Definition of frailty in older men according to questionnaire data (RAND-36/SF-36): The Helsinki Businessmen study

Objective  

To explore the association of frailty according to questionnaire data (modified Fried criteria) with important endpoints in older men.     

肝硬化患者腹腔镜胆囊切除术36例临床分析

目的 探讨腹腔镜胆囊切除术（LC）在治疗肝硬化患者中的临床效果.方法 对2005年1月～2010年8月间在笔者所在医院就诊的36例Child-Pugh A、B级肝硬化行LC的患者进行分析.结果 36例患者顺利完成LC,其中3例行胆囊大部分切除,3例因术中止血困难而中转开腹.所有患者术后无胆道损伤、术后再出血及肝功能衰竭等严重并发症.术后出现腹水3例,穿刺孔出血2例.结论 充分做好术前准备,准确掌握手术适应证,熟练的手术技巧,肝硬化患者行LC是安全的,对于肝功能A、B级须切除胆囊者应首选LC.     

Quality of life at the end of life. Analysis of the quality of life of oncologic patients treated with palliative care. Results of a multicenter observational study (staging)

Outcome in palliative care can be defined as patients' quality of life, quality of death and satisfaction with care. In an Italian multicentre prospectic study ('Staging') the quality of life of 571 palliative care patients with advanced cancer disease was assessed since the beginning of palliative care till the end of the study. We analyzed the tissue of quality of life missing data and the possibility to input the missing quality of life evaluation through the quality of life evaluation made by a proxy (doctor, nurse). The greatest functional impairment and an increasing level of some symptoms (fatigue, general malaise, emotional status) were observed during the last two weeks of life, whereas for other symptoms (gastro-intestinal, pain) some degree of control was possible. The quality of life analysis for palliative care patients should consider the different response of different quality of life components to the palliative care intervention.     

Using a quality of life (QoL)-monitor: preliminary results of a randomized trial in Dutch patients with early breast cancer

Quality of Life Research - The diagnosis and treatment of cancer negatively affect patients’ physical, functional and psychological wellbeing. Patients’ needs for care cannot be...     

Distinguishing between quality of life and health status in quality of life research: A meta-analysis

Despite the increasing acceptance of quality of life (QOL) as a critical endpoint in medical research, there is little consensus regarding the definition of this construct or how it differs from perceived health status. The objective of this analysis was to understand how patients make determinations of QOL and whether QOL can be differentiated from health status. We conducted a meta-analysis of the relationships among two constructs (QOL and perceived health status) and three functioning domains (mental, physical, and social functioning) in 12 chronic disease studies. Instruments used in these studies included the RAND-36, MOS SF-20, EORTC QLQ-30, MILQ and MQOL-HIV. A single, synthesized correlation matrix combining the data from all 12 studies was estimated by generalized least squares. The synthesized matrix was then used to estimate structural equation models. The meta-analysis results indicate that, from the perspective of patients, QOL and health status are distinct constructs. When rating QOL, patients give greater emphasis to mental health than to physical functioning. This pattern is reversed for appraisals of health status, for which physical functioning is more important than mental health. Social functioning did not have a major impact on either construct. We conclude that quality of life and health status are distinct constructs, and that the two terms should not be used interchangeably. Many prominent health status instruments, including utility-based questionnaires and health perception indexes, may be inappropriate for measuring QOL. Evaluations of the effectiveness of medical treatment may differ depending on whether QOL or health status is the study outcome.     

SF-36在我国COPD患者中应用的评价

目的评价医学结局调查评分（SF-36）在我国慢性阻塞性肺疾病（COPD）患者中应用的价值。方法对50例稳定期COPD患者进行英国医学研究会（MRC）呼吸困难分级、SF-36及肺功能测定，并对其结果进行相关性分析和多元逐步回归分析，计算Pearson相关系数，评价SF-36的有效性。结果相关分析：MRC呼吸困难分级和SF-36的7个部分有相关性（P〈0．01），肺功能指标和SF-36的3个部分有相关性（P〈0．05或〈0．01）。多元逐步回归分析MRC呼吸困难分级是SF-36的7个部分有意义的预测因素，肺功能指标中的用力肺活量（FVC）、第1秒钟用力呼气量（FEV1）、残气量（RV）和残气肺总量比（RV／TLC）分别是SF-36的4个部分有意义的预测因素。但与MRC呼吸困难分级相比，它们对生活质量的影响较小。结论SF-36是评价我国COPD患者生活质量的有效工具，和肺功能指标相比，呼吸困难的严重性是SF-36各个部分最有意义的预测因素。     

SF-36在我国COPD患者中应用的评价

目的评价医学结局调查评分(SF-36)在我国慢性阻塞性肺疾病(COPD)患者中应用的价值。方法对50例稳定期COPD患者进行英国医学研究会(MRC)呼吸困难分级、SF-36及肺功能测定,并对其结果进行相关性分析和多元逐步回归分析,计算Pearson相关系数,评价SF-36的有效性。结果相关分析:MRC呼吸困难分级和SF-36的7个部分有相关性(P<0.01),肺功能指标和SF-36的3个部分有相关性(P<0.05或<0.01)。多元逐步回归分析MRC呼吸困难分级是SF-36的7个部分有意义的预测因素,肺功能指标中的用力肺活量(FVC)、第1秒钟用力呼气量(FEV1)、残气量(RV)和残气肺总量比(RV/TLC)分别是SF-36的4个部分有意义的预测因素。但与MRC呼吸困难分级相比,它们对生活质量的影响较小。结论SF-36是评价我国COPD患者生活质量的有效工具,和肺功能指标相比,呼吸困难的严重性是SF-36各个部分最有意义的预测因素。     

Health-related quality of life in overweight and obese youths: Results of a multicenter study

Background  

We examined treatment-seeking overweight and obese youths to better understand the gender, age, and treatment modality differences in generic and disease-specific health-related quality of life (HRQOL).     

老年人与非老年人行腹腔镜胆囊切除术临床对比研究

目的　探讨老年胆囊疾病患者行腹腔镜胆囊切除术 (laparoscopiccholecystectomy ,LC)的安全性 ,并总结有关经验。方法　回顾性分析邵逸夫医院 2 0 0 0年连续施行LC的 1 532例病人 ,对比分析老年组 (≥ 65岁 ,1 96例 )与非老年组 (<65岁 ,1 336例 )的病程、合并症、手术时间、术后并发症等临床资料。结果　老年组的病程明显长于非老年组 (P <0 .0 5) ,老年组伴有心电图异常及合并症的比例高于非老年组 (P <0 .0 5) ,老年组病例中萎缩性胆囊炎及伴有胆囊颈部结石嵌顿者比例高于非老年组 (P <0 .0 5) ,两组的中转开腹率分别为 8 67%及 3 0 7% (P <0 .0 5) ,并发症发生率分别为 2 0 4 %及 1 2 7% (P >0 .0 5) ,平均总住院时间分别为 5 .46d及 4 .1 4d(P <0 .0 5) ,平均术后住院时间分别为 2 .63d及 1 96d(P <0 .0 5) ,全组病例均治愈出院。结论　虽然老年胆囊疾病患者合并症多 ,胆囊病变重 ,手术风险及手术难度更高 ,但只要正确掌握老年人LC的适应症 ,积极进行合理的围手术期处理 ,加强术中及术后的监测 ,老年人行LC的安全性与非老年人相近     

Smoking status and quality of life: a longitudinal study among adults with disabilities

BACKGROUND: Current research suggests that people with disabilities are more likely to use tobacco, less likely to quit, and less likely to be screened for tobacco use. However, little is known about the impact of changes in smoking status on the health-related quality of life (HRQL) of people with disabilities. OBJECTIVE: The primary objective of this paper is to examine the association between changes in HRQL and smoking status over time among people with disabilities. METHODS: The study data were derived from the Massachusetts Survey of Secondary Conditions, a longitudinal survey of adults with disabilities; Phase I was conducted in 1996-1998, Phase II in 1998-1999, and Phase III in 1999-2000. The main outcome measure was HRQL as measured by the Medical Outcomes Study Short Form-36 (SF-36). Analysis was primarily done in 2003. RESULTS: Current smokers and those who began smoking during follow-up had significantly poorer HRQL compared with nonsmokers with disabilities. Longitudinal analysis suggests that controlling for age, gender, race/ethnicity, education, and activities of daily living, changes in HRQL scores over time were associated with changes in smoking status. Compared to smokers, those who quit smoking during follow-up experienced a significant improvement in mean SF-36 scores over time for the dimensions of mental health, energy and vitality, and general health. CONCLUSIONS: Findings from this study highlight a strong need to inform public health programs, people with disabilities and healthcare providers about the association between tobacco cessation and improved health-related quality of life among people with disabilities.     

妊娠高血压疾病患者生活质量及心理健康状况的调查

目的:探讨妊娠高血压疾病患者的生活质量和心理健康状况。方法:选择2010～2011年期间妊娠高血压疾病患者60例(研究组)及健康孕妇60例(对照组)为调查对象,采用症状自评量表(SCL-90)和生活质量综合评定问卷(GQOLI-74)分别进行心理健康状况和生活质量调查。结果:SCL-90测评结果,研究组各因子评分均明显高于对照组(P<0.01),主要表现为明显的躯体化症状、强迫症状、人际关系敏感、抑郁、焦虑、恐怖、敌对、偏执及精神病性群。研究组的生活质量各维度评分均明显低于对照组(P<0.01)。结论:妊娠高血压疾病患者存在不同程度的心理健康问题,其生活质量处于较低的水平;在加强对患者的孕产期监护和治疗的同时,应对其实施积极有效的干预措施,使其生活状态稳定,提高生活质量。     

对比分析肾移植术患者与维持性血液透析患者的 营养状况及生活质量

目的 分析比较肾移植术与维持性血液透析对终末期肾病(End stage renal disrase,ESRD)患者营养状况及生活质量的影响.方法 195例ESRD患者根据治疗手段分为肾移植术组(n=60)和维持性血液透析组(n=135),分别采用营养不良-炎症量表和SF-36生活质量量表对两组患者的营养状态和生活质量进行评估比较.结果 对应治疗后,肾移植术组患者的TP、ALB、Hb及LDLC水平显著高于血液透析组患者(P<0.05),但两组患者的TIBC、TC及TG水平无明显统计学差异(P>0.05);肾移植术组患者的SF-36生活质量的八个维度均显著高于血液透析组(P<0.01).结论 肾移植术组患者的营养状况和生存质量均显著优于维持性血液透析组患者.     

Measuring health-related quality of life for persons with mobility impairments: an enabled version of the short-form 36 (SF-36E)

OBJECTIVE: Examine psychometric properties of the SF-36 and SF-36E for mobility-impaired individuals and assess whether the SF-36E yields higher health-related quality-of-life scores. METHODS: We altered the SF-36 Physical Function scale by substituting the word "go" for "walk" and "climb" and changed the stem to reflect function using assistive devices. We compared responses between versions for 201 individuals with disabilities (n = 95 wheelchair users, n = 48 other device users, 58 = no device users). RESULTS: Both surveys yielded reliable scores, but floor and ceiling effects occurred with both versions. Confirmatory factor analyses demonstrate good fit for the SF-36 and SF36E, but were compromised by low sample size. Respondents demonstrated significantly better Role Physical, Bodily Pain, and Vitality on the SF-36E, but worse General Health. CONCLUSIONS: The World Health Organization framework, the International Classification of Functioning, Disability, and Health (ICF) suggests that it is important to know both what one can do without assistance (capacity) and what one can do with assistance (performance). Results suggest that the SF-36E successfully measures performance among mobility-impaired individuals, including wheelchair users. However, further validation studies of the SF-36 and SF-36E are warranted with samples of individuals with disabilities.     

舒芬太尼在腹腔镜胆囊切除术中的应用观察

目的:比较舒芬太尼和芬太尼在腹腔镜胆囊切除术(LC)全凭静脉麻醉的效果及安全性。方法:选择ASAⅠ～Ⅱ级、择期行腹腔镜胆囊切除术病人40例,随机分成舒芬太尼组(SF组)和芬太尼组(S组,)每组20例。SF组采用舒芬太尼0.5μg/kg剂量诱导并以0.3μg/kg·h泵入维持麻醉,F组采用芬太尼5μg/kg剂量诱导并以3μg/kg·h泵入维持麻醉。两组均恒速输注丙泊酚6～8mg/kg·h。手术结束前30min停止舒芬太尼或芬太尼,结束前5min停止丙泊酚输注。结果:①诱导后至插管前(T1)两组血压、心率变化差异无统计学意义(P>0.05)。气管插管后(T2)、气腹后(T3)、气管拔管即刻(T4)及拔管后5min(T5)血压、心率变化SF组较F组小(P<0.01或P<0.05)。②丙泊酚的使用总量、苏醒时间、拔管时间、术后意识评分两组比较均有统计学意义(P<0.01)。③术后疼痛评分SF组较F组低。结论:舒芬太尼可安全有效的用于LC的全凭静脉麻醉,并且麻醉苏醒质量更高。     

Gender-specific changes in quality of life following cardiovascular disease: a prospective study

Gender-specific changes in Quality of Life (QoL) following cardiovascular disease (CVD) were studied in 208 patients to determine whether gender-related differences in postmorbid QoL result from differences in disease severity, premorbid QoL, or different CVD-related recovery. Premorbid data were available from a community-based survey. Follow-ups were done at 6 weeks, 6 months, and 12 months after diagnosis. Results showed that females had worse QoL at all three postmorbid assessments compared to males. However, multivariate analyses adjusting for premorbid gender differences and disease severity showed no significant gender-related differences for physical and psychologic functioning. Therefore, gender differences in QoL following CVD mainly result from premorbid differences in QoL, age, comorbidity, and disease severity at the time of diagnosis, and do not appear to be the consequence of gender-specific recovery. However, in clinical practice it is important to acknowledge the poorer QoL of females following CVD.     

The quality of life of patients with genital warts: a qualitative study

Background  

Genital warts, which are caused by infection with human papillomavirus (HPV), are one of the most common sexually transmitted diseases in Europe. Although genital warts are commonly perceived as a non-serious condition, treatment is often long, of varying effectiveness and the recurrence rate is high. Very few studies have been performed on the personal consequences of genital warts. The aim of this qualitative study, set in Denmark, was to examine the ways in which genital warts may affect patients' quality of life.     

Exploring the quality of life (QOL) in the Indian software industry: a public health viewpoint

Objectives  

Our objectives were to describe the QOL and its determinants among software professionals of Kolkata, and to compare the same according to information technology (IT) and IT-enabled services (ITeS) sub-sectors.     

Long term nutritional status and quality of life following major upper gastrointestinal surgery - a cross-sectional study

Background & aims

Major upper gastrointestinal surgery results in permanent alterations to the gastrointestinal tract, and previously been shown to impair nutritional status. The aim of this study was to assess long term nutritional status and quality of life in people having had major upper gastrointestinal surgery, and the relationship between the two measures.

Methods

People having had major upper gastrointestinal surgery greater than 6 months ago were recruited. Nutrition assessment included weight, anthropometry, Subjective Global Assessment, dietary intake and assessment of gastrointestinal symptoms; quality of life was assessed using the EORTC QLQ-C30 questionnaire. Associations between nutritional status, type of surgery and quality of life were analysed.

Results

Thirty people were recruited with fourteen people showing a degree of malnutrition according to subjective global assessment. Total gastrectomy and oesophagectomy surgery resulted in significantly higher percent weight loss than those having undergone pancreaticoduodenectomy (p = 0.01). Subjective global assessment correlated with quality of life (p = 0.003). Subjective global assessment and gastrointestinal symptoms were both significant variables in explaining quality of life (p < 0.001).

Conclusions

Nutritional status in this group was significantly compromised, and impacted on quality of life. Individualised nutrition intervention to address malnutrition and gastrointestinal symptoms should be integrated into post surgery management.