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高血压患者报告结局得分的常模构建

王涵 唐顺定 邓丽 张雯 张晓磬

王涵, 唐顺定, 邓丽, 张雯, 张晓磬. 高血压患者报告结局得分的常模构建[J]. 中华全科医学, 2023, 21(7): 1238-1242. doi: 10.16766/j.cnki.issn.1674-4152.003092
引用本文: 王涵, 唐顺定, 邓丽, 张雯, 张晓磬. 高血压患者报告结局得分的常模构建[J]. 中华全科医学, 2023, 21(7): 1238-1242. doi: 10.16766/j.cnki.issn.1674-4152.003092
WANG Han, TANG Shunding, DENG Li, ZHANG Wen, ZHANG Xiaoqing. Norm construction of scores for patient reported outcomes of hypertension[J]. Chinese Journal of General Practice, 2023, 21(7): 1238-1242. doi: 10.16766/j.cnki.issn.1674-4152.003092
Citation: WANG Han, TANG Shunding, DENG Li, ZHANG Wen, ZHANG Xiaoqing. Norm construction of scores for patient reported outcomes of hypertension[J]. Chinese Journal of General Practice, 2023, 21(7): 1238-1242. doi: 10.16766/j.cnki.issn.1674-4152.003092

高血压患者报告结局得分的常模构建

doi: 10.16766/j.cnki.issn.1674-4152.003092
基金项目: 

云南省科技厅联合专项基金资助项目 2019FE001-181

云南省科技厅联合专项基金资助项目 202101AY070001-221

详细信息
    通讯作者:

    张晓磬,E-mail:zxq84@126.com

  • 中图分类号: R544.1

Norm construction of scores for patient reported outcomes of hypertension

  • 摘要:   目的  构建高血压患者报告结局的划界常模,为社区快速判断高血压患者报告结局状态提供依据。  方法  2020年4—6月,随机抽取云南省2市4县中确诊且为单一用药的社区高血压患者,填写“高血压患者报告结局调查问卷”并计算“PROISCD-HY(V1.0)”量表得分,将人群作聚类分析后,以聚类结果作为人群划分依据,建立高血压患者报告结局得分的划界常模。  结果  此次调查最终收回487份单一用药的高血压患者报告结局调查问卷,经两步聚类法进行聚类分析,将调查对象按年龄和性别分为4类,即:男性≥65岁114例、18~64岁89例,女性≥65岁160例、18~64岁124例。4类人群除“精神/信仰”领域差异无统计学意义外,其余领域差异均有统计学意义(均P<0.05),聚类划分合理。以0.5s为间距,(x±s)和(x±0.5s)为界点构建高血压患者报告结局的划界常模,分为5种状态:[0, x-s)非常差,[x-s,x-0.5s)差,[x-0.5s,x+0.5s)一般,[x+0.5s,x+s)好,[x+s,100)非常好。最终量表总分的划界常模为:[0, 66.23),[66.23, 70.01),[70.01, 77.56),[77.56, 81.33),[81.33, 100)。其中,18~64岁男性量表总分划界常模为:[0, 70.08),[70.08, 73.50),[73.50, 80.34),[80.34, 83.76),[83.76, 100);18~64岁女性为:[0, 68.19),[68.19, 72.08),[72.08, 79.85),[79.85, 83.73),[83.73, 100);≥65岁男性量表总分划界常模为:[0, 65.73),[65.73, 69.43),[69.43, 76.81),[76.81, 80.51),[80.51, 100);≥65岁女性为:[0, 64.15),[64.15, 67.49),[67.49, 74.17),[74.17, 77.51),[77.51, 100)。  结论  此次研究构建了高血压患者报告结局得分划界常模,为后续的高血压患者报告研究提供了数据支持和评价的参考标准。

     

  • 表  1  487例高血压患者一般资料单因素方差分析(x±s,分)

    Table  1.   Univariate analysis of general data of 487 patients with hypertension (x±s, points)

    变量 类别 例数 TOT 统计量 P
    年龄 18~64岁 213 76.36±7.39 6.953a <0.001
    ≥65岁 274 71.78±7.06
    性别 男性 203 74.78±7.83 2.486a 0.013
    女性 284 73.07±7.60
    民族 汉族 229 74.33±9.19 1.477a 0.141
    其他 258 73.29±5.69
    婚姻状况 未婚 6 73.53±6.74 0.602b 0.548
    已婚 423 73.93±7.65
    其他 58 72.77±6.93
    文化程度 初中及以下 458 73.50±7.49 -3.353a 0.001
    初中以上 29 78.30±7.12
    注:TOT为量表总分。at值,bF值。
    下载: 导出CSV

    表  2  最终聚类结果

    Table  2.   The final clustering results

    组别 性别 年龄 例数[例(%)]
    1 男性 ≥65岁 114(23.4)
    2 女性 ≥65岁 160(32.9)
    3 女性 18~64岁 124(25.5)
    4 男性 18~64岁 89(18.3)
    注:文化程度的重要性(0.23)<1.00,因此不纳入聚类分析。
    下载: 导出CSV

    表  3  4组高血压患者PRO得分的单因素方差分析(x±s,分)

    Table  3.   One-way ANOVA of PRO scores in four groups of hypertensive patients (x±s, points)

    组别 例数 PHD MHD SHD SBD GMD SMD TOT
    1 114 69.69±10.12 72.76±11.21 72.07±11.74 60.38±12.04 69.28±8.08 81.36±9.25 73.31±7.42
    2 160 66.25±9.62 69.04±10.41 71.99±9.25 60.21±11.28 67.32±5.91 77.99±10.61 70.88±6.27
    3 124 74.15±12.08 73.38±11.68 78.92±11.26 62.97±12.14 72.98±8.28 80.70±12.32 75.56±8.22
    4 89 75.87±11.34 75.20±10.96 77.89±11.94 61.83±12.34 73.42±7.83 82.74±10.12 76.53±6.98
    F 20.469 6.994 14.303 1.577 19.675 4.340 15.407
    P <0.001 <0.001 <0.001 0.194 <0.001 0.005 <0.001
    注:PHD为身体健康,MHD为心理健康,SHD为社会健康,SBD为精神/信仰健康,GMD为共性模块,SMD为特异性模块,TOT为量表总分。
    下载: 导出CSV

    表  4  高血压患者PHD报告结局量表划界常模(分)

    Table  4.   The cut-off norm of PHD reported outcome Scale in hypertensive patients (points)

    性别 年龄 非常差 一般 非常好
    男性 18~64岁 [0, 65.15) [65.15, 70.78) [70.78, 82.03) [82.03, 87.65) [87.65, 100)
    ≥65岁 [0, 59.45) [59.45, 64.47) [64.47, 74.51) [74.51, 79.53) [79.53, 100)
    合计 [0, 61.41) [61.41, 66.97) [66.97, 78.08) [78.08, 83.63) [83.63, 100)
    女性 18~64岁 [0, 62.24) [62.24, 68.29) [68.29, 80.39) [80.39, 86.44) [86.44, 100)
    ≥65岁 [0, 56.73) [56.73, 61.64) [61.64, 71.44) [71.44, 76.35) [76.35, 100)
    合计 [0, 58.43) [58.43, 64.19) [64.19, 75.71) [75.71, 81.47) [81.47, 100)
    全人群 [0, 59.61) [59.61, 65.32) [65.32, 76.73) [76.73, 82.43) [82.43, 100)
    注:PHD为身体健康。
    下载: 导出CSV

    表  5  高血压患者MHD报告结局量表划界常模(分)

    Table  5.   The cut-off norm of MHD reported outcome Scale in hypertensive patients (points)

    性别 年龄 非常差 一般 非常好
    男性 18~64岁 [0, 65.16) [65.16, 70.50) [70.50, 81.18) [81.18, 86.52) [86.52, 100)
    ≥65岁 [0, 61.05) [61.05, 66.70) [66.70, 77.99) [77.99, 83.63) [83.63, 100)
    合计 [0, 62.74) [62.74, 68.31) [68.31, 79.45) [79.45, 85.02) [85.02, 100)
    女性 18~64岁 [0, 62.43) [62.43, 68.13) [68.13, 79.52) [79.52, 85.21) [85.21, 100)
    ≥65岁 [0, 59.32) [59.32, 64.64) [64.64, 75.27) [75.27, 80.58) [80.58, 100)
    合计 [0, 59.85) [59.85, 65.46) [65.46, 76.68) [76.68, 82.29) [82.29, 100)
    全人群 [0, 60.98) [60.98, 66.61) [66.61, 77.87) [77.87, 83.50) [83.50, 100)
    注:MHD为心理健康。
    下载: 导出CSV

    表  6  高血压患者SHD报告结局量表划界常模(分)

    Table  6.   The cut-off norm of SHD reported outcome Scale in hypertensive patients (points)

    性别 年龄 非常差 一般 非常好
    男性 18~64岁 [0, 66.34) [66.34, 72.29) [72.29, 84.18) [84.18, 90.12) [90.12, 100)
    ≥65岁 [0, 60.31) [60.31, 66.16) [66.16, 77.86) [77.86, 83.71) [83.71, 100)
    合计 [0, 62.59) [62.59, 68.67) [68.67, 80.82) [80.82, 86.89) [86.89, 100)
    女性 18~64岁 [0, 67.40) [67.40, 73.17) [73.17, 84.70) [84.70, 90.46) [90.46, 100)
    ≥65岁 [0, 63.13) [63.13, 67.76) [67.76, 77.01) [77.01, 81.63) [81.63, 100)
    合计 [0, 64.45) [64.45, 69.85) [69.85, 80.64) [80.64, 86.03) [86.03, 100)
    全人群 [0, 63.66) [63.66, 69.35) [69.35, 80.72) [80.72, 86.40) [86.40, 100)
    注:SHD为社会健康。
    下载: 导出CSV

    表  7  高血压患者SBD报告结局量表划界常模(分)

    Table  7.   The cut-off norm of SBD reported outcome Scale in hypertensive patients (points)

    性别 年龄 非常差 一般 非常好
    男性 18~64岁 [0, 49.51) [49.51, 55.75) [55.75, 68.23) [68.23, 74.47) [74.47, 100)
    ≥65岁 [0, 48.39) [48.39, 54.35) [54.35, 66.27) [66.27, 72.23) [72.23, 100)
    合计 [0, 48.87) [48.87, 54.96) [54.96, 67.13) [67.13, 73.21) [73.21, 100)
    女性 18~64岁 [0, 50.51) [50.51, 56.68) [56.68, 69.01) [69.01, 75.17) [75.17, 100)
    ≥65岁 [0, 49.25) [49.25, 54.86) [54.86, 66.08) [66.08, 71.69) [71.69, 100)
    合计 [0, 49.75) [49.75, 55.63) [55.63, 67.38) [67.37, 73.25) [73.25, 100)
    全人群 [0, 49.39) [49.39, 55.35) [55.35, 67.27) [67.27, 73.23) [73.23, 100)
    注:SBD为精神/信仰健康。
    下载: 导出CSV

    表  8  高血压患者GMD报告结局量表划界常模(分)

    Table  8.   The cut-off norm of GMD reported outcome Scale in hypertensive patients (points)

    性别 年龄 非常差 一般 非常好
    男性 18~64岁 [0, 66.22) [66.22, 70.04) [70.04, 77.68) [77.68, 81.5) [81.50, 100)
    ≥65岁 [0, 61.02) [61.02, 65.06) [65.06, 73.13) [73.13, 77.16) [77.16, 100)
    合计 [0, 62.97) [62.97, 67.08) [67.08, 75.29) [75.29, 79.39) [79.39, 100)
    女性 18~64岁 [0, 64.76) [64.76, 68.95) [68.95, 77.32) [77.32, 81.50) [81.50, 100)
    ≥65岁 [0, 61.51) [61.51, 64.52) [64.52, 70.54) [70.54, 73.55) [73.55, 100)
    合计 [0, 62.32) [62.32, 66.15) [66.15, 73.80) [73.80, 77.62) [77.62, 100)
    全人群 [0, 62.57) [62.57, 66.52) [66.52, 74.42) [74.42, 78.37) [78.37, 100)
    注:GMD为共性模块。
    下载: 导出CSV

    表  9  高血压患者SMD报告结局量表划界常模(分)

    Table  9.   The cut-off norm of SMD reported outcome Scale in hypertensive patients (points)

    性别 年龄 非常差 一般 非常好
    男性 18~64岁 [0, 72.81) [72.81, 77.92) [77.92, 88.14) [88.14, 93.25) [93.25, 100)
    ≥65岁 [0, 72.03) [72.03, 76.61) [76.61, 85.76) [85.76, 90.33) [90.33, 100)
    合计 [0, 72.34) [72.34, 77.17) [77.17, 86.83) [86.83, 91.66) [91.66, 100)
    女性 18~64岁 [0, 71.37) [71.37, 76.50) [76.50, 86.76) [86.76, 91.89) [91.89, 100)
    ≥65岁 [0, 65.34) [65.34, 71.39) [71.39, 83.48) [83.48, 89.52) [89.52, 100)
    合计 [0, 67.76) [67.76, 73.51) [73.51, 85.01) [85.01, 90.76) [90.76, 100)
    全人群 [0, 69.55) [69.55, 74.98) [74.98, 85.83) [85.83, 91.25) [91.25, 100)
    注:SMD为特异性模块。
    下载: 导出CSV

    表  10  高血压患者TOT报告结局量表划界常模(分)

    Table  10.   The cut-off norm of TOT reported outcome Scale in hypertensive patients (points)

    性别 年龄 非常差 一般 非常好
    男性 18~64岁 [0, 70.08) [70.08, 73.50) [73.50, 80.34) [80.34, 83.76) [83.76, 100)
    ≥65岁 [0, 65.73) [65.73, 69.43) [69.43, 76.81) [76.81, 80.51) [80.51, 100)
    合计 [0, 67.40) [67.40, 71.09) [71.09, 78.47) [78.47, 82.16) [82.16, 100)
    女性 18~64岁 [0, 68.19) [68.19, 72.08) [72.08, 79.85) [79.85, 83.73) [83.73, 100)
    ≥65岁 [0, 64.15) [64.15, 67.49) [67.49, 74.17) [74.17, 77.51) [77.51, 100)
    合计 [0, 65.47) [65.47, 69.27) [69.27, 76.87) [76.87, 80.67) [80.67, 100)
    全人群 [0, 66.23) [66.23, 70.01) [70.01, 77.56) [77.56, 81.33) [81.33, 100)
    注:TOT为量表总分。
    下载: 导出CSV
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  • 收稿日期:  2022-09-15
  • 网络出版日期:  2023-08-28

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