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Rofo 2003; 175(2): 169-175
DOI: 10.1055/s-2003-37221
Qualitätskontrolle
Originalarbeit
© Georg Thieme Verlag Stuttgart · New York

Die Messung der gesundheitsbezogenen
Lebensqualität bei der peripheren
arteriellen Verschlusskrankheit

Assessment of the Quality of Life of Patients with Peripheral Vascular DiseasesW.  A.  Wohlgemuth1, 2 , M.  Niechzial2 , E.  Nagel2 , K.  Bohndorf1
  • 1Klinik für Diagnostische Radiologie und Neuroradiologie, Klinikum Augsburg
  • 2Institut für Medizinmanagement und Gesundheitswissenschaften, Universität Bayreuth
Prof. Günther zum 60. Geburtstag gewidmet.
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Publication History

Publication Date:
13 February 2003 (online)

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Zusammenfassung

Mit dem sog. Short-Form 36 (SF-36) existiert bei der peripheren arteriellen Verschlusskrankheit (pAVK) ein anerkanntes mehrdimensionales Messinstrument der Lebensqualität ergänzt durch drei validierte krankheitsspezifische Messinstrumente (Claudication Scale CLAU-S, Fragebogen PAVK-86, Walking Impairment Questionnaire WIQ), die die krankheitsspezifischen Probleme der Claudicatio intermittens untersuchen. Ein krankheitsspezifisches Messinstrument für die kritische Ischämie fehlt bisher. Schätzen pAVK-Patienten ihre Lebensqualität selbst ein, so fühlen sie diese nicht nur aufgrund reduzierter körperlicher Funktionen (Mobilitätseinschränkungen, häusliche Verrichtungen, Körperpflege u. a.) und Schmerzen beeinträchtigt. Auch Schlaf, soziales und emotionales Wohlbefinden (Ängstlichkeit, Antriebsschwäche) sind stark mitbetroffen. Alle Ergebnisse deuten darauf hin, dass sich die Lebensqualität bei der pAVK unter einer konservativen Therapie nicht verbessert, sondern verschlechtert. Erst durch interventionelle Maßnahmen wie die PTA oder eine erfolgreiche Bypassoperation kommt es zu einer signifikanten Verbesserung der Lebensqualität in allen gemessenen Dimensionen. Die radiologisch interventionelle Therapie der pAVK muss sowohl bei der Indikationsstellung als auch bei der Evaluierung neuer Therapieverfahren zunehmend die Selbsteinschätzung der Lebensqualität der Patienten berücksichtigen.

Abstract

The Medical Outcome Short Form 36 is commonly used as a generic quality of life measure in the assessment of vascular disease. The Claudication Scale CLAU-S, the PAVK-86 Fragebogen, and the Walking Impairment Questionnaire WIQ are validated disease-specific questionnaires for intermittent claudication. A disease specific tool for critical ischaemia is lacking. Quality of life of patients with peripheral arterial occlusive disease is not only impaired in the physical functioning domains (mobility, self care, activities of daily living), but moreover in their social and emotional wellbeing. This situation worsens under conservative treatment. Angioplasty and operation produce similar improvements in all dimensions of hrQOL. As radiological interventional procedures just aim to improve hrQOL and do not bring a definite cure for the underlying disease, patients perception of their quality of life should be taken into account both in the indication for angioplasty and for the scientific evaluation of new treatment modalities.

Schlüsselwörter

Lebensqualität - Claudicatio intermittens (Therapie) - Periphere arterielle Verschlusskrankheit (Psychologie) (Therapie) - Angioplastie

Key words

Quality of life - intermittent claudication (therapy) - peripheral vascular diseases (psychology) (surgery) - angioplasty

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Dr. med. Walter A. Wohlgemuth

Klinik für Diagnostische Radiologie, Klinikum Augsburg

Stenglinstraße 2

86156 Augsburg

Phone: + 49-821-4002453

Fax: + 49-821-4003312

Email: w.wohlgemuth@online.de

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