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Institute of Environmental Medicine and Industrial Hygiene, National Taiwan University

Institute of Environmental Medicine and Industrial Hygiene, National Taiwan University advisor: Prof. Jung-Der Wang student: Sun-Shen Yang (d96841005). Background & Purpose:.

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Institute of Environmental Medicine and Industrial Hygiene, National Taiwan University

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  1. Institute of Environmental Medicine and Industrial Hygiene, National Taiwan University advisor: Prof. Jung-Der Wang student: Sun-Shen Yang (d96841005) Background & Purpose: The mobility, self-care, usual activities, pain, psychological functioning dimensions were correlated significantly for inter-domain (0.954～0.450), and were correlated to the summary index of EQ-5D (0.891～0.752) , EQ-5D VAS score (-0.783～-0.578) and the score of Barthel Index (-0.900～-0.478)(p < 0.01) (Table 2). The psychological functioning dimension of EQ-5D was found to be a significant predictor for total quality of life(EQ VAS score) ;and months of hemodialysis, self-care, usual activities dimensions of EQ-5D were found to be significant predictors for the score of Barthel Index using regression analysis (Table 3). The International Classification of functioning, Disability and Health(ICF) was recommended by the WHO to standardize descriptions of health and disability. There are 1,424 ICF codes within 30 chapters and four sections: body functions, body structures, activities and participation, and environmental factors. The disability level is linked to the disabled benefits system in our country. The purposes of this study are to compare the relationship between the Barthel Index and EQ-5D in disability evaluation in patients under maintenance of hemodialysis and to examine the suitability of EQ-5D questionnaire for hemodialysis patients to measure health and disability. Comparison of Barthel Index and EQ-5D in Disability Evaluation in Patients under Maintenance Hemodialysis Methods: We interviewed 110 hemodialysis patients and 114 control cases from a regional general hospital and analyzed dataset with SPSS for Windows version 11.0. The scores of EQ-5D were tested with t-test between hemodialysis patients and control group. Paired t-test was used to evaluate the test-retest reliability. Multiple regression analyses were conducted to predict the scores of EQ-VAS and Barthel Index by using five dimensions scores, age and months on hemodialysis. The mean scores of EQ-VAS relating to level 1、2、3 in each dimensions were significantly different (F value:177.01、143.55、186.71、74.23、37.10 , p <0.001, using one way ANOVA). The mean scores of Barthel Index relating to level 1、2、3 in each dimensions were significantly different (F value: 382.95、402.41、404.68、93.39、22.97, p <0.001, using one way ANOVA) . Results : One hundred-ten hemodialysis patients completed the questionnaire July 2006 and these were made up of 48 males and 62 females with a mean age of 65.5±12.9 years (Table 1a). The subjects were suffering from a mean of 34.6±32.8 months on hemodialysis, a mean of 2.6±.6 chronic diseases. The mean score for the mobility, self-care, usual activities, psychological functioning dimensions , and the summary index of hemodialysis patients were significantly greater than the control group. The mean scores for the EQ-VAS of hemodialysis group were significantly less than the control group (using t-test) (Table 1a). The hemodialysis patients selected at random (n=20) were retested after 1 week. The mean score for the mobility, self-care, usual activities, pain, psychological functioning dimensions , summary index, EQ-VAS, and the Barthel Index were no significant differences on test-retest. (using Paired t-test) (Table 1b). Discussion : The EQ-5D questionnaire is suitable for the hemodialysis patients to assess the HRQoL, but is not appropriate to be used in grading the disability level. Because the psychological functioning dimension was found to be a significant predictor for EQ-VAS score, and psychosocial factors may influence functional performance, temporarily or permanently.To consider the relationship between physical dimensions of EQ-5D and the Barthel Index, the usual activities dimension of EQ-5D was more relative to the mobility summary scores of the Barthel Index. The mean scores of the Barthel Index relating to level 1、2、3 in mobility, self-care, usual activities dimensions of EQ-5D were significantly different . The relationship between physical dimensions of EQ-5D and the Barthel Index were examined in this study but the items of instrumental ADL were not included. Conclusion: The EQ-5D questionnaire is suitable for hemodialysis patients to assess the HRQoL, and the physical dimensions is coherent to basic ADL in this study.

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