慢性乙型肝炎常見(jiàn)證型LDQOL1.0量表與SF-36量表生命質(zhì)量評(píng)價(jià)的比較研究
發(fā)布時(shí)間：2018-12-16 09:35
【摘要】：目的 對(duì)LDQOL1.0量表應(yīng)用于中國(guó)慢性乙型肝炎患者的信效度進(jìn)行檢驗(yàn),評(píng)價(jià)慢性乙型肝炎患者中醫(yī)主要證候的生存質(zhì)量。比較LDQOL1.0量表和SF-36量表對(duì)慢性乙型肝炎患者中醫(yī)證候生命質(zhì)量評(píng)價(jià)的異同,分析兩量表對(duì)慢性乙型肝炎中醫(yī)證候生命質(zhì)量評(píng)價(jià)的適用性和敏感性,為研制適用于慢性乙肝中醫(yī)證候生命質(zhì)量評(píng)價(jià)的量表奠定基礎(chǔ)。 方法 本研究采用橫斷面調(diào)查和隨機(jī)抽樣方法,運(yùn)用中文版肝病生命質(zhì)量量表(LDQOL1.0).健康調(diào)查簡(jiǎn)表(SF-36)調(diào)查2009年6月至2010年12月來(lái)自成都中醫(yī)藥大學(xué)附屬醫(yī)院、四川大學(xué)華西醫(yī)院、成都傳染病醫(yī)院等8家醫(yī)院的753名慢性乙型肝炎患者,收集包括社會(huì)人口學(xué)、中醫(yī)四診及實(shí)驗(yàn)室檢查等方面的疾病相關(guān)資料,通過(guò)專家判讀得出主要證型,運(yùn)用spssl9.0統(tǒng)計(jì)軟件對(duì)數(shù)據(jù)進(jìn)行處理,評(píng)價(jià)LDQOL1.0量表用于中國(guó)慢性乙型肝炎患者的信效度；通過(guò)t檢驗(yàn)、方差分析、多元回歸分析進(jìn)行統(tǒng)計(jì)推斷,探索慢性乙型肝炎常見(jiàn)證型的生存質(zhì)量影響因素,及兩量表間的區(qū)別與聯(lián)系。 結(jié)果 1.LDQOL1.0中文版的表面效度較為理想。整個(gè)量表的內(nèi)部一致性信度,Cronbach's a系數(shù)為0.908,各維度的Cronbach's a系數(shù)范圍是0.448-0.990,顯示較好的內(nèi)部一致性,測(cè)量信度較高。本研究運(yùn)用驗(yàn)證因子分析法,經(jīng)過(guò)方差最大正交旋轉(zhuǎn)因子分析提取出21個(gè)因子,能解釋總變異的70.65%,符合理論模型。內(nèi)容效度通過(guò)文獻(xiàn)整理完成,量表相關(guān)維度與慢性肝病的關(guān)系己在不同的研究中得到證實(shí)。 2.調(diào)查的6個(gè)影響因素中,年齡、HBV-DNA載量與集中力、疾病壓力、肝病相關(guān)癥狀呈負(fù)相關(guān)；年齡與肝病相關(guān)癥狀、性功能、記憶力呈負(fù)相關(guān)；CHB患者的病恥感、社交能力與性功能受婚姻狀況的影響最大。 3.脾氣虛證的患者生命質(zhì)量最高,肝膽濕熱證軀體功能質(zhì)量、生理職能質(zhì)量、心理健康質(zhì)量最差,其軀體疼痛感最強(qiáng),肝經(jīng)郁熱證總體健康質(zhì)量最差,肝胃郁熱證情感職能質(zhì)量最低。 4.SF-36量表在評(píng)估CHB患者各常見(jiàn)證型時(shí),其對(duì)生理健康的生命質(zhì)量評(píng)估更為敏感；LDQOL1.0量表在評(píng)估CHB患者常見(jiàn)證型時(shí),其對(duì)心理健康的生命質(zhì)量評(píng)估更為敏感。 結(jié)論 1.LDQOL1.0中文版信度效度較理想,適合評(píng)估中國(guó)CHB患者常見(jiàn)證型；LDQOL1.0作為專用量表與SF-36比較,評(píng)估CHB患者時(shí)具有一定的敏感性及特異性； 2.從兩種量表分析來(lái)看,脾氣虛患者主觀癥狀最輕,其生命質(zhì)量較好；證型中挾熱者主觀癥狀較重,其生命質(zhì)量較差； 3.對(duì)于CHB患者,除關(guān)注生理指標(biāo)外,應(yīng)更多的關(guān)注患者的心理、社會(huì)和經(jīng)濟(jì)問(wèn)題。醫(yī)護(hù)人員應(yīng)努力找出影響CHB患者生活質(zhì)量的相關(guān)因素,用實(shí)際行動(dòng)改善患者的生命質(zhì)量。 4.認(rèn)知行為療法及心理干預(yù)是治療CHB心理障礙的有效手段之一。
[Abstract]:Objective to test the reliability and validity of LDQOL1.0 scale in Chinese patients with chronic hepatitis B (CHB) and to evaluate the quality of life (QOL) of the main syndromes of TCM in patients with chronic hepatitis B (CHB). To compare the similarities and differences between LDQOL1.0 scale and SF-36 scale in evaluating the quality of life of TCM syndromes in patients with chronic hepatitis B, and to analyze the applicability and sensitivity of the two scales to the evaluation of quality of life of TCM syndromes of chronic hepatitis B. For the development of chronic hepatitis B syndrome quality of life evaluation scale for Chinese medicine to lay the foundation. Methods A cross-sectional survey and random sampling were used to evaluate the quality of life of liver diseases (LDQOL1.0). From June 2009 to December 2010, 753 patients with chronic hepatitis B came from the affiliated Hospital of Chengdu University of traditional Chinese Medicine, the West China Hospital of Sichuan University and the Chengdu Infectious Diseases Hospital. Collect relevant information on diseases, including social demography, four diagnoses of traditional Chinese medicine and laboratory examination, get the main syndromes through expert interpretation, and use spssl9.0 statistical software to process the data. To evaluate the reliability and validity of LDQOL1.0 scale in Chinese patients with chronic hepatitis B. By means of t test, variance analysis and multiple regression analysis, the factors affecting the quality of life of the common syndromes of chronic hepatitis B and the difference and relationship between the two scales were explored. Results the surface validity of the Chinese version of 1.LDQOL1.0 was satisfactory. The internal consistency reliability of the whole scale was 0.908, and the range of Cronbach's a coefficient of each dimension was 0.448-0.990, which showed better internal consistency and higher measurement reliability. In this study, the verification factor analysis was used to extract 21 factors through the maximum variance orthogonal rotation factor analysis, which can explain 70.65% of the total variation, which is in accordance with the theoretical model. Content validity was completed through literature review. The relationship between the scale dimension and chronic liver disease has been confirmed in different studies. 2. Age, HBV-DNA load were negatively correlated with concentration, disease stress, liver disease related symptoms, age had negative correlation with liver disease related symptoms, sexual function and memory. The stigma, social ability and sexual function of CHB patients are most affected by marital status. 3. The patients with spleen qi deficiency syndrome had the highest quality of life, the body function quality, physiological function quality and mental health quality of liver and gallbladder damp-heat syndrome were the worst, the somatic pain was the strongest, and the overall health quality of liver meridian stagnation heat syndrome was the worst. The quality of emotion function of liver and stomach stagnation heat syndrome was the lowest. The 4.SF-36 scale is more sensitive to the quality of life assessment of physical health when evaluating the common syndromes of CHB patients, and the LDQOL1.0 scale is more sensitive to the assessment of mental health quality of life in the evaluation of CHB patients' common witness type. Conclusion the reliability and validity of the Chinese version of 1.LDQOL1.0 is ideal, which is suitable for the evaluation of Chinese CHB patients with frequent witness type, LDQOL1.0 as a special scale compared with SF-36, the evaluation of CHB patients has a certain sensitivity and specificity. 2. From the analysis of the two scales, the subjective symptoms of spleen qi deficiency patients are the lightest, their quality of life is better, the subjective symptoms of heat carriers in the syndrome type are more serious, and the quality of life is poor. 3. For patients with CHB, more attention should be paid to their psychological, social and economic problems in addition to physiological indicators. Medical staff should try to find out the relevant factors that affect the quality of life of patients with CHB, and improve the quality of life with practical actions. 4. Cognitive behavioral therapy and psychological intervention are one of the effective methods for the treatment of CHB psychological disorders.
【學(xué)位授予單位】：成都中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類(lèi)號(hào)】：R512.62
本文編號(hào)：2382139
[Abstract]:Objective to test the reliability and validity of LDQOL1.0 scale in Chinese patients with chronic hepatitis B (CHB) and to evaluate the quality of life (QOL) of the main syndromes of TCM in patients with chronic hepatitis B (CHB). To compare the similarities and differences between LDQOL1.0 scale and SF-36 scale in evaluating the quality of life of TCM syndromes in patients with chronic hepatitis B, and to analyze the applicability and sensitivity of the two scales to the evaluation of quality of life of TCM syndromes of chronic hepatitis B. For the development of chronic hepatitis B syndrome quality of life evaluation scale for Chinese medicine to lay the foundation. Methods A cross-sectional survey and random sampling were used to evaluate the quality of life of liver diseases (LDQOL1.0). From June 2009 to December 2010, 753 patients with chronic hepatitis B came from the affiliated Hospital of Chengdu University of traditional Chinese Medicine, the West China Hospital of Sichuan University and the Chengdu Infectious Diseases Hospital. Collect relevant information on diseases, including social demography, four diagnoses of traditional Chinese medicine and laboratory examination, get the main syndromes through expert interpretation, and use spssl9.0 statistical software to process the data. To evaluate the reliability and validity of LDQOL1.0 scale in Chinese patients with chronic hepatitis B. By means of t test, variance analysis and multiple regression analysis, the factors affecting the quality of life of the common syndromes of chronic hepatitis B and the difference and relationship between the two scales were explored. Results the surface validity of the Chinese version of 1.LDQOL1.0 was satisfactory. The internal consistency reliability of the whole scale was 0.908, and the range of Cronbach's a coefficient of each dimension was 0.448-0.990, which showed better internal consistency and higher measurement reliability. In this study, the verification factor analysis was used to extract 21 factors through the maximum variance orthogonal rotation factor analysis, which can explain 70.65% of the total variation, which is in accordance with the theoretical model. Content validity was completed through literature review. The relationship between the scale dimension and chronic liver disease has been confirmed in different studies. 2. Age, HBV-DNA load were negatively correlated with concentration, disease stress, liver disease related symptoms, age had negative correlation with liver disease related symptoms, sexual function and memory. The stigma, social ability and sexual function of CHB patients are most affected by marital status. 3. The patients with spleen qi deficiency syndrome had the highest quality of life, the body function quality, physiological function quality and mental health quality of liver and gallbladder damp-heat syndrome were the worst, the somatic pain was the strongest, and the overall health quality of liver meridian stagnation heat syndrome was the worst. The quality of emotion function of liver and stomach stagnation heat syndrome was the lowest. The 4.SF-36 scale is more sensitive to the quality of life assessment of physical health when evaluating the common syndromes of CHB patients, and the LDQOL1.0 scale is more sensitive to the assessment of mental health quality of life in the evaluation of CHB patients' common witness type. Conclusion the reliability and validity of the Chinese version of 1.LDQOL1.0 is ideal, which is suitable for the evaluation of Chinese CHB patients with frequent witness type, LDQOL1.0 as a special scale compared with SF-36, the evaluation of CHB patients has a certain sensitivity and specificity. 2. From the analysis of the two scales, the subjective symptoms of spleen qi deficiency patients are the lightest, their quality of life is better, the subjective symptoms of heat carriers in the syndrome type are more serious, and the quality of life is poor. 3. For patients with CHB, more attention should be paid to their psychological, social and economic problems in addition to physiological indicators. Medical staff should try to find out the relevant factors that affect the quality of life of patients with CHB, and improve the quality of life with practical actions. 4. Cognitive behavioral therapy and psychological intervention are one of the effective methods for the treatment of CHB psychological disorders.
【學(xué)位授予單位】：成都中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類(lèi)號(hào)】：R512.62
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