“健康日”在胃癌患者与普通人群中测量健康相关生活质量的比较研究  

Comparative study on health-related quality of life using heathy days between patients with stomach cancer and the general population

作　　者：石钰霖 杨晓莹 王秋童 王宝华[2] 万霞[1] SHI Yulin;YANG Xiaoying;WANG Qiutong;WANG Baohua;WAN Xia(Institute of Basic Medical Sciences,Chinese Academy of Medical Science&School of Basic Medicine,PekingUnionMedical College,Beijing100005,China;Key Chronic Disease Control and Prevention Laboratory,National Center for Chronic and Non-communicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 100050,China)

机构地区：[1]中国医学科学院基础医学研究所·北京协和医学院基础学院,北京100005 [2]中国疾病预防控制中心慢性非传染性疾病预防控制中心重点慢病防控实验室,北京100050

出　　处：《中华肿瘤防治杂志》2023年第4期239-244,共6页Chinese Journal of Cancer Prevention and Treatment

基　　金：美国中华医学基金会项目(15-208);中国医学科学院协同创新团队项目(2016-12M-3-001)。

摘　　要：目的 比较健康相关生活质量(HRQOL)量表——“健康日”(HRQOL-5)测量胃癌患者与一般人群的差异,为该量表后续用于构建不同病种的健康状态权重提供依据。方法 选取淮河流域14个县(区)在2020-01-01-2021-07-31确诊的670例胃癌新发病例纳入病例组,按照1∶2匹配原则进行入户抽样调查选取1 340人纳入对照组。采用χ^(2)检验与Wilcoxon秩和检验比较2组间HRQOL的差异,Spearmen秩相关系数评价各条目间的相关关系,分别采用探索性因子分析与验证性因子分析揭示2组人群中HRQOL-5潜在结构的异同。结果 病例组中报告健康状况为不好或非常不好比例,以及身体不健康日、精神不健康日、日常活动受限、自理活动受限的天数均高于对照组,均P<0.05。2组人群中,HRQOL-5各条目均具有相关性,r范围为0.15~0.82,P<0.05。其中日常活动受限与自理活动受限r值最大,病例组和对照组分别为0.79和0.82。HRQOL-5在2组人群中均能提取出两个公因子,分别命名为“一般健康状况”和“活动受限”,验证性因子分析显示模型适配度非常好,结构稳定。结论 HRQOL-5是胃癌患者及普通人群中测量HRQOL可靠的工具,提示未来可区分不同亚组人群的健康状态权重。Objective To compare the differences on health-related quality of life(HRQOL) between patients with stomach cancer and the general population using Heathy Days(HRQOL-5),which would provide the basis for constructing health status weight based on Healthy Days for some specific diseases.Methods Totally 670 new cases of gastric cancer confirmed in 14 counties(districts) in the Huaihe River basin from January 1,2020 to July 31,2021 were selected to be included in the case group.According to the 1∶2 matching principle, household sampling survey was conducted and 1340 people were included in the control group.The chi-square test and Wilcoxon rank sum test were used to compare the differences on HRQOL between the case and control groups.The Spearmen rank correlation coefficient was used to evaluate the correlation between each paired items from HRQOL-5.Exploratory factor analysis(EFA) and confirmatory factor analysis(CFA) were used to explore differences in the underlying structure of HRQOL-5 in the case and control groups.Results The proportion of patients in the case group who reported bad health conditions, the number of bad health days in their physical or mental conditions, confined daily activities, and limited self-care activities were higher than those in the control group(all P values <0.05).Each item of HRQOL-5 was relevant in the two groups. The correlation coefficient between each paired items from HRQOL-5items ranged from 0.15to 0.82(P<0.05),with highest values of 0.79in case group and0.82in control group for the paired items between the usual activities limitations and self-care limitations,respectively.Two common factors were extracted from five items of HRQOL-5,and named as general health status and activities limitation in both case and control groups.Two models of CFA both had good fitness and stability.Conclusion HRQOL-5is reliable instruments for measuring HRQOL for stomach cancer cases and the general population,and can be differentiate the health status weight in subgroup population.

关 键 词：健康相关生活质量 健康日 胃癌 普通人群 

分 类 号：R735.2[医药卫生—肿瘤]