社区人群生活质量研究—年龄差异及其影响因素

本文为社区人群生活质量系列研究之一，重点介绍生活质量的年龄差异。通过对湖南省４８００户城乡家庭的生活质量调查，发现随着年龄的增加，躯体功能、心理功能、社会功能、物质生活条件的客观状态呈下降趋势；但上述方面的主观生活满意度除７５岁以上的老人较低外，其余受试随着年龄增加而满意度较好。这种主、客观生活质量评估的不一致性主要与个体的评价标准、需求重点等中介因素有关。进一步分析表明，青年人的总体生活满意度主要受物质生活条件的影响，中年人主要与社会功能状态有关，老年人则与躯体健康有关。因此，作者认为，研究生活质量既要从躯体、心理、社会功能、物质生活条件多维评定，也要同时测量客观状态与主观满意度两个方面，才能得出较为全面的结论。     

飞行员生活期望值与心理社会因素的相关性

本文对飞行员生活期望值研究显示，其与个性因素、客观生活状态、主观生态满意度以及主，客观社会支持有显著或高度显著相关性。发现社会功能期望值与强迫、抑郁因素有负性相关。生活期望值对生活事件、疾病并无作用。     

社区人群生活质量研究──I理论构思

从生活质量角度来重新评价医疗政策、临床疗效、疾病预后、健康与保健模式，已成为当代医学重要趋势之一。在国家自然科学基金资助下，本课题组于１９９３年开始这一研究。本文介绍研究的理论构想，包括生活质量的概念与维度、客观生活状态与主观生活满意度的相互关系与影响因素、生活质量问卷的编制方法三个问题。     

飞行员生活期望值探讨

对２４２例飞行员生活期望值研究结果提示，生活期望值与个性、客观生活状态、主观生活满意度以及主、客观社会支持呈显著相关；社会功能期望值与强迫、抑郁因子呈显著负相关；而生活期望值与生活事件及疾病情况未见有相关关系。     

医学领域生活质量研究的几个问题

从生活质量角度来重新评价医疗政策、临床疗效、疾病预后、健康与保健模式，已成为当代医学重要趋势之一，本文就医学领域中生活质量研究的几个问题包括生活质量的概念与内涵，主、客观指标的关系，测量的方法学争论等作一评述与探讨。     

城乡社区精神分裂症患者生活质量的比较研究

本文作者采用Ｏｌｉｖｅｒ的生活质量概况表（ＬＱＯＬ）对成都市城、乡两个社区７３例精神分裂患者进行了横断面调查。结果显示，城市患者在工作或劳动、居住状况及法律安全方面的主观满意度低于农村（Ｐ＜０．０５～０．００５）。患者生活质量中经济状况的主、客观指标呈“分离现象”；逐步回归分析表明影响城乡社区患者总体生活评价的因素有所不同。教育公众不歧视、理解并接纳患者以及教育患者家属改变对患者的不良态度仍将是社区精神卫生服务中不可缺少的重要一环。     

工作时间制度对作业工人生活质量影响的比较研究

近年来，作业时间制度。对作业人员身心健康可能带来的影响。已引起关注。本文应用生活质量这一综合性指标，评估了不同作业时间对工人的躯体、心理、社会功能和物质生活各方面的影响。结果表明“白班”工人生活质量最好，“夜班”与“轮班”制度将影响作业工人的心、身健康质量与社会、家庭生活。作者就这些影响因素的相互关系进行了讨论。     

2型糖尿病患者生活质量与抑郁状态、社会支持的关系

目的评估2型糖尿病患者生活质量与抑郁状态、社会支持的关系。方法应用Zung氏抑郁自评量表(SDS)、社会支持评定量表(SSRS)与糖尿病特异性生活质量量表(A-DQOL)对临床确诊的82例2型糖尿病患者进行调查。结果①男性忧虑程度Ⅰ得分较女性高(t=2.019,P<0.05);年龄<50岁者忧虑程度Ⅰ得分较≥50岁者高(t=2.286,P<0.05);②2型糖尿病合并抑郁状态发生率为69.5%,生活质量显著下降;③客观支持低者满意度、忧虑程度Ⅱ得分高(t=2.918,2.540,P均<0.05);④生活质量与客观支持呈负相关,与SDS评分呈正相关;⑤SDS评分及客观支持可以较好地预测满意度;SDS评分还可较好地预测影响程度、忧虑程度Ⅰ和Ⅱ。结论抑郁状态与客观支持是影响2型糖尿病患者生活质量的主要因素,SDS评分可以较好地预测生活质量。     

轮班制与护士生活质量研究

轮班制与护士生活质量研究梁锋李凌江王湘莲湖南医科大学附二院工作时间制度对作业人员心理健康可能带来的影响值得关注［１，２］。本文应用生活质量这一综合性指标，评估不同工作时间制度对医院护士的躯体、心理、社会功能和物质生活各方面的影响，为探索制订合理的工作...     

脑卒中患者生活质量及其影响因素对照研究

通过对８９名脑卒中患者与８９名健康对照者生活质量的评估研究表明，脑卒中患者生活质量在躯体、心理、社会功能、经济状态诸多方面均显著性差于对照者。一个月的常规治疗后，发现影响生活质量改变的主要因素是疾病的疗效与病人对治疗的期望等；而影响疗效的因素除年龄、病种、疾病严重程度外，还有生活质量的心理维度。作者据此认为，在致力于提高躯体治疗效果的同时，不应忽视改善患者生活质量的其它方面。     

成人癫癎患者生活质量的调查

目的 :观察成人癫患者的生活质量。方法 :用Spitzer生活质量指数对 6 2例成人癫患者进行生活质量的评定。结果 :①患者组生活质量有下降 ,与对照组相比差异具有极显著意义 (P <0 0 1) ;②原发性癫组和继发性癫组两组之间的生活质量比较差异无显著意义 (P >0 0 5 )。结论 :成人癫患者存在生活质量下降 ,合理的抗癫治疗、心理障碍的干预治疗是必要的     

Multimorbidity and quality of life: Systematic literature review and meta-analysis

Multimorbidity is typically defined as the co-existence of two or more chronic diseases within an individual. Its prevalence is highest among the elderly, with poor quality of life (QoL) being one of the major consequences. This study aims to: (1) understand the relationship between multimorbidity and QoL or health-related quality of life (HRQoL) through systematic literature review; (2) explore the strength of this association by conducting the first meta-analysis on the subject.Following PRISMA, Medline/PubMed, Embase, CINAHL and PsycINFO were searched for studies published through September 1st, 2018. Original studies with clear operationalization of multimorbidity and validated QoL (or HRQoL) measurement were retained. For random-effect meta-analysis, a minimum of three studies with the same multimorbidity tool (e.g. number of diseases or equal comorbidity index) and the same QoL tool were required. Number of diseases was most common and the only measure on which meta-analysis was carried out. The outcome of interest was the linear regression slope between increasing number of diseases and QoL. Heterogeneity was explored with meta-regression. Out of 25,890 studies initially identified, 74 studies were retained for systematic review (total of 2,500,772 participants), of which 39 were included in the meta-analysis. The mean decrease in HRQoL per each added disease, depending on the scale, ranged from: −1.55% (95%CI: −2.97%, −0.13%) for the mental component summary score of pooled SF-36, -12 and -8 scales to −4.37% (95%CI: −7.13%, −1.61%) for WHOQoL-BREF physical health domain. Additional studies considering severity, duration and patterns of diseases are required to further clarify this association.     

农村老年人生活质量及与负性生活事件、社会支持的相关性

目的:了解农村老年人生活质量的相关因素,以及负性生活事件和社会支持对生活质量的交互作用.方法:在湖南浏阳农村社区采用多阶段抽样方法,共调查了839名≥60岁的常住居民(应答率为89.2％).用老年人生活事件量表(LESE)评估老年人的生活事件及其刺激量,用社会支持评定量表(SSRS)评估社会支持,用6条目生活质量量表(QOL)评估生活质量.结果:样本QOL得分为(20±4),SSRS得分为(40±8),负性生活事件总刺激量得分在0 ～ 240分之间,中位数M=12(P25=2,P75=32).多元线性回归分析显示,与配偶一起生活(b=-0.55)、收入较高(b=0.52)、负性生活事件刺激量较低(b=1.63)、社会支持较高(b=-0.69)的老人有较高的生活质量.交互作用分析显示负性生活事件刺激量评分与社会支持评分存在交互作用(超额相对危险度为2.72,95％CI =0.48 ～4.97;交互作用指数为2.42,95％ CI=1.25～4.62).结论:本研究提示对农村老年人,尤其是遭遇了负性生活事件的农村老年人,提供社会支持,有助于改善其生活质量.     

社区精神分裂症病人生活质量对照研究

通过对１００例社区精神分裂症患者与１００名正常健康人对照研究表明，精神分裂症患者的躯体功能、心理功能、社会功能、物质生活条件均显著差于正常人；对病人总体生活质量影响最大的是健康状态，而不是物质生活条件。同时，对病人组５个月后随访研究表明，停服药物可以改善生活质量的一些方面；而持续服药可以缓解精神症状，但对生活质量改善不明显；无规律服药则对生活质量的改善和精神症状的缓解均不显著。     

Health-related quality of life in narcolepsy

Narcolepsy is a chronic sleep disorder characterised by symptoms of excessive daytime sleepiness and cataplexy. The aim of this study was to describe the health-related quality of life of people with narcolepsy residing in the UK. The study comprised a postal survey of 500 members of the UK narcolepsy patient association, which included amongst other questions the UK Short Form 36 (SF-36), the Beck Depression Inventory (BDI), and the Ullanlinna Narcolepsy Scale (UNS). A total of 305 questionnaires were included in the final analysis. The results showed that the subjects had significantly lower median scores on all eight domains of the SF-36 than normative data, and scored particularly poorly for the domains of role physical, energy/vitality, and social functioning. The BDI indicated that 56.9% of subjects had some degree of depression. In addition, many individuals described limitations on their education, home, work and social life caused by their symptoms. There was little difference between the groups receiving different types of medication. This study is the largest of its type in the UK, although the limitations of using a sample from a patient association have been recognised. The results are consistent with studies of narcolepsy in other countries in demonstrating the extensive impact of this disorder on health-related quality of life.     

Urticaria and quality of life

The common perspective of physicians on chronic urticaria (CU) refers to a benign disorder with no pain and no threat to function or life. Heath-related quality-of-life (HRQOL) tools have demonstrated the extent to which physicians underestimate the impact of this disorder. From the patient perspective, CU affects as many dimensions of the HRQOL as some life-threatening diseases or well-recognized disabling chronic skin disorders, such as psoriasis or atopic dermatitis. Pruritus as well as swelling and wheals triggered by unavoidable events, such as pressure or sweating, greatly contribute to HRQOL impairment. Recent trials have suggested that dermatology-specific HRQOL instruments could be more relevant than more objective severity scores when studying and comparing the benefit of various therapeutic strategies in chronic idiopathic urticaria.     

Incorporating quality of life measures in HIV clinical trials

Abstract

PURPOSE: To increase awareness regarding issues specific to health-related quality of life (HRQL) assessments for investigators designing clinical trials and for clinicians reading published reports on clinical trials. HQRL measures are becoming more prevalent, alongside conventional therapeutic and laboratory endpoints. However, they differ from these physiologic or biologic measurements because HRQL data are subjective. We discuss the criteria for selecting and implementing HRQL instruments to optimize the usefulness of HRQL assessments in clinical studies. METHOD: We conducted a review of selected design and measurement issues that should be considered when planning for the use of HRQL instruments in HIV/AIDS clinical trials. CONCLUSION: When used appropriately, HRQL measures can indicate the impact of HIV treatment on patient functioning and well-being and can help to inform clinicians about treatment effects.     

功能性消化不良患者抑郁心理对生活质量的影响

目的探讨功能性消化不良患者抑郁心理对生活质量的影响。方法应用李凌江等编制的生活质量综合评定问卷(gen-eral quality of life inventory,GOLI)评定48例功能性消化不良伴有明显抑郁症状患者的生活质量,并与52例无抑郁症状的功能性消化不良患者以及50例健康人进行比较。结论功能性消化不良伴抑郁症状患者除自尊、住房、收入与消费、生活环境等因素与健康对照组比较差异无显著性外,在生活质量的其他方面,功能性消化不良者均明显较健康对照组差(P<0.05)。与非抑郁组比较;认知功能、躯体不适感、生理功能、运动与感官功能等方面均明显降低(P<0.05),而非抑郁组与健康对照组除身体不适感、工作等方面下降外,其余各方面差异无显著意义。结论功能性消化不良伴抑郁症状患者生活质量明显降低。