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严重精神障碍患者的生活质量判断:患者自我报告与医护人员观点对比

Judgments of quality of life of individuals with severe mental disorders: Patient self-report versus provider perspectives.

作者信息

Sainfort F, Becker M, Diamond R

机构信息

Center for Health Systems Research and Analysis, School of Medicine, University of Wisconsin, Madison, USA.

出版信息

Am J Psychiatry. 1996 Apr;153(4):497-502. doi: 10.1176/ajp.153.4.497.

Abstract

OBJECTIVE

This study was an investigation of judgments regarding quality of life of individuals with severe mental disorders from two different perspectives: patient self-report versus provider.

METHOD

Judgments on several dimensions of quality of life were collected from a convenience sample of 37 schizophrenic patients and their primary clinicians by using the well-known Quality of Life Index of Spitzer et al. and the more recently developed Quality of Life Index-Mental Health. Both indexes capture judgments on a number of dimensions. Patterns of concordance for the patient-provider pairs were tested by using Cohen's kappa and Pearson correlation coefficients.

RESULTS

The results suggest that patients' and providers' judgments are more likely to coincide on clinical aspects, such as symptoms and function, than on social aspects. Specifically, there was moderate agreement on symptoms and function, less agreement on physical health, and little to no agreement on social relations and occupational aspects of quality of life.

CONCLUSIONS

Such differences support the notion that treatment strategies and mental health services should address a wide range of needs reflecting different aspects of quality of life perceived as important by different patients.

摘要

目的

本研究从两个不同视角对严重精神障碍患者的生活质量判断进行调查:患者自我报告与医护人员报告。

方法

采用斯皮策等人著名的生活质量指数以及最近编制的心理健康生活质量指数,从37名精神分裂症患者及其主治医护人员的便利样本中收集关于生活质量多个维度的判断。两个指数均涵盖对多个维度的判断。使用科恩kappa系数和皮尔逊相关系数检验患者 - 医护人员配对的一致性模式。

结果

结果表明,患者和医护人员在临床方面(如症状和功能)的判断比在社会方面更有可能一致。具体而言,在症状和功能方面存在中度一致性,在身体健康方面一致性较低,在生活质量的社会关系和职业方面几乎没有或完全没有一致性。

结论

此类差异支持以下观点,即治疗策略和心理健康服务应满足广泛的需求,这些需求反映了不同患者认为重要的生活质量的不同方面。

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