慢性病患者生命质量测定量表体系之肺结核患者生命质量测定量表QLICD-PT研制与应用

发布时间：2018-04-12 14:40

本文选题：肺结核 + 生命质量　；参考：《昆明医科大学》2012年硕士论文

【摘要】：目的研制慢性病患者生命质量测定量表体系之肺结核量表QLICD-PT,并对其进行考评；同时,应用QLICD-PT量表对肺结核患者的生命质量及其影响因素进行初步分析并制定最小临床显著差异(MCID)。方法慢性病患者生命质量测定量表体系共性模块QLICD-GM (Quality of Life Instruments for Chronic Disease-General module)已研制完成。依据共性模块与特异模块相结合的研究思想,在对文献回顾的基础上,结合我国文化特色,采用量表开发的程序化决策方式来研制量表QLICD-PT,并通过实测数据对量表进行效度、信度、反应度的考评。应用QLICD-PT量表分析肺结核患者生命质量影响因素、分析肺结核患者家庭关怀指数及社会支持评分与生命质量的关系、比较肺结核患者治疗前、治疗2个月末和完成疗程时的生命质量得分及制定QLICD-PT各领域最小临床显著差异(MCID)。整个研究过程中用到的统计学方法有统计描述、相关分析、配对t检验、因子分析、多重线性回归方法分析等。结果 1.研制出了由慢性病共性模块QLICD-GM(29个条目)和肺结核特异模块(12个条目)构成的肺结核患者生命质量量表QLICD-PT。 2.对肺结核患者生命质量量表QLICD-PT进行考评①信度考评：QLICD-PT量表各领域克朗巴哈α系数均大于0.7；各领域分半信度均大于0.6,总量表的分半信度为0.82,可以认为QLICD-PT量表信度较好。②效度考评：肺结核特异模块得分经因子分析与临床专家预先提出的理论结构基本上吻合。各个条目与所属领域相关系数较大,与不同领域的相关系数较小。QLICD-PT的共性模块与SF-36的8个领域的相关系数除情绪角色与共性模块的相关系数较低外,其余的相关系数在0.44-0.57。说明具有良好的效度。③反应度考评：治疗前与治疗2个月末各领域得分进行配对t检验均有统计学意义,可以认为QLICD-PT量表反应度较好。 3. QLICD-PT量表的初步应用：①影响肺结核患者生命质量的因素主要是文化程度和职业。②家庭关怀指数、社会支持评分与肺结核患者生命质量得分呈正相关,与QLICD-PT量表社会功能领域的相关系数高于其他领域的相关系数。③分别对不同性别、民族、婚姻状况不同治疗时间的肺结核患者生命质量得分进行重复测量资料方差分析后,结果显示随着治疗时间的推移,肺结核患者生命质量得分逐渐上升。④以锚为基础的方法制定的领域DHD、PSD、SOD、CGD、SPD、TOT的MCID分别为12.82、16.14、15.61、15.88、13.64、16.79。以分布为基础的方法制定的领域PHD、PSD、SOD、CGD、SPD、TOT的MCID分别为8.50、7.38、10.40、10.34、10.52、10.73。结论肺结核患者生命质量量表(QLICD-PT)有较好的信度、效度和反应度,可以用于肺结核患者生命质量的测评；影响肺结核患者生命质量的因素主要是文化程度和职业；家庭关怀和社会支持较多的肺结核患者的生命质量较高；通过治疗肺结核患者的生命质量得到了提高；以锚为基础的方法结果在本研究中仅供参考,MCID结果以分布为基础的方法制定为准,最终结果是PHD、PSD、SOD、CGD、 SPD、TOT的MCID分别为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.

【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R521

【参考文献】