下肢静脉曲张患者生活质量量表评价研究

目的 探讨下肢静脉曲张患者生活质量量表有效性.方法 收集河北医科大学第二医院2020年9—12月收治的192例下肢静脉曲张患者临床资料.统计并比较术前及术后3个月患者静脉临床严重程度评分(VCSS)、下肢静脉曲张生活质量相关量表静脉症状调查问卷(HASTI)评分、疾病特异性生活质量调查(AVVQ)评分;比较不同静脉曲张...     

纤维血管镜技术在下肢血管疾病中的应用

世界上第一台血管镜是由Rhea和Walker在1913年首先研制,用在犬的开胸术中观察心脏的“直管金属心脏内镜”。经过90余年的演进过程,血管镜经历了根本的变革,已经逐渐发展到临床应用阶段。光纤纤维血管镜系统由可屈式纤维血管内窥镜（其外径自0．5-4mm不等）,冷光源,冲洗系统,摄、录像系统,电视屏幕显示系统等共同组成,通常由一个集成架将其集装为一体。     

中文版家庭照顾者生活质量量表在居家心衰照顾者中的应用评价

目的翻译中文版家庭照顾者生活质量量表(FAMQOL)并评价其在慢性心衰患者家庭照顾者中的适用性和信效度。方法翻译并形成中文版FAMQOL,对155名居家慢性心衰患者家庭照顾者进行测试,检验量表的信度和效度。结果中文版FAMQOL的内容效度为0.94,与Zarit负担量表的相关系数为-0.71(P<0.01),生理、心理、社会维度与总量表的相关系数为0.82～0.90(P<0.01),总量表Cronbach’sα系数为0.88,重测信度为0.92。不同ADL水平患者的家庭照顾者生活质量存在显著差异(P<0.01)。结论中文版FAMQOL具有较好的信度、效度,适用于心衰患者家庭照顾者生活质量的测量。     

循证干预对2型糖尿病并发下肢血管病变患者生活质量的效果观察

目的 观察循证干预对2型糖尿病并发下肢血管病变患者生活质量的效果.方法 收集2018年11月至2020年11月中国医学科学院北京协和医院收治的108例2型糖尿病并发下肢血管病变患者的临床资料.根据干预方法不同将患者分为对照组和观察组,每组54例.对照组患者采取常规干预措施,观察组患者在常规干预基础上采取循证干预措施,比...     

中文版斜弱视患者生存质量量表的信度和效度检测

目的检测中文版斜弱视患者生存质量量表(Amblyopia and Strabismus Questionnaire,ASQE)的信度和效度。方法通过系统的前译-回译形成中文版ASQE,并对119例斜弱视患者进行测定,对结果进行信度和效度分析。结果中文版ASQE共5个维度26个条目,总量表的Cronbach′sα系数为0.906,重测信度为0.725～1.000,折半信度为0.893。各维度得分和量表总分相关(r=0.576～0.857,均P<0.01),因子分析提取了6个特征根大于1的因子,各条目载荷0.387～0.889,6个因子累积解释了66.697%的变异。结论中文版ASQE具有良好的信度和效度,适合中国斜弱视患者生存质量的测量。     

乳房整形者生活质量测定量表隆乳术模块中文版的应用评价

目的测定评价美国纪念斯隆凯特琳癌症中心（Memorial Sloan Kettering Cancer Cen—ter．MSKCC）和加拿大英属哥伦比亚大学（Universityof British Columbia,UBC）共同开发的乳房整形者生活质量测定量表（BREAST—Questionnaire,BREAST—Q）隆乳术模块中文版的应用效果。方法通过测定10例隆乳者术前2周、术前ld、术后14周、术后16周的生活质量对BREAST—Q量表（隆乳术前、术后）进行评价。结果术前2周隆乳者对乳房的满意度、社会心理状况与性生活状况3个领域的得分分别为（29．9±5．8）、（16．5±10．2）、（28．2±9．3）分。术后16周隆乳者对乳房的满意度、社会心理状况与性生活状况3个领域的得分分别为（65．3±10．0）、（67．5±17．8）、（56．5±22．2）分,与术前相比较,平均得分均相差20分以上,差异有统计学意义（P＜0．05）。但是身体状况的得分在术前2周为（64．9±11．9）分,术后16周为（56．0±14．5）分,差异无统计学意义（P〉O．05）。各领域的重测信度均在0．8以上,并且大部分在0．9以上;所有领域的Cronbach系数a均在0．6以上。结论BREAST—Q量表隆乳术模块中文版具有较好的信度和反应度,可用于中国隆乳者的生活质量测定,值得进一步扩大样本量进行研究。     

中文版HIV/AIDS患者疾病管理自我效能感量表的信效度评价

目的翻译HIV/AIDS患者疾病管理自我效能感量表(HIV-SE),并评价其信效度。方法将HIV患者疾病自我管理效能量表翻译成中文版并对242例接受或准备接受抗病毒治疗的HIV/AIDS患者进行调查。结果中文版HIV-SE总的Cronbach′sα为0.81,各分量表为0.73~0.93。各分量表与总分的相关系数(r)0.62~0.84;因子分析共提取公因子5个,解释总变异的64.89%,少数条目的归属与原量表有差异。结论从整体上看,HIV-SE具有较好的信度和效度,所提取的5个因子能较全面地反映该量表的结构,但在中国应用还需作一定调整。     

痴呆生活质量量表中文版的修订及信效度检测

目的建立痴呆生活质量量表(Dementia Quality of Life,DQoL)中文版,并检测信度和效度,以期为中国痴呆患者的生活质量测评提供有效工具。方法将DQoL翻译成中文,最终形成包括3个测试问题,29个条目,以及1项生活质量总体评价的5级量表。对简易精神状态检查量表(MMSE)筛选的40例轻中度痴呆患者进行生活质量评定,检测量表的信度和效度,并选取22例患者于4周后重测。结果 DQoL中文版Cronbach′sα系数为0.856;重测信度系数为0.726;内容效度指数(S-CVI)为0.986;量表5个维度间的相关系数为-0.133～0.694。结论 DQoL中文版具有较好的信度,效度略低,仍需扩大样本进行更深入的研究。     

下肢慢性动脉缺血疾病的腔内血管外科治疗

下肢慢性动脉缺血性疾病主要为下肢动脉硬化闭塞症所致 ,其次为多发性大动脉炎及血栓闭塞性脉管炎。 1964年 ,Dotter首次成功经腔内血管成形术 (PTA)治疗下肢慢性动脉缺血症。随着影像技术 ,材料工程学之迅速发展 ,血管腔内外科技术 (即可称微创治疗 )在治疗下肢动脉缺血症方面     

16层螺旋CT血管造影在下肢动脉疾病中的应用价值

目的探讨16层螺旋CT血管造影技术(computed tomography angiography,CTA)在下肢动脉疾病中的临床应用价值。方法对103例临床疑有下肢动脉疾病者行CTA检查。扫描层厚5mm,螺距1.15mm,重建层厚1.0mm,重叠30%。造影剂剂量90~100ml,注射速率3ml/s,高压注射器自动触发扫描,扫描时间20~30s,对全部图像进行最大密度投影(maximum intensity projection,MIP)、容积再现技术(volume rendering technique,VRT)、多平面重建(multiplanar reformation,MPR)使下肢血管清晰显示,并对图像进行评价。结果103例血管重建图像显示良好。动脉闭塞64例,动脉狭窄32例,动脉瘤4例,3例未见异常。40例行手术治疗,术中所现与CTA结果完全一致。结论16层螺旋CT血管造影能清晰地显示下肢动脉及其病变,可以成为下肢动脉疾病术前评价和筛选的主要方法。     

Validation of “Wound QoL” Hebrew version disease‐specific questionnaire for patients with lower extremity ulcerations

The slow healing process and high recurrence rate of lower extremity ulcerations (LEU) impose a considerable medical and economic burden and affect quality of life (QoL). Analyses of LEU‐related QoL in Israel are limited due to lack of a validated Hebrew disease‐specific evaluation instrument. The aim of this study was to validate the disease‐specific Hebrew “Wound QoL” questionnaire. The validation of the “Wound QoL” disease‐specific instrument, translated from English to Hebrew, was based on a comparison with the valid Hebrew version of the SF12v.2 health‐related questionnaire. The convenience sample for the “Wound QoL” validation (n = 32) was obtained from patient populations in the Maccabi Health Services’ outpatient clinics at the northern and southern parts of Israel. The study was conducted between June and September 2017. Face/construct validity was accepted by specialists’ consensus. Internal consistency assessed by Cronbach's α was .893. Concurrent validity reflected by Pearson's correlations between the tools was in the range of 0.830 to 0.950. The Wound QoL Hebrew version is a valid and reliable instrument suitable for implementation in an Israeli cultural environment.     

Psychometric evaluation of the Wound-QoL questionnaire to assess health-related quality of life in Chinese people with chronic wounds

Chronic wounds are very common wound types in clinics which have a prolonged and painful healing process. Chronic wounds affect health-related quality of life (HRQoL) on patients. However, there is no specific instrument to measure the HRQoL in Chinese patients with chronic wounds. Wound-QoL is a questionnaire targeted the experience of health-related life to patients with chronic wounds. The study aims to translate and cross-culturally adapt the Wound-QoL into Chinese and to evaluate its psychometric properties (validity, reliability, floor, and ceiling effect) in a convenience sample of 203 Chinese outpatients with chronic wounds. Reliability was good, with internal consistency of 0.798–0.960 and test–retest reliability of 0.720–0.838. Criterion-related validity was assessed by the correlation coefficient between Wound-QoL and generic European QoL instrument- EQ-5D-5L, which was found statistically significant (P<.001). No signs of floor or ceiling effect could be detected. Further, confirmatory factor analysis (CFA) was used to verify the reliability and validity of the instrument in this study. In conclusion, the Chinese Wound-QoL is a valid and reliable tool for measuring HRQoL in populations with chronic wounds.     

中文版胃肠神经内分泌肿瘤患者生活质量量表的信效度评定

目的验证中文版胃肠神经内分泌肿瘤患者生活质量量表(QLQ-GI.NET21)的信度及效度。方法在征得欧洲癌症治疗研究组织同意后,获得原始量表。邀请国内6名医护专家对量表内容进行评分,计算内容效度。应用癌症患者生存质量核心量表(QLQ-C30)和QLQ-GI.NET21分别对235例胃肠神经内分泌肿瘤患者进行问卷调查。并于2周后随机抽取60例进行再次问卷调查。结果共回收有效问卷220份,46例完成2周后的重测。QLQ-GI.NET21总量表内部一致性信度0.913;重测信度为0.899;内容效度指数为0.889;与QLQ-C30量表总分的相关性为0.417(P0.01),探索性因子分析提取出5个公因子,累积贡献率63.10%,具有良好的结构效度。该量表各条目有良好的区分度(P0.05)。结论中文版QLQ-GI.NET21量表具有良好的信效度,可用于胃肠神经内分泌肿瘤患者生活质量的测评。     

Quality of life and peripheral arterial disease

Peripheral arterial disease (PAD) is a common disease entity with the potential to cause considerable impairment in the quality of life (QoL) of millions of Americans. As there is no exact cure for PAD, thus representing a chronic illness, the goal of treatment is disease management including the prevention of cardiovascular events, and improving QoL by helping people with PAD live productive and satisfying lives. Disagreement exists between patients' clinically inferred QoL status and their perceptions of QoL exist concerning PAD. Whereas a clinician may be concerned with a physiological or anatomical abnormality that may ultimately lead to disease and discomfort, a patient may be more concerned with their overall sense of QoL, which is only in part related to their clinical health status. Thus, to truly understand the outcomes of PAD and its treatment, it is necessary to supplement the traditional clinical outcome measures with information from the patient point of view. In this article, we review measurement instruments available to assess patient-reported QoL, and discuss the potential these tools have for providing accurate and meaningful information to complement traditional clinical outcome data.     

The Scoliosis Research Society-22 questionnaire adapted for adolescent idiopathic scoliosis patients in China: reliability and validity analysis

Study design Outcome investigation to verify the internal consistency, reproducibility and validity of the adapted Chinese version of the Scoliosis Research Society-22 (SRS-22) questionnaire for measuring health-related quality of life (HRQoL) in children with idiopathic scoliosis. Objective To develop this questionnaire for the outcome measurement in treating Chinese adolescents with idiopathic scoliosis and evaluate its metric qualities. Summary of background data The SRS-22 questionnaire has proven to be a valid instrument for clinical assessment of patients with idiopathic scoliosis and has been successfully translated into Spanish and Turkish. In most developing countries, however, quality of life and psychological health have been poorly described when treating children with idiopathic scoliosis. Methods Trans-cultural adaptation of the SRS-22 questionnaire was carried out according to the International Quality of Life Assessment Project guidelines. The final version was approved by a committee of experts. The questionnaire was completed by 86 adolescents with idiopathic scoliosis who had been treated with a brace; this included 11 males and 75 females, aged from 10 to 18 years (mean 13.9 years). Curve magnitude ranged from 25° to 45° (mean 35.6°). A subgroup of 30 patients completed the questionnaire again in 3 or 4 weeks. Results Five common factors were acquired from factorial analysis, and the cumulative contribution ratio was 67.66%. The overall alpha coefficient of the questionnaire was 0.88. Coefficients for individual domains were as follows: function/activity, 0.70; pain, 0.80; self-image, 0.80; mental health, 0.88; and satisfaction, 0.81. The questionnaire as a whole had a test–retest correlation coefficient of 0.97. Test–retest correlation coefficients for individual domains were as follows: function, 0.85; pain, 0.96; self-image, 0.96; mental health, 0.95; and satisfaction, 0.91. Conclusion The Chinese version of the SRS-22 questionnaire is eligible in terms of reliability and validity, and can be used to measure HRQoL for adolescent idiopathic scoliosis patients in Mainland China. Electronic supplementary material The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

简体中文版罗兰-莫里斯残疾问卷评价城乡腰背痛患者的信度和效度

目的：探讨简体中文版罗兰-莫里斯残疾问卷（SC-RMDQ）在城乡腰背痛患者功能评估中的应用价值。方法2009年4月至2011年4月采用SC-RMDQ、简体中文版Oswestry功能障碍指数（SC-ODI）和视觉模拟量表（VAS）对187例腰背痛患者（城市99例、农村88例）进行问卷调查评估。记录腰背痛发病的主要原因;采用内部一致性分析（显著性水平α）和重复性分析（组内相关系数,ICC）进行可靠性测试,运用Pearson相关分析进行有效性测试。结果农村患者腰背痛主要原因为弯腰（49%）和扭伤（25%）,城市患者为久坐（39%）和震动（18%）。农村、城市腰背痛患者SC-RMDQ显著性水平α和ICC分别为0.883、0.874和0.952、0.949,内部一致性和重复性均良好;农村、城市腰背痛患者SC-RMDQ与SC-ODI评分之间（r =0.841、0.818）、SC-RMDQ与VAS评分之间（r =0.685、0.666）均有显著相关性（P＜0.05）。结论尽管农村与城市患者腰背痛主要原因不尽相同,但SC-RMDQ具有良好的可靠性和有效性,是评估城乡患者残疾的适合方法之一。     

Symptom-specific quality of life in patients with benign prostatic hyperplasia

BACKGROUND: We investigated which factors are most bothersome to preoperative patients with benign prostatic hyperplasia (BPH). METHODS: A total of 423 newly diagnosed patients and 388 preoperative patients with symptomatic BPH were evaluated. International prostate symptom score (IPSS) and IPSS quality-of-life (QOL) assessment score were used for assessment of symptoms and symptom-specific QOL of the patients with BPH. Uroflow variables were measured in all patients. Other objective variables such as prostate volume, transition zone volume, Schaefer's obstruction grade, and detrusor pressure at maximal urinary flow were evaluated in 209 preoperative patients. We analyzed the relationships between symptom-specific QOL and other variables. Statistical analyses were performed using Spearman's correlation coefficient and a stepwise linear regression model. RESULTS: Symptom-specific QOL scores had moderate to good correlation with IPSS (P < 0.0001; r = 0.525-0.560). Filling symptom subscore had a slightly greater impact on symptom-specific QOL than voiding subscore in both groups of patients. Weak stream, feeling of incomplete emptying, and nocturia significantly decreased symptom-specific QOL in both groups of patients. While newly diagnosed patients suffered from frequency as well, urgency had the strongest impact on symptom-specific QOL of preoperative patients. Objectively measurable variables had no association with symptom-specific QOL. CONCLUSION: Japanese patients with BPH generally suffer from weak stream, feeling of incomplete emptying, and nocturia in all disease phases. Frequency is problematic for newly diagnosed patients and urgency is problematic for preoperative patients as well. Symptom-specific QOL of BPH patients cannot be estimated by physically measurable variables.     

成人特发性脊柱侧凸患者SRS-22简体中文版问卷评分的影响因素分析

目的:探讨临床及影像学参数对成人特发性脊柱侧凸患者脊柱侧凸研究协会22项(SRS-22)量表简体中文版问卷评分的影响.方法:2008年1月～2012年12月109例无支具及手术治疗史的成人特发性脊柱侧凸患者接受SRS-22简体中文版的问卷调查.男17例,女92例;年龄19～40岁,平均24.8岁.冠状面主弯Cobb角16°～102°,平均37.3°.分析SRS-22各维度得分及亚总分与年龄、体重指数、主弯Cobb角及矢状面平衡间的相关性,并分别比较年轻(＜30岁)与年长(≥30岁)、小角度(Cobb角＜40°)与大角度(Cobb角≥40°)、胸弯与胸腰/腰弯以及男性与女性患者间SRS-22评分差异.结果:年龄与SRS-22亚总分、疼痛、心理状况及功能维度得分负相关(r分别为-0.35、-0.50、-0.31、-0.21,P＜0.05);体重指数与疼痛得分负相关(r=-0.23,P＜0.05);主弯Cobb角与SRS-22亚总分、自我形象及功能维度得分负相关(r分别为-0.31、-0.49、-0.30,P＜0.05);矢状面平衡与功能维度得分负相关(r=-0.26,P＜0.05).年长患者SRS-22亚总分、疼痛及心理得分低于年轻患者(P＜0.05).大角度患者SRS-22亚总分、自我形象及功能维度得分低于小角度患者(P＜0.05).胸弯患者自我形象及心理维度得分低于胸腰/腰弯患者(P＜0.05).女性患者的疼痛维度得分明显低于男性(P＜0.05),其余参数及得分无统计学差异.结论:年龄、侧凸Cobb角、体重指数、躯干矢状面平衡可影响成人特发性脊柱侧凸患者SRS-22简体中文版问卷不同维度得分.胸弯患者自我形象及心理受侧凸的影响较腰弯患者更大,女性患者对疼痛的耐受性低于男性.     

Health-related quality of life in adult patients with esophageal atresia--a questionnaire study

Background/Purpose

Long-term sequelae caused by associated anomalies or respiratory and gastrointestinal disorders are common after the repair of esophageal atresia (EA). The aim of this study was to assess the effect of these sequelae on the health-related quality of life (HRQoL) of patients with EA.

Methods

A questionnaire including a 36-item Gastrointestinal Quality of Life Index, a 15-item Respiratory Symptoms-Related Quality of Life Index, and a 36-item psychosocial survey and a symptoms query was sent to 159 patients with EA with or without tracheoesophageal fistula (TEF), who were operated on between 1949 and 1979, and to 400 healthy control subjects. A 36-item Health Survey Form was sent to patients with EA only and the results were compared with values of the general Finnish population.

Results

A total of 128 patients with EA (80%) and 162 control subjects (41%) returned the questionnaire. Median age [patients with EA, 38 (range, 24-54) years; control subjects, 36 (20-56) years] and sex distribution (M/F of patients with EA, 57:70; control subjects, 63:99) were comparable. Of the 128 patients, 115 (91%) had EA with a distal TEF, 8 (6%) had EA without TEF, 3 (2%) had EA with proximal and distal TEF, and 2 (1%) had TEF without EA. The types of esophageal repair were distributed as follows: primary end-to-end anastomosis (n = 112), colon interposition (n = 10), gastric tube (n = 3), thoracic skin tube (n = 1), and fistula closure only (n = 2). Thirty-eight patients had significant associated anomalies. Gastrointestinal Quality of Life Index scores did not differ statistically between patients with EA and control subjects. However, the incidence of regurgitation (17% vs 10%) and dysphagia (10% vs 2%) was significantly higher in patients with EA (P < .5). Low Respiratory Symptoms-Related Quality of Life Index was found in 10 of 128 patients with EA and in 3 of 163 control subjects (P < .05). Psychosocial survey scores and the incidence of acquired diseases did not differ between the groups (P = NS). The 36-item Health Survey Form indicated low HRQoL in 19 (15%) of patients with EA (expected value, 16%). Of the 19 patients with EA with low HRQoL, 8 (42%) had significant congenital or EA-associated diseases and 11 (58%) had acquired diseases. The type of EA or esophageal conduit was not related to HRQoL.

Conclusions

Most adult survivors of EA or TEF repair have a normal quality of life. Morbidity from esophageal functional disorders and respiratory disorders with or without acquired diseases impairs HRQoL in 15% of patients with EA.     

Influencing factors of the quality of life in Chinese burn patients: Investigation with adapted Chinese version of the BSHS-B

Objective

The study aims to evaluate the quality of life (QOL) in burn patients in China and find out principal influencing factors, so as to provide evidence for interventions.

Methods

A total of 271 burn patients in three major burn units in China were asked to fill in the adapted Chinese version (ACV) of the Burn Specific Health Scale-Brief (ACV BSHS-B) in order to seek out the principal influencing factors in combination with a self-designed demographic and disease condition questionnaire. Multivariable linear regression was used to analyse the principal influencing factors.

Results

The findings showed that there were seven principal influencing factors for the overall ACV BSHS-B score. They were: percent total body surface area (TBSA) burned (with the standardised regression coefficient being −0.594), burn area of lower limber (0.241), itch level (−0.227), pain level (−0.220), gender (0.217), mechanical ventilation (0.216) and hand deformity (−0.141).

Conclusion

QOL decreased in burn patients to different degrees depending on the intensity of burns. With a better understanding of influencing factors of burn patients’ QOL, the medical and nursing staff can take specific countermeasures to help patients gain a higher QOL.