Department of Respiratory Diseases, Division Heart & Lungs, University Medical Center Utrecht, The Netherlands.
Int J Nurs Stud. 2013 May;50(5):688-707. doi: 10.1016/j.ijnurstu.2012.07.017. Epub 2012 Aug 24.
Quality of Life (QoL) measurements to quantify disease burden have become an important outcome measure in Chronic Obstructive Pulmonary Disease (COPD) research and treatment. A large variety of QoL instruments is available. The objective of this review was to comprehensively evaluate content and psychometric properties of available QoL instruments used in COPD care and research.
A systematic literature search was performed.
The databases PubMed, Embase, CINAHL, and the Cochrane Library were used.
Two researchers independently identified eligible studies. Methodological quality of the studies and data on measurement properties were assessed by using the Consensus based Standards for selection of health Measurement Instruments (COSMIN). A best evidence synthesis for each instrument was performed.
77 studies describing 13 disease-specific and 10 generic QoL instruments were identified. The content of the instruments showed a great variety. 20 instruments measured mobility. Pulmonary symptoms were measured in 11 disease specific instruments. Pain, vitality, and spiritual activities were domains seen only in generic instruments. Social and emotional functioning were domains seen in disease specific instruments as well as in generic instruments. The methodological quality of the studies was mostly rated fair, according to the COSMIN checklist. The psychometric properties of the instruments (validity, reliability and responsiveness) were in general rated positive. The best evidence synthesis showed the strongest positive evidence for the disease specific instruments Chronic Respiratory Questionnaire (CRQ), COPD Assessment Test (CAT), Saint George Respiratory Questionnaire (SGRQ), and Living with COPD questionnaire (LCOPD). The generic instruments received less favorable ratings.
Despite the comprehensive overview we could not uniformly recommend the best instrument to evaluate QoL in COPD patients. However, we could recommend the disease specific instruments CRQ, CAT, SGRQ, or LCOPD. In addition to the best evidence synthesis, the decision to use one instrument over another, will be driven by study purpose and research questions in combination with the domains of the instrument. Given the large availability of instruments we discourage to develop new instruments, instead we encourage to design studies according the COSMIN standards to evaluate the psychometric properties of the existing instruments.
生活质量（QoL）测量已成为慢性阻塞性肺疾病（COPD）研究和治疗中评估疾病负担的重要指标。目前有多种 QoL 工具可供选择。本综述的目的是全面评估 COPD 护理和研究中使用的各种 QoL 工具的内容和心理测量特性。
系统文献检索。
使用 PubMed、Embase、CINAHL 和 Cochrane 图书馆数据库。
两位研究人员独立确定合格的研究。使用共识基础健康测量仪器选择标准（COSMIN）评估研究的方法学质量和测量特性数据。对每种仪器进行最佳证据综合。
确定了 77 项描述 13 种疾病特异性和 10 种通用 QoL 工具的研究。这些仪器的内容种类繁多。20 项工具测量了移动能力。11 种疾病特异性工具测量了肺部症状。疼痛、活力和精神活动仅在通用工具中出现。社会和情感功能在疾病特异性工具和通用工具中都可见。根据 COSMIN 清单，研究的方法学质量大多被评为中等。仪器的心理测量特性（有效性、可靠性和反应性）通常被评为阳性。最佳证据综合显示，慢性呼吸道疾病问卷（CRQ）、COPD 评估测试（CAT）、圣乔治呼吸问卷（SGRQ）和慢性阻塞性肺病生活质量问卷（LCOPD）等疾病特异性工具具有最强的阳性证据。通用工具的评价较低。
尽管我们进行了全面的综述，但仍不能统一推荐用于评估 COPD 患者生活质量的最佳工具。然而，我们可以推荐使用 CRQ、CAT、SGRQ 或 LCOPD 等疾病特异性工具。除了最佳证据综合外，选择使用一种工具而不是另一种工具的决定，将取决于研究目的和研究问题，结合工具的各个领域。鉴于仪器的大量可用性，我们不鼓励开发新的仪器，而是鼓励根据 COSMIN 标准设计研究，以评估现有仪器的心理测量特性。
