Tate D G, Riley B B, Perna R, Roller S
Department of Physical Medicine and Rehabilitation, University of Michigan Medical Center, Ann Arbor 48109-0050, USA.
Arch Phys Med Rehabil. 1997 Dec;78(12 Suppl 5):S18-25. doi: 10.1016/s0003-9993(97)90217-3.
The purpose of this study was to assess quality of life (QOL) and life satisfaction among women with physical disabilities or breast cancer, and to identify factors predictive of QOL and life satisfaction for women and men. QOL and life satisfaction differences were examined between women and men with physical disabilities and cancer, and between women with traumatic and chronic physical conditions.
A cross-sectional design employing several QOL and life satisfaction measures was used.
Two hundred sixteen outpatient subjects (99 women, 117 men) with physical disabilities or cancer were studied.
The Health Status Questionnaire-Short-Form 36 (SF-36), Functional Assessment of Cancer Therapy (FACT), Functional Living Index-Cancer (FLIC), and the Satisfaction With Life Scale (SWLS).
Women with traumatic conditions (amputation, spinal cord injury) reported poorer physical functioning and well-being, whereas women in the chronic (postpolio, breast cancer) group reported poorer health status. No significant gender differences were found with respect to QOL or life satisfaction. Whereas functional and emotional well-being were the strongest predictors of overall QOL for both men and women, self-perceived general health significantly predicted QOL for women (p < .05) and social well-being significantly predicted QOL for men (p < .01). Among men, life satisfaction was best predicted by marital status (p < .05), general health (p < .05), and social well-being (p < .01). The resulting QOL models had adjusted R2 values of .77 and .76 for women and men, respectively. Among women with traumatic conditions, functional well-being best predicted QOL (p < .01). Life satisfaction for women with chronic conditions was best predicted by age, education, and spiritual well-being.
QOL as measured by the impact of illness on an individual is best predicted by physical and functional well-being. Satisfaction with one's life was best predicted by functional ability. Although functional and physical ability were the best predictors for both QOL and life satisfaction, social functioning made significant and substantive contributions to these constructs. Spinal cord injury had the most impact on physical functioning, whereas prostate cancer had the least. Psychosocial functioning was most affected by amputation and least affected by prostate cancer.
本研究旨在评估身体残疾或患乳腺癌女性的生活质量（QOL）和生活满意度，并确定预测女性和男性生活质量及生活满意度的因素。研究了身体残疾和患癌症的女性与男性之间，以及患有创伤性和慢性身体疾病的女性之间的生活质量和生活满意度差异。
采用横断面设计，运用多种生活质量和生活满意度测量方法。
对216名患有身体残疾或癌症的门诊受试者（99名女性，117名男性）进行了研究。
健康状况问卷简表36（SF - 36）、癌症治疗功能评估（FACT）、癌症功能生活指数（FLIC）以及生活满意度量表（SWLS）。
患有创伤性疾病（截肢、脊髓损伤）的女性身体功能和幸福感较差，而慢性疾病（小儿麻痹后遗症、乳腺癌）组的女性健康状况较差。在生活质量或生活满意度方面未发现显著的性别差异。功能和情感幸福感是男性和女性总体生活质量的最强预测因素，自我感知的总体健康状况对女性生活质量有显著预测作用（p < 0.05），社会幸福感对男性生活质量有显著预测作用（p < 0.01）。在男性中，婚姻状况（p < 0.05）、总体健康（p < 0.05）和社会幸福感（p < 0.01）对生活满意度的预测作用最佳。所得的生活质量模型中，女性和男性的调整后R²值分别为0.77和0.76。在患有创伤性疾病的女性中，功能幸福感对生活质量的预测作用最佳（p < 0.01）。患有慢性疾病的女性的生活满意度最佳预测因素是年龄、教育程度和精神幸福感。
以疾病对个体的影响来衡量，生活质量的最佳预测因素是身体和功能幸福感。生活满意度的最佳预测因素是功能能力。虽然功能和身体能力是生活质量和生活满意度的最佳预测因素，但社会功能对这些指标也有显著且实质性的贡献。脊髓损伤对身体功能的影响最大，而前列腺癌的影响最小。心理社会功能受截肢影响最大，受前列腺癌影响最小。
