Ruta D A, Garratt A M, Leng M, Russell I T, MacDonald L M
Department of Public Health, University of Aberdeen, Scotland.
Med Care. 1994 Nov;32(11):1109-26. doi: 10.1097/00005650-199411000-00004.
Quality of life has been defined as "the extent to which our hopes and ambitions are matched by experience." To improve a patient's quality of life through medical care would be to "narrow the gap between a patient's hopes and expectations and what actually happens." Using the above definition as a conceptual basis, we produced a self-administered, Patient-Generated Index (PGI) of quality of life. The PGI was completed by 359 patients presenting with low back pain. The validity of the measure was assessed by correlating patients' PGI scores with a well-validated health profile, the Short-Form 36-item Health Survey (SF-36), and with their scores on a clinical back pain questionnaire. Stepwise multiple regression was then used to model the relationship between the PGI score and the SF-36. Patients' PGI scores showed a high correlation with SF-36 scales measuring pain, social functioning, and role limitations attributable to physical problems, and with the clinical questionnaire. Together with whether a person was retired or not, these health variables were able to explain 25% of the variance in PGI scores. Patient generated index scores were significantly lower in patients referred to hospital compared with those managed solely in general practice and tended to reflect the general practitioner's assessment of symptom severity. We conclude that it is possible to construct a questionnaire that quantifies the effect of a medical condition on patients' quality of life in a way that has meaning and relevance in the context of their daily lives. The PGI has considerable potential for routine use in a wide range of clinical conditions for which the measurement of outcome has hitherto proved very difficult.
生活质量被定义为“我们的希望和抱负与实际经历相匹配的程度”。通过医疗护理来提高患者的生活质量，就是要“缩小患者的希望和期望与实际发生情况之间的差距”。以上述定义为概念基础，我们编制了一份患者自评的生活质量指数（PGI）。359名腰痛患者完成了PGI。通过将患者的PGI评分与经过充分验证的健康状况量表——36项简短健康调查问卷（SF - 36）以及他们在临床背痛问卷上的得分进行关联，来评估该测量方法的有效性。然后使用逐步多元回归来建立PGI评分与SF - 36之间的关系模型。患者的PGI评分与SF - 36中测量疼痛、社会功能以及因身体问题导致的角色限制的量表，以及临床问卷显示出高度相关性。连同一个人是否退休，这些健康变量能够解释PGI评分中25%的方差。与仅在全科医疗中接受治疗的患者相比，转诊至医院的患者的患者生成指数得分显著更低，并且往往反映了全科医生对症状严重程度的评估。我们得出结论，有可能构建一份问卷，以一种在患者日常生活背景中有意义且相关的方式，量化医疗状况对患者生活质量的影响。PGI在广泛的临床病症的常规使用中具有相当大的潜力，而迄今为止，这些病症的结果测量一直非常困难。
