支气管哮喘患者的生存质量及相关因素

目的：探讨成年哮喘患者生存质量及相关因素.方法：采用支气管哮喘生存质量评估表,激惹、抑郁和焦虑自评量表,正性负性情绪量表,自尊量表,安全感量表对51例哮喘患者和40例正常对照组进行现场调查.结果：患者的抑郁得分、负性情绪得分均高于正常组（5.5±2.1/3.5±2.0,t=2.45,P=0.017;26.4±6.1/18.9±5.9,t=3.47,P=0.002）,患者的自尊得分和人际安全感得分均低于正常组（15.5±3.2/21.0±2.7;24.0±6.7/29.6±4.3;t=2.18,2.61,P=0.031、0.014）,而感情孤独得分高于正常组（15.5±2.6/10.0±4.2;t=2.37,P=0.023）.生存质量总分与职业、病程、内向性激惹得分呈负相关（r=-0.358,-0.308,-0.355,-0.342,P＜0.05）,与受教育程度、一秒钟用力呼气量、PANAS测量的正性情绪、自尊得分呈正相关（r或rs值分别为0.314,0.337,0.343,0.347,0.356,P＜0.05）,与抑郁、负性情绪得分呈负相关（r=-0.382,-0.435,P＜0.01）.结论：成年哮喘患者存在心理问题,生存质量与基本情况、不良情绪、心理状况等诸多因素有关.     

The validity of the Menopause Specific Quality of Life Questionnaire in older women

OBJECTIVES: To examine the validity of the Menopause Specific Quality of Life Questionnaire (MENQOL) domains when used with elderly women. We also determined whether MENQOL domain scores were related to depression and cognitive complaints. METHODS: 148 post-menopausal women (60-88 years old), not on hormone replacement therapy, were screened for a randomized control trial examining the effectiveness of hormone replacement therapy in the delay of cognitive impairment. Validation of the psychosocial, physical and sexual domains of MENQOL involved linear regression analysis with the mental component and the physical component of the SF-36, and with marital status, respectively. We used logistic regression analysis to examine the relationship between the above MENQOL domain scores and depression, and linear regression analysis to examine the relationship between these MENQOL domain scores and cognitive complaints. All regression analyses were adjusted for age, education, and whether or not a woman had surgical menopause. RESULTS: We found 44% of the variation in the MENQOL's physical and psychosocial domain scores could be explained by their respective validation measures, and that 18% of the variation in the sexual domain scores could be explained by marital status. Poor quality of life (QoL) on the physical and psychosocial domains was significantly associated with depressed affect and more cognitive complaints. CONCLUSIONS: The results support the validity of the MENQOL physical, psychosocial and sexual domains as QoL measures in elderly women. QoL impairment on the physical and psychosocial MENQOL domains are also related to depression and cognitive complaints.     

首发支气管哮喘患者心理健康状况及生存质量分析

目的调查首次发病支气管哮喘患者的心理健康状况,并分析心理学因素对患者生活质量的影响。方法采用抑郁自评量表、焦虑自评量表、多伦多述情障碍评定量表、社会支持评定量表、特质应对方式问卷、世界卫生组织生存质量测定量表简表调查112例首次发病支气管哮喘患者及110例正常对照者的心理健康状况。结果①首发支气管哮喘患者SAS评分显著高于对照组（t=4．89,P〈0．01）,SDS评分也显著高于对照组（t=3．69,P〈0．01）;②首发支气管哮喘患者较对照组客观支持少（t=2．05,P〈0．05）,对社会支持的利用较差（t=5．69,P〈0．01）;③首发支气管哮喘患者更多采用消极的应对方式（t=2．17,P〈0．05）;④患者较对照组存在述情困难,表现为难以描述自己的情感（t=6．35,P〈0．01）;⑤患者生活质量差于对照组,主要体现在生理领域（t=2．00,P〈0．05）;⑥相关分析结果表明,患者的生活质量受焦虑、抑郁情绪、述情困难、应对方式、较少的社会支持以及对支持的利用不足等多方面影响（P〈0．05或〈0．01）。结论首发支气管哮喘患者存在较多心理问题,影响患者的生活质量。心理健康状况差是支气管哮喘发病的危险因素。     

The impact of GINA suggested drugs for the treatment of asthma on Health-Related Quality of Life: a GA(2)LEN review

Asthma represents a serious global health problem. People of all ages in countries throughout the world are affected by this chronic airway disorder that, when uncontrolled, can place severe limits on daily life and can even be fatal. Asthma cannot be removed, but asthmatic symptoms can be cured; as for many other chronic diseases, pharmacotherapy is important to reduce the risk of asthma-related mortality, decrease disability and improve symptoms and quality of life. The action of antiasthmatic drugs directly contributes to decrease symptoms severity, improve spirometric results, reduce airway hyperresponsiveness and prevent irreversible airway remodelling. Antiasthmatic therapy is necessary for long-term control of asthma symptoms. Asthma and antiasthmatic drugs can influence patient's quality of life: this is why healthcare systems have recently focused on research studies about Health-Related Quality of Life (HRQL) in asthmatic patients. Numerous validated questionnaires are available and many studies have been performed evaluating HRQL in people affected by asthma, thus testifying a great interest in this topic. The aims of the present review are to examine the scientific literature of the last 4 years (January 2004–December 2007) dealing with the impact of asthma treatments suggested by Global Initiative for Asthma guidelines on patients' quality of life, and to identify the unexplored or not fully investigated areas concerning this issue.     

影响哮喘患者生活质量的心理和社会因素分析

目的探讨影响哮喘患者生活质量的心理社会因素,为制定心理干预和教育管理方案提供依据。方法对近10年来影响哮喘患者生活质量的心理社会因素的研究成果等进行综述。结果影响哮喘患者生活质量的心理社会因素主要包括:人格、应对、社会支持、情绪等。结论应该从改变患者的应对方式,提高其社会支持、改善情绪等方面入手,提高哮喘患者的生活质量。     

支气管哮喘病人焦虑与生命质量的相关性研究

目的　评估支气管哮喘病人焦虑与生命质量的水平 ;探讨支气管哮喘病人焦虑与生命质量的关系 .方法应用状态 -特质焦虑问卷 (STAIFORMY)和世界卫生组织生命质量量表简表 (WHOQOL -BREF) ,分别对支气管哮喘门诊病人和健康对照人群的焦虑和生命质量水平进行问卷调查 .结果　哮喘组状态焦虑为 45 1± 9 7,特质焦虑为46 5± 9 7,生命质量为 87 3± 13 2 ;健康组的状态焦虑为 3 7 7± 7 4,特质焦虑为 3 8 4± 8 1,生命质量为 95 4± 11 7.哮喘组状态焦虑、特质焦虑与生命质量均负相关 ,相关系数分别为 - 0 69和 - 0 79.结论　①支气管哮喘病人的状态焦虑及特质焦虑水平均高于健康人群 ,生命质量水平低于健康人群 ;②支气管喘病人的焦虑与生命质量负相关 .因此 ,在护理实践中应对哮喘病人进行焦虑的心理护理 ,提高其生命质量     

原发性骨质疏松症患者生活质量量表的信度与效度研究

目的:检验原发性骨质疏松症患者生活质量量表(Osteoporosis Quality of Life Scale,OQOLS)测试版的信、效度.方法:应用OQOLS测试版随机抽取240名原发性骨质疏松症患者进行现场测试,计算该量表的重测信度、内部一致性信度和结构效度、效标效度等.结果: OQOLS测试版的重测系数为0.784～0.927,Cronbach's α系数为0.835～0.979,因子分析显示OQOLS的结构效度良好,与SF-36的效标效度为0.301～0.846.结论: OQOLS测试版具有较好的信、效度,可以用于我国原发性骨质疏松症患者生活质量的测评.     

济南市部分区县老年人生活质量与生活满意度研究

目的:探讨老年人群生活质量和生活满意度的状况及影响因素.方法:采用SF-36健康调查表,对济南市1386名老年人进行调查.结果:老年人群慢性病的患病率为65.1%;影响老年人生活满意度的主要因素是:心理状况、家庭和睦情况、是否丧偶、慢性病和经济收入;老年人生活质量的主要影响因素为:生活满意度、慢性病、心理状况、生活功能状况,家庭和睦和经济收入.结论:老年人的生活满意度与生活质量密切相关.生理、心理和社会经济状况显著影响老年人的生活质量.     

Physical Activity and Quality of Life: Assessing the Influence of Activity Frequency,Intensity, Volume,and Motives

In the present study, the authors investigated the impact of exercise frequency, intensity, and volume along with exercise motives on quality of life (QOL) reports. The authors assessed exercise habits with the Godin Leisure Time Activity Scale and measured exercise motives with the Reasons for Exercise Inventory. The Quality of Life Inventory assessed satisfaction in 16 domains including health, work, and recreation. High-frequency exercisers reported significantly higher health, helping, and community-related QOL than those who exercised less frequently. The authors noted significantly higher healthrelated QOL in the heavy volume group compared with the other volume groups. Multiple regression tests revealed that activity intensity and exercise motives significantly predicted QOL reports. The strongest bivariate correlations with QOL existed for mild activity and exercising for fitness and health reasons. Thus, high-frequency activity of mild intensity that produces high kcal utilization and is performed to improve health and fitness has the strongest influence on QOL reports.     

The Predictors of Poorly Controlled Asthma in Elderly

Purpose

To evaluate asthma control in elderly individuals and identify the factors that predict poor control.

Methods

A retrospective, observational study evaluating 108 elderly individuals with asthma (59 females: ≥60 years, mean age: 70.5 years) was conducted at Ajou University Hospital from October 2010 to March 2011. Subjects were classified into two groups according to scores on the asthma control test (ACT). Group I consisted of 38 patients with ACT scores ≤19 (poor controllers) and group II included 70 patients with ACT scores >19 (controllers). Clinical data was analyzed. Spirometry was performed, and the ACT and asthma quality-of-life survey were completed. Medication possession ratios were calculated to evaluate compliance.

Results

Of the 108 enrolled subjects, 54.6% were female, 7.5% were obese, and 49.0% were atopic. The mean age of the patients was 70.5, and the average of time patients had suffered from asthma was 15.5 years. Comorbid conditions were found in more than 80% of the patients. Allergic rhinitis was most common comorbid condition; this was followed by cardiovascular disease and degenerative arthritis (76.9%, 65.7%, and 51.9%, respectively). Many patients (35.2%) were in poorly controlled states characterized by significantly lower asthma quality of life scores (P<0.001) and higher admission rates (P=0.034). Multivariate logistic regression analysis showed that a history of pulmonary tuberculosis was a predictor of poorly controlled asthma in elderly individuals even after adjusting for age, sex, smoking, lung function and other comorbidities (OR=4.70, CI=1.06-20.81, P=0.042).

Conclusions

The asthma of more than one-third of elderly individuals with this condition was poorly controlled, and a history of pulmonary tuberculosis may have contributed to this outcome. Proper evaluation and management of comorbid conditions in elderly patients with asthma is essential for the achievement of better control of the disease and a higher quality of life for those who suffer from it.     

小剂量帕罗西汀对功能性消化不良患者临床症状及生活质量的影响

目的 观察帕罗西汀对功能性消化不良患者消化不良症状及生活质量的影响。方法 按照罗马Ⅱ标准选择156例功能性消化不良患者随机分为两组，对照组78例给予多潘立酮（10mg tid）；治疗组78倒在多潘立酮治疗的基础上加抗抑郁药一盐酸帕罗西汀（10mg qd）。疗程8周，评定治疗前后患者的生活质量评分（生活质量指数问卷QL-INDEX）和消化不良症状评分。结果 8周后消化不良症状评分治疗组显著低于对照组（P〈0．01）；生活质量评分治疗组明显高于对照组（P〈0．05）。结论对功能性消化不良患者，小剂量盐酸帕罗西汀能明显改善患者的消化不良症状及生活质量。     

胆石症手术患者生活质量量表的信度与效度分析

目的:检验胆石症手术患者生活质量量表(Quality of Life Scale of Gallstones Surgery Patients,QLSGSP)测试版的信度与效度。方法:应用QLSGSP测试版随机抽取186名胆石症手术患者进行现场测试,计算该量表的重测信度、内部一致性信度和结构效度、效标效度等。结果:QLSGSP测试版的重测系数为0.938￣0.995,Cronbach'sα系数为0.779￣0.856,因子分析显示QLSGSP测试版的结构效度良好,与WHOQL-BREF的效标效度为0.431￣0.843。结论:QLSGSP测试版具有较好的信、效度,可以用于我国胆石症手术患者生活质量的测评。     

Prevalence and Correlates of Insomnia and its Impact on Quality of Life in Chinese Schizophrenia Patients

Study Objectives:

This study aimed to determine the prevalence and the sociodemographic and clinical correlates of insomnia in Chinese schizophrenia outpatients and its impact on patients'' quality of life (QOL).

Design:

Two hundred fifty-five clinically stable schizophrenia outpatients were randomly selected in Hong Kong and their counterparts matched according to sex, age, age at onset, and length of illness were recruited in Beijing, China. All subjects at both sites were interviewed by the same investigator using standardized assessment instruments.

Setting:

Hong Kong and Beijing, China.

Patients or Participants:

Clinically stable schizophrenia outpatients.

Interventions:

N/A.

Measurements and Results:

In the combined Beijing-Hong Kong sample the frequency of at least one type of insomnia over the previous 12 months was 36.0%; the rates of difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), and early morning awakening (EMA) were 21.2%, 23.6%, and 11.9%, respectively. Poor sleep was significantly associated with advanced age, older age at onset, fewer psychiatric admissions, severity of positive symptoms, anxiety, extrapyramidal symptoms (EPS) and depressive symptoms, less frequent use of atypical antipsychotic medications (AP), and more frequent use of benzodiazepines (BZD) and hypnotics. Poor sleepers had significantly poorer QOL in all domains than patients without insomnia. After controlling for the potential confounding effects of sociodemographic and clinical factors, a significant difference remained between the 2 groups with regard to the physical QOL domain. A multiple logistic regression analysis found that advanced age, fewer psychiatric admissions, severity of depressive symptoms and use of hypnotics were significant contributors to poor sleep.

Conclusion:

Insomnia is independently associated with poor QOL. More attention should be paid in clinical practice to the high rate of insomnia in Chinese schizophrenia patients.

Citation:

Xiang YT; Weng YZ; Leung CM; Tang WK; Lai KYC; Ungvari GS. Prevalence and correlates of insomnia and its impact on quality of life in Chinese schizophrenia patients. SLEEP 2009;32(1):105-109.     

哮喘儿童行为问题及其主观生活质量研究

随着医学模式、健康概念的转变 ,社会心理因素和行为方式与健康之间的相互影响已日益受到重视。人们对慢性疾病的认识不再局限于对躯体和生命数量的影响 ,其对心理行为和生活质量的影响也同样受到关注[1] 。哮喘作为儿童时期最常见的慢性疾病之一[2 ] ,且近年来患病率及死亡率有所上升[3] ,已严重危害了儿童的健康。本次研究旨在通过对不同程度的哮喘儿童与正常儿童的行为问题进行比较 ,了解哮喘儿童行为问题的发生 ,同时对哮喘儿童和主观生活质量进行了初步的探讨 ,以求在新的医学模式观点指导下 ,对哮喘儿童进行综合治疗 ,全面提高哮喘儿…     

The Behcet's Disease Quality of Life: reliability and validity of the Korean version

Purpose

The Behçet''s Disease Quality of Life (BD-QoL) is a BD-specific measure developed in the UK. The aim of this study was to adapt the BD-QoL for use in Korea.

Patients and Methods

The translation was based on the guidelines for cross-cultural adaptation. A total of 201 Korean patients with BD participated in this study. To evaluate the psychometric properties, internal consistency and test-retest reliability were used. Factor analysis was performed to examine the construct validity. To provide further evidence for validity, the correlation of BD-QoL with the Clinical Activity Form for Korean Patients with BD (BDCAF-K) and the Center for Epidemiologic Studies-Depression (CES-D) scales was assessed.

Results

The Korean version had high internal consistency (Cronbach''s alpha, 0.93) and test-retest reliability (r = 0.835). Factor analysis of the questionnaire revealed one interpretable factor as a general health-related quality of life factor. The Korean version significantly correlated with scores of CES-D (r = 0.749, p= 0.000), self-rating scale of well-being over the past 28 days (r = 0.446, p= 0.000), and BDCAF-K score (r = 0.502, p = 0.000).

Conclusion

Adaptation of the BD-QoL for use in Korea was successful. Together with the BDCAF-K, it may be a valuable tool for assessing the influence of interventions in BD patients and outcome in clinical trials.     

甲状腺肿瘤病人术后生活质量研究

目的：探讨甲状腺肿瘤病人术后的生存质量及其影响因素,方法：随访调查89例甲状腺肿瘤病人,采用WHO／QOL量表测量并比较各人群生存质量,结果：良性和乳头状癌甲状腺肿瘤病人生存质量和正常人群基本无差别;良性和非乳头状恶性甲状腺肿瘤病人在生存质量的部分维度存在差异,。结论：肿瘤的恶性程度影响病人的生活质量。     

社区原发性高血压患者生活质量调查

目的 :探讨社区高血压患者的生活质量及其影响因素。方法 :对 1992年参加社区原发性高血压综合干预跟踪研究的 177名患者进行随访及生活质量调查 ,被试者年龄范围 5 1～ 77岁。采用自编调查表和生活质量综合评定问卷 -74(GQOLI-74) ,完成各种测查者共 15 2人。结果 :79 6%的患者除服药外采用了调整生活方式、行为方式等非药物治疗的方法 ;生活质量问卷测查结果显示 ,被试者对健康状况和生活质量的总体评价及主观满意度在中等水平 (X±SD :12 89± 2 19) ;比较不同治疗模式下 (分为三组 :药物治疗 ,综合治疗 ,药物 运动治疗 )患者的生活质量 ,综合治疗组的物质生活维度、经济状况因子得分略高于其它两组 (P <0 0 5 ) ,药物 运动组的心理功能维度、正性情感因子及精神紧张度因子得分略高于其它两组(P <0 0 1)。结论 :综合干预措施对提高原发性高血压患者的生活质量、改善整体健康状况可起到积极的促进作用     

利培酮、氯氮平对精神分裂症患者生活质量的影响

目的 :探讨利培酮、氯氮平对精神分裂症患者生活质量的影响。方法 :对符合CCMD -Ⅱ -R诊断标准的精神分裂症患者 ,在使用利培酮 ( 2 4例 )、氯氮平 ( 2 6例 )治疗期间进行 6个月的随访 ,观察利醅酮、氯氮平对精神分裂症患者的精神症状、生活质量的影响。结果 :发现 :1、利培酮组对精神分裂症阳性、阴性症状的改善和氯氮平组相似 ,对PANSS总分的改善明显优于氯氮平组。 2、 6个月的治疗前后相比 ,利培酮对患者的生活质量的影响 ,除精神支柱外均非常明显地提高 ;氯氮平可以部分提高患者的生活质量 ,但对患者的生理领域、心理领域、独立性领域没有明显改善。 3、 6个月后 ,利培酮组比氯氮平组相比 ,利培酮组与氯氮平更能改善精神分裂症患者的生活质量 ,有利于患者重返社会。     

Asthma control,quality of life and successful sputum induction

Introduction

Induced sputum is widely used in clinical practice and scientific studies. This technique has become enormously useful in assessment of airway inflammation. However, some asthmatics are unable to expectorate sputum of sufficient quality and quantity necessary for further processing, therefore not providing reliable results. This research study aimed to examine whether asthma control and asthma quality of life influence the results of sputum induction.

Material and methods

Fourty-seven adult subjects, current non-smokers with symptomatic asthma, were studied. All participants underwent clinical assessment, skin prick testing, spirometry and sputum induction. Before sputum induction, subjects were asked to fill in the Mini Asthma Quality of Life Questionnaire (MiniAQLQ) and Asthma Control Questionnaire (ACQ).

Results

Twenty-nine (62%) subjects produced sputum eligible for processing. This group had a significantly lower ACQ score (0.83 ±0.65 vs. 1.37 ±0.77; p = 0.02), higher MiniAQLQ total score (5.67 ±0.99 vs. 4.86 ±1.07; p = 0.011), higher MiniAQLQ symptoms domain score (5.54 ±1.13 vs. 4.63 ±1.24; p = 0.013) and higher MiniAQLQ activity limitations domain score (6.08 ±0.92 vs. 5.07 ±1.37; p= 0.014). The noted differences between groups of patients were not only statistically but were clinically important.

Conclusions

The study results suggest that successful sputum induction may be expected in patients with better asthma control and better quality of life.