WHOQOL-100在子宫切除患者围手术期生存质量评估中的应用

Application of WHOQOL-100 on quality of life assessment of hysterectomy patients in preoperative period

目的应用世界卫生组织生存质量测定量表（WHOQOL-100）评估子宫切除患者围手术期生存质量，为提高其生存质量提供科学依据。方法应用WHOQOL-100量表对161例子宫切除患者，分别在入院时（术前）和术后3个月进行问卷调查，比较其子宫切除术前、术后的生存质量。结果经过手术和护理干预，子宫切除术后3个月患者总的生存质量和健康状况和生存质量自评分分别为（73±20）分和（81±6）分，高于术前的（63±14）分和（81±5）分，各领域得分也均高于术前，除生存质量自评分和独立性领域差异无统计学意义外（t=-0．110，P〉0．05；t=-1．323，P〉0．05），其余领域手术前后差异均有统计学意义（P〈0．05）。对手术前后生存质量的24个方面进一步比较发现，术后患者的消极感受、医疗依赖、社会安全保障3个方面得分低于术前[（70±18）分VS（70±21）分，（73±21）分VS（81±19）分，（65±15）分VS（65±18）分]，且医疗依赖方面差异有统计学意义（t=3．606，P〈0．01）；其他方面术后得分均高于术前，但积极感受、身材相貌、工作能力、交通条件4个方面差异无统计学意义（P〉0．05）。结论经过医疗和护理干预，子宫切除患者术后3个月的生存质量高于术前，应该重视子宫切除患者手术前、后的健康教育和心理治疗。

Objective Using the WHOQOL-100 to assess the quality of life for patients before and 3 months after hysterectomy. Methods 161 cases of patients were given questionnaire surveys before and 3 months after hysterectomy. The QOL of patients were investigated by WHOQOL-100. Compare and evaluate the quality of life （QOL） of patients before and 3 months after hysterectomy. Results The QOL and self-assessment score of patients 3 months after hysterectomy （73 ±20 and 81 ±6, respectively） was obviously higher than that of patients before hysterectomy （63 ± 14 and 81 ± 5, respectively） and the others factors after hysterectomy were higher than those before hysterectomy, except for self-assessment and independent region （ t = - 0. 110, - 1. 325 ; P 〉 0. 05 ）. In the deep analysis of 24 aspects on QOL, negative feeling, medical dependent and social safe guarantee score were lower than those before hysterectomy [ （70 ± 18） vs （70 ± 21 ） ; （73 ± 21 ） vs （81 ± 19） ; （65 ± 15 ） vs （65 ± 18 ） ], and the difference in the medical dependent was significant （ t = 3. 606, P 〈 0. 01 ）. Positive feeling, appearance, work competency and traffic condition do not reach the statistical significance （P 〉 0. 05 ）. Conclusions The QOL of patients 3 months after hysterectomy was higher than that before hysterectomy. Health education and psychological treatment of patients before and after hysterectomy should be emphasized.