5 结论
5.1 EQ-5D 量表具有良好的内部一致性、重测信度以及复本信度。在膝关节骨性关节炎领域具有较高的信度,测试结果具有较高的可靠性。
5.2 EQ-5D 量表具有较高的内容效度及结构效度,与 SF-36 量表效标效度一般。其内容可以较好地表达测试的目的,作为生活质量的测量,能够较准确的反应膝关节骨性关节炎患者的生活质量。
5.3 总的来看 EQ-5D 量表应用于膝关节骨性关节炎领域,评价 KOA 患者生活质量具有较高的信度及可接受的效度。
参考文献
[1] 贾东亮。骨性关节炎的治疗现状与进展[J].中国保健营养。2012,10.4177-4188.
[2] Yolanda Escalante1, Jose M. Saavedra1, etc.Physical exercise and reduction of pain inadults with lower limb osteoarthritis: A systematic review [J].J Back MusculoskeletRehabil. 2010;23(4):175-86.
[3] Nilza Aparecida de Almeida Carvalho, Simoni Teixeira Bittar, etc.Manual for guidedhome exercises for osteoarthritis of the knee.Clinics (Sao Paulo)。2010 Jun;65(8):775-80.
[4] Kim L. Bennell,Rana S. Hinman.A review of the clinical evidence for exercise inosteoarthritis of the hip and knee [J].Arch Phys Med Rehabil. 2012 Jul;93(7):1269-85.
[5] Dinesh Bhatia, Tatiana Bejarano, Mario Novo1 etc.Current interventions in themanagement of knee osteoarthritis [J] .J Pharm Bioallied Sci. 2013 Jan-Mar; 5(1): 30-38.
[6] Gaught AM, Carneiro KA.Evidence for determining the exercise prescription inpatients with osteoarthritis [J].J Phys Sportsmed.2013 Feb;41(1):58-65.
[7] 区广鹏,肖军,郑佐勇。老年膝关节骨性关节炎患病危险因素的调查[J].中国组织工程研究。2012,16(50):9463-9471.
[8] 张福强,吴明霞,刘献祥等。福州市中老年人骨性关节炎的性别和年龄分布[J].福建中医学院学报[J].2009,19(1)。43-47.
[9] 刘维嘉,黄有荣,潘能富等。绝经后妇女膝关节骨性关节炎。骨密度的临床研究[J] .中国骨质疏松杂志。2008,3(14):187-188.
[10] Lee R, Kean WF.Obesity and knee osteoarthritis [J].Inflammopharmacology.2012Apr;20(2):53-8.
[11] WlukaAE, Lombard CB, Cicuttini FM.Tackling obesity in knee osteoarthritis [J].NatRev Rheumatol.2013Apr;9(4):225-35.
[12] Arto T. Toivanen, Markku Heliovaara.Obesity, physically demanding work andtraumatic knee injury are major risk factors for knee osteoarthritis-a population-basedstudy with a follow-up of 22 years [J].Rheumatology 2010;49:308-314.
[13] Dinesh Bhatia, Tatiana Bejarano, Mario Novo1 etc.Current interventions in themanagement of knee osteoarthritis [J].J Pharm Bioallied Sci. 2013 Jan-Mar; 5(1): 30–38.
[14] 靳建云。膝骨性关节炎的发病机理及苗医的认识和治疗[J].贵阳中医学院学[J].2008,11(30): 44-46.
[15] Neogi T.Clinical significance of bone changes in osteoarthritis [J].Ther AdvMusculoskelet Dis.2012Aug;4(4):259-67.
[16] Durmus D, Alayli G, Bayrak IK, Canturk F.Assessment of the effect of glucosaminesulfate and exercise on knee cartilage using magnetic resonance imaging in patients with- 32 -knee osteoarthritis: a randomized controlled clinical trial [J]. Back MusculoskeletRehabil.2012 Jan 1;25(4):275-84.
[17] Poolman RW, van Wagensveld BA.Osteoarthritis of the knee: lose weight first [J].NedTijdschr Geneeskd.2013;157(14):A6043.
[18] Lee R, Kean WF.Obesity and knee osteoarthritis.Inflammopharmacology [J].2012Apr;20(2):53-8.
[19] ANGELA K. LANGE,BENEDICTE VANWANSEELE,Strength Training forTreatment of Osteoarthritis of the Knee: A Systematic Review [J].Arthritis Rheum. 2008Oct 15;59(10):1488-94.
[20] Baert IA, Jonkers I, Gait characteristics and lower limb muscle strength in womenwith early and established knee osteoarthritis [J].Clin Biomech (Bristol, Avon)。2013Jan;28(1):40-7.
[21] Kim L Bennell,Thorlene Egerton.Comparison of neuromuscular and quadricepsstrengthening exercise in the treatment of varus malaligned knees with medial kneeosteoarthritis a randomised controlled trial protocol [J].BMC Musculoskelet Disord.2011Dec 5;12:276.
[22] Martha L. Cammarata, Thomas J. Schnitzer, and Yasin Y. Dhaher.Does KneeOsteoarthritis Differentially Modulate Proprioceptive Acuity in the Frontal and SagittalPlanes of the Knee [J].Vol. 63, No. 9, September 2011, pp 2681-2689.
[23] Jasmijn F. M. Holla, MSc , Marike van der Leeden, PT, PhD .Proprioception, laxlty,muscle strength and activity imitations in early symptomatic knee osteoarthritis: Resultsfrom the check cohort [J]. Rehabil Med 2012; 44: 862-868.
[24] Arthritis & Rheumatism.Joint Proprioception, Muscle Strength, andFunctional Abilityin Patients With Osteoarthritis of the Knee [J]. June 15, 2007,57(5): 787-793.
[25] knoop J, Steultjens MP, van der lM.et al. Proprioception in knee osteoarthritis: anarrative review [J]. osteoarthritis Cartilage 2011,19: 381-388.
[26] Andressa Silva,Paula R.M.S.Serr?o, etc.The effects of therapeutic exercise on thebalance of women with knee osteoarthritis:a systematic review [J].Rev Bras Fisioter, S?oCarlos.2012,16(1):1-9.
[27] Arnold CM,Sran MM,Harrison EL.Exercise for fall risk reduction in communitydwelling older adults:a systematic review [J] .Physiother Can, 2008, 60(4):358- 372.
[28] 刘崇,阎芬等。运动延缓老年人平衡能力下降的研究进展[J].中国康复医学杂志,2009,24(7)。
[29] Hinman RS,Bennell KL,Metcalf BR,et al.Balance impairments in individuals withsymptomatic knee osteoarthritis:a comparison with matched controls wsing clinicaltests[J].Rheumatology,2002,41(12):1388-1394.
[30] 卓金锁。中医综合疗法治疗膝骨性关节炎的临床研究[D].北京中医药大学。2007,5.
[31] 丁明晖,李燕,张宏。温针灸治疗膝关节骨关节炎的近期效果[J].中国康复医学杂志。2009,29(4):889-902.
[33] Dowsey MM, Choong PF.The Utility of Outcome Measures in Total KneeReplacement Surgery [J].Int J Rheumatol. Epub 2013 Oct 31.
[33] Hungerford DS, Maclaughlin EJ, Mines CM,et al.Synergistic effect of using atranscutaneous electrical joint stimulator and an unloading brace in treating osteoarthritisof the knee [J].Am J Orthop (Belle Mead NJ)。 2013 Oct;42(10):456-63.
[34] Nam CW, Park SI, Yong MS, et al.Effects of the MWM TechniqueAccompanied byTrunk Stabilization Exercises on Pain and Physical Dysfunctions Caused by DegenerativeOsteoarthritis [J].J Phys Ther Sci. 2013 Sep;25(9):1137-1140.
[35] G. Kelley Fitzgerald,Sara R. Piva.Agility and Perturbation Training Techniques inExercise Therapy for Reducing Pain and Improving Function in People With KneeOsteoarthritis:ARandomized Clinical Trial [J].Phys Ther. 2011April; 91(4): 452–469.
[36] 刘崇,闫芬,李颖等。太极拳、健步走对改善女性老年人静态平衡功能效果的对比研究[J].中国康复医学杂志,2009,24(5),445-447.
[37] 周斌 . 运动 疗法在 膝骨 性 关节 炎治疗 中的应 用 [J]. 中国 中医骨 伤科 杂志。2009.17(4)。36-38.
[38] Martha L. Cammarata, Thomas J. Schnitzer, Yasin Y. Dhaher.Does Knee OsteoarthritisDifferentially Modulate Proprioceptive Acuity in the Frontal and Sagittal Planes of theKnee.Vol. 63, No. 9, September 2011, pp 2681–2689.
[39] 张方,傅书勇,王曼等。采用 EQ-5D 测量中国急性缺血性脑瘁中患者生存质量的相关性实证研究[J].中国药物经济学。2009,6:5-13.
[40] 高建民,田雯。EQ-5D 在农村医疗保障模式评价中的应用研究[J].中国卫生经济。2011,2. 30(336):22-26.
[41] 邢亚彬,马爱霞。欧洲五维健康量表 EQ-5D -5L 中文版的信效度研究[J].上海医药[J].2009,34(9):40-43.
[42] 罗娅珺,方芸,丁选胜 采用EQ-5D评估2 型糖尿病患者的生活质量及影响因素研究[J].中国药物经济学。2009,2:12-20.
[43] 王文娟,刘露,江启成。EQ- 5D 与 SF- 12 量表在安徽省农村糖尿病患者生命质量评估中的应用[J].中华疾病控制杂志。2013,4.17(4):287-291.
[44] 吉珂,周王艳,陈家应。基于 EQ-5D 量表的农村已婚育龄妇女健康相关生命质量评价[J].南京医科大学学报。2011,3(44):181-186.
[45] Bouwmans C, van der Kolk A, Oppe M, et al.Validity and responsiveness of theEQ-5D and the KIDSCREEN-10 in children withADHD.Eur J Health Econ. 2013 Nov 15.
[46] Subramaniam M,Abdin E, Yin Poon L, et al.EQ-5D as a measure of programmeoutcome: Results from the Singapore early psychosis intervention programme.PsychiatryRes. 2013 Oct 21. pii: S0165-1781(13)00650-1.
[47] Craig BM, Pickard AS, Lubetkin EI.Health problems are more common, but lesssevere when measured using newer EQ-5D versions.J Clin Epidemiol. 2013 Sep 24. pii:S0895-4356(13)00303-X.
[48] Marko Obradovic, Arun Lal,Hiltrud Liedgens Obradovic et al. Health and Quality ofLife Validity and responsiveness of EuroQol-5 dimension (EQ-5D) versus Short Form-6dimension (SF-6D) questionnaire in chronic pain.Outcomes 2013, 11:110[49] Mariana Brussoni1, Sami Kruse,Kerry Walker et al.Validity and reliability of theEQ-5D-3L ? among a paediatric injury population Health and Quality of Life[J]Outcomes.2013, 11:157.
[50] C?ster MC1, Bremander A, Rosengren BE, Magnusson H, Carlsson A, KarlssonMK.Validity, reliability, and responsiveness of the Self-reported Foot and Ankle Score(SEFAS) in forefoot, hindfoot, and ankle disorders [J].Acta Orthop. 2014Apr;85(2):187-94.
[51] Oh B1, Cho B2, Choi HC1, Son KY1, Park SM1, Chun S1, Cho SI3. The influenceof lower-extremity function in elderly individuals' quality of life (QOL): an analysis of thecorrelation between SPPB and EQ-5D.Arch Gerontol Geriatr. 2014 Mar-Apr;58(2):278-82.
[52] Kamrad I1, Henricsson A, Karlsson MK, Magnusson H, Nilsson J?, Carlsson?, Rosengren BE.Poor prosthesis survival and function after component exchange of totalankle prostheses [J].Acta Orthop. 2015 Feb 12:1-5.
[53] Stener S1, Kartus J, Ejerhed L.Anterior cruciate ligament reconstruction reducesbone mineral areal mass [J].Arthroscopy. 2013 Nov;29(11):1788-95.
[54] Deckers K1, De Smedt K, van Buyten JP, Smet I, Eldabe S, GulveA, BaranidharanG, deAndrès J, Gilligan C, Jaax K, Heemels JP, Crosby P. Chronic Low Back Pain:Restoration of Dynamic Stability [J].Neuromodulation. 2015 Feb 13.
[55] Hurley DA1, Tully MA, Lonsdale C, Boreham CA, van Mechelen W, Daly L, TynanA, McDonough SM. Supervised walking in comparison with fitness training for chronicback pain in physiotherapy: results of the SWIFT single-blinded randomized controlledtrial[J].Pain. 2015 Jan;156(1):131-47.
[56] Bernfort L1, Gerdle B, Rahmqvist M ect. Severity of chronic pain in an elderlypopulation in Sweden-impact on costs and quality of life [J].Pain. 2015 Mar;156(3):521-7.
[57] Okajima S1, HirotaA, Kimura E ect. Health-related quality of life and associatedfactors in patients with primary lymphedema [J].Jpn J Nurs Sci. 2013 Dec;10(2):202-11.
[58] Gandhi M, Thumboo J, Luo N, Wee HL, Cheung YB.Do chronic disease patientsvalue generic health states differently from individuals with no chronic disease?Acase of amulticulturalAsian population [J]. Health Qual Life Outcomes. 2015 Jan 23;13(1):8.
[59] Sundh J1, Johansson G2, Larsson K3, LindénA3, L?fdahl CG4, JansonC5, Sandstr?m T6.Comorbidity and health-related quality of life in patients with severechronic obstructive pulmonary disease attending Swedish secondary care units [J].Int JChron Obstruct Pulmon Dis. 2015 Jan 22;10:173-83.
[60] Putter CE1, Selles RW2, Haagsma JA3, Polinder S4, Panneman MJ5, HoviusSE6, BurdorfA7, van Beeck EF8. Health-related quality of life afterupper extremity injuries and predictors for suboptimal outcome [J].Injury. 2014Nov;45(11):1752-8.
[61] Cánovas-Martínez L1, Carceller-Ruiz JJ, Díaz-Parada P ect.Efficacy and Safety ofSublingual Fentanyl Tablets for the Management of Breakthrough Pain in Patients withChronic Musculoskeletal Pain with Neuropathic Component: Multicenter ProspectiveStudy [J]. Clin Drug Investig. 2015 Feb 6.
[62] Carreon LY1, Bratcher KR, Das N, Nienhuis JB, Glassman SD.Estimating EQ-5D values from the Oswestry Disability Index and numeric rating scales forback and leg pain [J]. Spine (Phila Pa 1976)。 2014Apr 15;39(8):678-82.
[63] Katz JN1, Perez MT, Niu NN, Dong Y, Brownlee SA, Elman SA, StenquistDS, Santiago A, Sanchez ES, Collins JE.Development and validation of a Spanishtranslation of the Yale activity questionnaire.2014,7.
[64] 曹至进。 药物自我处置和症状自我监控技能训练对住院精神分裂症患者生活质量的影响[J].河北医药。2014,36(16):2449-2451.
[65] 邓瑶,王金胜,袁秀柏等。SF-36量表应用于晚期吸血虫患者的信度和效度分析[J].中国血吸虫防治杂志。2012;1(22):40-45.
[66] Kwon JW, Moon JY, Kim SH ect.Reliability and Validity of a Korean Version of theLeicester Cough Questionnaire. Allergy Asthma Immunol Res. 2014 Dec 18.
[67] 陈天佳,周云仙。 SF-36量表用于炎症性肠病患者生存质量测定的效果评价[J]. 浙江中医药大学学报。2013,37(6)
[68] Georgopoulou S1, Efraimidou S2, MacLennan S ect.Antiphospholipid (Hughes)syndrome: description of population and health-related quality of life (HRQoL) usingthe SF-36 [J]. Lupus. 2014 Sep 19.
[69] 李灿,辛玲调查问卷的信度与效度的评价方法研究[J].中国卫生统计。2008,25(5):541-544.
[70] 赵斐然,周天驰。张俊颖等。量表(问卷)信度、效度评价在我国医学领域的应用与展望[J].中华中医药杂志。2014,29(7)。2280-2283.
[71] 宋小平,张敏,陈建军。SPSS在医学生物学试卷的信度和效度分析中的应用[J].生物学通报。2008,43(11):39-40.
[72] 史静琤,莫显昆,孙振球。量表编制中内容效度指数的应用[J].中南大学学报(医学版)。2012,37(2):152-155.
[73] 罗建秀,宋岩峰,吴思英。泌尿生殖障碍量表简版中文版信度效度分析[J].实用妇产科杂志。2014,30(11):836-839.
[74] Fatemeh Mohammad Niay Gharaei, Mojtaba Rafieian Enhancing Living Quality:Cross-cultural Differences in Personal Space between Kurdish and Northern Women inIran [J]. Procedia - Social and Behavioral Sciences, 2012, Vol.35 , pp.313-320.
[75] 刘伟。充血性心力衰竭中医证候量表的信度与效度评价河北大学[D].河北大学硕士学位论文。2011,5.
[76] 张彦红,梁伟雄,朱磊蒙等。特利尔认知评估量表与简易精神状态量表用于筛查血管性认知障碍的比较。中国康复医学杂志。2012,27(5):431-436.
[77] Antonio Roman, Joan Albert Barbera.Health-Related ect. Quality of Life in a NationalCohort of Patients With Pulmonary Arterial Hypertension or Chronic ThromboembolicPulmonary Hypertension [J]. Archivos de Bronconeumología (English Edition), 2013,Vol.49 (5)。
[78] 屈广鹏,肖军郑,佐勇等。老年膝关节骨性关节炎患病危险因素调查[J].中国组织工程研究。2012,16(50):9463-9470.
[79] 张善纲,范建忠,张建宏等。脑损伤患者应用洛文斯顿作业疗法认知评定量表的结构效度监测[J].中国临床康复。2006,10(10)。
[80] 曾海燕,王红妹,顾雯雯。 普适性生命质量量表考评及在社区慢性病患者中的应用[D].浙江大学硕士论文。2008,6.
致 谢
时光荏苒,转眼间三年的研究生生活即将结束。暮然回首,感慨万千,有喜悦、有感动、有感谢。从课题的选题到问卷的调查、再到论文的顺利完成,一直都离不开老师、同学、朋友给我热情的帮助,在这里请接受我诚挚的谢意!感谢我的导师荣湘江副教授,感谢三年来您的辛勤栽培,与孜孜不倦的教诲,让我在首体三年的生活充实而受益匪浅,让人感念至深。借此论文向导师致以深深的谢意!
感谢北京老年医院陈雪丽主任医师,在实验及论文撰写过程中对我的指导和帮助,在此表示衷心感谢。感谢北京老年医院康复科的各位医生及康复师,谢谢你们的指导与帮助。感谢我专业的各位同学,三年来,我们朝夕相处,共同进步,同窗之谊,我将终生难忘!
感谢父母及家人的支持,感谢你们对我无私的爱与照顾,你们永远是我坚强的后盾。感谢所有教导过我、关心过我的老师。感谢一起做实验的同学,以及在实验过程中给我的帮助同学。
最后,感谢在百忙之中对论文进行评审的各位专家、学者,谢谢你们!