The relationship between gender,social support,and health-related quality of life in a community-based study in Washington County,Maryland

Objective Men tend to report higher health-related quality of life (HRQOL) than women of the same age, despite higher mortality rates and lower life expectancy. Social support is one factor related to HRQOL that may contribute to the observed gender difference. The purpose of this study was to determine the factors associated with HRQOL, especially levels of social support, and variation by gender. Methods Multivariable logistic regression was used to analyze data from 4,498 men and 6,948 women participating in an ongoing community-based cohort study in Washington County, Maryland (CLUE-II). Results The results showed that men reported significantly better HRQOL than women. Men reported having higher levels of social support than women, but the magnitude of the association with HRQOL was similar. Having two or less close friends was associated with a statistically significant increase in the odds of reporting poorer HRQOL compared to having 10 or more close friends among both genders (men: OR = 1.49; women: OR = 1.53). Differences in the level of social support did not explain the gender difference in HRQOL. Conclusions Our findings show that social support is an important correlate of HRQOL for both men and women. However, the gender differences in HRQOL are not explained by social support or the other factors examined.     

中国成年人体重指数与生命质量的关系研究

目的 探讨中国成年人BMI与生命质量的关系。方法 纳入2010年中国慢性病及其危险因素监测的所有调查对象共83 347名。应用问卷收集调查对象的年龄、性别、相关疾病患病情况等信息。并使用WHO生存质量测定简表（QOL-BREF）测定其生命质量。测量体重和身高,计算BMI。采用秩和检验比较不同BMI分组的人群生命质量的差异;用多元logistic回归模型检验不同性别人群BMI与生命质量的关系。结果 83 347名调查对象中,与体重正常组相比,体重过轻、超重和肥胖组的生理维度得分均较低;超重组的心理和环境维度的得分高于其他3组;社会关系维度的得分以肥胖组最高,体重过轻组得分最低,差异均有统计学意义（P<0.000 1）。体重过轻男性的生理（OR＝1.38,95%CI：1.12～1.70）、心理（OR＝1.29,95%CI：1.08～1.54）、社会关系（OR＝1.26,95%CI：1.08～1.47）和环境（OR＝1.37,95%CI：1.12～1.67）4个维度的生命质量受损的危险度明显增加。超重和肥胖组男性的生理（OR＝0.88,95%CI：0.82～0.94;OR＝0.90,95%CI：0.82～0.98）、心理（OR＝0.88,95%CI：0.83～0.94;OR＝0.83,95%CI：0.77～0.90）、社会关系（OR＝0.89,95% CI：0.84～0.94;OR＝0.78,95% CI：0.71～0.85）和环境（OR＝0.85,95% CI：0.80～0.92;OR＝0.79,95%CI：0.73～0.86）维度的生命质量受损的危险度降低。超重组女性的社会关系（OR＝0.92,95%CI：0.85～0.98）和环境维度（OR＝0.91,95%CI：0.80～0.92）的生命质量受损的危险度显著降低。而肥胖女性社会关系维度的危险度也显著降低（OR＝0.86,95%CI：0.78～0.95）。结论 BMI分组不同的人群各个维度的生命质量不同,男性体重过轻组4个维度的生命质量均较差,男性超重和肥胖组各个维度生命质量均较好,女性超重组的社会关系和环境维度生命质量较好,女性肥胖组社会关系维度生命质量较好。     

中年女性知识分子生存质量及其影响因素

目的:通过对贵阳市中年女性知识分子生存质量的调查研究,获得该人群生存质量的现状及其影响因素。不仅为她们提供了健康保健的依据,同时也为卫生部门制定相关政策提供参考。方法:采用分层整群抽样的方法,自贵阳市不同行业中抽取40~60岁、中专或中级职称以上的在职人员628人作为研究对象。在正式调查前,抽取少部分样本进行内容效度和复测信度分析。所有研究人员进行一致性训练后,采用世界卫生组织生存质量量表(WHO-QOL-BREF)和自编的生存质量影响因素问卷在同一月份对中年女性知识分子采用现场自填式进行调查,获得生存质量的现状及影响因素。结果:中年女性知识分子生存质量和健康状况不理想,13.9%的中年女性知识分子生存质量较差(相似文献   

女性艾滋病病毒感染者和患者生存质量及影响因素调查

目的:了解女性艾滋病感染者和患者生存质量及影响因素。方法:应用WHOQOL-BREF中文版测量其生存质量。结果:女性HIV感染者及AIDS患者生存质量4个领域得分分别为:13.91±1.90(生理领域),12.33±1.97(心理领域),13.00±1.97(社会关系领域),12.00±1.87(环境领域)。单因素分析显示,职业、CD4细胞数、与配偶/固定性伴HIV检测前后性生活次数等因素与生存质量有关(P0.05)。多元线性回归分析结果表明,年龄、家庭收入、有非商业非固定性伴、艾滋病抗病毒治疗时间越长及由疾控人员告知HIV阳性结果并无其他人在场与艾滋病感染者生存质量呈正相关;年龄和家庭收入分别与社会关系及心理领域呈负相关。结论:艾滋病问题严重的威胁了女性艾滋病感染者和患者的生存质量,应提高其抵御艾滋病的能力。     

Gender differences in improvement of older-person-specific quality of life after hearing-aid fitting

Background

Age-related hearing loss is the third most common reason for disability in the world and has a significant impact on quality of life (QoL) amongst older adults.

Gender differences in health-related quality of life in patients with HIV/AIDS

Background: In studies evaluating the general US population, patients in primary care, and patients with chronic conditions, women consistently report poorer health-related quality of life (HRQoL) than men; however, studies evaluating HRQoL in patients with HIV/AIDS have not completely corroborated those findings. The objective of this study was to evaluate gender differences in HRQoL for participants in a large randomized trial comparing antiretroviral regimens. Methods: AIDS Clinical Trials Group (ACTG) 320 was a randomized, blinded, placebo-controlled trial comparing the 3-drug regimen of indinavir + zidovudine (or stavudine) + lamivudine with the 2-drug combination of zidovudine (or stavudine) + lamivudine in subjects with CD4 cell counts less than 200 cells/l and no prior treatment with protease inhibitors. Nine quality of life domains scored on 0–100 scales were assessed using the ACTG QOL 601-602 Health Survey at 3 points in the trial: baseline, 24 weeks and 40 weeks. Differences between men and women in HRQoL scores were assessed using the Wilcoxon rank-sum test and generalized estimating equation (GEE) models. Results: Overall, 202 females and 976 males were randomized to one of two treatment arms. Female participants were more likely to be black or Hispanic and tended to be younger. At baseline, females reported lower HRQoL scores than males in all of the domains except social functioning, and at week 40, women scored lower in all of the domains except overall health. In repeated measures models, women were found to score lower in all HRQoL domains except overall health, with significant differences of 3.5–6.7 points in 3 of the 9 quality of life domains: physical functioning, pain, and energy/fatigue. HRQoL scores improved for participants in the study over time and in response to potent treatment, and the improvements were similar for men and women. Conclusions: Women with HIV/AIDS report substantially poorer HRQoL than men with HIV/AIDS in several HRQoL domains. However, changes in domain scores over time and in response to treatment do not differ significantly by gender, implying that changes in domain scores may be better HRQoL outcomes to compare between HIV-infected men and women in clinical trials than mean domain scores.     

Leisure time physical activity and health-related quality of life: Cross-sectional and longitudinal associations

Studies that relate change in physical activity to change in health-related quality of life in the general population are needed to confirm associations suggested by cross-sectional studies. In the present study, cross-sectional as well as longitudinal associations between leisure time physical activity and health-related quality of life were studied in an apparently healthy population. The present study showed cross-sectional associations between at least moderately intense leisure time physical activity and general health perceptions, vitality, physical functioning and role limitations due to physical health problems. No associations were present for total leisure time physical activity. Change in leisure time physical activity was associated with change in social functioning in men as well as in women, irrespective of the intensity of physical activity. Only in men, change in total leisure time physical activity was associated with change in vitality and general mental health. In our study, cross-sectional associations were not confirmed by longitudinal analyses. Cross-sectional associations were mainly found for physical components of health-related quality of life, whereas longitudinal associations were predominantly observed for mental components of health-related quality of life. Confirmation of our results by those of other studies is needed in order to quantify health promotion messages.     

The development of the pediatric cardiac quality of life inventory: a quality of life measure for children and adolescents with heart disease

Objective Mortality after surgery for congenital heart disease (CHD) has decreased. Quality of life (QOL) assessment in survivors has become increasingly important. The purpose of this project was to create the Pediatric Cardiac Quality of Life Inventory (PCQLI). Methods Items were generated through nominal groups of patients, parents, and providers. The pilot PCQLI was completed by children (age 8–12), adolescents (age 13–18), and their parents at three cardiology clinics. Item reduction was performed through analysis of items, principal components, internal consistency (IC), and patterns of correlation. Results A total of 655 patient–parent pairs completed the pilot PCQLI. Principal components identified included: impact of disease (ID); psychosocial impact (PI); and emotional environment (EE). After item reduction ID and PI had excellent IC (ID = 0.88–0.91; PI = 0.78–0.85) and correlated highly with each other (0.81–0.90) and with the total score (TS) (ID = 0.95–0.96; PI = 0.87–0.93). EE was not correlated with ID, PI, or TS and was removed from the final forms. Two-ventricle CHD patients had a higher TS than single-ventricle CHD patients across all forms (P < 0.001). Conclusion The PCQLI has patient and parent-proxy forms, has wide age range, and discriminates between CHD subgroups. The ID and PI subscales of the PCQLI have excellent IC and correlate well with each other and the TS. Supported by the Critical Care Medicine Endowed Chair at The Children’s Hospital of Philadelphia. Abstract presented at the 54th Scientific Session of the American College of Cardiology, Orlando, Florida, 2005.     

优质护理对老年高血压患者生活质量的影响

目的：探讨优质护理对老年高血压患者生活质量的影响。方法：选取88例老年高血压患者作为研究对象,将其随机分成对照组和护理干预组,每组44例,并对所有患者实施医疗护理,给予对照组按照常规方法进行治疗及护理,护理干预组则在常规护理的基础上实施优质护理干预;对两组患者的生活质量改善情况加以观察。结果：护理干预组的护理有效率为90.91%,对照组护理有效率为79.55%,两组数据差异有统计学意义（P〈0.05）;护理干预组患者的生活质量良好率为86.36%,对照组则为70.45%,差异有统计学意义（P〈0.05）。结论：对老年高血压患者实施优质护理,可有效的提高患者的治疗依从性,使临床症状得到改善,有力的促进了患者生活质量的提高。     

Distinguishing between quality of life and health status in quality of life research: A meta-analysis

Despite the increasing acceptance of quality of life (QOL) as a critical endpoint in medical research, there is little consensus regarding the definition of this construct or how it differs from perceived health status. The objective of this analysis was to understand how patients make determinations of QOL and whether QOL can be differentiated from health status. We conducted a meta-analysis of the relationships among two constructs (QOL and perceived health status) and three functioning domains (mental, physical, and social functioning) in 12 chronic disease studies. Instruments used in these studies included the RAND-36, MOS SF-20, EORTC QLQ-30, MILQ and MQOL-HIV. A single, synthesized correlation matrix combining the data from all 12 studies was estimated by generalized least squares. The synthesized matrix was then used to estimate structural equation models. The meta-analysis results indicate that, from the perspective of patients, QOL and health status are distinct constructs. When rating QOL, patients give greater emphasis to mental health than to physical functioning. This pattern is reversed for appraisals of health status, for which physical functioning is more important than mental health. Social functioning did not have a major impact on either construct. We conclude that quality of life and health status are distinct constructs, and that the two terms should not be used interchangeably. Many prominent health status instruments, including utility-based questionnaires and health perception indexes, may be inappropriate for measuring QOL. Evaluations of the effectiveness of medical treatment may differ depending on whether QOL or health status is the study outcome.     

Measuring health related quality of life among women living with HIV

Although women had been under recognized in the literature on HIV/AIDS, increasing numbers of studies have focused on the lives and experiences of women living with HIV/AIDS. Areas of research in which the study of women and HIV continues to be noticeably lacking include health related quality of life (HRQOL). This paper describes HRQOL in an inner city sample of 287 HIV positive non-pregnant women, interviewed as part of a larger multi-site CDC funded study of the reproductive health of women. The average age of the respondents was 33 years and women had known their HIV status an average of 41 months. HRQOL was assessed using a 17-item modified version of the Medical Outcomes Study-HIV Health Survey and demonstrated acceptable internal consistency (0.64-0.89) and variability. Women in our study were similar to other HIV-positive female samples and reported lower levels of well-being and functioning than some HIV-positive male samples. Women's responses to individual items and areas of potential need for health care are discussed. Examination of HRQOL in women with HIV can aid in the comparison of how women and men are affected by HIV and can help health care professionals identify needed services and include possible interventions to promote quality of life. This revised version was published online in June 2006 with corrections to the Cover Date.     

ＨＩＶ 感染者／ＡＩＤＳ患者的生存质量及其影响因素分析

摘要：目的　了解ＨＩＶ 感染者／ＡＩＤＳ患者的生存质量及其影响因素,更好的预防和控制艾滋病。方法　于
２０１２年４月至２０１３年４月对２２９例ＨＩＶ 感染者／ＡＩＤＳ患者使用ＭＯＳ ＨＩＶ 生存质量表和社会支持度量表
进行面对面调查。结果　生存质量得分为６８．６４±１１．７６,其中ＨＩＶ 感染者７１．３１±１０．１０、已达到服药阶
段的ＨＩＶ 感染者６５．５９±１３．４９、ＡＩＤＳ患者６６．５２±１２．１０,差异有统计学意义;ＨＩＶ 感染者、已达到服药
阶段的ＨＩＶ 感染者和ＡＩＤＳ患者的得分在社会功能、疼痛、精力和情绪功能差异有统计学意义。ＨＩＶ 感染
者／ＡＩＤＳ患者的社会支持度得分为４６．３２±１２．４８, 其中ＨＩＶ 感染者４６．９１±１２．７６、已达到服药阶段的
ＨＩＶ 感染者４５．１２±１２．２１、ＡＩＤＳ患者４６．２６±１２．３２。多因素分析表明生存质量跟年龄、民族、有否其他
慢性疾病和社会支持度有关。结论　要更加重视ＨＩＶ 感染者／ＡＩＤＳ患者在感染ＨＩＶ 的同时是否还有其他
慢性疾病和其社会支持情况,切实提高ＨＩＶ 感染者／ＡＩＤＳ患者的生存质量。
关键词：ＨＩＶ;生存质量;因素
中图分类号：Ｒ５１２．９１　　文献标识码：Ａ　　文章编号：１００９ ６６３９ （２０１４）０５ ０４６９ ０４     

跨性别女性的特征及艾滋病相关知识行为调查

目的 了解跨性别女性(male-to-female,MTF)的性别特征、对艾滋病知识的知晓情况及其艾滋病相关行为状况。方法 2014年在济南市采用滚雪球法招募MTF进行问卷调查,采用描述性流行病学的方法分析该人群的艾滋病知识知晓情况及其相关行为状况。结果 共调查了55名MTF,均为生理性别男性,心理性别女性,性别冲突比较严重的27人(占49.1%),非常严重的8人(占14.5%)。以男性装扮从事社会生活的30人(占54.5%),以女性装扮从事社会生活的25人(占45.5%)。艾滋病基本知识平均知晓率为57.9%(22/38),对于该人群常见的多性伴、肛交等艾滋病相关的性行为知识了解很少。对于恋人或性伴的选择、交往过的恋人或发生性行为的对象、最近一次发生性行为的对象,选择男性的分别占58.2%(32/55)、50.9%(28/55)、63.6%(35/55)。最近一次发生性行为的对象为偶然性伴(网友和一夜情伴侣)的占56.3%(31/55)。性行为时从不使用安全套者18人(占32.7%),偶尔使用的29人(占52.7%),经常使用的4人(占7.3%),每次都用的4人(占7.3%)。结论 MTF人群中艾滋病知识匮乏,无保护性接受性肛交行为普遍存在,多性伴、性生活频繁、安全套使用率低。该人群为艾滋病高危人群,亟需开展针对该人群的艾滋病干预预防措施。     

The WHO quality of life assessment instrument (WHOQOL-Bref): The importance of its items for cross-cultural research

One of the fundamental issues in the area of assessment of quality of life is to determine what is important to the individuals' quality of life. This is even more crucial when the instrument is for use in diverse cultural settings. This paper reports on the importance ratings on WHOQOL-Bref items obtained as a part of WHOQOL pilot field trial on 4804 respondents from 15 centres from 14 developed and developing countries using 12 languages. All items were rated as moderately or more important, but this was expected because the items were selected by extensive qualitative research for their salience across the centres. Significant differences on mean importance ratings were found between centres, but rank orders of item for their importance showed highly significant correlations between centres. This was especially true for items in the top and the bottom thirds of the item list arranged by overall importance. Most items were rated as more important by women compared to men and by younger compared to older persons. The results are discussed for their relevance in cross-cultural research on quality of life assessment. This revised version was published online in June 2006 with corrections to the Cover Date.     

高效抗逆转录病毒治疗对云南省艾滋病病人生命质量影响研究

目的 探讨高效抗逆转录病毒治疗(HAART)对云南省艾滋病病人生命质量的影响.方法 采取典型抽样的方法,选择1个省级、2个州级、5个县级抗病毒治疗医院作为研究现场,选择在2009年4月以前在8个研究现场入组并接受抗病毒治疗的艾滋病病人作为研究对象,使用中文版SF-36量表和自编基本情况调查表对研究对象进行横断面调查,统计结果与国内同类研究结果进行比较.结果 ①1 194名调查对象SF-36量表8个领域百分转换得分中以躯体功能(PF)得分最高,为(86.00±18.48)分,总健康(GH)得分最低,为(44.37±21.59)分,领域间得分差异有统计学意义(P＜0.01).②1 194名接受抗病毒治疗病人SF-36量表8个领域得分均明显高于普通的(未接受抗病毒治疗)HIV感染者/AIDS病人(P＜0.01),但仍明显低于正常人群(P＜0.01).结论 云南省艾滋病患者接受抗病毒治疗后,生命质量得到明显提高,但仍低于正常人群.     

A reformulation of quality of life for medical science

Current quality of life measuring tools are suited for economic decision making, not to investigate causal processes which lead to patients making evaluations of their lives. An alternative approach is presented based on research into positive versus negative life-satisfaction. Quality of life is a causal sequence of psychological states where perceived symptoms cause problems and the problems and symptoms cause evaluations, and where the causal sequence is a complex interaction between morbidity and psychological factors. Different types of medical intervention affect different stages in the causal sequence and so different types of quality of life instrument are needed for different kinds of medical research.     

Measurement accuracy in assessing patient’s quality of life: to weight or not to weight domains of quality of life

Purpose  Health-related quality of life (HRQOL) measures typically do not incorporate patients’ preferences for domains such as physical, emotional, functional and social/family well-being, which may compromise precision. Method  A forced-choice domain-preference measure was developed to assess the importance of HRQOL domains. About 194 cancer patients completed the domain-preference measure, along with measures of HRQOL, coping, adjustment, and life satisfaction. Results  Patients ranked emotional well-being as most important and the loss of social-family well-being as the most difficult to do without. A weighting algorithm revealed no advantage to incorporating individuals’ domain preferences in HRQOL assessment; however, preliminary evidence suggested that HRQOL measurement may be more accurate in predicting outcomes for individuals with no distinct domain preferences than those with distinct preference profiles. Conclusion  This study provides preliminary evidence for the validity of current measures of HRQOL, which may inherently take into account patients’ domain preferences.     

Psychological acceptance and quality of life in the elderly

Many changes occur as people enter old age (e.g., declining productivity), and these changes may at times decrease quality of life. Do some people maintain high subjective quality of life despite these changes? This study investigated the influence of psychological acceptance (PA) on quality of life in a sample of 187 elderly from a home nursing service, a retirement village and various community groups. Average age was 78 years old with a range from 65 to 96. We administered a measure of psychological acceptance and The Comprehensive Quality of Life Scale (COMQol). As hypothesised, people higher in PA also had higher quality of life in the areas of health, safety, community participation and emotional well-being. In addition, individuals high in PA had less adverse psychological reactions to decreasing productivity. Interventions that increase PA may lead to improved quality of life and resilience amongst the elderly.     

河南省农村地区HIV/AIDS生存质量及影响因素调查

目的 调查HIV感染者生存质量及影响因素.方法 使用中文版WHOQOL-BREF量表,对驻马店市农村地区2608例HIV感染者进行问卷调查,计算生存质量总分及各领域得分,通过多元线性回归模型分析生存质量总分及生存质量各领域得分的影响因素.结果 HIV感染者生存质量得分为生理领域(12.96±1.94)、心理领域(11.79±1.19)、社会领域(13.79±2.44)、环境领域(12.40±1.93)、生存质量总得分(51.02±6.03).女性生存质量总分及生存质量各领域得分均高于男性.经多元线性回归模型分析得出生存质量影响因素有性别、年龄、职业、家庭纠纷及食欲等.结论 该地区HIV感染者生存质量社会领域得分较高,但心理领域得分较低,建议加强对该人群的心理干预.