社区人群生活质量研究──Ⅱ方法学及社区人群的总体生活质量

本文为社区人群生活质量系列研究之一。主要报告研究的方法学、样本的一般社会人口学资料与不同人群生活质量的总体评估结果。通过对湖南省４８００户城乡家庭的生活质量调查，从总体看，人们的物质生活条件，心身健康水平，医疗服务质量均有提高，娱乐生活也日渐丰富。但作为发展中国家，人们的生存需求仍是主导需求，改善物质生活条件仍是提高生活质量的重要目标。农村、老年人的生活质量尤应受到重视与改善。     

少年生活质量问卷的初步测试

生活质量在我国医学及相关领域的研究中日益受到重视。城乡社区成人的生活质量已有大样本报告［１］,在老人［２］、精神障碍患者［３］、肿瘤病人等群体中也进行了有关探讨。但青少年生活质量的研究未见诸报道。从国际上来看,对青少年生活质量的研究无论深度、广度都不...     

杭州市社区人群生活质量研究

生活质量是全社会关注的话题 ,在基本生活得到保障后 ,人们更多地开始关注生活质量。同时 ,生活质量的好坏是衡量人们心身健康的重要指标之一。在卫生医疗改革进一步深入的今天 ,了解社区居民的生活质量 ,有着非常重要的意义。评估社区人群的生活质量 ,可以为有关部门制订政策 ,提高医疗与健康服务质量 ,改善人们的健康与生活水平提供依据 ,并为今后前瞻性研究建立基础资料[1] 。另外 ,杭州市社区精神卫生和心理卫生工作一直以来都受到各界政府的重视 ,通过社区居民生活质量的调查 ,也为杭州市社区精神卫生和心理卫生工作的进一步深化提供一…     

职场人际关系攻击问卷的编制

目的:编制职场人际关系攻击问卷,并检验其信效度。方法:通过查阅文献、访谈等方法编制项目,采用便利抽样法选取武汉市某两所企业85名在职员工为初试,通过项目分析和探索性因素分析确定项目后,再选取武汉市某5所单位的408名在职员工为重测对象,确定问卷的信度和效度。结果:探索性因素分析结果表明,问卷由18个项目构成,包含直接攻击、间接攻击、直接受害和间接受害4个因素,可以解释总变异的61.649%,验证性因素分析表明,问卷有良好的结构效度(χ2/df=1.971,GFI=0.912,NFI=0.937,RMR=0.024,RMSEA=0.071),总量表的内部一致性系数为0.893,各分问卷的内部一致性系数在0.830~0.855之间,总量表和各分问卷的重测信度在0.82~0.90之间。结论:本研究编制的职场人际关系攻击问卷的心理测量学指标良好,可作为职场关系攻击的测量工具。     

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。     

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。     

公安院校低年级大学生心理压力问卷的编制

目的 研究公安院校低年级大学生的心理压力因素.方法 以警察院校994名低年级大学生(男生778人,女生216人)为研究对象,采用自编问卷调查和探索性因素分析的方法.结果 公安院校低年级大学生的心理压力因素有:人际关系和自我意识压力、求职就业压力、家庭期望和学校管理压力、集体压力.自编问卷的α系数为0.87,各分量表的α...     

高校学生社团会员心理契约问卷的编制

目的 编制高校学生社团会员心理契约问卷.方法 通过半开放式问卷调查,用探索性因素分析、验证性因素分析方法构建高校学生社团会员心理契约问卷的内容及结构.结果 问卷包含“社团责任义务”与“会员责任义务”两个分量表,a系数分别为0.93和0.94,各自解释累计总变异的57.46％和62.11％,且均包含规范型、人际型、发展型和理念型责任义务4个因子.验证性因素分析结果表明两分量表的四因素结构模型拟合良好,其中“社团责任义务”分量表的模型拟合指数RMSEA=0.06,NNFI=0.96,CFI=0.96,GFI=0.93;“会员责任义务”分量表的模型拟合指数RMSEA=0.06,NNFI=0.98,CFI=0.98,GFI=0.94.结论 编制的高校学生社团会员心理契约问卷具有良好的心理测量学指标,可用于相关的研究和实践中.     

大学生网络小说成瘾问卷编制

目的编制大学生网络小说成瘾问卷。方法在半开放式问卷与访谈的基础上,形成包含33个项目的预测问卷;对161名大学生进行问卷施测,通过项目分析和因素分析,形成由23个项目构成的正式问卷;以319名大学生为被试,对问卷的信度和效度进行检验。结果大学生网络小说成瘾问卷包含5个维度:作息健康状况、人际学业问题、耐受性、时间管理和戒断反应,共解释了62.140%的变异;五因素模型在验证性因素分析中得到了较好的验证(χ2/df=2.602,GFI=0.848,AGFI=0.809,NFI=0.826,CFI=0.848,IFI=0.885,RMSEA=0.075);信度分析显示各维度的α系数为0.669~0.843,分半信度为0.657~0.866,各维度与总分间有显著相关(0.714~0.879,P<0.01),各维度间有较高的相关(0.432~0.664,P<0.01)。结论编制的大学生网络小说成瘾问卷具有良好的心理测量学指标。     

社区人群生活质量研究──IV生活质量主、客观指标的相互关系及其影响因素

本文通过对生活质量主、客观指标相互关系及其影响因素的研究，结果发现，客观生活状态是影响主观生活满意度的主要因素。而不同群体在不同的客观生活状态水平下，主、客观指标评定的不一致性则与生活的需求重点、评价参照标准、个性与应付方式等中介因素有关。     

Measuring asthma-specific quality of life: structured review

Measuring quality of life (QoL) has become an increasingly important dimension of assessing patient well-being and drug efficacy. As there are now several asthma QoL questionnaires to choose from, it is important to appreciate their strengths and weaknesses. To assist in this choice, we have reviewed the existing questionnaires in a structured way. Information relating to the conceptual and measurement model, reliability, validity, interpretability, burden, administration format and translations was extracted from the published literature. The instruments differ in almost all criteria considered, and therefore it cannot be assumed that they measure the same thing. We recommend the selection of questionnaires that are designed only for asthma and that do not assess symptoms as part of QoL. Only two of the questionnaires reviewed fulfill these requirements: the Sydney Asthma QoL Questionnaire (AQLQ-S) and the Living with Asthma Questionnaire (LWAQ). However, for multinational studies, it may be convenient or practical to use questionnaires that have been linguistically validated in many languages (AQLQ-J, SGRQ). It remains unclear which of these questionnaires best reflects patient perceptions of QoL. Our review did not involve patients, so for the time being choosing from existing questionnaires requires a compromise based on the rigor of the development process and the target patient group.     

Determinants of quality of life in Greek middle-age women: a population survey

Objectives

The aim of the present study was to evaluate how sociodemographic parameters, lifestyle indicators and intensity of climacteric symptoms affect the quality of life (QOL) of Greek community dwelling middle-aged women.

Study design

This population survey included 1140 middle-aged women aged 45–65 who represented 1% of the whole female population of this age group in Greece, stratified by residential area.

Main outcome measures

Participants were asked to complete a questionnaire concerning sociodemographic and anthropometric parameters, medical history, the Utian quality of life (QOL) scale and the Greene climacteric scale rating menopausal symptoms.

Results

In the univariate analysis, normal body mass index, married status, higher education, employment, good financial status, physical exercise and a high calcium diet were associated with higher total QOL scores (p-value < 0.001). Multivariate regression analysis showed that higher total QOL scores were predicted by being married (separated/divorced/widowed: beta = −3.17, p-value = 0.008), by physical exercise (beta = 4.84 and beta = 4.57 for 1–3 h and >3 h per week respectively, p-value < 0.001) and by a good financial status (beta = 7.05, p-value < 0.001), while a higher score in the Greene scale resulted in lower total QOL scores (beta = −0.77, p-value < 0.001). Women with a better QOL were more health conscious and more probable to have utilized the public health preventive resources.

Conclusions

Menopause as a life event has no effect on the QOL of Greek middle-aged women. On the contrary, the presence and intensity of climacteric symptoms have a negative impact on all aspects of QOL. Marital and financial status, as well as physical exercise, are also significant predictors of QOL.     

Development of the sleep quality scale

Sleep quality affects health and the overall quality of life. As the factors that influence sleep quality and their relative importance vary among individuals, a self-report method is essential. Although various questionnaires have been used to assess sleep quality, few all-inclusive assessment scales have been developed. Therefore, the purpose of this study was to develop an instrument for measuring sleep quality and to study its validity and reliability. A Sleep Quality Scale (SQS) was developed using item analysis and factor analysis on items with content validity. SQS, composed of 28 items and six factors, accounted for 62.6% of the total variance. The difference of SQS score between insomniacs and normal subjects confirmed the construct validity (t = -13.8, P = 0.000). Concurrent validity was identified by the significant correlation of SQS with the Pittsburgh Sleep Quality Index (r = 0.72, P = 0.000). The Cronbach's alpha coefficient was 0.92 for internal consistency and the correlation coefficient was 0.81 for test-retest reliability at a 2-week interval. The developed SQS was therefore confirmed to be a valid and reliable instrument for the comprehensive assessment of sleep quality.     

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。     

成年哮喘病人生命质量评估表的初步制定

为制定适用于我国哮喘病人的生命质量评估表（ＡＱＬＱ），７７例成年哮喘病人参加了本研究。５１例参加ＡＱＬＱ原始表项目的筛选，２６例参加ＡＱＬＱ初表信度、效度和反应的检验。原始表包括９７个条目，根据各条目被病人选择的频度及其对病人影响程度选出能兼顾不同性别、年龄及用药情况的项目，制定出ＡＱＬＱ初表，共３５条，分为活动受限、哮喘症状、对刺激源反应、心理状态、自我健康关心等５个因子。对病情稳定病人重复检测，显示本表有良好的重测信度。ＡＱＬＱ初表与其它量表有较好的相关关系。     

The Huntington's disease quality of life battery for carers: reliability and validity

Research into the experience of the Huntington Disease (HD) spousal carer has established that carers experience several unique obstacles within their care-giving role. However, there is still a need to establish methodically the factors that impact on the HD spousal carers' situation and ultimately their quality of life. The aim of this pilot study, which was a result of three previous exploratory studies, was to validate a HD-specific quality-of-life (QoL) measure, the Huntington disease quality-of-life battery for carers (HDQoL-C) for use (initially) with spousal carers of HD patients. Eighty-seven HD spousal carers took part in the piloting of the HDQoL-C to assess its reliability and validity as a tool for use within QoL research. Results established the HDQoL-C as a multidimensional and psychometrically sound disease-specific and subjective QoL assessment tool that incorporates the individual's physical health, psychological state, level of independence, social relationships and personal beliefs. The HDQoL-C demonstrates good internal consistency, test-re-test reliability and congruent validity.     

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.     

Health information needs and health-related quality of life in a diverse population of long-term cancer survivors

Objective

To investigate health information needs and their association with health-related quality of life (HRQOL) in a diverse, population-based sample of long-term cancer survivors.

Methods

We analyzed health information needs from 1197 cancer survivors 4–14 years post-diagnosis drawn from two cancer registries in California. Multivariable regression models were used to identify factors associated with endorsement of total number and different categories of needs. The relationship between number of needs and HRQOL and effect modification by confidence for obtaining information was examined.

Results

Survivors reported a high prevalence of unmet information needs in the following categories: side effects & symptoms: 75.8%; tests & treatment: 71.5%; health promotion: 64.5%; interpersonal & emotional: 60.2%; insurance: 39.0%; and sexual functioning & fertility: 34.6%. Survivors who were younger, non-White, and did not receive but wanted a written treatment summary reported a higher number of needs. Number of information needs was inversely related to mental well-being, particularly for those with low confidence for obtaining information (P < 0.05).

Conclusion

These patterns suggest disparities in access to important health information in long-term survivors and that affect HRQOL.

Practice Implications

Findings suggest a need for tailored interventions to equip survivors with comprehensive health information and to bolster skills for obtaining information.     

Asthma severity and child quality of life in pediatric asthma: A systematic review

Objective

To systematically review evidence of asthma severity as a correlate of child quality of life (QOL) in pediatric asthma.

Methods

Online bibliographic databases (PsycINFO, PsycARTICLES, and MEDLINE) were used to identify relevant studies that specifically considered the relationship between asthma severity and child QOL.

Results

Fourteen studies matching inclusion and exclusion criteria were reviewed. Asthma severity was significantly related to child QOL in nine of these studies. Informant of QOL and type of QOL measure were found to influence the strength of the relationship between severity and child QOL in pediatric asthma.

Conclusions

Findings suggest that asthma severity is a correlate of child QOL. Children whose asthma symptoms are not well-managed are likely to experience an impaired level of QOL. Findings also suggest the need to utilize asthma-specific QOL measures and an informant of QOL other than the child's parent in order to receive the most accurate information about the child's level of functioning.

Practice implications

Researchers and healthcare providers basing clinical outcomes on QOL assessments should consider asthma severity in their evaluations. Further, researchers and healthcare providers should recognize the continued need to reduce asthma severity and improve asthma symptom control in their attempts to improve the QOL of children with asthma.