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The network: a strategy to describe the relationship between quality of life and disease activity. The case of inflammatory bowel disease.

医学 生活质量(医疗保健) 疾病 乙状结肠镜检查 炎症性肠病 感觉 溃疡性结肠炎 健康相关生活质量 物理疗法 内科学 结肠镜检查 心理学 社会心理学 结直肠癌 癌症 护理部
作者
Henrik Hjortswang,Sven Almér,Morten B. Strøm
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期刊:PubMed 卷期号:11 (10): 1099-104 被引量:22
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Health is a complex and multi-dimensional entity and is neither easily determined nor easily conveyed to others. Publications have often combined various variables of disease activity and health-related quality of life (HRQoL), used the variables interchangeably or utilized summation indices to compare health assessment. The aim of this study is to investigate the relationship between measurements of disease activity and HRQoL.design Cross-sectional evaluation of disease activity and HRQoL.Two hundred and eleven consecutive patients with ulcerative colitis.The catchment area of Linköping University Hospital.HRQoL was measured using two questionnaires, the Sickness Impact Profile (SIP) and the Rating Form of IBD Patient Concerns (RFIPC). Patients were also asked if they were 'feeling fit and well', as a measurement of general health perception. Disease activity was measured by means of symptom cards, laboratory tests and sigmoidoscopy.The correlations (Spearman's r (r5)) between variables of disease activity and HRQoL were low. 'Feeling fit and well' was best correlated to worries and concerns (the RFIPC, rs 0.32, P < 0.05), while there was a decreasing association with subjective functional status (the SIP, rs 0.31, P < 0.05), symptoms (stools per day, rs 0.15, not significant) and biological variables (endoscopy score, rs 0.04, not significant).The correlations between traditional measurements of disease activity and various measures of HRQoL are low. We therefore propose a system whereby the process is conceptualized using a 'network strategy', ordering the measurements of disease activity and HRQoL into five dimensions: biological variables, symptoms, functional status, worries and concerns, and health perceptions. We feel that this method of interpretation more accurately reflects the overall health of a group of patients with IBD than more traditional summation indices.

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