The impact of chemotherapy-induced nausea and vomiting on health-related quality of life

Goal of work The objectives of this prospective observational study were to estimate the frequency of patients who reported an impact of chemotherapy-induced nausea and vomiting (CINV) on their daily life and to evaluate the determinants of such an impact. Materials and methods Adult cancer patients at seven Italian oncology centers who were receiving cisplatin-containing regimens reported incidence and intensity of CINV for eight consecutive days in a diary and completed a Functional Living Index for Emesis (FLIE) questionnaire. Main results Overall, 34% of patients reported vomiting and 62% reported nausea after chemotherapy. On days 1 to 5 after receiving chemotherapy, 67% of patients who had at least one emetic episode and 77% of those who suffered from at least mild nausea experienced an impact on their daily activities as measured on the FLIE questionnaire. More than 90% of all patients with both acute and delayed nausea or vomiting reported an impact on their daily life. Both acute and delayed vomiting contributed in similar measure to impact daily life; however, the importance of delayed nausea was greater than that of acute nausea. Conclusions Despite antiemetic prophylaxis, CINV is still prevalent and often impacts the daily life of patients in Italy, especially in the delayed phase. The duration more than the severity seems to be responsible for the impact of CINV on the patients’ daily lives.     

Impact of urinary incontinence on sexual quality of life in Portuguese adults

Urinary incontinence (UI) is a symptom of an underlying disorder with a high prevalence, constituting an important public health problem due to its physical, psychological and social consequences. The impact it has on the individuals' quality of life is revealed in their daily activities, self‐perception, socialization, emotional health and in their sexual life. The objective of this study is to analyse the impact of incontinence on the sexual quality of life, identifying the role of the variables: gender, duration and severity of incontinence, impact of incontinence on the quality of life and type of incontinence. The sample was composed by 55 patients (54·05% male and 45·5% female) from health facilities, in Lisbon, with a mean age of 55 years, who answered a set of questionnaires, which included: the Incontinence Impact Questionnaire (IIQ‐7); the Urogenital Distress Inventory (UDI‐6); the Questionnaire on Sexual Quality of Life, male and female versions (SQoL‐F/SQoL‐M) and a sociodemographic questionnaire. The results indicate that UI has a negative impact on the sexual quality of life in general, especially if the incontinence symptoms endure for a long period of time; also the impact of UI on social relationships, and the stress UI has a significant and negative impact on the sexual quality of life. In this study, UI has a negative impact on sexual life compounded by restrictions and other negative consequences of living with urinary leakage. The authors conclude that further research is required to ascertain the full impact of UI on sexual quality of life. Finally, implications for nurses are also discussed: in addressing the sexual health of their patients, nurses have an important contribution in assuring that experiencing UI should not necessarily translate into negative sexual quality of life.     

疼痛对长期血液透析患者生活质量的影响

目的了解长期血液透析患者疼痛状况及其对生活质量的影响。方法选择北京协和医院维持性血液透析5年以上患者33例,平均年龄(60.7±9.6)岁,平均透析龄为(9.5±3.9)年(5～17年)。收集患者一般临床资料,用简明疼痛问卷(brief pain inventory,BPI)调查,了解疼痛原因、性质、程度和部位,及其对生活的影响;用SF-36健康调查量表调查患者生活质量。结果本组患者疼痛的发生率为75.8%,主要疼痛部位:肩(51.5%)、膝(36.4%)、腕(18.2%)、髋(15.2%)。自我疼痛程度评分为(3.7±1.9)分(0～10分),24.2%的患者需要长期服用止痛药来缓解疼痛。疼痛的程度和部位与患者的年龄、性别、原发病、透析时间、K t/V、血钙、血磷、甲状旁腺激素和血红蛋白没有关系。疼痛患者SF-36健康调查量表多方面得分均低于非疼痛患者。结论长期透析患者慢性疼痛发生率高,严重影响其生活质量,值得关注。     

Measuring quality of life with the sickness impact profile: A pilot study

A pilot-study was done to investigate the applicability of the sickness impact profile (SIP) in ex-ICU patients. For this study 221 consecutively admitted patients were reviewed retrospectively after excluding children, deceased pateints and readmissions. SIP was assessed in these patients by either interview or questionnaire. These were divided into three groups: i) Patients interviewed at home (n=26). ii) Patients receiving the SIP-questionnaire by mail (n=93). iii) As for group ii, but after receiving a telephone invitation to participate (n=102). Highest mean SIP-score was found in group i (16.3). Groups ii and iii scored 10.2 and 7.9 respectively. Analysis of variance demonstrated overall SIP-scores of these groups to be significantly different. The response in group iii (77%) was significantly higher compared to group ii (56%). Data collection in Group i appeared to be most expensive costing $13.20 per patient, followed by group iii ($3.79) and group ii ($2.56). It is concluded that the self-administered SIP is suitable for measuring outcome in ICU-patients and is much cheaper than the direct interview technique. The 3 different approaches should be considered as independent methods of which individual results cannot be compared. The response can be improved significantly by calling the patients before sending the questionnaire.     

护理在校生及实习生睡眠质量、生活质量和主观幸福感调查分析

目的调查分析护理在校生及实习生睡眠质量、生活质量与主观幸福感的情况。方法 325名护理在校生及实习生参与本研究,采用匹茨堡睡眠质量指数量表(Pittsburgh sleep Quality Index,PSQI)、生活质量综合评定问卷(General Qualityof Life Inventory,GQOL-I)、总体幸福感量表(General Well-Being Schedule,GWBS)进行评估。结果 17.11%的被调查者有睡眠质量问题,两组被试的PSQI总分差异有统计学意义(P<0.01),在读学生睡眠质量显著高于实习护士。实习护士GQOL-I总分、躯体功能、心理功能及社会功能评分显著低于在读学生,差异有统计学意义(P<0.01);而两组物质生活评分差异无统计性意义(P>0.05)。在读学生GWBS评分均高于实习护士,差异有统计学意义(P<0.01)。相关分析显示,护士睡眠质量下降与生活质量总分及总体幸福感总分因子呈显著负相关(P<0.01)。结论护理实习生睡眠质量较差,其生活质量、主观幸福感已受到负面影响。     

分段式健康教育对脑卒中患者生活质量的影响

目的:探讨分段式健康教育对脑卒中患者生活质量的影响.方法:将100例脑卒中患者随机分为观察组和对照组各50例,对照组实行传统健康教育,观察组在此基础上实行分段式健康教育.比较两组患者对护理工作的满意度、住院时间及出院前、出院1个月、出院2个月生活质量评分情况.结果:观察组对护理工作满意度、住院时间及出院前、出院1个月、出院2个月的生活质量评分情况均优于对照组(P＜0.05).结论:对脑卒中患者进行分段式健康教育能明显缩短住院时间,提高其护理满意度及生活质量.     

人脐带间充质干细胞治疗对乙肝肝硬化患者生命质量的影响

目的:探讨人脐带间充质干细胞(UC-MSC)治疗对乙肝肝硬化患者生命质量的影响。方法:将乙肝肝硬化患者44例随机分为对照组和治疗组各22例,对照组给予常规治疗,治疗组在此基础上给予UC-MSC治疗,疗程3个月。应用健康状况调查问卷(SF-36量表)分别在治疗前、治疗后12周进行自评量表式调查。结果:治疗后两组患者的生命质量均有所提高,但治疗组优于对照组(P<0.05);治疗组除社会功能(SF)、情感职能(RE)、精神健康(MH)3个维度外,其余维度得分均高于对照组(P<0.05)。结论:乙肝肝硬化患者生命质量差,而UC-MSC治疗能有效改善患者的临床症状,有助于提高患者生命质量。     

护理干预对肾病综合征患者生活质量的影响

目的:探讨护理干预对肾病综合征患者生活质量的影响.方法:对214例肾病综合征患者实施护理干预,采用SF-36生活质量量表调查比较干预前后患者生活质量.结果:本组214例肾病综合征患者干预4周后躯体疼痛、一般健康状况、精力、社会功能、情感职能、精神健康等项目评分均高于干预前(P<0.05).结论:护理干预有助于提高肾病综合征患者的生活质量,值得临床推广.     

Effects of an exercise program on respiratory function, posture and on quality of life in osteoporotic women: a pilot study

Objectives

To investigate the effects of an exercise program on respiratory function, thoracic kyphosis, tolerance to exercise and quality of life in women with osteoporosis.

Design

Pilot observational study.

Setting

Department of Physiotherapy, Federal University of Sao Carlos, Brazil.

Participants

Fourteen women with densitometric diagnosis of osteoporosis in the spine.

Interventions

An exercise program comprising of three sessions per week, lasting 1 hour each, over an 8-week period. Each session incorporated: 5 minutes of stretching exercises, including the lower limb and upper limb muscles; 15 minutes of posture exercises; 20 minutes of walking; 15 minutes of exercises to improve the strength of respiratory muscles and a 5-minutes, cool-down and relaxation.

Main outcome measures

Respiratory function evaluation, submaximal exercise tolerance test measurement of the thoracic kyphosis angle, and the Osteoporosis Assessment Questionnaire (OPAQ) to measure the quality of life at baseline and at 8-week follow-up.

Results

At follow-up, increases of between 12% and 23% in respiratory pressures were noted. The results also suggest an increase of 13% in submaximal exercise tolerance and a small increase of approximately 5% in the magnitude of thoracic curvature. The value of the OPAQ for this group of subjects is questionable. Sample size calculations based on the results of this pilot study are provided.

Conclusions

After an 8-week exercise program, benefits to the fitness of the participants were observed. The results suggest that exercise may have a role in the management of this group of patients. The outcome measures, with the possible exception of the OPAQ, and the protocol used in this pilot study would be feasible for a definitive study. Further research is recommended in a sufficiently powered study and should include an appropriate control group.     

癌症患者长期生存质量及其影响因素的研究

目的：调查癌症长期生存者的生存质量及影响因素。方法：使用自编调查表，采用自评和访谈的方法，对安徽省社会和劳动保障厅118例参加医疗保险的癌症长期生存者进行调查。结果：安徽省社会和劳动保障厅直属医保中心共有登记参保人员117，916人，其中癌症患者970人，癌症患者比例为8.2‰．癌症长期生存者257人．占癌症患者26．5％，118人完成调查访视，随访率为45．9％。癌症长期生存者生存质量的影响因素主要是肿瘤类型、TNM分期、治疗方式、治疗相关并发症和生活方式。结论：应密切关注癌症长期生存者的生存质量．加强癌症患者的随访，重视癌症的诊疗规范和综合治疗。     

跟踪式护理干预对脑卒中患者生活质量的影响

目的:探讨跟踪式护理干预对脑卒中患者生活质量的影响.方法:将120例脑卒中患者随机分为干预组和对照组各60例,干预组由专业护士对患者及家属实施3个月的跟踪式护理干预,对照组则实施常规出院指导.3个月后采用生活质量综合评定问卷(GQOLI)对两组的生活质量进行评定.结果:干预组患者生活质量优于对照组(P＜0.01).结论:跟踪式护理干预能有效地减少和预防脑卒中患者抑郁症的发生,提高治疗效果,有助于改善患者的日常活动能力,提高患者的生活质量.     

晚期恶性肿瘤患者姑息性治疗前后的生存质量调查

目的调查研究晚期恶性肿瘤患者治疗前后的生存质量。方法应用EORTC QLQ-C30量表对78例出现远处转移或局部复发、不适合根治性治疗且愿意参加本项调查研究的晚期癌症患者进行生存质量评分。所有的患者均接受了局部姑息性放射治疗,4例患者联合化疗,治疗过程中加强对症支持治疗和心理护理。结果治疗后患者的总体健康状况明显提高;5个功能领域除社会功能外,其他4个功能(躯体功能、角色功能、情绪功能、认知功能)的评分均有显著性提高;3个症状领域中的疲劳和疼痛状况明显改善,恶心呕吐症状略有加重;6个单一条目中的气促、失眠、食欲丧失和便秘状况明显改善,治疗前后腹泻评分相仿。患者治疗后经济困难评分略有增加,但无统计学差异。结论姑息性治疗、对症处理和有针对性的护理明显减轻了患者的症状、改善了患者的生存质量,且未明显增加患者经济负担。故对晚期癌症患者应加强心理护理,使患者积极面对癌症所带来的各种负面效应、配合治疗并调整心态,从而提高生存质量。     

Impact of nausea/vomiting on quality of life as a visual analogue scale-derived utility score

Pharmacoeconomic analysis is often based upon incremental cost per increase in survival (cost-effectiveness). Using this definition supportive care measures, which increase quality but not quantity of life, generate a zero denominator and cannot be directly compared with other components of health care cost. Cost-utility analysis, which measures incremental cost per increase in quality-adjusted life-years (QALY), where QALY=utility score x time at risk, addresses this problem, since successful supportive intervention increases the utility score and thus provides a finite denominator in QALY even when absolute survival is unchanged. However, utility scores for various supportive care modalities have not been well defined. As a pilot study to generate a first approximation of a utility score for nausea/vomiting, we used a rating scale technique and administered two visual analogue scale questions to 30 patients completing a cycle of chemotherapy. Patients rated their global quality of life during their previous cycle of chemotherapy with hypothetical absence or presence of nausea/vomiting as the only variable. The study population included 8 male and 22 female patients, with a median age of 56 years. The most common malignancies were breast cancer (8 patients), lung cancer (7 patients), and hematologic malignancies (7 patients). On a 100 mm visual analogue scale, the mean score for overall quality of life during chemotherapy was 79 mm without nausea/vomiting and 27 mm with nausea/vomiting (P<0.001, pairedt-test). The implied marked increase in utility with relief of nausea/vomiting suggests a significant impact on cost-utility analysis. Similar methodology could be used to estimate utility scores in other areas of supportive care.Presented in part at the 31st Annual Meeting of the American Society of Clinical Oncology, Los Angeles, California, 1995     

Effects of 12 weeks of supported treadmill training on functional ability and quality of life in progressive multiple sclerosis: a pilot study

Pilutti LA, Lelli DA, Paulseth JE, Crome M, Jiang S, Rathbone MP, Hicks AL. Effects of 12 weeks of supported treadmill training on functional ability and quality of life in progressive multiple sclerosis: a pilot study.

Objective

To examine the effects of body-weight supported treadmill training (BWSTT) on functional ability and quality of life in patients with progressive multiple sclerosis (MS) of high disability.

Design

Before–after trial.

Setting

Exercise rehabilitation research center.

Participants

Patients with progressive MS (N=6; 5 primary progressive, 1 secondary progressive) with high disability (mean ± SD expanded disability status scale, [EDSS]=6.9±1.07). All participants completed the trial.

Interventions

Subjects completed 36 sessions of BWSTT (30-min sessions, 3×wk) over 12 weeks.

Main Outcome Measures

Outcome measures included functional ability assessed by EDSS and Multiple Sclerosis Functional Composite (MSFC). Quality of life and fatigue were assessed by the MS Quality of Life-54 (MSQoL-54) and the Modified Fatigue Impact Scale (MFIS), respectively. All tests were administered at baseline and after 12 weeks of training.

Results

All participants progressively improved training intensity; treadmill walking speed increased (34%; P<.001), and percent body weight support was reduced (42%; P<.001). A significant improvement in both physical (P=.02) and mental (P=.01) subscales of the MSQoL-54 was found. Fatigue was nonsignificantly reduced by 31% (P=.22); however, a large effect size (ES) was noted (ES=–.93). Functional ability remained stable with nonsignificant improvements in MSFC (P=.35; ES=.23) and EDSS (P=.36; ES=–.08) scores.

Conclusions

Twelve weeks of BWSTT produces beneficial effects on quality of life and potentially reduces fatigue in patients with primary progressive MS of high disability level. Larger trials will be required to confirm these findings and to evaluate further the effects of BWSTT in progressive MS.     

环境因素对乳腺癌化疗患者生命质量的影响

目的 了解乳腺癌化疗患者生命质量现状,探索影响其生命质量的环境因素.方法 选取术后化疗的原发性乳腺癌患者201例,应用人口统计学和临床特征调查表、世界卫生组织残疾评定量表第二版及环境因素调查表进行测量,并对测量结果进行分析.结果 乳腺癌患者生命质量各个方面均有不同程度困难,统计分析表明,“朋友的物质或情感支持以及相互联系”、“社会保障的服务、体制和政策”以及“社会准则、实践和观念”是影响乳腺癌患者生命质量的环境因素.结论 在加强患者术后功能康复的同时,护理工作者应倡导对乳腺癌人群提供良好的社会保障服务,提高大众对乳腺癌疾病的科学认知,拓展患者社会支持来源,提高患者的社会支持水平.     

Testicular cancer: a longitudinal pilot study on stress response symptoms and quality of life in couples before and after chemotherapy

Goals of work The current study was designed to longitudinally examine stress response symptoms (SRS) and quality of life (QoL) in couples confronted with disseminated testicular cancer. The objectives were to examine couples’ patterns of adjustment over time and possible differences in adjustment between the patient and his partner. Materials and methods Couples completed the Impact of Event Scale and the QoL subscales physical functioning, social functioning, and mental health of the RAND-36 before chemotherapy (T1), after completion of chemotherapy (T2), and 1 year later (T3). Results Before chemotherapy 26% of the patients and 50% of partners reported clinically elevated levels of SRS. Patients reported lower physical and social functioning at T2 compared to T1 and T3. Partners reported an improvement in social functioning over the year and no changes in physical functioning or mental health. No relationships between patients and partners’ functioning were found. One year after diagnosis, QoL of patients and partners was similar to that of reference groups, and patients even reported better physical functioning than the reference group. SRS of patients and partners were negatively related at T1, and patients and partners’ social functioning were positively related at T2. Conclusions According to stress response levels, the period before the start of chemotherapy was most stressful for couples. Adjustment patterns differ between testicular cancer patients and their partners with patients reporting lowered QoL after completion of chemotherapy. QoL of couples returned to normal levels 1 year after diagnosis. The effect of disseminated testicular cancer on the QoL of patients and their partners seems to be temporary. A minority may need clinical attention for severe SRS.     

化疗加百忧解对癌症患者抑郁情绪及生活质量的影响

目的探讨化疗加百忧解对癌症患者疗效及生活质量的影响。方法将160例癌症患者随机分成对照组和实验组各80例,化疗时间均为3个周期。对照组行常规化疗,实验组在行常规化疗的同时服用百忧解。比较2组治疗前后抑郁发生情况及生活质量改善情况。结果实验组患者化疗后抑郁的发生率显著低于对照组,生活质量好的比例显著高于对照组。结论化疗加百忧解对癌症患者提高疗效和改善生活质量都有一定的价值。     

综合护理干预对喉癌患者生活质量的影响

目的:探讨综合护理干预对喉癌患者生活质量(QOL)的影响。方法:将87例喉癌患者随机分为实验组45例和对照组42例,对照组采用常规护理,实验组在此基础上实施综合护理干预。结果:实验组喉癌患者术前、术后2周及术后1个月QOL与对照组比较差异有统计学意义(P<0.05);实验组癌症患者QOL评分高于对照组(P<0.01)。结论:综合护理干预可提高喉癌患者生活质量。     

脑卒中患者配偶生活质量的调查研究

目的了解脑卒中患者配偶的生活质量,以便在今后的临床护理工作中,对患者配偶进行相应的心理干预,提高患者配偶的生活质量。方法应用生活质量综合评定问卷对118例脑卒中患者配偶及56名已婚正常对照者进行评定。结果脑卒中患者配偶的总体生活质量及躯体功能、心理功能、社会功能、物质生活均较正常者差,其中以心理健康和躯体健康对生活质量的影响最大。结论脑卒中患者配偶的生活质量较正常对照组差,并涉及到心身健康等多个方面。