Vercoulen Jan H, Daudey Leonie, Molema Johan, Vos Petra J, Peters Jeannette B, Top Mariska, Folgering Hans
Department of Medical Psychology, Radboud University Nijmegen Medical Center, The Netherlands.
Int J Behav Med. 2008;15(4):263-79. doi: 10.1080/10705500802365474.
To date, many health status instruments exist, but the validity of these instruments is questionable. This is caused by the fact that health status is poorly defined.
To develop a validated framework that improves conceptual insight into health status and its domains.
Based on theoretical and clinical considerations, we defined the domains of health status into concrete sub-domains by formulating conceptual models. Guided by these conceptual models, for each sub-domain, existing instruments were selected. We validated the conceptual models in the data of 168 COPD patients. Using factor analysis, underlying concepts in the data were identified.
The resulting framework included physiological functioning, complaints, functional impairment, and quality of life. These main domains were shown to be subdivided into 15 sub-domains.
The present study shows that health status consists of conceptually distinct sub-domains. Integral assessment of health status thus entails measuring all sub-domains. Existing instruments measure only few sub-domains. Integral assessment of health status thus requires the combination of different instruments. The present framework of health status can help in composing such a battery of instruments. Patient profiles obtained by the framework are essential in individualizing treatment.
迄今为止，存在许多健康状况评估工具，但这些工具的有效性值得怀疑。这是由于健康状况的定义不明确所致。
开发一个经过验证的框架，以提高对健康状况及其领域的概念性理解。
基于理论和临床考量，我们通过构建概念模型将健康状况的领域定义为具体的子领域。在这些概念模型的指导下，为每个子领域选择了现有的评估工具。我们在168例慢性阻塞性肺疾病（COPD）患者的数据中验证了这些概念模型。通过因子分析，确定了数据中的潜在概念。
最终形成的框架包括生理功能、症状、功能损害和生活质量。这些主要领域被进一步细分为15个子领域。
本研究表明，健康状况由概念上不同的子领域组成。因此，对健康状况的综合评估需要测量所有子领域。现有评估工具仅测量少数子领域。因此，对健康状况的综合评估需要结合不同的评估工具。目前的健康状况框架有助于构建这样一套评估工具。通过该框架获得的患者概况对于个体化治疗至关重要。
