南通市老年人生活质量的影响因素

目的了解南通市老年人生活质量状况及其危险因素。方法采用分层整群抽样的方法,欧洲五维健康量表及自制量表为调查工具,对南通市986名60岁以上老年人进行调查。结果南通市老年人对行动能力、自我照顾能力和焦虑或沮丧的满意度较高,对躯体疼痛或不适以及日常活动的满意度较低,且每个维度得分均是男性好于女性(P<0.05)。多因素分析显示南通是老年人生活质量的影响因素依次是居住方式、慢性病个数、体育锻炼、年龄、性别和职业。结论鼓励老年人适当参加体育锻炼,建立和谐的社会关系,提高老年人生活质量。     

南通市老年人生命质量影响因素的因子分析

目的 了解南通市老年人的生命质量及其影响因素.方法 2010年7月应用欧洲五维健康量表(EQ-5D)对南通市994例＞60岁的老年人进行问卷调查,探索性因子分析生命质量的影响因素.结果 英国权重计算城市老年人生命质量指数得分均数(0.590±0.092)高于农村老年人(0.560±0.115),农村老年人得分高于养老院老年人(0.447 ±0.154).社会经济因素、闲暇生活方式、慢性病、睡眠食欲、婚姻家庭和社会支持是影响老年人生命质量的主要因子.结论 政府应完善养老保险和医疗保险制度,加强老年人慢性病的健康管理,促进居家养老服务体系建设.     

安徽省池州市农村老年人生存质量现状与分析

目的了解安徽省池州市农村老年人生存质量,分析其影响因素。方法采用随机整群抽样的方法,在安徽省池州市随机抽取10个行政村,采用世界卫生组织生存质量简表(WHOQOL-BREF)对716名老年人进行问卷调查。结果池州市农村老年人总体生存质量平均得分为66.18±8.39,各领域得分分别为:生理56.04±16.87、心理60.09±11.69、社会关系56.37±9.49、环境58.68±11.42。多元线性回归分析结果显示,性别、年龄、健康状况、婚姻状况、收入水平、UCLA孤独量表得分、家庭支持情况和经济来源分别是影响老年人生活质量各领域评分的主要因素。结论影响农村老年人生存质量的因素众多,关注老年人健康的同时,更应关注老年人的心理变化和家庭支持情况对其的影响。     

福州市高龄老年人生活质量及影响因素

目的了解福州市高龄老年人的生活质量现状及影响因素。方法采用世界卫生组织生存质量测定量表简表(WHOQOL-BREF)对福州市的102名高龄老年人进行问卷调查。结果福州市高龄老年人生活质量总体得分为(56. 47±7. 30)分,生理、心理、社会关系和环境领域得分分别为(58. 82±17. 67)、(66. 79±14. 55)、(60. 70±12. 38)、(66. 64±13. 40)分,其中生理领域和社会关系领域得分显著低于常模水平(P0. 01)。性别、年龄、文化程度、患病个数、平均每月药品费与就诊费、养老模式是影响高龄老年人生活质量的重要因素(P0. 05)。结论高龄老年人生活质量普遍较差,应重视高龄老年人身心健康,积极治疗疾病,鼓励全社会对其投入更多的关爱。     

慢性乙型肝炎患者生活质量的影响因素

目的 了解慢性乙型肝炎患者生活质量现状,并对其生活质量的影响因素进行分析. 方法 采用整群抽样方法,以世界卫生组织生活质量调查表(WHO QOL-BREF)及自制量表为调查工具,对268例慢性乙型肝炎患者(病例组)和205名正常人(对照组)进行病例对照研究.用独立样本成组t检验比较两组各项得分的差异,多元线性逐步回归法和单因素方差分析及多重比较分析其影响因素.结果 病例组生活质量总分、生理领域得分、心理领域得分、社会关系领域得分、环境领域得分、QOL自评得分和健康自评得分分别为(62.88±8.22)、(64.71±15.05)、(64.35±14.71)、(67.20±12.98)、(59.58±13.23)、(60.75±21.54)、(58.13±19.15)分,均低于对照组相应得分[(67.31±5.82)、(73.21±11.26)、(68.94±10.13)、(69.83±8.65)、(63.97±10.24)、(66.90±17.57)、(76.26±14.27)分],差异均有统计学意义(P值均＜0.05).多元线性逐步回归分析结果显示:抑郁、病情较重、自费、对收入有无明显影响、食欲较差、乏力和担心传染是影响生理领域得分的危险因素,治疗信心是保护因素(P值均＜ 0.05);抑郁和复发是影响心理领域得分的危险因素,治疗信心和男性是保护因素(P值均＜ 0.05);抑郁、对周围人的态度不满意、复发和高龄是影响社会关系领域得分的危险因素,社会支持和治疗信心是保护因素(P值均＜ 0.05),不同职业者之间社会关系领域得分差异有统计学意义(P＜ 0.01);抑郁、对周围人的态度不满意、居住在乡村和复发是影响环境领域得分的危险因素(P值均＜ 0.05).结论 在临床医疗护理过程中,重视有抑郁症状患者的早期治疗,加强患者心理健康护理,加强医患沟通,提高患者的社会支持水平,利于提高患者的生活质量.     

体育锻炼对老年人生命质量的影响及相关因素的研究

目的 探讨体育锻炼对老年人生命质量的影响.方法 以长期参加晨练的60周岁至79周岁的老年人158名为研究组,以选自社区不参加体育锻炼的老年人172名为对照组.应用WHOQOL- 10 0量表和一般情况调查表进行调查,应用χ2检验,单因素t检验,Hotelling t 2检验,多元线性回归等方法进行分析.结果 总的健康情况和生命质量的总分、生理领域、心理领域、独立性领域、社会关系领域、环境领域和精神支柱领域等六个领域的平均得分在晨练组和对照组间均存在统计学差异（P＜0.01）,且晨练组得分均显著高于对照组.就整体而言,晨练组老年人的生命质量与对照组相比有极显著的统计学差异（P＜ 0 .01）,晨练组老年人的生命质量高于对照组.社会地位、身体健康的状况、家庭生活（家庭和睦、子女孝顺、配偶健在等）的质量、能否自己支配自己的爱好,如吸烟不受限制是影响老年人的生命质量的主要因素.结论长期参加体育锻炼能提高老年的生命质量.影响老年人生命质量的主要因素为社会地位、家庭生活质量、身体健康状况.     

吉安市社区老年人生命质量调查及影响因素

目的了解社区老年人生命质量及其影响因素。方法采用健康状况调查问卷(SF-36)中文版调查社区老年人生命质量,并通过单因素、多因素统计方法分析其影响因素。结果社区老年人生命质量情况为:躯体功能(41.94±23.29)分,躯体健康所致角色限制(53.64±43.03)分,躯体疼痛(80.24±20.25)分,总体健康感(43.20±19.07)分,生命力(60.40±15.67)分,社交能力(63.79±20.24)分,情感问题所致角色限制(71.13±37.16)分,心理健康(68.14±15.43)分,加权平均分为(64.06±17.49)分。影响老年人生命质量的因素有性别、年龄、体育锻炼、娱乐、以前从事职业、对生活满意度、冠心病、糖尿病、脑血管意外和慢性支气管炎。男性生命质量加权平均分及8个维度的得分均高于女性(P<0.05)。影响社区老年人生命质量的主要可控因素为每天外出散步、孤独感、疾病、对生活满意度、丧偶。结论社区老年人的躯体功能和总体健康感情况较差。社区应该加强业务管理,积极鼓励老年人参加体育锻炼,建立各种设施,以提高老年人的生活质量。     

新疆维哈失能老年人生活满意度与照护者照护负担、社会支持交互作用

目的探讨新疆维哈失能老年人生活满意度与其照护者照护负担、社会支持交互作用。方法应用生活满意度指数B量(LSIB)表、主要照护者负担量表(ZBI)和社会支持量表(SSRS)等对621对维哈失能老年人/照护者进行研究。结果 (1)维哈少数民族失能老年人生活满意度得分为(13.15±3.744)分,低于新疆汉族失能老年人,也低于国内常模;(2)交互作用表明:照护者有照护负担及低社会支持、高龄失能老年女性、重度失能、失能老年人文化程度低、患2种以上疾病、子女经济差是影响维哈失能老年人生活满意度的危险因素。结论照护者有照护负担且社会支持低是影响新疆维哈失能老年人生活满意度的主要危险因素,因素间交互作用大大降低了失能老年人生活满意度。     

新疆维吾尔族、哈萨克族失能老年人生活质量现状及影响因素

目的探讨维、哈失能老年人生活质量现状及影响因素。方法应用SF-36生活质量问卷对621例维、哈失能老年人进行研究。结果维、哈失能老年人生活质量得分为(91.25±11.96)分;Logistic回归分析显示:照护者照护负担、失能程度、失能老年人性别、失能老年人年龄、失能年限及认知情况、家庭人口数是影响被照护者生活质量的重要因素,其中照护者照护负担为主要影响因素。结论提高维、哈失能老年人生活质量应从减轻照护者负担着手,同时考虑失能程度的影响。     

南通市老年人抑郁状况及其影响因素分析

目的了解南通市老年人抑郁的患病现状及其影响因素。方法采用整群随机抽样的方法,以老年抑郁量表(GDS)及自制量表为调查工具,对南通市60岁以上老年人群进行调查,共收集有效问卷714份。结果南通市老年人群老年抑郁症状发生率为16.11%,其中中重度抑郁占2.24%。多因素Logistic回归分析显示,睡眠、家庭/亲友/邻里关系、个性是否乐观、体育锻炼是老年抑郁症状发生的影响因素。结论抑郁症状是老年人常见的心理健康问题,受生理、心理、家庭、社会等诸多因素的综合影响,应加强老年精神卫生服务,提供相应预防措施。     

Main and interactive effects of emotion dysregulation and HIV symptom severity on quality of life among persons living with HIV/AIDS

HIV symptoms are associated with a poorer quality of life (QOL) among persons living with HIV/AIDS (PLWHA). Yet, there is little understanding of emotional factors that impact the relation between HIV symptom severity and QOL. The present study examined the main and interactive effects of emotion dysregulation and HIV symptom severity on multiple indices of QOL, including physical (impact of physical problems related to HIV), psychological (frequency of negative feelings), independence (necessity of medical treatment to function in daily life), social (feelings of acceptance), environmental (satisfaction with living conditions and medical care), and spiritual (fear of the future and death) among a sample of 74 PLWHA. Participants (72.9% male; mean age?=?48.24, SD?=?7.85) were recruited from AIDS Service Organizations in the United States. Results indicated that higher HIV symptom severity is significantly associated with lower physical and independence QOL, whereas higher emotion dysregulation is significantly associated with lower scores on all measured aspects of QOL. Additionally, results indicated that the interaction of emotion dysregulation and HIV symptom severity was significantly associated with both physical and environmental QOL. The form of the observed significant interactions indicated that HIV symptom severity was related to poorer QOL among those with lower (versus higher) emotion dysregulation. The present findings indicate that emotion dysregulation is related to QOL among PLWHA and may interact with HIV symptom severity to negatively impact certain aspects of QOL. Given the profound impact that HIV has on QOL, this finding is important in understanding these relations mechanistically, and may be important in the development of novel psychological treatment strategies.     

Psychological adjustment and suicidal ideation in patients with AIDS

This article assesses the psychosocial adjustment to illness and examines the relationship between adjustment and psychosocial and medical variables in 91 ambulatory HIV-infected patients. The 91 subjects were receiving ambulatory medical care in hospitals (Memorial Hospital, New York Hospital, and St. Vincent's Hospital) and in private medical consult (Gay Men's Health Crisis) in New York. The majority (74.5%) of subjects had AIDS. The sample was composed principally of white Roman Catholic homosexual men living alone. However, 49.5% were black or hispanic, 31.9% had intravenous drug use as their HIV risk behavior, 54.9% had past psychiatric history (including illegal drug use), and 22% had previous suicide attempts. Self-report measures of psychological adjustment (Psychological Adjustment to Illness Scale), mood (Brief Symptom Inventory), physical (PHYS) and psychological (PSYCH) symptoms from the Memorial Symptom Assessment Scale-Short Form (MSAS-SF), social support (Social Support Questionnaire-Short Report), suicidal ideation (Scale for Suicide Ideation Self-Report), and measures of disease status (Karnofsky Performance Rating Scale, HIV CDC Classification, and Absolute CD4+ Lymphocyte Count) were used in the study. The average age of subjects was 40 years (SD = 6.80). fifty-two (63.4%) subjects acknowledged some indication of suicidal ideation. Variables that correlated with poor medical adjustment (health-care posture) were current suicide ideation (0.32, p = 0.003), number of psychological symptoms (0.45, p = 0.0001), physical symptoms (0.31, p = 0.006), social support (-0.24, p = 0.03), and satisfaction with the social support received (-0.36, p = 0.001). Poor sexual adjustment was related to current suicide ideation (0.39, p = 0.0004), number of psychological symptoms (0.40, p = 0.0003), satisfaction with the social support received (-0.28, p = 0.01), and number of physical symptoms (0.35, p = 0.002). In patients with a diagnosis of AIDS, the number of psychological symptoms (Beta = 0.29, R2 = 0.07, p = 0.02) and the satisfaction with the social support received (Beta = -0.38, R2 = 0.14, p = 0.003) were clear predictors of poor medical adjustment (health-care posture). Likewise, the predictors of poor sexual adjustment were psychological symptoms (Beta = 0.33, R2 = 0.10, p = 0.003) and suicidal ideation (Beta = 0.40, R2 = 0.10, p = 0.002). The results suggest that suicide ideation is associated with poor adjustment, rather than serving as an adaptive function, as has been suggested by others.     

炎症性肠病患者健康相关生活质量评价研究

目的 研究炎症性肠病(IBD)患者的健康相关生活质量(HRQoL)及其影响因素.方法 应用中文版IBD问卷(C-IBDQ),对IBD患者进行横断面调查,评价其HRQoL;通过相关分析和多元线性回归分析,筛选出影响IBD患者HRQoL的主要因素.结果 100例IBD患者(UC 80例,CD 17例,未分型3例)完成问卷,HRQoL总分为(175.9±37.9)分,各维度评分均有下降,其中情感功能受损最为明显;UC患者与CD患者HRQoL总分差异无统计学意义(P＞0.05).活动期IBD患者的HRQoL总分及各维度评分均明显低于缓解期患者(158.7±41.4比186.6±35.1;t=2.813,P=0.006);病程＜1年的患者HRQoL明显低于病程1年以上的患者(P＜0.05);重型IBD患者的HRQoL明显低于轻型患者(P＜0.05);医疗费用主要由个人支付的患者HRQoL较费用大部分由医保支付的患者低,两者在社会功能及经济负担维度差异有统计学意义(P＜0.05).多元线性回归分析提示,对IBD患者HRQoL有影响的因素为病情、疾病活动度、病程、付费方式等.结论 IBD患者HRQoL均有不同程度受损;影响IBD患者HRQoL的因素有病情、疾病活动度、病程、付费方式等;经济负担对IBD患者HRQoL有明显影响.     

Predictors of quality of life in older people living at home and in institutions

BACKGROUND AND AIMS: Health-related quality of life (QOL) is considered to be the key goal for health promotion in older people. The aim of this study was to describe the correlates of QOL in home-dwelling and institutionalized elderly. METHODS: One hundred and fifty-two elderly residents of long-term care homes and 160 community-dwelling elderly participated in the study. Assessment included demographic and social variables, health status, nutritional state, physical and cognitive function. Physical activity (PA) was assessed by two PA questionnaires: the Seven Day Recall PA Questionnaire and the Stanford Usual Activity Questionnaire. QOL was assessed with the Euroqol 5D questionnaire. RESULTS: Depression was the most powerful predictor of QOL in both community-dwelling and institutionalized elderly. Complaints associated with the musculoskeletal system in community-dwelling elders and manifestations of atherosclerosis and cardiovascular diseases in institutionalized elders were the most important concomitant diseases. Regular participation in PA, preventing obesity and maintaining an adequate level of physical and cognitive function, contributed more to overall QOL in community-dwellers than in older and frailer institutionalized elderly adults. CONCLUSIONS: The relative contribution of functional and medical comorbidities, as well as health-promoting behaviors to QOL, may be different in community-dwelling and institutionalized elders. Physical and cognitive function deficits, overweight/obesity, and lack of regular PA are among primary predictors of decreased QOL in home-dwelling elders. In institutionalized subjects, these functional/behavioral data seem to be of lesser importance, the role of concomitant diseases becoming dominant.     

Attachment and quality of life in patients with inflammatory bowel disease

Purpose

Inflammatory bowel diseases (IBD) are chronic disorders affecting psychological well-being, quality of life (QOL), social interactions, and close interpersonal relationships of patients affected. The attachment theory provides a theoretical framework to evaluate the quality of close interpersonal relationships in the context of chronic disorders. The aims of this study were to compare the attachment dimensions between IBD patients and healthy controls and to evaluate the impact of these dimensions on QOL in IBD patients.

Methods

One hundred three consecutive IBD outpatients (70 with Crohn’s disease and 33 with ulcerative colitis) were recruited in the IBD Unit of the University of Bologna. They were clinically evaluated and filled out the questionnaire Short Form health survey-36 (SF-36), assessing QOL, and the attachment style questionnaire (ASQ), assessing attachment dimensions. One hundred three matched healthy subjects filled out the same questionnaires and represented the control group.

Results

IBD patients exhibited worst scores in the QOL measures (both physical and mental health) and in the attachment dimensions Relationships as secondary and Preoccupation with relationships. In IBD, the significant predictors of physical health were disease activity and disease type, while the significant predictors of mental health were disease activity and type, surgery, and the attachment dimensions Confidence and Preoccupation with relationships.

Conclusions

Compared to controls, in IBD patients, the close interpersonal relationships are characterized by attachment insecurity that, in turn, is a significant predictor of QOL. These findings suggest plausible insights for psychological interventions in IBD patients with deterioration in QOL.     

A comparison of 16 weeks of continuous vs intermittent exercise training in chronic heart failure patients

The authors compared the effects of continuous (CON) and intermittent (INT) exercise training programs on functional capacity, quality of life (QOL), and cardiac function in 23 congestive heart failure patients. Patients were randomized to CON exercise training (n=13; aged 66±7 years; peak oxygen consumption [VO(2)], 12.4±2.5 mL/kg/min; weight, 83±12 kg; left ventricular ejection fraction [LVEF], 29.5%±7.2%) or INT exercise training (n=10; aged 59±11 years; VO(2), 12.2±6.5 mL/kg/min; weight, 87±24 kg; LVEF 27%±7.9%). These groups completed 16 weeks of stationary cycling at 70% VO(2) thrice weekly for 30 minutes continuously or 60 minutes (60 seconds work:60 seconds rest) intermittently; both groups completed the same absolute volume of work. Three QOL questionnaire responses, VO(2), LVEF, and regional tissue Doppler were quantified. After exercise training, VO(2) increased by 13% in the CON group (P=.12) and significantly by 21% in the INT group (P=.03), although not significantly between the groups (P=.72). In the CON group, Minnesota Living With Heart Failure score improved at 16 weeks (P=.02), while in the INT group, Hare-Davis scores improved (P=.02). Cardiac volumes, resting and peak LVEF, contractile reserve, and tissue velocities were all unchanged from baseline. Intermittent exercise may improve functional capacity to a greater extent than continuous exercise. QOL changes were variable between groups.     

Mind frames towards dying and factors motivating their adoption by terminally ill elders

OBJECTIVE: This study was designed to advance the understanding of the physical and psychosocial factors that motivate terminally ill elders not only to consider a hastened death but also not to consider such a death. METHODS: I conducted face-to-face in-depth qualitative interviews with 96 terminally ill elders. An inductive approach was taken to locating themes and patterns regarding factors motivating terminally ill elders to consider or not to consider hastening death. RESULT: Six mind frames towards dying emerged: (a) neither ready nor accepting; (b) not ready but accepting; (c) ready and accepting; (d) ready, accepting, and wishing death would come; (e) considering a hastened death but having no specific plan; and (f) considering a hastened death with a specific plan. From the data emerged approaches towards dying and accompanying emotions characterizing each mind frame, as well as factors motivating their adoption by elders. The results showed that psychosocial factors served more often than physical factors as motivators. DISCUSSION: The results demonstrate the importance of assessing the mind frame adopted by a terminally ill elder and his or her level of satisfaction with it. Terminally ill elders may experience a higher quality dying process when a traditional medical care approach is replaced by a holistic approach that addresses physical, spiritual, emotional, and social needs.     

Effects of aerobic physical exercise in the elderly with type 2 diabetes mellitus

The objective of this study was to determine the impact of an aerobic physical exercise program in the treatment of a group of elderly patients with type 2 diabetes mellitus (DM) in relation to metabolic control, physical capacity, quality of life (QOL) and attitudes toward diabetes. Patients were randomly assigned to either an experimental (n=19) or a control (n=20) group. The following measurements were conducted at baseline and after week 16: glycosylated hemoglobin (hbA1c), fructosamine, 3 h oral glucose tolerance test, treadmill test (Balke-Naughton), and a questionnaire on QOL and attitudes toward DM. After the intervention, the experimental group showed a significant decrease of glucose excursion during the oral glucose tolerance test (OGTT) (area under the curve) (16.6+/-3.8 vs. 15.3+/-3.1, P<0.05) and an increase in total time on the treadmill (s) (423+/-207 vs. 471+/-230, P<0.05). An improvement in the attitudes toward DM was observed in the experimental group (P=0.01) but not in the control group. Female gender, higher body mass index and hbA1c were factors associated with a response to the intervention. This study suggests that physical exercise has significant effects on glucose excursion during an OGTT and exercise tolerance in elderly patients with type 2 DM.     

上海嘉定地区1279例胃癌症状-就诊-确诊时间研究

目的调查上海嘉定地区胃癌患者从出现症状,到就诊及确诊时间。了解其影响因素,分析其与国际差距的原因。方法收集2012年12月至2020年4月上海交通大学附属瑞金医院北院病理诊断为胃癌患者共1279例的临床资料。调查患者首次就诊的症状(按照常见“胃癌报警症状”:腹痛、腹胀、反酸、嗳气、恶心呕吐、呕血黑便、乏力纳差等进行分类),就诊时间及确诊时间(胃镜活检或者外科手术病理确诊),采用多因素Logistic回归模型等方法进行统计学分析影响患者就诊及确诊因素。结果1279例患者就诊的主要症状为腹痛556例(43.47%)、饱胀、反酸、嗳气389例(30.42%);黑便、呕血、乏力205例(16.03%),进食梗阻感、恶心呕吐87例(6.80%),体检发现肿瘤指标升高42例(3.28%)。就诊时间平均为(1.25±0.55)个月,就诊时间与患者症状、就医距离、医疗费用支付途径等相关。确诊时间平均为(4.76±1.85)个月,确诊时间与患者就诊时间、首次就诊是否采用胃镜检查等相关。Logistic回归分析显示,就诊症状(OR=1.545,95%CI:1.341~1.781)、医疗费用支付途径(OR=1.939,95%CI:1.021~3.681)是胃癌确诊及时性的危险因素。就医距离(OR=1.695,95%CI:1.509~1.989)、首次就医选择胃镜检查(OR=1.008,95%CI:1.049~1.124)是胃癌确诊及时性的保护因素。结论上海嘉定地区胃癌患者出现症状以腹痛、饱胀反酸嗳气、呕血黑便乏力为主,就诊和确诊时间较国外时间长,与患者对胃癌认识及胃镜检查意识、就医距离、医疗费用支付途径等因素相关。