河北张北尚义地震后受灾群体生活质量纵向研究

目的 纵向研究地震后受灾群体生活质量随时间的改变,探讨社会支持等变量对灾后生活质量的影响。方法 调查对象来自距震中不同距离的2个自然村,震后3个月及9个月完成世界卫生组织生活质量简表等问卷的人数分别为335和256。结果 地震经历伴随着有生活质量多方面的损害,涉及心理、生理和环境维度。灾后获得的支持与援助是影响生活质量的重要因素。结论 灾害后生活质量受灾前,灾后及灾害相关的各种变量影响,应该全面评估并进行长期追踪。此外,本文提示灾后早期积极的援助和干预具有重要意义。     

A latent variable causal model of the quality of life and community tenure of psychotic patients

Services are intended to maintain patients in the community while improving the quality of their lives. The purpose of this study was to determine the extent to which psychiatric patients’ diagnoses, levels of autonomy, objective living conditions and degree of service utilization are associated with their perceived quality of life and, in turn, community tenure. A latent variable causal model was developed and tested using data from 152 schizophrenic and affective psychotic patients. Information was obtained using a semistructured interview, a quality of life scale, ratings on the Global Assessment Scale and patient hospital records. Results indicate that greater autonomy is significantly associated with greater perceived quality of life and that greater quality-of-life ratings are associated with greater community tenure.     

The relationships among family,friends, and psychological well-being for Thai elderly

Objectives: The extent to which family and friends contribute to psychological well-being (PWB) may be subject to cultural variability. This study examines the mechanisms by which relationships with family and friends contribute to PWB among Thai elders.

Method: Interviews were conducted with 469 men and women aged 60 and older in Nan Province, Thailand. The data were analyzed using structural equation modeling, controlling for age, gender, education, income, marital status, and health status.

Results: Family and friendship networks have a significant direct effect on family and friendship support. However, family and friendship networks do not have a significant direct effect on PWB, but rather an indirect effect via social support. Similarly, friendship support mediates the relationship between friendship networks and family support. Both family support and friendship support are significantly related to PWB but family support is the stronger predictor.

Conclusion: Using an adapting theoretical framework developed by Berkman, Glass, Brissette, & Seeman (2000) allows researchers to map the various pathways by which relationships with family and friends may contribute to PWB among older Thai adults.     

A mediational analysis of adverse experiences in childhood and quality of life in adulthood

ObjectivesThis study examined associations of three prevalent adverse childhood experiences (ACEs) – parents'' problematic alcohol use (PPAU), parental separation/divorce, and lack of support from a trusted adult–with adult quality of life (QoL), and potential mediators of associations.MethodsData were from a representative survey (N = 28,047) in Norway that assessed ACEs, QoL, and potential mediators: enduring perceptions of childhood hardships (Difficult Childhood Questionnaire; DCQ), current mental distress, and current social isolation. Latent regression analyses examined potential mediators.ResultsEach ACE was positively associated with perceptions of childhood as difficult (higher DCQ scores). In turn, ACEs were negatively associated with adult QoL through indirect effects. Lack of support from a trusted adult had the strongest negative association with adult QoL, compared to PPAU and parental separation/divorce. The association between the ACEs and QoL was explained through the mediators of mental distress and social isolation.ConclusionsOf the examined ACEs, lack of support from a trusted adult had the strongest negative impact on adult QoL. Adult support to vulnerable children could potentially ameliorate adult consequences of ACEs. In addition, adults reporting difficulties due to childhood adversities may benefit from therapeutic interventions that address both psychological distress and isolation.     

The association between needs and quality of life in an epidemiologically representative sample of people with psychosis.

The impact of meeting needs on quality of life in the severely mentally ill is investigated in this study. An epidemiologically representative sample of 133 patients meeting ICD-10 criteria for psychosis completed standardized instruments for measuring needs and quality of life. Covariance structure modelling was used to investigate the extent to which latent factors of met and unmet need were associated with latent quality of life. Patients rated about 0.7 more total (met plus unmet) needs than staff, mainly due to differences in rating unmet need. Patient ratings were more reliable than ratings by others of unmet need and quality of life. Both underlying unmet need and met need were negatively associated with underlying quality of life, but unmet need was the stronger relationship. The patient's perspective on their difficulties (especially their unmet needs) must be central to mental health care.     

An innovative and reliable way of measuring health-related quality of life and mental distress in the deaf community

Abstract Background Structured assessment of quality of life and mental distress in deaf people is difficult for various reasons. This paper describes the development and reliability of an interactive computer-based assessment package for measuring quality of life and psychological distress in the deaf population. Methods The Brief version of the WHO Quality of Life (WHOQOL) Questionnaire, the 12-item General Health Questionnaire (GHQ-12) and the Brief Symptom Inventory (BSI) had been translated into sign-language and videotaped. A total of 236 members of the deaf community in Upper Austria participated by responding to a programme consisting of self-administered written and videotaped test-items presented to them on a notebook computer. The reliability of the various assessments was established on this large community sample. Results When reliability of the versions for the deaf was compared with that of written versions of the same measures in general population samples, it was found to be somewhat lower, although still in an acceptable range, for the WHO-QOL and the GHQ-12. For the BSI, the reliability was even higher than that of the general population. Conclusions For deaf individuals whose preferred communication is sign language, quality of life and mental distress can be effectively and reliably assessed with the use of carefully translated and adapted common instruments.     

个案管理模式对社区老年抑郁症生活质量的影响

目的 探讨个案管理模式对我国社区老年抑郁症患者生活质量的影响.方法 将120例老年抑郁症患者随机分成干预组和对照组,干预组实行个案管理模式,即精神科医生、社区医生和个案管理员共同对老年抑郁症患者实施综合治疗方案,如健康教育、心理治疗和药物治疗等,对照组按照现行的医学模式进行.在治疗前,治疗第2、4、6、8、12周末分别应用汉密尔顿抑郁量表(Hamilton depression scale, HAMD17)和治疗时出现的症状量表(treatment emergent symptom scale, TESS)对两组患者的疗效和药物不良反应进行评定;在治疗前,治疗第4、8、12周末应用健康状况问卷(12-item short form health survey questionnaire,SF-12)对两组患者的生活质量进行评价.结果 在治疗12周末,干预组患者HAMD17总分(14.2±7.7)明显低于对照组HAMD17总分(24.9±5.9),两组间存在统计学差异(P=0.000);干预组有效率(83.1%)、临床治愈率(27.1%)明显高于对照组有效率(39.3%)、临床治愈率(5.4%),存在统计学差异(P=0.000和0.002);干预组SF-12的MCS(41.0±9.6)和PCS(39.3±9.2)均明显高于对照组的MCS(30.3±9.9)和PCS(30.5±6.8),两组间存在统计学差异(P=0.000);两组患者药物不良反应轻微.结论 应用个案管理模式可以有效地减轻老年抑郁症患者的抑郁症状,提高患者的生活质量.     

Post-traumatic stress syndrome in a large sample of older adults: determinants and quality of life

Objectives: The aims of this study are to assess in a sample of older adults consulting in primary care practices the determinants and quality of life associated with post-traumatic stress syndrome (PTSS).

Method: Data used came from a large sample of 1765 community-dwelling older adults who were waiting to receive health services in primary care clinics in the province of Quebec. PTSS was measured with the PTSS scale. Socio-demographic and clinical characteristics were used as potential determinants of PTSS. Quality of life was measured with the EuroQol-5D-3L (EQ-5D-3L) EQ-Visual Analog Scale and the Satisfaction With Your Life Scale. Multivariate logistic and linear regression models were used to study the presence of PTSS and different measures of health-related quality of life and quality of life as a function of study variables.

Results: The six-month prevalence of PTSS was 11.0%. PTSS was associated with age, marital status, number of chronic disorders and the presence of an anxiety disorder. PTSS was also associated with the EQ-5D-3L and the Satisfaction with Your Life Scale.

Conclusion: PTSS is prevalent in patients consulting in primary care practices. Primary care physicians should be aware that PTSS is also associated with a decrease in quality of life, which can further negatively impact health status.     

Health-related quality of life and health behaviors by social and emotional support

Background Social and emotional support is an important construct, which has been associated with a reduced risk of mental illness, physical illness, and mortality. Despite its apparent relevance to health, there have been no recent state or national population-based U.S. studies regarding social and emotional support. In order to better address this issue, we examined health-related quality of life (HRQOL) and health behaviors by level of social and emotional support in community-dwelling adults in the United States and its territories. Methods Data were obtained from the Behavioral Risk Factor Surveillance System, an ongoing, state-based, random digit telephone survey of the noninstitutionalized U.S. population aged ≥18 years. In 2005, one social and emotional support question, four HRQOL questions, two disability questions, one life satisfaction question, and four health behavior questions were administered in the 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands. An additional five HRQOL questions were administered in two states. Results An estimated 8.6% of adults reported that they rarely/never received social and emotional support; ranging in value from 4.2% in Minnesota to 12.4% in the U.S. Virgin Islands. As the level of social and emotional support decreased, the prevalence of fair/poor general health, dissatisfaction with life, and disability increased, as did the mean number of days of physical distress, mental distress, activity limitation, depressive symptoms, anxiety symptoms, insufficient sleep, and pain. Moreover, the prevalence of smoking, obesity, physical inactivity, and heavy drinking increased with decreasing level of social and emotional support. Additionally, the mean number of days of vitality slightly decreased with decreasing level of social and emotional support; particularly between those who always/usually received social and emotional support and those who sometimes received support. Conclusions These findings indicate that the assessment of social and emotional support is highly congruent with the practice of psychiatry. Assessment of social and emotional support, both in psychiatric and medical settings, may identify risk factors germane to adverse health behaviors, and foster interventions designed to improve the mental and physical health of at risk segments of the population.     

Association of social support with quality of life in patients with polyneuropathy

The aim of this study was to examine the impact of social support on quality of life (QoL) in patients with polyneuropathy. One hundred and fifty‐four patients with polyneuropathy were enrolled from a neuromuscular clinic. The QoL Instrument and the Medical Outcome Study‐Social Support Survey (MOS‐SSS) were used to assess QoL and social support, respectively. Disease severity and clinical factors were also assessed. Neuropathy patients had a lower QoL compared to a previously published normative sample (p < 0.0001) and an MOS‐SSS comparable to other patients with chronic disease. Social support correlated weakly with the self esteem and emotional well being mental health dimensions (r_s:0.20–0.38) but not the physical health QoL (PH‐QoL) domains. Physical and mental QoL also correlated significantly with presence of pain (r_s: ?0.39 and ?0.42, respectively) and number of autonomic symptoms (r_s: ?0.39 and ?0.30, respectively). Social support independently predicts MH‐QoL when controlling for age, gender, pain, and the Toronto Clinical Neuropathy Score (TCNS; p < 0.0001). TCNS and gender are independently related to PH‐QoL (p < 0.05). This study demonstrates that improved social support serves as an independent predictor of MH‐QoL when controlling for age, gender, pain, and severity of neuropathy. Future studies examining the effects of improving social support on QoL in patients with polyneuropathy are recommended.     

Conceptual principles of quality of life: an empirical exploration

Background Quality of life is a popular measure of outcomes and its widespread use has led to recent calls for a better understanding of the construct, emphasizing the need to build a substantial body of knowledge around what determines perceptions of life quality. Three widely reported and used conceptual principles are examined in this study. Methods Self-ratings of life quality and three likely determinants at an individual level (stress), an interactional level (social support) and a community level (neighbourhood belonging) were used. The study involved two groups of young adults from an urban community, one identified as having an intellectual disability (ID). Results Young adults with ID rated their satisfaction with health significantly higher and intimacy and community involvement lower than the comparison group. Social support emerged as the strongest predictor of life satisfaction across both groups. Conclusion The conceptual principles of subjective quality of life provide a useful framework to discuss findings and to stimulate further research.     

The effect of support group on the mental health and quality of life for mothers with autistic children

Background The purpose of this study was to explore the effect of support groups on the mental health and quality of life for mothers with autistic children. Method A quasi-experimental pre-post control group design was used in this study. The mothers had children without chronic diseases diagnosed as autistic based on Diagnostic and Statistical Manual of Mental Disorder-Fourth Edition (DSM-IV) and were their primary caregivers. The mothers were assigned to control or intervention groups based on their willingness. The 10 weeks of the support group programme served as an intervention. There were three waves of data collection: pre-test, post-test, and after 1 month follow-up. A total of 27 mothers with autistic children were assigned into experimental and control groups. In total, there were eight mothers in the experimental group and 19 mothers served as the control group. Results The results of this study showed that mental health had not significantly improved in the intervention group compared to those in the control group at the end of the first month during follow-up. However, the subjective well-being and employment status had an effect on their mental health. Only the subjective well-being had an effect on their quality of life. Conclusion According to the results of this study, recommendations included (1) regularly promulgating a caregiver support group, (2) the advancement of training skills within the group, and (3) upgrading and promoting nurses’ ability to lead support groups in the future.     

Mental distress and quality of life in a deaf population

BACKGROUND: High risks of mental illness within the deaf community are reported. The assessment of the level of mental distress and quality of life in the deaf community is difficult due to communication problems in spoken and written language. The deaf community is characterized by the use of sign language. METHODS: A new measure of acceptable reliability using sign language is described. The interactive computerised package including special versions of the World Health Organisation's Brief Quality of Life questionnaire (WHOQOL-BREF), the 12-Item General Health Questionnaire (GHQ-12) and five subscales of the Brief Symptom Inventory (BSI) was administered to a large community sample of deaf people (n = 236), and results were compared with normative data for German-speaking hearing people. RESULTS: The deaf sample has a significantly poorer quality of life than the general population for the physical and psychological domains (p < 0.01) as measured by the WHOQOL-BREF. However, in the domain of social relationships, no significant difference (p = 0.19) was demonstrated. All findings with the GHQ-12 and the BSI show much higher levels (p = 0.01) of emotional distress among the deaf. CONCLUSION: Although a poorer quality of life and a higher level of mental distress are demonstrated, the similarity to the general population in the domain social relationships shows that this does not affect all domains. These findings show the need for easily accessible health services for the deaf which offer sensitive communication with them.     

Social ties and psychological well-being in late life: the mediating role of relationship satisfaction

Objective: The current paper examines whether quantitative aspects of social support (i.e., support network characteristics) indirectly influence psychological well-being via older adults' qualitative perceptions of support (i.e., satisfaction with social relationships).

Methods: A sample of 416 adults aged ≥60 was drawn from the Social Integration and Aging Study, a community-based survey conducted in a small US (Midwestern) city. The survey assessed social networks, social support, and physical and mental health among older adults.

Results: Bootstrapping was used to examine mediation models. Greater support network size predicted lower perceived stress, fewer depressive symptoms, and better life satisfaction, yet this association was fully mediated by relationship satisfaction. For support network composition, greater proportion kin was associated with lower stress and better life satisfaction, though not depressive symptoms, however, relationship satisfaction did not mediate this link.

Discussion: Findings highlight the complex interplay of support network characteristics and satisfaction, and suggest the greater import of support satisfaction for older adults' psychological well-being.