学龄期1型糖尿病儿童生存质量差异的因素分析

目的 分析学龄期1型糖尿病(T1DM)儿童生存质量差异的因素,为制定改善TIDM患儿生存质量的治疗方案提供依据。方法 对2016年6月-2018年6月至西安市中心医院进行治疗的106例学龄期TIDM患儿进行问卷调查,问卷采用郑玲玲等编制的《重庆地区儿童青少年糖尿病患者生存质量调查量表》,观察调查问卷中患儿在影响领域、满意度领域得分,以及总体得分情况。观察不同的空腹血糖、糖化血红蛋白(HbA1c)等指标的患儿问卷得分差异,以及影响患儿生存质量的因素。结果 患儿生存质量量表分为影响领域和满意度领域两部分,106名学龄期T1DM患儿影响领域量表得分为(82.37±11.44)分,满意度领域(25.41±5.77)分,总体得分(110.54±18.89)分。空腹血糖≤6.1 mmol/L患儿的生存质量量表得分(105.16±14.88)明显低于空腹血糖>6.1 mmol/L的患儿(142.26±20.61)(t=10.064,P=0.001);HbA1c≤7.6%患儿的生存质量量表得分(103.67±19.26)明显低于HbA1c＞7.6%的患儿得分(144.58±22.27)(t=9.572,P<0.001)。不同性别、住址、家庭收入的患儿,其生存质量评分差异无统计学意义(P>0.05),但是糖尿病饮食遵守情况、胰岛素注射方式、注射次数、血糖监测次数以及病程会导致生存质量评分差异有统计学意义(P<0.001)。结论 1型糖尿病学龄期儿童的生存质量受多种因素影响,因此对此类儿童应制定严格的饮食方案,采用胰岛素泵进行注射,以维持患儿血糖和糖化血红蛋白在较长时间内的稳定。     

青岛地区1型糖尿病儿童及青少年血糖管理状况和生存质量的调查研究

目的 通过调查青岛地区1型糖尿病儿童及青少年血糖管理状况和生存质量,为儿童糖尿病的综合治疗提供依据。方法 采用儿童生存质量测定量表对2015年参加青岛大学附属医院内分泌儿科糖尿病营会活动的89名1型糖尿病儿童问卷调查,评价其血糖管理状况和生存质量。结果 1型糖尿病儿童糖化血红蛋白总体控制水平不良,血糖水平与年龄、病程、饮食、血糖监测频率、参加营会次数、居住地、母亲文化程度、家庭经济收入显著相关(P<0.05)。1型糖尿病儿童生存质量总得分是(80.73±12.68)分。血糖水平、居住地、父母婚姻状况、亲子交流情况是糖尿病儿童生存质量的相关因素(P<0.05),其中血糖水平是对生存质量发挥主导作用的因素。结论 青岛地区1型糖尿病儿童及青少年血糖控制水平总体欠佳,生存质量下降。医护人员需及早发现影响患儿血糖控制管理状况和生存质量的相关因素,积极干预,提高其血糖控制水平和生存质量。     

SF-36评价2型糖尿病患者生存质量的研究

目的：探讨SF-36在2型糖尿病患者生存质量评价中的作用。方法：采用简明健康调查问卷(SF-36)和糖尿病人生存质量特异性量表(DSQL)及相关因素调查表对210名2型糖尿病患者进行问卷调查。在SPSS支持下，进行分半信度、秩相关和逐步回归分析。结果：SF-36用于评价2型糖尿病患者生存质量的分半信度为0．9899。其与糖尿病生存质量特异性量表(DSQL)具有一定程度的相关性。经逐步回归分析，应对倾向、主观支持、客观支持、饮食控制被选人回归方程。结论：SF-36与DSQL配合使用可兼顾普适性与特异性，综合评价患者生存质量。     

2型糖尿病合并抑郁症患者生存质量分析

[目的]通过研究2型糖尿病合并抑郁症患者生存质量变化,探讨抑郁症对糖尿病生存质量影响及其相关影响因素. [方法]2型糖尿病患者98例,以抑郁自评量表(SDS)进行自我抑郁评分,根据SDS测定结果分为研究组(SDS≥51分)28例;对照组(SDS<50)51例.采用糖尿病病人特异性生存质量量表(DSQL)对两组患者进行生存质量测定.检测两组人群空腹血糖(FBG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c),分别计算体重指数(BMI)、胰岛素敏感指数(ISI),ISI=ln[1/(FBG×FINS)]. [结果]研究组较对照组生存质量总分(DSQL)、各纬度因子分明显升高,差异有统计学意义.研究组与对照组比较HbA1c升高,ISI明显下降,差异有统计学意义.以BMI、ISI、HbA1c、年龄、文化程度、病程为自变量,对生存质量总分进行逐步回归分析,DSQL评分与BMI、HbA1c、病程呈正相关,与ISI呈负相关,而与年龄、文化程度无相关性. [结论]BMI、HbA1c、ISI、病程是影响2型糖尿病患者生存质量的重要因素.抑郁症可导致糖尿病患者生存质量下降,与抑郁症血糖控制不良、胰岛功能减退、促进中心型肥胖形成等因素相关,在严格控制血糖,控制体重、改善胰岛功能的同时应重视糖尿病患者的健康教育、加强心理指导及治疗.     

镁与糖尿病

糖尿病具有镁缺乏的倾向，可能与糖尿相关的高尿镁症、营养因素以及高胰岛素血症相关的高尿镁症等因素有关。已证明，血浆镁水平与胰岛素敏感性呈负相关，补充镁可提高2型糖尿病病人的胰岛素敏感性及胰岛素的分泌；但是，并未证明在1型糖尿病及2型糖尿病病人中口服补充镁对基血糖控制品有有缓作用。对糖尿病易感大鼠口服补充镁可减少其发病。与无视网膜病变的病人相比，有(严重的)视网膜病变的病人血镁水平降低。前瞻性研究表明，血镁水平与视网膜病变的发生发展呈负相关，进一步研究补充镁预防2型糖尿病及视网膜病变的进展，并作为降低高血压的一种方法，是值得的。     

2型糖尿病患者生存质量相关因素的研究

目的探讨影响2型糖尿病患者生存质量的相关因素，为制定针对患者的干预措施提供依据。方法采用糖尿病人生存质量特异性量表(DSQL)及相关因素调查表对210名2型糖尿病患者进行问卷调查，并进行简相关和逐步回归分析。结果糖尿病生存质量与生理、心理、社会多种因素有关。逐步回归分析表明，应对倾向、学历、饮食控制、主观支持、病程、支持利用度被选入回归方程。结论应加强对2型糖尿病患者生存质量各种影响因素的干预，努力提高其生存质量。     

影响2型糖尿病患者睡眠质量的相关因素研究

目的 探讨影响2型糖尿病患者睡眠质量的相关因素.方法 随机选取上海第六人民医院内分泌科就诊的2型糖尿病患者283例,使用匹兹堡睡眠质量指数量表与汉密尔顿抑郁量表对患者的睡眠质量及抑郁状态进行评估.数据资料使用卡方检验、独立样本t检验、U检验、Spearman相关、逐步线性回归分析等进行分析.结果 2型糖尿病患者中,按睡眠质量分为两组,睡眠障碍患者（睡眠质量指数＞7）占32.16％（91例）.两组患者之间的胰岛素使用比例、抑郁状态比例的差异有统计学意义（x2=14.337、70.910,P=0.001）,舒张压的差异有统计学意义（Z=-2.172,P=0.030）,汉密尔顿抑郁量表焦虑躯体化、认识障碍、日夜变化、阻滞、睡眠障碍、绝望感等抑郁因子得分存在统计学差异（Z=-5.961、-4.854、-7.159、-7.159、-10.183、-4.882,均P＜0.05）.睡眠质量指数分别与抑郁评分、是否注射胰岛素这两个变量的相关性存在统计学意义（r =0.682,P＜0.05;r =0.209,P ＜0.05）,抑郁评分、是否注射胰岛素是影响睡眠质量指数的独立相关因素（β=0.430,P ＜0.05;β=1.142,P=0.022）.在注射胰岛素的患者中,注射胰岛素的次数与低血糖事件频率的相关性有统计学意义（r =0.235,P=0.041）,低血糖事件频率与抑郁评分的相关性有统计学意义（r=0.275,P=0.016）.结论 抑郁状态、注射胰岛素会影响2型糖尿病患者的睡眠质量.     

青岛地区儿童青少年1型糖尿病持续皮下胰岛素输注与每日多次注射胰岛素治疗的成本效果比较

目的 比较持续皮下胰岛素输注(continuous subcutaneous insulin infusion,CSII)与每日多次注射(multipledaily injection,MDI)胰岛素治疗0～18岁儿童青少年1型糖尿病(type 1 diabetes mellitus,T1DM)的卫生经济学获益.方法 ...     

社区2型糖尿病患者生存质量及其影响因素研究

目的了解天津市社区中2型糖尿病患者生存质量及影响因素，为提高患者生存质量提供依据。方法对天津市南开区和汉沽区近期社区普查检出的217名2型糖尿病患者进行了人户问卷调查，应用糖尿病患者生存质量特异性量表（DSQL）对患者生存质量进行测量，用流调用抑郁自评量表（CES-D）对患者抑郁状况进行评价。结果多元逐步回归分析结果显示，糖尿病并发症、抑郁严重程度、家庭居住地为乡镇、对待糖尿病的态度、血糖监测频率、人均月收入、年龄、饮食等因素可从不同维度影响生存质量评分。多因素非条件logistic回归显示，低生存质量的危险因素为：肉类及其制品摄人多（OR=1．617，95％CI：1．103～2．369）、DM并发症数量多（OR=2．817，95％CJ：1．696～4．678）、脑血管疾病（OR=3．073，95％CI：1．174～8．046）、抑郁程度（OR=1．924，95％CI：1．112～3．327），生存质量的保护因素为：豆类及其制品摄人多（OR=0．631，95％CI：0．447～0．891）。结论糖尿病可从不同方面影响患者的生存质量，在控制糖尿病病情的同时应针对影响生存质量评分的因素，采取不同的方法改善患者的生存质量。     

怎样减轻胰岛素注射时的痛苦

1型糖尿病患者从发病开始就需要终身进行胰岛素治疗；对于2型糖尿病患者，据调查显示：在他们的一生中，也有超过50％的患者迟早需要接受胰岛素治疗。由于目前胰岛素通常只能通过皮下注射途径给予，因此胰岛素注射给患者带来的痛苦常常成为患者拒绝胰岛素、不配合临床治疗的主要原因。怎样减轻胰岛素注射时给患者带来的皮肉之苦，是每个糖尿病患者和护理人员都十分关心的技术问题。注意以下几点可以减轻注射时的痛苦：     

Translation,cultural adaptation,cross-validation of the Turkish diabetes quality-of-life (DQOL) measure

Objective The aim of this study was to test the validity and reliability of the Turkish version of the diabetes quality of life (DQOL) questionnaire for use with patients with diabetes. Methods Turkish version of the generic quality of life (QoL) scale 15D and DQOL, socio-demographics and clinical parameter characteristics were administered to 150 patients with type 2 diabetes. Study participants were randomly sampled from the Endocrinology and Diabetes Outpatient Department of Dr. Lutfi Kirdar Kartal Education and Research Hospital in Istanbul, Turkey. Results The Cronbach alpha coefficient of the overall DQOL scale was 0.89; the Cronbach alpha coefficient ranged from 0.80 to 0.94 for subscales. Distress, discomfort and its symptoms, depression, mobility, usual activities, and vitality on the 15 D scale had statistically significant correlations with social/vocational worry and diabetes-related worry on the DQOL scale indicating good convergent validity. Factor analysis identified four subscales: satisfaction”, impact”, “diabetes-related worry”, and “social/vocational worry”. Conclusion Statistical analyses showed that the Turkish version of the DQOL is a valid and reliable instrument to measure disease related QoL in patients with diabetes. It is a simple and quick screening tool with about 15 ± 5.8 min administration time for measuring QoL in this population.     

Self-reported exercise and quality of life in young type 1 diabetic subjects

Evaluation of quality of life is important in treatment strategies of chronic illnesses, such as diabetes mellitus. The present study aimed at measuring the impact of self-reported exercise on quality of life in T1DM patients. Fifty-three young T1DM patients on intensive insulin-treatment regime who were regularly attending the Diabetes Clinic were selected. At the end of the scheduled clinic visit, they were asked to fill in an Italian version of the Diabetes Quality of Life (DQOL) questionnaire; 30 patients exercised regularly, whereas 23 were sedentary. Patients with clinical and laboratory evidence of major eye, renal and cardiovascular diseases were excluded. A significant difference in the scale of satisfaction (1.9 +/- 0.3 vs 2.2 +/- 0.5; p = 0.009), along with a better HbA1c level (7.0 +/- 1.0 vs 7.8 +/- 1.2; p = 0.014), was observed in physically active patients as compared to sedentary ones, whereas there were no differences between the 2 groups with respect to the impact and worry scale. Moreover, there were no significant correlations between glucose control parameters and the quality of life scores. In conclusion, we showed that self-reported exercise is associated with both a better quality of life and a better metabolic control in young T1DM patients. Further efforts should however be made to recognize all factors that can help motivate patients to exercise.     

Satisfaction and Quality of Life in Children with Type 1 Diabetes and Their Parents Following Transition to Insulin Pump Therapy

The purpose of this study was to describe satisfaction with the transition to insulin pump therapy and subsequent quality of life among 22 children with type 1 diabetes and their parents. Following the transition to pump therapy, children and parents completed a newly developed measure of insulin pump therapy satisfaction (Insulin Pump Therapy Satisfaction Questionnaire [IPTSQ]), and children completed a standardized measure of diabetes-related quality of life. IPTSQ results suggest that children and parents were overwhelmingly satisfied with insulin pump use. Parents and children reported greatest satisfaction with flexibility related to eating and sleeping afforded by pump therapy. Parent-child satisfaction were highly correlated (r = .53), and children's pump satisfaction was significantly positively correlated with diabetes-related quality of life (r = .51). These pilot data are among the first to document specific areas of satisfaction and indicate an association between insulin pump therapy satisfaction and quality of life. Understanding specific aspects of insulin pump therapy that are related to quality of life is important for improving health outcomes among youngsters with type 1 diabetes using insulin pumps.     

贵州省510名苗族儿童主观生活质量及影响因素研究

目的:分析贵州省苗族小学3～6年级儿童主观生活质量现状以及相关影响因素,以促进贵州省苗族儿童身心健康发展。方法:在贵州省苗族聚居县采用《儿少主观生活质量问卷》以分层整群随机抽样的方法抽取3～6年级苗族小学生510名作为研究对象。了解苗族儿童主观生活质量并对相关影响因素进行回归分析。结果:苗族儿童主观生活质量满意度较低。总体满意度均分为(44.59±12.64)分,为不太满意水平,显著低于全国常模的一般满意度水平,差异有统计学意义(P<0.05)。苗族儿童认知成分分数为(49.84±12.06),高于情感成分分数(42.28±10.09),差异有统计学意义(P<0.05)。各维度满意度以抑郁体验分数最低,家庭生活分数最高,分数从低到高排列依次为抑郁体验、躯体情感、焦虑体验、学校生活、同伴交往、生活环境、自我认识、家庭生活。男童认知成分、情感成分和总体满意度评分均低于女童,差异有统计学意义(P<0.05)。单亲家庭儿童情感评分、总体主观生活质量满意度显著低于其他家庭儿童(P<0.05);父母是文盲的儿童认知成分评分、总体主观生活质量满意度低于父母是初中以上文化程度儿童的评分(P<0.05);学习成绩差的儿童情感成分和总体满意度低于成绩好的儿童(P<0.05);父母不关心的儿童认知成分、情感成分和总体满意度评分均低于父母关心的儿童(P<0.05)。不同年级儿童主观生活质量满意度比较差异无统计学意义(P>0.05)。回归分析发现父母对儿童的关心、儿童健康状况及儿童学习成绩对主观生活质量有显著影响(P<0.05)。结论:苗族儿童主观生活质量满意度均较低,以情感成分满意度最低。男童主观生活质量满意度低于女童。儿童学习成绩越好,父母越关心儿童学习、儿童自身的健康状况越好,则主观生活满意度越高。家庭经济水平、家庭类型、父母文化程度、儿童所在年级、是否为独生子女及家庭成员关系并不明显影响儿童主观生活质量。     

Dimensions of quality of life in people with non-insulin-dependent diabetes

The purpose of the study was to find out which of five Quality of life (QoL) questionnaires are reliable and valid for evaluating the QoL in German patients with type 2 diabetes: the Diabetes Treatment Satisfaction Questionnaire (DTSQ), the Well-Being Questionnaire (WBQ), the Short Form SF36 of the Medical Outcome Study (SF36), the Diabetes39 and the Quality of Life with Diabetes (LQD) questionnaire. A stratified sample of 144 patients who were attending one of nine special hospitals for people with diabetes at the time of the study were given the questionnaires twice. Most of the scales of the questionnaires had internal consistencies () of above 0.80 as recommended; the retest reliabilities were lower, especially for scales evaluating satisfaction with levels of blood sugar and treatment in general. A factor analysis of all scale scores yielded four factors: (1) physical aspects, (2) well-being and satisfaction, (3) diabetes-specific stress, and (4) treatment satisfaction. Construct validity showed frequency of hypoglycemias, neuropathies, treatment with insulin and number of late complications to have a negative impact on QoL scores. No single questionnaire covered all relevant aspects of the QoL of subjects with type 2 diabetes. Thus, quality of life in diabetic people should be evaluated with scales representing the cognitive dimensions found in this study so as not to miss significant aspects.     

Quality of life, health satisfaction and family impact on caregivers of children with developmental delays

Objective   To study the quality of life, health satisfaction and family impact on caregivers of children with developmental delays in Taiwan.
Design   Cross-sectional study.
Subjects   The caregivers of children with diagnoses of developmental delays recruited from a teaching hospital in northern Taiwan.
Methods   The main caregivers of 48 male and 22 female children with developmental delays were recruited. WHOQOL-BREF for health-related quality of life (HRQOL), PedsQL-Health Satisfaction for health satisfaction, PedsQL-Family Impact Module and Impact on Family Scale for family impact were evaluated. The correlation of caregivers' HRQOL, health satisfaction and family impact were also studied.
Results   Caregivers in nuclear families had higher health satisfaction scores (78.2 for nuclear families vs. 66.9 for extended families, P  < 0.05) when assessed by the PedQL-Health Satisfaction questionnaire. Children's age was negatively correlated with family impact, including parent (−0.272, P  = 0.023), family (−0.262, P  = 0.029) and total scores (−0.281, P  = 0.018) as assessed using the PedsQL-Family Impact Module.
Conclusion   A negative relation between impact of burden and child's age suggests that family members gradually adapt to the delayed developmental status in their children as they grow. Caregivers in nuclear families having higher health satisfaction than those in extended families may be due to Chinese cultural effects.     

注意缺陷多动障碍儿童的生存质量和相关影响因素分析

目的 探讨注意缺陷多动障碍（ADHD）儿童的生存质量及其影响因素,为提高患儿的生存质量提供理论依据。方法 使用儿童生存质量测定量表（pediatric quality of life inventory TM version 4.0,PedsQL TM 4.0）中文版普适性核心量表、自制家庭环境量表对儿童及其父母评估。对92例ADHD患儿和88例正常儿童进行生存质量和家庭环境的病例对照研究。结果 ADHD儿童生存质量评分总分比对照组低,父母报告评分总分比对照组低。ADHD儿童父母的生存质量在生理、心理、社会关系、环境4个领域中都明显低于正常组父母。儿童的生存质量受父母的文化程度、家庭教养方式、父母间关系和社区环境等因素影响。结论 ADHD组儿童的生存质量受到明显的影响,应进一步完善ADHD儿童的治疗方案,为患儿及其家庭成员提供更多的支持和帮助,提高ADHD儿童的生活质量。