Comparative study of SF-36 and EQ-5D-5L in evaluating quality of life for patients with advanced schistosomiasis

doi:10.12140/j.issn.1000-7423.2021.05.012

Abstract

Abstract:

Objective To compare the effects of the 36-item short form health survey (SF-36) and the five-level EuroQol five-dimensional questionnaire(EQ-5D-5L) on the quality of life of patients with advanced schistosomiasis. Methods A total of 125 patients with advanced schistosomiasis were selected from two hospitals in Jiaxing City in 2020, and the general information of the patients was collected, including name, sex, age, and clinical classification of advanced schistosomiasis. The SF-36 and EQ-5D-5L scales were used in questionnaire; investigate the quality of life of patients with advanced schistosomiasis, the reliability and validity of the two scales in evaluating the quality of life of patients with advanced schistosomiasis, and the degree of differentiation in patients with different health levels were compared. The correlation between the scores of the two scales and the factors influencing patient scores were also analyzed. Results The 125 patients with advanced schistosomiasis ranged in age from 47 to 93 years, with an average age of (75.04 ± 7.53) years. There were 46 males (36.80%) and 79 females (63.20%). There were 54 cases (43.20%) of splenomegaly type and 71 cases (56.80%) of ascitic type. The Cronbach’s α coefficient of internal coherence in SF-36 was 0.780 and two factors were extracted by principal component analysis, with a cumulative contribution rate of 70.427%. The Cronbach’s α coefficient of EQ-5D-5L was 0.850 and two factors were extracted by principal component analysis, with a cumulative contribution rate of 85.884%. Among the dimensions of SF-36, the highest average score was on mental health (66.82 ± 7.90), and the lowest scores were on role physical (0) and role emotional (0); the average score of physical component summary (PCS) was(33.85 ± 8.92) and mental health measurement (MCS) was(39.76 ± 4.93), and number of patients with higher MCS score were higher than those with PCS. The average EQ-5D-5L utility index (UI) score was (0.801 ± 0.214). The patients with the dimension of "pain or discomfort" presenting “moderate difficulty, severe difficulty and extreme difficulty” accounted for highest proportion of 24.80%, and the dimension “anxiety or depression” lowest proportion of 5.60%. The average score on visual analogue scale (EQ-VAS) was 66.64 ± 7.85. The age of the patients showed significant influence on the scores of PCS, MCS and EQ-VAS (P < 0.01), but there was no significant difference in the scores of different gender and clinical classification of the patients (P > 0.05). The UI score and EQ-VAS score of those with higher PCS and MCS scores were higher than those with lower PCS and MCS scores (P < 0.01). With the increase of the severity of each dimension of EQ-5D-5L, PCS and MCS scores of patients decreased. PCS was correlated with UI and EQ-VAS scores (r = 0.716, 0.689, P < 0.01), and MCS was correlated with UI and EQ-VAS scores( r = 0.622, 0.544, P < 0.01). Conclusion Both SF-36 and EQ-5D-5L can be used to evaluate quality of life of patients with advanced schistosomiasis, and the assessment outcomes are comparable and complemental. However, as EQ-5D-5L advantages with higher reliability, validity and simpler system structure, thus is more suitable for evaluation of quality of life of patients with advanced schistosomiasis.

Key words: 36-item short form health survey, Five-level EuroQol five-dimensional questionnaire, Advanced schistosomiasis, Quality of life, Reliability, Validity

CLC Number:

R532.21

LIU Rong, ZHANG Jian-feng, YAN Xiao-lan, WEN Li-yong. Comparative study of SF-36 and EQ-5D-5L in evaluating quality of life for patients with advanced schistosomiasis[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2021, 39(5): 639-645.

Figures/Tables 6

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References 15

[1]	Zhang LJ, Xu ZM, Yang F, et al. Endemic status of schistosomiasis in People’s Republic of China in 2020[J]. Chin J Schisto Control, 2021, 33(3):225-233. (in Chinese)
	( 张利娟, 徐志敏, 杨帆, 等. 2020年全国血吸虫病疫情通报[J]. 中国血吸虫病防治杂志, 2021, 33(3):225-233.)
[2]	Zhang JF, Wen LY, Zhu MD, et al. Recent investigation and treatment of 1 060 advanced schistosomiasis cases in Zhejiang Province[J]. Chin J Parasitol Parasit Dis, 2010, 28(3):214-217. (in Chinese)
	( 张剑锋, 闻礼永, 朱明东, 等. 浙江省1 060例晚期血吸虫病患者近况调查及救治[J]. 中国寄生虫学与寄生虫病杂志, 2010, 28(3):214-217.)
[3]	Li L, Wang HM, Shen Y. Development and psychometric tests of a Chinese version of the SF-36 Health Survey Scales[J]. Chin J Prev Med, 2002, 36(2):109-113. (in Chinese)
	( 李鲁, 王红妹, 沈毅. SF-36健康调查量表中文版的研制及其性能测试[J]. 中华预防医学杂志, 2002, 36(2):109-113.)
[4]	Li L, Chen SJ, Fang YH, et a1. To assess the reliability and validity of Chinese version SF-36 in evaluating the quality of life for subacute post-stroke patients[J]. Chin J Rehabilit Med, 2017, 32(5):509-515. (in Chinese)
	( 李莉, 陈善佳, 方云华, 等. 中文版SF-36用于评价亚急性脑卒中患者生存质量的信度和效度[J]. 中国康复医学杂志, 2017, 32(5):509-515.)
[5]	Sun SP, Long JH, Zhang SX. Reliability and validity of the Mos item short form health survey in evaluating quality of life for patients with benign anorectal diseases[J]. J Color Anal Surg, 2019, 25(5):497-505, 512. (in Chinese)
	( 孙松朋, 龙俊红, 张书信. 中文版SF-36量表应用于肛肠良性疾病患者生命质量评价的信度和效度研究[J]. 结直肠肛门外科, 2019, 25(5):497-505, 512.)
[6]	Xing YB, Ma AX. Introduction to the application of EQ-5D-5L in Chinese[J]. Mod Bus Trade Ind, 2013, 25(1):177-179. (in Chinese)
	( 邢亚彬, 马爱霞. EQ-5D-5L中文版应用介绍[J]. 现代商贸工业, 2013, 25(1):177-179.)
[7]	Ministry of Health of the People’s Republic of China. Hygiene & health standard of the People’s Republic of China:diagnostic criteria for schistosomiasis. WS 261-2006[S]. Beijing: People’s Medical Publishing House, 2006: 3. (in Chinese)
	(中华人民共和国卫生部. 中华人民共和国卫生行业标准:血吸虫病诊断标准 WS 261-2006[S]. 北京: 人民卫生出版社, 2006: 3.)
[8]	Luo N, Liu G, Li M, et al. Estimating an EQ-5D-5L value set for China[J]. Value Health, 2017, 20(4):662-669. doi: 10.1016/j.jval.2016.11.016
[9]	Liang Z, Zhang T, Lin T, et al. Health-related quality of life among rural men and women with hypertension: assessment by the EQ-5D-5L in Jiangsu, China[J]. Qual Life Res, 2019, 28(8):2069-2080. doi: 10.1007/s11136-019-02139-3
[10]	Deng Y, Wang JS, Yuan XB, et al. Reliability and validity of SF-36 in advanced schistosomiasis[J]. Chin J Schisto Control, 2010, 22(1):40-46. (in Chinese)
	( 邓瑶, 王金胜, 袁修柏, 等. SF-36量表应用于晚期血吸虫病患者的信度和效度分析[J]. 中国血吸虫病防治杂志. 2010, 22(1):40-46.)
[11]	You H, Hua HY, Chen JF, et al. Application of SF-36 scale among patients with advanced-schistosomiasis in Jiangsu Province[J]. Chin J Epidemiol, 2012, 33(8):803-807. (in Chinese) pmid: 22967333
	( 尤华, 华海涌, 陈金凤, 等. SF-36量表在江苏省晚期血吸虫病患者中的应用[J]. 中华流行病学杂志, 2012, 33(8):803-807.) pmid: 22967333
[12]	Sawada A, Hiragi S, Tamura H, et al. Evaluation of the quality of life and health-related quality of life of patients with end-stage kidney disease resulting from kidney transplantation using the kidney disease quality of life-short form and EuroQOL-5 dimension-5 level questionnaires[J]. Transplant Proc, 2021, 53(3):881-884. doi: 10.1016/j.transproceed.2020.09.018
[13]	Zeng X, Sui M, Liu R, et al. Assessment of the health utility of patients with leukemia in China[J]. Health Qual Life Outcomes, 2021, 19(1):65. doi: 10.1186/s12955-021-01711-1
[14]	Xia J, Wu NW, Ma TP, et al. Evaluation of reliability and validity of EQ-5D-5L based on residents in southwest China[J]. J Sichuan Univ Med Sci Ed, 2020, 51(5):691-694. (in Chinese)
	( 夏静, 吴念韦, 马天佩, 等. 基于西南地区居民EQ-5D-5L量表信效度评价[J]. 四川大学学报(医学版), 2020, 51(5):691-694.)
[15]	Wang XN, Sun WW, Yan RZ, et al. Application of EQ-5D scale and SF-36 scale in quality of life evaluation of DKD patients[J]. Chin J Integr Tradit West Nephrol, 2020, 21(1):28-31. (in Chinese)
	( 王晓娜, 孙卫卫, 闫润泽, 等. EQ-5D量表与SF-36量表在DKD患者生命质量评价中的应用[J]. 中国中西医结合肾病杂志, 2020, 21(1):28-31.)

	第1水平	第2水平	第3水平	第4水平	第5水平
	Level 1	Level 2	Level 3	Level 4	Level 5
行动能力Mobility	0	0.066	0.158	0.287	0.345
自我照顾 Self-care	0	0.048	0.116	0.210	0.253
日常活动 Usual activity	0	0.045	0.107	0.194	0.233
疼痛或不舒服 Pain/discomfort	0	0.058	0.138	0.252	0.302
焦虑或抑郁 Anxiety/depression	0	0.049	0.118	0.218	0.258

	第1水平Level 1		第2水平Level 2		第3水平Level 3		第4水平Level 4		第5水平Level 5
	例数 No. case	构成比/%Proportion/%	例数 No. case	构成比/%Proportion/%	例数 No. case	构成比/%Proportion/%	例数 No. case	构成比/%Proportion/%	例数 No. case	构成比/%Proportion/%
行动能力Mobility	94	75.20	17	13.60	9	7.20	4	3.20	1	0.80
自我照顾 Self-care	101	80.80	14	11.20	5	4.00	3	2.40	2	1.60
日常活动 Usual activity	51	40.80	56	44.80	13	10.40	2	1.60	3	2.40
疼痛或不舒服 Pain/discomfort	24	19.20	70	56.00	24	19.20	7	5.60	0	0
焦虑或抑郁 Anxiety/depression	47	37.60	71	56.80	7	5.60	0	0	0	0

变量Variable		β值β value	t值t value	P值P value	95%置信区间95%CI
生理健康总测量 Physical component summary	常数Constant		7.860	< 0.01	48.753~81.581
	性别Gender	0.049	0.569	> 0.05	-2.250~4.065
	年龄Age	-0.369	-4.244	< 0.01	-0.641~-0.233
	临床分型Clinical classification	0.001	0.011	> 0.05	-3.011~3.044
心理健康总测量 Mental component summary	常数Constant		11.078	< 0.01	42.823~61.460
	性别Gender	-0.004	-0.050	> 0.05	-1.838~1.747
	年龄Age	-0.270	-3.022	< 0.01	-0.293~-0.061
	临床分型Clinical classification	0.062	0.710	> 0.05	-1.102~2.335
效用指数Utility index	常数Constant		5.297	< 0.01	0.701~1.538
	性别Gender	-0.028	-0.306	> 0.05	-0.093~0.068
	年龄Age	-0.124	-1.344	> 0.05	-0.009~0.002
	临床分型Clinical classification	-0.049	-0.546	> 0.05	-0.098~0.056
视觉模拟标尺EQ-VAS	常数Constant		14.125	< 0.01	85.990~114.025
	性别Gender	0.116	1.385	> 0.05	-0.810~4.583
	年龄Age	-0.429	-5.077	< 0.01	-0.621~-0.273
	临床分型Clinical classification	-0.118	-1.425	> 0.05	-4.446~0.725

	不同分数段Different fractions	例数 No. case	效用指数（均数 ± 标准差） UI ($\bar{x} \pm s$)	t值 t value	P值 P value	视觉模拟标尺（均数 ± 标准差） EQ-VAS ($\bar{x} \pm s$)	t值 t value	P值 P value
生理健康总测量Physical component summary	≤ 34.25	67	0.71 ± 0.25	-6.027	< 0.01	63.28 ± 6.94	-5.762	< 0.01
生理健康总测量Physical component summary	> 34.25	58	0.91 ± 0.10			70.52 ± 7.05
心理健康总测量Mental component summary	≤ 40.13	66	0.72 ± 0.25	-5.085	< 0.01	63.48 ± 7.01	-5.226	< 0.01
心理健康总测量Mental component summary	> 40.13	59	0.89 ± 0.11			70.17 ± 7.25

	水平 Level	例数 No. case	生理健康总测量PCS			心理健康总测量MCS
	水平 Level	例数 No. case	均数 ± 标准差 $\bar{x} \pm s$	F值F value	P值P value	均数 ± 标准差 $\bar{x} \pm s$	F值F value	P值P value
行动能力 Mobility	1	94	36.23 ± 7.63	13.833	< 0.01	40.76 ± 4.39	10.007	< 0.01
	2	17	30.84 ± 7.79			38.54 ± 3.30
	3	9	24.86 ± 5.09			37.19 ± 5.28
	4	4	16.44 ± 7.41			31.59 ± 4.81
	5	1	11.75			22.25
自我照顾 Self-care	1	101	36.05 ± 7.73	12.704	< 0.01	40.65 ± 4.32	7.844	< 0.01
	2	14	27.16 ± 6.41			38.08 ± 3.92
	3	5	24.95 ± 6.69			35.90 ± 6.33
	4	3	16.17 ± 9.25			31.25 ± 5.25
	5	2	18.25 ± 9.19			29.44 ± 10.16
日常活动 Usual activity	1	51	39.06 ± 7.29	21.088	< 0.01	42.23 ± 4.75	14.233	< 0.01
	2	56	32.58 ± 7.16			38.89 ± 3.23
	3	13	25.96 ± 4.55			37.71 ± 4.60
	4	2	21.25 ± 4.95			33.81 ± 3.98
	5	3	11.67 ± 4.88			27.00 ± 3.36
疼痛或不舒服^a Pain/discomfort^a	1	24	40.68 ± 7.53	31.485	< 0.01	42.53 ± 4.70	16.069	< 0.01
	2	70	35.67 ± 6.86			40.63 ± 3.93
	3	24	25.98 ± 5.45			36.65 ± 3.97
	4	7	19.25 ± 7.25			32.32 ± 6.03
焦虑或抑郁^b Anxiety/depression^b	1	47	38.68 ± 7.32	24.423	< 0.01	42.65 ± 4.57	28.537	< 0.01
	2	71	32.11 ± 7.81			38.67 ± 3.47
	3	7	19.14 ± 7.32			31.46 ± 6.38