慢性心衰中西医结合生存质量量表与SF-36量表的对比评价研究
摘要
慢性心力衰竭，简称慢性心衰，是多种心血管疾病的终末阶段。随着健康相关生存质量研究的深入与发展，生存质量已经成为评价慢性心衰临床疗效的重要指标。研究表明，慢性心衰患者处于生存质量十分低下的状态，中医在改善心衰患者生存质量方面具有独特的优势。慢性心衰中西医结合生存质量量表是按照国际通用的原则和程序，在明尼苏达心衰量表的基础上，加入与心衰相关的中医特色条目而研制成功的具有中医特色的疾病特异性量表。
研究目的：
以SF-36简明健康状况量表（SF-36量表）为标准参照，评价慢性心衰中西医结合生存质量量表在临床实际运用中的性能。
研究方法：
采用横断面调查法，2008年2月至2008年4月，对北京市5家医院内符合纳入标准的63名慢性心力衰竭住院患者，实施患者知情同意基础上生存质量的调查与再调查。内容包括慢性心衰中西医结合生存质量量表、SF-36量表的研究调查。采用国际上通用的量表测评方法评价SF－36量表与慢性心衰中西医结合生存质量量表的可行性、信度、效度及反应度。
研究结果：
（1）量表的可行性：SF-36量表的平均应答时间为10.9士4.6分钟，慢性心衰中西医结合生存质量量表的平均应答时间为12.0士4.9分钟，两种量表的完成率均为96.83%。
（2）量表的信度：SF-36量表的克朗巴赫ɑ系数为0.896，分半信度系数为0.903。慢性心衰中西医结合生存质量量表的克朗巴赫ɑ系数为0.951，分半信度系数为0.960，本量表的信度高于SF-36量表。
（3）量表的效度：内容效度：应用相关系数法、逐步回归分析证实两种量表均具有较好的内容效度。结构效度:经因子分析，慢性心衰中西医结合生存质量量表的测量结果与研究者对量表构想的结构是相符的。标准效度：将SF-36量表作为标准参照，计算慢性心衰中西医结合生存质量量表与SF－36量表的相关系数为0.79（p＜0.01），慢性心衰中西医结合生存质量量表具有较好的标准效度。
（4）两表的反应度：SF-36量表与慢性心衰中西医结合生存质量评价量表均具备区分不同时间(治疗前后)患者生存质量变化的能力（p＜0.01）。研究结论：
慢性心衰中西医结合生存质量量表考评结果表明，与标准参照量表SF－36量表相比，本量表具有较好的效度、信度和反应度，临床操作可行，能被患者接受，可以作为心衰中西医结合生存质量的评价工具，从而为心衰的新药研究和临床治疗方案的评价提供新的手段。
Chronic Heart Failure (CHF) is the ultimate phase of cardiovascular diseases. With the continuously deepening and development of the research in Health-Related Quality of Life (HRQOL), HRQOL has been an important index of evaluating the practical treatment of CHF. Many researches have shown that the quality of life of CHF patients is very poor; the Chinese medicine has unique advantage in improving the quality life of CHF patients. The Chronic Heart Failure Quality of Life scale of Chinese and Western Integrated Medicine is the disease-specific scale which reflects the characteristics of Chinese Medicine. According to the internationally-acknowledged principles and procedures, the scale which added some Chinese featured items of CHF to MLHFQ was formulated.
Research Objective:
To compare the effects of the Chronic Heart Failure Quality of Life scale of Chinese and Western Integrated Medicine and the 36-item short-form health status survey (SF-36) in Chinese patients with chronic heart failure ,to evaluate the capability of the Chronic Heart Failure Quality of Life scale of Chinese and Western Integrated Medicine.
Research Methods:
We conducted a cross-section survey of 63 participants who diagnosised definitely with chronic heart failure in 5 hospitals in Beijing from February, 2008 to April, 2008. It was performed using a test-retest design with to fill in the Chronic Heart Failure Quality of Life scale of Chinese and Western Integrated Medicine and the 36-item short-form health status survey. Scale’s capability was measured by its reliability, validity, feasibility and responsibility.
Research Result:
(1)Scale’s feasibility:
Average time of accomplished SF-36 was 10.9士4.6 minites.Average time of accomplished the Chronic Heart Failure Quality of Life scale of Chinese and Western Integrated Medicine was 12.0士4.9 minites. Both of the scales' accomplished rates were 96.83%.
(2) Scale’s reliability:
Cronbach's alpha coefficient of SF-36 was 0.896. Split-half reliability coefficient of it was 0.903. Cronbach's alpha coefficient of the Chronic Heart Failure Quality of Life scale of Chinese and Western Integrated Medicine was 0.951,Split-half reliability coefficient of it was 0.960,its reliability was better than SF-36.
(3) Scale’s validity.
Both of the two scales were good on content validity. The surveyed results were true of the Chronic Heart Failure Quality of Life scale of Chinese and Western Integrated Medicine ' structure conceived by designers in study by means of factor analysis. Correlative coefficient of the Chronic Heart Failure Quality of Life scale of Chinese and Western Integrated Medicine with SF-36 was 0.79,p<0.01.
(4) Scale’s responsibility:Both scales were good on responsibility(p<0.01).
Research Conclusions:
The Chronic Heart Failure Quality of Life scale of Chinese and Western Integrated Medicine is good on reliability, validity and feasibility , The scale can be used for measuring the quality of life for chronic heart failure.
研究目的：
以SF-36简明健康状况量表（SF-36量表）为标准参照，评价慢性心衰中西医结合生存质量量表在临床实际运用中的性能。
研究方法：
采用横断面调查法，2008年2月至2008年4月，对北京市5家医院内符合纳入标准的63名慢性心力衰竭住院患者，实施患者知情同意基础上生存质量的调查与再调查。内容包括慢性心衰中西医结合生存质量量表、SF-36量表的研究调查。采用国际上通用的量表测评方法评价SF－36量表与慢性心衰中西医结合生存质量量表的可行性、信度、效度及反应度。
研究结果：
（1）量表的可行性：SF-36量表的平均应答时间为10.9士4.6分钟，慢性心衰中西医结合生存质量量表的平均应答时间为12.0士4.9分钟，两种量表的完成率均为96.83%。
（2）量表的信度：SF-36量表的克朗巴赫ɑ系数为0.896，分半信度系数为0.903。慢性心衰中西医结合生存质量量表的克朗巴赫ɑ系数为0.951，分半信度系数为0.960，本量表的信度高于SF-36量表。
（3）量表的效度：内容效度：应用相关系数法、逐步回归分析证实两种量表均具有较好的内容效度。结构效度:经因子分析，慢性心衰中西医结合生存质量量表的测量结果与研究者对量表构想的结构是相符的。标准效度：将SF-36量表作为标准参照，计算慢性心衰中西医结合生存质量量表与SF－36量表的相关系数为0.79（p＜0.01），慢性心衰中西医结合生存质量量表具有较好的标准效度。
（4）两表的反应度：SF-36量表与慢性心衰中西医结合生存质量评价量表均具备区分不同时间(治疗前后)患者生存质量变化的能力（p＜0.01）。研究结论：
慢性心衰中西医结合生存质量量表考评结果表明，与标准参照量表SF－36量表相比，本量表具有较好的效度、信度和反应度，临床操作可行，能被患者接受，可以作为心衰中西医结合生存质量的评价工具，从而为心衰的新药研究和临床治疗方案的评价提供新的手段。
Chronic Heart Failure (CHF) is the ultimate phase of cardiovascular diseases. With the continuously deepening and development of the research in Health-Related Quality of Life (HRQOL), HRQOL has been an important index of evaluating the practical treatment of CHF. Many researches have shown that the quality of life of CHF patients is very poor; the Chinese medicine has unique advantage in improving the quality life of CHF patients. The Chronic Heart Failure Quality of Life scale of Chinese and Western Integrated Medicine is the disease-specific scale which reflects the characteristics of Chinese Medicine. According to the internationally-acknowledged principles and procedures, the scale which added some Chinese featured items of CHF to MLHFQ was formulated.
Research Objective:
To compare the effects of the Chronic Heart Failure Quality of Life scale of Chinese and Western Integrated Medicine and the 36-item short-form health status survey (SF-36) in Chinese patients with chronic heart failure ,to evaluate the capability of the Chronic Heart Failure Quality of Life scale of Chinese and Western Integrated Medicine.
Research Methods:
We conducted a cross-section survey of 63 participants who diagnosised definitely with chronic heart failure in 5 hospitals in Beijing from February, 2008 to April, 2008. It was performed using a test-retest design with to fill in the Chronic Heart Failure Quality of Life scale of Chinese and Western Integrated Medicine and the 36-item short-form health status survey. Scale’s capability was measured by its reliability, validity, feasibility and responsibility.
Research Result:
(1)Scale’s feasibility:
Average time of accomplished SF-36 was 10.9士4.6 minites.Average time of accomplished the Chronic Heart Failure Quality of Life scale of Chinese and Western Integrated Medicine was 12.0士4.9 minites. Both of the scales' accomplished rates were 96.83%.
(2) Scale’s reliability:
Cronbach's alpha coefficient of SF-36 was 0.896. Split-half reliability coefficient of it was 0.903. Cronbach's alpha coefficient of the Chronic Heart Failure Quality of Life scale of Chinese and Western Integrated Medicine was 0.951,Split-half reliability coefficient of it was 0.960,its reliability was better than SF-36.
(3) Scale’s validity.
Both of the two scales were good on content validity. The surveyed results were true of the Chronic Heart Failure Quality of Life scale of Chinese and Western Integrated Medicine ' structure conceived by designers in study by means of factor analysis. Correlative coefficient of the Chronic Heart Failure Quality of Life scale of Chinese and Western Integrated Medicine with SF-36 was 0.79,p<0.01.
(4) Scale’s responsibility:Both scales were good on responsibility(p<0.01).
Research Conclusions:
The Chronic Heart Failure Quality of Life scale of Chinese and Western Integrated Medicine is good on reliability, validity and feasibility , The scale can be used for measuring the quality of life for chronic heart failure.
引文
[1]江玲.与健康有关的生存质量评定探讨.中国康复理论与实践,2002,8(12);768、746
[2]WHO.The Development of the WHO Quality of Life Assessment Instrument .Geneva, WHO, 1993,1
[3]方积乾,万崇华,郝元涛.与健康有关的生存质量的研究概况.中国康复医学杂志,2000,15(1):40～41
[4] 梁万年,郝模.卫生事业管理学.北京:人民卫生出版社,2003,269-270.
[5] 胡善联.结果研究中的生存质量评价.肝脏,2003,8(4);2.
[6] 陈和年.生存质量研究.中华预防医学杂志,1996,27(3);178-180.
[7] 彭爱芝.生活质量—一种新型的健康评价方法.天津护理, 2005, 13(3); 182-183
[8] 方积乾. 生存质量测定方法及应用. 北京: 北京医科大学出版社, 2000,25-30.
[9] 方积乾.生存质量测定方法及应用. 第1版 北京:北京医科大学出版社,2000 ,12～17 ,72～75 ,81～84
[10] Spertus JA ,Winder JA ,Dewhurst TA , et al . Development and evaluation of the Seattle Angina Questionnaire :A new functional status measure for coronary artery disease. J Am Coll Cardiol ,1995 ,25 (2) :333～341
[11] 康德英,王家良,洪旗 健康相关生存质量及其评价方法.中华医学, 2001 ,81(13) : 829～830
[12] 刘加林,生存质量量表选择的策略, 四川医学,2006 , 27,( 7),675～676
[13]王家良. 临床流行病学——临床科研设计、衡量与评价.第 2 版. 上海:上海科学技术出版社,2001. 367, 427.
[14] 秦浩 陈景武. 医学量表条目的筛选考评方法及其应用.中国行为医学科2006.15(4).375～376.
[15]方积乾. 生存质量测定方法及应用. 北京: 北京医科大学出版社, 2000,3.
[16]方积乾,郝元涛,李彩霞等.世界卫生组织生活质量量表的信度与效度.中国心理卫生杂志,1999 ,13 (4) :203～205.
[17]郝元涛等. 结构方程模型及其在医学中的应用研究. 中国医院统计.2003 10(4): 240～244.
[18]万崇华.生命质量测定与评价方法.昆明:云南大学出版社.1999.1
[19] 刘智勇,癌症病人生存质量评价及其在中西医结合研究中的应用,中医药研究,2001, 17(1)
[20] 陈雪梅,王儒平,浅谈中医与生存质量的关系,中医药学刊,2006,24(6),1073-1074
[21] 李建婷, 郭新峰.中医药领域应用生存质量评价浅识[J].中医药学刊, 2004,22 (2):264- 5
[22] 陈雪梅,王儒平,浅谈中医与生存质量的关系,中医药学刊,2006,24(6),1073-1074
[23] Massie BM, ShahN B. Evolving trends in the epidemiologic factors of heart failure: rational for preventive strategies and comprehensive disease management.AmHeart J, 1997, 133: 703
[24] KannelW B,HoK,Thom T.Changing epidemiological features ofcardiac fai1ure. BrHeart J, 1994, 72(suppl): S3
[25] J Juenger, D Schellberg, S Kraemer, et al. Health related quality of life in patients with congestive heart failure: comparison with other chronic diseases and relation to functional variables. Heart 2002,87;235-241.
[26] Middel B, Bouma J, De Jongste MJL, Van Sonderen E, Niemeyer MG, Crijns HJGM, Van den Heuvel WJA Psychometric properties of the Minnesota Livi ng with Heart Failure Questionnaire. Clinical Rehabilitation,2001,1 5;489-500.
[27] Arena R, Humphrey R, Peberdy MA Relationship between the Minnesota Living with Heart Failure Questionnaire and key ventilatory expired gas measures during exercise testing in patients with heart failure. Journal of Cardiopulmonary Rehabilitation,2002,22;273-277.
[28] 龚开政. 中文版SF236 量表在心力衰竭患者生存质量评价中的应用研究. 中华物理医学与康复杂志,2004 ,26 (12),732-736
[29] 李伟.心力衰竭病人生命质量的影响因素分析与对策研究.硕士学位论文.天津医科大学;20030701.
[30] 沈维红. 慢性心力衰竭患者的心理调查及护理. 临床护理杂志,2004 ,3 (1);55-57.
[31] Berry C, McMurray J. A review of quality-of-life evaluations in patients with congestive heart failure. Pharmacoeconomics 1999, 16(3);247-71.
[32] 朱燕波,折笠秀树等.慢性心功能不全患者的生活质量,中国临床康复,2004,8(15);2928-2929
[33] Fox E,Landrum 一 McNifK,Z hongZ,et a l.Evaluation of prognostic criteriafor determining hospice eligibility in patients with advanced lung,heart,or liver disease. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments. JAMA,1999,282;1638-45.
[34] 朱燕波,折笠秀树,郑洁,等.心功能不全 QOL 量表中文译本信度效度的初步评价.中国行为医学科学,2004,13(3);337-339.
[35]邓艳红,董吁钢,陈丹丹等.堪萨斯城生存质量量表对慢性心力衰竭患者生存质量评估的可行性评价.中华心血管病杂志,2004,32(8);676-679.
[36] Ware JE. SF-36 Health Survey. Mannual and Interpretation Guide. Boston. MA: The Health Institute, 1993,1
[37]魏朝晖, 莫一心, 陈和年. 生命质量测定量表SF-36 的应用. 国外医学社会医学分册, 1997, 14 (4) : 145-147
[38] 李春波.何燕玲.健康状况调查问卷 SF-36 的介绍. 国外医学精神病学分册.2002,29(2);116-119.
[39] Ware JE, Snow KK, Kosinski M, et al. SF-36 Health survey-manual and interpretation guide. Boston, MA: The Health Institute, New England Medical Center,1993.
[40] 方 积 乾 . 生 存 质 量 测 定 方 法 及 应 用 . 北 京 : 北 京 医 科 大 学 出 版社.2000:263-269.
[41]刘朝杰.36 条目简明量表在中国人群中的适用性研究.华西医大学报.2001; 32(1): 39-42
[42] 任晓晖.用SF-36 量表评价慢性病患者的生命质量. 华西医大学报.2001; 32(2): 250-253
[43] 龚开政等. SF-36 在慢性心力衰竭患者中的信度和效度评价, 中国康复医学杂志, 2004,19(3);182-184
[44] Sidorov J, Shull RD, Girolami S, Mensch D. Use of the short form 36 in a primary care based disease management program for patient program for patients with congestive heart failure. Dis Manag 2003,6(2);111-117
[45] 龚开政等. 明尼苏达州心力衰竭生活质量问卷与36条简明健康状况调查表对慢性心力衰竭患者生活质量的评估作用, 中国临床康复,2004, 9(28); 29-31
[46] 丁家崇.老年人急性左心衰竭的康复治疗与预防.心血管康复医学杂志,1999,8(2);29-31.
[47] ACC/AHA指南:新的心衰指南强调早期诊断和早期治疗.2006.
[48] American College of Cardiology / American Heart Association guidelines: New heart failure guidelines stress early diagnosis and treatment.
[49]Patrick DL, Deyo RA. Generic and disease-specific measures in assessing health status and quality of life. Med Care, 1989, 27: 217-232.
[50]uenger J, Schellberg D, Kraemer S,et al. Health related qualityof life in patients with congestive heart failure: comparison with other chronic diseases and relation to functional variables. Heart 2002 Mar;87(3):235-241.
[51]Middel B, Bouma J, de Jongste M,et al. Psychometric properties of the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Clin Rehabil 2001 Oct;15(5):489-500.
[52]Cohn JN, Tognoni G; Valsartan Heart Failure Trial Investigators. A randomized trial of the angiotensin-receptor blocker valsartan in chronic heart failure. N Engl J Med 2001 Dec 6;345(23):1667-1675.
[53]Cowley AJ, Wiens BL, Segal R,et al. Randomised comparison of losartan vs. captopril on quality of life in elderly patients with symptomatic heart failure: the losartan heart failure ELITE quality of life substudy. Qual Life Res 2000;9(4):377-384.
[54]erry C, McMurray J. A review of quality-of-life evaluations in patients with congestive heart failure. Pharmacoeconomics 1999 Sep;16(3):247-271.
[55]刘凤斌等,生存质量研究及其与中医的关系探讨,医学与哲学,1997, 18 (12).
[56]刘凤斌等,生存质量在中医药研究中的应用探讨,中药新药与临床药理,1997, 8 (3).
[57]张子彬,Tsung O. Cheng[美],张玉传. 充血性心力衰竭学. 第 1 版. 北京:科学技术文献出版社,2000:3-24, 551-570.
[58]方积乾.生存质量测定方法及应用.北京:北京医科大学出版社,2000:3-23,3-47.
[59] 马文军,潘波.问卷的信度和效度以及如何用 SAS 软件分析.中国卫生统计,2000,17(6):364-365.
[60]张子彬,Tsung O. Cheng[美],张玉传. 充血性心力衰竭学. 第 1 版. 北京:科学技术文献出版社,2000:3-24, 551-570.
[61] 朱燕波,折笠秀树,郑洁,等.心功能不全 QOL 量表中文译本信度效度的初步评价[J].中国行为医学科学,2004,13(3);337-339.
[62]郑筱萸.中药新药临床研究指导原则(试行) 北京:中国医药科技出版社,2002:84-85.
[63]国家食品药品监督管理局 2002 年 5 月制定的《中药新药临床指导原则》.
[64]胡大一主编,2005 循证心血管医学.北京:中国科学技术出版社.2006,3.
[65]叶任高等主编.内科学(第六版).北京:人民卫生出版社. 2005.
[66] 孙振球.医学统计学.北京:人民卫生出版社,2002: 405-406.
[67] Ware JE. Standards for validating health measures: Definitionand content. Journal of Ch ronic D isease, 1987, 40 ( 6) : 473- 4801
[68] Ware JE. SF-36 Health Survey. Mannual and Interpretation Guide. Boston. MA: The Health Institute, 1993
[69] Juenger J, Schellberg D, Kraemer S,et al. Health related quality of life in patients with congestive heart failure: comparison with other chronic diseases and relation to functional variables. Heart 2002 Mar;87(3):235-241.
[70] 彭爱芝.生活质量—一种新型的健康评价方法.天津护理, 2005, 13(3); 182-183
[2]WHO.The Development of the WHO Quality of Life Assessment Instrument .Geneva, WHO, 1993,1
[3]方积乾,万崇华,郝元涛.与健康有关的生存质量的研究概况.中国康复医学杂志,2000,15(1):40～41
[4] 梁万年,郝模.卫生事业管理学.北京:人民卫生出版社,2003,269-270.
[5] 胡善联.结果研究中的生存质量评价.肝脏,2003,8(4);2.
[6] 陈和年.生存质量研究.中华预防医学杂志,1996,27(3);178-180.
[7] 彭爱芝.生活质量—一种新型的健康评价方法.天津护理, 2005, 13(3); 182-183
[8] 方积乾. 生存质量测定方法及应用. 北京: 北京医科大学出版社, 2000,25-30.
[9] 方积乾.生存质量测定方法及应用. 第1版 北京:北京医科大学出版社,2000 ,12～17 ,72～75 ,81～84
[10] Spertus JA ,Winder JA ,Dewhurst TA , et al . Development and evaluation of the Seattle Angina Questionnaire :A new functional status measure for coronary artery disease. J Am Coll Cardiol ,1995 ,25 (2) :333～341
[11] 康德英,王家良,洪旗 健康相关生存质量及其评价方法.中华医学, 2001 ,81(13) : 829～830
[12] 刘加林,生存质量量表选择的策略, 四川医学,2006 , 27,( 7),675～676
[13]王家良. 临床流行病学——临床科研设计、衡量与评价.第 2 版. 上海:上海科学技术出版社,2001. 367, 427.
[14] 秦浩 陈景武. 医学量表条目的筛选考评方法及其应用.中国行为医学科2006.15(4).375～376.
[15]方积乾. 生存质量测定方法及应用. 北京: 北京医科大学出版社, 2000,3.
[16]方积乾,郝元涛,李彩霞等.世界卫生组织生活质量量表的信度与效度.中国心理卫生杂志,1999 ,13 (4) :203～205.
[17]郝元涛等. 结构方程模型及其在医学中的应用研究. 中国医院统计.2003 10(4): 240～244.
[18]万崇华.生命质量测定与评价方法.昆明:云南大学出版社.1999.1
[19] 刘智勇,癌症病人生存质量评价及其在中西医结合研究中的应用,中医药研究,2001, 17(1)
[20] 陈雪梅,王儒平,浅谈中医与生存质量的关系,中医药学刊,2006,24(6),1073-1074
[21] 李建婷, 郭新峰.中医药领域应用生存质量评价浅识[J].中医药学刊, 2004,22 (2):264- 5
[22] 陈雪梅,王儒平,浅谈中医与生存质量的关系,中医药学刊,2006,24(6),1073-1074
[23] Massie BM, ShahN B. Evolving trends in the epidemiologic factors of heart failure: rational for preventive strategies and comprehensive disease management.AmHeart J, 1997, 133: 703
[24] KannelW B,HoK,Thom T.Changing epidemiological features ofcardiac fai1ure. BrHeart J, 1994, 72(suppl): S3
[25] J Juenger, D Schellberg, S Kraemer, et al. Health related quality of life in patients with congestive heart failure: comparison with other chronic diseases and relation to functional variables. Heart 2002,87;235-241.
[26] Middel B, Bouma J, De Jongste MJL, Van Sonderen E, Niemeyer MG, Crijns HJGM, Van den Heuvel WJA Psychometric properties of the Minnesota Livi ng with Heart Failure Questionnaire. Clinical Rehabilitation,2001,1 5;489-500.
[27] Arena R, Humphrey R, Peberdy MA Relationship between the Minnesota Living with Heart Failure Questionnaire and key ventilatory expired gas measures during exercise testing in patients with heart failure. Journal of Cardiopulmonary Rehabilitation,2002,22;273-277.
[28] 龚开政. 中文版SF236 量表在心力衰竭患者生存质量评价中的应用研究. 中华物理医学与康复杂志,2004 ,26 (12),732-736
[29] 李伟.心力衰竭病人生命质量的影响因素分析与对策研究.硕士学位论文.天津医科大学;20030701.
[30] 沈维红. 慢性心力衰竭患者的心理调查及护理. 临床护理杂志,2004 ,3 (1);55-57.
[31] Berry C, McMurray J. A review of quality-of-life evaluations in patients with congestive heart failure. Pharmacoeconomics 1999, 16(3);247-71.
[32] 朱燕波,折笠秀树等.慢性心功能不全患者的生活质量,中国临床康复,2004,8(15);2928-2929
[33] Fox E,Landrum 一 McNifK,Z hongZ,et a l.Evaluation of prognostic criteriafor determining hospice eligibility in patients with advanced lung,heart,or liver disease. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments. JAMA,1999,282;1638-45.
[34] 朱燕波,折笠秀树,郑洁,等.心功能不全 QOL 量表中文译本信度效度的初步评价.中国行为医学科学,2004,13(3);337-339.
[35]邓艳红,董吁钢,陈丹丹等.堪萨斯城生存质量量表对慢性心力衰竭患者生存质量评估的可行性评价.中华心血管病杂志,2004,32(8);676-679.
[36] Ware JE. SF-36 Health Survey. Mannual and Interpretation Guide. Boston. MA: The Health Institute, 1993,1
[37]魏朝晖, 莫一心, 陈和年. 生命质量测定量表SF-36 的应用. 国外医学社会医学分册, 1997, 14 (4) : 145-147
[38] 李春波.何燕玲.健康状况调查问卷 SF-36 的介绍. 国外医学精神病学分册.2002,29(2);116-119.
[39] Ware JE, Snow KK, Kosinski M, et al. SF-36 Health survey-manual and interpretation guide. Boston, MA: The Health Institute, New England Medical Center,1993.
[40] 方 积 乾 . 生 存 质 量 测 定 方 法 及 应 用 . 北 京 : 北 京 医 科 大 学 出 版社.2000:263-269.
[41]刘朝杰.36 条目简明量表在中国人群中的适用性研究.华西医大学报.2001; 32(1): 39-42
[42] 任晓晖.用SF-36 量表评价慢性病患者的生命质量. 华西医大学报.2001; 32(2): 250-253
[43] 龚开政等. SF-36 在慢性心力衰竭患者中的信度和效度评价, 中国康复医学杂志, 2004,19(3);182-184
[44] Sidorov J, Shull RD, Girolami S, Mensch D. Use of the short form 36 in a primary care based disease management program for patient program for patients with congestive heart failure. Dis Manag 2003,6(2);111-117
[45] 龚开政等. 明尼苏达州心力衰竭生活质量问卷与36条简明健康状况调查表对慢性心力衰竭患者生活质量的评估作用, 中国临床康复,2004, 9(28); 29-31
[46] 丁家崇.老年人急性左心衰竭的康复治疗与预防.心血管康复医学杂志,1999,8(2);29-31.
[47] ACC/AHA指南:新的心衰指南强调早期诊断和早期治疗.2006.
[48] American College of Cardiology / American Heart Association guidelines: New heart failure guidelines stress early diagnosis and treatment.
[49]Patrick DL, Deyo RA. Generic and disease-specific measures in assessing health status and quality of life. Med Care, 1989, 27: 217-232.
[50]uenger J, Schellberg D, Kraemer S,et al. Health related qualityof life in patients with congestive heart failure: comparison with other chronic diseases and relation to functional variables. Heart 2002 Mar;87(3):235-241.
[51]Middel B, Bouma J, de Jongste M,et al. Psychometric properties of the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Clin Rehabil 2001 Oct;15(5):489-500.
[52]Cohn JN, Tognoni G; Valsartan Heart Failure Trial Investigators. A randomized trial of the angiotensin-receptor blocker valsartan in chronic heart failure. N Engl J Med 2001 Dec 6;345(23):1667-1675.
[53]Cowley AJ, Wiens BL, Segal R,et al. Randomised comparison of losartan vs. captopril on quality of life in elderly patients with symptomatic heart failure: the losartan heart failure ELITE quality of life substudy. Qual Life Res 2000;9(4):377-384.
[54]erry C, McMurray J. A review of quality-of-life evaluations in patients with congestive heart failure. Pharmacoeconomics 1999 Sep;16(3):247-271.
[55]刘凤斌等,生存质量研究及其与中医的关系探讨,医学与哲学,1997, 18 (12).
[56]刘凤斌等,生存质量在中医药研究中的应用探讨,中药新药与临床药理,1997, 8 (3).
[57]张子彬,Tsung O. Cheng[美],张玉传. 充血性心力衰竭学. 第 1 版. 北京:科学技术文献出版社,2000:3-24, 551-570.
[58]方积乾.生存质量测定方法及应用.北京:北京医科大学出版社,2000:3-23,3-47.
[59] 马文军,潘波.问卷的信度和效度以及如何用 SAS 软件分析.中国卫生统计,2000,17(6):364-365.
[60]张子彬,Tsung O. Cheng[美],张玉传. 充血性心力衰竭学. 第 1 版. 北京:科学技术文献出版社,2000:3-24, 551-570.
[61] 朱燕波,折笠秀树,郑洁,等.心功能不全 QOL 量表中文译本信度效度的初步评价[J].中国行为医学科学,2004,13(3);337-339.
[62]郑筱萸.中药新药临床研究指导原则(试行) 北京:中国医药科技出版社,2002:84-85.
[63]国家食品药品监督管理局 2002 年 5 月制定的《中药新药临床指导原则》.
[64]胡大一主编,2005 循证心血管医学.北京:中国科学技术出版社.2006,3.
[65]叶任高等主编.内科学(第六版).北京:人民卫生出版社. 2005.
[66] 孙振球.医学统计学.北京:人民卫生出版社,2002: 405-406.
[67] Ware JE. Standards for validating health measures: Definitionand content. Journal of Ch ronic D isease, 1987, 40 ( 6) : 473- 4801
[68] Ware JE. SF-36 Health Survey. Mannual and Interpretation Guide. Boston. MA: The Health Institute, 1993
[69] Juenger J, Schellberg D, Kraemer S,et al. Health related quality of life in patients with congestive heart failure: comparison with other chronic diseases and relation to functional variables. Heart 2002 Mar;87(3):235-241.
[70] 彭爱芝.生活质量—一种新型的健康评价方法.天津护理, 2005, 13(3); 182-183