慢性乙型肝炎常见证型LDQOL1.0量表与SF-36量表生命质量评价的比较研究
发布时间：2018-12-16 09:35
【摘要】：目的 对LDQOL1.0量表应用于中国慢性乙型肝炎患者的信效度进行检验,评价慢性乙型肝炎患者中医主要证候的生存质量。比较LDQOL1.0量表和SF-36量表对慢性乙型肝炎患者中医证候生命质量评价的异同,分析两量表对慢性乙型肝炎中医证候生命质量评价的适用性和敏感性,为研制适用于慢性乙肝中医证候生命质量评价的量表奠定基础。 方法 本研究采用横断面调查和随机抽样方法,运用中文版肝病生命质量量表(LDQOL1.0).健康调查简表(SF-36)调查2009年6月至2010年12月来自成都中医药大学附属医院、四川大学华西医院、成都传染病医院等8家医院的753名慢性乙型肝炎患者,收集包括社会人口学、中医四诊及实验室检查等方面的疾病相关资料,通过专家判读得出主要证型,运用spssl9.0统计软件对数据进行处理,评价LDQOL1.0量表用于中国慢性乙型肝炎患者的信效度；通过t检验、方差分析、多元回归分析进行统计推断,探索慢性乙型肝炎常见证型的生存质量影响因素,及两量表间的区别与联系。 结果 1.LDQOL1.0中文版的表面效度较为理想。整个量表的内部一致性信度,Cronbach's a系数为0.908,各维度的Cronbach's a系数范围是0.448-0.990,显示较好的内部一致性,测量信度较高。本研究运用验证因子分析法,经过方差最大正交旋转因子分析提取出21个因子,能解释总变异的70.65%,符合理论模型。内容效度通过文献整理完成,量表相关维度与慢性肝病的关系己在不同的研究中得到证实。 2.调查的6个影响因素中,年龄、HBV-DNA载量与集中力、疾病压力、肝病相关症状呈负相关；年龄与肝病相关症状、性功能、记忆力呈负相关；CHB患者的病耻感、社交能力与性功能受婚姻状况的影响最大。 3.脾气虚证的患者生命质量最高,肝胆湿热证躯体功能质量、生理职能质量、心理健康质量最差,其躯体疼痛感最强,肝经郁热证总体健康质量最差,肝胃郁热证情感职能质量最低。 4.SF-36量表在评估CHB患者各常见证型时,其对生理健康的生命质量评估更为敏感；LDQOL1.0量表在评估CHB患者常见证型时,其对心理健康的生命质量评估更为敏感。 结论 1.LDQOL1.0中文版信度效度较理想,适合评估中国CHB患者常见证型；LDQOL1.0作为专用量表与SF-36比较,评估CHB患者时具有一定的敏感性及特异性； 2.从两种量表分析来看,脾气虚患者主观症状最轻,其生命质量较好；证型中挟热者主观症状较重,其生命质量较差； 3.对于CHB患者,除关注生理指标外,应更多的关注患者的心理、社会和经济问题。医护人员应努力找出影响CHB患者生活质量的相关因素,用实际行动改善患者的生命质量。 4.认知行为疗法及心理干预是治疗CHB心理障碍的有效手段之一。
[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.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R512.62
本文编号：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.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R512.62
【参考文献】
相关期刊论文 前10条
1 王丹民;;慢性乙肝患者心理状态调查分析及干预[J];安徽医药;2007年05期
2 时小红;徐珊;;萎缩性胃炎脾气虚证免疫小分子蛋白组表达的研究[J];浙江中医药大学学报;2012年05期
3 钟丽;莫新少;游雪梅;陈似霞;陈德凤;刘倩;;肝移植病人生存质量及影响因素的研究[J];护士进修杂志;2007年23期
4 覃光地;毛德文;邱华;;慢性肝病患者生存质量的评价现状[J];实用肝脏病杂志;2008年06期
5 蔡善荣;健康相关生命质量的研究概况[J];国外医学(社会医学分册);1999年01期
6 靳秀;;认知治疗对慢性乙型肝炎患者焦虑和抑郁情绪的影响[J];医药论坛杂志;2007年09期
7 刘金兰;乙型肝炎患者的健康教育[J];井冈山医专学报;2002年01期
8 吴创鸿;慢性肝炎患者心理健康状态及影响因素研究[J];健康心理学杂志;1998年02期
9 朱玉霞;闫树英;温冬兰;张玉喜;;500例乙肝患者心理分析及护理对策的调查[J];宁夏医学杂志;2009年02期
10 宋建新,刘晓东,齐俊英,田德英;慢性乙型肝炎患者的情绪障碍调查及治疗对策[J];同济医科大学学报;2001年03期
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