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伤口-QoL问卷对慢性伤口健康相关生活质量评估的有效性和可行性

Validity and feasibility of the wound-QoL questionnaire on health-related quality of life in chronic wounds.

作者信息

Augustin Matthias, Conde Montero Elena, Zander Nicole, Baade Katrin, Herberger Katharina, Debus E Sebastian, Diener Holger, Neubert Thomas, Blome Christine

机构信息

German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.

Department of Vascular Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.

出版信息

Wound Repair Regen. 2017 Sep;25(5):852-857. doi: 10.1111/wrr.12583. Epub 2017 Nov 2.

Abstract

Chronic wounds have a major socioeconomic impact due to their frequency, chronicity, and societal costs. Patients experience substantial quality of life (QoL) impairments. The use of questionnaires for a continuous assessment of QoL and resulting interventions to improve the situation of the individual are an important cornerstone of a guideline-based wound care. The aim of this study was to investigate the validity of the Wound-QoL questionnaire. Patients with chronic wounds from two different centers were included in the prospective study. All patients completed the Wound-QoL and two other QoL questionnaires (European Quality of Life-5 Dimensions, EQ-5D, and Freiburg Life Quality Assessment for wounds, FLQA-wk) at baseline and at two more time points (4 and 8 weeks, respectively). Wound status was defined with an anchor question. Two hundred and twenty-seven patients (48.5% women) participated in the study. Mean age was 66.9 years (range 17-96, median 69.5). Indications were venous leg ulcers (40.1%), pyoderma gangraenosum (14.1%), diabetic or ischemic foot ulcers (5.3%), pressure ulcers (2.6%), and other etiologies (30.0%). The Wound-QoL showed good internal consistency, with high Cronbach's alpha in all the subscales and in the global scale in all time points (>0.8). Convergent validity was satisfactory since there were significantly (p ≤ 0.001) good correlations with the EQ-5D (range = 0.5-0.7) and FLQA-wk global score (r > 0.8) at every time point. Responsiveness was high, too. The Wound-QoL is a simple, valid tool for the longitudinal assessment of QoL in patients with chronic wounds. This questionnaire is suitable for use in clinical trials, quality of care studies and clinical routine.

摘要

慢性伤口因其发生率、慢性病程及社会成本而具有重大的社会经济影响。患者的生活质量(QoL)受到严重损害。使用问卷对生活质量进行持续评估并采取相应干预措施以改善个体状况,是基于指南的伤口护理的重要基石。本研究的目的是调查伤口生活质量问卷(Wound-QoL)的有效性。来自两个不同中心的慢性伤口患者被纳入这项前瞻性研究。所有患者在基线以及另外两个时间点(分别为4周和8周)完成了伤口生活质量问卷以及另外两份生活质量问卷(欧洲五维健康量表,EQ-5D,以及弗赖堡伤口生活质量评估量表,FLQA-wk)。通过一个锚定问题来定义伤口状况。227名患者(48.5%为女性)参与了研究。平均年龄为66.9岁(范围17 - 96岁,中位数69.5岁)。病因包括下肢静脉溃疡(40.1%)、坏疽性脓皮病(14.1%)、糖尿病或缺血性足部溃疡(5.3%)、压疮(2.6%)以及其他病因(30.0%)。伤口生活质量问卷显示出良好的内部一致性,在所有时间点的所有子量表及总量表中,克朗巴哈系数均较高(>0.8)。由于在每个时间点与EQ-5D(范围 = 0.5 - 0.7)和FLQA-wk总量表得分(r > 0.8)均存在显著(p≤0.001)的良好相关性,所以收敛效度令人满意。反应度也很高。伤口生活质量问卷是用于纵向评估慢性伤口患者生活质量的一种简单、有效的工具。该问卷适用于临床试验、护理质量研究及临床常规应用。

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