Kutner N G
Department of Rehabilitation Medicine, School of Medicine, Emory University, Atlanta, GA 30322.
Am J Kidney Dis. 1994 Aug;24(2):321-33. doi: 10.1016/s0272-6386(12)80198-3.
Along with survival and other types of clinical outcome, the functioning and well-being that characterize end-stage renal disease patients are important indicators of the effectiveness of the medical care that they receive. In addition, maximizing functioning in chronically ill patients can be viewed as secondary prevention. Patient-reported functioning and well-being indicate how patients are doing in their daily lives and how they feel about their lives. Measurements used to assess patient functioning and well-being by health services researchers are applicable to health outcome assessment in the clinical setting. Disease- and treatment-specific outcome measurements are more sensitive to disease severity and treatment intervention effects, while generic outcome measurements provide generalizability across diseases or conditions. Specific measurements can provide data about clinically meaningful changes, and generic measurements help to indicate the significance of these outcomes in patients' daily lives. Using both types of patient-reported measurements, as well as performance-based assessments, will provide outcome-based data on end-stage renal disease patients' functional limitation and disability, and help to define relevant rehabilitation protocols for end-stage renal disease patients.
除了生存及其他类型的临床结局外，终末期肾病患者的功能状况和生活质量是其所接受医疗护理效果的重要指标。此外，使慢性病患者的功能最大化可被视为二级预防。患者报告的功能状况和生活质量表明了患者在日常生活中的表现以及他们对自己生活的感受。卫生服务研究人员用于评估患者功能状况和生活质量的测量方法适用于临床环境中的健康结局评估。针对疾病和治疗的特定结局测量对疾病严重程度和治疗干预效果更为敏感，而通用结局测量则可在不同疾病或状况中进行推广。特定测量可提供有关具有临床意义的变化的数据，通用测量则有助于表明这些结局在患者日常生活中的重要性。同时使用这两种患者报告的测量方法以及基于表现的评估，将提供有关终末期肾病患者功能受限和残疾的基于结局的数据，并有助于为终末期肾病患者制定相关的康复方案。
