两种生活质量量表在慢性化脓性中耳炎中的差异比较

Comparison of Two Diseasespecific Instruments Assessing HealthRelated Quality of Life in Patients with Chronic Otitis Media

目的使用慢性中耳炎疗效调查量表(chronic otitis media outcome test,COMOT-15)和苏黎世慢性中耳炎量表(Zurich chronic middle ear inventory,ZCMEI-21)评估慢性化脓性中耳炎(chronic suppurative otitis media,CSOM)及中耳胆脂瘤患者健康相关生活质量(health-related quality of life,HRQoL)的总体情况,比较两份问卷相关性及差异。方法回顾性选取2020年5月—2022年5月在兰州大学第二医院耳鼻咽喉头颈外科行手术治疗的101例CSOM和中耳胆脂瘤患者为研究对象,采用COMOT-15及ZCMEI-21,结合患者性别及气导平均听阈(air conduction-pure tone average,AC-PTA)比较患者的HRQoL,采用Cronbach'sα评价内部一致性并作为信度指标,使用Pearson相关性分析量表之间的相关性及与患耳AC-PTA间的相关性,使用Mann-Whitney U检验探究性别与量表间的相关性。结果101例患者两种量表得分均呈正态分布,除COMOT-15耳部症状维度(Cronbach'sα=0.602)和ZCMEI-21耳部症状维度(Cronbach'sα=0.473)外,两份问卷总维度和子维度均表现出满意的内部一致性。CO-MOT-15和ZCMEI-21的总维度与子维度之间存在中等到强的相关性;术侧患耳AC-PTA与两份量表总维度、耳部症状、听力、社会心理维度之间存在较好的相关性;耳部症状维度与两份量表总维度、听力、社会心理维度之间存在较好的相关性;COMOT-15和ZCMEI-21在性别方面存在不同程度的差异。结论两种量表具有较高的内部一致性、强相关性,但侧重点不同。COMOT-15侧重听力,涉及不同场景下的听力情况,适合以听力为重点的研究。ZCMEI-21提供了慢性中耳炎耳部症状的综合评估,如眩晕、耳流脓等症,在社会心理、就医问题上,更能反映患者心理健康及对医疗需求的真实情况,同时应严格规范量表的时间窗以确保数据的真实有效性。

Objective Using the chronic otitis media outcome test(COMOT-15)and the Zurich chronic middle ear inventory(ZCMEI-21)to evaluate the current health-related quality of life(HRQoL)in chronic suppurative otitis media(CSOM)and middle ear cholesteatoma patients.In this study,the aim was therefore to evaluate and compare two disease-specific questionnaires for the assessment of HRQoL.Methods A retrospective study was conducted on 101 cases of CSOM and middle ear cholesteatoma,HRQoL was assessed in patients using the COMOT-15 and the ZCMEI-21,combined with patient gender and air conduction-pure tone average(AC-PTA)comparison.The HRQoL of patients were evaluated using Cronbach'sαas a reliability index,using the Pearson correlation scale to explore the correlation between them and the correlation with AC-PTA,and using the Mann-Whitney U test to explore gender differences and correlations between scales.Results In 101 patients,both questionnaires showed total scores and sub scores exhibited satisfactory internal consistency with the exception of the COMOT-15 symptom sub score(Cronbach'sα=0.602)and the ZCMEI-21 symptom sub score(Cronbach'sα=0.473).Fair correlations between the AC-PTA and the total scores,symptom,hearing,psychosocial impact sub scores were found.Fair correlations between the symptoms sub scores and the total scores,hearing,psychosocial impact sub scores were found.COMOT-15 and ZCMEI-21 have different degrees of differences in revealing gender differences.Conclusion Both questionnaires exhibited satisfactory psychometric properties and moderate to strong correlations between all sub scores and the total scores.However,there are several subtle differences.COMOT-15 focuses on listening,and the questions involve in listening situations in different scenarios,so it is suitable for listening-focused research questions.ZCMEI-21 provides a comprehensive assessment of the symptoms of chronic otitis media(COM),including dizziness,ear discharge and other symptoms.In terms of social psychology and medical treatment,it can better reflect the patient's mental health and the real situation of medical needs.At the same time,the time window of the questionnaire should be strictly regulated to ensure the authenticity and validity of the data.