Gift H C, Atchison K A
National Institute of Dental Research, National Institutes of Health, Bethesda, MD 20892-6401, USA.
Med Care. 1995 Nov;33(11 Suppl):NS57-77. doi: 10.1097/00005650-199511001-00008.
Health-related quality of life is a multidimensional concept with five broad domains: opportunity/resilience, health perception, functional states, impairments/diseases, and duration of life. It addresses the tradeoff between how long and how well people live. The health-related quality of life approach has provided greater opportunity for investigation of the interrelations among oral health, health, and related outcomes. The inclusion of patient-driven measures, such as perceptions and functional status, is critical. Oral health-related quality of life measures are being developed and used in research on aging populations. Clinical measures of oral health, perceptions of general and oral well-being, and reported physical, social, and psychological functioning are independent, but correlated, components of overall oral health-related quality of life. An oral health-related quality of life approach benefits 1) clinical practitioners in selecting treatments and monitoring patient outcomes; 2) researchers in identifying determinants of health, tracking levels of health risk factors, and determining use of services in populations; and 3) policy-makers establishing program and institutional priorities, policies, and funding decisions. This overview indicates substantial value in pursuing several recommendations. A theoretical framework from which concepts, measures, and models can be derived must be developed to address oral health, oral health-related quality of life, health, and health-related quality of life. Oral health outcomes or states must be identified and classified along some continuum of impairment, function, disability, and opportunity. Indicators of appropriate concepts and domains must be adapted or established. Extended analyses on the relations among oral health, oral health-related quality of life, health, and health-related quality of life should be conducted with use of the Boston VA Normative Aging Study and other appropriate data sets.
与健康相关的生活质量是一个多维度概念，包含五个广泛领域：机会/恢复力、健康认知、功能状态、损伤/疾病以及生命时长。它涉及人们在寿命长短和生活质量之间的权衡。与健康相关的生活质量方法为研究口腔健康、健康及相关结果之间的相互关系提供了更多机会。纳入患者驱动的指标，如认知和功能状态，至关重要。与口腔健康相关的生活质量指标正在老年人群体研究中得到开发和应用。口腔健康的临床指标、对总体健康和口腔健康的认知，以及报告的身体、社会和心理功能，是与口腔健康相关的总体生活质量中相互独立但又相互关联的组成部分。与口腔健康相关的生活质量方法有益于：1）临床医生选择治疗方法并监测患者治疗结果；2）研究人员确定健康的决定因素、追踪健康风险因素水平以及确定人群中的服务使用情况；3）政策制定者确定项目和机构的优先事项、政策及资金决策。本综述表明，采纳若干建议具有重大价值。必须构建一个理论框架，从中衍生出概念、指标和模型，以解决口腔健康、与口腔健康相关的生活质量、健康以及与健康相关的生活质量等问题。必须沿着损伤、功能、残疾和机会的某种连续统一体来识别和分类口腔健康结果或状态。必须调整或确立适当概念和领域的指标。应利用波士顿退伍军人事务部标准老龄化研究及其他合适数据集，对口腔健康、与口腔健康相关的生活质量、健康以及与健康相关的生活质量之间的关系进行深入分析。
