Hillers T K, Guyatt G H, Oldridge N, Crowe J, Willan A, Griffith L, Feeny D
Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
J Clin Epidemiol. 1994 Nov;47(11):1287-96. doi: 10.1016/0895-4356(94)90134-1.
The objective of this work was to develop and test a questionnaire to measure health-related quality of life for patients after myocardial infarction (MI). In a cross-sectional survey, 63 patients identified the most frequent and important problems following acute myocardial infarction. The Quality of Life after Myocardial Infarction (QLMI) instrument was developed on the basis of these most frequent and important problems. The QLMI was administered, along with instruments measuring health utilities, social function, and emotional function, in a randomized trial of rehabilitation versus conventional care. The most frequent and important problems fell into areas of symptoms, restriction, confidence, self-esteem, and emotions, each of which is represented in the 26-item QLMI. Effect sizes of the overall QLMI in differentiating between rehabilitation and control groups (0.35), and in detecting improvement over 12 months (1.22) were comparable or larger than any other instrument. The Pearson's correlation coefficient between QLMI administered at 8 and 12 months following AMI varied between 0.75 and 0.87 for the five domains and the overall score. We found substantial correlations of the QLMI with other measures with moderate concordance with predictions about how the instrument should behave if it is a valid measure of health-related quality of life. The QLMI demonstrates a high degree of reliability, and is more responsive than other questionnaires. Relations between the QLMI and other measures provide moderate to strong evidence of its validity in discriminating between patients following AMI according to their health-related quality of life, and in measuring changes in health-related quality of life over time.
这项工作的目的是开发并测试一份问卷，以测量心肌梗死（MI）患者的健康相关生活质量。在一项横断面调查中，63名患者确定了急性心肌梗死后最常见和最重要的问题。基于这些最常见和最重要的问题，开发了心肌梗死后生活质量（QLMI）工具。在一项康复治疗与传统护理的随机试验中，对QLMI以及测量健康效用、社会功能和情感功能的工具进行了应用。最常见和最重要的问题分为症状、限制、信心、自尊和情绪等方面，26项的QLMI中每项都有体现。QLMI在区分康复组和对照组方面的总体效应量（0.35），以及在检测12个月内的改善情况方面的效应量（1.22），与任何其他工具相当或更大。急性心肌梗死后8个月和12个月时进行的QLMI之间，五个领域和总分的皮尔逊相关系数在0.75至0.87之间。我们发现QLMI与其他测量方法有显著相关性，与关于该工具如果是健康相关生活质量的有效测量方法应如何表现的预测有适度一致性。QLMI显示出高度的可靠性，并且比其他问卷更具反应性。QLMI与其他测量方法之间的关系为其在根据健康相关生活质量区分急性心肌梗死后患者以及测量健康相关生活质量随时间的变化方面的有效性提供了中等至有力的证据。
