King Madeleine T, Kenny Patricia M, Marks Guy B
Quality of Life Office, Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, University of Sydney, Brennan MacCallum Building (A18), Sydney, 2006, NSW, Australia.
Qual Life Res. 2009 Apr;18(3):301-12. doi: 10.1007/s11136-009-9448-4. Epub 2009 Feb 19.
To further our understanding of the relationships between asthma control and health-related quality of life (HRQOL) and provide insights into the relative usefulness of various measures in different research contexts. We present a conceptual model and test it with longitudinal survey data.
Participants recruited via population sampling and hospital Emergency Departments completed questionnaires every 6 months for up to 3 years. Measures included: sleep disturbance, use of short-acting beta agonists (SABA), activity limitation, urgent medical visits, hospital use, Marks' Asthma Quality of Life Questionnaire (AQLQ-M) and the SF-36 Health Survey. Correlation analysis and multi-level models tested predictions from the conceptual model.
A total of 213 people with asthma aged 16-75 years provided 967 observations. Correlations between asthma control and asthma-specific HRQOL were stronger than those between asthma control and generic HRQOL. The asthma control variables explained 54-58% of the variance in asthma-specific HRQOL and 8-25% of the variance in generic HRQOL. Activity limitation was the main contributor to between-person variation, while sleep disturbance and SABA use were the main contributors to within-person variation.
Sleep disturbance and SABA use may be most useful in evaluating treatment effectiveness, while activity limitation may be better when monitoring the impact of asthma in populations.
加深我们对哮喘控制与健康相关生活质量（HRQOL）之间关系的理解，并深入了解不同研究背景下各种测量方法的相对有用性。我们提出一个概念模型并用纵向调查数据对其进行检验。
通过人群抽样和医院急诊科招募的参与者每6个月填写一次问卷，为期最长3年。测量指标包括：睡眠障碍、短效β受体激动剂（SABA）的使用、活动受限、紧急医疗就诊、住院情况、马克斯哮喘生活质量问卷（AQLQ-M）和SF-36健康调查。相关性分析和多层次模型检验了概念模型的预测。
共有213名年龄在16至75岁之间的哮喘患者提供了967份观察数据。哮喘控制与哮喘特异性HRQOL之间的相关性强于哮喘控制与一般HRQOL之间的相关性。哮喘控制变量解释了哮喘特异性HRQOL中54%至58%的方差以及一般HRQOL中8%至25%的方差。活动受限是个体间差异的主要因素，而睡眠障碍和SABA的使用是个体内差异的主要因素。
睡眠障碍和SABA的使用在评估治疗效果时可能最有用，而在监测哮喘对人群的影响时，活动受限可能更合适。
