The MOS SF-36 health survey questionnaire in severe chronic airflow limitation: Comparison with the Nottingham health profile

This study documents the cross-sectional, health-related quality of life (HRQOL) measures obtained at baseline for patients with severe chronic airways limitation (CAL) being assessed for home oxygen therapy (HOT) at the Flinders Medical Centre, Adelaide, South Australia. Two generic quality of life instruments, the Nottingham Health Profile (NHP) and the Medical Outcomes Study (MOS) short form 36-item questionnaire (SF-36), were administered by interview to the same patients to permit comparisons to be made between the two instruments. SF-36 mean scores were also compared with scores obtained in separate studies of a South Australian elderly general population and of groups of Australian subjects with various medical and psychiatric conditions. NHP mean scores were compared with scores from an elderly group of Adelaide residents from a household survey. HRQOL measures were obtained for 60 patients, 32 males and 28 females. At assessment for HOT, patients with severe CAL were experiencing severe impairment in their quality of life in comparison to age-matched South Australian norms, with physical disability the major limitation. There were several significant correlations between the domains of the SF-36 and the NHP which were predominantly gender-specific. Only small decrements in mental health were found with the SF-36 questionnaire. The SF-36 and the NHP appear to provide discrepant information for severely disabled CAL patients for the subjective domains of emotional and mental health.     

冠心病患者中文版SF-36和QOL-35量表的相关分析

目的 了解两种量表(SF-36和QOL-35)对生活质量分析的一致性.方法 2008年6月至2009年4月北京协和医院心内科就诊并进行冠状动脉造影的冠心病患者或可疑冠心病患者781例,采用中文版SF-36和QOL-35量表对患者的生活质量进行测量,并收集患者的一般人口学资料和临床资料.对SF-36和QOL-35量表结果进行简单相关分析和典型相关分析.结果 781例患者SF-36总得分为62.63±12.47,QOL-35总得分为62.70±9.69.简单相关分析显示SF-36总分和QOL-35总分(r=0.725,P＜0.01),SF-36生理机能和QOL-35独立生活能力(r=0.933,P＜0.01),SF-36精神健康和QOL-35心理健康(r=0.132,P＜0.01),SF-36社会功能和QOL-35社会功能(r=0.215,P＜0.01)之间均具有相关性.典型相关分析显示SF-36和QOL-35之间相关性显著(r=0.946,P＜0.01).结论 SF-36和QOL-35在评价冠心病患者生活质量总体水平一致.     

Quality of life of patients with irritable bowel syndrome in Korea

Objective  The impact of irritable bowel syndrome (IBS) on HRQOL has been widely studied in the West. However, there are few data from Asian countries. The aim of this study was to assess the health-related quality of life (HRQOL) of patients suffering from IBS in Korea. Methods  Consecutive patients from six secondary and six tertiary medical centers in Korea were enrolled and completed self-administered questionnaires on sociodemographics and IBS-associated symptoms. HRQOL was assessed using the generic Short Form 36 (SF-36) and the disease-specific IBS-QOL questionnaires. Results  Of the 932 patients with abdominal pain and bowel symptoms, 664 IBS patients who fulfilled the Rome II criteria were analyzed. On all eight SF-36 scales, IBS patients had a significantly worse HRQOL than the general population (P < 0.01). The overall score for the IBS-QOL was 74.2. The health concern domain was most affected (mean score 64.2), and the sexual domain (mean score 86.7) was least affected in the IBS-QOL. Significant impairment of HRQOL was only observed in patients with severe symptoms both in the generic and specific HRQOL measurement, whereas patients with mild and moderate symptoms showed only mild impairment (P < 0.01). Female patients reported a significantly lower HRQOL than male patients (P < 0.05), but the difference was minimal. The IBS-QOL was significantly associated with female gender, total symptom score, self-reported symptom severity, and level of education in the multivariate analysis. Conclusions  IBS-related symptoms had a great effect on the HRQOL of Korean patients. These results and the considerable prevalence of IBS in Korea indicate that IBS has a substantial social impact in this country.     

Severity of cardiovascular disease and health-related quality of life in men with prostate cancer: a longitudinal analysis from CaPSURE

OBJECTIVE: To evaluate the influence of comorbid cardiovascular disease severity on health-related quality of life (HRQL) in men treated with radical prostatectomy (RP) or radiotherapy (RT) for early stage prostate cancer. METHODS: Subjects (n=830) with non-metastatic disease who had been diagnosed in 2000-2002 were drawn from Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE). We evaluated the influence of cardiovascular disease (CVD) severity on generic and disease-specific HRQL before and 6, 12, 18, and 24 months after treatment with RP or RT. HRQL was measured with the SF-36 and the UCLA Prostate Cancer Index. RESULTS: Men with moderate (n=193) or severe (n=51) cardiovascular disease had worse pre-treatment HRQL than did men without CVD (n=293) (P<0.01); HRQL scores were worse in men referred for RT. During 24 months of follow-up, men with moderate or severe CVD had worse SF-36 physical and mental component summaries and worse bowel function at all time points (P<0.05). Men with severe CVD also experienced a slower recovery in physical function (P=0.03) and sexual functioning (P=0.02) than did men without CVD. CONCLUSIONS: Prostate cancer patients with moderate to severe CVD have worse HRQL during follow-up. Those with severe CVD recover their physical and sexual functioning more slowly after treatment.     

Sleep disturbance in relation to health-related quality of life in adults: The fels longitudinal study

Objective  Sleep disturbances are prevalent problems in the general population. Symptoms of insomnia can impact various physical and mental conditions. Furthermore, sleep disturbances may worsen the quality of life independently of co-occurring medical conditions. In this study, we examined the relationships between self-reported sleep disturbance symptoms and health-related quality of life measures in the Fels Longitudinal Study. Design  Cross-sectional study. Participants  A total of 397 adults (175 men and 222 women) aged 40 years and older were included in the present study. Measurements  Three self-reported sleep disturbance measures (difficulty falling asleep, nocturnal awakenings and maintaining sleep, and daytime tiredness) were collected between 2003 and 2006. Health-related quality of life measures were assessed using the Medical Outcomes Survey Short Form (SF)-36. Socio-demographic status (marital status, employment status, and education) and current medical conditions were collected from participants during study visits. Results  Individuals who reported frequent sleep disturbances showed significantly worse quality of life on all SF-36 subscales examined. The odds ratio (OR) ranged from 1.71 to 18.32 based on symptoms of insomnia across seven SF-36 domains in analyses adjusted for significant covariates influencing quality of life. Participants with severe sleep disturbances (both sleep problems and daytime impairment) showed generally higher odds of reporting poor SF-36 scores (adjusted ORs; 5.88–17.09) compared to participants with no problems. Conclusion  Sleep disturbance is comprehensively and independently associated with poor health-related quality of life in middle-aged and older adults.     

Demoralisation, distress and pain in older Western Australians

OBJECTIVE: To assess the relationship of psychiatric morbidity, morale, physical activity and the presence of pain in older people. METHOD: Older people attending senior citizens' clubs were administered the 28-item General Health Questionnaire (GHQ-28), the Revised Philadelphia Geriatric Centre Scale (RPGCS) and five self-report questions from the Brief Disability Questionnaire. They also rated the presence of pain on a five-point scale. Multiple and logistic regression were used to adjust for socio-demographic factors and identify variables independently associated with psychological status and morale. RESULTS: Of 112 people approached, 86% agreed to take part (n = 96). The sample showed a wide range in total GHQ scores (mean = 2.9, range = 0-19) and RPGCS scores (mean = 2.3, range = 1.1-3.0). Twenty-one per cent had psychological distress as defined by a score of > or = 6 on the GHQ-28 (n = 19). Fifty-four respondents (56%) reported low morale as defined by a score < 2 on the RPGCS. There was a close relationship between psychological distress, low morale on the RPGCS (OR = 5.5 [1.5-20.5]) and moderate to severe pain (OR = 5.3 [1.8-15.9]). When adjusted odds ratios were calculated to control for confounding factors, moderate to severe pain remained independently associated with psychological distress (OR = 1.6 [1.3-2.4] p = 0.02), and limitations in daily activities with low morale (OR = 3.64 (1.001-8.4) p = 0.05). CONCLUSIONS: There is a close relationship between physical disability, low morale and psychological distress. IMPLICATIONS: An increased index of suspicion for psychological distress is warranted in all older people with physical disability, particularly in the presence of moderate to severe pain.     

郑州市社区常见慢性病患者HRQoL的评价 及影响因素分析

摘要:目的　了解社区慢性病居民HRQoL水平及影响因素。方法　用浙大版SF-36量表,采用分层随机抽样,入户问卷调查,调查区包括1个中心城区和1个新兴城区。结果　共调查705人,常见慢性病占36.60%;慢性病患者与非慢性病患者在7个维度的得分有差异;不同患病种类数的生理健康各维度得分均有差异;健康状况的自我判断、NCDs患病数、两周内是否患病、食欲状况和在岗时职业对生理健康的影响显著,Adjusted R2＝0.407;健康状况的自我判断、年龄、与家人相处情况和对目前生活状况的满意度对心理健康影响显著,Adjusted R2＝0.179。结论　社区慢性病患者HRQoL低于非慢性病患者,应通过社区健康管理和改善亲友关系来提高其HRQoL。     

高效抗逆转录病毒治疗艾滋病病人生命质量影响因素研究

[目的]探讨接受高效抗逆转录病毒治疗（HAART）的艾滋病病人生命质量及其影响因素。[方法]采取典型粕耐羊的方法,选择在2009年4月以前在8个抗病毒医院接受抗病毒治疗的艾滋病病人作为研究对象,使用中文版SF-36量表和自编基本情况调查表对研究对象进行横断面调查,应用EpiData3．1建立数据库,用SPSS12．0进行统计分析。[结果]①1194名调查对象SF-36量表8个领域百分转换得分中以躯体功能（PF）得分最高（86．00土18．48）,总健康（GH）得分最低（44．37士21．59）领域间得分差异有显著性（P〈0．01）;②女性患者的总健康（GH）、肌体疼痛（BP）维度得分高于男性患者（P〈0．05）;年龄小的患者PF、GH得分高于年龄大的患者（P〈0．05）;文化程度低的患者的PF、VT、RE、MH、BP得分低于文化程度高的患者（P〈0．05）;已婚患者生命质量好于未婚和离异／独居／分居患者（P〈0．05）;农村户籍的调查对象的PF、GH、SF 3个维度得分明显高于城镇户籍的调查对象（P〈0．05）;公职人员、个体从业人员生命质量好于无业人员和农民（P〈0．05）。[结论]性别、年龄、文化程度、婚姻状况、户籍、职业是影响高效抗逆转录病毒治疗艾滋病患者生命质量的因素。     

Comparing the Discriminative Validity of Two Generic and One Disease-Specific Health-Related Quality of Life Measures in a Sample of Patients with Dry Eye

OBJECTIVE: The purpose of this study was to compare the discriminative properties of two generic health-related quality of life (QoL) instruments (SF-36 and EQ-5D) and a newly developed disease-specific patient-reported outcomes instrument (Impact of Dry Eye on Everyday Life (IDEEL)) to distinguish between different levels of dry eye severity. METHODS: Assessment of 210 people: 130 with non-Sjogren's Keratoconjunctivitis Sicca (non-SS KCS), 32 with Sj?gren's Syndrome (SS) and 48 controls; comparison of SF-36, EQ-5D, and IDEEL age-adjusted data by dry eye severity levels. Severity was assessed based on diagnosis (non-SS KCS, SS, control), patient-report (none, very mild, mild, moderate, severe, extremely severe) and clinician-report (none, mild, moderate, severe). RESULTS: Discriminative validity results were consistent for all instruments. Significant differences between severity levels were found with most SF-36 scales (P < 0.05), all EQ-5D scales (P < 0.05), and all IDEEL scales (P < 0.0001), except for Treatment Satisfaction. IDEEL scales consistently outperformed the generic QoL measures regardless of the severity criterion used. Most SF-36 scales outperformed the EQ-5D QoL scale, but the EQ-5D visual analog scale outperformed the SF-36 scales, except for General Health Perceptions. CONCLUSIONS: The disease-specific IDEEL scales are better able to discriminate between severity levels than the majority of the generic QoL scales. Preliminary evidence demonstrates that the IDEEL will be sensitive to QoL changes over time, although further testing in controlled longitudinal studies is needed.     

Development and testing of a utility measure for major, unipolar depression (McSad)

Objective: To develop and test a direct utility measure (McSad) for major, unipolar depression. Methods: A depression specific, multi-attribute health state classification system was created; clinical validity was evaluated by experts using specially designed structured exercises; a cross-sectional survey was conducted to obtain directly measured utilities for depression health states. Setting: Tertiary care, university medical centre. Participants: Three psychiatrists, 3 psychiatric nurses and 3 social workers assessed depression health state clinical validity. Survey participants were referred by psychiatrists and consisted of 105 out-patients, currently in remission with at least one episode of major, unipolar depression in the past two years. Survey results: Respondent self-health state utility (mean and 95% confidence interval (CI)) was 0.79 (0.74–0.83). Utilities for hypothetical, untreated depression health states were: mild depression, 0.59 (0.55–0.62); moderate depression, 0.32 (0.29–0.34); severe depression, 0.04 (0.01–0.07). Fifty-six percent of respondents rated severe depression worse than being dead. Utilities for the hypothetical health states were not correlated with self-health utility. The intra-class correlation coefficient (ICC) was satisfactory for 13 of the 14 health states assessed. Conclusions: McSad was feasible and acceptable in patients with a history of major unipolar depression. The utilities for mild, moderate and severe untreated depression show the low health-related quality of life associated with depression. Initial assessments of test–retest reliability and validity yielded satisfactory results but further studies are needed to extend our knowledge of the measurement properties of McSad.     

The relationship between quality of life and posttraumatic stress disorder or major depression for firefighters in Kaohsiung,Taiwan

Objective The work of firefighters involves the risk of exposure to the harmful effects of toxic substances as well as the possibility of enormous emotional shock from disasters, which may result in psychiatric impairments and a lower quality of life. Therefore, we examined quality of life, prevalence of posttraumatic stress disorder (PTSD) and major depression, and the related risk factors for firefighters in Kaohsiung, Taiwan. Methods This is a two-stage survey study. During the first stage, we used the 36-item Short-Form Health Survey (SF-36) and the Disaster-Related Psychological Screening Test (DRPST) to assess quality of life, probable PTSD, probable major depression, and the related risk factors for 410 firefighters. During the second stage, psychiatrists categorized these probable cases according to self-reported questionnaires against DSM-IV into PTSD or major depression group, subclinical group, and health group. All the data were analyzed with SPSS 10.0 Chinese version. Results The estimated current prevalence rates for major depression and PTSD were 5.4% (22/410) and 10.5% (43/410), respectively. The firefighters with estimated PTSD or major depression scored significantly lower on quality of life measures than subclinical PTSD/major depression and mentally healthy groups, which was evident in eight concepts and two domains of the SF-36. The major predictors of poor quality of life and PTSD/major depression were mental status, psychosocial stressors, or perceived physical condition. Conclusion Firefighters have a higher estimated rate of PTSD, and the risk factors that affect quality of life and PTSD/major depression should encourage intervention from mental health professionals.     

SF-36在我国COPD患者中应用的评价

目的评价医学结局调查评分(SF-36)在我国慢性阻塞性肺疾病(COPD)患者中应用的价值。方法对50例稳定期COPD患者进行英国医学研究会(MRC)呼吸困难分级、SF-36及肺功能测定,并对其结果进行相关性分析和多元逐步回归分析,计算Pearson相关系数,评价SF-36的有效性。结果相关分析:MRC呼吸困难分级和SF-36的7个部分有相关性(P<0.01),肺功能指标和SF-36的3个部分有相关性(P<0.05或<0.01)。多元逐步回归分析MRC呼吸困难分级是SF-36的7个部分有意义的预测因素,肺功能指标中的用力肺活量(FVC)、第1秒钟用力呼气量(FEV1)、残气量(RV)和残气肺总量比(RV/TLC)分别是SF-36的4个部分有意义的预测因素。但与MRC呼吸困难分级相比,它们对生活质量的影响较小。结论SF-36是评价我国COPD患者生活质量的有效工具,和肺功能指标相比,呼吸困难的严重性是SF-36各个部分最有意义的预测因素。     

Factors influencing health-related quality of life of Asians with anxiety disorders in Singapore

As little is known about health-related quality of life (HRQoL) in Asians with anxiety disorders, we assessed HRQoL in Singaporeans with anxiety disorders and identified factors influencing their HRQoL. Outpatients with anxiety disorders (n = 119) attending a hospital psychiatric clinic completed the Short Form 36 Health Survey (SF-36), Beck Anxiety Inventory (BAI) and General Health Questionnaire (GHQ-12). SF-36 score reduction from population norms (quantified as the number of standard deviations below the mean) in these subjects was compared with existing data on Singaporeans with various medical conditions and Americans with panic disorder (PD). Factors influencing HRQoL were examined using stepwise multiple linear regression models. SF-36 score reduction in these subjects (0.3-1.4 SD) was greater than that in Singaporeans with systemic lupus erythematosus or thyroid cancer survivors for seven scales but similar to that in Americans with PD (0.5-1.7 SD). BAI and GHQ-12 scores, presence of PD/generalized anxiety disorder, presence of chronic medical conditions, being married or increasing age accounted for 19-61% of the variance in six selected SF-36 scales. In conclusion, it can be said that Singaporeans with anxiety disorders experience clinically important reductions in HRQoL; both clinical and socio-demographic factors influence HRQoL in such subjects.     

COPD稳定期患者疾病严重程度与生命质量的相关性研究

目的研究慢性阻塞性肺疾病稳定期患者疾病严重程度与生命质量的相关性。方法对79例慢性阻塞性肺疾病稳定期患者进行综合评估,根据严重程度分为A、B、C和D组,与对照组（18例）分别进行36条目健康测量简表（SF-36）评分,比较组间生命质量各维度的差别。结果A组患者在SF-36量表各维度得分与对照组比较,差异无统计学意义（P〉0．05）。B、C和D组患者生命质量较对照组下降,D组下降维度最多且得分最低。结论COPD患者的生活质量较差,随着COPD患者疾病严重程度增加其生命质量下降。     

The Short Form Health Survey (SF-36): Translation and validation study of the Iranian version

This was a large population-based study to develop and validate the Iranian version of the Short Form Health Survey (SF-36) for use in health related quality of life assessment in Iran. A culturally comparable questionnaire was developed and pilot tested. Then, the Iranian version of the SF-36 was administered to a random sample of 4163 healthy individuals aged 15 years and over in Tehran. The mean age of the respondents was 35.1 (SD=16.0) years, 52% were female, mostly married (58%) and the mean years of their formal education was 10.0 (SD=4.5). Reliability was estimated using the internal consistency and validity was assessed using known groups comparison and convergent validity. In addition factor analysis was performed. The internal consistency (to test reliability) showed that all eight SF-36 scales met the minimum reliability standard, the Cronbachs coefficients ranging from 0.77 to 0.90 with the exception of the vitality scale (=0.65). Known groups comparison showed that in all scales the SF-36 discriminated between men and women, and old and the young respondents as anticipated (all p values less than 0.05). Convergent validity (to test scaling assumptions) using each item correlation with its hypothesized scale showed satisfactory results (all correlation above 0.40 ranging from 0.58 to 0.95). Factor analysis identified two principal components that jointly accounted for 65.9% of the variance. In general, the Iranian version of the SF-36 performed well and the findings suggest that it is a reliable and valid measure of health related quality of life among the general population.     

Serving street-dwelling individuals with psychiatric disabilities: outcomes of a psychiatric rehabilitation clinical trial

OBJECTIVES: This study tested a psychiatric rehabilitation approach for organizing and delivering services to street-dwelling persons with severe mental illness. METHODS: Street-dwelling persons with severe mental illness were randomly assigned to the experimental program (called Choices) or to standard treatment in New York City. We assessed study participants at baseline and at 6-month intervals over 24 months, using measures of service use, quality of life, health, mental health, and social psychological status. The average deviation from baseline summary statistic was employed to assess change. RESULTS: Compared with persons in standard treatment (n = 77), members of the experimental group (n = 91) were more likely to attend a day program (53% vs 27%), had less difficulty in meeting their basic needs, spent less time on the streets (55% vs 28% reduction), and spent more time in community housing (21% vs 9% increase). They showed greater improvement in life satisfaction and experienced a greater reduction in psychiatric symptoms. CONCLUSIONS: With an appropriate service model, it is possible to engage disaffiliated populations, expand their use of human services, and improve their housing conditions, quality of life, and mental health status.     

Binge status and quality of life after gastric bypass surgery: a one-year study

OBJECTIVE: This study evaluated gastric bypass surgery outcomes according to presurgical binge eating severity. RESEARCH METHODS AND PROCEDURES: Adult patients completed assessment questionnaires including the Short Form-36, Gormally Binge Eating Scale (BES), and Beck Depression Inventory (BDI) before and 12 months after surgery. RESULTS: One hundred nine patients (18 men, 91 women) were recruited. Based on their baseline BES scores, patients were non- [n = 52 (48%)], moderate [n = 31 (28%)], or severe [n = 26 (24%)] binge eaters. Although the percentage of excess weight loss was greatest after 12 months in the severe binge eaters, the difference among groups was not significant. Severe binge eaters had higher baseline BDI scores than either non- or moderate binge eaters (p = 0.001). After surgery, BDI scores declined significantly in all groups from the baseline scores but remained higher postoperatively in the severe binge eaters (p = 0.018). BES scores declined significantly (p = 0.000) after surgery within all groups. There was no difference in the Short Form-36 physical component summary scores at baseline among groups. Mental component summary scores were significantly lower in the severe binge eaters (p = 0.001). After surgery, there was no difference among groups in either physical or mental component summary scores. DISCUSSION: In conclusion, data from the present study suggest that patients have similar outcomes in terms of improved depression scores, binge eating behavior, and health-related quality of life regardless of their binge eating severity before surgery. Patients with the most severe binge eating behavior before surgery showed the most improvement when assessed 12 months after surgery.     

PICC导管在重型颅脑损伤患者中的应用及护理配合要点

目的 研究重型颅脑损伤患者应用PICC导管的护理配合要点.方法 样本取自医院2019年4月—2020年8月收治的50例重型颅脑损伤患者,均应用PICC导管,采用"双盲法"分参照组(传统护理,n=25)、试验组(综合护理,n=25),两组生活质量、情绪状态、并发症发生率及置管成功率比较.结果 护理前比较SF-36评分、情...