慢性肝病的生命质量量表评价

生命质量研究是随着人群健康改善情况逐渐发展起来的一种健康测量技术,作为患者躯体功能、心理状态、社会适应和环境因素指标的一种反映,能全面体现患者健康水平.生命质量正是在这种客观健康水平提高和主观健康观念更新的背景下应运而生的一套评价健康水平的指标体系.     

慢性咳嗽的生活质量评估

慢性咳嗽是常见的临床症状,对患者生活质量的各个方面,尤其是社会心理领域有着广泛的负面影响.慢性咳嗽患者的生活质量通过咳嗽积分、普适性量表、专门的咳嗽量表进行评估.专门的咳嗽量表能精确地反映咳嗽患者生活质量的细微变化,成为评估慢性咳嗽患者生活质量有效、可靠的工具.通过专门的评估工具,可以定量或半定量地分析咳嗽引起的生活质量改变,进而判断咳嗽严重程度及临床治疗效果.     

肠易激综合征患者生存质量的评价

目的　探讨与评价社区人群中肠易激综合征 (IBS)患者的健康相关生存质量 (HRQOL)情况。方法　在广东省采用分层、整群、随机抽样的调查中收集到的符合RomeⅡ诊断标准的 2 31例IBS患者 ,并随机选取 6 36例非IBS(NIBS)者为对照组 ;生存质量的调查采用世界卫生组织推荐的SF 36量表。结果　 (1)两组对象在年龄、性别、学历及城乡分布方面 ,经检验差异无显著性 (P >0 0 5 ) ;(2 )IBS组比NIBS组在生理机能、生理职能、情感职能、社会功能、躯体疼痛、精力、一般状况、精神健康、健康变化等各个维度分值均有明显降低 (P <0 0 5 ) ;IBS就诊者SF 36各个维度的分值比非就诊者有所降低 ,但差异无显著性 (P >0 0 5 ) ;(3)SF 36各维度分值与IBS患者每月犯腹痛的次数相关 (P <0 0 5 ) ;并与患者自诉腹痛对生活和工作的影响程度相关 (P <0 0 5 ) ;也与IBS患者是否出现乏力的症状相关 (P <0 0 5 ) ;(4)应对方式与HRQOL明显相关 ;控制应对方式对HRQOL的影响后 ,IBS组仍比NIBS组的HRQOL有明显下降。结论　与NIBS者相比 ,IBS患者生存质量明显下降 ;SF 36量表适用于IBS的HRQOL评估 ;但有必要进行有关IBS特异的生存质量量表的研究分析。     

残胃癌患者的生命质量评价

目的 研究残胃癌患者的健康相关生命质量(HRQoL)及其影响因素.方法 选取因早期胃癌接受胃大部切除术≥10年者130例,根据术后残胃是否发生癌变分为残胃癌组80例和残胃组50例.2组均接受癌症普适性量表生命质量测定量表(QLQ)-C30和胃癌特异性量表QLQ-STO22调查,评价其HRQoL.正态分布数据两组间比较行t检验.非正态分布数据两组间比较行Wilcoxon秩和检验.采用最优尺度回归分析筛选HRQoL相关的临床影响因素.结果 所有研究对象均完成量表调查.与健康对照组比较,残胃癌组总体生命质量评价、躯体功能、角色功能、情绪功能、认知功能、社会功能评分皆较低,差异均有统计学意义(t=-6.678、-7.111、-10.605、-5.748、-4.765、-21.170,P均＜0.01),疲倦、疼痛、腹泻、恶心与呕吐、食欲不振、经济困难、吞咽困难、腹痛、反流症状、饮食受限、焦虑、身体外观、脱发评分皆较高,差异均有统计学意义(t=6.925、4.218、4.728,Z=-5.236、-7.890、-7.698、-10.058、-3.612、-6.914、-9.711、9.940、-7.987、-4.966,P均＜0.01).与残胃组比较,残胃癌组总体生命质量评价、躯体功能、角色功能、情绪功能、认知功能、社会功能评分皆较低,差异均有统计学意义(t=-5.861、-5.821、-7.077、-7.999、-2.808、-5.710,P均＜0.01),疲倦、疼痛、恶心与呕吐、食欲不振、经济困难、吞咽困难、饮食受限、焦虑、身体外观、脱发评分皆较高,差异均有统计学意义(t=9.363、6.842,Z=-2.654、-6.256、-3.266、-4.132、-2.854、-7.996、-4.258、-2.005,P均＜0.01).与健康对照组比较,残胃组社会功能评分较低,差异有统计学意义(t=-9.820,P＜0.01),腹泻、恶心与呕吐、经济困难、吞咽困难、反流症状、饮食受限、身体外观、脱发评分皆较高,差异均有统计学意义(t=3.020,Z=-1.981、-3.775、-6.505、-6.098、-8.032、-3.369、-3.147,P均＜0.05),疲倦和疼痛的症状评分则较低,差异均有统计学意义(t=-2.890、-2.439,P均＜0.05).患者的HRQoL与学历、婚姻状况、家庭收入、残胃病程均正相关.结论 残胃癌患者的HRQoL均有不同程度下降.学历、家庭收入、残胃病程、婚姻状况等因素会影响残胃癌患者的HRQoL.     

Evaluation of the quality of life after surgical treatment for thoracic esophageal cancer

Background Surgical treatment for thoracic esophageal cancer is highly invasive. The importance of evaluating the postoperative quality of life (QOL) is beginning to be recognized. Methods We reviewed the QOL of 46 patients who had undergone thoracolaparotomy for thoracic esophageal cancer using questionnaires (a questionnaire prepared at our department and the scale of health-related QOL [sf36v-2]) and respiratory function tests. Results (1) Results of the sf36v-2: there was no significant difference other than score of bodily pain (BP) and score of role, physical (RP). (2) Results of our questionnaire: (2-1) activity: the activity level recovered nearly to the preoperative level in 70% of the patients after a mean of 10.4 months post-esophagectomy. (2-2) Wounds: none of the patients complained of chronic pain or inconvenience in daily living. (2-3) Eating: the mean quantity of food per meal was about 2/3 of the quantity before surgery. Seventeen patients felt some problems concerning the passage of food through the site of anastomosis. A mean weight loss of about 7 kg was observed after surgery compared with the preoperative level. (3) Results of respiratory function tests: significant differences were observed in % vital capacity and % maximum ventilation volume but not in forced expiratory volume in 1 second compared with the preoperative levels (P < 0.01). Conclusions The postoperative QOL of patients who underwent esophagectomy was maintained at a satisfactory level. Their respiratory function was slightly reduced compared with the preoperative level, but their daily activities were similar to those of healthy people, and their eating problems were tolerable.     

铜陵市娱乐场所女性服务人员生存质量评价

目的 了解娱乐场所女性服务人员的生存质量现状,为采取相应措施提高其生存质量提供参考依据. 方法 选用世界卫生组织的生存质量测定量表简表(WHOQOL-BREF中文版),对86名娱乐场所和92名餐饮业女性服务人员进行了问卷调查,比较两者生存质量的差异. 结果 娱乐业女性服务人员的生理健康、心理健康、社会关系3个维度,及综合评分分值均明显低于餐饮业女性服务人员.娱乐业女性服务人员的抚养人是父母亲、关爱程度高、本人交友态度热情、家庭幸福的比例较餐饮业低. 结论 娱乐业女性服务人员的生存质量较低,应针对这一特殊人群采取措施提高其生存质量.     

Evaluation of quality of life in clinical trials of cardiovascular disease

There is an increasing interest in the use of quality of life methods to assess the benefits of treatment in cardiovascular disease. When selecting dimensions of quality of life and the instruments to measure these dimensions, the key issue is the detection of a response to treatment during the trial. The sensitivity of a variety of instruments appropriate to hypertension, angina and congestive heart failure is reviewed. Quality of life should be assessed in double blind randomized controlled trials. A Health Index must be included to take into account any mortality and morbidity occurring during the trial. Data are presented on the measurement of quality of life in patients taking placebo prior to entering trials of antihypertensive treatment. The variation with age, sex and nationality is discussed. Also reported are the results arising from observer bias in a single-blind trial.     

老年白内障患者超声乳化吸除联合人工晶状体植入术后生存质量的变化

目的：探讨老年白内障患者超声乳化吸除联合人工晶状体植入术后生存质量的提高状况。方法：超声乳白内障化吸除联合人工晶状体植入术治疗的老年白内障患者116例，分别在手术前，手术后1周和1、3、6个月作眼科检查并完成生存质量问卷。结果：生存质量得分及自理，活动，社交和心理4个指标的得分在手术后1周和1、3、6个月4个时点比较，两两之间比较差异无显著性（P＞0．05），但术后4个时点均高于手术前得分，且差异有显著性（P＜0．05）。结论：老年性白内障患者在行白内障超声乳化吸除联合人工晶状体入术后1周，生存质量即提高，从术后1周至6个月，生存质量无明显变化。     

Evaluation of the quality of life in patients followed for differentiated cancer of the thyroid

Thyroid cancer often has good prognosis but can impact quality of life. The objective of this study is to evaluate quality of life in patients treated for differentiated thyroid carcinoma and look for associated factors. An observational cross-sectional study with comparison group was conducted in the Endocrinology Department of the Ibn Rochd University Hospital between October 2013 and February 2015. The patient group included 124 adult patients followed for differentiated thyroid carcinoma; the control group comprised 124 healthy subjects of the same age. Quality of life was evaluated by 3 questionnaires validated in Arabic: SF36, Hamilton anxiety and Hamilton depression. Patients’ quality of life was significantly impaired compared to controls on the two Hamilton and all SF36 scores. Factors influencing quality of life were TNM stage, radioiodine therapy and dose, and the presence of metastases. The psychological management of patients with thyroid cancer is an essential point always to be considered, especially in the presence of risk factors for impaired quality of life.     

重视对支气管哮喘患者的生活质量评估

随着现代科学的发展,医学模式已经从生物模式转变为生物．心理．社会模式。医生的职责不仅是治疗患者的躯体疾病,而且要消除患者的痛苦和烦恼,使他们在精神上获得安全感和满足感,并保护和恢复患者的社会角色。因此,研究疾病与治疗对患者生理、心理和社会活动的影响,能更全面地反映患者的健康状况,能更体现现代医学模式的转变。生活质量作为一种综合评估患者健康水平的新指标逐渐受到人们的重视,并显示出在疾病临床评估中的重要性。     

江苏省晚期血吸虫病患者生命质量评估

目的了解江苏省晚期血吸虫病(晚血)患者的生命质量状况。方法采用SF-36量表对江苏省部分在册晚血患者进行问卷调查,评价其生理和心理健康。结果 8个维度晚血患者生命质量的各项分值均低于健康人群,男性患者以心理健康指标降低明显,而女性患者则以生理健康指标显著降低;经济发达地区患者的生命质量优于经济不发达地区;经济收入较低的患者生命质量较差;高年龄组晚血患者的心理健康指标较好。结论晚血患者的生命质量显著低于健康人群,影响患者生命质量的主要因素与社会保障机制和公共卫生体系的完善密切相关,对晚血患者治疗的同时更应关注心理健康。     

我国女性慢性丙型肝炎患者远期生存质量评估

目的 了解我国女性慢性丙型肝炎患者生存质量并分析其影响因素。 方法 对河北省固安县1988年～1993年41例女性输血后丙型肝炎患者的现状进行调查。采用SF-36健康相关生存质量量表对女性慢性丙型肝炎患者和51例当地女性非丙型肝炎人群进行评估。 结果 41例女性内型肝炎患者平均年龄(40.0±7.0)岁,随访时间10～15年,自然阴转率为19.51％(8/41)。女性慢性丙型肝炎患者在生理职能、身体疼痛、活力、情感职能、社会职能、总体健康、精神健康7个方面的远期生存质量低于非丙型肝炎普通女性人群,差异有显著性。 结论 平均感染13年的女性输血后慢性丙型肝炎患者远期生存质量差。慢性丙型肝炎是影响生存质量的一个独立因素。     

Evaluation of an instrument assessing influence of Gout on health-related quality of life

OBJECTIVE: To evaluate the reliability and validity of an instrument assessing the influence of gout (acute and chronic) on health-related quality of life (HRQOL). METHODS: Focus groups were used to examine the content of an existing Gout Assessment Questionnaire (GAQ1.0). GAQ2.0 was developed, consisting of a section describing the impact of gout on HRQOL [Gout Impact (GI)] and 4 sections describing subjects' gout overall and demographic data. The GAQ2.0 and the Medical Outcomes Study Short Form-36 Version 2 (SF-36v2) were completed by gout patients in 3 US cities. GI scales were examined using clinical judgment, review of item statistics, Rasch analysis, and confirmatory factor analysis. RESULTS: Subjects (n = 308) were predominantly male (90.2%), Caucasian (75.9%), with a mean age 62.2 +/- 11.8 years. Half the subjects (49.7%) reported > or = 3 attacks in the past year. Two-week test-retest reliability for each scale was good (0.77 to 0.89) for all 5 GI scales. All scales achieved high sufficient (0.86 to 0.89) or excellent (0.93 to 0.97) ratings based on 10-item adjusted alpha coefficients. Correlations and tests among known groups indicated subjects with more severe gout had higher GI scores (i.e., greater gout impact). GI scores correlated more highly with patient-reported measures of gout severity than the SF-36v2 and several traditional measures of gout severity. CONCLUSION: The GAQ2.0 is an instrument for measuring the impact of gout on HRQOL. The GI section exhibited acceptable reliability and validity characteristics. Future studies should assess GI responsiveness, minimally important differences, and psychometric properties in other patient populations.