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从左心室功能障碍研究(SOLVD)试验生活质量子研究的基线数据观察生活质量评估。

Assessment of quality of life as observed from the baseline data of the Studies of Left Ventricular Dysfunction (SOLVD) trial quality-of-life substudy.

作者信息

Gorkin L, Norvell N K, Rosen R C, Charles E, Shumaker S A, McIntyre K M, Capone R J, Kostis J, Niaura R, Woods P

机构信息

Institute for Behavioral Medicine, Providence, Rhode Island 02920.

出版信息

Am J Cardiol. 1993 May 1;71(12):1069-73. doi: 10.1016/0002-9149(93)90575-w.

Abstract

The improvement of aspects of a patient's quality of life may be as important as prolonging survival in evaluating clinical trials of heart failure. The purpose of this study was to analyze the psychometric properties of the baseline measures from the quality-of-life substudy from the Studies of Left Ventricular Dysfunction (SOLVD) trial. The measures included the 6-Minute Walk Test, Dyspnea Scale, Living with Heart Failure, Physical Limitations, Psychologic Distress and Health Perceptions, as reported by both patients and staff. Cognitive functioning, such as Vocabulary, Digit Span and Trails Making, was also assessed. Patients were classified as New York Heart Association class I (n = 158) versus II or III (n = 150). The internal consistencies (i.e., reliabilities) of the self-report measures were high, except for the Health Perceptions of Class II or III patients. Reliability of the SOLVD quality-of-life battery was confirmed by significantly better life quality among New York Heart Association class I patients versus class II or III patients combined on the Walk Test, Physical Limitations, Dyspnea, Living with Heart Failure, Psychologic Distress and staff perceptions of patient health. In accordance with prior studies, the measures were uncorrelated with left ventricular ejection fraction. By demonstrating strong internal consistencies, reliability based on physician reports, and independence of ejection fraction levels, use of this quality-of-life assessment battery in this and other clinical trials of compromised ventricular functioning is supported.

摘要

在评估心力衰竭的临床试验中,改善患者生活质量的各个方面可能与延长生存期同样重要。本研究的目的是分析左心室功能障碍研究(SOLVD)试验中生活质量子研究的基线测量指标的心理测量特性。这些测量指标包括患者和工作人员报告的6分钟步行试验、呼吸困难量表、心力衰竭生活状况、身体限制、心理困扰和健康认知。还评估了认知功能,如词汇、数字广度和连线测验。患者被分为纽约心脏协会I级(n = 158)和II或III级(n = 150)。自我报告测量指标的内部一致性(即信度)较高,但II或III级患者的健康认知除外。在步行试验、身体限制、呼吸困难、心力衰竭生活状况、心理困扰以及工作人员对患者健康的认知方面,纽约心脏协会I级患者的生活质量明显优于II或III级患者合并组,这证实了SOLVD生活质量测评组合的信度。与先前的研究一致,这些测量指标与左心室射血分数无关。通过证明其强大的内部一致性、基于医生报告的信度以及与射血分数水平的独立性,支持在本研究以及其他心室功能受损的临床试验中使用这种生活质量评估组合。

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