Levo Hilla, Stephens Dafydd, Poe Dennis, Kentala Erna, Rasku Jyrki, Pyykkő Ilmari
Department of Otolaryngology, University of Helsinki, Finland.
Int J Rehabil Res. 2012 Sep;35(3):197-202. doi: 10.1097/MRR.0b013e3283531f95.
The purpose of this study was to determine the factors explaining changes in the generic quality of life among patients with Menière's disorder (MD) and to evaluate the EuroQol 5D (EQ-5D) quality-of-life measures. A questionnaire focusing on symptoms and disabilities caused by MD was collected from 726 individuals. General health-related quality of life (EQ-5D) was evaluated using the time trade-off (TTO) and visual-analogue scale (VAS). Personal traits were measured with the sense of coherence. The TTO-VAS score difference was modeled with activity limitations, participation restrictions, attitudes, and symptoms. For TTO as the outcome measure, one symptom-based, three attitude-based, one activity limitation, and one participation restriction item explained 43% of the variability. For VAS, six attitude-based, one symptom-based, three activity limitations, and one participation restriction item explained 43% of the variability of the data. The correlation between TTO and VAS (r=0.515, P<0.001) explained only 27% of the variance. The difference between TTO and VAS was reflected in attitudes towards the illness. The model explained 10% of the variability in the VAS and TTO difference. There was a disease duration effect in the TTO-VAS difference. In conclusion, a symptom-based model combined with disabilities provided a good description of general quality of life in MD. The TTO-based and VAS-based evaluation explained somewhat different aspects of MD. The difference between TTO and VAS could be described as an attitude toward the ailment. Evaluation of disabilities and the difference in TTO and VAS can be used to guide the rehabilitation to promote attitude change.
本研究的目的是确定解释梅尼埃病（MD）患者总体生活质量变化的因素，并评估欧洲五维健康量表（EQ-5D）的生活质量测量指标。从726名个体中收集了一份聚焦于MD所致症状和残疾的问卷。使用时间权衡法（TTO）和视觉模拟量表（VAS）评估与总体健康相关的生活质量（EQ-5D）。用连贯感来衡量个人特质。用活动受限、参与受限、态度和症状对TTO-VAS得分差异进行建模。对于以TTO作为结果指标，一个基于症状的项目、三个基于态度的项目、一个活动受限项目和一个参与受限项目解释了43%的变异性。对于VAS，六个基于态度的项目、一个基于症状的项目、三个活动受限项目和一个参与受限项目解释了43%的数据变异性。TTO与VAS之间的相关性（r = 0.515，P < 0.001）仅解释了27%的方差。TTO与VAS之间的差异体现在对疾病的态度上。该模型解释了VAS和TTO差异中10%的变异性。在TTO-VAS差异中存在病程效应。总之，一个基于症状的模型与残疾情况相结合，能很好地描述MD患者的总体生活质量。基于TTO和基于VAS的评估解释了MD在某些方面的不同情况。TTO与VAS之间的差异可描述为对疾病的态度。对残疾情况以及TTO和VAS差异的评估可用于指导康复，以促进态度转变。
