基于现代与经典测量理论的四种慢性病生命质量测定量表研制及其初步应用

In the biopsychosocial medical model, increasing attention has been paid to quality of life, a people-oriented comprehensive experience indicator. In this study, a disease-specific scale is developed for measuring the quality of life in patients with four kinds of common chronic diseases (cervical spondylosis, osteoporosis, gout, and hyperthyroidism) using a set of strict scale development procedures and methods. The psychometric properties of the new scale are evaluated in preliminary clinical application using the theories of modern measurement (generalizability and item response) and classical test.. After the completion of this project, and combined with our previously established scale for measuring quality of life in patients with 13 chronic diseases (including general module QLICD-GM and disease-specific modules), a comprehensive scale can be formed for measuring the quality of life in Chinese patients with common chronic diseases. This work will provide a comprehensive basis for screening of treatment regimens and evaluation of intervention measures in patients with chronic disease, which is conducive to open up a new direction for clinical research on chronic disease. The research is of great significance for promoting research on the quality of life in patients with chronic diseases, as well as for constructing new evaluation system for the clinical curative effect on chronic diseases.

顺应生物-心理-社会医学模式背景下日益重视生命质量这一“以人为本”的综合体验性指标的趋势，以一套严格的量表开发程序和方法研制4种常见慢性病（颈椎病、骨质疏松、痛风、甲亢）特异性生命质量量表。同时，采用现代测量理论中的概化理论和项目反应理论并结合经典测量理论对其测量学特性在临床应用中进行评价。. 本项目完成后，结合前期研究中已完成的我国慢性病患者生命质量测定量表体系共性模块(QLICD-GM)和13种慢性病的特异模块量表，可以形成一个更加全面的慢性病生命质量测定量表体系。为慢性病患者治疗方案的筛选、干预措施评价等提供综合依据，有利于开辟慢性病临床研究新方向。对于促进我国慢性病患者生命质量研究、新的慢性病临床疗效评价体系构建等均有重要意义。

生命质量量表研制是生命质量研究一项基础和关键性的工作。顺应生物-心理-社会医学模式背景下日益重视生命质量这一“以人为本”的综合体验性指标的趋势，在我们之前的研究中，以共性模块与特异性模块结合的量表开发方式，系统、独立地开发我国慢性病患者生命质量测定量表体系QLICD（Quality of Life Instruments for Chronic Diseases）。该体系目前已包括一个可以用于各种慢性病的共性模块QLICD-GM以及在此基础上形成的13种慢性病的特异测定量表，分别是糖尿病(QLICD-DB)，高血压(QLICD-HY)、冠心病(QLICD-CHD)、慢性胃炎(QLICD-CG)、消化性溃疡(QLICD-PU)、肠易激综合征(QLICD-IBS)、慢性阻塞性肺病(QLICD-COPD)、慢性肺原性心脏病(QLICD-CPHD)和支气管哮喘(QLICD-BA)等。因此，在本项目中，我们延续共性模块和特异模块相结合的方式，揉合现代与经典测量理论，从宏观和微观两个层面，拓展开发适合我国人群的4种常见患病率较高的慢性病（颈椎病、骨质疏松症、痛风、甲亢）生命质量测定的特异量表。初步推广应用临床，并对已开发几种疾病量表（糖尿病、慢性阻塞性肺病、糖尿病肾病等）的测量学特性进行临床测试评价和修订。本项目完成后，形成更加全面的常见慢性病生命质量测定体系，和一种更先进的量表开发理论方法。为慢性病综合治疗及疗效评价提供方便有效的测量工具。对于政府卫生政策的提出，全方位提高慢性病患者的生存质量具有重要的科学价值、社会效益和经济意义。