世界卫生组织生活质量问卷在慢性疾病患者及家庭照料者中的应用

目的　评估慢性疾病患者及照料者的生活质量。方法　应用WHOQOL 10 0在治疗前和治疗 1年后对 4 6 0例慢性疾病 (高血压、精神分裂症、卒中、终末期肾病、头颈部肿瘤和乳腺癌 )患者及其 4 18名家庭照料者的生活质量进行了评定。结果　不同疾病患者在不同时间 (如治疗前后 )评定WHOQOL 10 0的结果有显著性不同 ,治疗前在各维度和因子 (共 30项 )中 6种疾病患者间的差异均达显著性 (P <0 0 1) ;治疗后有效组的生活质量均有所改善 ,而无效组则比治疗前更差 (P <0 0 5 )。不同疾病患者的家庭照料者评定WHOQOL 10 0的结果也有显著不同 (P <0 0 1)。结论　WHOQOL 10 0能较好地区分不同慢性疾病患者和照料者的生活质量。     

Eppendorf精神分裂症量表中文版的信度和效度

目的：研究Eppendorf精神分裂症量表(ESI)中文版的信度和效度。方法：信度评价采用分半信度、内部一致性、重测信度。效度评价采用区分效度、内容效度、平行效度、结构效度。结果：KSI量表和各因子的分半信度为0．8087—0．9738，Cronbach α系数为0．7694—0．9508；1周后重测信度为0．677—0．876。各因子与总分的相关系数在0．815—0．909之间，因子之间的相关小于因子与总分的相关；ESI与阳性症状与阴性症状量表(PANSS)有很好的相关性，因子分析得出4个因子与原作者的因子相关系数在0．747—0．943之间。结论：ESI量表有较好的信度和效度，值得推广和使用。     

精神分裂症伴肺结核患者生活质量与心理健康的相关分析

目的探讨精神分裂症伴肺结核患者的生活质量、心理健康状况及其相互关系。方法采用世界卫生组织生活质量量表（WHOQOL-100）和症状自评量表（SCL-90）,对53例精神分裂症伴肺结核患者进行评定,并与53例精神分裂症患者资料进行对照比较。结果精神分裂症伴肺结核组WHOQOL-100总分以及心理领域、独立性领域、社会关系领域、精神支柱领域评分均明显低于对照组（P〈0．05）。精神分裂症伴肺结核组SCL-90总分以及躯体化、人际关系敏感、抑郁、焦虑、恐怖因子分均高于对照组,差异具有显著性（P〈0．05～0．01）。WHOQOL-100总分与SCL-90躯体化、人际关系敏感、抑郁、焦虑、恐怖、精神病性等因子分呈负相关（P〈0．05）。结论精神分裂症伴肺结核患者较不伴肺结核患者的生活质量和心理健康状况更差,二者关系密切。应重视改善他们的心理健康状况和生活质量。     

心理行为治疗对脑卒中患者临床疗效及生活质量影响的研究

目的 观察心理行为治疗对脑卒中患者的临床疗效及生活质量的影响.方法 120例脑卒中患者随机分为治疗组和对照组,对照组患者接受常规治疗、护理及康复训练,治疗组在对照组基础上进行心理行为干预治疗4周.治疗前及治疗后4周2组分别进行症状自评量表(SCL-90)、生活质量综合评定问卷(GQOLI)评定、Fugl-Meger评分、FMA评定运动功能康复情况和Barthel指数评定日常生活活动能力.结果 治疗组SCL-90在躯体化、人际关系、抑郁焦虑、恐怖因子上得分明显,生活质量综合评定中社会功能维度、心理健康维度、躯体健康维度、总体生活功能维度得分高于对照组(P<0.05).Fugl-Meger评分、Barthel指数评分、FCA运动功能、FCA认识功能明显优于对照组(P<0.05).结论 心理行为治疗能明显提高脑卒中患者的临床疗效,改善心理健康,提高生活质量.     

焦虑、抑郁情绪对癫患者生活质量的影响

目的探讨焦虑、抑郁情绪对癫患者生活质量的关系。方法应用生活质量综合评定问卷(GQOLI)、Zung焦虑自评量表(SAS)及Zung抑郁自评量表(SDS)对60例癫患者(癫组)及60名健康自愿者(对照组)进行评定,并对生活质量与焦虑、抑郁作相关分析。结果癫患者的生活质量总分及躯体功能、心理功能、社会功能、物质生活4个维度分均明显低于对照组(P<0.01),而SAS及SDS评分则均明显高于对照组(P<0.01);生活质量总分及躯体功能、心理功能、社会功能、物质生活4个维度分均与SAS及SDS评分呈显著性负相关。结论癫患者的生活质量较差,焦虑、抑郁情绪明显;其生活质量与焦虑、抑郁情绪密切相关。     

脑梗死患者的生活质量与其焦虑、抑郁情绪的相关性研究

目的 探讨脑梗死患者的生活质量与其焦虑、抑郁情绪的关系。方法 采用Zung焦虑自评量表（SAS）、Zung抑郁自评量表（SDS）及生活质量综合评定问卷（GQOLI）对80例脑梗死患者（脑梗死组）及80名健康人（对照组）进行问卷调查，并对生活质量与其焦虑、抑郁情绪作相关分析。结果 脑梗死患者的生活质量总分及躯体功能、心理功能、社会功能3个维度评分均明显低于对照组（P〈0．01），而SAS及SDS评分均明显高于对照组（P〈0．01）。脑梗死患者的生活质量总分及躯体功能、心理功能、社会功能3个维度评分均与SAS及SDS评分呈显著性负相关。结论 脑梗死患者的生活质量较差，焦虑、抑郁情绪明显；其生活质量与焦虑、抑郁情绪密切相关。     

神经症患者的生活质量及影响因素研究

目的探讨神经症患者的生活质量及其影响因素。方法用生活质量综合评定问卷比较100例神经症患者和100名健康人的生活质量差异。以自编调查表项目、社会支持量表、匹兹堡睡眠质量指数、症状自评量表评分为自变量，以生活质量综合问卷评分为因变量，进行相关分析和多元线性回归分析。结果除物质生活维度外，与健康对照组比较，神经症患者的生活质量综合问卷总分和各维度分都明显下降（P〈0．01）。相关分析结果显示，神经症患者的经济收入、社会支持量表总分与生活质量问卷总分呈显著正相关（P〈0．01）；病程、共病、睡眠质量指数及躯体化、强迫症状、抑郁、焦虑、恐惧因子分与生活质量问卷总分呈显著负相关（P〈0．01）．多元线性回归分析结果显示，生活质量问卷中的4个维度（因变量）与经济收入、社会支持量表总分、病程、共病、睡眠质量指数及躯体化、强迫症状、抑郁、焦虑、恐惧因子分10个自变量整体都具显著线性相关（P〈0．01）。结论神经症患者的生活质量较正常人差，生活质量各维度有27．4％～57．2％由经济收入、社会支持量表总分、病程、共病、睡眠质量指数及躯体化、强迫症状、抑郁、焦虑、恐惧因子分10个因素变化所决定。     

焦虑、抑郁情绪对癫患者生活质量的影响

目的 探讨焦虑、抑郁情绪对癫(癎)患者生活质量的关系.方法 应用生活质量综合评定问卷(GQOLI)、Zung焦虑自评量表 (SAS)及Zung抑郁自评量表 (SDS)对60例癫(癎)患者(癫(癎)组)及60名健康自愿者(对照组)进行评定,并对生活质量与焦虑、抑郁作相关分析.结果 癫(癎)患者的生活质量总分及躯体功能、心理功能、社会功能、物质生活4个维度分均明显低于对照组(P＜0.01),而SAS及SDS评分则均明显高于对照组(P＜0.01);生活质量总分及躯体功能、心理功能、社会功能、物质生活4个维度分均与SAS及SDS评分呈显著性负相关.结论 癫(癎)患者的生活质量较差,焦虑、抑郁情绪明显;其生活质量与焦虑、抑郁情绪密切相关.     

家庭负担访谈问卷中文简化版评估精神障碍患者家庭成员的照料负担（英文）

背景:在制定慢性精神障碍患者管理计划时需要解决的一个重要问题就是照料者的负担,但是迄今为止,国内还没有可靠的方法来评估上述负担。目标:评估家庭负担访谈问卷(Family Experience Interview Schedule,FEIS)中文简化版在国内住院精神障碍患者的照料者中使用的信度和效度。方法:我们翻译114项条目的英文版FEIS,并回译。然后用中文版评估606名住院精神障碍患者的主要照料者。排除9项社会人口学变量和9项超过15%的受访者都不能回答的条目后,我们随机选取一半样本问卷对剩余的96项进行了探索性因子分析,并根据因子分析的结果选择最终简化版量表包含的项目。利用另一半样本数据,通过相关性分析、验证性因子分析和内部一致性方法来评估最终简化版量表的信度和效度。结果:最终的中文版量表由28个条目组成,包括五个维度:(a)患者的暴力行为;(b)患者的自杀倾向;(c)照料者的抑郁和焦虑症状;(d)照料者的日常生活受扰乱;(e)照料者对医疗服务的满意度。这五个维度解释了总方差的50.5%。验证性因子分析发现该五因子模型是合理的[χ2/df=2.94,p0.001,拟合优度指数[GFI]=0.85,比较拟合指数[CFI]=0.85,近似均方根误差[RMSEA]=0.08]。每个条目和对应的因子之间的相关系数均在0.5以上。整个量表的Cronbachα系数为0.76,五个维度的Cronbachα系数在0.71和0.84之间。结论:28项FEIS简化中文版评估的家庭负担五个维度具有良好的内部一致性,因此,可以用来评估国内重性精神障碍患者照料者的家庭负担的各个维度。还需要进一步工作来评估该量表的重测信度和随时间而改变的灵敏度。     

焦虑、抑郁情绪对癫(癎)患者生活质量的影响

目的 探讨焦虑、抑郁情绪对癫(癎)患者生活质量的关系.方法 应用生活质量综合评定问卷(GQOLI)、Zung焦虑自评量表 (SAS)及Zung抑郁自评量表 (SDS)对60例癫(癎)患者(癫(癎)组)及60名健康自愿者(对照组)进行评定,并对生活质量与焦虑、抑郁作相关分析.结果 癫(癎)患者的生活质量总分及躯体功能、心理功能、社会功能、物质生活4个维度分均明显低于对照组(P＜0.01),而SAS及SDS评分则均明显高于对照组(P＜0.01);生活质量总分及躯体功能、心理功能、社会功能、物质生活4个维度分均与SAS及SDS评分呈显著性负相关.结论 癫(癎)患者的生活质量较差,焦虑、抑郁情绪明显;其生活质量与焦虑、抑郁情绪密切相关.     

Consciousness and disturbances of consciousness

Summary The problem of consciousness is discussed briefly, including the contrary views of consciousness as a transcendental phenomenon and as an animistic fiction. Measurement of consciousness is possible only indirectly by means of quantitative assessment of accompanying behavioral deficits.Knowledge of the structural basis of consciousness is incomplete. The ascending reticular activating system (ARAS) is necessary for the maintenance of the state of consciousness. The monoamine and a great number of descending projections modulate the ARAS. The contents of consciousness depend also on telencephalic structures, primarily on the telencephalic cortex. Certain localized telencephalic lesions bring about disturbances of consciousness. The role of the corpus callosum in the problem of consciousness is discussed (one brain—two minds hypothesis).Then a classification of the various disturbances of consciousness is proposed. The term disturbances of vigilance is used for all disturbances of consciousness which are caused by a lesion in or a functional disorder of the ARAS or any of its modulating subsystems. The term disturbances of the contents of consciousness refers to disturbances of consciousness due to global or localized lesions or functional disorders of telencephalic structures. A list of characteristic features is given for each class of disturbance of consciousness.

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Zusammenfassung Das Problem Bewußtsein wird kurz skizziert. Dabei werden die gegensätzlichen Auffassungen über Bewußtsein als transzendentales Phänomen bzw. als animistische Fiktion erörtert. Die Messung von Bewußtsein ist indirekt nur über die Bestimmung des begleitenden Verhaltensdefizits möglich. Die Kenntnis über die strukturellen Grundlagen des Bewußtseins ist lückenhaft. Für die Aufrechterhaltung des Bewußtseinsgrades kommt dem aufsteigenden retikulären aktivierenden System (ARAS) eine notwendige — wenngleich nicht hinreichende — Bedeutung zu. Das ARAS wird durch monoaminerge und eine große Zahl vom Großhirn absteigender Projektionssysteme moduliert.Telenzephale Strukturen und vor allem der telenzephale Kortex scheinen für die Entfaltung von Bewußtseinsinhalten unentbehrlich. Auch umschriebene telenzephale Läsionen können partielle Störungen der Bewußtseinsinhalte verursachen. Die Bedeutung des Balkens für das Bewußtsein wird diskutiert (one brain—two minds-Hypothese).Im letzten Abschnitt wird eine Taxonomie der verschiedenartigen Bewußtseinsstörungen versucht. Unter dem Begriff Vigilanzstörungen werden alle Bewußtseinsstörungen zusammengefaßt, die durch Läsion oder Funktionsstörungen des aufsteigenden retikulären aktivierenden Systems (ARAS) — einschließlich seiner modulierenden Subsysteme — bedingt sind. Unter Störung der Bewußtseinsinhalte werden Bewußtseinsstörungen verstanden, die durch globale oder lokale Läsion bzw. Funktionsstörung telenzephaler Strukturen verursacht werden. Für beide Klassen von Bewußtseinsstörungen wird ein Merkmalskatalog beschrieben.

     

Quality of life and its measurement: important principles and guidelines

Background The importance of the valid assessment of quality of life (QOL) is heightened with the increased use of the QOL construct as a basis for policies and practices in the field of intellectual disability (ID). Method This article discusses the principles that should guide the measurement process, the major interrogatories (i.e. who, what, when, where, why, and how) of QOL measurement, issues and procedures in the cross-cultural measurement of QOL, and the current uses of QOL data. Results Based on the above methods, the article presents a number of important guidelines regarding QOL measurement. Conclusion From a measurement perspective the use of the QOL construct is changing. Initially it was used as a sensitizing notion, social construct, and unifying theme. Increasingly, it is being used as conceptual framework for assessing quality outcomes, a social construct that guides quality enhancement strategies, and a criterion for assessing the effectiveness of those strategies. This new role places additional emphasis on the valid assessment of one's QOL.     

Outcome and neurological sequelae of patients after tetanus

From 1969-1985, 106 people contracted tetanus in Finland. The outcome of the disease was good in 78 cases (returned to work), poor in 27 (12 died, 5 institutionalized and 10 retired) and unknown in 1. Poor outcome was the result of a disease requiring respirator treatment. Other clinical factors significantly correlated with poor outcome were blood pressure lability, hyperglycemia, hyperthermia, tachycardia and anticoagulation therapy. Forty people who were representative of the whole series with regard to sex, age and severity of disease attended a follow-up study on average 7 years and 4 months later. Forty age- and sex-matched controls had the same examinations, and compared with them, the 40 patients still had significantly more muscle fatigue and cramps, nervousness, decreased mental capacity and difficulties in balance, speech and memory. They also had more clinical findings, such as peripheral paresis, muscular atrophy, decreased or absent tendon reflexes and decreased mental capacity than the controls.     

Perceptual Pragmatism and the Naturalized Ontology of Color

This paper considers whether there can be any such thing as a naturalized metaphysics of color—any distillation of the commitments of perceptual science with regard to color ontology. I first make some observations about the kinds of philosophical commitments that sometimes bubble to the surface in the psychology and neuroscience of color. Unsurprisingly, because of the range of opinions expressed, an ontology of color cannot simply be read off from scientists’ definitions and theoretical statements. I next consider two alternative routes. First, conceptual pluralism inspired by Mark Wilson's analysis of scientific representation. I argue that these findings leave the prospects for a naturalized color ontology rather dim. Second, I outline a naturalized epistemology of perception. I ask how the correctness and informativeness of perceptual states is understood by contemporary perceptual science. I argue that the detectionist ideal of correspondence should be replaced by the pragmatic ideal of usefulness. I argue that this result has significant implications for the metaphysics of color.     

Theory of Mind and psychometric schizotypy

The extent to which Theory of Mind impairments are a trait associated with schizotypy is unclear. To date, findings have been mixed. We compared two groups of psychometrically identified schizotypes, namely, those characterized by positive schizotypy (perceptual aberrations and magical ideation; n = 36) and those characterized by negative schizotypy (social anhedonia; n = 30) to a low schizotypy comparison group (n = 68) in terms of their Theory of Mind performance. Theory of Mind was assessed in two ways: a composite Hinting Task and the Reading the Mind in the Eyes Test. The groups were also compared in terms of their self-reported levels of referential thinking. Our results indicate that individuals characterized by positive schizotypy show Theory of Mind deficits, as measured by the Hinting Task. The three groups did not differ in terms of the Eyes Test. Referential thinking was significantly associated with the Eyes Test but not the Hinting Task. Overall these findings suggest that different aspects of schizotypy are associated differentially with Theory of Mind deficits. The results also provide further rationale for the inclusion of multiple tasks when attempting to study multifaceted constructs such as Theory of Mind.     

The use of quality of life data at the organization and systems level

Background To date researchers have given little attention to the use of quality of life (QOL) data for organization and systems-level change. This article presents two state-level examples of how QOL data are currently used in the USA. Method Individuals with intellectual disability (ID) were assessed on an ongoing basis using two multidimensional QOL instruments. Data were analysed at the individual and organizational level. Results Examples of statewide data utilization include: (1) determining significant predictors of quality outcomes; (2) developing provider profiles; (3) comparing individuals with ID with those without ID; (4) developing state-level performance standards; and (5) implementing continuous programme improvement. Conclusions The availability of this type of data allows service delivery systems to: (1) significantly alter the relationship between individual consumers and service providers; (2) open the system to scrutiny by citizens with and without ID; (3) improve responsiveness and quality outcomes; and (4) shape future directions of the service delivery system for people with ID.     

IL-1 and dysfunction of haemostasis systems

Single intravenous administration of IL-1 to intact white rats resulted in a two-phase change in fibrinolysis: short-time activation and subsequent inhibition. Activity of the tissue activator of plasminogen (TAP) increased in tissues of the experimental rats. This fact is indirect evidence of release the inhibitor of TAP from the vascular endothelium of these organs in blood flow. A 4 hour incubation of IL-1 with blood caused no inhibition of fibrinolysis. No significant changes in the haemostasis system were found. Original Russian Text ? G.V. Andreenko, I.P. Ashmarin, M.A. Karabasova, L.V. Lyutova, 2008, published in Neirokhimiya, 2008, Vol. 25, Nos. 1–2, pp. 124–127.     

Cross-cultural study of person-centred quality of life domains and indicators: a replication

Background The increased use of the quality of life (QOL) concept internationally suggests the need to evaluate its etic (universal) and emic (culture-bound) properties. This study replicated and expanded a previous cross-cultural study on QOL. Method The three respondent groups (consumers, parents and professionals; total n = 781) were from four European countries: France, Belgium, Italy and Poland. The Cross Cultural Survey of Quality of Life Indicators was used to assess the importance and use of eight core dimensions of QOL. Two hypotheses were tested: (1) the etic properties would be demonstrated if there were similar profiles for the respondent and geographical groups, and if indicators grouped into the proposed QOL domains; and (2) the emic properties would be demonstrated if there were significant differences on scores across groups. Results Results supported both hypotheses. Conclusion The present study replicated the findings of a large cross-cultural study that the QOL construct has both etic and emic properties.     

Subjective theories of illness and clinical and psychological outcomes in patients with irritable bowel syndrome

Objectives

Patients' ideas about the nature, cause, and treatment of their illnesses are part of the complex process of coping with illness. To date, limited research on subjective theories of illness in patients with irritable bowel syndrome (IBS) has been performed. The aim of the study was to investigate patients' subjective theories of illness and how these are related to clinical and psychological outcome criteria, in particular IBS symptom severity and quality of life.

Methods

Eighty-eight patients with IBS, as defined by Rome III criteria, were administered a battery of questionnaires to collect the following data: sociodemographic variables, subjective theories of illness (Subjektive Krankheitstheorien, Cause Questionnaire), anxiety (Hospital Anxiety and Depression Scale), depression (Beck Depression Inventory), quality of life (SF-12), and IBS symptoms (Questionnaire for Gastrointestinal Symptoms).

Results

Almost all patients reported theories of illness reflecting their subjective causal assumptions. The most frequently mentioned causal factors were physical illness, intrapsychic factors, and stress.Patients with mainly somatic attributions had higher IBS symptoms scores (P<.05) and reduced physical quality of life. Intrapsychic attributions were associated with reduced mental quality of life and enhanced physical quality of life (P<.01). All correlations were independent of gender, age, and irritable bowel subgroups.

Conclusions

Subjective theories of illness can have significant implications for IBS symptom severity, as well as for physical and mental quality of life.