摘要
目的:确定亚健康的描述性定义和评价标准。
方法:按照德尔菲(Delphi)法原理,对副高级以上职称、对亚健康研究感兴趣且在各自领域具有权威的临床医学、公共卫生学专家进行数轮咨询,首先开展五轮专家讨论会及两轮问卷咨询确定亚健康定义和一级评价指标,接着为调查指标相对重要性开展两轮指标权重专家咨询,最后总结归纳反馈意见,计算相关参数并得出结论。
结果:为探讨亚健康定义开展五轮专家讨论会及两轮问卷咨询,得出亚健康的描述性定义:“亚健康是一种动态的状态,可导致个体可自我感受到的生理功能、心理功能或社会适应功能不同程度的下降,但未达到任何可诊断疾病的标准。”在两轮指标权重专家咨询中,参与专家平均年龄56.8±12.8岁。两轮咨询的回收率分别为100%和89.5%,权威程度平均值分别为0.76和0.75,协调系数分别为0.183和0.348,对协调系数行卡方检验P值均＜0.01。7项一级指标(消化道功能、睡眠、性功能、疲劳、疼痛、情绪、生活快乐和满意度)的加权权重值(%)分别为13.1、15.7、12.0、15.4、13.5、15.8、14.5。
结论:参与本次研究的专家代表性较强,积极性较高,权威性、协调性较好,拟订的亚健康定义较为全面的描述了亚健康的全貌,其评价标准将用于下一步的人群流行病学调查。
Objectives: to establish a descriptive definition and evaluation criterion ofsubhealth.
Methods: According to the principles of Delphi method, we consulted clinical andepidemiological experts who were authoritative in their own fields and interestedin the subhealth study for several times. The titles of them were at least associateprofessors. First, we held 5 charrettes and 2 questionnaire consultations in orderto discuss the definition of subhealth,then we held 2 questionnaire consultationsto evaluate the importance of all the indices.At last, we concluded the feedbackopinions and calculated relevant indications.
Results: After the 5 charrettes and 2 questionnaire consultations, we got adescriptive definition of subhealth that was generally recognized by theexperts--subhealth is a dynamic state that leads to different degrees ofdecreasing of physical, psychological and social adaptive functions which are sensed by individuals, however, the decreasing is not enough to be diagnosed as any diagnostic disease. In the 2 questionnaire consultations, the age of the experts who took part in was 56.8±12.8(mean±SD) years. The return rates of the two consultations were 100% and 89.5%, respectively. The mean values of authorities were 0.76 and 0.75,respectively. The harmonious coefficients were 0.183 and 0.348,respectively,and were both statistic significant(P<0.01). The weighted evaluation scores (%) of the 7 primary indices were as follows: 13.1 (digestive functions),15.7(sleep),12.0(sexual function), 15.4(fatigue), 13.5(pain), 15.8(emotions), 14.5(joy and satisfaction of life). Conclusions: The experts participating this study are of good enthusiasm, authority and the harmony of experts' opinions are acceptable. The definition of subhealth we finally established well describes what subhealth is, and the evaluation criterion is qualified for epidemiological investigation and will be used in population later on.
引文
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