面部烧伤患者伤残接受度与应对方式及希望水平的相关性

目的:调查面部烧伤患者伤残接受度、应对方式及希望水平的临床现状,并分析伤残接受度与应对方式及希望水平的相关性.方法:通过横断面调查的方法选择2013年6月至2016年6月在西安市中心医院住院治疗的面部烧伤患者,采用患者一般情况调查表、伤残接受度量表(Acceptance of Disability Scale,AODS)、希望水平指数量表(Hope Level Index Scale,HII)及医学应对方式问卷(Medical Coping Methods Questionnaire,MCMQ)对患者进行调查.本研究共计发放180份问卷,回收有效问卷172份.结果:面部烧伤患者的伤残接受度较低,总分为63.05±14.39;希望水平处于中等水平,总分为31.40±5.00,在回避应对及屈服应对的得分明显高于国内常模,在面对应对的得分明显低于国内常模,差异具有统计学意义(P＜0.05);相关性分析结果显示希望水平各维度得分与伤残接受度各维度得分及总分呈正相关关系(r=0.223～0.325,P＜0.05),回避应对及屈服应对与伤残接受度各维度得分及总分呈负相关关系(r=-0.281～-0.151,P＜0.05),面对应对与伤残接受度各维度得分及总分呈正相关关系(r=0.375～0.406,P＜0.05).结论:面部烧伤患者伤残接受度水平相对较低,临床医护人员可通过调动积极心理资源及帮助患者采用积极的应对方式,以提升其心理健康状态.     

肝癌部分切除术患者心理弹性与社会支持、应对方式的相关性

目的:探讨肝癌部分切除术患者心理弹性与社会支持、应对方式的相关性.方法:选取某院2018年5月-2020年5月112例肝癌部分切除术患者,调查患者一般资料,使用中文版心理弹性量表(CD-RISC)评价患者心理弹性,并通过中文版医学应对问卷(MCMQ)和社会支持评定量表对患者进行问卷调查,分析患者心理弹性与社会支持、应对方式的相关性.结果:肝癌部分切除术患者心理弹性CD-RISC量表坚韧、乐观、自强及量表总分均低于国内常模(t=-15.278,-14.425,-25.434,-21.392;P＜0.05);肝癌部分切除术患者社会支持量表中主观支持、客观支持、对社会支持的利用度及量表总评分均低于国内常模(t = 12.345,19.822,24.273,19.156;P＜0.05);肝癌部分切除术患者应对方式MCMQ量表中面对维度评分低于国内常模,回避、屈服维度评分高于国内常模(t =-9.166,9.538,8.092;P＜0.05);肝癌部分切除术患者心理弹性量表评分与社会支持量表中主观支持、客观支持、对社会支持的利用度以及量表总分呈现正相关(r = 0.659,0.468,0.596,0.742;P＜0.05);心理弹性量表评分与应对方式MCMQ量表中面对维度呈现正相关,与回避、屈服维度分别呈现负相关(r = 0.631,-0.598,-0.538;P＜0.05).结论:肝癌部分切除术患者心理弹性水平低于正常人,且心理弹性水平与社会支持及应对方式密切相关,患者社会支持度越高,采取的积极应对方式越多,心理弹性水平也越高.     

慢性乙型肝炎患者心身症状和应对方式对生活质量的影响

目的 :研究慢性乙型肝炎患者的心身症状水平和应对方式对生活质量的影响。方法 :对 15 2名住院慢性乙肝病人用慢性肝病问卷 (CLDQ)、症状自评量表 (SCL - 90 )、医学应对问卷 (MCMQ)进行调查。结果 :慢性乙肝患者SCL - 90得分与常模和对照组有显著差异 ,各因子与CLDQ各维度呈负相关 ,以SCL - 90总均分 0 .4 4为划界分将病人分成阳性组和阴性组 ,阳性组CLDQ各维度得分均低于阴性组。患者面对应对低于常模 ,回避和屈服应对高于常模 ,阳性组比阴性组患者更倾向于采用回避和屈服应对 ,这两种消极的应对方式与生活质量呈负相关。结论 :慢性乙肝患者的心身症状及不良的应对方式对患者的生活质量有较大影响 ,要想通过心理干预减轻患者心身症状 ,提高患者的生活质量 ,重点应该放在改变不良应对方式上     

急性脑梗死患者自尊水平与应对方式相关性分析

目的:分析急性脑梗死(ACI)患者自尊水平与应对方式的相关性.方法:前瞻性选取2019年1月-2020年10月在本院完成治疗的120例ACI患者作为研究对象.治疗后随访2 m,分别于治疗后3 d,出院前1 d,随访2 m时,采用自尊量表(SES)及医学应对问卷(MCMQ)评估患者自尊水平与应对方式状况.经双变量Pearson直线相关性分析ACI患者自尊水平与应对方式的相关性.结果:出院前1 d、随访2 m,ACI患者面对评分均高于治疗后3 d,回避、屈服评分均低于治疗后3 d,且随访2 m面对评分高于出院前1 d,回避、屈服评分低于出院前1 d(P<0.05);出院前1 d、随访2 m,ACI患者SES评分均高于治疗后3 d,且随访2 m SES评分高于出院前1 d(P<0.001);经双变量Pearson直线相关性检验,结果显示,ACI患者SES评分与面对评分呈正相关(r>0,P<0.05);与回避、屈服评分呈负相关(r<0,P<0.05).结论:ACI患者治疗后自尊水平与应对方式息息相关,其自尊水平越高,应对方式越好.     

系统康复训练联合个性化心理疏导对体外循环心脏瓣膜术后患者心理韧性、应对方式及生活质量的影响

目的:探讨系统康复训练联合个性化心理疏导对体外循环心脏瓣膜术后患者心理韧性、应对方式及生活质量的影响。方法:采用简单随机抽签法将100例心脏瓣膜术后患者分为对照组(n=50)和观察组(n=50),对照组给予常规干预,观察组在对照组基础上给予系统康复训练联合个性化心理疏导;比较两组干预后中文版Connor-Davidson心理韧性量表评分、中文版医学应对方式问卷(MCMQ)评分、心功能改善情况及出院时简明健康调查问卷(SF-36)评分。结果:干预后,观察组心理韧性各维度(坚韧、自强、乐观)评分均明显高于对照组(t=7.938,6.719,8.393;P0.01);干预后,观察组MCMQ量表中面对评分明显高于对照组(t=2.002,P0.05),回避、屈服等评分明显低于对照组(t=-3.818,-4.395;P0.01)。观察组较对照组心功能改善率明显提高(χ~2=5.005,P0.05),出院时6min步行距离明显增加(t=4.616,P0.01)。出院时,观察组SF-36量表中躯体功能、身体疼痛、总体健康、活力、社会功能等评分均明显高于对照组,差异均有统计学意义(t=3.586,2.486,4.190,2.418,2052;P0.05)。结论:系统康复训练联合个性化心理疏导能够改善体外循环心脏瓣膜术后患者心理韧性、应对方式,有助于提高患者心功能及生活质量。     

强迫症患者生活质量及相关因素分析

目的:了解强迫症患者生活质量的现状,探讨其相关影响因素。方法:采用自编一般情况调查表、健康状况问卷(SF-36),Yale-Brown强迫量表(Y-BOCS)、汉密尔顿抑郁量表(HAMD),对60例强迫症患者进行调查。结果:除外生理健康和疼痛,强迫症患者总体生活质量其它各维度均低于中国常模(P<0.001);强迫症患者汉密尔顿抑郁分、强迫症严重程度分、强迫思维分与SF-36各维度均相关(P<0.05,或P<0.01);而强迫行为仅与SF-36中的社会功能、情感职能、精神健康和精力四个维度相关;就业状况与生理职能相关;合并躯体疾病的患者在一般健康、社会功能和精神健康维度得分更低,合并其它精神障碍的患者在疼痛、一般健康、社会功能和精神健康维度得分更低。结论:强迫症患者的生活质量明显低于正常人群,强迫的严重程度,尤其是强迫思维、同时是否合并其它躯体和精神障碍及就业状况对患者的生活质量有很大的影响。     

不同分期老年矽肺患者生命质量与社会支持的关系

目的 探讨不同分期老年矽肺患者生命质量、应对方式的差异及两者之间的关系.方法 采用简明健康状况调查问卷(SF-36)和医学应对问卷对127例老年矽肺患者进行问卷调查.结果 ①方差分析表明不同分期老年矽肺患者的生命质量中生理功能、生理职能、躯体疼痛、活力、社会功能、情感职能和精神健康差异显著(F=9.688,6.915,9.766,14.859,7.649,4.204,5.086;P＜0.05或＜0.01);患者应对方式的3个因子面对、回避、屈服均有显著差异(F=5.922,7.736,11.749;P＜0.01);②相关分析显示面对与生命质量中的生理功能、生理职能、总体健康、活力和社会功能因子呈正相关;回避与生命质量中的生理功能、生理职能、躯体疼痛、总体健康、活力和社会功能因子呈正相关;屈服与生命质量中的各因子均呈负相关.结论 老年矽肺患者的生命质量随着疾病临床分期的发展而逐步下降;积极的应对方式有利于患者生命质量的提升.     

酒精所致精神障碍患者社会支持、应对方式与生活质量的相关性

目的:探讨酒精所致精神障碍患者社会支持、应对方式与生活质量的相关性。方法:选取本院2012年1月-2017年12月收治的200例酒精所致精神障碍患者作为观察组,选取同期本院健康体检者102例为对照组,利用社会支持评定量表、SF-36生活质量量表、医学应对问卷对酒精所致精神障碍患者和健康体检者进行问卷调查,并对结果进行统计分析。结果:(1)观察组主观支持得分、客观支持得分、支持利用度得分及总分均低于对照组,差异具有统计学意义(t=9.589,17.013,13.276;P0.05);(2)两组躯体痛疼评分比较差异无统计学意义(t=1.575,P0.05);两组一般健康状况、生理机能、精神健康、社会功能、情感职能评分比较差异具有统计学意义(t=6.065,19.456,6.785,8.181,7.732;P0.05);(3)两组患者面对、屈服评分比较,差异具有统计学意义(t=4.269,9.259;P0.05),而回避评分比较差异无统计学意义(t=0.252、P0.05);(4)根据相关分析结果显示:主观支持、客观支持、支持利用度、回避与生活质量呈正相关,而屈服与生活质量呈负相关。结论:酒精所致精神障碍患者其生活质量水平较低,主要与酒精所致精神障碍患者的应对方式以及获得社会支持程度较低有关。     

甲状腺腺瘤患者术前焦虑与应对方式的相关性研究

目的 探讨女性甲状腺腺瘤患者术前焦虑与应对方式的关系,为临床护理提供依据.方法 于术前采用状态特质焦虑问卷(STAI)和医学应对方式问卷(MCMQ)对140例女性甲状腺腺瘤患者进行评估.结果 女性甲状腺腺瘤患者术前S-AI水平明显高于常模,而T-AI水平、面对和屈服得分明显低于常模,差异有统计学意义,均P<0.01. 结论护理人员应在患者采取积极的应对方式,促进患者术后康复.     

脑梗死急性期抑郁状态对SF-36生存质量的影响

目的探讨脑梗死患者急性期抑郁状态对其亚急性期生存质量的影响。方法符合研究标准的急性期脑梗死病例88例，经“Zung抑郁自评量表（Self-rating depression scale，SDS）”评分后分为轻度抑郁组（36例）和中度抑郁组（52例）。运用“健康状况调查问卷SF-36（以下简称SF-36）”评定患者的生存质量。结果两组患者在SF-36的8个维度中，轻度抑郁患者躯体健康，躯体疼痛，心理健康，情绪角色，精力，总体健康的评分明显高于中度抑郁组（P〈0．05，0．01，0．001）。结论脑梗死患者抑郁程度与其SF-36生存质量密切相关。抑郁程度重者生存质量较差。     

Quality of life in patients with Japanese cedar pollinosis: using the SF-8 health status questionnaire (Japanese version)]

BACKGROUND: The number of patients with Japanese cedar pollinosis (JCP) is increasing, and now, has extended up to about 15% of the Japanese. It is reported that the QOL is an important outcome in the JCP treatment. This study aimed to evaluate the QOL in patients with JCP by means of the SF-8 Health Survey (Japanese Version), a new, even shorter generic health survey. METHODS: 411 patients with JCP who visited 10 ENT clinics in Osaka from March 14 to March 26 (peak pollen season) were questioned, and 204 patients without any treatments in this season were engaged in this study as subjects. In this study, the QOL scores were evaluated using the SF-8. This is an 8-item version of the SF-36 that yields a comparable 8-dimension health profile and comparable estimates of summary scores for the physical and mental components of health. RESULTS: The QOL score depressed in the patients with JCP compared with healthy subjects (Japanese national norms). Both Mental Component Score (MCS) and Physical Component Score (PCS) scores decreased more in females than in males. In females, MCS were significantly lower than national norms. The older the patients were, the lower PCS scores were showed. The severity of nasal symptoms influenced the PCS scores. CONCLUSION: These results showed the tendency similar to the early studies using SF-36 questionnaire. The sensitivity of SF-8 in the individual is not better than that of other specific QOL questionnaires, but SF-8 can be answered in a short time compared with other questionnaires including SF-36. We suggested that SF-8 become a useful questionnaire in the future.     

间质性肺疾病患者的生活质量和焦虑、抑郁症状

目的:评价间质性肺疾病(ILD)患者的生活质量和焦虑、抑郁症状。方法:选取在北京协和医院就医的间质性肺疾病患者192例。采用健康调查简表(SF-36)测量患者的生活质量,并与已有研究中的一般人群的得分进行比较;用医院焦虑抑郁量表(HAD)测量患者的焦虑、抑郁症状。结果:除躯体疼痛、活力、精神健康维度之外,ILD患者SF-36其他维度评分均低于一般人群[如,总体健康分(44.3±21.9)vs.(66.0±20.9),均P0.001];HAD焦虑平均分为(5.0±4.3),抑郁平均分为(4.4±4.3)。焦虑、抑郁症状阳性者分别为43例(22.4%)、42例(21.9%),焦虑和抑郁共存者33例(17.2%)。SF-36各维度评分与HAD焦虑、抑郁评分均呈负相关(r=-0.34～-0.73,均P0.001)。进入焦虑回归方程的变量有呼吸困难、年龄(β=0.44、-0.23),进入抑郁回归方程的变量是呼吸困难(β=0.37)。结论:间质性肺疾病患者的生活质量低于一般人群,且部分患者存在焦虑、抑郁症状。ILD患者的呼吸困难程度越重、年龄越小,焦虑症状越重;呼吸困难程度越重,抑郁症状越重。     

乳腺癌患者照顾者生活质量及相关因素分析

目的:评估乳腺癌患者照顾者的生活质量(QOL),分析影响QOL的相关因素。方法:采用健康调查简表(SF-36)、Jalowiec应对量表和一般情况调查表对蚌埠医学院附属医院肿瘤外科123名乳腺癌患者照顾者及门诊110名健康对照者进行调查。结果:乳腺癌患者照顾者的SF-36评分在躯体疼痛、总体健康、精力、社会功能、情感职能和精神健康6个维度比一般健康成人体检者低(P<0.05和P<0.01);"乐观"应对方式上两组比较有显著差异(P<0.05);"逃避"、"姑息"、"听天由命"、"情感宣泄"应对方式得分与SF-36多项得分呈显著负相关(P<0.05或P<0.01);情感宣泄、听天由命、姑息、逃避、面对、寻求支持、依靠自我等多个因素进入回归方程,分别对QOL多个维度的变异有预测作用,以"听天由命"对照顾者的QOL的影响作用最大。结论:乳腺癌患者照顾者的QOL比一般人群差;乳腺癌患者照顾者的生存质量与其应对方式密切相关。     

Quality of life in nasal polyposis.

BACKGROUND: Nasal polyposis (NP) is a frequent inflammatory chronic disease of the upper respiratory tract, which may impair quality of life (QOL). The NP impact, which is frequently associated with lower respiratory disorders, has never before been studied. OBJECTIVE: We initiated this prospective study to establish internal validity and reliability of the generic SF-36 questionnaire in NP and to determine to what level daily functioning becomes impaired as a result of NP. METHODS: Forty-nine consecutive patients with NP were included. They were assessed for the severity of nasal symptoms and underwent pulmonary function tests. The QOL profiles in patients with NP were compared with those of patients with perennial rhinitis (n = 111) and healthy subjects (n = 116). RESULTS: Cronbach's coefficient alpha demonstrated the high reliability and validity of the SF-36 questionnaire for patients with NP (alpha =.89). NP impaired QOL more than perennial allergic rhinitis (P <.05). The impairment of QOL was greater when NP was associated with asthma (P <.05). SF-36 scores appeared highly correlated to pulmonary function (FEV1, maximal midexpiratory flow, forced vital capacity), suggesting relationships between QOL in NP and associated bronchial obstruction. Severity of nasal symptoms were not related to QOL scales. In addition, sequential evaluations of QOL, nasal symptoms, and pulmonary function were performed 10 months after the first evaluation in 28 patients with NP. These evaluations demonstrated that NP treatment either with nasal steroids or endonasal ethmoidectomy significantly improved both nasal symptoms and QOL without significant change of pulmonary function. CONCLUSION: Our study clearly demonstrated that the SF-36 questionnaire presented a high internal validity and reliability in patients with NP. NP impaired QOL to a greater degree than perennial allergic rhinitis. QOL improvement after NP treatment is related to nasal symptoms improvement.     

The role of the Short Form 36 Health Survey in autologous chondrocyte implantation

The purpose of this study was to examine the use of the Short Form 36 Health Survey (SF-36) in the preoperative assessment and postoperative review of patients undergoing autologous chondrocyte implantation (ACI) of the knee. We used the SF-36, a validated health related quality of life survey, and The Modified Cincinnati Knee score, a commonly used knee function scoring system, to evaluate 25 consecutive patients preoperatively and 1 year following surgery. Before surgery, patients scored lower for all aspects of general health and level of functioning compared to a normalised general population. We demonstrated significant increases of overall SF-36 scores following surgery, reflecting improvements to perceived general health. Most significant improvements were seen in the physical categories of "Physical Functioning" (44.8 to 56.2, p=0.014), "Role Physical"(35.0 to 52.2, p=0.044) and "Bodily Pain"(33.6 to 50.9, p=0.001). Higher preoperative SF-36 scores were found to correlate significantly with greater increases of Modified Cincinnati Knee scores. Postoperative knee function scores correlated well with physical categories of the SF-36. However, we found poor correlation between postoperative Modified Cincinnati Knee scores and SF-36 scores for vitality, social functioning and emotional domains. This suggests that knee function scores alone do not incorporate all the benefits to patient health following ACI surgery. We recommend using a knee function scoring system and the SF-36 for both the preoperative assessment and postoperative review of ACI patients.     

以Cameron适时干预模式为基础的健康管理方案在全髋关节置换术患者中的应用

目的:探讨以Cameron适时干预(“Timing it right”,TIR)模式为基础的健康管理方案对全髋关节置换术(total hip replacement,THR)患者的改善效果.方法:采用方便抽样的方法选择在西南医科大学附属医院治疗的THR患者作为研究对象,对照组采用常规的健康教育指导,观察组采用以Cameron TIR模式为基础的健康管理方案进行全程干预;统计分析两组患者干预前后的Harris髋关节功能评分、生命质量[简明健康状况评估表(Short Form 36-item Health Survey,SF-36)]评分、康复锻炼依从性及临床并发症的发生情况.结果:干预前两组患者的Harris髋关节功能总分及各维度得分、SF-36得分差异无统计学意义(P＞0.05);除畸形维度以外,干预1,3,6个月后观察组在上述指标的得分均明显高于对照组,差异具有统计学意义(P＜0.05);观察组的康复锻炼依从性明显高于对照组(P＜0.05),临床并发症的发生率差异无统计学意义(w0.05).结论:以Cameron TIR模式为基础的健康管理方案能有效提升THR术患者的康复锻炼依从性,改善关节功能及生命质量,减少临床不良并发症的发生率.     

The impact of biopsychosocial factors on quality of life: women with primary biliary cirrhosis on waiting list and post liver transplantation

Objectives. Primary biliary cirrhosis (PBC) is the second most common reason for liver transplants among women in the USA. While survival rates are high, there is evidence of persistent problems post‐transplant. This study aimed to identify significant contributors to quality of life (QOL) for women with PBC on waiting list (WL) and post‐transplant (PT) and compare QOL in each group with US population norms. Design. A cross‐sectional, two‐group study design was used. Methods. WL and PT participants were recruited through medical centres and on‐line. QOL was measured by the Short Form‐36 and an indicator of Social QOL created for this study. A biopsychosocial model incorporating demographic, biomedical, psychological, and sociological factors guided choice of variables affecting QOL. Analyses examined (1) all factors for differences between WL and PT groups, (2) association between factors and QOL outcomes within each group, (3) multivariate regression of QOL on factors in the model for the sample as a whole, and (4) comparison of QOL outcomes with national norms. Results. One hundred women with PBC participated in the study, 25 on WL and 75 PT. Group comparisons showed improvement for PT participants in most biomedical and psychological variables and in QOL outcomes. QOL was related to many, but not all, of the variables in the model. In multivariate analysis, Fatigue, Depression, Coping, and Education – but not Transplant Status – were identified as indicators of QOL. Physical QOL improved significantly after 5 years PT, when it was no longer worse than national norms. Mental QOL remained worse than national norms despite distance in time from transplant. Conclusions. The model proved useful in identifying a range of factors that contributed to QOL for women with PBC before and after transplant. Recommendations were made for clinical practice to improve QOL through a combination of treatment and self‐management.     

肝炎后肝硬化患者生存质量调查与影响因素分析

目的测量并评价肝炎后肝硬化患者生存质量（QOL）以及影响因素。方法采用SF-36量表,对220例肝炎后肝硬化患者和220例正常对照者进行QOL测量与评价,并对其影响因素进行单因素分析和多因素逐步回归分析。结果肝炎后肝硬化患者SF-36总评分与对照组相比差异有统计学意义。影响肝炎后肝硬化患者QOL的主要因素是性别、Child-Pugh分级、血小板计数（P=0.004、0.013、0.011）。结论肝炎后肝硬化患者生存质量全面下降,Child-Pugh分级、性别与血小板计数为肝硬化患者生存质量的主要影响因素。