影响脑卒中患者恢复期生存质量相关因素分析

目的通过对影响脑卒中患者急性期生存质量相关因素进行前瞻性研究,为提高脑卒中患者卒中后恢复期的生存质量提供帮助。方法选取2010-11—2011-10大庆龙南医院神经内科符合实验录入标准的脑卒中住院患者100例。入院后详细询问病史,填写一般情况调查表,并做相关检查。采用脑卒中影响量表评定脑卒中患者生存质量,汉密尔顿抑郁量表评定抑郁程度,神经功能缺损程度用美国国立卫生研究院卒中量表评分,改良兰金量表评定患者的生活自理能力。结果配合完成调查100例,经单因素分析及多元回归分析,年龄、家庭人均月收入、脑卒中次数及神经功能缺损状况、生活自理能力、是否接受康复治疗及卒中后抑郁对患者发病后3个月生存质量有影响。结论积极治疗脑卒中后抑郁,及早进行康复护理干预,促进神经功能康复,重视脑卒中患者(尤其是老年患者)生存质量,做好脑卒中二级预防工作以减少卒中次数是提高脑卒中患者生存质量的重要保证。     

脑卒中后焦虑障碍相关因素及症状特点的研究

目的 了解脑卒中后焦虑障碍（PSAD）的发生率，相关因素及症状特点，寻找防治措施。方法 采用SAS量表对115例脑卒中病人进行测评，收集年龄，病程,性别，卒中次数，肌力等资料，对所获资料统计分析。结果 PSAD的发生率为38．26％，病程，卒中次数，偏瘫程度等与PSAD的发生相关，但与其严重程度无关。常见症状有不幸预感，乏力，睡眠障碍，焦虑等。结论 宜加强防治脑卒中，给予心理疏导，争取家庭社会支持。     

脑卒中后抑郁的相关因素

脑卒中后抑郁(post-stroke depression,PSD)是脑卒中后急性期至2-3年内常见的并发症。目前对PSD的研究发现,PSD的发生不但与卒中损伤部位和卒中后神经功能缺损程度等生物学因素有关,还与病人本身的人格特征、认知功能损害程度以及社会支持等心理社会因素有关。     

河南地区脑卒中患者生存质量及影响因素的调查研究

目的探讨河南地区脑卒中患者的生存质量状况及其影响因素,为提高患者生存质量提供依据。方法对1230例脑卒中患者进行流行病学问卷调查,收集被调查者的相关资料,并进行条件Logistic回归分析。结果多因素分析表明共6项有显著性(P0.05),按危险度(OR)高低排序依次是卒中导致的功能障碍(OR值=2.45)、早期康复治疗(OR值=2.31)、急性期及时治疗(OR值=1.69)、心理状况(OR值=1.23)、年龄(OR值=0.98)、婚姻状况(OR值=0.79)。结论脑卒中患者生存质量较低,河南地区脑卒中患者生存质量的主要影响因素分别是卒中导致的功能障碍、早期康复治疗、急性期及时治疗、心理状况、年龄、婚姻状况。     

脑卒中后抑郁的相关因素的临床研究

脑卒中是发病率、病死率和致残率较高的疾病。该疾病的发生后期经常出现并发症,其中卒中后抑郁（PSD）是最为常见的并发症之一,其可影响患者的认知能力,也可影响患者的生存质量。本研究分析了卒中后抑郁（PSD）发病率和     

急性脑卒中后抑郁焦虑的发生率及相关因素研究

目的 探讨急性脑卒中后抑郁、焦虑症状的发生率及相关因素。方法 采用SDS和SAS对389例急性脑卒中患者进行量表自评。结果 抑郁症状的发生率为39.6％、焦虑症状的发生率为41.6％,分析发现抑郁症状的发生与左侧大脑半球病变、病程>1个月及SAS评分高有关;而焦虑症状的发生则与左侧大脑半球病变、病程≤1个月及SDS评分高有关。结论 急性脑卒中患者存在明显的负性情绪障碍,应及早诊断和处理,以促进病人全面康复。     

脑卒中患者的睡眠障碍及其相关因素分析

目的探讨脑卒中患者睡眠障碍的情况及其影响因素。方法选择526例脑卒中急性期住院病人,采用匹兹堡睡眠质量指数问卷(PSQI)、神经功能缺损程度评分(NDS)、症状自评量表(SCL-90)、日常生活能力量表(ADL)进行调查。结果在526例脑卒中患者中,睡眠障碍患者(PSQI总分>7分者)341例(64.8%)。睡眠障碍患者与非睡眠障碍患者在性别、年龄、SCL-90、NDS和ADL评分方面比较,差异均有统计学意义(P<0.05或P<0.01)。多元逐步回归分析显示,睡眠障碍与患者的性别、年龄、精神状态、神经功能缺损程度、日常生活能力、脑卒中的部位及病变范围大小密切相关。结论脑卒中患者睡眠障碍的发生率较高,要改善脑卒中后的睡眠障碍,除了防止脑卒中外,还需要患者自身有良好的心理状态,改善睡眠有助于患者神经功能缺损的康复和生存质量的提高。     

影响脑卒中患者生活质量的因素分析

目的：探讨影响脑卒中患者生活质量（QOL ）的相关因素,为临床护理提供指导。方法采用脑卒中影响量表（SIS）对200例脑卒中患者进行QOL测评,并对可能影响QOL的因素进行单因素和多因素分析。结果（1）脑卒中患者的SIS总评分421～610分,平均（530.16±38.40）分,第25、50、75百分位分别是503分、533分和557分。（2）暴露于病程＞4周、作业治疗、延伸护理、有配偶和右侧半球病变者的SIS评分高于病程＜4周、无作业治疗、无延伸护理、无配偶和左侧半球病变者,P＜0.05。（3）Pearson相关分析显示,SIS评分与神经功能缺损评分（NIHSS ,R＝－0.658,P＝0.000）、焦虑评分（SAS ,R＝—0.617,P＝0.000）、抑郁评分（SDS ,R＝－0.628,P＝0.000）负相关,与入院时格拉斯哥昏迷评分（GCS ,R＝0.491,P＝0.044）和社会支持（SSRS ,R＝0.698,P＝0.000）正相关。（4）逐步多元线性回归分析显示,病程、延伸护理、NIHSS、SSRS和SDS入选以SIS评分为结果变量的线性模型,P＜0.05。结论病程、延伸护理、神经功能缺损、SSRS和SDS是影响脑卒中患者QOL的独立因素,出院后实施延伸护理,提高社会支持度,及时心理疏导改善抑郁状态有利于脑卒中患者QOL的提高。     

老年脑卒中后抑郁及相关影响因素分析

目的　了解老年脑卒中后抑郁 (PSD)的发生率及与性别、文化程度、病变部位、病灶数目、致残程度的关系 ,对日常生活能力恢复的影响。方法　采用老年抑郁量表对 96例脑卒中患者进行评定 ,分为抑郁组和非抑郁组进行分析比较。结果　共有 44例患者有抑郁症状 ,总发生率为 45 83 % ,女性患者、文化水平偏低、病变部位在左半球及多个病灶者发生率高 ,致残程度与PSD呈正相关。结论　老年PSD发生率高 ,是多种因素共同作用的结果 ,直接影响病人的生存质量及功能恢复。     

急性脑卒中后焦虑相关因素的调查研究

脑卒中后焦虑(PSAD)是脑血管病常见的并发症。文献报道,脑卒中患者PSAD的发病率为21%~28%,本研究对308例脑卒中患者进行现状调查,探讨PSAD发生率及其与初发、复发、经济收入、知识水平的关系。     

Health-related quality of life in sporadic adult-onset ataxia.

Despite progressive disability in sporadic adult-onset ataxia (SAOA), little is known about patients' assessment of their ataxic disorder and its impact on health-related quality of life (Hr-QoL). This study investigated Hr-QoL by means of the following self-administered scales: Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Beck Depression Inventory (BDI), and the Medical Outcome Study Short Form (SF-36). Twenty-two unselected ataxia patients were included. Sleep-related complaints were found in 9 (41%) of 22 and symptoms of depression in 6 (38%) of 16 patients. Compared to a large german control group, SAOA patients had lower scores in all SF-36 dimensions except for bodily pain. The greatest impairment was found in the domain physical functioning, followed by the domains social functioning and role limitations (emotional problems). There was a significant negative correlation of all nonmotor SF-36 dimensions with the BDI score. Walking aid dependency was significantly correlated with poorer health status perception in several motor and nonmotor domains. In addition, impaired sleep quality was correlated with an impaired general health perception and with bodily pain. The study demonstrates a great impact of SAOA on Hr-QoL. Adequate treatment of depression, motor disability, and impaired sleep quality is essential to improve Hr-QoL in ataxic patients.     

Health-related quality of life and its relationship to cognitive and emotional functioning in multiple sclerosis patients

The existing knowledge about the health-related quality of life (HRQoL) and its relationship to cognitive and/or emotional functioning in multiple sclerosis (MS) is scarce. We assessed differences between subgroups of MS outpatients (n = 209) on one HRQoL instrument: a version of the Functional Assessment of Multiple Sclerosis quality of life instrument; on two cognitive functioning tests: the Mini-Mental State Examination and the clock drawing test; and on two emotional functioning tests: the Hamilton Rating Scale for Depression and the Hamilton Rating Scale for Anxiety. Three disease-related characteristics were assessed: physical disability, duration of the illness, and clinical course. The results showed that each of these has an effect on at least one dimension of HRQoL and on one mental functioning test. Thus, the more severe, the more progressive, and the longer the illness duration, the lower the HRQoL. Likewise, cognitive mean scores decreased and emotional mean scores increased with greater illness severity and progressive the MS. Furthermore, we also found significant correlations between cognitive and emotional functioning tests and HRQoL dimensions. Thus, the worse cognitive functioning and the higher depressive and anxiety symptoms score the lower the HRQoL.     

Health-related quality of life and mental health in older women with urinary incontinence

Objectives: The purpose of this cross-sectional study was to compare health-related quality of life (QOL) and mental health between older women with and without urinary incontinence.

Method: This study is a secondary data analysis using raw data from 1874 women aged 65 years or older who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) IV (2008–2009), a nationally representative sample.

Results: In the pain/discomfort dimension of the EuroQol-5, 25.4% of the participants experienced urinary incontinence and 14.7% did not (p = .001). In the anxiety/depression dimension, urinary incontinence was present in 8.3% of the participants and absent in 3.6% (p = 0.012). In addition, the results of an ANCOVA showed that scores in both the EuroQol visual analogue scale and the EQ-5D index were significantly lower in participants with urinary incontinence relative to those without. The risk of stress and depression in older women with urinary incontinence was approximately 2 and 1.5 times higher, respectively, than that of participants without urinary incontinence.

Conclusion: Health-related QOL in older women with urinary incontinence was relatively low, while levels of stress and depression were high. Therefore, in order to improve QOL and mental health in older women, the understanding and management of urinary incontinence interventions is required.     

Health-related quality of life measures and psychiatric comorbidity in patients with migraine

Background and purpose:  The identification of factors associated to health-related quality of life (HRQoL) measures in patients with migraine has major implications in terms of prognosis and treatment. This study aimed at investigating associations between HRQoL and comorbid mood and anxiety disorders.
Methods:  Consecutive adult outpatients with a diagnosis of migraine with or without aura were assessed using the Mini International Neuropsychiatric Interview (M.I.N.I.) Plus version 5.0.0 and the Migraine-Specific Quality-of-Life Questionnaire (MSQ).
Results:  Data of 112 patients (82 females), 69 without aura, mean age 41.2 ± 13.3 years were analyzed. According to the M.I.N.I., 50% patients had a lifetime or current DSM-IV diagnosis of mood or anxiety disorder. There was no between-groups difference in MSQ total and subscale scores in relation to the presence/absence of psychiatric comorbidity, independently whether that was current or lifetime. In the group of subjects with psychiatric disorders, age at onset of migraine correlated with MSQ-total (rho = −0.407 P  = 0.002), and subscale scores (Role Function-Restrictive, rho = −0.397, P  = 0.002; Emotional Function, rho = −0.487, P  < 0.001).
Conclusions:  Our findings suggest that current and/or lifetime psychiatric comorbidities are not associated with HRQoL measures in patients with migraine. However, patients with migraine and psychiatric comorbidities may represent a specific subgroup deserving particular attention for targeted interventions.     

Health-related quality of life in narcolepsy

OBJECTIVES: To describe health-related quality of life in Norwegian patients with narcolepsy compared with data from the general population. PATIENTS AND METHODS: Seventy-seven patients with narcolepsy with cataplexy were included in the final analysis. Health-related quality of life was assessed by SF-36 questionnaire. RESULTS: Men and women with narcolepsy had lower scores in all SF-36 domains, except vitality. Most profoundly affected were bodily pain (men: p = 0.0001, women: p = 0.0001), social function (men: p = 0.0001, women: p = 0.0001) and general health (men p = 0.04, women: p = 0.0001). CONCLUSIONS: Narcolepsy has a clear negative effect on quality of life which is not sufficiently counteracted by medical treatment. We suggest that earlier diagnosis and treatment after onset of symptoms may be important in reducing the negative effects on quality of life. Special attention should be paid to the patients social functioning and general well-being.     

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.     

Depression,anxiety and quality of life in parents of children with epilepsy

0bjectives – To assess the impact of childhood epilepsy on parental quality of life (QOL) and psychological health, and to investigate possible correlations between parental QOL and background variables as well as parental anxiety and depression. Subjects and methods – Parents having an epileptic child (n = 263) and parents having a healthy child (n = 270) were enrolled. Groups were in balance for background variables. Short‐Form Health Survey (SF‐36) Questionnaire, Zung Depression Scale (ZDS) and Zung Anxiety Scale (ZAS) were applied to all parents. Patients were divided into the first visit group (newly diagnosed epilepsy) and follow‐up visit group. Results – The parents of children with epilepsy had significantly lower QOL scores in SF‐36 for all subscales and higher levels of depression and anxiety by using ZDS and ZAS. The factors correlated with parental QOL were seizure control, visit status, anxiety, depression, employment, cost of epilepsy, status epilepticus, drug side effect and age of parents. Conclusions – Childhood epilepsy has a severe impact on parental QOL and psychological health, and recognition of possible correlations between parental QOL and background variables will be helpful to improve parental QOL.     

Health-related quality of life and its determinants among adults with autism

The purpose of this study was to determine health-related quality of life (HRQOL) among adults with autism, and compare it to the HRQOL of the general adult population in the United States (US). Factors predicting HRQOL of adults with autism were also identified. A cross-sectional online survey was conducted to gather study information. From adults with autism registered with the Interactive Autism Network (IAN), those aged 18 years and above and having the capacity to self-report were identified and approached for study participation. The final sample included 291 adults with autism. One-way t-test revealed adults with autism to have significantly lower physical and mental HRQOL than their counterparts in the US population. Using linear regression analysis, modifiable factors including social support and coping along with other socio-demographic and medial characteristics were identified as significant predictors of physical and mental HRQOL. Greater perceived adequacy of social support from friends and family was associated with better HRQOL, while greater use of maladaptive coping was associated with lower HRQOL. Clinicians and other health interventionist should consider assessing these factors among adults with autism, and provide necessary capabilities to these adults with the aim of improving their HRQOL.     

抑郁症患者生活质量及其相关因素分析

目的 分析抑郁症患者生活质量及其相关因素,为制定提高患者生活质量的对策提供参考。方法 于2018年11月19日-2019年9月7日在湛江中心人民医院、广东医科大学附属医院、广东三九脑科医院选取符合《国际疾病分类（第10版）》（ICD-10）抑郁症诊断标准的住院患者117例。通过查阅病历,收集患者血常规、尿常规、血生化检查、血气分析等临床客观指标,采用抑郁症患者生活质量测定量表QLICD-DE(V2.0)评定患者生活质量。采用简单相关分析探讨QLICD-DE(V2.0)评分与各临床客观指标的相关性,并使用多重线性回归分析进一步筛选与抑郁症患者生活质量相关的因素。结果 简单相关分析显示,抑郁症患者QLICD-DE(V2.0)总评分与血清总蛋白和血小板分布宽度均呈正相关（r=0.198、0.281,P<0.05或0.01）,与红细胞压积呈负相关（r=-0.300,P<0.01）。多重线性回归分析结果显示,血清白/球蛋白比值和治疗依从性（B=-19.836、-3.711,P<0.05或0.01）是躯体功能的影响因素;血小板分布宽度（B=2.706,P<0.01）是心理功...     

视神经脊髓炎患者生活质量调查

目的观察视神经脊髓炎(neuromyelitis optica,NMO)患者扩展残疾状况量表(expanded disability status scale,EDSS)评分、病程、年龄、性别及水通道蛋白4(AQP4)-IgG与生活质量的关系,初步探讨影响NMO患者生活质量的因素。方法对40例NMO患者进行EDSS评分,填写国外广泛使用于NMO患者的中文版简化36医疗结局研究量表(MOSSF-36,简称SF-36量表),分别对NMO患者的EDSS评分、病程、年龄、AQP4-IgG与SF-36量表评分的相关性进行分析。结果 NMO患者EDSS评分与生活质量中生理健康呈中度负相关(r=-0.572,P=0.0001),与心理健康无相关性(r=-0.284,P=0.075)。其中EDSS评分与SF-36量表8个维度中的生理机能(r=-0.484,P=0.002)、生理职能(r=-0.532,P=0.0004)、躯体疼痛(r=-0.386,P=0.014)、一般健康状况(r=-0.420,P=0.007)、精力(r=-0.378,P=0.016)和社会功能(r=-0.373,P=0.018)均呈负相关,与"健康变化"这一项呈低度正相关(r=0.347,P=0.028),而与"情感职能"和"精神健康"两项无相关性(均P0.05)。年龄仅与生理健康(r=-0.390,P=0.013)和其中生理功能(r=-0.498,P=0.001)这一维度呈负相关,病程、性别、AQP4-IgG与生活质量均无相关性(均P0.05),EDSS评分与年龄呈低度正相关(r=0.384,P=0.015)。结论 EDSS评分可作为NMO患者生活质量尤其是生理健康的一个预测因子,临床可常规评定NMO患者EDSS得分,从而指导临床医生关注患者生活质量并进行必要干预。