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哮喘控制和生活质量的测量:纵向数据为其在不同研究背景下的相对效用提供了实际见解。

Measures of asthma control and quality of life: longitudinal data provide practical insights into their relative usefulness in different research contexts.

作者信息

King Madeleine T, Kenny Patricia M, Marks Guy B

机构信息

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.

出版信息

Qual Life Res. 2009 Apr;18(3):301-12. doi: 10.1007/s11136-009-9448-4. Epub 2009 Feb 19.

Abstract

PURPOSE

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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