云南省宁洱县农村老年人抑郁流行现状及社会经济差异分析

目的分析云南省农村老年人抑郁的流行现状及所存在的社会经济差异。方法采用多阶段分层随机抽样的方法,抽取云南省宁洱县1 629名60岁及以上老年人进行问卷调查。结果云南省宁洱县老年人总体抑郁率、轻度抑郁和中重度抑郁率分别为12.0%、9.9%和2.0%;女性的抑郁率高于男性(■=10.907,P0.01);70～74岁年龄组老年人的抑郁率最高(■=13.452,P0.05);与配偶居住的老年人其抑郁率低于未与配偶居住者(■=22.870,P0.05)。家庭年人均收入越好(OR=0.582,95%CI:0.408～0.830)、医疗服务可及性越好(OR=0.691,95%CI:0.505～0.945)和社会经济地位越高(OR=0.530,95%CI:0.387～0.726)的老年人患抑郁的可能性越低。结论云南省宁洱县农村老年人的抑郁率存在明显的社会经济差异,应加强女性、未与配偶居住者和低社会经济地位老年人的心理健康疏导,降低其抑郁的发生。     

云南省宁洱县农村老年人睡眠障碍现状及社会经济差异分析

目的 分析云南省宁洱县≥60岁农村老年人睡眠障碍现状及其社会经济差异。方法 采用多阶段分层随机抽样方法,抽取宁洱县1 629例≥60岁农村老年人进行问卷调查。结果 云南省宁洱县≥60岁农村老年女性的睡眠障碍患病率高于男性（χ2 = 32.928,P＜0.001）;受教育程度越低、家庭财产越低和医疗服务可及性越差的老年人,其患睡眠障碍的可能性越高（教育程度为初中及以上OR = 0.801,95%CI:0.635～1.010;家庭财产中等OR = 0.659,95%CI:0.497～0.874;家庭财产好OR = 0.675,95%CI:0.527～0.865;医疗服务可及性好OR = 0.670,95%CI:0. 539～0.832）。结论 云南省宁洱县农村老年人的睡眠障碍患病率存在显著的社会经济差异。应加强受教育程度低、家庭财产低和医疗服务可及性差的农村老年人的睡眠健康教育,以提高其睡眠质量。     

云南省宁洱县农村老年人睡眠质量现状及与心血管疾病的关系研究

  目的  分析云南省农村老年人睡眠质量现状及与心血管疾病的关系。  方法  采用多阶段分层随机抽样方法,抽取1 629例宁洱县≥ 60岁农村老年人进行问卷调查和体检,采用多因素Logistic回归法分析睡眠质量与心血管疾病患病的关系。  结果  云南省宁洱县老年人匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)总分平均为(7.48±3.89)分,男性(6.67±3.69)分,女性(8.07±3.92)分;睡眠障碍、高血压、冠心病和脑卒中的患病率分别为56.78%、52.85%、8.16%和8.66%;女性睡眠障碍率高于男性(62.81%和48.55%,P < 0.001);家庭人均年收入越低和医疗服务可及性越差的老年人其睡眠障碍率越高(P < 0.001);有睡眠障碍的老年人其患高血压、冠心病和脑卒中的可能性越高(均有P < 0.05)。  结论  云南省农村老年人的睡眠障碍率较高,改善老年人的睡眠质量可能会在一定程度上预防和控制心血管疾病的发生。     

山东省农村老年人生命质量评价及影响因素分析

目的：评价山东省农村老年人生命质量，分析生命质量的影响因素。方法：采用SF-36量表对451名山东省农村老年人的生命质量进行测量并对该群体的生命质量影响因素进行分析。结果：本次调查的451名山东省农村老年人的生命质量总得分平均为78．48±15．35；性别、年龄、职业、日常生活功能、收入状况、慢性病患病、家庭关系等10个因素能影响其生命质量总分及维度评分。结论：应针对山东省农村老年人生命质量的现状及影响因素制定具体措施，以全面提高老年人的生活质量。     

SF-36健康调查量表应用于城市贫困人群的信度和效度

"生命质量"是70年代国外医学界引入的概念[1],自引入以来,产生了许多生命质量测评量表,其中SF-36健康调查量表(the SF-36 Health Survey)已成为全球应用最广的生命质量测评工具,被普遍作为生命质量测量量表使用.本文采用SF-36健康调查量表对沈阳市贫困人群的生命质量进行调查,分析其信度和效度,为SF-36健康调查量表在贫困人群的应用提供了资料.     

浙江省两地区老年高血压人群生命质量研究

高血压是常见的老年慢性疾病,许多研究认为高血压严重危害着老年人的生命质量~([1,2]).然而,由于研究方法,特别是研究量表的不同,有关高血压与生命质量的关系还有不少争议.SF-36量表最初由美国Ware等学者提出,因其简明且具有良好的心理测评特性被广泛用于老年人群生命质量评价.因此,本文采用中文版SF-36量表探索浙江省老年高血压人群的生命质量及其可能的影响因素.     

宁夏5县农村老年人生命质量及影响因素分析

目的 了解宁夏5县农村老年人生命质量状况,并探讨其影响因素,为改善农村老年人生命质量提供参考依据.方法 选取"农村居民家庭卫生健康询问调查"2015年随访数据,采用欧洲5维健康量表(EQ-5D量表)的方法对宁夏5县2 595名农村老年人的生命质量及其影响因素进行分析.结果 调查对象中,男性1379人(占53.1％),女...     

农村社区老年人抑郁状况及对生命质量影响

目的了解农村社区老年人的抑郁状况，并探讨其与老年人生命质量的关系，为增进老年健康提供科学依据。方法对湖南省衡阳市农村社区中的老年人（年龄≥60岁），采用多阶抽样方法抽样，利用SF-36量表和流行病学调查用抑郁自评量表（CES—D），对衡阳市农村老年人进行生命质量、抑郁状况评分。结果衡阳市农村社区老年人抑郁的总发生率为32．68％，男性为25．65％，女性为44．35％；老年女性抑郁发生率显著高于男性（72=12．10，P〈0．01）。老年人抑郁发生率有随年龄增加而上升的趋势，且不同年龄组（60岁～、70岁～、80岁）间差异有统计学意义（X^2=49．50，P〈0．01）。丧偶老年人抑郁发生率显著高于配偶健在老年人（X^2=4．81，P〈0．05）。医药费自负的老年人抑郁发生率显著高于有医保的老年人（X^2=17．20，P〈0．01）。生命质量中的生理功能、社会功能、情感职能和精神健康分值均与抑郁呈负相关，且差异有统计学意义（P〈0．05）。结论衡阳市农村社区老年人抑郁的总发生率为32．68％，他们生命质量中的生理功能、社会功能、情感职能和精神健康分值均与抑郁呈负相关。     

山东省农村老年人生命质量评价及其影响因素的多元分析

目的 综合评价山东省农村老年人的生命质量,并探讨现阶段老年人生命质量的影响因素,为增进老年人的生命质量提供参考依据. 方法 应用分层随机抽样方法确定了山东省青岛、潍坊、济南等6个地市60岁以上农村老年人为调查对象,以面对面访谈形式进行现场调查,应用SF-36量表测量该群体的生命质量,用多元逐步回归分析对可能影响老年人生命质量的因素进行筛选. 结果 山东省451例农村老年人的生命质量加权平均分为78±15.35,影响农村老年人生命质量的主要因素包括日常活动能力、情绪控制、慢性病患病、生活满意度和睡眠状况. 结论 卫生管理部门及老年工作者应制定针对性的干预措施,促进农村老年人生命质量的提高.     

SF-36量表中文版的应用及分级截断点选择的研究

目的 探讨美国简明健康测量量表SF-36用于中国老年人生活质量测量的可行性,并依据中国调查表来划分美国SF-36量表中文版的总分分级范围。方法 采用SF-36量表和中华医学会研制的老年人生活质量调查表同时对苏州市区167名老年人的生活质量进行测定,并对比分析其信度、效度。结果 中国老年人生活质量调查表和SF-36量表经因子分析产生的8个共因子与理论结构基本一致,结构效度的累积方差贡献为74.244％和72.081％,其分半信度分别为0.6676和0.9384。SF-36量表的同质性信度系数除生活活力、社会功能和心理健康3个维度,其他5个维度变化范围为0.81～0.89,满足群组比较的要求。SF-36量表较中国老年人生活质量量表的信度、效度更好。同时,确定划分SF-36量表的总分良好与中等的最佳截断点为117分,Kappa值为0.58。结论SF-36量表可以用于中国老年人的健康状况测量评估,划分生活质量“良”与“中”的最佳截断点为117分,为衡量老年人生活质量水平提供参考。     

Quality of life in people with multiple sclerosis: data from the Sonya Slifka Longitudinal Multiple Sclerosis Study

Current knowledge about the health-related quality of life (HRQoL) experienced by people with multiple sclerosis (MS) is limited. We compared item and component scale scores on the Medical Outcomes Short Form 12 (SF-12) of 2,109 people with MS to U.S. norms and published data on persons with other medical conditions. We also built regression models for SF-12-derived mental (MCS) and physical component scale (PCS) scores. Seventy-five percent of the sample had been diagnosed with MS for over 5 years, and one-half to two-thirds received help with at least one activity of daily living (ADL) or instrumental activity of daily living (IADL), respectively. The mean PCS score was 36.2 (Standard Error: 0.27), significantly lower by 14 points than the U.S. population norm and by 4-12 points than mean scores for individuals with diabetes, congestive heart failure, myocardial infarction, hypertension or depression. The mean MCS score was 49.2 (Standard Error: 0.25), significantly lower than the norm for the U.S. population and the mean scores for the chronic condition groups except congestive heart failure and depression. We identified several demographic, disease, and health services factors that were significantly related to quality of life and highlighted a number of areas for improvement. We concluded that the quality of the lives of people with MS could be enhanced by removing barriers to MS care, general health care, and mental health care; meeting needs for help with activities of daily living and instrumental activities of daily living; supporting employment; and improving access to disease modifying agents and symptomatic treatments.     

Smoking and functional status among Medicare managed care enrollees

BACKGROUND: Smoking is a major determinant of health status and outcomes. Current smoking has been associated with lower scores on the Short Form-36 Health Survey (SF-36). Whether this occurs among the elderly and disabled Medicare populations is not known. This study assessed the relationships between smoking status and both physical and mental functioning in the Medicare managed-care population. METHODS: During the spring of 1998, data were collected from 134309 elderly and 8640 disabled Medicare beneficiaries for Cohort 1, Round 1 of the Medicare Health Outcomes Survey. We subsequently used these data to calculate mean standardized SF-36 scores, self-reported health status, and prevalence of smoking-related illness, by smoking status, after adjusting for demographic factors. RESULTS: Among the disabled, everyday and someday smokers had lower standardized physical component (PCS) and mental component (MCS) scores than never smokers (-2.4 to -4.5 points; p <0.01 for all). Among the elderly, the lowest PCS and MCS scores were seen among recent quitters (-5.1 and -3.7 points, respectively, below those for never smokers; p <0.01 for both), but current smokers also had significantly lower scores on both scales. For the elderly and disabled populations, MCS scores of long-term quitters were the same as nonsmokers. Similar patterns were seen across all eight SF-36 scales. Ever smokers had higher odds of reporting both less-than-good health and a history of smoking-related chronic disease. CONCLUSIONS: In the elderly and disabled Medicare populations, smokers report worse physical and mental functional status than never smokers. Long-term quitters have better functional status than those who still smoke. More effort should be directed at helping elderly smokers to quit earlier. Smoking cessation has implications for improving both survival and functional status.     

中老年艾滋病感染者生命质量及其影响因素研究

目的 调查四川省中老年艾滋病高流行区泸县50岁以上的HIV/AIDS患者的生命质量,并分析不同因素对生命质量的影响,为今后提高HIV/AIDS患者的生命质量提供参考依据。方法 截至2018年6月,根据纳入和排除标准在四川省泸县共纳入50岁以上的HIV/AIDS患者共计228例。采用自行设计的问卷收集一般人口学信息、艾滋病抗病毒治疗信息,采用SF - 12调查患者的生命质量,采用多元线性回归方法分析生命质量的影响因素。结果 中老年HIV/AIDS患者的躯体健康总评（PCS）和心理健康总评（MCS）分别为（45.60±11.88）分和（54.17±11.70）分。通过多元线性回归分析发现,经济收入（β = 1.49）、现在正在接受治疗（β = 8.62）与患者PCS评分呈现正相关,而是否患有慢性病（β = - 10.55）与患者PCS评分呈现负相关。年龄与MCS评分呈正相关（β = 0.35）,而分居/离异/丧偶（β = - 3.91）,是否患有慢性病（β = - 4.79）、现在正在接受治疗（β = - 19.12）与患者的MCS评分呈现负相关。结论 中老年HIV/AIDS患者PCS评分较低,而MCS评分较高。低收入、未接受抗病毒治疗、患有慢性病、婚姻状况为分居、离异或丧偶的患者,生命质量较低,应积极采取措施提高中老年HIV/AIDS的生命质量。     

脂肪营养不良对接受抗逆转录病毒治疗的艾滋病患者生活质量的影响

目的 评价脂肪营养不良(lipodystrophy,LD)的艾滋病患者生活质量,并探讨脂肪营养不良对艾滋病患者生活质量的影响.方法 选择皖北2个县区261名接受抗病毒治疗的患者为研究对象,收集其人口学资料等基本信息,根据身体外周部位和中心部位的脂肪变化评估是否发生脂肪营养不良,并采用SF-36量表进行生活质量评价.结果 共有147(56.3％)人出现了LD.女性、年龄大的患者LD检出率高,差异有统计学意义(均有P＜0.05).LD组躯体健康和心理健康的平均得分均低于非LD组,差异有统计学意义(均有P＜0.05).多元线性回归表明控制其他因素后,LD对躯体健康和心理健康得分均有影响.此外,躯体健康领域还受到经济状况及年龄的影响,而心理健康领域受到经济状况及睡眠时间的影响.结论 LD是影响接受抗逆转录病毒治疗艾滋病患者生活质量的独立危险因素,预防LD对提高该人群生活质量具有积极作用.     

The effects of antipsychotic treatment on quality of life of schizophrenic patients under naturalistic treatment conditions: An application of random effect regression models and propensity scores in an observational prospective trial

The study examines the effect of different types of antipsychotic treatment on the health related quality of life (HRQL) of people with schizophrenia under naturalistic outpatient treatment conditions. In a prospective study design, 307 schizophrenic patients were followed over a period of 2.5 years. HRQL, clinical characteristics, and type of antipsychotic medication were assessed five times every 6 months. HRQL was assessed by the SF-36. Random effect regression models were computed for the SF-36 mental (MCS) and physical (PCS) component scores. Propensity scores were included in the regression models to reduce a possible sample selection bias. Monotherapeutic treatment with new atypical neuroleptic drugs had a more positive effect on the mental health related quality of life (MCS) in comparison to treatment with polypharmacological treatment but not with oral conventional antipsychotics. Monopharmaceutical treatment with depot-antipsychotic drugs had a more positive effect on the physical health related quality of life (PCS) in comparison to polypharmacological treatment. Study results indicate that atypical antipsychotic drugs are not superior to conventional antipsychotics with regard to the effect on QOL. However, monopharmaceutical treatment can be assumed to be more effective in improving mental and physical related QOL than polypharmaceutical treatment.     

Health-related quality of life of among elders in rural China: the effect of widowhood

Purpose

China has an enormous and rapidly growing population of widowed elders. Little is known about how losing a spouse affects elders’ health-related quality of life (QOL), especially in the rural areas where most Chinese elders live. This article analyzes QOL data collected in 2014 among rural Chinese elders to address this question.

Methods

SF12 questionnaires and information about individual and household characteristics were collected from 3053 elders aged 60 and above in rural China. We compared the physical component summary (PCS) and mental component summary (MCS) scores between 1925 married elders and 1060 widowed elders in a bivariate model stratifying by gender and age group and in a general factorial ANOVA multivariate analysis that examined and controlled for other predictors of PCS and MCS scores including education, chronic disease, and family and household factors.

Results

Widowed male and female elders’ physical health and mental health were in decline with age. Widowed men had lower PCS and MCS scores than married men. Widowed women also had lower PCS scores, but differences in MCS scores did not reach statistical significance. In multivariate analysis, widowhood was associated with lower PCS and MCS scores overall. Support from children was associated with better QOL and, based on interaction analysis, appeared to mitigate negative effects of widowhood.

Conclusions

Widowed rural elders in China have lower physical and mental quality of life than their married counterparts. These elders rely on their children for care, and a supportive family is associated with better QOL.

     

空巢老年人健康相关生存质量及空巢社会因素研究

目的 分析≥60岁空巢老年人健康相关生存质量现状及空巢相关社会因素,为制定健康老龄化相关策略和措施提供依据.方法 采用整群抽样方法 选取浙江省部分地区城乡≥60岁老年人4995名.采用逐步logistic回归进行空巢社会因素的多因素分析.用多元线性回归模型在校正混杂因素后,比较空巢和非空巢老年人的健康相关生存质量.结果 逐步logistic回归分析显示,与非空巢老年人相比较,空巢老年人年龄多集中在70～79岁(P=0.0417),文化程度高(P＜0.0001),以及居住于农村(P＜0.0001)和低收入者(P=0.0178,P=0.0049)趋向于空巢的概率较大.空巢老年人较非空巢者对生活的满意度较高(P=0.0070,P=0.0035),情绪状态较好(P=0.0371).多元线性回归在校正了年龄、性别、婚姻状况、文化程度、居住地、个人年收入以及生活满意度评分和情绪评分等因素后,结果 显示空巢老年人在生理领域中的躯体疼痛(P=0.0032)维度,心理领域的情感所致功能限制(P=0.0033)维度以及心理领域(P=0.0342)的得分较非空巢老年人低.结论 空巢老年人的健康相关生存质量低于非空巢者,尤其体现在心理功能方面.空巢老年人具有高文化程度、低收入以及居住于农村等特征,是实施健康老龄化需要重点关注的对象.     

Relationship of dietary intake and lifestyle factors to health-related quality of life in the community-dwelling elderly

Quality of life (QOL) encompasses a broad notion of health and is increasingly used to evaluate the effectiveness of health care services. The purpose of this cross-sectional study was to assess health-related quality of life (HR-QOL) in the community-dwelling elderly (mean age, 72.7±0.3 y; female 46.4%, n=179) in Japan and to explore diminished factors. We assessed HR-QOL by the 36-Item Short-Form Health Survey (SF-36), maximum walking speed, step counts, Tokyo Metropolitan Institute of Gerontology (TMIG) index, dietary intake and blood biochemistry. Two summary scores of the SF-36 were calculated (physical component score: PCS, mental component score: MCS). We divided participants into two groups based on the standard values of PCS and MCS classified by age (high and low group), which was further stratified into a high PCS and high MCS (BH) group and a low PCS and low MCS (BL) group. Mean maximum walking speed and daily step counts were 207.7±2.8 cm/s and 7,008±289. Eighty-one percent of the participants had full scores in the TMIG index. Daily intake of energy and protein were 2,081±33 kcal and 74.5±0.9 g. The maximum walking speed, TMIG index, alcohol consumption and chewing ability were significantly higher in the BH group than those in the BL group, but not dietary intake. Stepwise logistic regression analysis indicated that maintaining maximum walking speed might be associated with sustaining HR-QOL in the healthy elderly.     

Relationship of health-related quality of life to symptom severity in diabetes mellitus: a study in Trinidad and Tobago.

Our objective was to estimate the effect of greater symptom severity in diabetes mellitus on measures of health-related quality of life in a cross-sectional design in 35 government primary care health centres in Trinidad. Data were gathered on 2,117 subjects with clinical diabetes and analysed for 1,880 (89%). For each scale of the short form 36 (SF-36) questionnaire (a generic measure of health-related quality of life), scores were presented by quartile of symptom severity, measured using the Diabetes Symptom Checklist. Mean (SD) SF-36 scores were 44 (10) for the physical component score (PCS) and 45 (12) for the mental component score (MCS). Greater severity of diabetic symptoms was associated with lower scores on each of the subscales of the SF-36. Comparing lowest and highest quartiles of DSC score, the adjusted difference in PCS was -11 (95% confidence interval -12 to -9) and for MCS -16 (-18 to -14). Our results provide standardised data for health related quality of life in relation to severity of illness from diabetes, these might be used to aid the evaluation of relevant interventions.