Health-related Quality of Life and Virologic outcomes in an HIV Clinic

Objective: The purpose of this study was to describe the relationship between viral load and health-related quality of life (HRQOL) in a cohort of persons with human immunodeficiency virus (HIV) infection. Design: We evaluated HRQOL measurements in a clinical cohort of HIV-positive patients recruited from a university-associated HIV primary care clinic. HRQOL instruments included the medical outcomes survey-short form-36(MOS-SF-36) from which mental and physical component summary scores (MCS and PCS) and subscale scores were calculated. Results: Significant negative associations were found between viral load and SF-36 PCS, physical functioning (PF), role-physical (RP), bodily pain (BP), general health (GH), role-emotional (RE), and vitality (VT). Similar negative associations were found between CD4 cell count and SF-36 summary and subscale scores, with the notable exception of bodily pain. Multivariate analyses controlling for the effects of CD4 cell count and other clinical variables indicated viral load as an independent predictor of SF-36 PCS, RP, BP and VT scores. Conclusions: The relationship between viral load, a measure of HIV disease activity, and several dimensions of the SF-36, a patient-focused measure of HRQOL, appears to be strong and independent of CD4 cell count. These findings suggest that having a lower viral load positively impacts the quality of life of HIV-positive patients. This revised version was published online in July 2006 with corrections to the Cover Date.     

无锡市普通健康人群生命质量评价及影响因素分析

目的评价无锡市普通健康人群的生命质量,分析影响人群生命质量的主要因素,为提高人群生命质量提供参考依据。方法对调查对象的基本情况和生命质量进行问卷调查,评价结果与杭州市、四川省、美国常模比较,用t检验、方差分析和多元线性回归统计方法分析影响生命质量的因素。结果无锡市普通健康人群SF-36评价结果与杭州市、四川省、美国常模比较,在不同领域存在差异,尤以GH、VT、MH三个领域显著;多因素分析结果显示影响无锡市普通健康人群生命质量的主要因素有城乡差别、年龄、性别、精神因素(创伤或压抑)、体育锻炼、吸烟和文化程度7个因素。结论制定了无锡市普通健康人群不同性别及年龄的SF-36评价参考值;影响无锡市普通健康人群生命质量的因素是多方面的,但生活行为方式对其各领域的影响日益突出,应提倡健康的生活方式来提高人群的生命质量。     

Goal Disturbance in Relation to Anxiety,Depression, and Health-related Quality of Life After Myocardial Infarction

Aim of this cross-sectional study, was to examine whether the sudden event of hospitalization for Myocardial Infarction (MI) would lead to a disturbance in the attainment of important higher order or life goals, and secondly, whether goal importance as well as goal disturbance would be related to emotional distress and health-related quality of life (HRQL) shortly (two to five weeks) after the MI. Respondents were 160 patients who were hospitalized for MI. Results indicate that patients experience goal disturbance as a result of their cardiac event. Hierarchical regression analyses showed that independently from demographics, medical characteristics and prior lifestyle, disturbance of important higher order goals was a powerful correlate of anxiety, depression as well as HRQL. Furthermore, the extent to which patients valued higher order goals in their life (goal importance) was an independent correlate of depression. Based on self-regulation theory, we suggest that emotional distress and lower levels of HRQL can be explained in terms of threat to goal attainment. Recommendations for further research and practical implications for rehabilitation programs were formulated.     

Prevalence of Iron Deficiency and Health-related Quality of Life among Female Students

Objective: To investigate prevalence of iron deficiency and examine the relationship between iron status and Health-related Quality of Life among female students.

Design: Cross-sectional study.

Subjects and Setting: Data were collected from 543 female students, aged 17 to 38 years, attending University or secondary schools in Clermont-Ferrand (France) and its metropolitan area. Three groups were defined, according to the rate of serum ferritin: iron deficient (serum ferritin <15μg/L), iron depletion borderline (serum ferritin 15–20 μg/L), and iron replete (serum ferritin > 20 μg/L). Those 3 groups of menstruating female students were compared in terms of health-related quality of life using univariate analysis.

Measures of Outcome: Health-related Quality of Life based on SF-36 questionnaire, and iron status measured by serum ferritin.

Results: The prevalence of iron deficiency was 19.3 %, the prevalence of borderline iron status was 11.4 %. Regarding the SF-36 questionnaire, the only significant difference between iron deficient and iron replete female students concerned the dimension reflecting ‘general health', which was significantly lower in iron deficient group (p = 0.015).

Conclusion: Iron deficiency seems to impair the perceived general health in female students. Further research should be conducted on this little known subject.     

上海居民慢性病与生命质量关系的研究

目的研究上海居民慢性病患病情况及其对生命质量的影响,分析慢性病与生命质量的关系。方法采用随机、分层、多阶段抽样的方法抽取调查对象,运用自填式问卷调查方式对919名居民进行调查,问卷包括调查对象基本情况问卷及SF-36健康调查量表。结果上海居民慢性病患病率达25.14%,其中高血压患病率最高。有慢性病者的SF-36量表各维度得分均比无慢性病者低,而且慢性病数量影响生命质量,慢性病越多生命质量越差。结论慢性病已经成为一个重要的公共卫生问题,严重损害人们的生命质量。     

上海市两个社区糖尿病患者的生存质量及影响因素

[目的]了解社区糖尿病患者的生存质量状况并探讨其影响因素,为采取干预措施及评价提供依据与基线资料。[方法]从上海市浦东新区的2个社区卫生服务中心的糖尿病患者管理库中,用单纯随机抽样法共抽取300人进行面对面调查,应答率为99．0％。问卷调查糖尿病患者生存质量及影响因素,利用多因素非条件logistic逐步回归进行影响因素分析。[结果]社区糖尿病患者生存质量的躯体功能、躯体角色、躯体疼痛、总体健康感、活力、社会功能、情绪角色和精神健康8个维度的得分分别为85、100、87．5、62、75、87．5、100、78分。生存质量的促进因素主要包括已婚、掌握良好的糖尿病相关知识、良好的饮食习惯和运动、血糖水平控制良好及进行健康检查;生存质量的负面因素主要包括年龄大、女性、病程长、患其他慢性病数量、相关症状数量。[结论]糖尿病患者生存质量较低,需要采取综合干预措施进一步改善其生存质量,重点在于改善饮食和运动习惯、积极控制血糖水平、治疗相关合并症或并发症等。     

Risk Factors for Acute Myocardial Infarction in Central India: A Case-Control Study

Background:

Atherosclerosis is a multi-factorial disease involving the interplay of genetic and environmental factors. Studies highlighting the public health importance of risk factors like chronic infections causing acute myocardial infarction (AMI) in the Indian context are scarce. This study was undertaken to study the association of socio-demographic and life-style factors with acute myocardial infarction in central India.

Materials and Methods:

The cases and controls were group-matched for age, gender, and socio-economic status. A blinded research associate administered the study questionnaire. We performed an unconditional multiple logistic regression analysis.

Results:

The case-control study included 265 cases of AMI and 265 controls. The results of final model of logistic regression analysis for risk factors of AMI included 11 risk factors at α = 0.05. They were waist hip ratio, body mass index, stress at home in last 1 year, hypertension, family history of CHD, past history of gingival sepsis, tobacco smoking, raised total serum cholesterol, Chlamydia pneumoniae, Helicobacter pylori and raised C-reactive protein.

Conclusion:

The findings confirm the role of conventional risk factors for cardiac disease and highlight need for research into the association between chronic infections with AMI.     

Time-Restricted Eating Improves Quality of Life Measures in Overweight Humans

Time-restricted eating (TRE) reduces weight in humans, but its effects on quality of life have not been well characterized. By performing a secondary analysis of a randomized clinical trial, we examined the effects of TRE (12-week intervention, 8 h eating window) vs. non-TRE (unrestricted eating) on quality of life (QoL) measures. Twenty subjects with overweight and prolonged eating window (mean (SD): 15.4 h (0.9)) were randomized to either 12 weeks of TRE (8 h eating window: (n = 11)) or non-TRE (n = 9). QoL data were collected with the 36-item Short Form Survey (SF-36) pre- and post-intervention. Given a two-way ANOVA model and post-hoc t-test analysis, the TRE group improved limitations due to emotional health post-intervention: +97.0 (10.0)) vs. baseline: +66.7 (42.2) (p = 0.02) and perceived change in health over the last year end intervention: +68.2 (16.2) vs. baseline: +52.3 (23.6) (p = 0.001) relative to baseline. The TRE group improved limitations due to emotional health TRE: +97.0 (10.0) vs. non-TRE: +55.6 (44.1) (p = 0.05) and perceived change in health (TRE: +68.2 (16.2) vs. non-TRE: +44.4 (31.6) (p = 0.04) relative to the non-TRE group at post-intervention (p < 0.025). In conclusion, 12 weeks of TRE does not adversely affect QoL and may be associated with modest improvements in QoL relative to baseline and unrestricted eating; these findings support future studies examining TRE compliance and durability.     

心电图诊断急性心肌梗死的研究进展

作为一种常见的内科急症,急性心肌梗死会给患者的生命安全带来严重威胁。经过多年的实践和研究,临床医学已经可以证明冠状动脉血供急剧减少或者中断,是导致患者发生急性心肌梗死的直接原因。发病后患者的心肌会在较长时间内处于严重缺血的状态,最终致使心肌出现缺血性坏死,引发急性心肌梗死。从病理角度来说,急性心肌梗死患者的心电图检查结果为进行性的改变,医生完全可以根据心电图检查结果,在短时间内判断患者的病症,以便拿出有效的治疗手段和措施。     

早期心脏康复对急性心肌梗死PCI术患者康复效果的影响

目的 分析急性心肌梗死经皮冠状动脉介入术(percutaneous coronary intervention,PCI)患者用早期心脏康复措施效果.方法 在2018年6月—2019年9月抽取68例本院收治的行急性心肌梗死PCI术的患者作为研究对象,随机分为两组(对照组、观察组),每组各34例.对照组采用常规管理,基于此...     

深圳市梅林社区老年人生存质量研究

目的了解深圳市梅林社区老年人的生存质量状况。方法随机抽取深圳市梅林社区60岁以上老年人350名,采用SF-36量表对其进行问卷调查。调查数据采用SPSS14.0软件包进行描述性分析、t检验、F检验、多元逐步回归分析。结果与国内同类研究比较,深圳市梅林社区老年人在生存质量的8个维度都获得较高的评分,与美国常模比较,在MH维度的评分较低。生存质量维度评分等级排列,深圳市梅林社区78.4%的老年人生存质量在中等及以上水平,生存质量总得分在75分以上者占71.8%。高龄、离异或丧偶、医疗保障和退休前职业对老年人生存质量有影响,年龄与文此程度是影响深圳市梅林社区老年人生存质量的主要因素。结论深圳市梅林社区老年人生存质量处于中等及以上水平;文化程度和心理、精神状态对老年人的生存质量产生广泛影响,加强社区卫生服务,加强社区健康教育,积极关注老年人的心理、精神健康是提高老年人生存质量的重要措施。     

某军队研究所人员生命质量调查与分析

目的观察军队科研人员的生活质量,比较不同因素对其生活质量的影响。方法采用SF-36量表中文版对所内129名人员进行生活质量测评。结果与中国青年常模比较,所内人员SF-36量表PF、VT、MH的评分明显高,BP、RE的评分明显低(P<0.01);女性的PF得分低于男性,而本科以下学历的人员VT、MH明显高于研究生以上学历(P<0.05);睡眠不足的人RP、GH、VT、RE、MH评分较低,而吸烟、饮酒、饮食、运动对各维度的评分无显著性影响(P<0.05,P<0.01);机关人员在RP、GH、VT、MH评分上明显高于研究室人员,而工作的紧张度增加致使VT、MH的评分下降(P<0.05,P<0.01);结论军队科研人员整体的健康状况水平较好,文化程度、睡眠、工作性质和工作强度对军队科研人员的身体和心理健康均有一定程度影响。     

健康教育对急性心肌梗死恢复期患者生活质量的影响

目的 了解健康教育对急性心肌梗死恢复期患生活质量的影响。方法 在知情同意的基础上用前瞻性非随机对照研究的方法，对30名急性心肌梗死恢复期的住院患开展包括讲授、个别讲解、健康教育手册、电话咨询等方式的健康教育，出院3个月后到患家中进行访谈并使用生活质量问题卷和抑郁量表，了解其生活质量及其各维度的变化。另用30名病情相似的患作为对照。结果 干预组生活质量得分及躯体、心理、职责角色、健康意识等维度的得分显高于对照组。结论 健康教育能显提高急性心肌梗死恢复期患的生活质量。     

Health-related quality of life as a predictor of mortality among community-dwelling older persons

Health-related quality of life (HRQOL) measures predict cause-specific mortality, but few studies have explored whether generic self-reported HRQOL measures are independently associated with mortality in community-dwelling older persons. We postulated that a general measure of HRQOL, the short form 36-item questionnaire (SF-36), would be independently predictive of mortality among community-dwelling older persons. To evaluate this hypothesis, we followed a fixed cohort of 4,424 community-dwelling older persons recruited from a 2000 population-based survey in Taiwan until 2003 and investigated whether HRQOL was predictive of 3-year mortality, even after adjusting for traditional clinical risk variables. The data were collected via a door-to-door survey, and interviewers collected information on the subjects’ demographics, medical history, utilization of health services, functional ability, falls, and self-reported physical and mental symptoms. Of the 6053 eligible subjects, 4,424 residents agreed to participate in the baseline survey and were contacted in 2003. During the 3-year period, the 3-year cumulative mortality rate for the study population was 5%. Mortality was significantly higher among males (5.57% vs. 4.27%, p = 0.049), and cumulative mortality increased with age (χ ²-test for trend; χ ² = 7.734, p = 0.001). For all scales except bodily pain, there was a significant relationship between a 10-point lower baseline score and mortality. Our primary multivariate risk model, which included two summary measures of HRQOL and significant clinical variables, demonstrated that a 10-point decrease in either the baseline Physical Component Summary (PCS) score or the baseline Mental Component Summary (MCS) score was associated with higher mortality (PCS: RR: 1.60, 95% CI: 1.39–1.83; p < 0.001; MCS: RR: 1.16, 95% CI: 1.01–1.34; p = 0.036). The findings suggested that low baseline PCS and MCS scores were important independent risk factors for 3-year mortality among community-dwelling older persons, even after adjusting for other risk factors.     

上海市某区老年人生命质量影响因素分析

目的了解上海市某区老年人生命质量及影响因素,为有关部门提高老年人生命质量提供决策依据。方法采用SF-36量表调查上海市某区社区、敬老院和老年病房在住老人生命质量,同时调查有关人口学资料等情况,用单因素分析、多因素分析方法进行数据处理。结果居住社区的老人生命质量相对较高,敬老院次之,老年病房较低。生命质量影响因素有：疾病（脑血管意外、冠心病、骨折、慢支、糖尿病和关节炎等）、婚姻、文化程度、老人每月收入及农民等。结论要大力发展社区卫生服务,加强健康促进工作;提高敬老院医疗服务配置标准,满足患有各种慢性病的老年人需长期服药减轻病痛的需求。     

尿激酶早期静脉溶栓治疗急性心肌梗塞的临床分析

目的探讨尿激酶早期静脉溶栓治疗急性心肌梗塞（AMI）的临床疗效。方法2006年7月-2008年7月间的74例AMI患者，随机分为对照组和治疗组，每组37例，分别采用常规治疗和尿激酶早期静脉溶栓治疗，对比观察两组的临床疗效及肌酸激酶（CK）、心肌磷酸肌酶（CKMB）水平变化。结果治疗24h后，治疗组的显著进步率、总有效率均明显高于对照组，两组比较差异有统计学意义（P〈0．05）。治疗组治疗24h后，CK，CKMB水平较治疗前明显下降，差异有统计学意义（P〈0．05），并且明显低于同期对照组治疗后水平，差异有统计学意义（P〈0．05）。而对照组治疗前后CK，CKMB水平比较，差异无统计学意义（P〉0．05）。结论尿激酶早期静脉溶栓是治疗急性心肌梗塞的有效手段。     

急性心肌梗死患者住院费用构成及影响因素分析

目的:了解急性心肌梗死患者住院费用构成及主要影响因素,为合理控制医疗费用提出建议。方法:收集2007—2009年广州市某三甲医院急性心肌梗死病例485例,采用描述性统计方法研究住院费用的变化趋势和构成情况,采用相关分析、秩和检验和多重线性回归等方法研究患者性别、年龄、支付方式、住院天数等对住院费用的影响。结果:急性心肌梗死患者住院费用逐年上升,治疗费构成比最高;影响住院费用的主要因素是手术情况、住院天数、支付方式、特级护理、年龄和疗效。结论:实施临床路径管理,优化医院内部流程,缩短平均住院日;完善医疗保障制度,实行按病种限价付费,降低医疗费用。     

上海市浦东新区围产期妇女生命质量评价

目的了解上海市浦东新区围产期妇女的生命质量状况。方法应用健康调查简表(SF-36量表)对浦东新区围产期妇女分为产前、产后两组人群分别进行生命质量评价。将产前妇女的生命质量与浦东新区社区居民中年轻女性进行比较,产后妇女的生命质量与产前妇女进行比较。结果产前妇女生命质量的总评分为70.04分,产后妇女生命质量的总评分为73.18分。产前妇女的生命质量比社区年轻女性差,产后妇女的生命质量好于产前妇女。结论围产期妇女的生命质量状况不容乐观。建议在家庭的参与下,提高围产期妇女的知信行水平,有利于改善围产期妇女的生命质量。