Solomon G D
Department of General Internal Medicine, Cleveland Clinic Foundation, OH 44195-5039, USA.
Neurology. 1997 Mar;48(3 Suppl 3):S10-5. doi: 10.1212/wnl.48.3_suppl_3.10s.
Although headache is among the most common pain complaints seen by physicians, the measurement of health-related quality of life (HRQoL) in headache patients is in its earliest stages. Two types of questionnaire have been used to measure HRQoL in headache sufferers: general and disease-specific instruments. General quality-of-life (QoL) instruments use scales to assess QoL with respect to a number of activities within physical, social, psychological, and behavioral life domains. Disease-specific instruments reflect particular limitations or restrictions associated with specific disease states. These instruments are designed to be most sensitive in determining the effects of treatment or the longitudinal course of disease. Data from the Medical Outcomes Study Short Form (SF)-20 and SF-36 generic QoL instruments demonstrated that chronic headache disorders were associated with significant limitations in all eight health domains of patient wellbeing and functioning. The SF-20 outcomes profiles for each of the common benign headache disorders (migraine, tension-type headache, mixed headache, and cluster headache) appear to be unique for the specific headache diagnosis. The SF-20 and SF-36 were also used to compare headache disorders with other chronic illnesses. Chronic headache disorders, including migraine, were found to cause significantly more impairment of function than diabetes, hypertension, osteoarthritis, and low back pain. Preliminary studies of QoL during pharmacologic therapy have suggested that disease specific instruments may be more sensitive than generic instruments for evaluating the longitudinal impact of treatment. Generic QoL instruments, such as the SF-20 or SF-36, may be more useful to define populations being studied than to measure changes in the population over time. The publication of headache-specific QoL instruments, which have been widely used in clinical trials and have been validated, is awaited. Until such time, the SF-36 will remain the standard measure of QoL in headache.
尽管头痛是医生最常遇到的疼痛主诉之一，但对头痛患者健康相关生活质量（HRQoL）的测量尚处于初期阶段。有两种问卷被用于测量头痛患者的HRQoL：通用型和疾病特异性工具。通用生活质量（QoL）工具使用量表来评估在身体、社会、心理和行为生活领域内一系列活动方面的生活质量。疾病特异性工具反映与特定疾病状态相关的特定限制或约束。这些工具旨在最灵敏地确定治疗效果或疾病的纵向病程。医学结局研究简表（SF）-20和SF-36通用QoL工具的数据表明，慢性头痛疾病与患者健康和功能的所有八个健康领域的显著限制相关。每种常见的良性头痛疾病（偏头痛、紧张型头痛、混合型头痛和丛集性头痛）的SF-20结局概况对于特定的头痛诊断似乎都是独特的。SF-20和SF-36也被用于将头痛疾病与其他慢性疾病进行比较。发现包括偏头痛在内的慢性头痛疾病比糖尿病、高血压、骨关节炎和腰痛导致的功能损害明显更多。药物治疗期间生活质量的初步研究表明，疾病特异性工具在评估治疗的纵向影响方面可能比通用工具更灵敏。通用QoL工具，如SF-20或SF-36，在定义所研究的人群方面可能比测量人群随时间的变化更有用。人们期待着已在临床试验中广泛使用并经过验证的头痛特异性QoL工具的发表。在此之前，SF-36仍将是头痛患者生活质量的标准测量工具。
