用SF-36测量四川HIV感染者生命质量的研究

Using the SF-36 to Assess the Quality of Life of People Living with HIV in Sichuan

目的了解四川省人类免疫缺陷病毒(HIV)感染者的生命质量现状,评价SF-36的信度和效度。方法在四川大竹和资中抽取114名HIV感染者进行调查,问卷包括SF-36及附加的、反映感染者总体健康状态及对外界敌意心理趋势的条目。对其中40名感染者进行2周后的重测以评价效度。将SF-36所测得的HIV感染者的生命质量值与1603名四川省普通农村居民结果进行比较,同时按不同社会人口学特征分析感染者的生命质量,以及对SF-36进行信度效度分析。结果SF-36各维度内部一致性信度系数为0.75～0.92,重测信度系数为0.53～0.83。SF-36能较好的区分不同健康自评的人群。结构效度方面,躯体疼痛与躯体功能,活力与心理健康的条目间有混杂。各个维度平均得分21.4～61.0,中值0～65,远远低于普通人群。年龄、感染时间长短、性别等对生命质量的某些维度有影响。心理趋势方面,极端心理成分较少,但感受到歧视和对自己生活不满的成分较为普遍。对自己健康状况打分平均为52.3,中值为50。结论HIV感染带来生命质量的严重恶化,SF-36可用于HIV感染者生命质量的研究。

Objective To test the reliability and validity of the SF-36 in assessing the quality of life of people living with HIV in Sichuan province. Methods A questionnaire survey was undertaken in 114 people living with HIV in Dazhu and Zizhong county of Sichuan, which included the SF-36 for assessing quality of life and additional items for assessing the hostility mentality trend. A repeated survey was undertaken two weeks later in 40 out of the 114 respondents to evaluate the retest reliability of the questionnaire. The quality of llfe of the people living with HIV was assessed against the norm of 1604 rural residents in Sichuan. Results The internal consistent coefficients （Cronbach＇s α） of the eight scales of the SF-36 ranged from 0. 75 to 0. 92. The test-retest reliability coefficients of the eight scales of the SF-36 ranged from 0. 53 to 0. 83. The respondents who reported worse health scored significantly lower in all of the eight scales. The factor analysis extracted eight scales, with only four items without a dominant factor load on its corresponding scales. The average scores of the people living with HIV for the eight scales ranged from 21.4 to 61.0, significantly lower than the norm of the general rural residents. Age, gender, and length of infection were the major factors that impacted the quality of life of people living with HIV. It was common for the people living with HIV felt being stigmatized and dissatisfied with live. Conclusion HIV infection deteriorates people＇s quality of life and the SF-36 is a valid instrument to assess the quality of life of people living with HIV.