聚乙二醇干扰素α-2a治疗慢性丙型肝炎患者生活质量的研究

目的 评价聚乙二醇干扰素α-2a对慢性丙型肝炎患者生活质量(QOL)的影响.方法 对干扰素治疗前的慢性丙型肝炎患者(A组102例)和健康对照人员(B组44例)进行生活质量综合评定问卷-74 (GQOLI-74)测定,比较两组QOL状况.A组患者中,分别给予聚乙二醇干扰素α-2a及利巴韦林治疗1年(A1组72例)或不进行任何抗病毒治疗(A2组30例).分别在治疗结束时及治疗结束半年后对各组患者进行GQOLI-74量表测定,比较A1和A2组患者各时段QOL差异.结果 A组患者QOL状况除心理功能(P＞0.05)外,GQOI-74量表中其他维度及总分均较B组下降(P值均＜0,05).无论干扰素治疗结束时还是治疗结束后半年时,A1组患者躯体功能、心理功能、社会功能维度及总分值均高于同期的A2组患者(P值均＜0.05).治疗结束时,A1组患者躯体功能、心理功能、社会功能维度及总分值均较治疗前高(P值均＜ 0.05);治疗结束半年后,A1组患者社会功能维度较治疗结束时高(P＜0.05).结论 慢性丙型肝炎患者的QOL低于健康对照人员,聚乙二醇干扰素α-2a可以改善慢性丙型肝炎患者QOL.     

老年初诊肺癌住院患者生活质量现状调查

目的调查老年初诊肺癌住院患者生活质量(QOL)现状,分析其影响因素。方法分析老年初诊肺癌患者QOL各维度间相关性、一般资料与各维度的相关性,同时对QOL影响因素进行多元线性回归分析。结果老年初诊肺癌患者总体健康状况与躯体因素、情绪功能和社会功能呈显著相关(P<0.05);年龄与躯体因素呈负相关、文化程度和身体状态与总体健康状况呈正相关。结论老年初诊肺癌患者QOL取决于躯体功能、心理状况和社会环境,年龄、身体状态、经济状况和文化程度等也会影响其QOL。     

社会支持对老年类风湿关节炎患者生活质量的影响

目的 通过对老年类风湿关节炎(RA)患者的生活质量(QOL)和社会支持调查数据分析,为有效改善患者QOL措施的制定提供依据.方法 对老年RA患者82例进行WHOQOL-BREFQOL和社会支持量表调查.结果 病程＞1年的患者的躯体健康、心理功能、环境以及QOL总评分明显低于病程≤1年的(P＜0.05);病程＞1年的患者的主观支持、支持利用及社会支持总评分明显低于病程≤1年的(P＜0.05);社会支持项目中的主观支持与QOL领域中的环境和心理功能呈正相关(r=2.661、1.780;P＜0.05);支持利用与心理功能和躯体健康呈正相关(r=1.647、3.235;P＜0.05).结论 社会支持对于老年RA患者QOL的改善有重大意义.     

社区良性前列腺增生症患者生活质量及影响因素分析

目的了解社区良性前列腺增生症(BPH)患者的生活质量(QOL)以及存在的影响因素。方法本研究从社区干预及整体护理的角度,采用自编的BPH患者QOL量表(BPHQLS)、国际前列腺症状评分(IPSS),以回答问题并记分的形式进行分析,对BPH患者的生存质量进行全面评价,从而了解BPH患者的QOL,以及影响其QOL的生理、心理、社会和环境方面的因素。结果 BPH患者组疾病、生理、心理3个维度得分及总分显著低于非患者组(P<0.01),而社交因素在两组之间无显著性差异(P=0.200)。结论社区老年前列腺疾病患者QOL与疾病本身及心理、生理方面存在相关性,通过有效干预可以为BPH患者提供科学的诊疗和护理。     

老年肝硬化患者生存质量状况及相关因素

目的 评价老年肝硬化患者生存质量(QOL)状况及其相关影响因素.方法 采用QOL调查问卷对老年肝硬化患者QOL状况进行评价;运用单因素分析和多元逐步回归方法分析相关影响因素.结果 老年肝硬化患者QOL总评分明显低于健康人(P＜0.05);与老年肝硬化患者QOL相关的因素包括肝硬化分级、乏力、病程、腹胀或腹水、纳差或便秘、情绪稳定性、社会支持、心理健康和婚姻状况;通过多因素回归分析结果显示,病程、肝硬化分级、不适症状、社会支持度和情绪稳定性是影响患者QOL的关键因素.结论 通过加强规范治疗,认真开展健康教育,争取全面的社会支持,给予老年肝硬化患者更多的心理帮助,能提高其QOL.     

影响尿毒症患者生存质量的因素及对策

目的　了解尿毒症患者生存质量及其影响因素 ,探讨相关对策。方法　采用生活质量综合评定问卷— 74及自行设计的影响因素调查表 ,对 12 6例尿毒症患者 (观察组 )及 12 6例随机选择的一般内科疾病患者 (对照组 )进行调查评定分析。结果　观察组患者的总体生存质量及躯体功能、心理功能、社会功能、物质生活均较对照组差 ,其中以躯体功能、社会功能和物质生活对其生存质量的影响较大 (P<0 .0 1)。结论　尿毒症患者的生存质量较差 ,应采取相应护理干预措施。     

312例老年肺炎患者生存质量及其影响因素分析

目的探讨老年肺炎患者生存质量(QOL)状况及影响因素的关系。方法采用世界卫生组织QOL测定量表简表对312例老年肺炎患者的QOL进行测量,运用单因素Kruskal-W allis检验和多元逐步回归等统计方法对相关影响因素进行分析。结果老年肺炎患者QOL水平较低,各领域得分依次为社会关系领域(58.33分)、环境领域(56.25分)、心理领域(54.17分)、生理领域(46.43分)。性别、年龄、文化程度、婚姻状况、病程、吸烟史、有害气体、合并疾病、食欲、家庭满意度,自身评价及中医证候等因素对患者的QOL均有显著影响。结论尽早对危险因素进行干预,如戒烟、预防感冒、积极治疗基础疾病、对患者的精神健康给予足够的重视等,有助于提高患者的QOL。     

一侧全肺切除术后肺癌患者生命质量及影响因素分析

目的 探讨一侧全肺切除术后,肺癌患者生命质量(QOL)状况及影响因素.方法 对一侧全肺切除术后6～18个月的肺癌患者,采用SF-36量表和自制量表进行调查.采用t检验、秩和检验和逐步回归进行统计分析.结果 一侧全肺切除术后,肺癌较非肺癌患者的QOL差.QOL受咳嗽、疼痛、性别、城市与农村、年龄等因素影响较大.结论 一侧全肺切除术后肺癌患者近期QOL下降.改善呼吸功能和心理行为干预,可改善躯体功能,减轻心理压力,提高QOL.     

强直性脊柱炎患者生存质量及其影响因素

采用SF-36量表对148例强直性脊柱炎(AS)患者身心健康状态等8个方面进行评分,并分析各个方面与患者生存质量(QOL)的关系.结果As患者总体健康状况、躯体疼痛、躯体功能及社会功能等8个方面SF-36量表评分均较低,且均对患者QOL具有重要影响.认为对影响As患者QOL的影响因素积极采取干预措施十分必要.     

老年甲状腺肿瘤患者术后生活质量及其影响因素

目的评价老年甲状腺肿瘤患者术后生活质量(QOL)及其相关影响因素。方法采用QOL调查问卷评价老年甲状腺肿瘤患者QOL;运用单因素分析和多元逐步回归方法分析相关影响因素。结果老年甲状腺肿瘤患者术后QOL总评分明显低于健康人(P<0.05),其中社会功能、情绪功能和心理健康三个方面差异显著(P<0.01);与老年甲状腺肿瘤患者术后QOL相关的因素包括刀口区疼痛、吞咽不畅、失眠、食欲丧失、情绪、社会支持、心理健康等;通过多因素回归分析结果显示,患者术后疼痛程度越低,社会支持度高、心理健康程度高、没有吸烟、饮酒等不良生活习惯者QOL状况越好。结论通过加强规范治疗,改善患者疾病困扰,避免疾病恶化;争取全面社会支持,帮助患者进行精神疏导,改善负面情绪不良生活习惯等多途径,帮助其提高术后QOL。     

中国七省市慢性阻塞性肺疾病患者的生命质量现况调查

目的 评估COPD患者的牛命质量及其影响因素.方法 2002-2004年对北京、上海、广东、辽宁、天津、重庆和陕西等7个地区城乡40岁及以上人群进行COPD横断面调查,对入选的20245人进行问卷调查和肺功能检测,采用12个条目的 简短生命质量量表(SF-12)评估生命质量,支气管舒张试验后FEV1/FVC＜70%者诊断为COPD.SF-12评分经秩转换后采用一般线性模型分析比较各组间的差别.采用多因素逐步线性同归分析方法 分析影响生命质量的因素.结果 与非COPD患者相比,COPD患者的生命质量下降,心理成分评分分别为(56±7)分和(57±6)分,躯体成分评分分别为(46±9)分和(50±6)分,差异均有统计学意义(F值分别为4.442和453.960,P＜0.05和P＜0.01).COPD患者的心理成分评分主要受气促严重程度、体重指数、合并疾病、性别和居住在城乡的影响;COPD患者的躯体成分评分主要受气促严重程度、合并疾病、性别、COPD分级、职业粉尘烟雾暴露史、年龄、文化程度和既往诊断COPD的影响.结论 COPD患者的生命质量下降,并与气促和疾病严重程度、体重指数和合并疾病密切相关.改善气促症状,加强营养支持,减少合并疾病,远离危险因素的暴露可以改善COPD患者的生命质量.     

社区慢性心力衰竭患者生存质量及其影响因素分析

目的了解太原市某社区慢性心力衰竭患者的生存质量现状及其影响因素,为社区医疗机构管理慢性心力衰竭患者提供理论依据。方法采用自设一般资料问卷、明尼苏达心力衰竭生存质量问卷,对太原市某社区116例慢性心力衰竭患者进行测评并分析其影响因素。结果社区慢性心力衰竭患者的生存质量总分为39.13分±25.28分,与上海市普通门诊的心力衰竭患者的生存质量相比,总体生存质量较低;社区心力衰竭患者中女性、性格不开朗、有家族史者、在职的患者,由配偶以外的子女或他人照顾者、运动量越少、用药种类越多,患者生存质量越差。结论太原市社区慢性心力衰竭患者的总体生存质量较上海市普通门诊的心力衰竭患者低,其生存质量受性别、性格、家族史、照顾者、运动、用药种类、职业状况的影响,应针对不同影响因素在社区开展多学科合作的综合管理,以提高其生存质量。     

Impact of chronic obstructive pulmonary disease on respiratory status and quality of life in newly diagnosed patients with lung cancer

OBJECTIVE AND BACKGROUND: A significant proportion of patients with lung cancer have associated COPD, which is considered an independent risk factor and cause of morbidity and mortality. However, the effect of COPD on respiratory status and quality of life in lung cancer has not been evaluated. METHODS: Newly diagnosed patients with lung cancer were assessed at diagnosis before starting treatment, for detailed respiratory status, spirometry and World Health Organization-Bref Quality of Life questionnaire in Hindi (WHOQOL-Bref Hindi). RESULTS: One hundred and sixty patients were studied. Spirometry was abnormal in 92.7% patients, 42% had COPD, and the majority (88.6%) had advanced disease (stage III and IV). Patients scored poorly in all QOL domains, with social domain faring worst. Karnofsky Performance status (KPS) correlated significantly with all QOL domains. No significant differences were found in clinical profile, KPS, or QOL scores between patients with and without COPD. Chest pain and dyspnoea severity (assessed by Medical Research Council) grading and visual analogue scale correlated with physical QOL domain. CONCLUSION: Patients with lung cancer have a poor QOL that is affected by the severity of respiratory profile and KPS. The presence of COPD does not significantly affect QOL in lung cancer patients.     

Effect of pulmonary rehabilitation on quality of life in patients with COPD: the use of SF-36 summary scores as outcomes measures

PURPOSE: Pulmonary rehabilitation (PR) is an accepted therapy for patients with chronic obstructive pulmonary disease (COPD), improving both exercise capacity and quality of life (QOL). Generic measures of QOL have been criticized as being insensitive to detecting the improvement in QOL after PR in contrast to disease-specific instruments. The authors looked at the Medical Outcomes Survey Short Form 36-item questionnaire (SF-36), a generic QOL measure, to detect changes in QOL in COPD patients after completion of PR. METHODS: Patients with COPD who participated in a PR program completed the QOL questionnaire before and after completion of PR. Exercise tolerance was assessed by the 6-minute walking test. Quality of life was assessed by the SF-36; the authors calculated its eight dimensions as well as mental (MCS) and physical (PCS) component summary scores. RESULTS: The patients realized a significant improvement in exercise tolerance; 6-minute walking test distance increased from 470 +/- 104 m (mean +/- standard deviation) to 536 +/- 133 m (P = 0.0006) after PR. Quality of life also improved in nearly all dimensions and in both summary scores; PCS improved from 26.1 +/- 8.0 before PR to 30.5 +/- 9.0 after PR (P = 0.008) and MCS improved from 27.9 +/- 7.0 before PR to 34.1 +/- 5.0 after PR (P = 0.0002). CONCLUSION: The SF-36 and its summary scores are sensitive instruments to detect improvement in QOL in COPD patients after PR.     

肥厚型心肌病患者的生活质量及其影响因素

目的 研究肥厚型心肌病（hypertrophic cardiomyopathy,HCM）患者的生活质量及其影响因素,为综合防治提供依据。 方法 连续纳入 150例HCM 患者,同期选取150例年龄和性别匹配的健康对照者,采用36 条目健康调查简表（36-item short-form health survey,SF-36）评估患者的生活质量,同时收集患者的临床资料及超声心动图指标,然后通过多元线性回归分析其影响因素。 结果 HCM患者在SF-36的生理功能、生理职能、躯体疼痛、一般健康状况、精力、社会功能、情感职能和精神健康这8个维度的得分以及生理健康总分、心理健康总分均显著低于正常对照组（P<0.05）。多元线性回归分析显示,年龄≥65岁（β=?0.153,P<0.05）、女性（β=?0.130,P<0.05）、NYHA心功能分级Ⅲ~Ⅳ级（β=?0.213,P<0.01）、左室流出道梗阻（β=?0.418,P<0.01）、合并其它疾病（β=?0.174,P<0.01）、抑郁（β=?0.389,P<0.01）和焦虑（β=?0.176,P<0.05）是HCM患者生活质量下降的独立危险因素。 结论 HCM患者的生活质量全面受损,与人口学因素、临床特征和情绪障碍密切相关。因此,要提高 HCM 患者的生活质量,除了解除左室流出道梗阻、积极治疗合并疾病外,还应根据患者的具体情况有针对性地开展健康教育和心理干预。     

Factors influencing quality of life (QOL) for Korean patients with rheumatoid arthritis (RA)

The aim of the study was to identify factors influencing the health-related quality of life (HR-QOL) for Korean RA patients and factors associated with each dimension of the EQ-5D. Two hundred and twenty-five RA patients were recruited from one University Hospital in Seoul, South Korea. Their clinical and socio-demographic data were widely collected by means of interviews, self-administered questionnaires, and clinical examinations. Multiple logistic regression analyses were performed to determine the factors influencing QOL and factors associated with each dimension of the EQ-5D. The mean EQ-5D utility observed for Korean RA patients was 0.60 (?0.29 to 1.0). Functional disability measured with Health Assessment Questionnaire (OR = 10.0, CI 2.8–34.5), disease activity score (DAS) 28 (OR = 2.6, CI 1.4–4.9), and pain VAS (OR = 2.2, CI 1.2–4.1) was three main factors influencing on QOL of RA patients. Although the functional disability consistently showed significant associations with all dimensions, various factors were associated with the each five specific dimension of EQ-5D. Pain (OR = 2.5, CI 1.4–4.6), history of hospitalization (OR = 2.1, CI 1.0–4.3), and men (OR = 2.6, CI 1.0–6.8) were associated with lower QOL in mobility. Use of alternative medicine (OR = 2.0, CI 1.1–3.7) and disease activity (OR = 3.1, CI 1.7–5.7) were associated with lower self-care QOL. For the patients with discomfort in usual activity, pain (OR = 4.7, CI 2.4–9.2) and the presence of anemia (OR = 2.3, CI 1.2–4.5) were major influencing factors. Higher disease activity (OR = 4.5, CI 1.0–21.2) and pain (OR = 3.3, CI 1.9–5.8) were associated with the pain/discomfort dimension of EQ-5D, and the pain (OR = 3.3, CI 1.9–5.8) was an independent associating factor of anxiety/depression. The strongest determinants of lower QOL in Korean RA patients were functional disability, higher disease activity, and subjective pain. However, various factors are influencing on the QOL for RA patients according to aspects of QOL. It suggested that clinicians should pay more attention to other factors of RA patients as well as clinical remission to improve their QOL.     

Outcomes and health-related quality of life following hospitalization for an acute exacerbation of COPD

OBJECTIVE: The purpose of this study was to understand the outcomes for patients admitted to hospital for an acute exacerbation of COPD, and to determine the factors influencing quality of life and health service utilization of patients with COPD. METHODOLOGY: Hospital outcomes of 282 patients with moderate and severe COPD, for an acute exacerbation, were retrospectively evaluated. After 24 months of follow up, health-related quality of life (QoL) and health service utilization (emergency room (ER) visit and readmission) in 54 patients admitted previously, were surveyed by questionnaires. RESULTS: Of 282 COPD patients admitted for an acute exacerbation, 28 patients (9.9%) died during hospitalization, 241 patients (85.5%) were discharged home, and only 13 patients (4.6%) needed long-term care facilities. Although over 50% of the patients had survived over 2 years after discharge, their QoL was poor. Patients who frequently went to the ER or were admitted, were those with poor QoL, severe dyspnoea and frequent exacerbation. COPD exacerbation and dyspnoea were the main factors influencing QoL of the patients. Age, comorbidity, QoL, FEV1, frequency of COPD exacerbation, long-term oxygen therapy, and family doctor were the factors determining the likelihood of patients visiting the ER. Frequency of COPD exacerbation, family doctor and living alone were the factors determining which patients were likely to be admitted to hospital. CONCLUSION: The outcomes and QoL of patients admitted for an acute exacerbation of COPD were poor. The major factors influencing QoL were frequency of COPD exacerbation and severity of dyspnoea. Improvement of social and medical networks (e.g. reducing the number of patients living alone and providing family doctors for patients) may reduce health care service utilization.     

老年甲状腺功能亢进患者情绪障碍和生活质量调查

目的 对老年甲状腺功能亢进患者情绪障碍及生活质量进行调查,并分析影响其生活质量的因素。方法 选择2022年1月至2023年4月湖北文理学院附属医院襄阳市中心医院收治的134例老年甲状腺功能亢进患者。并对其进行甲状腺激素水平检测和问卷调查,包括基础资料、焦虑自评量表(SAS)、抑郁自评量表(SDS)及简明生活质量量表(SF-36)。采用SPSS 26.0软件进行数据分析。根据数据类型,组间比较分别采用t检验及方差分析。采用Pearson相关性分析患者情绪障碍与生活质量的相关性;采用多因素logistic回归分析老年甲状腺功能亢进患者生活质量的影响因素。结果 本次老年甲状腺功能亢进患者SAS得分为(52.97±4.33)分,SDS得分为(54.89±4.68)分,生活质量得分为(65.25±6.39)分。不同受教育程度、居住方式、家庭人均月收入、游离甲状腺素(FT4)和游离三碘甲状腺原氨酸(FT3)水平的老年甲状腺功能亢进患者生活质量得分比较,差异有统计学意义(P<0.05)。Pearson相关性分析显示,老年甲状腺功能亢进患者生活质量得分与SAS、SDS得分均呈负相关性(r=-0.403、-0.361;均P<0.05)。多因素logistic回归分析结果显示,受教育程度、家庭人均月收入、FT3和FT4水平以及SAS和SDS得分是老年甲状腺功能亢进患者生活质量的影响因素(P<0.05)。结论 老年甲状腺功能亢进患者容易发生情绪障碍,生活质量较低,而受教育程度、家庭人均月收入、FT3和FT4水平以及情绪障碍均是影响其生活质量的重要因素。     

Effect of inhaled anticholinergic drug on pulmonary function and quality of life in elderly patients with chronic obstructive pulmonary disease

Effects of inhaled anticholinergic drug on the physiological function of the respiratory system and quality of life (QOL) in elderly patients with chronic obstructive pulmonary disease (COPD) have not been fully elucidated. We examined the pulmonary function, static respiratory pressures, and ventilation during exercise, before and after inhalation of oxitropium bromide (OTB) in 12 male patients with COPD (mean age 82.1 +/- 0.6 years). QOL was measured with a St George's Respiratory Questionnaire (SGRQ) in the patients. Forced expiratory volume in one second was increased by the inhalation of OTB in the patients, whereas the ratio of residual volume to total lung capacity was decreased by the inhalation. Maximum inspiratory pressure was significantly increased after the administration of OTB. Dyspnea sensation during exercise measured on the Borg scale was reduced by the inhalation of OTB. The scores of SGRQ were improved by one-month treatment with OTB. These results suggest that the treatment with OTB are effective for both physiological function and several aspects of QOL in elderly patients with COPD.     

慢性阻塞性肺疾病患者生命质量评估的临床应用价值及改善措施

慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)具有高患病率及高病死率的特点,很多研究表明COPD患者的生命质量已经受损,目前生命质量作为一项病情评判指标.而外界干预已经对生命质量的很多方面已经显示出积极的影响,例如吸入糖皮质激素、支气管扩张剂,吸氧,肺康复锻炼,施行疾病特异的自我管理计划,肺减容术等.本文综述了COPD患者生命质量评估在临床中的应用价值以及改善生命质量的措施.