银川市老年人自我护理能力与生活质量的相关性

促进老年人的自我健康管理意识,提高老年人的自我护理能力是实现"健康老龄化"的重要举措.本文就银川市社区老年人自我护理能力的现状及其与生活质量的关系进行了调查分析.     

慢性肺动脉高压患者心电图SⅠQⅢTⅢ的临床意义

目的 探讨心电图SⅡQⅢTⅢ在慢性肺动脉高压患者中的发生率及其对心肺功能的预测价值.方法 对经右心导管确诊为肺动脉高压的50例患者,收集心电图及临床资料,分析SⅠQⅢTⅢ在慢性肺动脉高压患者中的发生率,并将患者按有无典型的SⅠQⅢTⅢ分为A、B两组,比较两组肺动脉高压的程度、肺动脉高压功能评级和6分钟步行试验距离.结果 ①有23(46%)例出现典型SⅠQⅢTⅢ改变,9(18%)例出现不典型的SⅠQⅢ、SⅠTⅢ、QⅢTⅢ改变;②A、B两组肺动脉高压程度无明显差别,A组肺动脉高压功能评级高于B组(2.39±1.03 vs 1.78±0.64,P＜0.05),6分钟步行试验距离低于B组(325.45±126.62 vs 475.84±165.23 m,P＜0.001).结论 ①对心电图出现SⅠQⅢ患者,在排除急性肺栓塞后应考虑存在慢性肺动脉高压可能;②慢性肺动脉高压患者心电图出现SⅠQⅢTⅢ者的心肺功能损害较无SⅠQⅢTⅢ者差.     

不同养老模式下老年人自我护理能力与生活质量的相关性

目的了解不同养老模式下老年人的自我护理能力和生活质量的相关性。方法采用自我护理能力测定表和生活质量综合评定问卷对盐城市家庭养老、机构养老和社区居家养老的老年人自我护理能力和生活质量进行调查分析。结果不同养老模式下老年人的自我护理能力和生活质量具有差异性(P0.01),不同养老模式的自我护理能力和生活质量呈正相关(P0.05)。结论不同养老模式下老年人自我护理能力与生活质量关系密切,需针对性地进行自我护理干预提高自我护理能力,促进其生活质量的改善。     

肺动脉高压患者健康相关生活质量的调查研究

目的:评估在靶向药物治疗时代肺动脉高压(PAH)患者生活质量现状,探讨影响患者生活质量的危险因素.方法:选择2017年1月至2018年12月连续在中国医学科学院阜外医院经右心导管检查确诊为PAH的患者,利用简明生活质量量表第二版进行生活质量评分,并通过多因素Logistic回归分析影响患者生理健康和心理健康的危险因素....     

右心室功能与系统性红斑狼疮合并肺动脉高压患者的病情及生活质量的相关性

目的探讨右心室功能与系统性红斑狼疮(SLE)合并肺动脉高压(PAH)患者的病情及生活质量的相关性。方法选择2017年3月至2018年1月于安徽医科大学第一附属医院就诊的SLE合并PAH患者90例纳入SLE+PAH组,将同期于我院就诊的常规SLE患者82例纳入SLE组,再将同期于我院体检健康的成年患者91例纳入对照组。收集所有患者一般资料及检测指标,并比较三组患者间差异。随后根据SLE+PAH组患者PAH病情(EULAR/ACR标准)进行分组,比较两组患者间右心室舒张末期面积(RV EDA)、右心室心肌功能指数(RV MPI)、肺动脉收缩压(PASP)、三尖瓣环收缩期位移(TAPSE)、右室面积变化分数(RV FAC)、三尖瓣口舒张早期和晚期血流峰值比(E/A)、舒张早期三尖瓣血流峰值和三尖瓣瓣环组织多普勒速度比值(E/e’)的差异。最后分析上述指标与患者病情评分及生活质量评分(SF-36)的相关性。结果SLE+PAH组RV基底直径(39.74±4.92:28.29±4.13:27.34±3.72)、RV EDA(22.83±3.62:17.92±2.38:17.47±2.94)、RV MPI(0.52±0.08:0.41±0.05:0.36±0.06)、PASP(61.34±9.12:24.19±2.94:18.53±2.34)及E/e’(6.64±1.63:4.87±0.92:3.25±0.43)均显著高于其他两组(F=232.90,85.31,143.32,1462.63,521.57;均P <0.01),而TAPSE(14.83±3.14:20.38±3.29:25.54±3.52)、RV FAC(27.23±4.42:37.14±5.33:42.37±6.13)、E/A(0.62±0.18:1.24±0.29:1.56±0.23)显著低于其他两组(F=394.56,186.90,370.56;P <0.05)。SLE+PAH组中WHO分类Ⅰ-Ⅱ期共计52例,而Ⅲ-Ⅳ期共计38例。Ⅰ-Ⅱ组中TAPSE(21.62±2.93:9.41±3.29)、RV FAC(41.39±4.23:27.14±3.95)、E/A(0.84±0.21vs0.47±0.19)均显著高于Ⅲ-Ⅳ组(t=18.54,16.28,8.59;均P <0.01),而RV基底段直径(37.47±4.83:43.19±5.24)、RV EDA(19.33±3.72:23.43±3.98)、RV MPI(0.42±0.08:0.74±0.09)、PASP(41.42±6.43:83.39±11.23)及E/e’(4.88±0.78:9.47±2.94)显著低于Ⅲ-Ⅳ组(t=-5.35,-5.01,-17.78,-22.41,-10.77,均P <0.01)。SLE+PAH组患者RV MPI及PASP与病情呈正相关,且为影响SLEDAI评分的独立危险因素(β=0.185,0.226;P <0.01);而TAPSE及RVFAC与病情呈负相关,为SLEDAI评分的保护因素(β=-0.271,-0.410;P <0.01);该组患者中RV MPI及PASP与SF-36得分呈负相关,且为影响患者SF-36评分的独立危险因素(β=-0.404,-0.573;均P <0.01)。结论 PASP及MPI作为影响SLE合并PAH患者病情及生活质量的独立危险因素,在今后临床工作中应加以重视。     

社区老年慢性病患者自我护理能力与生命质量的相关性

目的探讨社区老年慢性病人自我护理能力与生命质量的相关性。方法采用一般情况调查表、自我护理能力的测量量表(ESCA)和健康调查简表(SF-36)对250例社区老年慢性病患者进行问卷调查分析。结果社区老年慢性病患者的自我护理能力总分为(110.20±21.23)分,生命质量总分为(442.16±87.57)分。自我护理的4个维度,即自护知识、自我概念、自护责任感、自护技能与生命质量均有相关性(P<0.05)。结论护理人员在对老年慢性病患者的护理过程中,应着重提高患者的自我护理能力,改善其生命质量。     

延续护理模式对AMI患者自我护理能力和生活质量的影响

目的：探讨延续护理模式对急性心肌梗死(AMI)患者自我护理能力和生存质量的影响。方法：将84例AMI患者随机分为观察组及对照组各42例,对照组给予常规性护理,观察组给予延续护理模式进行护理,对比分析两组患者干预前后疾病知识、自护能力及生活质量的变化。结果：观察组干预后合理饮食、合理作息、运动锻炼、情绪控制、遵医用药等知识评分显著高于对照组(P<0.05)。观察组干预后心理维度、生理维度、社会适应性以及生存质量总评分高于对照组,差异有统计学意义(P<0.05)。观察组干预后心绞痛稳定性、躯体受限程度、心绞痛发作程度、疾病认知程度、治疗满意度等评分显著高于对照组(P<0.05)。结论：延续护理模式能有效提高急性心肌梗死患者疾病知识及自我护理能力,改善患者生活质量。     

西地那非治疗肺动脉高压的疗效及其对患者生活质量的影响

目的观察西地那非治疗肺动脉高压（PAH）的效果及其对患者生活质量的影响。方法选择PAH患者98例,给予口服西地那非（20 mg,3次/d）6个月,给药前后分别进行超声心动图、6分钟步行试验（6MWT）及生活质量调查问卷SF-36评分等。结果与治疗前比较,治疗后6MWT延长,超声心动图中的左心房直径、三尖瓣环收缩偏移数值、左心室射血分数增加,Tei指数、右心室直径、右心房直径、肺动脉收缩压降低,P均〈0.05;SF-36评分8个领域中的5项均得到提高,P均〈0.05。结论西地那非治疗PAH有效,且可明显改善患者生活质量。     

探析自我护理强化对糖尿病性视网膜病变术后患者自我护理能力及生存质量的影响

目的分析糖尿病性视网膜病变术后患者接受自我护理强化措施后,对其带来的影响。方法研究时间选择2017年10月—2019年10月,120例研究对象均为糖尿性视网膜病变术后患者,此次研究采用的分组方式为单双号分组法,单号分为常规组,该组接受常规护理措施,双号分至另一组,为试验组,该组患者接受自我护理强化措施,对两组研究结果进行分析。结果试验组护理自我护理能力评分均高于常规组,差异有统计学意义(t=16.830、6.038、4.105,P<0.05);试验组各项生活质量评分均显著高于常规组,差异有统计学意义(t=25.733、12.056、38.581、19.242,P<0.05);试验组各项健康行为达标率明显高于常规组,差异有统计学意义(χ²=10.909、8.292、11.582、9.219,P<0.05);试验组临床护理总满意度明显高于常规组,差异有统计学意义(χ²=9.259,P<0.05)。结论通过运用自我护理强化的方式能够对糖尿病性视网膜病变患者产生积极的促进作用,值得推广。     

Health-related quality of life in patients with pulmonary arterial hypertension

STUDY OBJECTIVES: Patients with pulmonary arterial hypertension (PAH) often present with dyspnea and severe functional limitations, but their health-related quality of life (HRQOL) has not been studied extensively. This study describes HRQOL in a cohort of patients with PAH. DESIGN: Cross-sectional study. SETTING: A tertiary care, university hospital-based, pulmonary hypertension (PH) clinic. PARTICIPANTS: We studied HRQOL in 53 patients with PAH (mean age, 47 years; median duration of disease, 559 days). Eighty-three percent were women, 53% received epoprostenol, and 72% reported moderate-to-severe functional limitations with a New York Heart Association class 3 or 4 at enrollment. MEASUREMENTS AND RESULTS: We examined HRQOL by administering the Nottingham Health Profile, Congestive Heart Failure Questionnaire, and Hospital Anxiety and Depression Scale. We used the Visual Analog Scale and standard gamble (SG) techniques to measure preferences for current health (utilities). Compared with population norms, participants reported moderate-to-severe impairment in multiple domains of HRQOL, including physical mobility, emotional reaction, pain, energy, sleep, and social isolation. Mean SG utilities were 0.71, suggesting that, on average, participants were willing to accept a 29% risk of death in order to be cured of PH. CONCLUSIONS: PAH is a devastating condition that affects predominately young women in the prime of their life. Understanding HRQOL and preferences are important in the care and management of these patients. Compared with population norms, patients with PAH have substantial functional and emotional limitations that adversely affect their HRQOL.     

Sildenafil improves health-related quality of life in patients with pulmonary arterial hypertension

BACKGROUND: Sildenafil inhibits phosphodiesterase-5, enhancing cyclic guanosine monophosphate- mediated relaxation of pulmonary vasculature and is effective in treating patients with pulmonary arterial hypertension (PAH). METHODS: Patients with PAH (n = 278) received oral sildenafil (20, 40, or 80 mg three times daily) in a 12-week, double-blind, placebo-controlled study and an open-label extension. Health-related quality of life (HRQoL) was recorded by patients using the Medical Outcomes Study 36-item short form (SF-36) and EuroQol 5D (EQ-5D) questionnaires at baseline and after 12 and 24 weeks of therapy. Data are presented for patients who received sildenafil for up to 24 weeks. RESULTS: Sildenafil-treated patients, compared with placebo-treated patients, exhibited significant improvement in exercise capacity at week 12 (p < 0.001). Increases from baseline to week 12 were observed in all SF-36 domains for sildenafil-treated patients, with statistically significant improvements, compared with placebo-treated control subjects, in physical functioning (p < 0.001), general health (p < 0.001), and vitality (p < 0.05). Statistically significant improvements were also observed for the EQ-5D current health status (p < 0.01) and utility index (p < 0.01). These benefits were maintained for 24 weeks. Treatment groups were pooled for analyses as the results for the 6-min walk distance, SF-36, and EQ-5D were not dose dependent. CONCLUSIONS: Sildenafil improves HRQoL of PAH patients. These improvements appear to be maintained for at least 24 weeks. The effects are strongest in domains addressing the physical impact of health on daily activities and patients' overall perception of health.     

Evaluation of disease-specific health-related quality of life in patients with pulmonary arterial hypertension

BACKGROUND: Pulmonary arterial hypertension (PAH) remains a debilitating and life-threatening disease despite improvements in hemodynamics, exercise capacity and survival with recent therapeutic advances. Health-related quality of life (HRQOL) has, therefore, been proposed as an important outcome for evaluating care. Relatively little, however, is known regarding HRQOL or its determinants in PAH. The Minnesota Living with Heart Failure questionnaire was recently adapted and validated for HRQOL measurement in PAH. We applied this pulmonary hypertension-specific version (MLHF-PH) to a larger population of PAH patients. METHODS: Ninety-three consecutive outpatients with PAH completed the MLHF-PH. Scores were assessed for correlations with demographics, symptoms, hemodynamics and treatments. RESULTS: Patients with PAH had significantly impaired HRQOL as assessed by the disease-specific MLHF-PH. Each physical and emotional component, as well as total scores on the MLHF-PH indicated severely depressed HRQOL. As compared to other diagnoses, PAH associated with scleroderma had the worst HRQOL. Patients with WHO functional Class II symptoms reported better HRQOL than Class III patients. Fatigue, weakness and abdominal discomfort were each associated with more severely depressed HRQOL, as was current epoprostenol use. With the sole exception of the right atrial pressure, hemodynamic measurements did not correlate with HRQOL scores. Simultaneous evaluation of HRQOL with a non-disease-specific questionnaire (SF-36) revealed a similarly impaired status, although identified fewer associations with patient-specific factors. CONCLUSION: Severely impaired HRQOL is present in this population of patients with PAH evaluated with a disease-specific questionnaire. The availability of a pulmonary hypertension-specific HRQOL questionnaire may enable further targeted investigations of factors that might improve outcomes.     

Comparison and validation of three measures of quality of life in patients with pulmonary hypertension

Background: Pulmonary hypertension, when advanced, markedly limits exercise capacity, activities of daily living and quality of life (QoL). No measure of QoL has yet been validated for the assessment of pulmonary hypertension. The aim of the study was to compare the validity of the Minnesota Living with Heart Failure (MLwHF) questionnaire, the Short Form‐36 (SF‐36) questionnaire and the Australian Quality of Life (AQoL) measure for assessing pulmonary hypertension treatment. Methods: Eighty‐three patients were enrolled in three studies of pulmonary hypertension treatment (treprostinil, bosentan and sildenafil). They were assessed at baseline and 3 months with the MLwHF questionnaire. Treprostinil and bosentan groups also had 6 and 12 months’ data. Twenty‐one patients in the sildenafil trial completed concurrently, the SF‐36 and AQoL measures at baseline and 3 months. QoL scores were correlated with the 6‐min walk test distance, New York Heart Association functional class and right heart catheter‐derived haemodynamic parameters of the disease for all matching time points and for changes in scores and clinical measurements over time. Results: The MLwHF and SF‐36 scores correlated well with the 6‐min walk test distance and New York Heart Association functional class, but did not correlate with haemodynamic measurements. MLwHF and SF‐36 scores also correlated with the rate of change of the 6‐min walk test distance and New York Heart Association functional class over time. Conclusion: The MLwHF questionnaire and SF‐36 are useful tools for the assessment of QoL in pulmonary hypertension and may be useful in the ongoing evaluation of QoL in the treatment and study of pulmonary hypertension.     

社区护理干预对高血压患者生活质量的影响

目的 研究护理干预对本社区高血压患者生活质量的影响及其血压控制效果评价。方法 对172例原发性高血压患者采用答卷方式调查其生活质量指标，并检测其动态血压指标。实施社区综合防治管理后复查并比较实施前、后动态血压变化及生活质量的变化。结果 实施社区干预后其动态血压各指标，患者的健康感觉、躯体症状、工作能力、性生活状况、认识功能、社会参与能力、生活满足感等均有显著改善并有统计学意义（P均〈0．01），唯睡眠状态变化不明显（P〉0．05）。结论 社区护理干预对高血压患者无论在改善高血压患者行为变化即生活方式、提高生活质量、降低其血压水平、提高其血压控制率等方面有积极作用。     

Survival and quality of life for patients with peripheral type chronic thromboembolic pulmonary hypertension.

BACKGROUND: The validity of pulmonary thromboendarterectomy for treatment of relatively peripheral type of chronic thromboembolic pulmonary hypertension (CTEPH) remains uncertain. The survival and quality of life (QOL) of patients with relatively peripheral type of CTEPH was investigated at follow up. METHODS AND RESULTS: Between April 1999 and March 2006, 83 consecutive patients with CTEPH were evaluated for surgical indication and underwent computed tomography angiography. The extent of central disease was scored (ie, CD score), and a CD score of 相似文献   

The quality of life of patients with hypertension

The authors evaluated the self-reported quality of life in patients with systemic arterial hypertension and assessed whether clinicians and normotensive respondents from the general public appreciate the impact that hypertension has on health-related quality of life. A quality-of-life questionnaire was completed by 385 individuals: persons with hypertension (n=188), normotensive persons (n=148), and clinicians (n=49). A utility score, which represents one's self-perceived health-related quality of life, was generated for each group by using standardized time tradeoff questionnaires. Quality of life with hypertension was judged to be significantly higher according to affected individuals (mean utility score, 0.980), compared with normotensive persons (mean utility score, 0.948) and clinicians (mean utility score, 0.942), who were asked to assume that they had hypertension (p<0.0005). Clinicians and normotensive individuals tend to overemphasize the impact that hypertension has on quality of life, as compared to affected patients. The relatively low impact that hypertensive individuals indicate high blood pressure has on their quality of life may contribute to their lack of compliance with treatment regimens.     

Quality of life and psychological symptoms in patients with pulmonary hypertension

Background

Pulmonary arterial hypertension (PAH) has a delay in diagnosis that makes time since diagnosis of interest in this population.