社会支持对老年冠心病患者心理状况及生活质量的影响

目的 探讨老年冠心病患者的社会支持与心理状况及生活质量的相关性,为提高老年冠心病患者生活质量提供科学依据.方法 采用社会支持量表、焦虑自评量表、抑郁自评量表和健康状况调查问卷(SF-36)对200例住院老年冠心病患者进行评定.结果 老年冠心病患者社会支持水平(32.21±4.35)低于常模(t=4.89,P＜0.01);60.85%的患者存在着不同程度的焦虑和抑郁症状;社会支持得分等组心理状况龊蜕钪柿烤哂谏缁岢值头肿?P均＜0.01).结论 老年冠心病患者获得的社会支持程度与患者的心理状况及生活质量关系密切,医务人员应注意调动患者的社会支持来源,纠正其负性情绪,从而提高患者的生活质量.     

肿瘤化疗患者抑郁情绪与应对方式生活质量相关性分析

目的探讨肿瘤化疗患者抑郁情绪与应对方式、生活质量之间的关系。方法采用横断面调查方法,对符合纳入标准的139例肿瘤化疗患者应用抑郁自评量表、特质应对方式问卷和欧洲癌症研究与治疗组织的生活质量问卷进行调查,收集到的数据进行一般性描述分析、两独立样本t检验、Spearman相关性分析、Stepwise回归分析。结果67例（48．2％）肿瘤化疗患者存在不同程度的抑郁情绪;非抑郁组与抑郁组肿瘤化疗患者积极应对和消极应对方式差异存在统计学意义（P〈0．05）,两组在生活质量中的躯体功能、角色功能、情绪功能、认知功能、总体健康状况、疲乏、恶心呕吐、疼痛、失眠、食欲丧失、便秘差异均有统计学意义（P〈0．05）;抑郁程度、应对方式和生活质量之间存在着不同程度相关性;回归分析显示消极应对和总体健康状况、认知功能、食欲丧失是肿瘤化疗患者抑郁情绪的影响因素。结论肿瘤化疗患者抑郁情绪发生率较高,应对方式和生活质量对抑郁情绪发生产生重要影响,三者关系密切,提示医护人员应多关注肿瘤化疗患者的心理、应对方式及生活质量。     

住院冠心病病人的生活质量及其相关因素调查

[目的]探索住院冠心病病人的生活质量及其相关因素。[方法]采用健康状况调查问卷(SF-36)、A型行为类型问卷(TABP)、汉密顿抑郁量表(HAMD)和汉密顿焦虑量表(HA-MA),对80例住院冠心病病人进行测试。[结果]冠心病病人的生活质量水平明显低于常态老人,生活质量与焦虑、抑郁情绪呈显著负相关,生活质量受病人的文化程度、既往住院次数的影响较大,也与经济收入、家庭负担、总病程、性别、行为类型等多方面因素有关。[结论]住院冠心病病人的生活质量水平较低,且生活质量水平受多种因素影响。实施有效的心理护理能促进疾病的康复,提高病人的生活质量。     

冠心病患者性别差异对生活质量的影响

目的:探讨冠心病患者性别差异对生活质量的影响.方法:采用健康调查简表(SF-36)、汉密顿焦虑自评量表(HAMA)、汉密顿抑郁自评量表(HAMD)和匹兹堡睡眠质量指数(PSQI),对47例男性和41例女性冠心痛患者进行评定对比.结果:女性冠心痛患者HAMA、HAMD和PSQI三项总分均大于男性冠心病患者(P＜0.05);女性冠心痛患者SF-36总分值均显著低于男性冠心病患者(P＜0.01).结论:冠心痛患者的焦虑、抑郁程度及睡眠质量与性别差异有密切关系,影响其生活质量.根据性别差异,针对性地采取不同的干预措施,从而提高冠心病患者的生活质量.     

冠心病病人支架植入术后焦虑、抑郁与后期生活质量的相关性研究

[目的]了解冠心病病人支架植入术后焦虑、抑郁与其1个月后生活质量状况及其两者之间的关系。[方法]选择133例在西安市3所三级甲等医院行支架植入术的冠心病病人,采用综合医院焦虑、抑郁量表（HAD）进行调查,于支架植入术后1个月采用健康调查简表（SF 36）电话随访调查。[结果]133例支架植入术后的冠心病病人中焦虑、抑郁发生率分别为31.58%和27.07%;支架植入术1个月后冠心病病人中12.03%生活质量处于良好,其余均处于一般水平;焦虑、抑郁与生活质量总分和多个维度呈不同程度负相关,且有焦虑、抑郁的病人和无焦虑、抑郁的病人生活质量在多个维度上差异有统计学意义。[结论]冠心病病人支架植入术后焦虑、抑郁状况与其1个月后的生活质量明显相关。     

住院冠心病病人的生活质量及其相关因素调查

[目的]探索住院冠心病痛人的生活质量及其相关因素。[方法]采用健康状况调查问卷（SF-36）、A型行为类型问卷（TAI铲）、汉密顿抑郁量表（HAMD）和汉密顿焦虑量表（HAMA）。时80例住院冠心病病人进行测试。[结果]冠心病痛人的生活质量水平明显低于常态老人，生活质量与焦虑、抑郁情绪呈显著负相关，生活质量受病人的文化程度、既往住院次数的影响较大，也与经济收入、家庭负担、总病程、性别、行为类型等多方面因素有关。[结论]住院冠心痛病人的生活质量水平较低，且生活质量水平受多种因素影响。实施有效的心理护理能促进疾病的康复，提高病人的生活质量。     

消化系统肿瘤术后化疗患者抑郁情绪、人格特征及生活质量的调查分析

目的 研究消化系统肿瘤术后化疗患者的抑郁、人格特征和生活质量状况以及此类患者抑郁情绪与人格特征、生活质量的相关性。方法 采用横断面调查方法,对261例消化系统肿瘤术后化疗患者应用抑郁自评量表、艾森克人格问卷简式量表以及欧洲癌症研究与治疗组织的生活质量问卷进行调查,并分析患者抑郁与其人格特征以及生活质量之间的关系。结果 消化系统肿瘤术后化疗患者抑郁得分显著高于国内常模,抑郁发生率为19.5％;非抑郁与抑郁患者在人格特征的P维度和N维度以及生活质量中躯体功能、角色功能、情绪功能、认知功能维度、总体健康状况、症状维度以及单一条目中的疼痛、失眠、便秘、腹泻、经济困难方面的评分比较差异显著。抑郁情绪与人格特征中N维度、L维度以及生活质量均存在不同程度的相关。结论消化系统肿瘤术后化疗患者的抑郁情绪与人格特征和生活质量有显著相关性。护理人员要关注消化系统肿瘤术后化疗患者的生活质量,同时全面评估患者的人格特征,从而制定针对性的护理干预措施,改善患者的抑郁情绪,提高患者的生活质量。     

早期介入认知行为治疗对重度抑郁发作患者生活质量的影响

目的 探讨早期介入认知行为治疗对重度抑郁发作患者生活质量的影响.方法 选取60例重度抑郁发作患者,随机分为干预组和对照组,各30例.对照组给予常规药物治疗、护理和健康教育,干预组在对照组的基础上早期进行6周的认知行为治疗.在基线、第4周、第6周采用汉密尔顿抑郁量表、健康状况调查问卷进行评定.结果 抑郁量表及健康状况调查问卷各维度评分在基线组间比较,差异无统计学意义(P>0.05).重复测量的方差分析结果显示,抑郁量表及健康状况调查问卷各维度评分时间主效应有统计学意义(P<0.05).抑郁量表及健康状况调查问卷的7个维度(心理健康维度除外)评分组间主效应有统计学意义(P<0.05).结论 重度抑郁发作患者早期给予认知行为治疗,可明显改善患者的抑郁情绪,提高其生活质量.     

帕金森病患者生活质量指数对照研究

目的探讨帕金森病患者的生活质量。方法对50例帕金森病患者和42例健康对照组采用生活质量指数问卷、汉密顿抑郁量表和汉密顿焦虑量表评定生活质量和焦虑抑郁状况。结果生活质量指数问卷评定,帕金森病患者在活动、日常生活、健康、近期支持、总体精神状况5项和生活质量总指数均低于对照组(P<0.05或0.01)。研究组生活质量与其运动障碍、焦虑抑郁情绪严重程度得分呈负相关。结论积极治疗帕金森病患者的运动障碍和焦虑抑郁情绪,加强心理干预是提高其生活质量的主要途径。     

腹膜透析患者焦虑抑郁状况及其与生活质量的相关性分析

目的探讨腹膜透析患者焦虑、抑郁状况及其与生活质量的相关性。方法对238例腹膜透析患者应用Hamilton焦虑、抑郁量表、生命质量量表(medicaloutcomesstudy36-itemshortformhealthsurvey,MOSSF-36)进行现状调查,了解患者焦虑、抑郁状况及其与生存质量的相关性。结果患者焦虑发生率为48.31%,无焦虑患者生活质量躯体不适(bodilypain,BP)、总体健康感觉(generalhealthphysical,GHP)、社交能力(socialfunction,SF),情感健康(emotionalwell-being,EW)评分均高于焦虑患者(均P0.05);患者抑郁症发生率为55.46%,无抑郁患者生活质量GHP、SF和EW评分均高于抑郁患者(均P0.05);患者焦虑、抑郁情绪与生活质量总分及各维度呈负相关(均P0.01)。结论腹膜透析患者焦虑、抑郁症发生率较高,而且患者焦虑、抑郁情绪越严重者,其生存质量越低。     

Association of depression and anxiety with reduced quality of life in patients with predialysis chronic kidney disease

Aim: Although depression and anxiety are the most common psychological problems among dialysis patients, little is known about the association between depression, anxiety and quality of life (QOL) in patients with predialysis chronic kidney disease (CKD). Therefore, we assessed the prevalence of depression and anxiety, and their association with QOL in patients with predialysis CKD. Methods: Two hundred and eight predialysis patients (male 61.1%) with a mean age of 55.7 ± 13.7 years and an estimated glomerular filtration rate < 60 ml/min/1.73 m² were enrolled. Depression and anxiety were assessed with the Hospital Anxiety and Depression Scale. Patients with anxiety and depression scores ≥ 8 were diagnosed with anxiety and depression disorders respectively. The WHOQOL‐BREF questionnaire was used to assess patient QOL. Results: The prevalence of depression (47.1%) and anxiety (27.6%) did not differ across CKD stages. Depression correlated positively with age, employment, income, education, comorbidity index, haemoglobin level, albumin concentration and anxiety score, and negatively with all WHOQOL‐BREF domain scores. Anxiety correlated significantly with QOL, but not with socioeconomic factors. In a multiple regression analysis, haemoglobin level, anxiety and QOL were independent factors associated with depression. In a linear regression analysis, depression and anxiety independently correlated with QOL after we adjusted for age, alcohol use, employment, income, education, haemoglobin level and albumin concentration. Conclusions: Patients with predialysis CKD have a high prevalence of depression and anxiety, which are associated with reduced QOL. Early detection of depression and anxiety and active interventions should be considered to improve the QOL of these patients.     

影响帕金森病患者生活质量的因素

目的：调查帕金森病（PD）患者的认知功能、抑郁和影响生活质量的因素。方法：老年PD患者（PD组）与非PD患者（对照组）各50例,采用自填结合个人访谈法,选用老年抑郁量表（ODI）、简易精神状态量表（MMSE）、帕金森病统一评分量表（UPDRS）、Hoehn-Yahr分级及Schwab-England量表评定患者抑郁状态功能、认知功能及可能影响生活质量的因素。结果：①PD组患者的认知功能和生活质量均低于对照组,抑郁程度高于对照组（P〈0.05）。结论：ADL、认知功能及抑郁程度是影响PD患者生活质量的主要因素,在诊治过程中应重视改善这3方面的症状。     

Domains and determinants of quality of life after stroke caused by brain infarction

OBJECTIVE: To evaluate the domain-specific quality of life (QOL), including physical, social and role functioning, mental health, vitality, bodily pain, and general health domains, and to assess QOL's clinical and sociodemographic correlates in patients who were disabled by ischemic stroke. DESIGN: One-year prospective study of an inception cohort of patients with first-ever brain infarction. SETTING: Stroke unit of a neurologic department of a university hospital. PATIENTS: Eighty-five consecutive patients (36 women, 49 men; mean age +/- SD, 65+/-12.5 yr) with first-ever stroke of a mild to moderate nature caused by brain infarction. MAIN OUTCOME MEASURES: Patients were examined at 3 and 12 months poststroke. QOL was measured using the RAND 36-Item Health Survey. The variables studied were lateralization of cerebral lesion, neurologic and functional status, depression, age, gender, marital status, and living conditions. Depression was evaluated according to the criteria of Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition. Neurologic impairment was assessed by Scandinavian Stroke Scale, performance in activities of daily living by the Barthel index, and the intellectual deterioration by the Mini-Mental State Examination. RESULTS: QOL was poorer for the patients with mild to moderate stroke impairments at 3 months poststroke. The test domains most prone to being affected were physical functioning, physical role limitations, vitality, and general health. Only the domains of physical functioning and physical role limitations improved during the follow-up at 1 year. Depression, although mostly minor, was the most important reason for impaired QOL. Depression, being married, and age emerged as significant independent contributors to the low score value of vitality. Depression and being married were related to the low score value of physical role limitations. CONCLUSIONS: Stroke affects QOL, impairing its physical and psychosocial domains. The most important determinants of low QOL seem to be depression and being married. These findings provide new challenges for stroke rehabilitation, calling for identification of patients and spouses in need of supportive services.     

Quality of Life, Health Status, and Depression: Comparison Between Adolescents and Adults After the Fontan Procedure With Healthy Counterparts

BACKGROUND:: Quality of life (QOL) in adolescents and adults who have undergone the Fontan procedure and are living with only 1 ventricle is presumed to be diminished. OBJECTIVES:: This study aimed to compare QOL, health status, and prevalence of depression in adolescents/adults after the Fontan procedure with healthy counterparts and to identify predictors of QOL in the Fontan group. METHODS:: Using a comparative, cross-sectional design, 54 adolescents and adults with single ventricle congenital heart disease who have undergone the Fontan procedure were compared with 66 age-matched healthy counterparts. Quality of life, health status, depression, and social support were measured using the Satisfaction With Life Scale, Short Form Survey Version 2, Patient Health Questionnaire Depression Module, and Multidimensional Scale of Perceived Social Support. Clinical variables were abstracted from medical records. Predictors of QOL were determined using multiple linear regression. RESULTS:: Adolescents and adults in the Fontan group reported lower physical health status (mean [SD] = 46.5 [9.3] vs mean [SD] = 55.9 [5.1], P < .001) and were more depressed (mean [SD] = 7.3 [5.9] vs mean [SD] = 4.5 [4.3], P < .004) than their healthy counterparts. There were no differences in QOL, mental health status, or social support between the 2 groups. Functional status (New York Heart Association class), depression, and social support accounted for 55% of the variance in QOL in the Fontan group. CONCLUSIONS:: Despite lower levels of physical health, the QOL of Fontan patients was comparable with that of their healthy counterparts; this finding contradicts previous proxy reports, self-reports, and assumptions that QOL is lower in patients with complex single ventricle congenital heart disease. However, because Fontan patients were more depressed than their healthy counterparts, the need for early screening and detection is warranted.     

慢性肾脏病患者生活质量评估方法与影响因素的研究现状

慢性肾脏病(chronic kidney disease,CKD)是一类以肾功能进行性恶化为主要表现的、伴有全身多系统病变的疾病,具有发病率高、死亡率高的特点。CKD患者常受到疼痛、焦虑、并发症等困扰,生存质量差,给患者、家属、社会经济和公共卫生事业造成极大压力。目前,对CKD患者的生活质量评估以量表法最为常用,分为普适性量表和疾病特异性量表,各有优劣,临床常结合使用。影响CKD患者生活质量的因素较为复杂,包括社会人口学、疾病相关表现、并发症、治疗情况以及心理状态等方面。本文对CKD患者生活质量评估方法及影响因素进行综述。     

机械瓣膜置换术后患者生活质量及影响因素的调查分析

目的调查机械瓣膜置换术后患者的生活质量(quality of life,QOL)状况,了解其影响因素。方法采用方便抽样的方法,选取2011年1-12月于山东大学齐鲁医院心脏外科机械瓣膜置换术后患者164例,调查其一般资料及健康相关生活质量。结果 164例患者生活质量总体水平较好,平均得分为(620.97±136.46)分。影响患者生活质量的因素共10个,目前心功能(Ⅱ、Ⅲ)、婚姻状况(离异或丧偶)是患者术后生活质量主要影响因素。结论机械瓣膜置换术后患者生活质量整体水平较好,应依据影响因素的不同进行有针对性的护理干预,进一步提高患者的生活质量。     

现行心理护理对肝癌患者抑郁及生活质量的影响及启示

目的 探讨原发性肝癌（PLC）患者抑郁与生活质量的关系,以及现行心理护理对PLC患者抑郁及生活质量的影响.方法 入院时采用抑郁自评量表（SDS）和肝癌患者生活质量测定量表（QOL-LC V2.0）对76例PLC患者进行调查,其中伴有抑郁的19例患者于出院当天再次测评.结果 76例PLC患者的抑郁与生活质量各维度及生活质量总分呈负相关（Pearsonr=-0.33～-0.56）;实施心理护理后,19例伴抑郁患者,出院时的抑郁水平低于入院时,其中11例SDS评分指数降至正常,3例的抑郁水平稍升,其余5例均有不同程度的下降;出院时19例PLC伴抑郁患者仅心理功能维度的生活质量有提升.结论 现行的心理护理对改善PLC患者的抑郁、提高心理功能维度的生活质量有一定成效,但尚不足以全面提高患者的生活质量,有必要进一步结合循证研究结果实施心理护理,以提高PLC患者的生活质量.     

脑卒中患者抑郁状况及生活质量的研究

目的 分析脑卒中缓解期患者抑郁状况及生活质量的影响因素,为进一步提高其生活质量提供理论依据.方法 选取2015年下半年该院收治的符合纳入排除标准的120例脑卒中缓解期患者,运用一般资料调查表、Zung 抑郁自评量表(SDS)、世界卫生组织生存质量评估简表(WHOQOL-BREF)进行调查,分析影响因素与生活质量的关系.结果 恢复期脑卒中患者抑郁评分为(51.29±11.35)分,WHOQOL-BREF量表生理、心理、社会关系、环境、总的生存质量、总的健康状况领域评分分别为(13.42±1.34)分、(12.19±1.26)分、(13.29±2.71)分、(13.37±1.31)分、(2.94±0.57)分、(3.42±0.77)分.Logistic回归分析显示脑卒中缓解期患者生活质量的影响因素主要为学历、居住情况、月收入及抑郁程度.结论 在对脑卒中患者进行康复训练的同时,仍需重视患者自身、家庭、社会等多方面的因素,以提高患者的生活质量.     

慢性失眠患者失眠程度、抑郁情绪与生活质量的相关性

目的 通过探讨慢性失眠患者失眠严重程度、抑郁情绪与生活质量的相关性,评估影响患者生活质量的主要因素.方法 连续收集126例成年慢性失眠患者,根据失眠严重程度指数量表(ISI)得分分为亚临床、中度、重度失眠三组,根据贝克抑郁问卷(BDI)得分分为伴和不伴抑郁两组,用SF-36健康调查量表(SF-36)评分,分别对生活质量进行比较.结果 失眠程度重的患者SF-36(除机体疼痛外)得分低(P<0.01);伴有抑郁情绪的患者SF-36(除机体疼痛外)得分低(P<0.05);相关性分析得出ISI得分与SF-36(除机体疼痛外)得分呈负相关(P<0.05),BDI得分与SF-36得分呈显著负相关(P<0.01);控制BDI变量偏相关分析,ISI得分与SF-36(生理功能、生理职能、总体健康、活力和生理健康)得分呈负相关(P<0.05);控制ISI变量偏相关分析,BDI得分与SF-36得分(除生理机能和机体疼痛外)呈显著负相关(P<0.01).结论 慢性失眠患者失眠严重程度与生活质量相关,但与慢性失眠相关的抑郁情绪起到主要作用,这提示慢性失眠治疗中应注重改善患者情绪问题.     

Social support as a mediator between depression and quality of life in Chinese community-dwelling older adults with chronic disease

The older adults with chronic disease usually show poor mental health and experience low quality of life (QOL). This study aimed to examine the mediating role of social support in the relationship between depression and QOL in community-dwelling older adults with chronic disease. A total of 387 Chinese older adults aged 60 or above with chronic disease were included in this cross-sectional study. Social support was negatively associated with depression and positively associated with physical component scale (PCS) and mental component scale (MCS). Depression and social support were all predictors of PCS and MCS. Mediation analysis suggested that social support partially mediated the impact of depression on PCS and MCS. Understanding the mediating role of social support might be beneficial in reducing the adverse impact of depression on QOL in community-dwelling older adults with chronic disease.