本文選題：肺結(jié)核 + 生命質(zhì)量�。� 參考：《昆明醫(yī)科大學》2012年碩士論文

【摘要】：目的研制慢性病患者生命質(zhì)量測定量表體系之肺結(jié)核量表QLICD-PT,并對其進行考評；同時,應用QLICD-PT量表對肺結(jié)核患者的生命質(zhì)量及其影響因素進行初步分析并制定最小臨床顯著差異(MCID)。 方法慢性病患者生命質(zhì)量測定量表體系共性模塊QLICD-GM (Quality of Life Instruments for Chronic Disease-General module)已研制完成。依據(jù)共性模塊與特異模塊相結(jié)合的研究思想,在對文獻回顧的基礎上,結(jié)合我國文化特色,采用量表開發(fā)的程序化決策方式來研制量表QLICD-PT,并通過實測數(shù)據(jù)對量表進行效度、信度、反應度的考評。應用QLICD-PT量表分析肺結(jié)核患者生命質(zhì)量影響因素、分析肺結(jié)核患者家庭關懷指數(shù)及社會支持評分與生命質(zhì)量的關系、比較肺結(jié)核患者治療前、治療2個月末和完成療程時的生命質(zhì)量得分及制定QLICD-PT各領域最小臨床顯著差異(MCID)。整個研究過程中用到的統(tǒng)計學方法有統(tǒng)計描述、相關分析、配對t檢驗、因子分析、多重線性回歸方法分析等。 結(jié)果 1.研制出了由慢性病共性模塊QLICD-GM(29個條目)和肺結(jié)核特異模塊(12個條目)構(gòu)成的肺結(jié)核患者生命質(zhì)量量表QLICD-PT。 2.對肺結(jié)核患者生命質(zhì)量量表QLICD-PT進行考評①信度考評：QLICD-PT量表各領域克朗巴哈α系數(shù)均大于0.7；各領域分半信度均大于0.6,總量表的分半信度為0.82,可以認為QLICD-PT量表信度較好。②效度考評：肺結(jié)核特異模塊得分經(jīng)因子分析與臨床專家預先提出的理論結(jié)構(gòu)基本上吻合。各個條目與所屬領域相關系數(shù)較大,與不同領域的相關系數(shù)較小。QLICD-PT的共性模塊與SF-36的8個領域的相關系數(shù)除情緒角色與共性模塊的相關系數(shù)較低外,其余的相關系數(shù)在0.44-0.57。說明具有良好的效度。③反應度考評：治療前與治療2個月末各領域得分進行配對t檢驗均有統(tǒng)計學意義,可以認為QLICD-PT量表反應度較好。 3. QLICD-PT量表的初步應用：①影響肺結(jié)核患者生命質(zhì)量的因素主要是文化程度和職業(yè)。②家庭關懷指數(shù)、社會支持評分與肺結(jié)核患者生命質(zhì)量得分呈正相關,與QLICD-PT量表社會功能領域的相關系數(shù)高于其他領域的相關系數(shù)。③分別對不同性別、民族、婚姻狀況不同治療時間的肺結(jié)核患者生命質(zhì)量得分進行重復測量資料方差分析后,結(jié)果顯示隨著治療時間的推移,肺結(jié)核患者生命質(zhì)量得分逐漸上升。④以錨為基礎的方法制定的領域DHD、PSD、SOD、CGD、SPD、TOT的MCID分別為12.82、16.14、15.61、15.88、13.64、16.79。以分布為基礎的方法制定的領域PHD、PSD、SOD、CGD、SPD、TOT的MCID分別為8.50、7.38、10.40、10.34、10.52、10.73。 結(jié)論肺結(jié)核患者生命質(zhì)量量表(QLICD-PT)有較好的信度、效度和反應度,可以用于肺結(jié)核患者生命質(zhì)量的測評；影響肺結(jié)核患者生命質(zhì)量的因素主要是文化程度和職業(yè)；家庭關懷和社會支持較多的肺結(jié)核患者的生命質(zhì)量較高；通過治療肺結(jié)核患者的生命質(zhì)量得到了提高；以錨為基礎的方法結(jié)果在本研究中僅供參考,MCID結(jié)果以分布為基礎的方法制定為準,最終結(jié)果是PHD、PSD、SOD、CGD、 SPD、TOT的MCID分別為8.50、7.38、10.40、10.34、10.52、10.73。
[Abstract]:Objective to develop the tuberculosis scale QLICD-PT for the quality of life scale of chronic disease patients and evaluate them. Meanwhile, QLICD-PT scale was applied to analyze the quality of life and its influencing factors of patients with pulmonary tuberculosis, and to make the smallest clinical significant difference (MCID).
Scale general module of the system QLICD-GM method for the determination of the quality of life of patients with chronic disease (Quality of Life Instruments for Chronic Disease-General module) has been developed. The research idea for common module and the specific module combination, based on the literature review, combined with China's cultural characteristics, the programmed decision scale development to develop QLICD-PT scale, and the scale of the data validity, reliability, responsiveness evaluation. Using the QLICD-PT scale analysis of influence factors of the quality of life of patients with pulmonary tuberculosis in patients with pulmonary tuberculosis, analysis of the relationship between family care index and social support score and quality of life, treatment of lung tuberculosis patients before treatment and at the end of the 2 month when the treatment was completed, the scores of life quality and develop the QLICD-PT minimum clinically significant differences (MCID). Statistical methods used in this study include statistics Description, correlation analysis, paired t test, factor analysis, multiple linear regression analysis, and so on.
Result
1. the TB patient's quality of life scale (QLICD-PT.), composed of QLICD-GM (29 items) and tuberculosis specific module (12 items), was developed.
2. on the quality of life of patients with pulmonary tuberculosis QLICD-PT scale evaluation of reliability evaluation: QLICD-PT scale in all areas of Baja were more than 0.7 kroner coefficient; the field split half reliability was greater than 0.6, the total scale of the split half reliability was 0.82, that of QLICD-PT scale with good reliability. The validity of rating: theoretical structure of pulmonary tuberculosis the specific module score by factor analysis and clinical experts put forward previously basically consistent. Each item and belongs to the field of correlation coefficient, correlation coefficient and the general module in addition to emotional role correlation coefficient of 8 areas of general module small correlation coefficient with different areas of the.QLICD-PT and SF-36 were lower, the correlation coefficient with the rest of the good at 0.44-0.57.. The validity of the reaction degree evaluation before treatment and treatment in all areas at the end of 2 scores was analyzed by paired t test were statistically significant, can think of the QLICD-PT scale The degree of reactivity is better.
Preliminary application of 3. QLICD-PT scale: the factors influencing the life quality of patients with pulmonary tuberculosis is the main cultural level and occupation. The family care index, social support score and positive pulmonary tuberculosis patients with quality of life score, the correlation coefficient of social function and QLICD-PT scale is higher than that of other areas. The correlation coefficients were of different gender nationality, marital status, different treatment time of pulmonary tuberculosis patients with quality of life scores were repeated measures ANOVA, the results showed that with treatment time, pulmonary tuberculosis patients quality of life scores increased gradually. The method to develop the field of Anchor Based DHD, PSD, SOD, CGD, SPD, TOT and MCID respectively. For the 12.82,16.14,15.61,15.88,13.64,16.79. distribution based method PHD, PSD, SOD, CGD, SPD, TOT and MCID were 8.50,7.38,10.40,10.34,10.52,10.73.
Conclusion the quality of life of patients with pulmonary tuberculosis (QLICD-PT) scale has good reliability, validity and responsiveness, and can be used to evaluate the quality of life of patients with pulmonary tuberculosis; factors affecting the quality of life of patients with pulmonary tuberculosis is the main cultural level and occupation; family care and social support of patients with pulmonary tuberculosis by high quality of life; quality of life the treatment of pulmonary tuberculosis patients has been improved; results with Anchor Based on the research results for reference, MCID method based on a distribution of the formulation as the standard, the final results are PHD, PSD, SOD, CGD, SPD, TOT and MCID were 8.50,7.38,10.40,10.34,10.52,10.73.

【學位授予單位】：昆明醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R521

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本文編號：1740178