Hwang Hei-Fen, Chen Chih-Yi, Lin Mau-Roung
Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan; Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan.
Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan.
Arch Phys Med Rehabil. 2017 Dec;98(12):2540-2547. doi: 10.1016/j.apmr.2017.05.013. Epub 2017 Jun 16.
To examine the level of agreement between patients and their proxies on a measure of health-related quality of life (HRQL) 1 year after traumatic brain injury (TBI).
A cross-sectional study.
Four hospitals in Taipei.
Participants (N=176) were patients with TBI (n=88) identified from discharge records of 4 hospitals in Taiwan and family members or friends (n=88) who could answer questions regarding the patient's health and HRQL 1 year after the injury.
Not applicable.
A health profile of the brief Taiwanese version of the World Health Organization Quality of Life (WHOQOL-BREF) and 2 health utility measures of the time tradeoff (TTO) and standard gamble (SG).
Compared with proxy responses, patients provided higher ratings on the domains of the WHOQOL-BREF and lower ratings on the TTO and SG. Intraclass correlation coefficients between patient and proxy ratings varied among the 4 domains of the WHOQOL-BREF, in which levels of agreement were moderate or good for physical capacity (.69) and low for psychological well-being (.45), social relationships (.24), and the environment (.32). Levels of agreement were extremely low for the TTO (0.0) and SG (.10). A profile analysis showed that patients' ratings on the WHOQOL-BREF, on average, were significantly greater than those of their proxies (mean difference, 3.07), with a similar distribution of scatter responses (mean difference, .002) and shape agreement (mean difference, .57). Greater variations in the patient-proxy level of agreement appeared in patients who were younger and had more severe injuries, and also with parent and child proxies.
To assess the HRQL of patients with a TBI, the level of patient-proxy agreement was adequate for the physical domain but was lower for the social and environmental domains, and the agreement was very low for the TTO and SG. Furthermore, a patient's age and injury severity, and the patient-proxy' relationship may affect the agreement.
研究创伤性脑损伤（TBI）1年后患者与其代理人在健康相关生活质量（HRQL）测量方面的一致性水平。
横断面研究。
台北的四家医院。
参与者（N = 176）包括从台湾四家医院出院记录中确定患有TBI的患者（n = 88）以及能够回答有关患者受伤1年后健康状况和HRQL问题的家庭成员或朋友（n = 88）。
不适用。
台湾版世界卫生组织生活质量简表（WHOQOL - BREF）的健康概况以及时间权衡法（TTO）和标准博弈法（SG）这两种健康效用测量方法。
与代理人的回答相比，患者对WHOQOL - BREF各领域的评分更高，而对TTO和SG的评分更低。患者与代理人评分之间的组内相关系数在WHOQOL - BREF的4个领域中各不相同，其中身体功能领域的一致性水平为中等或良好（.69），而心理健康（.45）、社会关系（.24）和环境（.32）领域的一致性水平较低。TTO（0.0）和SG（.10）的一致性水平极低。轮廓分析表明，患者对WHOQOL - BREF的评分平均显著高于其代理人（平均差异为3.07），散射反应分布相似（平均差异为.002）且形状一致性良好（平均差异为.57）。患者与代理人一致性水平的差异在年龄较小、损伤较严重的患者以及父母和子女作为代理人的情况中更为明显。
评估TBI患者的HRQL时，患者与代理人在身体领域的一致性水平足够，但在社会和环境领域较低，而在TTO和SG方面的一致性非常低。此外，患者的年龄、损伤严重程度以及患者与代理人的关系可能会影响一致性。
