Lin Gong-Hong, Huang Yi-Jing, Huang Chien-Yu, Lu Wen-Shian, Chen Sheng-Shiung, Hou Wen-Hsuan, Hsieh Ching-Lin
School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
School of Occupational Therapy, Chung Shan Medical University, and Occupational Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan.
Qual Life Res. 2016 Sep;25(9):2283-93. doi: 10.1007/s11136-016-1274-x. Epub 2016 Mar 26.
Traumatic limb injury (TLI) can have a negative impact on a patient's quality of life (QOL), and the patient's QOL may fluctuate over time. However, the longitudinal change patterns of QOL in patients with TLI are largely unknown. The aim of this study was to investigate the QOL trajectories in patients with TLI in 4 QOL domains: physical capacity, psychological well-being, social relationships, and environment.
The patients' QOL was assessed within 14 days and at 1, 3, 6, 12, and 24 months after injury. In each QOL domain, 4 latent growth curve models (LGMs, including non-growth, linear growth, quadratic growth, and cubic LGM) were adopted to examine the QOL trajectories across the 6 time points.
A total of 499 patients completed the 6 assessments. For all 4 QOL domains, the cubic LGM had the best model fitting (root-mean-square error of approximation < 0.01) revealing that the patients' 4 QOL domains changed with cubic trajectories: QOL improved in the first 6 months, deteriorated in the second 6 months, and improved smoothly at 12-24 months after injury.
This study found that the trajectories in the 4 QOL domains were cubic trajectories in patients with TLI. These findings indicate that clinicians should pay additional attention to improve the patients' QOL in the first 6 months after injury and to prevent or reduce QOL deterioration at 6-12 months.
创伤性肢体损伤(TLI)会对患者的生活质量(QOL)产生负面影响,且患者的生活质量可能随时间波动。然而,TLI患者生活质量的纵向变化模式在很大程度上尚不清楚。本研究的目的是调查TLI患者在4个生活质量领域的生活质量轨迹:身体能力、心理健康、社会关系和环境。
在受伤后14天内以及1、3、6、12和24个月对患者的生活质量进行评估。在每个生活质量领域,采用4种潜在增长曲线模型(LGMs,包括非增长、线性增长、二次增长和三次LGM)来检查6个时间点的生活质量轨迹。
共有499名患者完成了6次评估。对于所有4个生活质量领域,三次LGM具有最佳的模型拟合度(近似均方根误差<0.01),表明患者的4个生活质量领域呈三次轨迹变化:受伤后的前6个月生活质量改善,接下来的6个月恶化,在受伤后12 - 24个月平稳改善。
本研究发现,TLI患者4个生活质量领域的轨迹为三次轨迹。这些发现表明,临床医生应格外注意在受伤后的前6个月改善患者的生活质量,并在6 - 12个月预防或减少生活质量的恶化。