生存质量及其相关观念

本文介绍了生存质量的含义和主要内容,并对其相关概念作了详细的阐述,它们包括健康、健康状态、健康相关生存质量、功能状态、情绪、症状等.了解这些概念有助于加深我们对生存质量的理解,并更好地在临床工作中加以运用.     

Analysis of the Concept of Quality of Life

ABSTRACT. Nurses provide the constant human care that can make the difference between a life that is valuable to the last and a life that ends in humiliation, deprivation and suffering. Nurses, therefore, more than other health professionals, need a deep and reflective view of patients' value and quality of life. In this paper the concept of quality of life is analysed from a philosophical and scientific perspective. Quality of life in connection with treatment of a disease has its roots in the philosophical conception of the value of human life in general. Characteristics such as happiness, physical activity and interpersonal relations are what give life value and meaning. From the scientific viewpoint, it seems difficult to define the concept, given its multidimensional characteristics. However, the analysis indicates a growing interest among health-professionals to develop scientific intersubjectivity of the concept in terms of measurable parameters.     

'The real stuff': implications for nursing of assessing and measuring a terminally ill person's quality of life

Two quality of life (QoL) assessment and measurement tools, the Client Generated Index (CGI) and the McGill Quality of Life (MQOL) questionnaires, were trialled within district nursing palliative care to test usefulness and feasibility for holistic intervention selection, individualized palliative care planning, and measurement of the quality of dying. The specific focus of this paper is to discuss the less tangible outcomes of the trial, which illuminate the partly 'hidden' value and nature of clinical nursing. These outcomes include awareness that the use of such tools may: by actual administration of the tool be, in and of itself, a therapeutic nursing action; focus on 'the real stuff from the client's perspective, that which matters most to the terminally ill client, but may not be classically considered as prompting nursing intervention; and facilitate 'the real stuff' of nursing, perhaps known but not usually articulated by nurses, and which usually does not feature on care plans nor in time allocation schedules.     

住院精神分裂症患者生存质量及相关因素

目的探讨慢性精神分裂症患者的生存质量以及相关因素。方法采用简明曼彻斯特生存质量评定量表(MANSA)和阳性和阴性症状量表(PANSS)对150例住院精神分裂症患者进行评定。结果住院精神分裂症患者质量偏低。不满意的因子项目为经济状况和社会交往;基本满意的因子项目为法律与安全及健康状况。影响患者生存质量的主要因素为:经济状况、费用来源、饮食满意度、业余生活满意度、躯体状况满意度、心理健康满意度、阴性症状和自知力。而与年龄、性别、教育程度、病程、家族史等无关。结论该生存质量评定量表给患者、家属、医生、政府等提供了有价值的工具。     

37例门静脉高压症患者手术后生存质量的追踪调查

目的 了解门静脉高压症患者手术后生存质量的变化,为实施临床护理提供实证依据.方法 采用消化病生存质量指数追踪测定37例门静脉高压症手术患者在术前、术后2周至2年的生存质量值.结果 患者术前平均消化病生存质量指数值为(101.2±12.2)分;术后2周和5周时分别为(93.7±13.5)分、(93.3±9.4)分,下降明显,与术前比较,P＜0.05;术后10～16周为94.3～97.6分,与术前比较无显著性差异,P＞0.05;术后6月～2年,稳定在99.5～102.3分.结论 术后2～5周是生存质量最低阶段,是临床护理最关键的时期,术后5周起消化病生存质量指数开始提升,术后16周恢复术前水平.     

临终关怀对社区居民临终患者生活质量的影响

目的探讨临终关怀对社区居民临终患者生活质量的影响。方法选取我社区2013年12月~2014年7月60例临终患者为观察组,对其实施临终关怀。选取我社区同期36例临终患者为对照组,行常规护理。比较两组睡眠情况、心理状态、自尊水平以及生活质量。结果 1个月后,观察组入睡时间较少,睡眠时间较长,焦虑、抑郁评分较低,自尊水平较高,疼痛程度评分较低,与对照组比较有显著性差异(P0.05)。观察组生活质量评分高于对照组,有显著性差异(P0.05)。结论实施临终关怀能够改善临终患者的不良心理,提高患者临终期间的生活质量。     

生存质量在眼科疾病防治中的应用

新开发的生存质量量表包括了视功能和症状的现状及其对精神心理、视觉相关的日常生活和社会活动执行情况的影响及对本人生存质量的满意度项目，不仅满足了眼科疾病的特殊要求，还可应用于测量不同眼疾患者医疗干预效果的评价。     

哮喘患者生存质量的研究

哮喘患者生存质量是为适应生物、心理和社会医学模式下产生的评估哮喘患者健康状况的一种指标。影响哮喘患者生存质量的因素较多,主要因素有年龄、性别、哮喘发作程度及用药量、肺功能、文化程度、风俗习惯等。我国哮喘患者生存质量评估表与欧美的评估表在某些方面不同,主要是反映生存质量的项目不同和表达项目的语言及方式不同。目前,哮喘患者生存质量评估已广泛应用于临床。     

外科领域的生存质量研究

外科领域生存质量研究对象已涉及外科大多数病种。测定时多将普适性量表和针对某一病种的特异性量表结合使用，采用自评量表法。对于术后生存质量下降期进行生存质量测定时，应注意测定时点的设定。     

输卵管性不孕妇女生存质量的调查分析

目的：探讨输卵管性不孕妇女生存质量及其影响因素,并为输卵管性不孕症治疗决策的选择提供相应的依据。方法：采用生存质量测评量表SF-36对80名输卵管性不孕妇女及80名已生育或妊娠的健康妇女进行了同期的横断面调查与比较。结果：输卵管性不孕妇女的生存质量较正常健康妇女人群低,除了生理功能及躯体疼痛外,输卵管性不孕妇女有关社会功能、生理问题对功能的限制、心理问题对功能的限制、心理健康、活力、健康的总体评价、健康变化程度等七个方面的主观满意度均较对照组低,差异有显著意义（P〈0．05）。患者的年龄、文化程度及居住环境对其生存质量有影响。结论：在治疗不孕症时,不应仅针对其病因治疗,而且要重视心理和社会因素的作用,加强心理治疗,重视健康教育,针对性地改善患者在精神、社会、心理等方面的主观体验,以促进不孕症妇女生存质量的提高。     

Quality of Life for Family Caregivers of People with Chronic Health Problems

The trend toward community-based care, along with advances in medical technology, has resulted in increased numbers of individuals with complex healthcare needs being cared for at home by their families. This shift from hospital to community care places increased demands on family caregivers. Families are now providing long-term care for chronically ill people with a variety of conditions. Caregiver research has, for the most part, explored burden, stress, and depression as outcomes of caregiving. There is little research assessing the quality of life(QOL) of long-term caregivers. In the research on quality of life, the patient is most frequently the focus. With the increased demand on families as caregivers, quality of life needs to be included as a variable in studying family caregivers for chronically ill individuals. The purpose of this paper is to discuss issues in studying quality of life in family caregivers of persons with chronic conditions. Conceptualization of quality of life is explored, measurement of quality of life examined and the research on quality of life reviewed, with a focus on the quality of life of the family caregiver.     

Development of an HIV Assessment Tool

The objective of this study was to establish the validity and reliability of a visual analog scale that rates HIV-related symptom severity and general well-being. Three groups of subjects completed the HIV Assessment Tool (HAT): uninfected subjects (n=53); people with HlV infection (n=60), and people with CDC-defined AIDS (n=43) according to the 1987 criteria. Test-retest reliability was .96 and Cronbach's alpha was .92. Face, content, and construct validity were established. Significant differences were found between healthy subjects and those with HIV or AlDS supporting discriminant validity. Correlation of the Karnofsky performance status with the HAT was significant (r=.51, p <.001) which demonstrated concurrent validity. Factor analysis helped identify general well-being, general symptoms, and HIV-specific symptoms. The instrument can be used to relate HlV symptoms to disease progression, and to evaluate the effectiveness of nursing interventions     

生存质量测评中量表、特殊量表及其使用问题

生存质量在疾病的防治中起着越来越重要的作用,生存质量的测量用了各种工具和评分,组成-系列符合测量目的的量表.量表可分为总量表和特殊量表,在投人使用之前均应检测信度、效度和反应度.而测量结果需用合适的方法进行分析,最终得到科学的依据.本文就生存质量测量中量表、特殊量表及其使用问题作一简介.     

精神疾病与生存质量研究

对精神病患者、家庭照料者生存质量研究的进展及选择生活质量评估工具的几点重要原则做以介绍。     

不同性别护士生活质量的调查分析

目的了解不同性别护士生活质量并分析其影响因素。方法采用生活质量调查表(the world health organization quality of Life,WHOQOL)和工作生活质量量表(quality of nursing work life,QNWL)对70名男护士与120名女护士进行问卷测评。结果男护士生活质量得分(77.89±13.84)分高于女护士(67.99±9.20)分;男护士工作生活质量得分(164.47±23.21)分高于女护士(146.75±24.76)分;护士工作生活质量是影响其生活质量的重要因素(r=0.66)。结论扩大男护士队伍是科学合理调配人力资源的方法;通过人性化的弹性排班、补充护理人力资源、降低职业风险是提高护士工作生活质量,改善其生活质量的保证。     

Knowledge of stroke in rehabilitation and community samples

This study examined the stroke knowledge of 60 stroke rehabilitation patients, 46 spouses, 25 family members, and 103 people in the general community. Changes in stroke knowledge with time, and determinants of stroke knowledge, were also examined. Clinical participants were assessed on acute admission, admission to and discharge from rehabilitation, and 6 and 12 months after discharge. Community participants were assessed once. Instruments used were the Stroke Care Information Test, Australian ADL Index, Frenchay Activities Index, Illness Behaviour Questionnaire and Zung Self-rating Depression Scale. The stroke knowledge of all participants, particularly patients, was poor, but improved with time. Better-informed patients were younger, had milder strokes, were less depressed, were less likely to develop abnormal illness behaviour, and made a better functional recovery than patients with poorer knowledge. Structured information programmes are needed for stroke patients and their families. Improved community awareness of stroke may help the prospects for recovery and quality of life for people who have strokes.     

Quality of life of Chinese patients newly diagnosed with gastrointestinal cancer: a longitudinal study

Cancer of the gastrointestinal (GIT) tract is a major health problem in China. The aims of the study were to investigate quality of life of Chinese patients newly diagnosed with gastrointestinal (GIT) cancer, identify factors predicting quality of life, and to examine the pattern of stability and change in symptoms, psychosocial measures and quality of life over a 6 months period. A convenience sample of 146 newly diagnosed GIT cancer patients recruited from three major hospitals in Shanghai completed a self-report questionnaire initially and 6 months later. Results indicated that Chinese patients newly diagnosed with GIT cancer experience a range of symptoms associated with cancer and its treatment that resulted in varying degrees of symptom distress, anxiety and depression, and decreased quality of life. Findings from this research give insights into the importance of ongoing quality of life assessment, symptom management, and intervention to improve quality of life of Chinese cancer patients. It also raised questions about measures of quality of life that are culturally relevant.     

大学生生命质量调查

[目的]初步探讨大学生生命质量的差异。[方法]采用非等概率多阶段分层、整群抽样,对某大学1998级至2001级工、管、医专业全日制在册本、专科四个年级学生,无记名填写WHOQOL-100量表、焦虑自评量表(SAS)、抑郁自评量表(SDS)、运用SPSS10.0 for windows统计软件进行统计学处理。[结果]回收合格问卷1171份,WHOQOL-100总生命质量及健康状况平均分(总分)为57.1.较一般正常人低,除环境领域外,5个领域均有显著差异,WHOQOL-100与SAS、SDS评分呈明显负相关。工、管、医专业学生间的总分无显著性差异,但生理领域医学专业较管理专止高。成人本科生总分低于普通大学生。不同年级大学生总分存在显著差异。生理领域评分男生高于女生,而在社会领域评分女生高于男生。[结论]大学生生命质量有待于针对其薄弱环节进行改善。     

Testing the validity of a translated pharmaceutical therapy-related quality of life instrument, using qualitative 'think aloud' methodology

Background and objective: In pharmacy practice, there is a need for valid and reliable instruments to study patient‐reported outcomes. One potential candidate is a pharmaceutical therapy‐related quality of life (PTRQoL) instrument. This study explored the face and content validity, including cognitive aspects of question answering of a PTRQoL instrument, translated from English to Swedish. Method: A sample of 16 customers at Swedish community pharmacies, was asked to fill in the PTRQoL instrument while constantly reporting how they reasoned. The resulting interviews and concurrent probing, were audio‐taped, transcribed verbatim and analysed using constant comparison method. Results and discussion: The relation between the measurement and its theoretical underpinning was challenged. Respondents neglected to read the instructions, used response options in an unpredictable way, and varied in their interpretations of the items. Conclusion: The combination of ‘think‐aloud’, retrospective probing and qualitative analysis informed on the validity of the PTRQoL instrument and was valuable in questionnaire development. The study also identified specific problems that could be relevant for other instruments probing patients’ medicines‐related attitudes and behaviour.