Harlin Stephen L, Harlin Ryan D, Sherman Thomas I, Rozsas Courtney M, Shafqat M Shuja, Meyers William
Department of Surgery, Drexel University, College of Medicine, Philadelphia, Pennsylvania, USA.
Ostomy Wound Manage. 2009 Sep 15;55(9):30-9.
Patients with chronic wounds of the lower extremity (CWLEs) often experience functional disability and emotional distress; incorporating health-related quality of life (HRQoL) measurements in clinical practice may improve understanding of chronic wound patients' healthcare needs. A computer-administered instrument that measures HRQoL variables in patients with CWLEs was developed to overcome common limitations to assessing HRQoL in this population. Face validity of the questionnaire variables assessing physical, social, emotional, and functional well-being was obtained and a computer application to display the structured questionnaire on an electronic kiosk with touch-screen interface was developed. All patient responses are stored in the clinic's electronic health record system. To evaluate use of this system in a wound care clinic, 66 consecutive patients were asked to complete the questionnaire; of those, 64 participated. Internal consistency of the instrument across responses was estimated by the Kuder-Richardson formula 20 as 0.79. None of the patients requested help completing the questionnaire or working with the touch-screen interface. Patients most frequently reported frustration (63%), trouble sleeping (48%), anxiety (42%), and impaired mobility (41%), confirming that CWLEs negatively affect patient quality of life. These findings suggest that additional validation and reliability studies, including research to evaluate the relationship between HRQoL, protocols of care, and wound outcomes, are warranted.
下肢慢性伤口(CWLE)患者常伴有功能残疾和情绪困扰;在临床实践中纳入健康相关生活质量(HRQoL)测量,可能会增进对慢性伤口患者医疗需求的理解。为克服评估该人群HRQoL的常见局限,开发了一种计算机管理工具来测量CWLE患者的HRQoL变量。获得了评估身体、社会、情感和功能健康状况的问卷变量的表面效度,并开发了一种计算机应用程序,用于在带有触摸屏界面的电子信息亭上显示结构化问卷。所有患者的回答都存储在诊所的电子健康记录系统中。为评估该系统在伤口护理诊所的使用情况,连续66名患者被要求完成问卷;其中64人参与。通过库德-理查森公式20估计该工具在所有回答中的内部一致性为0.79。没有患者在完成问卷或使用触摸屏界面时寻求帮助。患者最常报告的是沮丧(63%)、睡眠问题(48%)、焦虑(42%)和行动不便(41%),证实CWLE对患者生活质量有负面影响。这些发现表明,有必要进行额外的效度和信度研究,包括评估HRQoL、护理方案和伤口结局之间关系的研究。