Measuring health-related quality of life in patients with irritable bowel syndrome: Can less be more?
Measuring health-related quality of life in patients with irritable bowel syndrome: Can less be more?
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DOI：
10.1097/01.psy.0000204897.25745.7c
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发表时间：
2006-03-01
影响因子：
3.3
通讯作者：
Dorscheimer, K
中科院分区：
文献类型：
--
作者：
Lackner, JM;Gudleski, GD;Dorscheimer, K
目的：本研究评估了一个简短的，经过充分验证的通用健康相关生活质量（HRQOL）指标的能力，以表征肠易激综合征（IBS）患者的症状负担，参考美国社区生活的成年人的大型调查。研究方法：104例罗马II诊断的IBS患者在美国国立卫生研究院资助的临床试验的基线评估期间完成了疼痛、心理功能障碍（神经质、躯体化、痛苦、虐待）和HRQOL（SF-36、IBS-QOL、CDC HRQOL-4）的测量。四项CDC HRQOL-4评估了整体健康状况以及过去30天内因身体健康状况不佳、精神健康状况不佳和活动受限而导致的天数。结果：IBS患者平均15/30天，身体或心理健康状况较差。这些平均总体不健康天数超过了美国调查中患有关节炎、糖尿病、心脏病/中风、癌症和III级肥胖（体重指数>= 40 kg/m（2））的受访者的平均不健康天数。15%的患者认为肌肉骨骼疾病而不是IBS症状是他们活动受限的主要原因。IBS患者的总体不健康天数与IBS症状严重程度、虐待、疼痛和心理困扰直接相关。控制影响感知和报告HRQOL的个性变量并没有减少CDC HRQOL-4和其他研究指标之间的关联的统计学意义。结论：CDC HRQOL-4是一种心理测量学上合理、快速和有效的工具，其HRQOL特征反映了中度至重度IBS的症状负担，对认知行为治疗相关的治疗效果敏感，并且不是被确定为HRQOL潜在混杂因素的人格变量的代表。HRQOL与心理困扰相关，但不是多余的。
Objective: This study assessed the ability of a brief, well-validated generic health-related quality of life (HRQOL) measure to characterize the symptom burden of patients with irritable bowel syndrome (IBS) with reference to a large survey of U.S. community-living adults. Methods: One hundred four Rome II diagnosed patients with IBS completed measures of pain, psychological dysfunction (neuroticism, somatization, distress, abuse), and HRQOL (SF-36, IBS-QOL, CDC HRQOL-4) during baseline assessment of a National Institutes of Health-funded clinical trial. The four-item CDC HRQOL-4 assesses global health and the number of days in the past 30 days resulting from poor physical health, poor mental health, and activity limitation. Results: Patients with IBS averaged 15 of 30 days with poor physical or mental health. These average overall unhealthy days exceeded those of respondents with arthritis, diabetes, heart disease/stroke, cancer, and class III obesity (body mass index >= 40 kg/m(2)) from the U.S. survey. Fifteen percent of patients identified musculoskeletal disorders, not IBS symptoms, as the major cause of their activity limitation. Overall unhealthy days among patients with IBS varied directly with IBS symptom severity, abuse, pain, and psychological distress. Controlling for personality variables that influence perception and reporting HRQOL did not diminish the statistical significance of associations between the CDC HRQOL-4 and other study measures. Conclusions: The CDC HRQOL-4 is a psychometrically sound, rapid, and efficient instrument whose HRQOL profile reflects the symptom burden of moderate-to-severe IBS, is sensitive to treatment effects associated with cognitive behavior therapy, and is not a proxy for personality variables identified as potential confounders of HRQOL. HRQOL is related to but not redundant with psychological distress.