严重和持久神经性厌食症患者生活质量评估：通用和专用工具的比较。
Assessment of quality of life in people with severe and enduring anorexia nervosa: a comparison of generic and specific instruments.
机构信息
School of Medicine, University of Western Sydney, Sydney, Australia.
出版信息
BMC Psychiatry. 2013 Nov 7;13:284. doi: 10.1186/1471-244X-13-284.
BACKGROUND
Criticisms that generic measures of health-related quality of life (HRQoL) are not sensitive to impairment in anorexia nervosa (AN) has spurred the development of disease-specific measures. This study aimed to compare the psychometric properties of a generic to a disease-specific measure of HRQoL.
METHODS
63 participants with AN completed measures of a generic HRQoL (SF-12), disease-specific HRQoL (Eating Disorders Quality of Life Questionnaire; EDQOL), functional impairment (days out of role; DOR; Work and Social Adjustment Scale; WSAS), and eating disorder severity (Eating Disorder Examination; EDE) at baseline, post-treatment, and 6- and 12-months follow-up. Cronbach's α was computed for the SF-12 and EDQOL (internal consistency). Correlations were assessed between SF-12/EDQOL scores and DOR, WSAS, and EDE scores (convergence validity). Three sets of three multiple linear regressions were performed using SF-12 and EDQOL scores as predictors and change in DOR, WSAS, and EDE global scores from baseline to (i) post-treatment, (ii) 6-month follow-up, (iii) and 12-month follow-up as dependent variables (predictive validity and sensitivity).
RESULTS
The EDQOL displayed stronger internal consistency (α = 0.92) than the SF-12 (α = 0.80). The SF-12 converged more strongly with DOR and the WSAS (r(p) = -0.31 to -0.63 vs. 0.06 to 0.70), while the EDQOL converged more strongly with the EDE (r(p) = -0.01 to 0.48 vs. -0.01 to -0.37). The SF-12 demonstrated stronger predictive validity (β = -0.55 to 0.29) and sensitivity to changes in ED severity (β = -0.47 to 0.32).
CONCLUSIONS
The SF-12 is a valid and sensitive measure of HRQoL impairment in patients with AN. While the SF-12 may be preferred in research comparing EDs to other populations, and in research and practice as an indicator of functional impairment; the EDQOL may be preferred by clinicians and researchers interested in HRQoL impairment specifically associated with an ED and as an additional indicator of ED severity.
背景
有人批评通用的健康相关生活质量（HRQoL）衡量标准不能准确反映神经性厌食症（AN）的损害，这促使了疾病特异性衡量标准的发展。本研究旨在比较通用和疾病特异性 HRQoL 衡量标准的心理测量特性。
方法
63 名 AN 患者在基线、治疗后以及 6 个月和 12 个月随访时，完成了通用 HRQoL（SF-12）、疾病特异性 HRQoL（饮食失调生活质量问卷；EDQOL）、功能障碍（缺勤天数；DOR；工作和社会适应量表；WSAS）和饮食失调严重程度（饮食失调检查；EDE）的评估。对 SF-12 和 EDQOL 进行了 Cronbach's α 计算（内部一致性）。评估了 SF-12/EDQOL 评分与 DOR、WSAS 和 EDE 评分之间的相关性（收敛有效性）。使用 SF-12 和 EDQOL 评分作为预测变量，使用 DOR、WSAS 和 EDE 总分从基线到（i）治疗后、（ii）6 个月随访和（iii）12 个月随访的变化作为因变量，进行了三组三个多元线性回归（预测有效性和敏感性）。
结果
EDQOL 的内部一致性更强（α=0.92），而 SF-12 的内部一致性较弱（α=0.80）。SF-12 与 DOR 和 WSAS 的相关性更强（r(p)=-0.31 至-0.63 与 0.06 至 0.70），而 EDQOL 与 EDE 的相关性更强（r(p)=-0.01 至 0.48 与-0.01 至-0.37）。SF-12 表现出更强的预测有效性（β=-0.55 至 0.29）和对 ED 严重程度变化的敏感性（β=-0.47 至 0.32）。
结论
SF-12 是一种有效的、敏感的 AN 患者 HRQoL 受损衡量标准。虽然在比较 ED 与其他人群的研究中，以及作为功能障碍指标的研究和实践中，SF-12 可能更受欢迎；但对于关注特定于 ED 的 HRQoL 受损的临床医生和研究人员，以及作为 ED 严重程度的附加指标，EDQOL 可能更受欢迎。
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