Department of Health Statistics,School of Public Health,Shanxi Medical University,Taiyuan,China.
Department of Mathematics,School of Basic Medical Sciences,Shanxi Medical University,Taiyuan,China.
Int Psychogeriatr. 2019 Jan;31(1):123-132. doi: 10.1017/S1041610218000595. Epub 2018 May 3.
ABSTRACTBackground:Our study aims to detect different types of response shifts (RS) and true changes of quality of life (QOL) measurement in patients with Alzheimer's disease (AD) using structural equation modeling (SEM) in domain level.
Patients with AD aged over 60 years old were collected from the Department of Neurology and Geriatrics in Taiyuan Central Hospital, China. The 12-item Short Form (SF-12) Health Survey was measured in 238 patients with AD prior to hospitalization and one month following discharge. RS was detected by SEM approach. The statistical process consisted of four steps and fitted four models. We interpreted changes of parameters in models to detect RS and to assess true change.
The results showed reprioritization of social functioning (SF) (χ2 = 4.13, p < 0.05), reconceptualization of role limitations due to emotional problems (RE) (χ2 = 17.03, p < 0.001), uniform recalibration of bodily pain (BP) (χ2 = 12.24, p < 0.001), and non-uniform recalibration of mental health (MH) (χ2 = 4.41, p < 0.05), respectively. The true changes of common factors were deteriorated in general physical health (PHYS) (-0.10, χ2 = 8.30, p < 0.005) and improved in general mental health (MENT) (+0.29, χ2 = 20.95, p < 0.001). The effect-sizes of RS were only small.
This study showed that patients with AD occurred three types of RS and true changes one month following discharge. RS had effects on the QOL of patients. Better understanding of potential changes in QOL in patients with AD is crucial.
摘要
本研究旨在通过结构方程模型（SEM）在领域层面检测阿尔茨海默病（AD）患者的不同类型的反应转移（RS）和生活质量（QOL）测量的真实变化。
从中国太原市中心医院神经内科和老年科收集了 238 名年龄在 60 岁以上的 AD 患者。在入院前和出院后一个月，使用 12 项简明健康调查（SF-12）进行测量。通过 SEM 方法检测 RS。统计过程包括四个步骤和拟合四个模型。我们通过模型中的参数变化来解释 RS 的变化并评估真实变化。
结果表明，社会功能（SF）的重新排序（χ2=4.13，p < 0.05），情感问题所致角色限制的重新概念化（RE）（χ2=17.03，p < 0.001），身体疼痛的统一重新校准（BP）（χ2=12.24，p < 0.001）和心理健康的非统一重新校准（MH）（χ2=4.41，p < 0.05）。一般健康状况（PHYS）恶化（-0.10，χ2=8.30，p < 0.005），一般心理健康状况（MENT）改善（+0.29，χ2=20.95，p < 0.001），共同因素的真实变化。 RS 的效应大小仅为小。
本研究表明，AD 患者在出院后一个月发生了三种类型的 RS 和一种真实变化。 RS 对患者的 QOL 有影响。更好地理解 AD 患者 QOL 中潜在的变化至关重要。
