Dijkers M
Rehabilitation Institute of Michigan, Wayne State University, Detroit 48201, USA.
Spinal Cord. 1997 Dec;35(12):829-40. doi: 10.1038/sj.sc.3100571.
While objective measures of impairment, disability and handicap can serve as outcome measures for the providers of medical and vocational rehabilitation services, for persons with spinal cord injury (SCI) themselves the only relevant measure of quality of life (QOL) is their own judgment as to their well-being. Subjective QOL in persons with SCI has been measured as happiness, psychological well-being morale and life satisfaction. Various studies have reported inconclusive or contradictory findings, likely due to small sample size, sample composition, measures used and other methodological issues. A meta analysis was performed to try to resolve these apparent discrepancies. A total of 22 studies with an average sample size of 102, was retrieved. Information on the relationship between QOL and impairment, disability, and handicap, if provided, was abstracted. Findings include the following: persons with SCI tend to report lower subjective well-being than non-disabled people; the relationship between impairment and QOL is weak (mean correlation: -0.05: 95% confidence interval: -0.12 to 0.02), and generally not found to be statistically significant; the association between disability and QOL is somewhat stronger (mean r: -0.21; confidence interval: -0.27 to -0.14), but not found consistently; the relationship between QOL and (aspects of) handicap is strongest (range for mean r: -0.17 to -0.48), and fairly consistently found. The number of studies available is too small to make analysis of factors that explain contradictory findings possible. Further use of subjective QOL measures in research on long-term outcomes of SCI is recommended, in order to properly reflect the perspective of the patients/clients themselves.
虽然损伤、残疾和残障的客观测量可作为医疗和职业康复服务提供者的结果指标，但对于脊髓损伤（SCI）患者自身而言，生活质量（QOL）的唯一相关衡量标准是他们对自身幸福感的判断。脊髓损伤患者的主观生活质量已通过幸福感、心理健康、士气和生活满意度来衡量。各种研究报告的结果尚无定论或相互矛盾，这可能是由于样本量小、样本构成、所使用的测量方法及其他方法学问题所致。进行了一项荟萃分析以试图解决这些明显的差异。共检索到22项研究，平均样本量为102。提取了有关生活质量与损伤、残疾和残障之间关系的信息（若有提供）。研究结果如下：脊髓损伤患者往往报告主观幸福感低于非残疾人群；损伤与生活质量之间的关系较弱（平均相关性：-0.05；95%置信区间：-0.12至0.02），且一般未发现具有统计学意义；残疾与生活质量之间的关联稍强一些（平均r值：-0.21；置信区间：-0.27至-0.14），但并非始终如此；生活质量与残障（各方面）之间的关系最强（平均r值范围：-0.17至-0.48），且相当一致地被发现。现有研究数量过少，无法对解释矛盾结果的因素进行分析。建议在脊髓损伤长期预后研究中进一步使用主观生活质量测量方法，以便恰当地反映患者/服务对象自身的观点。
