（r = -0.21，P = 0.08）和巴氏评分（r = 0.09，p = 0.45）仅显示出较弱的、无统计学意义的相关性。
结论
患者生成指数似乎具有中等可靠性且易于完成，但对变化的反应较差，限制了其在临床实践或研究中的实用性。
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