Discriminant properties of commonly used quality of life measures in heart failure

Health-related quality of life (HRQL) instruments have been used to measure HRQL in heart failure patients, but how different instruments compare in the same groups of patients is not known. The purpose of this study was to compare the reliability and validity of three HRQL measures in 211 heart failure patients recruited from clinics affiliated with an urban hospital. Two disease-specific instruments, the chronic heart failure questionnaire (CHQ) and the living with heart failure questionnaire (LHFQ), and one generic instrument, the short-form 12 (SF-12), were administered. Patients reported moderate to low HRQL scores. Floor or ceiling effects were noted in the disease-specific instruments. Internal consistency reliabilities of the CHQ and LHFQ were satisfactory. Construct, convergent, and discriminant validity were supported for each instrument. Each scale and subscale, except for the SF-12 mental component scale, differentiated between patients with New York Heart Association (NYHA) class I, II, and III plus IV; the LHFQ physical subscale was the only measure to differentiate between patients with NYHA class III and IV. All three instruments were satisfactory for measuring HRQL, but the disease-specific instruments were preferable to the generic instrument. The decision of which instrument to use depends on the purpose of the study.     

Coping,meaning in life,and quality of life in congestive heart failure patients

OBJECTIVE: The present study examined (1) whether particular coping strategies used to deal with congestive heart failure (CHF) are related to meaning in life across time, and (2) whether meaning in life mediates the effect of coping on health-related quality of life. METHODS: A sample of 155 CHF patients received questionnaire packets at two time points, 6 months apart. Main outcome measures included Meaning in Life and Mental and Physical Health-Related Quality of Life (HRQOL). RESULTS: Coping (particularly acceptance/positive reinterpretation and religious coping) was not only related to meaning in life, but also to increased meaning over time. Further, meaning in life was related to both mental and physical components of HRQOL. However, coping was minimally related to HRQOL and its effects were not mediated by meaning in life. CONCLUSIONS: These results add to accumulating evidence that life meaning is important in the context of living with a chronic, life-threatening illness. Further, coping--especially acceptance and religious coping--is related to increased life meaning over time in the context of life limiting illness.     

Health-related quality of life of children and adolescents with chronic illness – a two year prospective study

The aim of this study was to compare the self-reported health-related quality of life (HRQL) of children and adolescents with diabetes, asthma or cystic fibrosis (CF) with the HRQL of a large community sample, to assess the extent to which the HRQL of the children and adolescents with chronic illness changes over time, and to examine the consistency of changes in different HRQL domains. One hundred and twenty three young people aged 10-16 years with asthma, diabetes, or CF were recruited from specialist paediatric clinics. Children rated their HRQL using the Child Health Questionnaire (CHQ) and three disease-specific measures at baseline, 6, 12, 18 and 24 months post-baseline. In several areas, the HRQL of children with chronic illness was significantly worse than that of children in the community sample. Over the 2 years of the study, although children with asthma and diabetes did not report significant changes in CHQ scores rating their physical health, they reported significant improvements in scores rating the extent to which health problems interfered with physical and family activities. CHQ scores describing their physical health reported by children with CF declined significantly but there was no significant change in scores rating interference with physical and family activities.     

Health-related quality of life in patients after lumbar disc surgery: a longitudinal observational study

Objectives Objectives of this study are (1) to compare health-related quality of life (HRQOL) of patients after lumbar disc surgery with reference data from the German general population; (2) to examine whether changes in HRQOL occur over time; (3) to investigate associations between HRQOL and socio-demographic and health-related factors. Methods The study sample consisted at baseline of 189 patients who underwent lumbar disc surgery. Baseline assessment was carried out 1–4 days after surgery, the first follow-up 2 months, the second follow-up 6 months after surgery. HRQOL was assessed by means of the WHOQOL-BREF. Results During follow-up, patients showed significant improvement in “physical well being” and “overall quality of life.” However, it did not reach the level of the general population at any assessment point. There was also a slight improvement of “psychological well being.” The domains “social relationships” and “environment” remained unchanged and showed persistently higher scores than the general population. Cohabitating was positively associated with QoL. Negatively associated were unemployment, part-time employment, desire for early retirement, higher intensity of pain and depression. Conclusion Supplementing physical rehabilitation by psychosocial interventions may help improve patients’ HRQOL.     

Randomised comparison of losartan vs. captopril on quality of life in elderly patients with symptomatic heart failure: The losartan heart failure ELITE quality of life substudy

Objective: To measure health-related quality-of-life (HRQoL) in elderly symptomatic heart failure patients following treatment with an angiotensin II receptor antagonist (losartan) vs. an angiotensin-converting-enzyme (ACE) inhibitor (captopril). Methods: Patients (age 65 years) were randomised to losartan, titrated to 50 mg once daily, or captopril, titrated to 50 mg three times daily, as tolerated. Sickness Impact Profile (SIP) and Minnesota Living with Heart Failure (LIhFE) questionnaires were administered at baseline, weeks 12 and 48. Composite hypothesis testing of change in HRQoL from baseline for completers, and withdrawal for unfavourable events (death, clinical/laboratory adverse experience) was used to account for differential dropout rates. Results: In 203 patients completing the substudy (week 48), significant and comparable improvements in HRQoL from baseline were observed for both treatment groups (p 0.001). Although there was a trend favouring losartan vs. captopril for the composite HRQoL endpoint (unadjusted p = 0.018, one-sided), this was not considered significant after adjusting for multiple testing. Significantly more captopril patients in the substudy subset withdrew for unfavourable reasons (19.6 vs. 10.9%, p = 0.038). Conclusions: Significant improvements in HRQoL were observed in elderly patients with symptomatic heart failure treated with losartan and captopril long-term. A trend favouring losartan in the composite measure of drug tolerability/quality of life was not significant, but losartan was generally better tolerated than captopril in that significantly fewer losartan patients discontinued therapy.     

Health-related quality of life (HRQoL) in patients with cancer and other concurrent illnesses

This study analyzed the impact of eight common chronic medical conditions on cancer patients' health-related quality of life (HRQoL) as measured by the functional living index-cancer (FLIC). The FLIC was administered to a population of 405 people in 14 communities in the North Central US within 4-8 weeks of diagnosis with breast or colorectal cancer. At that time, patients also self-reported any other health conditions for which they had been receiving medical treatment. The impact of the selected chronic conditions on the FLIC scores was analyzed using Student's t-tests and linear multiple regression. In the bivariate analysis, patients with heart/circulation problems had lower FLIC total scores (p < 0.05), physical well-being subscale scores (p < 0.05), and nausea subscale scores (p < 0.01). Patients with diabetes had lower nausea subscale scores (p < 0.05). The social well-being subscale score was higher with the report of arthritis/joint problems (p = 0.001). In multivariate analysis adjusted for age, arthritis/joint problems were predictive of the social well-being (p < 0.01) and hardship due to cancer (p < 0.05) subscale scores; heart/circulation problems (p < 0.001) and diabetes were predictive of the nausea subscale scores. ECOG performance status was significant predictor for the FLIC total and all of the subscale scores. HRQoL as measured with the FLIC scores in patients with cancer is impacted by the presence of other concurrent health conditions; this finding has implications for HRQoL theory and application.     

Health-related quality of life and health utility for the institutional elderly in Taiwan

Objective: To explore the health-related quality of life (HRQOL) and health utility in an institutional elderly population. Methods: Four hundred sixty-five elderly persons living in long-term care institutions in Taiwan were interviewed using Taiwans abbreviated version of the World Health Organization Quality of Life (WHOQOL-BREF), rating scale (RS) and the Time-Trade-Off (TTO) utility measurement. Results: The WHOQOL-BREF showed acceptable internal consistency ( range: 0.75–0.80 across domains) and validity. The sexual activity facet had the lowest response rate. Educational level, number of chronic diseases, physical performance, and number of caregivers had significant (p < 0.05) impacts on the domain scores of the WHOQOL-BREF. Physical performance had the strongest impact on the physical domain (R²=0.40) and accounted for significant percentages of the variance on the other three domains (R²=0.06–0.13). The mean RS score (score 0–100) was 61.3 ± 16.2 (mean ± SD). The mean TTO utility (score 0–1) was 0.92 ± 0.22. Conclusions: Results indicate that the WHOQOL-BREF, excepting the sexual activity item, is useful for evaluating HRQOL of conscious elderly in institutions. The validity of TTO utility for studying the institutionalized elderly needs further evaluation.     

Health-related quality of life measures for women with urinary incontinence: the Incontinence Impact Questionnaire and the Urogenital Distress Inventory

Urinary incontinence (UI) is a relatively common condition in middle-aged and older women. Traditional measures of symptoms do not adequately capture the impact that UI has on individuals' lives. Further, severe morbidity and mortality are not associated with this condition. Rather, Ul's impact is primarily on the health status and health-related quality of life (HRQOL) of women. Generic measures of HRQOL inadequately address the impact of the condition on the day-to-day lives of women with UI. The current paper presents data on two new condition-specific instruments designed to assess the HRQOL of UI in women: the Urogenital Distress Inventory (UDI) and the Incontinence Impact Questionaire (IIQ). Used in conjunction with one another, these two measures provide detailed information on how UI affects the lives of women. The measures provide data on the more traditional view of HRQOL by assessing the impact of UI on various activities, roles and emotional states (IIQ), as well as data on the less traditional but critical issue of the degree to which symptoms associated with UI are troubling to women (UDI). Data on the reliability, validity and sensitivity to change of these measures demonstrate that they are psychometrically strong. Further, they have been developed for simple, self-administration.The Continence Program for Women (CPW) Research Group is comprised of: Richard C. Bump, MD (1990–1993), Denise P. Elser, MD, J. Andrew Fantl MD, Donna K. McClish, PhD, and Jean F. Wyman, PhD, Schools of Medicine and Nursing, Virginia Commonwealth University/Medical College of Virginia, Richmond, VA; Richard C. Bump MD (1993-present) and James P. Theofrastous, MD, School of Medicine, Duke University, Durham, NC; and Curt D. Furberg, MD, PhD, Samuel S. Lentz, MD, Timothy M. Morgan, PhD, Deirdre Robinson, MD, and Sally A. Shumaker, PhD, The Bowman Gray School of Medicine of the Wake Forest University, Winston-Salem, North Carolina, USA.     

Health-related quality of life in endstage renal failure

The objective of this study was to describe the health-related quality of life (HRQOL) of patients on different forms of treatment for endstage renal failure in such a way that the data could be used in a cost-utility analysis of renal failure treatment in Britain. Twenty-four British renal units participated in this study. 997 adult dialysis and transplant patients were randomly selected from these units using the European Dialysis and Transplant (EDTA) Registry Database. The Health Measurement Questionnaire was compieted by 705 of the 900 patients who were alive at the time of the survey (response rate of 78%). The HRQOL data were linked with comorbidity data and with clinical data from the EDTA Registry. Compared to the general population, patients with endstage renal failure experienced a lower quality of life. Many factors contributed to this, but uncertainty about the future and lack of energy emerged as key components. Transplant recipients reported better HRQOL than dialysis patients, they reported fewer problems with physical mobility, self-care, social and personal relationships and usual activities. They also experienced significantly less distress, while dialysis patients reported problems with depression, anxiety, pain and uncertainty about the future. These differences remained after controlling for age and comorbidity.     

Health-related quality of life of mothers of children with leukemia in Japan

Objective: The study compared the health-related quality of life (HRQOL) of Japanese mothers of children with leukemia to that of mothers of children without leukemia. Method: We used the Medical Outcomes Study 36-item Short-Form (SF-36) to measure the HRQOL of 97 mothers of children (average age 6.2, range 0–14) with leukemia diagnosed between 1999 and 2000, and compared their scores to those of 240 mothers of children without leukemia matched to the children with leukemia. Main results: Of the eight unadjusted domain scores of the SF-36, five were significantly low among mothers of children with leukemia compared to mothers of children without leukemia: role-physical functioning (RP), general health perception (GH), vitality (VT), social functioning (SF) and mental health (MH). Their SF-36 domain scores, when adjusted for demographic and clinical factors were also significantly low in RP, GH, VT, SF, RE and MH. The MH and SF scores in mothers of children with leukemia requiring hospital care were, respectively, approximately 20 points (1 standard deviation (SD), p < 0.0001) and 30 points (1.5 SD, p < 0.0001) lower than that of mothers of children without leukemia. Conclusion: Mothers of children with leukemia requiring hospital care have poor HRQOL, particularly with regard to mental health and social functioning, and are at a greater risk for depression. These results suggest that the current system for treating leukemic diseases of children in Japan should also include close monitoring of mothers mental health, and provision of appropriate treatment and psycho-social support.     

Social support and health-related quality of life in chronic heart failure patients

Objectives: Objectives of this study were to: (1) describe perceived social support during a baseline hospitalization and 12 months later among heart failure patients; (2) examine differences in social support as a function of gender and age (less than 65 and 65 years or older); and (3) examine social support as a predictor of health-related quality of life. Background: Social support is a predictor of well-being and mortality, but little is known about support patterns among heart failure patients and how they influence quality of life. Methods: The sample included 227 hospitalized patients with heart failure who completed the Social Support Survey and the Chronic Heart Failure Questionnaire at baseline; 147 patients completed these questionnaires again 12 months after baseline. Results: Mean baseline and 12-month total support scores were 56 and 53, respectively, with a score of 76 indicating the most positive perceptions of support. The ANOVA indicated significant interactions of gender by age for total (F = 5.04; p = 0.03) and emotional/informational support (F = 4.87; p = 0.03) and for positive social interactions (F = 4.43; p = 0.04), with men under age 65 perceiving less support than men aged 65 and older and women in either age group. Baseline support did not predict 12-month health-related quality of life, but changes in social support significantly predicted changes in health-related quality of life (R ² = 0.14). Conclusions: Overall, perceptions of support were moderate to high, but there was wide variation in perceptions over time. Men under age 65 reported less support than other groups of patients. Importantly, changes in social support were significant predictors of changes in health-related quality of life. This revised version was published online in June 2006 with corrections to the Cover Date.     

Social network and health-related quality of life in older adults: A population-based study in Spain

This study examined the association between social network and health-related quality of life (HRQL) in older adults and compared this against the association between HRQL and a disabling disease such as osteoarthritis. A cross-sectional survey was done on 3600 subjects representative of the Spanish non-institutionalised population aged 60 years and over. Data were collected through home-based personal interview and physical examination. HRQL was measured with the SF-36 health questionnaire. Data analysis was performed with multiple linear regression models with adjustment for the main confounders. Of the total sample, 38.6 of subjects were unmarried, 17.6 were living alone, 4.7 saw their family seldom or never, and 2.9 saw their friends seldom or never. Unmarried status and living alone were associated with lower scores in the social and mental quality-of-life components, though statistical significance was not in general attained (p > 0.05). Seeing family members seldom or never was associated (p < 0.05) with worse scores in the following scales of SF-36 questionnaire role-physical, body pain, general health and mental health. HRQL was lower among those who saw friends seldom or never, and the reduction in HRQL proved similar to that associated with osteoarthritis, on the physical functioning (coefficients –8.4 vs. –8.1) and general health scales (–7.8 vs. –6.6); the reduction in HRQL was even greater than that associated with osteoarthritis for other scales, such as vitality (–9.6 vs. –6.7; p > 0.05) and social functioning (–14.5 vs. –3.7; p < 0.05). We conclude that only a small proportion of Spains elderly population lack frequent social relationships, yet low frequency of relationships with friends is associated with a decline in quality of life similar to or greater than that associated with osteoarthritis.     

Health-related quality of life: gender differences in childhood and adolescence

Summary. Objectives: To assess whether gender and age differences can be found in different aspects of health-related quality of life (HRQOL) of children and adolescents, and to what extent these results correspond to theoretical and empirical findings from developmental psychology. Methods: A newly developed HRQOL questionnaire was completed by 3 710 youths aged nine to 17 years in seven European countries. The “Kidscreen 52” questionnaire consists of 10 scales operationalising aspects of the physical, psychological and social dimensions of HRQOL. With the use of ANOVA and effect sizes, the influence of age and gender on aspects of HRQOL is reported. Results: Children report a very good quality of life largely independent of gender. After 12 years, HRQOL decreases in the majority of aspects. In the physical and psychological dimensions, a stronger decrease is found for females than for males. Conclusions: Children have higher HRQOL than adolescents in many aspects. With increasing age, HRQOL is frequently worse for females than for males. Examination of the individual aspects leads to a differentiation of the results with relevance for public health.

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Zusammenfassung. Gesundheitsbezogene Lebensqualit?t: Geschlechtsunterschiede in Kindheit und Jugend Fragestellung: Die Studie geht der Frage nach, in welchen Aspekten der gesundheitsbezogenen Lebensqualit?t (HRQOL) von Kindern und Jugendlichen Geschlechts- und Altersunterschiede zu finden sind und wie weit sie damit theoretischen und empirischen entwicklungspsychologischen Erkenntnissen entsprechen. Methode: Ein neu entwickelter HRQOL-Fragebogen wurde von 3 710 Kindern und Jugendlichen von neun bis 17 Jahren aus sieben europ?ischen L?ndern beantwortet. Der “Kidscreen 52”-Fragebogen besteht aus 10 Skalen, welche Aspekte der physischen, psychischen und sozialen Dimensionen der HRQOL operationalisieren. Der Einfluss von Alter und Geschlecht auf die verschiedenen HRQOL-Aspekte wird mit Hilfe von ANOVA und Effektst?rken detailliert berichtet. Ergebnisse: Kinder bis zum Alter von etwa 12 Jahren berichten weitgehend unabh?ngig vom Geschlecht über eine sehr gute Lebensqualit?t. Danach sinkt die Lebensqualit?t in der Mehrheit ihrer Aspekte. In der k?rperlichen und psychischen Dimension ist für die weiblichen Jugendlichen eine st?rkere Abnahme zu beobachten als für die m?nnlichen Jugendlichen, was bei den ?lteren Jugendlichen zu einem bedeutend weniger guten Befinden der jungen Frauen führt. Schlussfolgerung: Die HRQOL von Kindern ist in vielen Aspekten h?her als jene der Jugendlichen, mit zunehmendem Alter ist die HRQOL von weiblichen Jugendlichen h?ufig weniger gut als jene der m?nnlichen Jugendlichen. Eine Betrachtung der einzelnen Aspekte führt zu einer Differenzierung der Ergebnisse mit konkreter Relevanz für Public Health.

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Résumé. Qualité de vie en lien avec la santé: différences entre les sexes chez les enfants et les adolescents Objectifs: Analyser l’effet du genre et de l’age sur différents aspects de la qualité de vie en lien avec la santé (HRQOL). Voir dans quelle mesure ces résultats correspondent à des connaissances théoriques et empiriques issues de la psychologie développementale. Méthodes: 3 710 enfants et adolescents de neuf à 17 ans de sept pays européens ont répondu à un questionnaire indiquant la HRQOL. Cet instrument, ?Kidscreen 52?, se compose de 10 échelles qui mesurent des aspects des dimensions physiques, psychiques et sociales de la HRQOL. L’influence de l’age et du sexe sur les différents aspects de HRQOL est analysée à l’aide de ANOVA. Résultats: Les enfants rapportent une qualité de vie très bonne jusqu’à l’age de 12 ans environ, indépendamment du sexe. Ensuite la qualité de vie baisse. En ce qui concerne les aspects physiques et psychiques, une diminution plus forte est observée chez les jeunes femmes que chez les jeunes hommes. La qualité de vie est ensuite nettement moins bonne chez les jeunes femmes plus agées. Conclusion: La HRQOL des enfants est globalement meilleure que celle des adolescents. Avec l’age, la HRQOL est fréquemment moins bonne pour les jeunes femmes que pour les jeunes hommes. Il faut tenir compte de ces différents aspects pour des actions de santé publique.

     

The MacNew heart disease health-related quality of life instrument: Reference data for users

Objective: To report reference data for the heart-specific MacNew Heart Disease Health-Related Quality of Life instrument. Methods: One thousand five hundred and six patients with myocardial infarction (n = 346), heart failure (n = 201), and ischaemic heart disease (IHD, n = 959) were surveyed 4 months after hospital discharge. Quality of life scores were determined, stratified by diagnostic category, age and sex. Changes in scores from 4 to 8 months post-discharge were calculated for a subset of 830 patients, stratified by age and sex. Results: At 4 months there were no significant differences in scores between myocardial infarction and electively admitted IHD patients, however the scores of heart failure patients were significantly lower (indicating poorer quality of life) than those of patients with other diagnoses. There were few significant differences between age groups or sexes when comparing within diagnostic groups. Change from 4 to 8 months was not associated with diagnosis, age, or sex but was associated with events within the period (readmission or revascularisation). The change data suggest that a value of 0.5 may be a useful indicator of the minimal clinically important difference. Conclusions: These reference data will assist in sample size calculations and with comparison of results in other studies, and will be of use to researchers who are using or intending to use the MacNew instrument.     

Health-related quality of life in women with polycystic ovary syndrome, a self-administered questionnaire, was validated

OBJECTIVE: We examined the measurement properties of a questionnaire (PCOSQ) measuring health-related quality of life (HRQOL) in women with the polycystic ovary syndrome (PCOS). STUDY DESIGN: This multicenter prospective randomized placebo-controlled blinded study enrolled 393 patients with PCOS at tertiary care sites. Participants were randomized to placebo or troglitazone (150 mg/d, 300 mg/d, or 600 mg/d). At baseline (n=393) and after 44 weeks of treatment (n=284) the proportion of normal menstrual cycles, the free testosterone (T) level, four objective measures of facial hair growth (hair density and hair growth rate by photography, and hair diameter and hair growth rate using plucked hairs), and a subjective assessment of the degree of hirsutism, the modified Ferriman-Gallwey (F-G) score, were determined. At both visits, patients also completed the PCOSQ. Since the trial was conducted, troglitazone has been removed from the market because of toxic effects. The PCOSQ includes 26 questions (items) that address five areas of concern (domains), including emotions, body hair, body weight, fertility, and menstruation rated on a seven-point scales in which lower scores denote higher degrees of patient concern and a lower HRQOL. RESULTS: Cronbach's alpha was >0.7 for four of five domains. Factor analysis provided moderate to strong support for the five-domain structure of the PCOSQ. Cross-sectional correlations were weak with all measures but the F-G score and hair growth (r=-.46, P < .01). The change in the F-G score showed a statistically significant (P < .01) correlation with changes in PCOSQ hair growth (r=-.22), weight (r=-.17), infertility (r=-.20), and menstruation (r=-.20). Changes in the proportion of normal menstrual cycles correlated with change in the infertility domain (r=.14, P < .03) and with the change in the menstruation domain (r=.31, P < .001). The PCOSQ proved as responsive as the F-G, and more responsive than the objective measures of hair growth, to effects of troglitazone. CONCLUSIONS: Our data provides some support for the discriminative and longitudinal validity, and appreciable support for the responsiveness, of the PCOSQ.     

我国农村不同收入居民健康状况与生命质量研究

目的：评价不同收入农村居民的健康状况及健康相关生命质量,分析家庭经济对人群健康的影响及其健康问题的特点。方法：采用欧洲五维度健康量表对不同收入农村居民的健康状况进行测量。结果：五维度任一维度存在问题的比例随着收入的降低而增高,而VAS评分也随之降低。低收入阶层在两周患病率、慢性病患病率、年需住院率三个指标上呈现出＂三高＂的现象,应住院未住院率则随着收入的降低而增高。结果提示,低收入阶层存在的健康问题多,对卫生服务的需要高但利用低,女性人群有健康问题比例较男性高。结论与建议：经济收入对居民有较大的影响,要关注低收入老年人群和女性群体,政府应该完善健康保障制度,强化医疗救助政策,降低低收入人群卫生服务的经济障碍,提高健康和卫生服务利用的公平性。     

Health-related quality of life of day-case surgery patients: a pre/posttest survey using the EuroQoL-5D

Aim This paper describes and compares the perceived health-related quality of life (HRQoL) of day-case surgery patients before and after their procedures and examines some associated patient-related factors. Method A pre/posttest survey design was employed to collect data from Finnish adult day-case surgery patients using participant-completed EuroQoL 5-Dimensional Classification Component Scores (EQ-5D) questionnaires given 2 weeks presurgery (n = 131) and 2 weeks postsurgery (n = 131) in 2004. Results No noticeable change after minor surgery was found using the EQ-5D. Using the EQ-5D index, patients perceived their HRQoL as high before and after surgery. Almost one fifth (17%) reported no pain or discomfort before the procedure compared with 40% after it. As measured by the EuroQol visual analogue scale (EQ_VAS), those patients who reported chronic illness before the operation had a lower perception of their HRQoL compared with those who did not. It was also found that self-care and usual activities were more disturbed after surgery. Conclusions Although there were increases and decreases within items of the EQ-5D, overall, there was no improvement on EQ-5D scores. More research is needed to explore the sensitivity and responsiveness of the EQ-5D measure in day-case surgery patients.     

心理护理干预对慢性心力衰竭患者生活质量的影响

目的探讨心理护理干预对慢性心衰患者生活质量的影响。方法调查2009年1月1日—2010年12月31日期间入院的患者,随机分为心理干预组和对照组。入院前均行院内临床检查及填写抑郁自评量表(SDS)及生活质量量表(SF-36)。出院后3个月随访患者心脏超声指标及SDS和SF-36评分。结果纳入200例患者,其中干预组98例和对照组102例。两组入院基线指标及SDS和SF-36评分差异均无统计学意义(P0.05),出院后3个月随访发现,干预组SDS标准分与对照组相比,差异有统计学意义(42.2±7.9比49.1±11.1,P0.05)。干预组SF-36总分与对照组相比,差异有统计学意义(585.3±142.1比551.9±112.3,P0.05)。并且SF-36量表各维度中5项指标评分均于随访时发生显著变化(P0.01)。结论心理护理干预可通过改善心衰患者心理异常而提高患者生活质量。