Traumatic experiences in psychiatric outpatients

Fifty-four newly referred psychiatric outpatients were interviewed and a life history of severe traumatic experiences was taken. Forty-four gave a positive history, 17 of whom developed symptoms of post-traumatic stress (PTSS). Twelve met a past or current diagnosis of PTSD. Factors relating to the occurrence of PTSS included early trauma, more traumatic events, incest, perceiving the event as frightening, being physically injured, perceiving the event as being life threatening, seeing a physician, and being hospitalized. Age at trauma and differences between men and women are also discussed.     

Understanding stress and quality of life for clergy and clergy spouses

To better understand the stress and quality of life of clergy and clergy spouses, a survey research design was utilized involving a random sample of clergy. Of the 436 respondents involved in this study there were 259 clergy who were employed full‐time and 177 clergy spouses. Various scales related to Family Stress Theory and the ABC‐X model were used in this investigation. Whereas clergy spouses had greater psychological and physiological stress than clergy, clergy had a greater sense of coherence and spiritual resources. Clergy spouses, however had a greater level of coping. Findings indicated that for both clergy and clergy spouses spiritual resources had the greatest total effect on their quality of life. Copyright © 2004 John Wiley & Sons, Ltd.     

Health-related quality of life and sexual function in women with stress urinary incontinence and overactive bladder

Background:   We evaluated the impact of stress urinary incontinence (SUI) and overactive bladder (OAB) on health-related quality of life (HRQOL) and sexual function.
Methods:   A total of 245 women (SUI; n  = 123 and OAB; n  = 122) from 21 to 79 years old (mean 50.4) were included in the primary analyses. To obtain HRQOL and sexual function assessments, patients were asked to fill in the 'Bristol Female Lower Urinary Tract Symptoms (BFLUTS)' and the 'Medical Outcomes Study Short Form (SF-36)' questionnaires.
Results:   Of the eight domains in the SF-36 questionnaire, only 'general health' was significantly different between the groups. Patients with SUI had a better general health than those with OAB ( P  = 0.016). When comparing the BFLUTS scores in the two groups, the score for 'BFLUTS-filling symptoms' was higher in the OAB group ( P  = 0.002) but that for 'BFLUTS-incontinence symptoms' was higher in the SUI group ( P  < 0.001). The score for 'BFLUTS-sex' was higher in the SUI group than in the OAB group but this was not statistically significant ( P  = 0.096). Of the 169 patients who had a sex life, the SUI group had experienced pain ( P  = 0.033) and leakage ( P  = 0.056) more frequently during intercourse than the OAB group.
Conclusion:   Both SUI and OAB have a detrimental impact on patient HRQOL in Korean women. In addition, our findings suggest that women with SUI had more frequently experienced pain during intercourse and coital incontinence than those with OAB.     

The relationship between kinesiophobia and health-related quality of life in patients with rheumatoid arthritis: A controlled cross-sectional study

ObjectivesTo evaluate the kinesiophobia and kinesiophobia-related factors in patients with rheumatoid arthritis (RA) and provide a better perspective on the relationship between kinesiophobia and patients’ health-related quality of life (HRQoL).MethodsA total of 88 patients (67 females, 21 males) with RA and 93 healthy volunteers (67 females, 26 males) were included in the study between March 2020 and July 2020. Kinesiophobia was evaluated using the Tampa Scale of Kinesiophobia (TSK) and HRQoL was evaluated using the 36-item Short-Form Health Survey (SF-36). The Fatigue Severity Scale (FSS), Beck Depression Inventory (BDI), Health Assessment Questionnaire Disability Index (HAQ-DI), International Physical Activity Questionnaire (IPAQ) (Short Form) were completed by all participants.ResultsThe median age was 52.0 (IQR, 45.0-58.0) years in the RA group and 50.0 (IQR, 41.5-56.0) years in the control group. Age and sex were not significantly different between the groups. The median TSK score was 45.0 (IQR, 39.0-49.75) in the RA group, 39.0 (IQR, 37.0-43.0) in the control group (P < 0.001). The median FSS, BDI, and HAQ-DI scores were higher and the median HRQoL domains were lower in the RA group than in the control group (P < 0.05). Multivariate linear regression analysis including age, sex, education level, body mass index (BMI), morning stiffness duration, Disease Activity Score in 28 joints, FSS, BDI, visual analog scale and IPAQ scores variables showed that FSS scores (B = 1.07, P < 0.05), BDI scores (B = 0.24, P < 0.05), and BMI (B = 0.22, P < 0.05) were independent variables for kinesiophobia in patients with RA (R² = 0.32). TSK was a predictive variable for HAQ-DI (B = 0.03, P < 0.001), the physical functioning domain of the HRQoL (B = -1.18, P < 0.001), the bodily pain domain of the HRQoL (B = -0.78, P < 0.05), respectively.ConclusionPhysicians should have awareness of kinesiophobia in patients with RA. Educating patients about kinesiophobia, developing strategies for avoiding kinesiophobia, and specific treatment strategies with a multidisciplinary approach may improve HRQoL and disability.     

门诊强化教育对支气管扩张症患者生活质量和运动能力的影响

目的探讨门诊强化教育干预对稳定期支气管扩张症患者生活质量和运动能力的影响。方法将稳定期支气管扩张症患者63例按随机数字表法分为对照组31例和观察组32例,对照组按常规行门诊教育和指导,观察组在对照组基础上实施门诊强化教育干预,于入组时及干预后测评自我护理能力、生活质量和6min步行距离。结果干预后,观察组自我护理能力、生活质量得分显著优于对照组(P0.01,P0.05);观察组6min步行距离显著长于对照组(P0.01)。结论门诊强化教育干预能提高稳定期支气管扩张症患者的自我护理能力,改善生活质量,增强运动能力。     

绝经后女性骨密度和生活质量、睡眠质量及疲劳之间相关性研究

目的 本研究旨在探讨绝经后妇女的生活质量(quality of life,QOL)、睡眠质量和疲劳水平与骨密度(bone mineral density,BMD)之间的关系。方法 本研究纳入113例无骨折的绝经后骨质疏松症(postmenopausal osteoporosis,PMO）患者,172例骨量减少患者和102例BMD正常的患者。疼痛、生活质量、睡眠质量和疲劳的严重程度使用视觉模拟量表(VAS)、欧洲骨质疏松症基金会QOL问卷(QUALEFFO-41)、匹兹堡睡眠质量指数(PSQI)和个人力量(CIS)问卷检查表评估。结果 在VAS和QUALEFFO-41总分方面,三组间差异无统计学意义 (P＞0.05)。另一方面,与BMD正常组相比,PMQ和骨量减少组的PSQI和CIS总分比较差异具有统计学意义(分别为P = 0.015和0.007)。结论 QOL、睡眠质量和疲劳对PMO或骨量减少的女性影响显著。     

痤疮患者身体意象与生活质量现状及相关研究

目的探讨痤疮患者身体意象与生活质量现状及其相关关系,为痤疮患者的心理护理提供依据。方法采用方便抽样法选取北京市某三级甲等医院皮肤科门诊就诊的痤疮患者392例,采用皮肤病生活质量指数、身体意象量表进行问卷调查。结果痤疮患者身体意象评分为8.31±6.09,生活质量评分为8.57±5.98;不同痤疮等级患者身体意象及生活质量评分比较,差异无统计学意义(均P0.05);痤疮患者身体意象与生活质量呈显著正相关(P0.01)。结论痤疮患者易形成消极身体意象,其生活质量水平较差,两者关系密切。临床护理工作中需采取措施引导患者悦纳自我和改变不良认知来提高患者身体意象水平,以提高其生活质量。     

Treatment of stress urinary incontinence using a copolymer system: impact on quality of life

OBJECTIVE: To investigate the effect on quality of life (QoL) of a novel system for treatment of stress urinary incontinence (SUI). PATIENTS AND METHODS: In an open, prospective, multicentre study, 42 women not previously treated by invasive therapy and with urodynamically verified SUI received 4 x 1.0 mL or 4 x 0.7 mL of non-animal stabilized hyaluronic acid/dextranomer copolymer injected transurethrally into the urethra via the Implacer device (Zuidex system, Q-Med AB, Uppsala, Sweden). QoL was assessed using the King's Health Questionnaire. The patients' perception of treatment benefit and the number of incontinence episodes/24 h were also investigated. RESULTS: There were significant improvements over baseline in seven of 10 domains of the King's Health Questionnaire at 3 months, and these improvements were sustained at 1 year. For the change from baseline to 1 year, eight of 10 domains showed a significant positive correlation with the number of incontinence episodes/24 h. In terms of treatment benefit, most of the women perceived an improvement at 1, 3, 6 and 12 months. Of the 18 women requiring re-treatment, most perceived an improvement at 3, 6 and 12 months. CONCLUSION: Treatment with the Zuidex system produced significant improvements over a year in both subjective QoL and objective incontinence measures, with a significant positive correlation between them.     

Relationship between life events and personality in psychiatric disorder

In order to investigate any relationship between personality and the occurence of stressful life events. 7.5 outpatients with depressive and anxiety disorders had life events rated for a nine-month period and assessments made of premorbid personality using a recently devised instrument. In comparisons made of events occurring beofre the onset of illness, subjects with personality disorders had significantly more undesirable life events than subjects with non-disordered personality. After the development of illness subjects with personality disorders had a significant excess of events which were classed as primarily self-generated rather than chance occurrences. Analysis by personality type revealed the presence of sociopathic traits to be the most important determinant of life events, these traits significantly correlating with both the total rate of life events and the rate of undesirable events in both studied periods. The findings have implications for clinicians and also for research workers who have not usually considered the confounding effect of personality when making life-events comparisons.     

The association between anastomotic leakage and health-related quality of life after colorectal cancer surgery

Aim

Colorectal anastomotic leakage (AL) is a serious complication. Studies on the impact of AL on health-related quality of life (HRQoL) are scarce. We aimed to investigate the association between AL and HRQoL in colorectal cancer patients up to 2 years after diagnosis, and to evaluate whether AL is associated with a clinically relevant decrease in HRQoL over time.

Methods

Patients diagnosed with Stage I–III colorectal cancer undergoing elective surgical resection with primary anastomosis between 2010 and 2017 were included. HRQoL was evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30, represented by the summary score, and analysed at diagnosis and at 6 months and 2 years post-diagnosis. Multivariable linear regression was performed to assess the association between AL and HRQoL, while multivariable logistic regression was used to investigate the association between AL and a clinically relevant HRQoL decrease (≥10 points) during follow-up compared to the time of diagnosis.

Results

In total, 1197 patients were included of whom 63 (5%) developed AL. AL was not associated with HRQoL at 6 months post-diagnosis nor at 2 years post-diagnosis. However, having AL was associated with an increased risk of a clinically relevant decrease in HRQoL at 6 months post-diagnosis (OR 3.65, 95% CI 1.62–8.21) but not at 2 years after diagnosis (OR 1.91, 95% CI 0.62–5.93).

Conclusion

Although AL was not associated with HRQoL at 6 months or 2 years post-diagnosis, AL was a determinant of a clinically relevant decrease in HRQoL at 6 months after diagnosis. Future work should identify feasible and effective strategies to prevent declines in QoL in this patient population.     

The relationship between physical and psychological complaints and quality of life in severely injured patients

PurposeThe purpose of this study was two-fold. The first goal was to investigate which variables were associated with the remaining physical limitations of severely injured patients after the initial rehabilitation phase. Second, we investigated whether physical limitations were attributable to the association between psychological complaints and quality of life in this patient group.MethodsPatients who were 18 years or older and who had an injury severity score (ISS) > 15 completed a set of questionnaires at one time-point after their rehabilitation phase (15–53 months after their trauma). The Short Musculoskeletal Function Assessment (SMFA) questionnaire was used to determine physical limitations. The Hospital Anxiety and Depression Scale, the Dutch Impact of Event Scale and the Cognitive Failure Questionnaire were used to determine psychological complaints, and the World Health Organization Quality of Life assessment instrument-BREF was used to measure general Quality of Life (QOL).Differences in physical limitations were investigated for several trauma- and patient-related variables using non-parametric independent-sample Mann-Whitney U tests. Multiple linear regression was performed to investigate whether the decreased QOL of severely injured patients with psychological complaints could be explained by their physical limitations.ResultsOlder patients, patients with physical complaints before the injury, patients with higher ISS scores, and patients who had an injury of the spine or of the lower extremities reported significantly more physical problems. Additionally, patients with a low education level, patients who were living alone, and those who were unemployed reported significantly more long-term physical problems.Severely injured patients without psychological complaints reported significantly less physical limitations than those with psychological complaints. The SMFA factor of Lower extremity dysfunction was a confounder of the association between psychological complaints and QOL in all QOL domains.ConclusionsLong-term physical limitations were mainly reported by patients with psychological complaints. The decreased QOL of severely injured patients with psychological complaints can partially be explained by physical limitations, particularly those involving lower extremity function. Experienced physical limitations were significantly different for some trauma and patient characteristics. These characteristics may be used to select patients for whom a rehabilitation programme would be useful.     

Haemorrhoids and quality of life

Aim There are few studies into the quality of life of patients with haemorrhoids. The aim of this study was to assess the quality of life of patients with haemorrhoids in an adult general population. Method Participants, who attended the Austrian nationwide healthcare programme for colorectal cancer screening at four medical institutions, were enrolled prospectively between 2008 and 2009. A colonoscopy was performed in all patients. Haemorrhoids were classified according to an international grading system and defined as symptomatic in cases with bleeding, itching, soiling or pain. Quality of life was measured by the Short Form‐12 Health Survey. Results Of 976 participants, 380 patients (39%) had haemorrhoids. The median physical health score was 52.6 (range 20.6–61.3) in the symptomatic and 53.2 (range 16.2–61.3) in the asymptomatic group (P = 0.7993). The median mental health score showed also no significant difference between both groups [symptomatic group, 52.8 (range 12.4–62.6); asymptomatic group, 54.8 (range 18.7–67.2); P = 0.0738]. Conclusion Haemorrhoids, irrespective of their degree, do not influence quality of life measured by the Short Form‐12 Health Survey.     

Mental health and quality of life among doctors,nurses and other hospital staff

Numerous studies have shown that doctors, nurses or other hospital staff may suffer from tremendous stress at work. A high level of work-related stress might increase vulnerability to mental illness and result in a poor quality of clinical care. This study was conducted in a Taiwanese regional general hospital. Minor psychiatric disorder, depressive disorder and quality of life were assessed for all staff, using self-rating questionnaires including the Chinese Health Questionnaire 12-item version, the Center for Epidemiologic Studies Depression Scale and World Health Organization Quality of Life Scale brief version. Nearly half of the staff had either a minor psychiatric disorder or depressive disorder. Nurses and pharmacists had the highest prevalence. The risk factors included single/divorced and being a nurse or pharmacist. Quality of life for hospital staff was poor, as compared with the Taiwanese norms, and was even worse for the nurses and pharmacists. In conclusion, the management teams of hospitals should pay more attention to the mental condition of all hospital staff, especially nurses and pharmacists. Adequate staffing, support, counselling or psychological intervention are required for further management, and may logically result in better mental health on the part of the staff and a better quality of care. Copyright © 2009 John Wiley & Sons, Ltd.     

69例腹膜透析患者生活质量分析

目的探讨本中心腹膜透析（PeritonealDialysis,PD）对慢性肾衰竭患者生活质量的影响,并初步分析影响PD患者生活质量的因素。方法肾内科腹膜透析患者69例,运用KDQOL-SFTMl．3（包括健康调查简表MedicalOutcomesStudyHealthStatusShortForm,SF-36和Kidneydiseasetargetarea,KDTA）生活质量量表调查,根据Hays方法进行评分。结果（1）男性PD患者与女性PD患者在KDTA和SF-36总分方面有显著性差异。（2）每天透析剂量6000ml以上PD患者与每天透析剂量在6000ml以下的PD患者在KDTA和SF-36总分方面有显著性差异。（3）PD患者的生活质量与透析时间的长短明显相关。（4）40岁以下患者在KDTA和SF-36的总分方面与4（J岁以上患者无明显差异（P〉0．05）。（5）透析费用支付方式对PD患者的生活质量影响明显,医疗保险的PD患者的生活质量评分在KDTA及SF-36总分方面明显高于新农合的PD患者。结论影响PD患者生活质量的因素除医学因素外,非医学因素亦占重要地位。     

The relationship between ICU survivorship,comorbidity and educational level in quality of life after intensive care

Background

ICU survivors have lower quality of life (QoL) compared to a non-ICU-treated population. The reason for this is not fully understood, but differences in baseline characteristics may be an important factor. This study evaluates the roles of comorbidity and educational level as possible explanatory factors for differences in QoL in ICU survivors compared to a non-ICU-treated population.

Methods

Using a provisional questionnaire with 218 questions in 13 domains on QoL after intensive care, we compared the responses from 395 adult ICU survivors and 195 non-ICU-treated controls. An initial bivariable linear correlation analysis compared the responses from the two groups. Two secondary multivariable regression analyses tested for effect modification by comorbidity and educational level, respectively, on the effect on QoL from belonging to the ICU survivor group compared to the control group.

Results

There was a significant difference in QoL between the two groups in 170 of 218 (78%) questions. In the multivariable analyses, associations between group belonging and QoL remained in 139 questions. In 59 of these, both belonging to the ICU survivor group and comorbidity was associated to QoL, in parallel to each other. Comorbidity moderated the association between group belonging and QoL in six questions, with the highest proportion of questions within the domains of cognition and urinary functions, and the lowest proportion within appetite and alcohol, physical health, and fatigue. In 26 questions, both belonging to the ICU survivor group and educational level were associated to QoL, in parallel to each other. Educational level moderated the association between group belonging and QoL in 34 questions, with the highest proportion of questions within the domains of urinary functions, ADL and physical health, and the lowest proportion within the domains of cognition, appetite and alcohol, pain, sensory functions, and fatigue.

Conclusions

Lower QoL seen in ICU survivors compared to non-ICU-treated controls, as measured by our provisional questionnaire, cannot be explained only by a higher burden of comorbidity, and rarely by only educational level. In issues where comorbidity or educational level was associated to QoL, it often was so in parallel to an association from belonging to the ICU survivor group. Comparing QoL in ICU survivors to that of a non-ICU-treated population may be adequate despite differences in baseline characteristics.