目的: 采用欧洲五维健康量表(five-dimensional euro quality of life, EQ-5D)和脑卒中专用生活质量量表(stroke specific quality of life scale, SS-QOL)测量缺血性脑卒中患者的生活质量,比较EQ-5D及SS-QOL测量结果的差异。方法: 采用EQ-5D和SS-QOL测评南通市某三甲医院236例缺血性脑卒中患者的生活质量,对两个量表的内部一致性信度、已知组别效度、Spearman相关性、区分度及集中趋势进行比较。结果: EQ-5D与SS-QOL的Cronbach's-α系数分别为0.826和0.948;EQ-5D与SS-QOL得分在不同梗死半球、NIHSS评分、洼田饮水试验分级等疾病相关特征方面差异均有统计学意义(P＜0.05);两量表总体呈显著相关(r=0.773,P=0.000),但部分维度间无相关性(P＞0.05);EQ-5D效用值、EQ-VAS值在不同SS-QOL分数分组中差异均有统计学意义(P＜0.01);SS-QOL总分在EQ-5D不同维度、不同水平间差异均有统计学意义(P＜0.01);EQ-5D存在天花板效应(53.4%),总体集中趋势较差;SS-QOL总分不存在天花板效应,总体集中趋势良好。结论: EQ-5D和SS-QOL均有良好的信度、效度和区分度,可用于评价缺血性脑卒中患者的生活质量;EQ-5D具有天花板效应,适用于中、重症患者快速筛查;SS-QOL无天花板效应,适用于全面评估患者生活质量动态变化。
Objective: To measure the quality of life of patients with ischemic stroke by using five-dimensional euro quality of life (EQ-5D) and stroke specific quality of life scale (SS-QOL), and to compare the differences between EQ-5D and SS-QOL. Methods: The EQ-5D and SS-QOL were used to evaluate the quality of life of 236 ischemic stroke patients in a tertiary hospital in Nantong city. Internal consistency reliability, known-group validity, Spearman's correlation, discriminant validity, and central tendency of the two scales were compared and analyzed. Results: The Cronbach's α coefficients of EQ-5D and SS-QOL were 0.826 and 0.948, respectively. EQ-5D and SS-QOL scores were different in different infarct hemispheres, NIHSS score, water swallow test grades, and other disease-related characteristics (P＜0.05). The two scales showed a significant overall correlation (r=0.773, P=0.000), but some dimensions were not correlated (P＞0.05). There were significant differences in EQ-5D utility value and EQ-VAS value among different SS-QOL scores (P＜0.01). The total score of SS-QOL was statistically significant in different dimensions and levels of EQ-5D (P＜0.01). The EQ-5D exhibited a ceiling effect (53.4%), with an overall poor central tendency. In contrast, the SS-QOL total score showed no ceiling effect and had a good overall central tendency. Conclusion: EQ-5D and SS-QOL have good reliability, validity and discrimination, which can be used to evaluate the quality of life of patients with ischemic stroke. EQ-5D has a ceiling effect and is suitable for rapid screening of moderate and severe patients. SS-QOL has no ceiling effect and is suitable for comprehensive evaluation of the dynamic changes of patients' quality of life.
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