Basic technology-data analysis
Calculate the risk score c of the disease combination
A= (hazard score is greater than 1.0)-1.0
B= Risk score is less than 1.0.
C=A +B
Calculate the risk of disease death
D=C ×E (E is the age and sex of the disease in the specific mortality rate)
The existence of death risk is the degree of death risk under the action of risk score.
Comparing the death risk with the average death rate of this age group, we can find the gap between the death risk and the average level.
Basic technology-data analysis
Calculate the evaluation age
Evaluation age is the age value calculated according to the mortality level.
Total death risk ∑ D
Check the age table of health assessment with total death risk.
Calculate growth age
The age of growth is the age that can be achieved through efforts to reduce risk factors.
After changing the risk factor, calculate a new risk score C'.
Calculate the new death risk D'
Calculate growth age
Achievement evaluation-personal evaluation
Healthy type
The evaluation age is younger than the actual age.
Types of self-created risk factors
The evaluation age is older than the actual age, and the evaluation age is quite different from the growth age.
Risk factors that are difficult to change.
The evaluation age is older than the actual age, and there is little difference between the evaluation age and the growth age.
General hazard type
The estimated age is close to the actual age, and the expected death process is equivalent to the local average.
Outcome evaluation-group evaluation
Crowd risk assessment
Find out the key goals of disease prevention and treatment
Attribute analysis of risk factors
Evaluate the effect of health promotion
Analyze the influence of risk factors on health.
Influence of risk factors on life expectancy
Distribution range of risk factors in the population
Identify key risk factors that endanger health.
Multi-level health measurement method
Individual health measurement
Physical health: measuring health and evaluating health
Mental health:
Negative: anxiety, depression, behavioral and emotional control, cognitive function.
Positive: happiness, life satisfaction and other depression, anxiety, personality and psychological screening.
Social health: communication, social function, social support and family.
Group health measurement
Physical health: assess health risk factors, quality of life and health services.
Mental health: epidemiological screening
Social health: assessment of social health status
Health-related quality of life
The quality of life was first put forward by the American economist K.Calbaith in the 20th century.
Macro-level-study people's quality of life.
Micro-level-study the quality of life of individual families.
Medical level-combining quality of life theory with medical practice to form health-related quality of life (HRQOL).
Health-related quality of life: it is a comprehensive evaluation of the physiological, psychological and social life effects caused by diseases and treatments.
concept
A brand-new medical evaluation technology
It not only cares about the survival time of patients, but also cares about the quality of life of patients.
It not only considers objective physiological indexes, but also emphasizes subjective feeling and functional state.
It is not only used to guide clinical treatment, but also used for rehabilitation and health decision-making.
Several definitions abroad
HRQOL technology began in 1949, when Karnofsky and Burchenal used the functional status table to measure the physical function of cancer patients undergoing chemotherapy.
May. K.Aaronson believes that HRQOL is a multidimensional concept, which mainly includes functional status, psychological and social happiness, health awareness and symptoms related to disease treatment.
Morales AJ believes that it is mainly composed of the following four aspects: physiological and professional functions, psychological state, social communication and economic conditions.
Health-related quality of life
definition
It refers to the measurement of health status and subjective satisfaction related to personal life events under the influence of diseases, accidental injuries and medical intervention.
research objects
Mainly patients, including healthy people.
research contents
The relationship between personal life events (decisive factors) and personal health status and subjective satisfaction (changing factors).
Basic idea
Quality of life of people with a certain number of lives at a certain time.
Death means the complete disappearance of the quantity and quality of life.
Health or disease is a constantly changing and indistinguishable state.
The quality of life presents three states: balance, improvement and decreasing with time.
Determination content and index
Physical health
A state that reflects a person's physical strength and vitality.
Activity limitation: refers to the limitation of physical activity and the decline of self-care ability.
Limited social function: it reflects the influence on personal physiology, psychology and social life. It is a comprehensive index reflecting the quality of life.
Physical limitation: refers to the feeling of fatigue, weakness and powerlessness expressed by individuals in daily activities.
Determination content and index
psychology
All diseases will bring different degrees of psychological changes, mainly emotions and consciousness.
Emotional reaction: in some serious chronic diseases (cancer, etc. ), negative emotions are mainly manifested as fear, anxiety, depression and other symptoms, which can be measured by psychological measurement tools.
Cognitive function: In the late stage of any disease, there are cognitive dysfunction, including the loss of wit, thinking, attention and memory.
Determination content and index
Social function state Social communication is a basic need of people and a standard to measure whether a person can live a normal life. According to the depth of social interaction, it can be divided into three levels:
Social integration: refers to individuals belonging to one or more highly close social organizations and participating in society as members.
Social contact: refers to interpersonal communication and community participation.
Intimacy: the closest social trust relationship in personal network.
Determination content and index
Subjective judgment and satisfaction
Self-health and life judgment: refers to patients' comprehensive judgment on disease, life state and life value.
Satisfaction and happiness: both are good emotional responses when personal needs are met.
Satisfaction is the degree of satisfaction with the event. It is the conscious judgment of human beings.
Happiness is a comprehensive feeling state of the whole life, which produces spontaneous spiritual pleasure and vitality. It is used to measure the overall quality of life of patients.
Validity and reliability of the scale
Validity of the scale:
Validity or correctness of measurement results.
Reliability of scale:
Consistency or reliability of measurement results.
Factors affecting scale:
A. representativeness of the sample;
B, measurement content, measurement environment and time;
C, the seriousness of the investigator and the investigator's record.
For example, 1 Health and Happiness Index Assessment (IWB).
Includes two parts.
The first part is about daily activities, such as sports, physical activities and social activities.
The second part includes a comprehensive description of the symptoms and health problems of 2 1.
IWB is positively correlated with the self-evaluation level of people's overall good adaptability, and negatively correlated with age, the number of chronic diseases, the number of doctors and the number of people with bad functional symptoms.
Scale Example 2 Scale of disease impact
Disease Impact Scale is a scale with 136 items established by M.Bergner, including 12 problems, of which 3 are classified as physiological problems, 4 as psychological problems, and the other 5 represent independent problems.
The disease impact scale is mainly used to measure behavior changes and role performance under the influence of disease and treatment.
Example 3 Life Function Index Scale (FLIC) for Cancer Patients
Established by Canadian scholars, with 22 entries.
The disease characteristic scale is suitable for cancer patients, especially for cancer patients with good prognosis, such as breast cancer and cervical cancer.
It comprehensively describes the patient's activity ability, social ability, emotional state and subjective feelings.
Health survey scale (SF-36)
Simplification of American Medical Outcome Questionnaire
Including physical health and mental health.
Widely recognized in Europe and America
14 national translation, testing and specification making
Can be used for international comparison and communication.
Health Survey Scale (SF-36): Contents
Physiological function: question 3
Social function: Question 9( 10)
Physiological function: question 4
Physical pain: questions 7 and 8
Mental health: question 6, question 9
Emotional function: question 5
Vitality: Questions 9(5) and 9(7)
General health: question 1, question 10.
Health change: question 2
Application health monitoring and comparison
1) population health monitoring
2) Evaluation of disease degree
3) Clinical trial efficacy evaluation
4) Effect evaluation of preventive intervention and health care measures
Practical cases of quality of life assessment
Calculate the healthy life year E=∑Wk*Yk.
Health investment benefit evaluation benefit evaluation cost benefit evaluation
Selection of clinical treatment methods