南海市造口病人生活质量调查研究

目的：提高南海市造口病人生活质量。方法：发放自行设计的调查表，内容包括造口病人个人情况，造口及营养情况，造口病人社交及家庭生活情况，调查了南海市160例造口病人，逐一上门访视，召开联谊会。结果：113例占70．6％造口病人基本能自理造口；144例占90％家庭能接受造口病人，相处较好；104例占65％有造口周围皮肤问题；98例占61．2％对造口用品认识较少；131例占81．9％营养不均衡。已婚142例，其中70例配偶健在，只有20例有夫妻性生活；69例占43．1％参加社交活动。结论：160例造口病人生活质量较低，必须加强镇（区）社区护士对造口护理知识培训，定期访视并适时组织造口病人联谊活动，提供社会支持，才能提高造口病人生活质量。     

社区护理干预提高造口病人生活质量的研究

目的 探讨对造口病人实施社区护理干预,提高其生活质量的效果。方法 调查、建立造口病人健康档案、服务、召开造口病人联谊会。结果 开展社区护理干预后造口病人的生活质量明显高于社区护理干预前,11项评价指标分别经秩和检验,10项P<0.01,1项P<0.05,存在显著性差异。结论 实施造口病人近距离、低消费的社区服务有利于提高造口病人生活质量。     

Correlates of quality of life in older adult veterans

The purpose of this correlational study was to test theoretical propositions describing positive relationships between health promotion, sense of coherence, personal autonomy, and quality of life in older adult veterans and to explore their overall contribution to the prediction of quality of life. The sample consisted of 135 veterans aged 65 to 85 years who completed the Health-Promoting Lifestyle Profile, the Sense of Coherence-13 Scale, the Perceived Enactment of Autonomy Scale, and the Quality of Life Profile: Seniors Version, Short Scale. Health-promoting lifestyle, sense of coherence, and autonomy were positively correlated to quality of life. When the independent variables were subjected to a regression analysis, health-promoting lifestyle and autonomy explained 38% of the variance in quality of life.     

Exploration of gender differences in how quality of life relates to posttraumatic stress disorder in male and female veterans

Significant gaps exist in our knowledge about gender differences in quality of life among individuals with posttraumatic stress disorder (PTSD). We addressed these gaps by using data from two randomized clinical trials of veterans treated in Department of Veterans Affairs settings: 358 male Vietnam veterans who received group therapy and 203 female veterans who received individual psychotherapy. Using confirmatory factor analysis, we found that a four-factor structure for the Quality of Life Inventory provided the best fit for both groups. Overall quality of life was poor in men and women, and in general, they did not differ in quality of life or in how PTSD was associated with quality of life; the few statistically significant differences were small and clinically insignificant. For both men and women, numbing was uniquely associated with reduced quality of life. We suggest that quality of life should receive increased attention in research and clinical efforts to help veterans with PTSD.     

Caregiving at the end of life: Perceptions of health care quality and quality of life among patients and caregivers

This study explored the association between perceptions of health care quality and quality of life in patients with advanced metastatic cancer and their informal caregivers (n=39). Patients' and caregivers' perceptions of health care quality, mental health, health-related quality of life, symptoms, and burden were measured. The key findings included the following: 1) patients' mental health and depression scores correlated with those of caregivers, suggesting that the mental health of patients and their caregivers are associated; 2) patients and caregivers shared similar perceptions regarding health care quality; 3) the presence of depression in caregivers correlated with caregivers being less satisfied with the health care being given to their patients (this correlation did not exist for patients, a finding that may be due in part to the protective buffering effect that caregivers provide their patients as illness progresses); and 4) a modified Primary Care Assessment Survey, originally designed for primary care patients, was a useful measure of health care assessment for both patients and caregivers. These data suggest that patients with advanced disease and their caregivers share similar perceptions and evolve as a "unit of care," and caregivers, as unique and important members of the patient's health care team, are also in need of care. When depressed, caregivers may unilaterally lose trust by becoming less satisfied with the quality of health care being provided to their patients.     

Oral health and quality of life among patients with head and neck cancer or haematological malignancies

The aim of the present study was to monitor the health-related quality of life (HRQOL) of patients with head and neck cancer or haematological malignancies during a period from before to after medical treatment, and to investigate the relationships between patient experiences of oral symptoms and HRQOL. The sample consisted of 41 consecutive patients. At the start, during and end of radiotherapy or the second/third cycle of chemotherapy, patients rated their experiences of oral symptoms on a 100-mm visual analogue scale and completed the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ) C30 and the EORTC QLQ H&N35 (head and neck patients). At the end of treatment, an interview was done regarding the perceived influence of oral status on HRQOL. Among patients receiving radiotherapy, HRQOL tended to decrease over time, and oral symptoms increased. Patients who reported that their oral symptoms had influenced their everyday life (56%) reported more severe oral symptoms and lower HRQOL scores at the end of treatment when the oral symptoms were most intense. The findings from correlational analyses support the patients' reports from the interviews. For patients receiving chemotherapy for haematological malignancies, the quality of life did not change during the chemotherapy cycle. They reported very few oral symptoms, and very few reported that oral symptoms had any influence on their HRQOL. However, the correlational data indicate a relation between oral symptoms and HRQOL. Patients who reported more severe oral symptoms also reported lower HRQOL scores. The results demonstrate that oral status is related to HRQOL in these patient groups.     

乳腺癌术后患者生存质量和婚姻质量的调查分析

目的评估乳腺癌术后患者的生存质量和婚姻质量。方法应用EORTCQLQ-C30量表和Olson婚姻质量问卷对52例手术后1个月以上,年龄在60岁以下的乳腺癌患者及对照组52例进行调查。并筛选出影响乳腺癌术后患者生存质量的重要因素。结果乳腺癌术后患者的生存质量低于对照组,躯体功能、角色功能、社会功能、情绪功能、功能领域、经济状况及总分等比较,差异存在显著性意义。而乳腺癌患者婚姻质量在婚姻满意度、夫妻交流、性生活3个方面得分明显低于常模。结论乳腺癌术后患者的生存质量及婚姻质量低于一般人群,有必要对其进行有针对性的心理社会干预,尽可能促进身心康复。     

The relationship between health related quality of life and sensory deficits among patients with diabetes mellitus

Abstract

Purpose: (1) To profile sensory deficits examined in the ability to process sensory information from daily environment and discriminate between tactile stimuli among patients with controlled and un-controlled diabetes mellitus. (2) Examine the relationship between the sensory deficits and patients’ health-related quality of life.

Methods: This study included 115 participants aged 33–55 with uncontrolled (n?=?22) or controlled (n?=?24) glycemic levels together with healthy subjects (n?=?69). All participants completed the brief World Health Organization Quality of Life Questionnaire, the Adolescent/Adult Sensory Profile and performed the tactile discrimination test.

Results: Sensory deficits were more emphasized among patients with uncontrolled glycemic levels as expressed in difficulties to register sensory input, lower sensation seeking in daily environments and difficulties to discriminate between tactile stimuli. They also reported the lowest physical and social quality of life as compared to the other two groups. Better sensory seeking and registration predicted better quality of life. Disease control and duration contributed to these predictions.

Conclusions: Difficulties in processing sensory information from their daily environments are particularly prevalent among patients with uncontrolled glycemic levels, and significantly impacted their quality of life. Clinicians should screen for sensory processing difficulties among patients with diabetes mellitus and understand their impacts on patients’ quality of life.

• Implications for Rehabilitation

• Patients with diabetes mellitus, and particularly those with uncontrolled glycemic levels, may have difficulties in processing sensory information from daily environment.

• A multidisciplinary intervention approach is recommended: clinicians should screen for sensory processing deficits among patients with diabetes mellitus and understand their impacts on patients’ daily life.

• By providing the patients with environmental adaptations and coping strategies, clinicians may assist in optimizing sensory experiences in real life context and elevate patients’ quality of life.

• Relating to quality of life and emphasizing a multidisciplinary approach is of major importance in broadening our understanding of health conditions and providing holistic treatment for patients.

     

健康教育对乳腺癌术后患者生存质量的影响

目的探讨早期健康教育对乳腺癌患者术后生存质量的影响。方法将83例乳腺癌根治患者随机分为康复组(45例)和对照组(38例),康复组于术后24h开始健康教育;对照组行常规护理及随意自我锻炼。对2组患者分别于术后第30天应用癌症患者生存质量调查表进行问卷调查。结果康复组生存质量明显高于对照组,11项评价指标中有10项差异有显著性(P<0.01)。结论术后健康教育可以促进乳腺癌术后患肢功能康复,提高生存质量。     

重组改构人肿瘤坏死因子用于肝癌介入治疗后毒副反应的护理

重组改构人肿瘤坏死因子是一类基因工程抗肿瘤药物，可直接杀伤肿瘤细胞，使肿瘤出血、坏死、体积缩小。通过肝动脉插管联合化疗药物栓塞，可大大提高肿瘤局部药物浓度，降低非靶区药物浓度，减少化疗药物毒副反应，但其本身可引起一系列的不良反应，给患者的身心带来较大的痛苦。2005年4—6月，我科对20例原发性肝癌患者用rmhTNF与化疗药物联合栓塞治疗后引起的毒副反应实施了有效的护理，取得了良好的效果，现报道如下。     

Health-related quality of life among Canadians with migraine

The objective was to determine the impact of migraine on health-related quality of life (HRQOL) among Canadians. Analysis was based on the public use microdata set of the Canadian Community Health Survey (CCHS), limited to those aged ≥15 residing in Manitoba. HRQOL was measured using the SF-36 survey, which covers 8 health concepts. Multivariate linear regression was used to model each SF-36 scale against age, gender, education, income, migraine status and presence of mood or anxiety disorders. Of the 7236 CCHS respondents, 9.7% reported a diagnosis of migraine. Reported migraine predicted statistically significant (p<0.0001) lower HRQOL in all SF-36 domains with profound impairment of physical role, bodily pain and general health. Those reporting a mood disorder scored significantly lower in all domains with pronounced effects on emotional role, social functioning and general health. Reported anxiety disorder was associated with lower HRQOL in 6/8 domains. Canadians with migraine report significant impairment in HRQOL compared to the general population, independent of psychiatric morbidity.     

Oral health related quality of life among imprisoned Dutch forensic psychiatric patients

Because dental health and oral pathology may affect forensic psychiatric patients' well being, it is important to be able to assess oral health related quality of life (OH-QoL) in these patients. Two studies were conducted among Dutch forensic psychiatric male patients to assess the psychometric properties and some potential predictors of the Oral Health Impact Profile-14 (OHIP-14) as a measure of OH-QoL. Study 1 involved 40 patients who completed the OHIP-14 before receiving professional dental care and were retested 3 months later. The internal consistency was good, the test-retest correlations were fair, and over the 3 months follow-up no significant changes in OH-QoL were observed. Study 2 consisted of 39 patients who completed an improved version of the original OHIP-14, as well as measures to validate of the OHIP. Dental anxiety and unhealthy dentition jointly explained 26.7% of the variance in OH-QoL, and the better patients performed their oral hygiene behavior, the better their OH-QoL. It is concluded that the Dutch OHIP-14 is a useful instrument, and that nurses, especially in forensic nursing, should pay particularly attention to dental anxiety when encouraging patients to visit OH professionals and to perform adequate oral hygiene self-care.     

肠癌患者心理健康和家庭社会功能与生活质量的多因素分析

目的：探讨肠癌患者的生活质量情况及其影响因素。方法：选择2001-01／2002—07四川省肿瘤医院及四川大学华西医科大学附属医院确诊的肠癌患者为调查对象。编制符合中国国情的肠癌患者的生活质量评价量表．采用面访问卷方法进行调查。内容包括：①一般人口学特征。②疾病及治疗情况。③生活质量情况。生活质量情况参照癌症患者生活质量测定量表（EORTC-QLQ-30）设计，内容包括日常躯体功能。心理健康状态，家庭社会功能，一般症状与副反应以及自我生活质量评价5个主要测量维度，并增加肠癌特殊副反应条目，生活质量所有相关条目共计42项。每个条目取值0-10分，各条目得分越高生活质量越好。采用特尔菲法为各测量条目附权重，各测量维度及总分计算方法为：分值：∑条目得分&;#215;权重&;#215;10。生命质量总分=日常躯体功能评分＋心理健康评分＋家庭社会功能评分＋一般症状副反应评分＋特殊副反应评分＋自我总评价评分。采用多元线性回归模型分析影响患者生活质量的因素。结果：发放问卷94份，收回合格问卷94份，有效率100％。①生活质量权重及各测量维度评分情况：肠癌患者生活质量评分总评分为58.16&;#177;15．7。日常躯体功能、心理健康、社会家庭功能、一般症状及副反应、特殊副反应、自我生活质量评价的评分分别是9．75&;#177;3．16，14.09&;#177;4．44，10．84&;#177;3．48，8．50&;#177;2．50，11．64&;#177;4．81，4．01&;#177;1．42。权重值分别是0．161，0．237、0．189，0.128，0．21,0．075。单条目评分时经济发生困难（归属家庭社会功能）、害怕疾病转移（归属心理健康）、体育锻炼（归属日常躯体功能）评分较低。②不同肠癌患者生活质量评分比较：转移性肠癌、直肠癌、结肠癌患者生活质量总评分分别是65．53&;#177;9．04，52．03&;#177;16．17，64．28&;#177;17．13，差异有显著性（F=5．883，P〈0．05）。③生活质量的多因素分析：肠癌患者的治疗后特殊副反应与生活质量评分呈正相关。线性回归分析结果显示，“两周内遭遇精神刺激”与生活质量总分及所有维度得分均呈负相关；费用报销比例高与总分、自我生活质量评价，日常躯体功能和心理健康状况呈正相关。诊断距今时间长与患者的日常躯体功能呈正相关，家庭月收入高与社会家庭功能呈正相关，配偶健康状况差与患者的心理健康状况和自我生活质量评价呈负相关。结论：肠癌患者最关心的是治疗后的康复和肿瘤复发、转移的问题。普遍表达经济压力对生活质量的影响。临床应重点关注患者的特殊副反应．并帮助其恢复一般生活功能。应针对患者开展疾病、心理及社会医学多学科的康复指导和健康教育。     

肠癌患者心理健康和家庭社会功能与生活质量的多因素分析

目的:探讨肠癌患者的生活质量情况及其影响因素。方法:选择2001-01/2002-07四川省肿瘤医院及四川大学华西医科大学附属医院确诊的肠癌患者为调查对象。编制符合中国国情的肠癌患者的生活质量评价量表,采用面访问卷方法进行调查。内容包括:①一般人口学特征。②疾病及治疗情况。③生活质量情况。生活质量情况参照癌症患者生活质量测定量表(EORTC-QLQ-30)设计,内容包括日常躯体功能,心理健康状态,家庭社会功能,一般症状与副反应以及自我生活质量评价5个主要测量维度,并增加肠癌特殊副反应条目,生活质量所有相关条目共计42项。每个条目取值0～10分,各条目得分越高生活质量越好。采用特尔菲法为各测量条目附权重,各测量维度及总分计算方法为:分值=条目得分×权重×10。生命质量总分=日常躯体功能评分+心理健康评分+家庭社会功能评分+一般症状副反应评分+特殊副反应评分+自我总评价评分。采用多元线性回归模型分析影响患者生活质量的因素。结果:发放问卷94份,收回合格问卷94份,有效率100%。①生活质量权重及各测量维度评分情况:肠癌患者生活质量评分总评分为58.16±15.7。日常躯体功能、心理健康、社会家庭功能、一般症状及副反应、特殊副反应、自我生活质量评价的评分分别是9.75±3.16,14.09±4.44,10.84±3.48,8.50±2.50,11.64±4.81,4.01±1.42。权重值分别是0.161,0.237、0.189,0.128,0.21,0.075。单条目评分时经济发生困难(归属家庭社会功能)、害怕疾病转移(归属心理健康)、体育锻炼(归属日常躯体功能)评分较低。②不同肠癌患者生活质量评分比较:转移性肠癌、直肠癌、结肠癌患者生活质量总评分分别是65.53±9.04,52.03±16.17,64.28±17.13,差异有显著性(F=5.883,P<0.05)。③生活质量的多因素分析:肠癌患者的治疗后特殊副反应与生活质量评分呈正相关。线性回归分析结果显示,“两周内遭遇精神刺激”与生活质量总分及所有维度得分均呈负相关;费用报销比例高与总分、自我生活质量评价,日常躯体功能和心理健康状况呈正相关。诊断距今时间长与患者的日常躯体功能呈正相关,家庭月收入高与社会家庭功能呈正相关,配偶健康状况差与患者的心理健康状况和自我生活质量评价呈负相关。结论:肠癌患者最关心的是治疗后的康复和肿瘤复发、转移的问题。普遍表达经济压力对生活质量的影响。临床应重点关注患者的特殊副反应,并帮助其恢复一般生活功能。应针对患者开展疾病、心理及社会医学多学科的康复指导和健康教育。     

Untreated peristomal skin complications among long-term colorectal cancer survivors with ostomies

This ethnography of family caregiving explored why peristomal skin complications are common and undertreated among colorectal cancer survivors with intestinal ostomies. Data were collected through in-depth interviews with 31 cancer survivors and their family caregivers, fieldwork, structured assessments, and medical records review, and analyzed with qualitative theme and matrix analyses. Survivors who received help changing the skin barrier around their stoma had fewer obstacles to detection and treatment of peristomal skin complications. Half of the survivors received unpaid help with ostomy care, and all such help came from spouses. Married couples who collaborated in ostomy care reported that having assistance in placing the ostomy appliance helped with preventing leaks, detecting skin changes, and modifying ostomy care routines. In addition, survivors who struggled to manage ostomy care independently reported more obstacles to alleviating and seeking treatment for skin problems. Oncology nurses can improve treatment of peristomal skin problems by asking patients and caregivers about ostomy care and skin problems, examining the peristomal area, and facilitating routine checkups with a wound, ostomy, and continence nurse.     

系统性健康教育对骨质疏松患者生活质量的影响

目的探讨系统性健康教育对骨质疏松患者生活质量的影响。方法对80例原发性骨质疏松患者进行为期6个月的系统性健康教育,即:干预前评估、制订个体化健康教育计划及内容、采取多种教育形式相结合的方法实施健康教育,实施前后对患者的生活质量进行比较。结果实施系统性健康教育后,患者在总体健康感觉、社会功能、躯体疼痛、心理健康、精力5个方面得分与教育前比较,差异具有统计学意义(P0.01或P0.05)。结论系统性健康教育可有效提高骨质疏松患者的生活质量。