Quality of life related to fear of falling and hip fracture in older women: a time trade off study
Quality of life related to fear of falling and hip fracture in older women: a time trade off study
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DOI：
10.1136/bmj.320.7231.341
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发表时间：
2000-02-05
影响因子：
105.7
通讯作者：
Quine, S
中科院分区：
文献类型：
--
作者：
Salkeld, G;Cameron, ID;Quine, S
目的评估老年女性髋部骨折和害怕跌倒的效用(对健康的偏好)。这项技术通过找出受访者在较长但较低的生活质量和较短的完全健康时间之间没有表现出偏好的时间点，得出对健康状况的估计。为有髋部骨折风险的老年女性设置了一项外部髋关节保护器的随机试验。参与者194名年龄大于或等于75岁的妇女参加了随机对照试验，或者有资格参加试验但拒绝面对面完成生活质量调查的妇女。结果测量要求受访者通过使用EuroQol工具对自己的健康进行评估，然后对三种健康状态(害怕摔倒，髋部骨折很好，结果在0(死亡)和1(完全健康)之间的范围内，“严重的”髋部骨折(导致入住养老院)被评为0.05；“良好”髋部骨折(保持独立生活在社区)为0.31，跌倒恐惧为0.67。在接受调查的女性中，80%的人宁愿死(效用=0)，也不愿经历因髋关节不良：骨折和随后进入疗养院而失去独立性和生活质量。试验组和拒服用者之间的平均效用权重差异不显著。一项对36名女性进行的重测研究发现，结果是可靠的，相关系数在0.61到0.88之间。结论在超过平均预期寿命的老年女性中，跌倒和髋部骨折严重威胁着生活质量。年龄较大的预兆对他们的健康有很高的边际价值。任何丧失在社区中独立生活的能力都会对他们的生活质量产生可考虑的有害影响。
Objective To estimate the utility (preference for health) associated with hip facture and fear of falling among older women.Design Quality of life survey with the time trade off technique. The technique derives an estimate of preference for health stales by finding the point at which respondents show no preference between a longer but lower quality of life and a shorter time in full health.Setting A randomised trial of external hip protectors for older women at risk of hip fracture.Participants 194 women aged greater than or equal to 75 years enrolled in the randomised controlled trial or who were eligible for the trial but refused completed a quality of life inter view face to face.Outcome measures Respondents were asked to rate their own health by using the Euroqol instrument and then rate three health states (fear of falling, a "good" hip fracture, and a "bad" hip fracture) by using time trade off technique.Results On an interval scale between 0 (death) and 1 (full health), a "bad" hip fracture (which results in admission to a nursing home) was valued at 0.05; a "good" hip fracture (maintaining independent living-in the community) 0.31, and fear of falling 0.67. Of women surveyed, 80% would rather be dead (utility = 0) than experience the loss of independence and quality of life that results from a:bad hip:fracture and subsequent admission to a nursing home. The differences in mean utility weights between the trial groups and the refusers were not significant. A test-retest study on 36 women found that the results were reliable with correlation coefficients within classes ranging from 0.61 to 0.88.Conclusions Among older women who have exceeded average life expectancy, quality of life is profoundly threatened by falls and hip fractures. Older x-omen place a very high marginal value on their health. Any loss of ability to live independently in the community has a consider-able detrimental effect on-their quality of life.