慢性疾患・難治性疾患患者のQOL : 研究の視点について(指定演題1,臨床判断学とQOL評価)

概要

論文の詳細を見る
Health-related quality of life (HRQOL) has been acknowledged as important and relevant end points in clinical trials. Since the measure of QOL is derived from patients' subjective experience of illness and treatment, application of the outcome in clinical studies has great potential for us to expand traditional clinical research to more holistic science. In this article, I argue that we should overcome a profound barrier to make meaningful use of patient's report of QOL in clinical studies. The barrier is rooted in the positivistic paradigm of bio-medicine, prevalent in medicine and clinical epidemiology. I would argue that we should start from sympathetic understanding of the 'patient's world of illness' through hermeneutic approach, and that we need to move towards an ecological framework in which clinical, psychological, and social conditions of patients are systematically theorized. Accordingly, a new generation of clinical trials may be necessary in terms of mode of interventions, study design, and analytic methods in order to understand the complex interaction among clinical medicine, social environment, and patients' psychological attributes.
東京女子医科大学の論文
2000-05-25