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1.
This study examines the change in health-related quality oflife (HRQoL) among (60 years) elderly persons as a result ofhealth education intervention. A community-based interventionstudy was performed in eight randomly selected villages (Intervention:n = 4; Control: n = 4) in rural Bangladesh. A total of 1135elderly persons was selected for this study. The analyses include839 participants (Intervention: n = 425; Control: n = 414) whoparticipated in both baseline and post-intervention surveys.Participants in the intervention area were further stratifiedinto compliant (n = 315) and non-compliant (n = 110) groupsbased on the reported compliance to the intervention activities.The intervention includes, for example, physical activity, adviceon healthy food intake and other aspects of management. To createan enabling environment, social awareness was provided by meansof information about the contribution of and challenges facedby elderly persons at home and the community, including informationabout elderly persons' health and health care. The interventionactivities were provided to the elderly persons, caregivers,household members and community people for 15 months. The HRQoLwas assessed using a multi-dimensional generic instrument designedfor elderly persons. Multivariate analyses revealed that inthe non-compliant group the probabilities of increased scoreswere less likely in overall HRQoL (OR 0.52, 95% CI 0.32–0.82).Among the Control group, increased scores were less likely inthe physical (OR 73, 95% CI 0.54–0.99), social (OR 0.37,95% CI 0.27–0.50), spiritual (OR 0.60, 95% CI 0.34–0.94),environment (OR 0.36, 95% CI 0.26–0.49) dimensions andoverall HRQoL (OR 0.44, 95% CI 0.32–0.59) (adjusted forage, sex, literacy, marital status and economic status). Thisstudy concludes that provision of community-based health educationintervention might be a potential public health initiative toenhance the HRQoL in old age.  相似文献   

2.

Purpose

To assess health-related quality of life (HRQOL) of subjects at risk of type 2 diabetes undergoing lifestyle intervention, and predictors for improved HRQOL.

Methods

The Finnish Diabetes Risk Score was used by general practitioners to identify individuals at risk. Low-intensity interventions with an 18-month follow-up were employed. HRQOL was assessed using the SF-36 at baseline and compared with results from a general Norwegian population survey and further at 6 and 18 months. Simple and multiple linear regression analyses were applied to identify predictors of changes in HRQOL of clinical importance.

Results

Two hundred and thirteen participants (50 % women; mean age: 46 years, mean body mass index: 37) were included: 182 returned for 18-month follow-up, of whom 172 completed the HRQOL questionnaire. HRQOL was reduced with clinical significance compared with general Norwegians. The mean changes in HRQOL from the baseline to the follow-up were not of clinical importance. However, one out of three individuals achieved a moderate or large clinical improvement in HRQOL. The best determinant for improved HRQOL was obtained for a composite, clinically significant lifestyle change, i.e. both a weight reduction of at least 5 % and an improvement in exercise capacity of at least 10 %, which was associated with an improvement in five out of the eight SF-36 domains.

Conclusion

Subjects at risk of type 2 diabetes report a clinically important reduction in HRQOL compared with general Norwegians. The best predictor of improved HRQOL was a small weight loss combined with a small improvement in aerobic capacity.  相似文献   

3.
目的:探讨肥胖对小学生健康相关生活质量的影响。方法:采用儿科健康相关生活质量普适性核心量表4.0(Pediatric Quality of Life InventoryTM Version4.0,PedsQLTM4.0)调查广州市778名小学生的健康相关生活质量,通过测量身高、体重,计算体重指数进行营养状况的分类。结果:正常体重、超重和肥胖儿童分别为396人、38人和69人。协方差分析表明,肥胖组角色功能评分(xd±sx)较正常体重组降低(5.71±2.08)分(P<0.05)。肥胖组躯体、情感和社交功能评分与正常体重组及超重组间的差异均无统计学意义(P>0.05),仅在后2个维度的评分呈下降趋势。结论:肥胖儿童的健康相关生活质量中角色功能评分低于正常体重儿童。  相似文献   

4.

Purpose

To evaluate the impact of nocturnal calf cramping (a condition that affects one in two people over 60 years of age) on quality of sleep and health-related quality of life.

Methods

Eighty adults who experienced nocturnal calf cramp at least once per week and eighty age- and sex-matched controls who never experienced nocturnal cramp were recruited from the Greater Newcastle and Central Coast regions of New South Wales, Australia. All participants completed the SF-36v2 and the Medical Outcomes Study Sleep Survey (MOS-SS).

Results

People who experienced nocturnal muscle cramps reported more sleep disturbance (p < 0.001), less adequate sleep (p = 0.001), less quantity of sleep (p = 0.02) and more snoring (p = 0.03). Both sleep problem summary indices for the MOS-SS identified people who experienced nocturnal muscle cramp as having more sleep problems than the controls. People who experienced nocturnal muscle cramps had lower health-related quality of life for the SF-36 domains role physical (p = 0.007), bodily pain (p = 0.003) and general health (p = 0.02). SF-36 domains that primarily relate to mental health were not significantly different between groups. The impact of nocturnal calf cramps on health-related quality of life was largely explained by their negative impact on quality of sleep.

Conclusions

Nocturnal calf muscle cramps are associated with substantially reduced quality of sleep and reduced physical aspects of health-related quality of life.  相似文献   

5.

Aim

To evaluate possible differences in health-related quality of life (HRQoL) according to self-reported smoking status in a multiethnic urban Asian population in Singapore.

Subjects and methods

In this community-based cross-sectional survey of a stratified random sample, interviewers obtained socioeconomic, clinical and HRQoL—Short Form-36, Version 2 (SF-36v2), Health Utilities Index Mark 3 (HUI3) and EuroQoL 5-Dimensions (EQ-5D)—data in English, Chinese or Malay. The association between self-reported smoking status and HRQoL at the overall scale and individual attribute levels stratified by gender were evaluated using regression analyses.

Results

Of 3,006 consenting participants with a mean age of 48 (SD: 16.44) years, 49.9 % males, Chinese: Malay: Indian?=?49.9 %: 25.3 %: 24.8 %, 727 (34.4 %) male and 1,386 (65.6 %) female are never smokers, 208 (86.7 %) male and 32 (13.3 %) female are ex-smokers, 104 (78.8 %) male and 28 (21.2 %) female are occasional smokers, while 460 (88.3 %) male and 61 (11.7 %) female are regular smokers. After adjusting for socioeconomic and clinical variables, male ex-smokers reported lower SF-36v2 MCS (regression coefficient: ?1.60, P?=?0.026) and HUI3 utility scores (regression coefficient: ?0.024, P?=?0.040) compared to never smokers. Female regular smokers reported lower HUI3 utility scores as compared to never smokers (regression coefficient: ?0.056, P?=?0.004).

Conclusion

Compared with never smokers, male ex-smokers and female regular smokers reported poorer HRQoL in this multiethnic Asian study.  相似文献   

6.
Health-related quality of life was estimated using the physical and mental summary scores of the SF-12 Health Survey in a cross-sectional study of a general population of 23,312 individuals aged 40-47 years in Hordaland County, Norway. The mean scores in the main occupational groups were adjusted for lifestyle factors using a six-way analysis of covariance. The category of legislators, senior officials, and managers scored highest on both the physical and the mental components, whereas the drivers scored lowest on the physical health and agricultural and fishery workers scored lowest on mental health. Smoking showed marked dose-response relationships with reduced physical and mental health, and inverse U-shaped relationships were found for alcohol consumption and the body mass index, with the mental scale for body mass index peaking above the recommended range of 18.5 to 25.0 kg/m2. Although selection bias related to the choice of occupation cannot be ruled out, the low scores of the quality of life measure for the agricultural and fishery workers and the drivers most likely reflect the effect of known health stressors for these occupations.  相似文献   

7.
探讨“5-1-1-0”干预模式对超重、肥胖中小学生生活质量的作用,为儿童肥胖的预防提供技术支持.方法 选取北京市某远郊县的4所小学二~六年级和4所初中七~八年级的超重肥胖儿童,干预校和对照校分别包括2所小学和2所初中,分别有129名、79名学生.对干预校进行为期3个月的5-1-1-0健康生活方式干预,对照校开展正常的健康课和体育课.结果 干预组干预前后生活质量总分分别为(145.45±17.77),(148.26±20.00),差异无统计学意义;对照组干预前后生活质量总分分别为(144.96±16.64),(146.75±19.20),差异无统计学意义.干预后干预组学生同伴关系、生活质量满意度、自我满意度和其他方面的得分均高于对照组(P值均<0.05).干预组干预后学生的活动机会性、运动能力和生活环境得分均较干预前明显升高(P值均<0.05),对照组干预前后各维度因子得分以及总分、标准T分差异均无统计学意义(P值均>0.05).干预前与干预后两组生活质量等级分布差异均无统计学意义(P值均>0.05).结论 5-1-1-0行为干预模式能有效改善超重肥胖中小学生生活质量.  相似文献   

8.
The aim of this study was to examine the impact of the most prevalent comorbid chronic diseases in hypertensives on health-related quality of life (HRQOL) in the general representative Korean population using the EuroQOL-5D (EQ-5D) and to assess this impact by sex and after controlling for sociodemographic factors. The effects of hypertension and comorbidity on HRQOL were examined using multiple linear regression models with Fourth Korean National Health and Nutrition Examination Survey data. In a total of 5736 adults, the prevalence of hypertension alone was 20.8%, and the prevalence rates of hypertension comorbid with diabetes mellitus (DM), cardiovascular disease (CVD), and musculoskeletal (MS) disease were 9.5%, 3.8%, and 33.5%, respectively. Females with hypertension and other comorbidity showed worse HRQOL scores, with the exception of hypertension and CVD, where males scored worse for HRQOL. After adjustment, subjects with comorbid DM, CVD, or MS experienced EQ-5D scores decreasing by 0.01, 0.09, and 0.05, respectively. Since comorbidity impairs HRQOL in hypertensives, health providers should consider comorbid diseases in hypertensives when developing methods of intervention to effectively manage hypertension.  相似文献   

9.
10.

Objective

To examine changes in breast cancer knowledge, attitudes, beliefs and behaviors following implementation of a tribal run CDC Breast and Cervical Cancer Program (BCCP), we report 2006 survey results from Hopi women and contrast findings with 1993 survey data and BCCP reports.

Methods

Community meetings, focus groups, and researchers jointly developed a culturally appropriate survey instrument. Hopi women randomly selected from Tribal enrollment lists were interviewed in-person by Hopi interviewers; 250 women ≥ age 18 participated (87% response) between June and December, 2006.

Results

Among women 40+, 77.5% reported ever having had a mammogram and 68.9% reported having done so within the past 2 years, an increase from 45.2% and 46% self-reported in 1993. Compared to 1993, more women in 2006 (88.1% vs. 59%) believed that a mammogram can detect cancer and more than 90% now believe that early detection of cancer can save lives. Women reported a preference (60%) for receiving health care at the Hopi BCCP. Survey results were validated using programmatic data which estimated 76.6% of Hopi women had received mammography screening.

Conclusion

Implementation of a tribal run BCCP has resulted in a substantial increase in mammography screening on the Hopi reservation.  相似文献   

11.
The objective of this study was to evaluate the impact of a comprehensive, multifaceted disease management program on self-reported quality of life (QOL) for adult patients with epilepsy. The study (1996-2000) employed a quasi-experimental research design in which primary care clinics in a southwestern integrated delivery system were assigned to either the intervention or comparison group. The impact evaluation involved a comparison of responses to a validated QOL survey before and after a disease management intervention for adult health plan members with epilepsy. The intervention consisted of both formal provider training and associated tools and reinforcements as well as direct-to-patient interventions, including a comprehensive education booklet, a seizure diary, a patient education class, and a resource list. Pre-post analysis utilizing paired t-tests was conducted to identify any pre-post differences in QOL for both the intervention and comparison group patients, as measured by the seven specific domains of the epilepsy QOL instrument (QOLIE-31). The intervention group patients showed statistically significant positive changes in two QOL domains: Seizure Worry (p < 0.001) and Emotional Well-being (p < 0.05). One other domain, Overall Quality of Life, showed improvement in the intervention group that approached statistical significance (p < 0.06). There were no statistically significant changes for the comparison group. A well-designed, comprehensive disease management program can improve patient empowerment and coordination of care between the patient and provider, which resulted in an improvement in quality of life, one of the most central patient outcomes in this difficult disease.  相似文献   

12.

Purpose

Telemonitoring is being increasingly used for chronic disease monitoring. While the primary aim of telemonitoring is to improve chronic disease management and decrease hospitalizations, the potential impact on patient’s health-related quality of life may be an additional benefit.

Methods

Two hundred and five patients aged 60 years and older with multiple medical conditions were enrolled in a one-year randomized controlled trial of daily home telemonitoring. Health-related quality of life was measured with the 12-Item Short-Form at the beginning and at the completion of the study. Per protocol analysis of the 166 patients responding to the follow-up survey was performed.

Results

Among the 166 responders, there were no significant differences at baseline in the physical component summary (PCS) scores (p value = 0.32), nor the mental component summary (MCS) scores (p value = 0.12) between the telemonitored group and the usual care group. There was also no difference in the 12-month PCS scores (p value = 0.39) or MCS scores (p value = 0.10) between groups. There was no difference in the change from baseline to 12-month MCS scores between groups (p value = 0.89); however, there was a significant difference in the baseline to 12-month change of PCS scores between groups, with the telemonitored group having a greater decrease in PCS scores (?4.3 ± 9.3), compared to the usual care group (?1.2 ± 8.5) over the course of the study (p value = 0.03).

Conclusion

Home telemonitoring in older adults with multiple comorbidities does not significantly improve self-perception of mental well-being (as measured by MCS scores) and may worsen self-perception of physical health (as measured by PCS scores).  相似文献   

13.
目的 探讨高血压与糖尿病联合作用对农村居民生存质量的影响。方法 在湖北省宜昌市夷陵区采取分层整群抽样的方法,采用社区人群功能测定量表对8 583名≥35岁居民进行问卷调查和体格检查,采用Logistic回归分析高血压、糖尿病、糖尿病合并高血压对生存质量的影响。结果 一般人群(无高血压和糖尿病者)5 327人,高血压患者不伴糖尿病者2 893例,糖尿病患者不伴高血压者184例,糖尿病患者合并高血压者179例;以一般人群为对照,在控制了一般人口学特征和生活方式指标对生存质量的影响后,高血压对体能和社会交往有明显影响(OR=1.11,95%CI=1.00~1.23;OR=1.23,95%CI=1.01~1.49);糖尿病对日常活动有明显影响(OR=1.80,95%CI=1.30~2.50);糖尿病合并高血压对日常活动和整体健康有明显影响(OR=1.57,95%CI=1.13~2.19;OR=1.46,95%CI=1.03~2.08)。结论 高血压与糖尿病对农村居民生存质量的影响表现在不同的维度,而糖尿病合并高血压则影响居民整体健康。  相似文献   

14.
Quality of life (QOL) encompasses a broad notion of health and is increasingly used to evaluate the effectiveness of health care services. The purpose of this cross-sectional study was to assess health-related quality of life (HR-QOL) in the community-dwelling elderly (mean age, 72.7±0.3 y; female 46.4%, n=179) in Japan and to explore diminished factors. We assessed HR-QOL by the 36-Item Short-Form Health Survey (SF-36), maximum walking speed, step counts, Tokyo Metropolitan Institute of Gerontology (TMIG) index, dietary intake and blood biochemistry. Two summary scores of the SF-36 were calculated (physical component score: PCS, mental component score: MCS). We divided participants into two groups based on the standard values of PCS and MCS classified by age (high and low group), which was further stratified into a high PCS and high MCS (BH) group and a low PCS and low MCS (BL) group. Mean maximum walking speed and daily step counts were 207.7±2.8 cm/s and 7,008±289. Eighty-one percent of the participants had full scores in the TMIG index. Daily intake of energy and protein were 2,081±33 kcal and 74.5±0.9 g. The maximum walking speed, TMIG index, alcohol consumption and chewing ability were significantly higher in the BH group than those in the BL group, but not dietary intake. Stepwise logistic regression analysis indicated that maintaining maximum walking speed might be associated with sustaining HR-QOL in the healthy elderly.  相似文献   

15.
The perception about one's health includes feelings about physical and psychological characteristics as well as ways of managing interpersonal relationships. The purpose of this study was to examine the effect of the Health Education Program 'Skills for primary school children' (KE.TH.E.A.-Ministry of Education of Greece. 1998. Educational Program of Prevention: Skills for Elementary Students [Eκπαιδευτικ? υλικ? πρ?ληψη?: Δεξι?τητε? για Παιδι? του Δημοτικο?]. Athens: KE.TH.E.A, 1998) on children's perceptions about certain dimensions of their quality of life: physical well-being, mental well-being, moods and emotions, self-concept, leisure-autonomy, family life, financial resources, friends, school environment and social acceptance (bullying). Two hundred and eighty-six students of fifth and sixth grade, from schools of Northern and Southern Greece participated. One hundred and twenty-eight (n = 128) formed the experimental group and 158 the control group (n = 158). The experimental group followed the skills program for 23 weeks (one 45 min lesson/week), whereas the control group did not. The Kidscreen Questionnaire (Kim S, Laird M. An Outcome Evaluation of Lions Quest 'Skills for growing' Grades K-5, 1993. Available at: http://www.Lions-quest.org. Accessed: 2 April 2009) was applied to assess health-related quality of life. Results from multivariate analysis of variance with repeated measures indicated that children in the experimental group significantly improved their perceptions of physical well-being, family life, financial aspects, friends, school life and social acceptance. On the other hand, children in the control group significantly improved their perceptions for physical well-being, whereas they deteriorated them significantly for family life, mood and feelings and social acceptance. Also, children as a whole improved their self-concept. Furthermore, analysis of covariance showed that the experimental group had better perceptions of autonomy than the control group in the final measurement. It can be concluded that such a program could lead to the improvement of (i) physical well-being, (ii) family life, (iii) financial resources, (iv) friends, (v) school environment, (vi) social acceptance and (vi) Leisure-Autonomy and to stable perceptions about mood and feelings, dimensions of health-related quality of life.  相似文献   

16.

Background  

Investigations focusing and implementing on the impact of cancer on health-related quality of life (HRQoL) by the way of a mean comparison between cancer patients and subjects from the general population, are scarce and usually cross-sectional. Longitudinal application of HRQoL instruments to a general, initially healthy population allows for change to be assessed as an event occurs, rather than afterwards. The objective of the present study was to investigate the impact of new cancer on HRQoL.  相似文献   

17.

Purpose  

To estimate the impact of traffic-related noise annoyance on health-related quality of life (HrQoL) in a population-based study and potential effect modification by gender.  相似文献   

18.

Purpose

Relatively little is known about the level of impairment in patients with dizziness.

Research question

How much does dizziness impair the quality of life of patients referred to a multidisciplinary dizziness unit?

Patients and methods

All 2,252 patients completed the Dutch version of the Dizziness Handicap Inventory (DHI-D; score 0?C100 with higher scores representing more impairment). The results were classified into three categories: mild, moderate, and severe impairment. The three domains in the DHI representing physical, functional, and emotional aspects of dizziness were compared, as well as DHI scores of men versus women, between diagnoses, and the relationship between DHI and age.

Results

A total of 2,242 patients (64% women, mean age 54?years) completed the DHI with a mean score of 40.6. Almost 70% of patients had moderate or severe complaints. The handicap perceived by patients was primarily caused by physical and functional factors and less by emotional factors. Female patients and patients with hyperventilation syndrome and/or anxiety disorder had significantly higher DHI scores on all subscales. There was an S-shaped relationship between DHI score and age, and older patients reported more impairment.

Conclusion

Dizziness has considerable impact on health-related quality of life of dizzy patients.  相似文献   

19.
Toward a general model of health-related quality of life   总被引:1,自引:0,他引:1  
A health-related quality of life (HRQOL) model that fitted data collected in previous studies from two separate samples—patients with chronic physical illness and patients with chronic mental illness—was adapted and tested on a representative sample drawn from the normal population. This model, which implied that both physical and mental health influenced number of friendships, personal growth, and job satisfaction, fitted the data very well. However, an alternative model reversing the directions of the pathways so that friendships, personal growth, and job satisfaction affected physical health and mental health, with the latter two having a mutual effect on each other, fitted the data even better. This suggests that, although a medical model of HRQOL may be more important when it comes to alleviating illness, a psychosocial model of HRQOL may be more important when it comes to maintaining health and preventing illness. Moreover, the fact that essentially the same five-factor structural model fits three distinct populations, healthy and unhealthy, suggests that there may be a general model of quality of life applicable to all populations. The implications of these findings for clinical theory, policy, and practice are discussed.  相似文献   

20.
The purpose of this study was to determine if participation in a community-based fitness program improves: a) strength and endurance, b) self-concept and quality of life, and c) positive social interactions among participants with disabilities. Nineteen children completed the study (10 experimental group, 9 control group). Pre/post testing included body mass index (BMI), energy expenditure index (EEI), Presidential Fitness Test (PFT), strength testing using a handheld dynamometer, PedsQL, and the Piers-Harris 2 Self-Concept Scale (PH-2). The experimental group participated in an 8-week exercise program two times per week and were given a home exercise program (HEP). No statistically significant differences were observed in BMI, EEI, PFT, strength, quality of life, or self-concept. A statistically significant difference in social interactions was found between the first and second half of the exercise program while the children performed group activities and ran track based on repeated measures MANOVA at p<0.05. While changes in fitness may not be observed following an 8-week exercise program, improvements in social interactions may be possible.  相似文献   

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