Spitzer生活质量指数测量脑座中患者的效度研究

作用Ｓｐｉｔｚｅｒ生活质量指数测量了７６例脑座中患，并分别与２０例腰腿痛病人、晚期癌症病人配对比较，对Ｓｐｉｔｚｅｒ生活质量指数测量脑座中的有效性进行了研究。结果显示：在单项对总分的贡献率中，“活动”、“生活”、“健康”三项说明了８９％的变量，“支持与感受”仅解释了１１％；其与言语、认知、运动功能、日常生活活动相关，Ｐ值均小于０．０１，借此可区别腰腿痛，脑座中、晚期癌症病人的生活质量。本研究提     

人性照护对晚期癌症病人生存质量的影响

目的：研究人性照护对晚期癌症病人生存质量的影响．方法：对晚期癌症病人实施人性照护而采取相关护理措施．使用癌症生存质量核心量表EORTIC QLQ-C30（Version3），焦虑自评量表（SAS）抑郁自评量表（SDS）等进行测评，并与常规相好照评定．结果：病人生活质量的情感功能、认知功能、社会功能、整体健康状况，乏力症状与常规组有显著性差异．结论：人性照护可减轻焦虑和抑郁、纠正病人消极的认知，提高晚期癌症病人的生活质量。     

脑卒中病人生活质量的多中心研究

目的：了解脑卒中病人的生活质量(QOL)及其影响因素。方法：采用多中心研究方法，应用健康测量量表SF-36和自行编制的“患者一般状况量表”，对西安市、兴平市和户县共11所不同等级医院的神经内外科和老年病科共146例脑卒中病人进行调查，用多元逐步回归方法分析影响生活质量的因素。结果：脑卒中病人的生活质量明显低于正常人群，生活质量与吸烟、偏瘫、家人对病人的关心和健康变化状况有关。结论：加强脑卒中及其有关疾病尤其是偏瘫的治疗和康复护理，改善病人的躯体功能，劝其戒烟，鼓励家属给予更多的关心和支持，是促进脑卒中病人早日康复的重要保证。     

脑卒中患者生活质量的评估及其影响因素

目的：从国内外脑卒中患者生活质量研究的现状出发，探讨脑卒中患者生活质量的评估及其康复治疗对脑卒中生活质量的影响。资料来源：应用计算机检索Medline1994-01／2004—12的与脑卒中生活质量相关文献，检索词“stroke，quality of life，rehabilitation”，并限定文献语种为English。同时计算机检索万方数据库1998—01／2004—12的与脑卒中生活质量相关文献，检索词“脑卒中，生活质量，康复”，并限定文献语种为中文。资料选择：就检索到的80篇文献进行筛选，选择临床以患者为观察对象的研究，以“脑卒中，生活质量，康复”为主要研究内容的文献15篇，排除综述类文献。资料提炼：共筛选到15篇文章，包括850例患者，按照脑卒中生活质量、脑卒中康复分类，其中6篇与脑卒中生活质量有关，9篇与脑卒中康复有关。资料综合：目前在脑卒中患者生活质量研究中常用的量表有疾病影响问卷、健康质量量表、诺丁汉健康问卷、简短36条目问卷、世界卫生组织生活质量量表、Niemi的中风生存质量研究量表、Frenchav活动指数等10余种，其中后两种为脑卒中专用量表。影响脑卒中患者生活质量的因素有年龄、性别、损害部位及脑卒中类型、有无抑郁及日常生活活动能力水平等，康复治疗可提高脑卒中患者的生活质量。结论：目前国内使用的生活质量量表没有统一规定的评估标准，不便于比较，应积极研制适合中国国情、文化背景的评估量表；针对脑卒中患者的运动功能、语言、认知功能和心理障碍进行康复治疗能有效提高脑卒中患者的生活质量。     

晚期癌症病人的心理疾患及处理对策

为检查接受化疗的晚期癌症病人的心理疾患及其处理对策之间的关系，作者对１３２例晚期癌症病人进行了调查研究。 研究对象和方法１３２例接受化疗的晚期癌症病人接受了调查，其中８８例为女性，４４例为男性，年龄３３～８３岁（平均６０．７４ＳＤ＝１１．７８）；乳腺癌占２７％，卵巢癌占１８％，肺癌占１３％，结肠、直肠癌占１１％，其它癌症占３１％。调查方法是采用情绪状态全图（ＰＯＭＳ），测量参加者心理疾患的水平，调查表以邮寄的方式发出和收回。ＰＯＭＳ共６５个项目，主要从６个方面反映情绪状态：（１）紧张－焦虑；（２…     

癌症康复中疼痛的治疗

癌痛是影响病人生存质量的主要问题。一些研究发现大约３０％～５０％可以行走的癌症病人受到疼痛的折磨，对于晚期癌症病人来说，疼痛的发病率可以达到９０％。疼痛影响病人的活动功能及生存质量。如果癌症的康复成功则意味病人的疼痛得到了控制。肿瘤的骨浸润，神经浸润，软组织浸润，或内脏浸润引起的疼痛占与癌症相关疼痛的６５％～７５％。癌症的治疗引起的疼痛１５％～２５％。还有５％～１０％的病人主诉的疼痛与癌症无关但是也需要治疗。疼痛的治疗方法包括：主要疾病调整治疗方法，如外科治疗、化疗、放疗；心理方法，如生活方式的…     

氟西汀对脑卒中患者抑郁状况及生活质量的影响

目的：脑卒中后抑郁发病率高，且严重影响脑卒中患者的生活质量，研究氟西汀对其情感障碍及生活质量的改善作用，为临床提供参考依据。方法：研究对象为1999-03／2002-07在同济医院神经内科和荆州市第一人民医院神经内科住院的脑卒中患者，共112例。随机分为治疗组和对照组，治疗组给予口服氟西汀，并给予改善脑部血液供应、营养神经细胞及常规康复治疗；对照组给予心理治疗，其余治疗同治疗组。采用汉密顿抑郁量表、日常生活活动能力及生活质量指数量表评分，观察患者治疗前后抑郁状态、日常生活活动能力及生活质量的变化情况。结果：治疗组、对照组总有效率分别为80．9％，61．2％，两组相比差异具有显著性意义(x^2=5．36．P&;lt;0．05)。治疗组治疗后汉密顿抑郁量表，日常生活活动能力，生活质量指数评分较治疗前明显改善(t=8．4，7．6，2．8，P&;lt;0．05)；治疗后治疗组汉密顿抑郁量表、日常活动能力．生活质量指数评分较对照组增高(t=5．2，5．9、6．6，P&;lt;0．05)。结论：氟西汀对脑卒中后抑郁状态，日常生活活动能力均有显著改善作用，可促进脑卒中患者的神经功能恢复，提高其生活质量。     

告知癌症病人真实诊断最佳时机的调查及分析

目的探讨告知癌症病人真实诊断的最佳时机，以提高癌症病人的生活质量。方法采用自行设计的调查问卷，分别对无患癌症的成年人（普通健康人群）、肿瘤科医务工作者、癌症病人家属和癌症病人进行调查，以了解告知癌症病人真实诊断的最佳时机。结果50．0％医护人员认为在治疗中期告知病人真实诊断时机较好；68．2％病人家属认为在治疗晚期告知病人真实诊断时机较好；76．5％病人认为在治疗中期告知病人真实诊断时机较好；45．1％普通健康人群认为诊断早期告知病人真实诊断时机较好。结论作为医护人员在行使告知权时，要站在病人的角度思考问题，选择恰当的告知方法，尽量降低对病人产生的负面影响，提高病人生活质量。     

股静脉穿刺置管在晚期癌症病人生命维持中的作用

股静脉穿刺置管在晚期癌症病人生命维持中的作用杨万芬关键词股静脉置管，晚期癌症病人，静脉通道Ｋｅｙｗｏｒｄｓ：Ｆｅｍｏｒａｌｖｅｉｎｃａｔｈｅｔｅｒ；Ｌａｔｅｃａｎｃｅｒｐａｔｉｅｎｔ；ＳｅｔｕｐＩ．Ｖ静脉通道的建立，在危重病人，特别是晚期癌症病人的生...     

晚期癌症病人对安宁疗护的需求现状及安宁疗护对病人生活质量的影响

[目的]探讨晚期癌症病人对安宁疗护的需求现状分析及安宁疗护对病人生活质量的影响。[方法]2016年6月—2017年6月应用晚期癌症病人安宁疗护需求问卷对128例晚期癌症病人进行安宁疗护需求进行调查,分析安宁疗护对病人生活质量的影响。[结果]晚期癌症病人对安宁疗护的需求总评分为52.58分±3.25分,其中生理需求方面评分最高的条目是睡眠质量得到保证,其次是疼痛能有效控制、皮肤及口腔保持清洁完整,心理需求方面评分最高的是家人支持及陪伴,其次是与家人探讨死亡问题、宗教人员精神支持等。病人经安宁疗护后躯体功能、角色功能、社会功能、情绪功能、认知功能及总生活质量评分较干预前明显提高(P0.05)。[结论]晚期癌症病人对安宁疗护的需求较高,护理人员应重视病人安宁疗护需求,最大限度减轻病人生理及心理不适,提高病人生活质量。     

农村脑卒中患者居家康复模式探索及成效分析

目的:探索农村脑卒中患者居家康复的模式及其对日常生活活动能力、生活质量、焦虑和抑郁情绪的影响。方法:随机选择100例脑卒中偏瘫患者分为观察组(48例)与对照组(52例)。2组患者均接受常规药物治疗及乡村医生的健康宣教和康复咨询,观察组在此基础上增加医务人员的综合康复治疗及心理辅导,时间为3个月,治疗前后均采用改良Barthel指数(MBI)、生活质量指数(QLI)、Zung焦虑自评量表(SAS)及Zung抑郁自评量表(SDS)进行评定。结果:观察组治疗后与治疗前比较,MBI评分和QLI评分明显提高,SAS和SDS评分明显降低(P0.05);对照组治疗3个月后与治疗前比较,MBI评分明显提高(P0.05)。治疗后,与对照组比较,观察组MBI评分和QLI评分明显提高,SDS和SAS评分明显降低(P0.05)。结论:居家综合康复治疗及心理辅导对农村脑卒中患者的日常生活活动能力、生活质量、焦虑和抑郁情绪具有明显的改善作用,值得进一步深入推广。     

Perceived cancer-related financial difficulty: implications for patient satisfaction with quality of life in advanced cancer

Goals of work Cancer and its treatment often lead to financial difficulty in patients with advanced cancer. The goal of this study was to investigate the relationship between perceived cancer-related financial difficulty and patient satisfaction with quality of life (QoL) in advanced cancer. Materials and methods A case series of 954 cancer patients treated at Cancer Treatment Centers of America, a private tertiary care oncology facility in the USA, was investigated. Perceived financial difficulty was measured using the QLQ-C30 financial difficulty subscale. Patient satisfaction with QoL was measured using the Ferrans and Powers Quality of Life Index (QLI). The relationship between perceived financial difficulty and QLI was evaluated using multivariate analysis of variance and multiple regression analysis. Results Of 954 patients, 579 were women and 375 were men, with the median age at presentation of 56 years (range 20–90 years). Sixty-six percent did not respond to prior treatment. Most common cancers were breast (26%), colorectal (19%), and lung (16%). Two hundred ninety-six (31%) patients perceived their financial condition as poor. Every 10-year increase in current age was significantly associated with a decline in all QLI subscales except for family subscale. Newly diagnosed patients had significantly better QLI scores for all subscales as compared to those who did not respond to definitive treatment elsewhere before coming to our hospital. After controlling for the effects of age and treatment history, every 10-unit increase in perceived financial difficulty score was statistically significantly associated with 0.52, 0.36, 0.32, 0.24, and 0.40 unit decline in QLI health/physical, social/economic, psychological/spiritual, family, and overall function score, respectively. Conclusions We found that perceived financial difficulty is strongly correlated with patient satisfaction with QoL in advanced cancer. These findings indicate a need for the providers of cancer care to be aware that nonclinical factors such as perceived financial difficulty can have an important bearing on QoL of cancer patients.     

晚期肿瘤病人疼痛控制状况及其生活质量的研究

目的了解晚期肿瘤病人的疼痛控制状况及其生活质量状况。方法采用一般资料及疾病相关情况、疼痛相关情况、疼痛强度量表、疼痛治疗指数、疼痛信念及简明健康状况调查表对北京市5所三级甲等医院的202例住院晚期肿瘤疼痛病人进行调查。结果 202例晚期肿瘤病人中,应用止痛药治疗189例(93.56%),按时用药133例(65.84%),对止痛效果表示满意165例(81.68%),对于疼痛相关知识了解的仅20例(9.90%),疼痛治疗不足48例(23.76%),疼痛强度评分为(4.66±2.25)分,疼痛信念总均分为(2.41±0.98)分,生活质量各维度得分低于国内常模。疼痛控制组病人的生理机能、躯体疼痛、精神健康3个维度得分均高于疼痛未控制组(P<0.01或P<0.05)。结论晚期肿瘤病人疼痛控制状况不佳,生活质量较差,而疼痛控制有助于改善晚期肿瘤病人的生活质量。     

功能综合评定量表效度的研究

目的:研究功能综合评定(FCA)量表在评测残疾患者中的效度。方法:对已明确诊断的20例残疾患者进行FCA量表效度分析,其中脑血管意外患者7例,外伤性颅脑损伤患者6例,脑瘤术后患者5例,脊髓损伤患者2例。将FCA运动分、认知分、社会交往分与Barthel指数、简易精神状态检查(MMSE)、生活质量指数(QLI)得分作相关分析。结果:FCA运动分与Barthel指数显著相关(r=0.977,P<0.001),FCA认知分与MMSE评分也显著相关(r=0.926,P<0.001),FCA社会交往分与QLI评分也有较好的相关性(r=0.978,P<0.001)。结论:FCA与Barthel指数、MMSE及QLI有良好的标准效度,是整体残疾功能评测的一项有效的评测工具。     

芬太尼透皮贴剂用于利卡汀介入治疗肝癌患者疼痛的疗效观察

目的：探讨芬太尼透皮贴剂用于肝癌晚期患者行利卡汀介入治疗术后疼痛的疗效观察、生活质量和不良反应。 方法：临床选择60例肝癌晚期行利卡汀治疗后疼痛患者,使用芬太尼透皮贴剂止痛,进行止痛效果观察、生活质量和不良反应的分析。 结果：60例肝癌晚期患者使用芬太尼透皮贴剂后,疼痛完全缓解者40例(66%);部分缓解者10例(16%);轻度缓解者6例(10%);无效果者4例(6%)。 结论： 芬太尼透皮贴剂作为长效持续止痛剂,具有镇痛效果良好、成瘾性小、不良反应轻、无创伤性和使用便捷等优点,适用于肝癌晚期行利卡汀介入治疗术后的止痛疗法。     

The relationship between insomnia and patient satisfaction with quality of life in cancer

Goals of work Insomnia is the most common sleep disorder in patients with advanced cancer. The goal of this study was to investigate the relationship between insomnia and patient satisfaction with quality of life (QoL) in cancer. Materials and methods A case series of 954 cancer patients treated at Cancer Treatment Centers of America was investigated. Insomnia was measured using the EORTC QLQ-C30 insomnia subscale. Patient satisfaction with QoL was measured using the Ferrans and Powers Quality of Life Index (QLI). The relationship between insomnia and QLI was evaluated using multivariate analysis of variance and multiple regression analysis. Results Of 954 patients, 579 were females and 375 males, with the median age at presentation of 56 years (range, 20–90 years). Most common cancers were breast (26%), colorectal (19%), and lung (16%). After controlling for the effects of age and treatment history, every 10-unit increase in insomnia was statistically significantly associated with 0.67-, 0.17-, 0.42-, 0.20-, and 0.42-unit decline in QLI health/physical, social/economic, psychological/spiritual, family, and overall QoL functioning, respectively. Conclusions We found that insomnia is strongly correlated with patient satisfaction with QoL in cancer. Future studies should evaluate the impact of integrative cancer care services on patient satisfaction with QoL.     

脑卒中偏瘫患者的早期康复护理效果观察

目的：探讨脑卒中偏瘫患者的早期康复护理临床疗效。方法：选取2010年3月～2013年3月因脑卒中在我院住院接受治疗的偏瘫患者75例,随机分为观察组38例和对照组37例。两组均给予常规治疗和护理,观察组在此基础上进行早期康复干预。对两组患者不同阶段的神经功能障碍评价（MESSS）得分及QLI评分进行比较。结果：两组患者入院后3个月与出院后1个月与入院时MESSS得分比较,具有统计学差异（P〈0.05）。观察组入院后3个月与出院后1个月MESSS得分均低于对照组（P〈0.05）。出院后,两组患者的生活质量指数（QLI）评分显著高于入院2周,差异具有统计学意义（P〈0.05）。除家庭支持外,出院后观察组的QLI评分显著高于对照组（P〈0.05）。结论：对脑卒中偏瘫患者进行早期康复护理,可促进患者神经功能的恢复和生命质量的改善,值得临床推广应用。     

Ferrans and Powers' Quality of life index applied in urinary incontinence research--a pilot study

Scand J Caring Sci; 2011; 25; 410–416
Ferrans and Powers’ Quality of life index applied in urinary incontinence research – a pilot study Background: The aim of this study was to explore the usefulness of applying a global, evaluation‐based quality of life (QoL) questionnaire in assessing the impact of urinary incontinence (UI) on women’s lives. Methods: The study population comprised long‐term gynaecological cancer survivors (n = 160) and controls from the general population (n = 493). The presence of UI was assessed by the question ‘Do you leak urine?’ while UI perceived as a problem was assessed on a five‐point scale from ‘No problem’ to ‘A very large problem’. QoL was measured by Ferrans & Powers’ QoL index (QLI), generic version II. Results: UI was distributed equally among women with a history of gynaecological cancer and among women from the general population (34%). UI has a negative impact on overall QLI as well as a wide range of items. Approximately 20% of the incontinent women defined UI as no problem, with QLI scores similar to continent women. Only 5% experienced UI as a large/very large problem; with exceptionally low QLI scores. The psychometric testing of QLI (acceptability, internal consistency reliability and known‐group validity) supports the use of QLI in UI‐studies. Conclusions: The Ferrans & Powers’ QLI is considered an acceptable tool for UI research, but further psychometric testing is required.     

Can anorexia predict patient satisfaction with quality of life in advanced cancer?

Goals  Anorexia is the second most common symptom after fatigue in patients with advanced cancer. We quantified the relationship between anorexia and patient satisfaction with quality of life (QoL) in advanced cancer. Materials and methods  A case series of 954 cancer patients treated at the Cancer Treatment Centers of America. Anorexia was measured using the QLQ-C30 loss of appetite/anorexia subscale. Patient satisfaction with QoL was measured using the Ferrans and Powers Quality of Life Index (QLI). The relationship between anorexia and QLI was evaluated using multivariate analysis of variance and multiple regression analysis. Main results  Of 954 patients, 579 were females and 375 males with the median age at presentation of 56 years. Of these patients, 66% had failed prior treatment. Most common cancers were breast (26%), colorectal (19%), and lung (16%). After controlling for the effects of age, treatment history, and other QLQ-C30 symptom subscales, every 10 unit increase in anorexia was statistically significantly associated with 0.18 unit decline in QLI health and physical function score. Conclusion  We found that anorexia is significantly correlated with patient satisfaction with health and physical function in advanced cancer. Future studies should evaluate the impact of integrative cancer care services on patient satisfaction with QoL.     

The relationship between dyspnea and patient satisfaction with quality of life in advanced cancer

Goals of the work

Dyspnea is a common symptom in patients with advanced cancer. The goal of this study was to investigate the relationship between dyspnea and patient satisfaction with quality of life (QoL) in advanced cancer.

Materials and methods

A case series of 954 cancer patients treated at the Cancer Treatment Centers of America® was investigated. Dyspnea was measured using the EORTC dyspnea subscale. Patient satisfaction with QoL was measured using the Ferrans and Powers Quality of Life Index (QLI). The relationship between dyspnea and QLI was evaluated using multivariate analysis of variance and multiple regression analysis.

Results

Of 954 patients, 579 were females and 375 males with the median age at presentation of 56 years (range: 20–90 years). Of these patients, 66% did not respond to prior treatment. Most common cancers were breast (26%), colorectal (19%) and lung (16%). After controlling for the effects of age and treatment history, every ten unit increase in dyspnea was statistically significantly associated with 0.81, 0.16, 0.47, and 0.47unit decline in QLI health/physical, social/economic, psychological/spiritual and global function score, respectively.

Conclusions

We found that dyspnea is strongly correlated with patient satisfaction with QoL in advanced cancer. Future studies should evaluate the impact of integrative cancer care services on patient satisfaction with QoL.