Pyykkő Ilmari, Manchaiah Vinaya, Levo Hilla, Kentala Erna
Department of Otolaryngology, University of Tampere, Tampere, Finland.
Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX USA ; Department of Behavioural Sciences and Learning, The Swedish Institute for Disability Research, Linköping University, Linköping, Sweden ; Audiology India, Mysore, Karnataka India.
Springerplus. 2015 Nov 24;4:717. doi: 10.1186/s40064-015-1527-0. eCollection 2015.
The study was aimed at evaluating the validity of impact measures among patients with Ménière's disease (MD) with outcome variables of EuroQol generic health-related quality of life (HRQoL) measures (i.e., EQ-5D) by using Visual Analogue Scale (VAS) and EQ-5D index values. 183 members (out of 200 contacted) of the Finish Ménière Association returned the questionnaires that they had filled out. Various open-ended and structured questionnaires focusing on diagnostic aspects of symptoms and impairment caused by the disease were used. For activity limitation and participation restriction, standardized questionnaires were used. Open-ended questions on impact of the disease were asked, and subsequently classified based on the WHO-ICF classification. The general HRQoL was evaluated with EQ-5D index value and EQ VAS instruments. Correlation and linear regression analyses were used to explore the association between HRQoL and other aspects. Based on the explanatory power of different models the disease specific semeionic model provides the most accurate prediction in EQ-5D index calculations (38 % of the variance explained). In EQ VAS scores, HRQoL is most accurately determined by participation restriction (53 % of the variance explained), but the worst prediction was in ICF-based limitations (8 % of the variance explained). Interestingly, attitude and personal trait explained the reduction of HRQoL somewhat better than ICF-based variables. Activity limitation and participation restrictions are significant components of MD, but are less frequently recognized as significant factors in self-evaluating the effect of MD on the quality of life. The current study results suggest that MD patients seem to have problem identifying factors causing activity limitation and participation restrictions and hence use the semiotic description focusing on complaints.
该研究旨在通过视觉模拟量表（VAS）和欧洲五维度健康量表（EQ-5D）指数值，评估梅尼埃病（MD）患者中影响测量的有效性，其结果变量为欧洲五维度健康量表通用健康相关生活质量（HRQoL）测量指标（即EQ-5D）。芬兰梅尼埃病协会200名被联系成员中的183名返回了他们填写的问卷。使用了各种侧重于疾病引起的症状和损伤诊断方面的开放式和结构化问卷。对于活动受限和参与限制，使用了标准化问卷。询问了关于疾病影响的开放式问题，并随后根据世界卫生组织国际功能、残疾和健康分类（WHO-ICF）进行分类。使用EQ-5D指数值和EQ VAS工具评估总体HRQoL。采用相关性和线性回归分析来探索HRQoL与其他方面之间的关联。基于不同模型的解释力，疾病特异性符号学模型在EQ-5D指数计算中提供了最准确的预测（解释了38%的方差）。在EQ VAS评分中，HRQoL最准确地由参与限制决定（解释了53%的方差），但基于ICF 的限制方面预测最差（解释了8%的方差）。有趣的是，态度和个人特质对HRQoL降低的解释比基于ICF的变量稍好。活动受限和参与限制是梅尼埃病的重要组成部分，但在自我评估梅尼埃病对生活质量的影响时，它们作为重要因素的认可度较低。当前研究结果表明，梅尼埃病患者似乎难以识别导致活动受限和参与限制的因素，因此使用侧重于症状的符号学描述。
