Krespi Margorit Rita, Bone Mike, Ahmad Rashid, Worthington Breeda, Salmon Peter
Turk Psikiyatri Derg. 2009 Spring;20(1):56-67.
Existing quality of life measures fail to incorporate patients' own understanding of evaluation of life following the diagnosis of end stage renal failure (ESRF). Previous qualitative research has identified ways of evaluating life that have not been captured by existing quantitative research and that can be possible targets for clinical practice. Nonetheless, quantification is necessary if clinicians are to be informed of potentially important ways of evaluating life. It is also necessary to devise patient-derived measures of quality of life if the aim is also to monitor improvement in ways of evaluating life following interventions devised to change them.
Three studies were carried out. In the first two, the ways of evaluating life that were previously identified were quantified, a questionnaire that measures ways of evaluating life was developed, and the clinical utility of this questionnaire was examined in a sample of 156 hemodialysis patients. In the third study the predictive validity of this questionnaire was examined in a sample of 153 hemodialysis patients.
The findings identified a number of targets for clinical practice. These included feeling unable to 'get round' limitations, mixed negative feelings about caregivers, and failure to find something positive about ESRF The newly developed 3 subscales of life evaluation were internally consistent. The findings also show that thes subscales had construct and predictive validity.
The present studies provide a disease-specific life evaluation questionnaire consisting of 3 subscale for use in hemodialysis patients that can supplement existing generic quality of life measures.
现有的生活质量衡量标准未能纳入患者自身对终末期肾衰竭(ESRF)诊断后生活评估的理解。先前的定性研究已确定了一些生活评估方式,这些方式未被现有的定量研究所涵盖,并且可能成为临床实践的目标。然而,如果要让临床医生了解潜在的重要生活评估方式,量化是必要的。如果目标还包括监测旨在改变生活评估方式的干预措施实施后生活评估方式的改善情况,那么设计源自患者的生活质量衡量标准也是必要的。
进行了三项研究。在前两项研究中,对先前确定的生活评估方式进行量化,开发了一份衡量生活评估方式的问卷,并在156名血液透析患者样本中检验了该问卷的临床效用。在第三项研究中,在153名血液透析患者样本中检验了该问卷的预测效度。
研究结果确定了一些临床实践的目标。这些目标包括感觉无法“克服”限制、对护理人员的复杂负面情绪,以及未能从ESRF中找到积极的方面。新开发的生活评估3个分量表内部一致。研究结果还表明,这些分量表具有结构效度和预测效度。
本研究提供了一份针对疾病的生活评估问卷,由3个分量表组成,用于血液透析患者,可补充现有的通用生活质量衡量标准。