Higginson I J, McCarthy M
Health Services Research Unit, London School of Hygiene and Tropical Medicine, UK.
Palliat Med. 1994 Oct;8(4):282-90. doi: 10.1177/026921639400800403.
We compared two measures that have been used by professionals to assess the quality of life and care of patients with advanced cancer. The Support Team Assessment Schedule (STAS) is an instrument for palliative cancer support teams to record and evaluate their care; the Hebrew Rehabilitation Centre for the Aged Quality of Life (HRCA-QL) index was used in the National Hospice Study (USA) to assess patients with advanced cancer. STAS has 17 items, each scaled 0 (best) to 4 (worst), and HRCA-QL has five items scaled 0 (worst) to 2 (best). The STAS and the HRCA-QL were assessed contemporaneously by the members of one support team on 128 consecutive patients referred over 17 months. Seventy-four patients spent more than four weeks in care. Ratings for four out of five HRCA-QL items deteriorated significantly in the four to six weeks before death. HRCA-QL index items correlated with similar STAS items. Correlations were highest at referral, especially in patients seen more than four weeks before death (e.g. symptom control (STAS) with health (HRCA-QL) Spearman's rho = -0.64) and the HRCA-QL total was correlated with STAS subtotal of six items (rho = -0.45). There were few correlations at death. The findings support the validity of both measures for the aspects compared, but indicated that STAS was more sensitive to changes in patients in the last six weeks of life.
我们比较了专业人员用于评估晚期癌症患者生活质量和护理质量的两项指标。支持团队评估表（STAS）是一种供姑息性癌症支持团队记录和评估其护理情况的工具；美国国家临终关怀研究中使用希伯来老年康复中心生活质量（HRCA-QL）指数来评估晚期癌症患者。STAS有17个项目，每个项目的评分范围为0（最佳）至4（最差），HRCA-QL有5个项目，评分范围为0（最差）至2（最佳）。一个支持团队的成员在17个月内连续接诊的128例患者中同时对STAS和HRCA-QL进行了评估。74例患者接受护理的时间超过四周。在死亡前的四至六周内，HRCA-QL的五个项目中有四个的评分显著恶化。HRCA-QL指数项目与类似的STAS项目相关。在转诊时相关性最高，尤其是在死亡前四周以上就诊的患者中（例如，症状控制（STAS）与健康状况（HRCA-QL）的斯皮尔曼相关系数rho = -0.64），HRCA-QL总分与STAS六个项目的小计相关（rho = -0.45）。在死亡时相关性很少。研究结果支持这两项指标在所比较方面的有效性，但表明STAS对患者生命最后六周的变化更敏感。
