阻塞性睡眠呼吸暂停低通气综合征患者生活质量及情绪和抑郁探讨

目的 通过阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的健康相关生命质量(HRQoL)、日间过度嗜睡(EDS)、抑郁情绪等调查量表,研究OSAHS患者与上述量表之间的相关性.方法 入组71例,其中41例OSAHS患者为患者组,30例正常人为对照组,使用健康调查量表(SF-36)评价生活质量,用Epworth嗜睡量表(ESS)评估EDS,Zung抑郁自评量表(SDS)评价抑郁情绪.结果 患者组与对照组相比,其ESS评分明显升高(14.68±6.25)分vs (5.96±2.38)分(P＜0.01).其SF-36评分中有4个维度评分不同程度下降,以SF最为明显VT(59.15±22.82)分vs(80.33±11.66)分(P＜0.01);SF(80.85±14.66)分vs (90.86±6.67)分(P＜0,01);RE(76.59±15.67)分vs (92.50±6.12)分(P＜0.01).OSAHS患者组中ESS评分与SF-36评分中3个维度呈负相关(PF:r=-0.407,P＜0.01;RP:r=-0.523,P＜0.01;VT:r=-0.417,P＜0.01),其SDS评分与SF-36评分中1个维度呈负相关(SF:r=-0.381,P＜0.05).结论 OSAHS患者的生活质量较正常人群下降,并且与日间过度嗜睡、抑郁情绪明显有关.     

直肠癌保肛术后老年患者焦虑及抑郁与生存质量的相关性

目的了解直肠癌保肛术后老年患者焦虑及抑郁与生存质量现状,并探讨其相关性。方法采用自行设计的患者一般资料调查问卷、医院综合焦虑抑郁量表(hospital anxiety and depression scale,HADS)和SF-36健康调查量表(the MOS 36 items short form health survey,SF-36)对60例直肠癌保肛术后老年患者进行调查。患者焦虑及抑郁与生活质量的相关性采用Pearson相关分析。结果直肠癌保肛术后老年患者SF-36总分为(64.20±11.76)分;其焦虑阳性者占36.67%,抑郁阳性者占30.00%。直肠癌保肛术后老年患者焦虑及抑郁与生存质量均呈负相关(r值分别为-0.312和-0.495,均P0.05)。结论护理人员应积极给予直肠癌保肛术后老年患者心理情感支持,指导其采用放松疗法等措施,以减轻患者焦虑及抑郁情绪,从而提高其生存质量。     

急性心力衰竭患者焦虑抑郁状况及对生活质量的影响

目的探讨急性心力衰竭患者急性期的焦虑抑郁状况对生活质量的影响,为医护人员采取适当的心理干预提供依据。方法收集2014年1月~2015年1月在我院诊断为心力衰竭并且处于急性期的患者,采用一般资料问卷焦虑自评量表、抑郁自评量表以及SF-36生活质量量表对患者进行调查,按自评量表分为焦虑组与非焦虑组、抑郁及非抑郁组,比较2组患者在心衰急性期中SF-36生活质量量表评分,并对焦虑抑郁评分与生活质量评分进行相关性分析。结果 114例心衰急性期患者中,焦虑和抑郁的患者分别有61例(53.8%)和27例(23.7%)。焦虑、抑郁患者生活质量评分明显低于非焦虑、非抑郁患者,分别为(371.25±102.36)分和(464.13±131.47)分、(346.78±112.36)分和(478.65±131.21)分,差异有统计学意义。随SF-36生活质量评分增加,焦虑及抑郁评分呈现减低的趋势,Person相关系数分别为-0.424(P=0.014)及-0.416(P=0.008)。结果焦虑或抑郁的心衰急性期患者生活质量评分低于无焦虑或抑郁症心衰患者,并且焦虑或抑郁与生活质量呈负相关,医护人员应对心衰急性期患者加强评估及防治措施,预防和缓解焦虑或抑郁的发生。     

居家老年临终患者生活状况与家属心理状态的调查

目的 了解居家老年临终患者生活状况与家属心理状态变化的相关性.方法 对60例居家老年临终患者,采用日常生活活动能力量表(ADL)、生活满意度指数A(LSI-A)、临终患者舒适度问卷进行调查;对60名主要照顾家属采用焦虑自评量表(SAS)、抑郁自评量表(SDS)进行评分,对两者进行相关性分析.结果 居家老年临终患者的ADL与患者的舒适度(r=0.348,P<0.01)和生活满意度评分(r=0.314,P<0.05)呈正相关,与家属的焦虑抑郁情绪没有相关关系.患者的舒适度与家属的焦虑情绪呈负相关(r=-0.372,P<0.01),与家属的抑郁不相关,患者的LSIA与家属的焦虑(r=-0.309,P<0.05)和抑郁(r=-0.314,P<0.05)均呈负相关.结论 居家老年临终患者的舒适度和生活满意度与家属心理状态之间彼此相互影响,应给予相应的临终关怀措施,以提高患者的生活质量,减轻家属的负性心理状态.     

应对方式对癌症患者抑郁情绪和生活质量的影响

目的探讨应对方式对癌症患者抑郁情绪和生活质量的影响。方法住院癌症患者完成一般资料问卷、抑郁自评量表(SDS)、医学应对问卷(MCMQ)、中国癌症患者生活质量调查问卷(QLQ)调查。结果符合条件的234 例患者中,54.27%伴有不同程度的抑郁情绪。MCMQ面对因子(r=-0.378, P=0.006)和回避因子(r=-0.374, P=0.008)与抑郁情绪呈负相关,屈服因子与抑郁情绪呈正相关(r=0.684, P=0.000)。MCMQ面对因子(r=0.232, P=0.043)和回避因子(r=0.317, P=0.000)与生活质量呈正相关,屈服因子与生活质量呈负相关(r=-0.479, P=0.007)。分别以抑郁程度和生活质量为因变量进行多元逐步回归分析,回归方程分别为：Y(抑郁程度)=-0.631+0.161X3(屈服),Y(生活质量)=3.317-0.085X3(屈服)+0.257X2(回避)。结论应对方式是影响癌症患者心理和生活状态的一个重要因素。     

集体运动激励在慢性阻塞性肺疾病稳定期患者中的应用

目的探讨集体运动激励对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)稳定期患者焦虑和抑郁情绪及生活质量的影响。方法选取COPD稳定期患者93例,按照随机数字表法分为干预组47例和对照组46例。对照组行常规护理及运动疗法,干预组在此基础上实施集体运动激励方法。干预前和干预后12周采用汉密尔顿焦虑量表(hamilton anxiety scale,HAMA)、汉密尔顿抑郁量表(hamilton depression scale,HAMD)评定患者的焦虑和抑郁情绪;采用健康状况调查问卷(short form-36health survey,SF-36)评定患者的生活质量。结果干预后,干预组患者HAMA和HAMD评分低于对照组,SF-36评分高于对照组患者,两组比较,均P<0.05,差异具有统计学意义。结论集体运动激励可有效地改善COPD稳定期患者的焦虑和抑郁情绪及生活质量。     

延续性护理在骨关节术后患者居家管理中的应用

目的：探讨延续性护理在骨关节术后患者居家管理中的应用效果。方法：选取2021年6月1日～2022年3月1日就诊于山东省某三甲医院的骨关节手术患者为研究对象，最终纳入对照组和观察组各43例；对照组出院后常规随访，观察组给予出院后延续性护理。比较分析两组疼痛评分[采用视觉模拟评分法(VAS)],焦虑评分[采用汉密顿焦虑量表(HAMA)],抑郁评分[采用汉密顿抑郁量表(HAMD)],生活质量评分[采用简明健康状况调查问卷(SF-36)]。结果：出院后1个月，观察组VAS、HAMA、HAMD评分均低于对照组(P<0.01),SF-36各维度评分均高于对照组(P<0.01)。结论：延续性护理对骨关节术后患者居家管理有积极影响，可减轻患者疼痛，缓解患者焦虑、抑郁情绪，同时提高患者生活质量。     

循证护理对结肠癌造瘘患者情绪及生活质量的影响

目的探讨循证护理(EBN)在改善结肠癌造瘘患者焦虑、抑郁及提高生活质量的作用。方法收集90例结肠癌腹壁造瘘患者, 随机分为观察组及对照组各45例, 对照组给予常规护理, 观察组在对照组基础上给予EBN, 使用焦虑量表(SAS)及抑郁量表(SDS)对情绪进行评分, 使用SF-36量表对生活质量进行评分, 并在出院前进行满意度问卷。结果护理干预前两组患者SAS及SDS评分均无统计学差异, 干预后两组SAS及SDS评分均显著低于干预前(P < 0.05), 且均以观察组明显低于对照组(分别为P=0.021, 0.013)。SF-36评分显示两组的总体健康程度、躯体疼痛、生理功能、生理职能、社会功能、精神健康及情感职能均有统计学差异, 均以观察组评分高于对照组(P < 0.05)。满意度问卷发现两组在服务态度、宣教水平、护理质量及心理支持四项的满意度有统计学差异, 以观察组高于对照组(P < 0.05)。结论循证护理有助于改善结肠癌造瘘患者的焦虑及抑郁程度, 从而提高生活质量。      

强直性脊柱炎患者生活质量变化及其影响因素研究

目的:探讨强直性脊柱炎(AS)患者的生活质量及其各维度的状况,并分析其影响因素。方法:筛选50例AS患者为研究对象,收集AS患者一般资料、健康状况调查问卷(SF-36)、抑郁自评量表(SDS)和焦虑自评量表(SAS)、评估疼痛目测类比法(VAS)、疾病活动指数(BASDAI)、整体指数(BAS-G)、功能指数(BASFI)、症状分级评分、血沉(ESR)、超敏C反应蛋白(hs-CRP)、а酸性糖蛋白(-аAGP),SF-36各维度标准分、抑郁自评量表(SDS)和焦虑自评量表(SAS)标准分与常模组比较。SF-36自评量表分值越高,提示生活质量越好;反之,提示生活质量越差。结果:①强直性脊柱炎患者生活质量及各维度积分均明显低于常模组,生活质量总分不及格的高达78%;SAS和SDS标准分均明显高于常模组,有焦虑、抑郁情绪的患者分别占30%、36%。②BASDAI标准分>4的患者生活质量积分较BASDAI≤4低。③AS患者生活质量及各维度积分与年龄、病程、SAS和SDS标准分、BASDAI、BAS-G、BASFI、症状总积分、VAS评分及ESR、hs-CRP、-аAGP等炎症指标呈负相关。结论:78%的AS患者生活质量有下降趋势,并伴有不同程度的焦虑、抑郁,其生活质量积分与症状体征积分、年龄、病程、疾病活动、焦虑抑郁积分、急性时相反应物等影响因素密切相关。     

2型糖尿病患者焦虑抑郁与生活质量的相关性研究

目的:调查2型糖尿病(T2DM)患者焦虑、抑郁发生情况并分析其与生活质量的相关性。方法:采用Zung焦虑自评量表(SAS)、抑郁自评量表(SDS)、中文版健康调查简表(SF-36)对天津4家三级甲等医院的234例T2DM患者的心理健康和生活质量进行横断面调查。结果:T2DM患者焦虑、抑郁的发生率分别为14.5%和18.4%。焦虑、抑郁评分高于国内常模,差异有统计学意义(P0.01)。SAS和SDS评分与SF-36量表8个维度均呈负相关(P0.01)。结论:T2DM患者存在焦虑、抑郁情绪障碍,且焦虑、抑郁情绪与生活质量存在相关性。     

维持性血液透析患者睡眠质量、抑郁和生活质量相关关系的研究

目的探讨维持性血液透析患者睡眠质量、抑郁与生活质量之间的关系。方法收集符合标准维持性血液透析患者71例,采用匹兹堡睡眠质量指数（PSQI）评估睡眠质量,以简明健康状况调查表（SF-36量表）和BECK抑郁自评问卷（BDI）分别评估生活质量和抑郁情况。记录年龄、性别、婚姻、干体重、血红蛋白、铁蛋白、转铁蛋白饱和度、钙、磷、全段甲状旁腺激素、白蛋白、C-反应蛋白、透析前及透析后血肌酐、尿素氮。结果睡眠质量较差（PSQI评分〉5）的血液透析患者占76.1%;睡眠质量较好组患者的生活质量总分、生理及心理健康总分均高于睡眠质量较差组（P〈0.01）,睡眠质量较差组的抑郁评分高于睡眠质量较好组（P〈0.05）;中-重度抑郁患者（BDI评分≥8分）占63.4%,该组患者生活质量总分、生理及心理健康总分均低于非中-重度抑郁组（P〈0.01）,且睡眠质量差（P〈0.01）;SF-36生活质量总分、生理健康总分及心理健康总分和睡眠质量及抑郁相关（P〈0.01）,睡眠质量和抑郁是生活质量独立的危险因素。结论维持性血液透析患者睡眠质量较差、抑郁较为常见,睡眠和抑郁之间相互影响,并且降低了患者的生活质量。     

Effects of Delayed-Release Dimethyl Fumarate (DMF) on Health-Related Quality of Life in Patients With Relapsing-Remitting Multiple Sclerosis: An Integrated Analysis of the Phase 3 DEFINE and CONFIRM Studies

PurposeDelayed-release dimethyl fumarate (DMF; also known as gastro-resistant DMF) has been reported to have clinical and neuroradiologic efficacy in people with relapsing-remitting multiple sclerosis (RRMS) in the Phase 3 DEFINE and CONFIRM studies. An integrated analysis of data from DEFINE and CONFIRM was conducted to estimate more precisely the therapeutic effects of delayed-release DMF. Here we describe the impact of RRMS on health-related quality of life (HRQoL) at baseline and assess the effects of delayed-release DMF on prespecified HRQoL end points over 2 years.MethodsPatients with RRMS were randomly assigned to receive delayed-release DMF 240 mg PO BID or TID or matching placebo for up to 2 years (96 weeks). As a tertiary end point in both studies, patient-reported HRQoL was assessed using the Physical and Mental Component Summaries (PCS and MCS, respectively) of the 36-item Short Form Health Survey (SF-36); global assessment of well-being, as measured on a visual analog scale (VAS); and the EuroQoL-5D (EQ-5D) VAS, administered at baseline and at weeks 24, 48, and 96. Higher scores suggested better HRQoL.FindingsThe integrated analysis included 2301 patients treated with delayed-release DMF BID (n = 769) or TID (n = 761) or placebo (n = 771). The mean PCS and MCS scores at baseline were lower overall compared with those reported in the general US population and were ≥5 points lower (a clinically meaningful difference) in patients with a baseline Expanded Disability Status Scale (EDSS) score of ≥2.5 compared with those in patients with a baseline EDSS score of 0. At 2 years, mean PCS and MCS scores were increased from baseline in the patients treated with delayed-release DMF, whereas the mean PCS and MCS scores were decreased from baseline in the placebo group; the difference in PCS and MCS scores was significant for the delayed-release DMF BID and TID groups compared with placebo. SF-36 subscale scores generally remained stable or were improved relative to baseline in patients treated with delayed-release DMF and decreased in patients receiving placebo; improvements were significant for delayed-release DMF BID and TID versus placebo on most subscales. Compared with that in the placebo group, the proportions of patients in the delayed-release DMF groups exhibiting a ≥5-point improvement in SF-36 score were significantly higher. The following factors were found to be predictive of improved PCS and MCS scores at 2 years: delayed-release DMF treatment, lower baseline EDSS score, age ≤40 years (PCS only), and corresponding lower baseline PCS or MCS score. Changes from baseline in VAS and EuroQoL-5D scores were generally consistent with changes in SF-36 scores.ImplicationsThese HRQoL benefits parallel the improvements in clinical and magnetic resonance imaging end points with delayed-release DMF, suggesting that delayed-release DMF treatment improves patient-perceived health status as well as neurologic and physical functioning. ClinicalTrials.gov identifiers: NCT00420212; NCT00451451.     

Depression symptoms have a greater impact on the 1-year health-related quality of life outcomes of women post-myocardial infarction compared to men.

OBJECTIVE: Several studies report that women with CAD have a poorer prognosis than men and suggest that depressive symptoms may be a contributing factor. The purpose of this study was to examine gender differences in depressive symptoms, as they relate to health-related quality of life outcomes following an AMI. METHODS: Patients with documented AMI completed a questionnaire including the Short Form 36 physical (PCS), and mental component summary (MCS) scores, and Beck Depression Inventory at baseline and at 1 year after AMI admission. RESULTS: 486 (82%) patients completed the follow-up questionnaire. Females had significantly worse PCS and MCS scores at baseline and 1-year follow-up compared to males The mean 1-year Beck scores were significantly higher (p=0.01) for females (10.02+/-8.23) compared to males (7.78+/-8.01) indicating more reported depressive symptomatology. Multivariate analyses showed significant gender-related differences in the PCS scores at 1 year, but no gender-related differences in the 1-year MCS scores. CONCLUSIONS: These results suggest that gender differences in mental health at 1 year relate to gender-related differences at 1-year depression levels. The higher level of depression in women may be a consequence of gender differences in recovery patterns from an AMI and requires further investigation.     

Quality-of-life assessment in an outpatient parenteral antibiotic program

OBJECTIVE: To measure changes and to identify predictors of change of health-related quality of life (HRQoL) for enrollees into an outpatient parenteral antibiotic therapy (OPAT) program. METHODS: A multidisciplinary, single-center, prospective investigation was conducted at a 1000-bed Canadian adult tertiary-care teaching hospital. Over a 15-month study period, consenting patients who were enrolled in the OPAT program completed paired Short Form-36 (SF-36) questionnaires within 48 hours prior to discharge from the hospital and again 26-30 days after discharge. Sociodemographic data and clinical variables were also collected for the purpose of determining potential predictors of change in quality of life. RESULTS: During the study period, 134 patients were enrolled in the OPAT program and 82 completed the paired SF-36 questionnaires. Study participants experienced a significant improvement in 3 SF-36 domains (physical functioning, bodily pain, role emotional) and the mental component summary scale (MCS) scores when they were transferred from the hospital to home setting. The SF-36 scores for all domains and summary scales were lower than the Canadian population average (all p < 0.001). Multiple linear-regression analysis revealed that infectious disease diagnosis and baseline physical component summary scale (PCS) scores were predictors of the change in the PCS score when patients transferred from the hospital to the home setting. Length of hospital stay and baseline MCS scores were predictors of the change in MCS scores when patients transferred from the hospital to the home setting. CONCLUSIONS: This study reveals that some domains in HRQoL appear to improve 4 weeks after discharge for adults enrolled in an OPAT program and that there are different predictors for changes in physical and mental health.     

Measurement properties of the short form (SF)-12 applied to patients with stroke

The purpose of this study was to examine the reliability and validity of the Short Form (SF)-12 and to determine its ability to detect changes in health related quality of life (HRQOL) following stroke. The study involved a cohort of 90 patients admitted with an ischemic stroke to a hospital in the northeastern United States. The items of the SF-12 were found to be reliable (alpha=0.833-0.894) and to load on a physical and mental component. Three months post-stroke the physical component summary (PCS) scores of the SF-12 were significantly less than population norms. The PCS scores were also lower after stroke (3 month=42.5, 12 month=46.3) than before stroke (48.8). Mental component summary (MCS) scores did not differ significantly from population norms or across time (range=53.6 to 54.9). We conclude that the reliability and validity of the SF-12, as well as its brevity and capacity to document changes in the physical component of HRQOL, provide support for its use in patients with stroke.     

Improved health-related quality of life 12 months after bypass or angioplasty for peripheral arterial disease

Revascularization procedures are known to have a favorable influence on multiple outcomes for patients with peripheral arterial disease. Their affect on health-related quality of life (HRQOL) is less certain. This study was conducted to document changes in HRQOL associated with revascularization procedures and to identify variables associated with HRQOL and changes in HRQOL 12 months after revascularization. Forty-four patients undergoing arterial bypass or angioplasty improved significantly in their HRQOL as measured by the physical component summary (PCS) and mental component summary (MCS)scales of the SF-12. These measurements of HRQOL at 12 months were most highly correlated with the same measures at baseline. For the 12-month PCS, regression analysis showed that a higher baseline PCS, a greater improvement in vascular status, and a higher baseline MCS were predictive of higher scores. For the change in PCS, regression analysis revealed that men with lower baseline PCS scores showed the greatest improvements. Higher 12-month MCS but lesser changes in MCS were shown by regression analysis to be predicted by a higher baseline MCS. Obesity contributed positively to 12-month MCS but negatively to MCS change. In conclusion, the results of this study verify that HRQOL can be improved by revascularization procedures, but that HRQOL at 12 months and improvement in HRQOL are determined by baseline measures. (J Vasc Nurs 2000;18:75-82)     

Patients reported health-related quality of life five years post coronary artery bypass graft surgery--a methodological study.

BACKGROUND: The number of individuals undergoing Coronary Artery Bypass Graft Surgery (CABGS) to treat coronary artery disease is steadily increasing. AIM: The purpose of the study was to describe the cohort's characteristics, their angina and breathless symptoms and report health-related quality of life (HRQoL) five years after CABGS. METHODS: One hundred and twenty-eight patients participated in the follow-up study using the quality of life Short-Form 36 (SF-36) questionnaire. Angina and breathless symptoms were also recorded. RESULTS: One hundred and nine patients were interviewed (face-to-face) and 19 completed postal questionnaires. The SF-36 component summaries of the face-to-face patients indicated that their physical (PCS) and mental (MCS) health was relatively good (45.8 and 53.6, respectively, with 0=worst health and 100=best health and 50 being the mean score), compared to the postal patients' mean PCS of 30.8 (p<.001). The postal MCS was also lower but not statistically significant (49.6, p=.081). At follow-up, the majority of patients were asymptomatic in terms of angina and breathlessness compared to their pre-operative status. CONCLUSION: The findings demonstrate that patient perceived HRQoL five years after CABGS is generally good and patients remain relatively asymptomatic although data collection methods highlight differences in physical HRQoL.     

Health status rated with the Medical Outcomes Study 36-Item Short-Form Health Survey after spinal cord injury

OBJECTIVE: To describe the health status of Australians with spinal cord injury (SCI). DESIGN: Survey. SETTING: Australian population-based sample. PARTICIPANTS: Participants (N=305) with SCI at recruitment to a randomized trial. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) health questionnaire. RESULTS: Compared with the general population, our sample reported significantly lower scores in 6 SF-36 domains (physical function, role-physical, bodily pain, general health, social function, vitality) and the physical component summary (PCS) score, but unexpectedly higher mental component summary (MCS) scores (difference in mean MCS scores, 4.6; 95% confidence interval [CI], 2.4-6.8). Compared with people with tetraplegia, those with paraplegia had better physical function and PCS scores (difference, 21; 95% CI, 17-24; difference, 3; 95% CI, 1-5, respectively), and worse bodily pain scores (difference, 9; 95% CI, 2-15). Recent urinary infections were associated with worse general health, vitality, mental health, and MCS scores. Receiving family or external physical care was associated with worse physical function and PCS scores, but better mental health and MCS scores. Older age at injury was associated with lower bodily pain and PCS scores. CONCLUSIONS: Using the SF-36, Australians with SCI rate their physical (not mental) health status as worse than the general population.     

Clinical impact of rehabilitation and ICU diary on critically ill patients: A systematic review and meta-analysis

Background

Various physical and mental sequelae reduce the quality of life (QOL) of intensive care unit (ICU) patients. Current guidelines recommend multi-angular approaches to prevent these sequelae. Some studies have demonstrated the clinical effectiveness of rehabilitation or the ICU diary against these sequelae, whereas others have not.

Aim

The aims of the present study were to establish whether rehabilitation or the ICU diary was useful for reducing the severity of anxiety, depression, and post-traumatic stress disorder (PTSD) in ICU patients. We also investigated whether these interventions improved the QOL of these patients.

Study design

We conducted a systematic review and meta-analysis of relevant randomized controlled trials published between January 1, 1985, and October 19, 2022, with the following search engines: PubMed, CHINAHL, all Ovid journals, and CENTRAL. The hospital anxiety and depression scale (HADS), the short-form health survey (SF-36), the EuroQol 5-dimensions, 5-levels (EQ-5D-5L), and the Impact of Event Scale-Revised (IES-R) were used as outcome measures. The quality of evidence across all studies was independently assessed using Review Manager software (v.5.4).

Results

We included 12 rehabilitation studies and five ICU diary studies. Rehabilitation had no significant effects on HADS-anxiety, HADS-depression, or EQ-5D-5L, but significantly improved the physical component summary (PCS) [MD = 3.31, 95%CI (1.33 to 5.28), p = .001] and mental component summary (MCS) [MD = 4.31, 95%CI: (1.48 to 7.14), p = .003] of the SF-36. The ICU diary significantly ameliorated HADS-anxiety [MD = 0.96, 95%CI: (0.21 to 1.71), p = .01], but did not affect HADS-depression, the IES-R, or the PCS or MCS of the SF-36.

Conclusions

The present study showed that rehabilitation initiated after discharge from the ICU effectively improved SF-36 scores. The ICU diary ameliorated HADS-anxiety. Neither rehabilitation nor the ICU diary attenuated HADS-depression or IES-R in this setting. Rehabilitation and the ICU diary partially improved the long-term prognosis of ICU patients.

Relevance to clinical practice

The present study provides evidence for the beneficial effects of rehabilitation and the ICU diary for ICU patients. Rehabilitation alone does not ameliorate anxiety, depression, or PTSD symptoms, but may improve QOL. The ICU diary only appeared to ameliorate anxiety.     

The relationship between functional disability and health-related quality of life in patients with a rotator cuff tear

Purpose:To determine the relationship between functional disability and health-related quality of life (HRQoL) in rotator cuff tear (RCT) patients. Method:In 67 RCT patients (mean age, 54 years; 57% males), functional disability was self-reported with the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), HRQoL with the Short-Form 36 Health Survey (SF-36), and pain by visual analogue scale. ASES results were divided into tertiles (12-38, 39-51, and 52-82). Results:Mean ASES score was 48 (range, 12-82). Patients with the highest functional disability and highest pain level had the lowest HRQoL. For the highest, middle, and lowest ASES categories, respectively, mean SF-36 Physical Component Summary (PCS) scores were 35 SD 5, 36 SD 8, and 41 SD 6 (p< 0.001) (r = 0.47 for ASES vs. PCS; p< 0.001), and Mental Component Summary (MCS) scores were 50 SD 13, 56 SD 10, and 58 SD 8 (p = 0.011) (r = 0.37 for ASES vs. MCS; p= 0.003). Conclusions: Patients with higher functional disability had lower HRQoL. RCT extensively affects patients' lives; therefore, capturing both generic and shoulder-specific measures of RCT problems is recommended. [Box: see text].