社区综合护理对提高慢性心力衰竭患者生存质量的效果

目的 研究社区综合护理对提高慢性心力衰竭患者生存质量的效果。方法 70例慢性心力衰竭患者,随机分为观察组和对照组,每组35例。对照组接受常规门诊医护服务,观察组在此基础上开展社区综合护理干预,对比两组临床治疗情况以及生存质量评分。结果 观察组患者的规范化疗效为97.1%、疾病认知率为97.1%、住院率为14.3%、病死率为2.9%,明显优于对照组的74.3%、77.1%、40.0%和20.0%(P<0.05)。观察组患者的生存质量评分明显优于对照组(P<0.05)。结论 社区综合护理干预有利于提高患者对疾病的认知率,降低慢性慢性心力衰竭患者发病率,改善其生活质量,值得推广应用。     

浅谈苏轼的医学贡献

苏轼通晓医理、熟悉药性,有济世救人之心,并尽可能多地收集民间验方,将验方、名方整理成册。苏轼坚持良好的饮食起居,擅于食疗养生,重视修身养性和练功,其营养成,并撰写成文,写过《问养生》、《书养生后论》、《养生说》、《续养生说》、《养生偈》等数十篇养生方面的文章,还有一些养生知识散在于他的诗词中。苏轼所到之处,总是尽可能了解民情民苦,力求减轻人民疾苦,重视疫病预防。     

抑肝散治疗儿童注意缺陷多动障碍47例临床观察

目的:观察抑肝散治疗儿童注意缺陷多动障碍(ADHD)阴虚阳亢证的临床疗效。方法:将符合本研究纳入和排除标准的94例ADHD患者分为对照组和观察组各47例。两组均采用盐酸哌甲酯片,5 mg/次,2次/d。对照组服用静灵口服液,10 m L/次,2次/d。观察组内服抑肝散,1剂/d。两组疗程均为12周。进行治疗前后斯诺佩评估(SNAP-Ⅳ)量表(父母版),美国康纳(Conner)设计的简易多动症行为评价量表、韦氏智力量表和阴虚阳亢证评分。结果:两组临床疗效经Ridit分析,观察组优于对照组(P0.05);治疗后观察组SNAP-Ⅳ量表和阴虚阳亢证评分低于对照组(P0.01);治疗后观察组Conner量表学习、品行、身心障碍、冲动-多动、焦虑及多动指数等因子评分均低于对照组(P0.01);治疗后观察组韦氏智力量表的言语理解指数(VCI),知觉推理指数(PRI),工作记忆指数(WMI),加工速度指数(PSI),一般能力指数(GAI),认知熟练指数(CPI),总智商(FSIQ)等因子评分均高于对照组(P0.01)。结论:抑肝散配合盐酸哌甲酯片能降低ADHD儿童阴虚阳亢证,SNAP-Ⅳ评定量表和Conner行为评价量表各因子评分,并能升高韦氏智力量表各因子评分,能改善ADHD的症状,提高患者的智力水平,临床疗效优于静灵口服液。     

Alcohol and hepatitis C mortality among males and females in the United States: a life table analysis

OBJECTIVE: Evidence from previous studies suggests that heavy alcohol use (HAU) exacerbates the rate of fibrosis progression in the liver and results in increased probability for premature death among patients with hepatitis C virus (HCV) infection. The current study uses population-based mortality data to investigate whether heavy drinking affects the age of death among individuals with HCV and, if so, whether this effect differs between men and women. METHODS: A total of 7,263,163 death records in the United States between 2000 and 2002 were drawn from the Multiple Cause of Death (MCD) public-use data files compiled by the National Center for Health Statistics (NCHS). International Classification of Diseases, Tenth Revision (ICD-10) codes were used to identify the presence of HCV (B17.1 and B18.2) and HAU (as indicated by alcohol-induced medical conditions, F10 and K70) either as the underlying cause or as one of the contributing causes of death. The deaths were divided into 4 distinctive cause-of-death categories: HCV without HAU, HAU without HCV, HCV plus HAU, and all others. The mean ages of death and the cumulative probabilities of death derived from multiple-cause life table were compared across these categories. RESULTS: Hepatitis C virus deaths showed an excessive prevalence of HAU when compared with non-HCV deaths. Compared with deaths of HCV without HAU, the mean age of death was shortened for deaths of HCV plus HAU (from 55.1 to 50.0 years among males, and from 61.0 to 49.1 years among females). The cumulative probability of death before age 65 was much higher for the latter than the former group (0.91 vs 0.68 among males, and 0.88 vs 0.47 among females). While HCV alone showed a disproportionate effect on premature death in males, HAU presented a stronger effect in females, resulting in a "catching-up" effect that diminished the gender difference in age of HCV death. CONCLUSIONS: This study provides mortality-based evidence to further establish heavy alcohol consumption as one of the key risk factors contributing to premature deaths from HCV in the United States. More importantly, this study, for the first time, presents empirical evidence that alcohol consumption affects men and women differently in HCV mortality.     

Validation of the Stroke and Aphasia Quality of Life Scale in a multicultural population

Purpose: This study aimed to determine the reliability and validity of the Stroke and Aphasia Quality of Life Scale (SAQOL-39?g) and its Mandarin adaptation SAQOL-CSg in Singaporean stroke patients.

Method: First-time stroke survivors were recruited at three months post-stroke and underwent a series of questionnaires in their dominant language (English/Mandarin). This included: SAQOL-39?g/CSg, National University Hospital System (NUHS) Aphasia Screening Test, Barthel Index, Modified Rankin Scale, Mini Mental State Examination, Frontal Assessment Battery, Center for Epidemiologic Studies Depression Scale and the Eurol-Qol Health Questionnaire (EQ-5D). The SAQOL-39?g/SAQOL-CSg was repeated within 1 week (±?6 days).

Results: Ninety-four participants (96.9%) were able to self-report and their results presented here. Both the SAQOL-39?g/SAQOL-CSg showed good internal consistency (α?=?0.96/0.97), test–retest reliability (ICC=?0.99/0.98), convergent (r_s ?=0.64–0.81 and 0.66–0.88, respectively) and discriminant (r_s?=?0.35–0.53 and 0.48–0.62, respectively) validity. The correlation between the SAQOL-39?g and the EQ-5D Visual Analogue Scale was 0.27. Further inspection of the EQ-5DVAS scores revealed correlations in different directions for Malay versus Chinese participants.

Conclusions: Both the SAQOL-39?g and SAQOL-CSg demonstrated good reliability and validity. Our results suggested some influence of ethnicity in self-rating of health status in relation to SAQOL-39?g scores. Further research is warranted to examine its use with stroke survivors with greater stroke severity and over time.

• Implications for Rehabilitation

• Validation of SAQOL in Singapore:

• Both the SAQOL-39g and the SAQOL-CSg may be used to measure the HRQoL of stroke survivors with and without aphasia in Singapore.

• Further investigation is required to examine use with stroke survivors with greater stroke severity and over time.

     

护理干预对哮喘患者生活质量的影响

目的:探讨护理干预对哮喘患者生活质量的影响。方法:将62例哮喘患者随机分为干预组32例和对照组30例,对照组给予哮喘病常规治疗及保健知识教育,干预组在此基础上给予认知、心理及行为干预。观察两组生活质量及肺功能等的变化。结果:干预组哮喘症状计分、半年急诊次数、误工及误学天数、β2激动剂喷数及AQLQ中活动受限均较对照组有明显改善(P<0.01,P<0.05)。结论:对支气管哮喘患者实行护理干预可以明显改善其生活质量。     

健康教育对慢性精神分裂症患者生活质量的影响

目的探讨系统健康教育对慢性精神分裂症患者生活质量的影响。方法将100例慢性精神分裂症患者随机分为研究组与对照组,每组各50例,研究组进行为期2年的系统健康教育,用阴性症状评定量表(SANS)、Morning Side康复状态量表(MRSS)和世界卫生组织生活质量量表(WHO.QOL-100)评价效果。结果研究组患者再入院率和入组后第1、2年末SANS、MRSS评分明显低于同期对照组,而WHO.QOL-100评分明显高于同期对照组。结论系统健康教育对提高慢性精神分裂症患者生活质量有明显的促进作用。     

Prevalence and impact of disability and sexual dysfunction on Health-Related Quality of Life of Nigerian stroke survivors

Purpose: To investigate the impact of disability and sexual dysfunction on Health-Related Quality of Life (HRQoL) among Nigerian stroke survivors (SSv) and to determine their association using sexual functioning (SF), Global Disability Measure and Function (GDMF), and demographic profiles.

Methods: This study involved 121 consecutive SSv attending healthcare services in two tertiary health facilities in Nigeria. Demographic details were obtained through interview while HRQoL, SF, and Global Disability (GD) were assessed using Stroke-Specific Quality of Life (SS-QoL-12), Changes in Sexual Functioning Questionnaire (CSFQ-14), and World Health Organization Disability Assessment Schedule (WHODAS-2.0), respectively. Determinants of HRQoL were explored using the Poisson regression analysis.

Results: Most of the SSv had moderate/severe GD (95%) and low SF (86.8%). Their HRQoL decreased with increase in their age (p?=?0.005) and with increase in GD (p?=?0.001). This association remained unchanged even when adjusted for SF (p?=?0.001). Those with low SF but with mild GD had relatively better HRQoL than those with moderate/severe GD even when they had higher SF. Their HRQoL was negatively impacted by their GD but not by their SF despite direct correlation between SF and HRQoL. With a unit increase in level of GD, there was 8% decrease in HRQoL scores in psychosocial and 17% decrease in physical domains.

Conclusion: Although sexual dysfunction and global disability are prevalent among Nigerian SSv, their low HRQoL is determined by their disability and not by SF. Hence, effort at reducing global disability should be the focus of rehabilitation after stroke.

• Implication for Rehabilitation

• Global functional and sexual deficiencies abound in stroke survivors and they impact negatively on their overall quality of life.

• Sexual dysfunction correlates negatively on physical and psychosocial wellbeing of stroke survivors.

• Rehabilitation goal(s) should focus disability reduction and improvement of sexual functioning to enhance quality of life.

• Rehabilitation professionals should equip themselves with tools to counsel stroke survivors on sex issue since sexual dysfunction is common post stroke.

     

炎症性肠病患者治疗依从性影响因素调查与分析

目的:调查炎症性肠病(IBD)患者的治疗依从性现状,分析其影响因素。方法:采用问卷调查法对82例IBD患者发放自行设计的治疗依从性问卷,对其一般资料及影响因素进行调查。结果:IBD患者服药依从性和生活方式依从性相对较高,而定期复查和适当锻炼的依从性较差。患者是否参加自我管理项目的教育和患者的文化程度是其治疗依从性的主要影响因素(P0.05)。结论:应加强对IBD患者的健康教育,尤其应加强对文化程度较低患者治疗依从性相关知识的宣教。     

Plasma linoleic acid partially mediates the association of bipolar disorder on self-reported mental health scales

We have shown that bipolar individuals have reduced quality diets, including lower intake of polyunsaturated fatty acids (PUFA). We have also reported reduced plasma levels of the n-6 PUFA, linoleic acid (LA), and the n-3 PUFA, eicosapentaenoic acid (EPA) in bipolar subjects. In the current analysis we hypothesized that LA and EPA plasma levels would mediate lower self-reported mental health and life functioning scores in bipolar subjects. In a cross-sectional study, we collected a 7-day diet record in bipolar (n = 56) and control subjects (n = 46) followed by a fasted blood draw. We used structured equation modeling path analysis to test for mediating effects of dietary intake and plasma levels of LA and EPA on self-reported mental health questionnaire scores, including the Life Functioning Questionnaire (LFQ), the Patient Health Questionnaire (PHQ9), and the Short Form Health Survey (SF12), extracting the mental health component summary score (SF12-MH). We adjusted for age, gender, psychiatric medication use, body mass index (BMI), and total caloric intake as covariates with bipolar disorder as the primary predictor. We found a significant path association from bipolar disorder to lower plasma LA levels (p = 0.03) and significant paths from plasma LA to PHQ9 (p = 0.05), LFQ (p = 0.01) and SF12-MH (p = 0.05) scores, such that lower plasma LA predicted worse outcomes. We found no significant paths from plasma EPA levels to any of the outcome measures. These findings suggest that plasma LA levels partially mediate the effect of bipolar disorder on self-reported measures of mental health and life functioning.