社区获得性肺炎生存质量测评工具研究思考

Study and consideration on quality of life assessment tools for community-acquired pneumonia

目的分析成人社区获得性肺炎(CAP)生存质量测评工具研制及应用现状。方法通过计算机检索美国国立医学图书馆PubMed数据库、中国生物医学文献数据库、中国知网、万方数据库和维普数据库从建库至2020年9月收录的有关成人CAP生存质量测评工具研制及应用的文献。由2位研究者独立提取文献的作者、标题、发表年份、研究内容、涉及的测评工具及其领域、条目数等信息并进行统计分析。结果共纳入文献31篇(中文22篇,外文9篇),文献最早发表于1998年,近5年发表数量总体呈增长趋势。纳入文献中涉及CAP生存质量测评工具16个,应用测评工具37次。31篇文献中,关于测评工具研制、测量学特性及适用性评价的文献7篇,研究各种干预措施对CAP患者生存质量影响的文献20篇,测评工具应用于其他方面4篇。各测评工具涉及领域、条目不完全相同,涉及领域最多的是健康调查简表(SF-36,8个),条目最多的是生活质量综合评定问卷(GQOLI,74个)。条目涉及咳嗽、咳痰、胸痛、呼吸困难等症状,焦虑、抑郁、沮丧、厌烦、担心等心理状态,交友、工作、看电影、参加运动比赛等社会活动,穿衣、洗漱、做家务、购物等日常活动,对自我照料能力、体力活动能力、治疗效果等满意度。结论现有测评工具可为CAP生存质量的测评提供一定依据,但部分测评工具存在局限性,有待进一步修订完善。

Objective To analyze the development and application status of quality of life assessment tools for adult patients with community-acquired pneumonia(CAP).Methods The literatures about the development and application of quality of life assessment tools for adult patients with CAP were retrieved from following databases:American National Medical Library PubMed,Chinese Biomedical Literature,China National Knowledge Infrastructure,Wanfang and VIP by computer from inception years of databases to September,2020.The author,title,year of publication,research content,assessment tools and their domains,number of items and other information involved in the literatures were extracted and analyzed by two researchers independently.Results A total of 31 articles(22 in Chinese and 9 in foreign languages)were recruited in the study,of which the first was published in 1998,and the number of publications of articles showed an increasing trend in the past five years.Sixteen assessment tools for quality of life in patients with CAP were involved and used for 37 times in the enrolled articles.Among the 31 articles,7 were about the development and applicability of assessment tools,the evaluation of metrological characteristics and applicability,20 were about the effect of various interventions on the quality of life in CAP patients,and 4 were about the application of assessment tools in other aspects.The domains and items involved in each assessment tool were not exactly the same,the most frequently involved domains were the Short Form of Health Survey(SF-36,8 domains),and the most frequently involved items were Generic Quality of Life Inventory(GQOLI,74 items).The items included cough,expectoration,chest pain,dyspnea and other symptoms,anxiety,depression,dejection,boredom,worry and other psychological states,making friends,working,watching movies,participating in sports competitions and other social activities,dressing,washing,housework,shopping and other daily activities,and satisfaction in self-care ability,physical activity ability,treatment effect,etc.Conclusion The present assessment tools can provide a certain basis for the assessment of quality of life in patients with CAP,but some assessment tools have limitations and need to be further revised and improved.