Research In Health-related Quality Of Life Of General Practice Patients With Common Chronic Diseases With The Generic SF-36 And EQ-5D Scales

â… .ObjectivesTo test performance of the SF-36 Health Survey and the EQ-5D scale.To evaluate health-related quality of life of the general population and general practice patients with common chronic diseases in Hangzhou city.Factors influencing health-related quality of life in patients with common chronic diseases are explored.To develop the norm of the general population for the EQ-5D scale and update the norm of general population for the SF-36 scale in Hangzhou.â…¡.Methods1,Select subjects:Using stratified random sampling.First,three districts were selected from eight districts of Hangzhou randomly.Second,three community health service centers were selected randomly from each district.2,Survey methods and contents:(1)By spot field investigation,1800 general population and 1800 patients were selected to complete the SF-36 and EQ-5D by self-administration.(2)The reliability,validity and responsiveness were tested according to the standard procedure of the International Quality of Life Assessment Project.We compared health-related quality of life of the general population and general practice patients with common chronic diseases.Factors influencing health-related quality of life in patients with common chronic diseases were explored. We also developed the norm of general population for the EQ-5D and updated the norm of the general population for the SF-36 in Hangzhou.3,Statistical analysis:EpiData3.1 were used for data entry.T-test,correlation analysis,factor analysis,nonparametric tests,multivariate analysis of variance, multivariable linear regression and other methods were used for data analysis with software SPSS 16.0 for Windows.â…¢.Results1,The Cronbach' s a coefficients of internal consistency reliability ranged from 0.516 to 0.922.Two-weeks test-retest reliability coefficients ranged from 0.652 to 0.832.The correlations between an item and its hypothesized scale were identical for all.Factor analysis identified two principal components:a"physical"factor and a"mental"factor.Taken together,these two factors could be used to explain 62.5%of the total variance.Coefficients between SF-36 scale "physical"score and age,subjective health and number of comorbidity were -0.356,0.388,-0.126 respectively. Coefficients between SF-36 scale "mental"score and age,subjective health and number of comorbidity were -0.251,0.751,-0.133 respectively.2,Kappa between EQ-5D five dimensions ranged from 0.473 to 0.849.The ICCs of reliability were 0.476 for the EQ-5D index and 0.778 for the VAS score.Patients without impairments on a given EQ-5D dimension tended to have higher SF-36 subscale scores than patients reporting 'any' impairment(i.e.some/moderate or severe).The pearson correlation between EQ-5D index and SF-36 scale ranged from 0.32 to 0.62,and the pearson correlation between EQ-5D VAS and SF-36 scale ranged from 0.33 to 0.6.3,The SF-36 scale scores for patients with seven kinds of chronic diseases were lower than general population,with scores of apoplectic sequela the lowest.Patients with comorbidity had higher SF-36 subscale scores,except mental health subscale,than patients with one chronic disease.The EQ-5D index and VAS for patients with seven kinds of chronic diseases were lower than the general population,with scores of apoplectic sequela the lowest.And patients reporting 'any' impairment on a given EQ-5D dimension were higher than the general population, with apoplectic sequela the highest.Patients with comorbidity had higher EQ-5D index and VAS than patients with one chronic disease.Health-related quality of life was different in sex and age,so we developed the norm of general population for the EQ-5D and updated the norm of the general population for the SF-36 in Hangzhou,according to sex and age respectively.4,Experience of illness,apoplectic sequela and arthritis/rheumatism had obivously influence on scores of SF-36 scale.High blood pressure had positive effects on the PF,RP,BP,VT,SF and MH subscale,and diabetes had positive effects on the BP,SF and MH subscale.Number of comorbidity had influence on PF,RP,BP,GH,VT,SF and RE subscale.Experience of illness,apoplectic sequela,arthritis/rheumatism and back/neck disease had higher reporting impairment rate and lower VAS score of the EQ-5D.Number of comorbidity had influence on morbidity,pain and anxiety dimension.Diabetes had positive effects on the EQ-5D VAS and EQ-5D index,and diabete patients reporting 'any' impairment on a given EQ-5D dimension were lower.High blood pressure patients reporting 'any' impairment on self-care,uaual activities and pain/discomfort dimension were lower.â…£.Conclusions1,The reliability and validity of SF-36 scale was well except SF subscale.The reliability and validity of the EQ-5D scale was also well and its data completion rate was higher than the SF-36,so it had obvious advantages on feasibility and utility.2,Quality of life in patients with chronic diseases were worse than general population,with apoplectic sequela the worst.Experience of illness,apoplectic sequela and arthritis/rheumatism had much more impairments on the quality of life.Number of comorbidity had influence on several aspects of quality of life.