Parkerson G R, Connis R T, Broadhead W E, Patrick D L, Taylor T R, Tse C K
Department of Community and Family Medicine, Duke University Medical Center, Durham, NC 27710.
Med Care. 1993 Jul;31(7):629-39. doi: 10.1097/00005650-199307000-00005.
The health-related quality of life of 170 adult insulin-dependent diabetic patients was measured cross-sectionally to compare a disease-specific instrument, Diabetes Quality of Life (DQOL) questionnaire, and two generic instruments, the Duke Health Profile (DUKE) and the General Health Perceptions Questionnaire (GHP). The generic measures provided as much or more information about health-related quality of life as the disease-specific instrument. This was demonstrated both by comparison of the DQOL with the DUKE and GHP and by comparison of the disease-specific with the generic components of a modified version of the DQOL. Patients with the diabetic complication of nephropathy had increased worry over their health and lower general health perceptions. Neither the duration of diabetes nor the intensity of insulin therapy, however, was found to have a statistically significant effect on any of the health-related quality of life scores. Nondiabetic factors, such as the comorbidity, nondiabetic medications, marital status, social relationships, and family arguments were found to be predictors of health-related quality of life more often than the diabetic factors duration of diabetes, complications, and intensity of insulin therapy. These analyses suggest the clinical value of using generic questionnaires to measure health-related quality of life and psychosocial factors to identify nondiabetic problems that might respond to intervention, thereby potentially enhancing the effect of diabetes-specific therapy.
对170名成年胰岛素依赖型糖尿病患者的健康相关生活质量进行了横断面测量，以比较一种疾病特异性工具——糖尿病生活质量（DQOL）问卷，以及两种通用工具——杜克健康状况量表（DUKE）和一般健康感知问卷（GHP）。通用测量工具提供了与疾病特异性工具一样多或更多的关于健康相关生活质量的信息。这一点通过将DQOL与DUKE和GHP进行比较，以及将DQOL修改版的疾病特异性部分与通用部分进行比较得到了证明。患有糖尿病肾病并发症的患者对自身健康的担忧增加，一般健康感知较低。然而，未发现糖尿病病程和胰岛素治疗强度对任何健康相关生活质量得分有统计学上的显著影响。与糖尿病因素（糖尿病病程、并发症和胰岛素治疗强度）相比，非糖尿病因素，如合并症、非糖尿病药物、婚姻状况、社会关系和家庭争吵，更常被发现是健康相关生活质量的预测因素。这些分析表明，使用通用问卷测量健康相关生活质量以及利用社会心理因素识别可能对干预有反应的非糖尿病问题具有临床价值，从而有可能增强糖尿病特异性治疗的效果。
