Living conditions and palliative care needs among end-of-life former commercial plasma donors affected with HIV/AIDS in rural Henan of China

Objective China began providing antiretroviral therapy to people living with HIV/AIDS （PLWHA） in 2003. This study was to investigate the living conditions, including quality of life and happiness, and need for palliative care of end-of-life PLWHA in rural Henan. Methods One hundred end-of-life AIDS patients were selected from Weishi, Zhenping and Tanghe counties in Henan, using convenience sampling. The World Health Organization Quality of Life for HIV （WHOQOL-HIV） BREF Chinese Version was used to measure the quality of life and the Memorial University of Newfoundland Scale of Happiness （MUNSH） was employed to measure subjective welfare. Qualitative interviews and focus group discussions were undertaken to learn about the palliative care provided and the specific needs of the end-of-life patients. Results Patients’ overall quality of life was moderate （12.62±1.97）. Highest scores were in the spirituality/religion/personal beliefs, higher than the average scores in the Chinese population （P0.01）, while psychological （13.58±2.06） and environment （12.50±3.28） domain scores were similar to the latter （P0.05）. Both independence （12.15±2.15） and physiological （14.04±3.16） domain scores were lower than the average of the people living with HIV/AIDS in other studies （P0.01）; however, all were in the moderate range. The average MUNSH score was 21.00±6.20, which was also moderate. The in-depth interviews indicated that the Henan Provincial Government’s policy of treatment and care had a beneficial impact on end-of-life AIDS patients, although the care components could be improved. Conclusions Living conditions of the end-of-life AIDS patients were moderate, and the HIV/AIDS palliative care model used was beneficial to them. Care could be improved by assisting the family unit as a whole.     

Epidemiology of Human Immuno-deficiency Virus and Quality of Life for People Living with HIV/AIDS in China

HIV/AIDS is increasing in prevalence in China and spread of infection from highly risk populations to the general populations was recognized. Despite the fact, there are still only few scientific reviews on quality of life （QOL） for people living with HIV/AIDS （PLWHAs）. However, many PLWHAs are struggling with social and psychological influences such as substances abuse, cultural beliefs, depression, stigma, poverty, which can affect their QOL. Public unawareness about infection and disease, willingness to seek medical care and motivation to follow therapy are indirectly influencing health outcome. In 2003 Chinese government has established the so-called the ＂Four Frees and One Care＂ policy. The policy was officially implemented from 2004 in some areas, yet to date it is not implemented nationwide. This paper discussed the epidemiology of HIV, underlying psychosocial factors affecting PLWHAs and their impact on QOL. We put forward some recommendations for stakeholders, advocacy groups, non-government organizations and Chinese government.     

Quality of life for primary caregivers of muscular dystrophy patients in South Korea

Background Although some studies measured the burden of caregivers and the factors that influenced their feelings of burden, few studies have measured the quality of life （QOL） for primary caregivers of patients with muscular dystrophy （MD）. We assessed the QOL for primary caregivers of patients with MD in South Korea and identified factors associated with caregivers＇ QOL. Methods Ninety dyads of patients with MD and their primary caregivers were enrolled in this study. The QOL of caregivers of patients with MD was assessed subjectively using the World Health Organization Quality of Life Assessment, Life Brief Form. Caregivers＇ emotional status was assessed using the Beck Depression Inventory （BDI） and family function level was evaluated using the Family APGAR scale. Patients reported their emotional status using the BDI or the Children＇s Depression Inventory. The functional levels of patients were evaluated by the modified Barthel Index. Results Caregivers＇ QOL was statistically associated with family income, family function, emotional status of patients, level of education, and emotional status of caregivers （P 〈0.05）. Caregivers who were employed had a significantly higher QOL than those who were not （P 〈0.05）. In multiple regression analyses, emotional and employment status of caregivers was strongly associated with caregivers＇ QOL. Conclusion Rehabilitation teams should consider not only the physical factors of patients but also the psychological and demographic factors of primary caregivers of patients with MD.     

Chinese Medicine Improves Postoperative Quality of Life in Endometriosis Patients: A Randomized Controlled Trial

Objective:To investigate the effect of Chinese medicine(CM) and Western medicine(WM) on quality of life(QOL) after conservative surgery for endometriosis.Methods:A total of 320 patients with endometriosis were randomized into two groups by using random block design,CM group(160 cases,activating blood circulation and removing blood stasis treatment based on syndrome differentiation) and WM group(160 cases,gonadotropin-releasing hormone agonist or gestrinone treatment) after conservative surgery.Treatment was given for 3-6 months(according to the revised American Fertility Society scoring system stage),and the World Health Organization QOL-BREF(WHOQOL-BREF) was applied to patients before and after treatment to assess QOL.Results:There were 136 cases in the CM group and 141 cases in the WM group completing therapy.In the CM group,the use of the WHOQOL-BREF showed that the physical,psychological and environmental scores post- treatment were significantly higher than those at pre-treatment(P<0.05),and for 12 items(pain and discomfort, energy and fatigue,sleep and rest,mobility,activities of daily living,work capacity,negative feelings,health and social care:accessibility and quality,participation in and opportunities for recreation/leisure activities,appetite, QOL score,overall health status and QOL),the difference in scores was significant(P<0.05).In the WM group,4 items(pain and discomfort,opportunities for acquiring new information and skills,QOL score,overall health status and QOL) had significantly different scores post-treatment compared with those at pre-treatment(P<0.05).Before treatment,the QOL in the two groups of patients showed no significant difference(P>0.05).After treatment,the scores for physical health in the CM group were significantly higher than those of the WM group(P<0.05) and the scores of 4 items(mobility,activities of daily living,sexual activity,QOL score) in the CM group were significantly higher than those in the WM group(P<0.05).Conclusions:CM and WM treatment could improve the QOL of patients with endometriosis after conservative surgery.CM treatment is more effective than WM.     

Clinical observation on the efficacy of Xiaoshui decoction (消水方) combined with intrapleural perfusion of cisplatin in treating malignant pleural effusion

Objective： To observe the clinical efficacy of Xiaoshui decoction （XSD,消水方） combined with intrapleural perfusion of cisplatin in the treatment of malignant pleural effusion. Methods： Fifty-one patients with malignant pleural effusion were randomly assigned to two groups. The treated group patients） received oral administration of XSD combined with intrapleural perfusion of cisplatin, and control group （25 patients） was only treated with intrapleural perfusion of cisplatin. The effects of 26 he he short-term efficacy, quality of life scores and clinical symptom scores of malignant pleural effusion were evaluated. Results： The short-term efficacy in the treated group and the control group was 72.0% and 58.3%, respectively, and no significant difference was found （P〉0.05）. In contrast, the quality of life in the treated group was significantly improved compared to that of the control group （P〈0.05）, and so was the symptom remission （P〈0.05）. Conclusions： The combined therapy of XSD and intrapleural perfusion of cisplatin did not show obvious improvement in short-term efficacy, but the therapy remarkably alleviated the symptoms and improved the quality of life of patients.     

Effectiveness of Bushen Huoxue Granule (补肾活血颗粒) on 5-Serotonin and Norepinephrine in the Brain of Parkinson's Disease Patients with Depressive State

Objective：To observe the clinical curative effect of Chinese medicine Bushen Huoxue Granule（补肾活血颗粒,BHG） on Parkinson＇s disease（PD） patients with depressive state.Methods：Sixty-two PD patients with depressive state were randomly assigned to two groups by using a random number table,31 in each group.Madopar was given to all as the conventional treatment.The fluoxetine hydrochloride dispersible tablet was given to the patients in the control group and BHG was given to those in the treatment group.The therapeutic course for all was 12 weeks.Before and after treatment,Hamilton depression rating scale（HAMD） was applied to judge the curative effect,and the changes of cerebral neurotransmitters levels in the brain of patients were detected by encephalofluctuograph technique.Results：The scores of HAMD in the two groups were decreased markedly after 12-week treatment.It was lower in the treatment group than that in the control group with significant difference（P〈0.01）.The contents of norepinephrine（NE） and 5-serotonin（5-HT） in the PD patients were obviously lower than normal value.There was no significant difference between the two groups before treatment（P〉0.05）.The contents of NE and 5-HT were all increased in the two groups after treatment（P〈0.05）,with significant differences between the two groups（P〈0.01）.Conclusion：BHG could increase the contents of NE and 5-HT in PD patients＇ brain to improve the depressive state of PD patients.     

癌症疼痛病人伴随阿片类药物导致便秘的中医汤剂标准化治疗：一项多中心前瞻性随机对照试验

Objective： To observe the efficacy and the influence on quality of life （QOL） of syndrome differentiation treatment with Chinese medicine （CM） for opioid-induced constipation as well as the safety and influence on analgesic effect of opioids. Methods： Totally 406 cases enrolled from 53 collaborating medical centers were randomly assigned to a CM group and a control group. The CM group were treated with CM decoction based on syndrome differentiation, and the control group were treated with Phenolphthalein Tablet. Both groups were treated for 14 days. Cleveland constipation score （CCS）, numedcal rating scale （NRS） of pain and Chinese version of European Organisation for Research and Treatment of Cancer, Quality of Life Questionnaire-C30 V3.0 （EORTC QLQ-C30 V3.0） were used to evaluate the efficacy, pain controlled and QOL status. Results： The comparisons of CCS score reduction and QOL between the two groups after treatment suggested that the improvements of constipation and QOL in the CM group were better than that in the control group （P〈0.05）. The total efficiency of the CM group was better than the control group （93.5% vs. 86.4%, P〈0.05）. There was no significant difference in NRS scores between before and after treatment in both groups. There was no serious drug-related adverse event during the course of study. Conclusion： CM decoction could effectively treat opioid-induced constipation and improve patients＇ QOL at the same time. It is safe and doesnt affect the analgesic effect of opioids when treating constipation.     

A Randomized Trial of Chinese Medicine Lirukang Granule (利乳康颗粒) Combined with Psychological Intervention for Cyclomastopathy and Menoxenia

Objective:To observe the influence of therapy with Chinese medicine Lirukang Granule（利乳康颗粒）,LRKG) combined with psychological intervention on anxiety states and sex hormones in patients with cyclomastopathy and menoxenia.Methods:A total of 470 subjects were randomly assigned to three groups by the net-central randomization system,the treatment group（161 patients,treated with LRKG and psychological intervention）,the Chinese medicine group（157 patients,treated with LRKG）,and the psychological intervention group（152 patients,treated with psychological intervention）.The dose of LRKG was 12 g three times per day; psychological intervention included establishing relations,cognitive intervention and psychological persuasion, 30-40 min per session,once a week.The therapy duration for all groups was three months.The efficacy was compared and anxiety state/State-Trait Anxiety Invertory（STAI） scoring was measured before and after treatment.The serum estradiol（E₂）,progesterone（P）,prolactin（PRL） and follicle stimulating hormone（FSH） levels of 60 patients selected randomly from each group during the luteal phase were measured before and after treatment,and a group of 20 healthy women were evaluated for comparison.A follow-up was arranged for one year after treatment.Results:Thirty subjects were lost to follow-up.（1） Comparison of efficacy:the markedly effective rate and the total effective rate of the treatment group were 86.67%（131/150） and 98.00%（147/150）, respectively;of the Chinese medicine group,64.58%（93/144） and 90.27%（130/144）,respectively;and of the psychological intervention group,0%（0/146） and 3.42%（5/146）,respectively.The markedly effective rate and the total effective rate in the treatment group were significantly higher than those in the Chinese medicine and psychological intervention groups（P<0.05）.（2） Comparison of STAI scoring:STAI scoring was decreased dramatically in the treatment group after treatment compared with that of the Chinese medicine group（P<0.01）, but there was no significant difference compared with the psychological intervention group.（3） Comparison of levels of sex hormones:E₂,P,PRL and FSH of the three patient groups were disordered before treatment,and significantly different from healthy women（P<0.01）.After treatment,the levels of P and FSH of the treatment group were significantly increased（P<0.01）,E₂ and PRL were significantly reduced,which were also significantly decreased compared with the psychological intervention groups（P<0.01）.（4） Follow-up:the markedly effective rate and the total effective rate of the treatment group remained higher than those of the other two groups after one year of treatment（P<0.05）.（5） Adverse reactions:no obvious adverse reactions were found among the three groups.Conclusions:Therapy with Chinese medicine combined with psychological intervention was effective for short-term and long-term treatment of cyclomastopathy and menoxenia.The mechanism might be related to the regulation of sex hormones.     

Prevalence of juvenile fibromyalgia syndrome in an urban population of Turkish adolescents: impact on depressive symptoms, quality of life and school performance

Background Juvenile Fibromyalgia Syndrome （JFMS） is a chronic health condition characterized by widespread musculoskeletal pain and multiple tender points （TP）.The objective of this study was to determine the prevalence of JFMS in the urban population of Samsun and to determine the impact of JFMS on depression symptoms,school performance and quality of life （QOL）.Methods A cross-sectional study was conducted in 1109 children （mean age （14.8±2.0） years old）.A questionnaire was applied to the children and a medical examination including TP was performed.Yunus and Masi＇s criteria were used for diagnosis of JFMS.The children with JFMS were compared with an age and sex matched non-JFMS group.Depression was assessed with Children＇s Depression Inventory （CDI） and QOL was evaluated with Pediatric Quality of Life Inventory 4.0 （PedsQL4.0）.Results Sixty-one （5.5%） （13 boys and 48 girls） of 1109 children met the diagnostic criteria of JFMS.While PedsQL scores of children with JFMS were lower than the non-JFMS group for physical,emotional,social,school functioning and total score （P=0.001）,CDI total score was higher in the JFMS group than in the non-JFMS group （P=0.001）.The JFMS group reported more school absences （P=0.001） and the average school grade was lower in the JFMS group than in the non-JFMS group （P=0.03）.Conclusion The prevalence of JFMS is high in school age children.Since JFMS is a common problem of childhood,early diagnosis and identification of the disorder and more comprehensive and successful treatment approaches with appropriate psychological assistance may prevent more complex and severe problems in adulthood.     

社会支持、焦虑和抑郁情绪对中小学教师生活质量影响的路径分析

目的 了解社会支持、焦虑和抑郁情绪对中小学教师生活质量的影响,为改善中小学教师的生活质量提供依据.方法 采用分层整群抽样方法,用世界卫生组织生存质量测定量表简表(WHOQOL-BREF)配合社会支持评定量表(SSRS)、焦虑自评量表(SAS)和抑郁自评量表(SDS)对郴州市城区622名中小学教师进行测评,然后用结构方程模型分析软件Amos7.0作路径分析.结果 中小学教师生活质量的4 个领域(生理领域、心理领域、社会关系领域和环境领域)得分分别为:(60.88±11.67)分、(58.54±12.62)分、(64.46±13.86)分和(41.29±14.37)分;路径分析结果显示,焦虑对生活质量的4个领域均有直接(负向)影响(P<0.05);抑郁对生活质量的心理领域、社会关系领域和环境领域有直接(负向)影响(P<0.05);焦虑、抑郁对社会支持有直接(负向)影响(P<0.05);社会支持对生活质量的4个领域均有直接(正向)影响(P<0.05);社会支持作为中介变量调节焦虑、抑郁与生活质量4个领域的关系.焦虑、社会支持对生活质量4个领域影响的总效应大于抑郁.结论 焦虑和抑郁情绪可能影响中小学教师的生活质量;社会支持作为中介变量调节焦虑、抑郁与生活质量的关系.     

Relationship between quality of life and aerobic capacity of patients entering phase II cardiac rehabilitation after coronary artery bypass graft surgery

BackgroundThis cross-sectional study examined the relationship between patients' aerobic fitness and general health perceptions and how they correspond with functional aerobic impairment (%FAI) and quality of life (QOL).MethodsOne hundred and two patients were administered a version of the World Health Organization Quality of Life brief form questionnaire (WHOQOL-BREF). Then, each patient underwent cardiopulmonary exercise tests to determine their aerobic fitness and %FAI. We performed Pearson's and Spearman's correlation analyses to assess the association between variables on the WHOQOL-BREF questionnaire and the each patient's aerobic fitness.ResultsPearson's correlation coefficient demonstrated a significant association between WHOQOL-BREF scores and peak oxygen uptake (peak VO₂) in the physical domain (p = 0.006) and environment domain (p = 0.011). Spearman's correlation coefficient also demonstrated a significant association between WHOQOL-BREF scores and the %FAI in the environmental domain (p = 0.036).ConclusionQOL of patients who have undergone coronary artery bypass graft surgery is influenced not only by impaired aerobic fitness but also by poor physical and psychological well-being. The implementation of proper lifestyle modifications and the strengthening of social support networks following CABG surgery are very important for maximizing cardiovascular fitness and improving the QOL of these patients.     

心理干预对HIV／AIDS病人心身症状和生活质量影响的研究

目的探讨心理危机干预对HIV感染者／AIDS病人心身症状和生活质量的影响。方法采用90项症状自评量表和世界卫生组织生活质量量表中文版对108例深圳市HIV感染者／AIDS病人进行问卷调查和分析。结果HIV感染者／AIDS病人干预后,SCL-90在敌对和精神病症2项没有显著性差异（P〉0.05）,其余8个因子和SCL-90总分、阳性总分、阳性均数、阳性项目数等4方面均低于干预前（P〈0.01）。WHOQOL-100评估在干预后,除了对药物及医疗手段的依赖性、性生活、交通条件和精神支柱等方面及领域没有统计学意义（P〉0.05）外,其余5大领域及21个方面和总的生存质量与健康状况生活质量均高于干预前有统计学意义（P〈0.05）。结论心理危机干预可以改善HIV感染者的心身症状,提高生活质量。     

Factors associated with generic and disease-specific quality of life in epilepsy

Objective To investigate the association between quality of life (QOL) and sociodemographic factors,clinical seizure factors,depression and anxiety in patients suffering from epilepsy.Methods We examined 141 consecutive patients with epilepsy (mean age 25.8±9.6,61.7% male).All patients completed the Self‐Rating Depression Scale,Self‐Rating Anxiety Scale,WHOQOL‐BREF and QOLIE‐31(Chinese version).Multiple linear regression analyses were applied to investigate factors impact on QOL.Results The results revealed...     

刮痧拔罐法治疗乳腺增生的临床疗效观察

【目的】验证刮痧拔罐法治疗乳腺增生的临床疗效。【方法】将80例乳腺增生病例随机分为刮痧拔罐组42例和常规组38例。常规组给予常规基础治疗(包括心理疏导和口服中成药小金丸等),刮痧拔罐组在常规基础治疗的同时应用刮痧和拔罐疗法,取穴璇玑、膻中、肩井、库房、天宗、大椎、阿是穴(乳房结块或疼痛处)。观察2组治疗前后主症疼痛模拟量表(VAS)评分、世界卫生组织生活质量测定简式量表(WHOQOL-BREF)评分,并比较2组临床疗效。【结果】(1)刮痧拔罐组的总有效率为88.10%,优于常规组的65.79%,2组间比较,差异有统计学意义(P0.01)。(2)治疗后,刮痧拔罐组的VAS评分显著降低(P0.01);常规组有降低趋势,但差异无统计学意义(P0.05)。组间比较,刮痧拔罐组改善VAS评分作用优于常规组(P0.05)。(3)治疗后,刮痧拔罐组在生理领域的评分显著提高(P0.05),其余各领域评分差异均无统计学意义(P0.05);常规组治疗前后各领域评分比较,差异均无统计学意义(P0.05)。组间比较,刮痧拔罐组改善WHOQOL-BREF生理领域评分作用优于常规组(P0.05)。【结论】刮痧拔罐治疗乳腺增生可以改善患者临床症状,提高患者生活质量。     

艾滋病合并低血红蛋白血症患者生存质量的评价研究

目的了解河南省农村地区艾滋病合并低血红蛋白血症患者的生存质量,为采取相应措施提高患者的生存质量提供依据。方法使用世界卫生组织艾滋病生存质量测定量表简表(WHOQOL-HIV-BREF)的中文版,对河南省某3个地区艾滋病高发村71例艾滋病合并低血红蛋白血症患者进行调查,计算生存质量总分及各领域得分并与常模进行比较。结果艾滋病合并低血红蛋白血症患者的生存质量得分分别为:生理领域(12.69±1.58)分,心理领域(12.39±1.67)分,独立性领域(11.61±1.67)分,社会关系领域(12.56±1.69)分,环境领域(12.11±1.57)分,精神支柱和个人信仰领域(10.65±1.81)分,自我总的生存质量及健康状况(11.58±2.19)分。患者在生理领域、心理领域、社会关系领域以及自我总的生存质量及健康状况方面的得分低于常模,差异有统计学意义(P<0.05);在独立性领域、环境领域和精神支柱个人信仰领域的得分与常模比较,差异无统计学意义(P>0.05)。结论艾滋病合并低血红蛋白血症患者的生存质量明显低于普通人群,因此需要全社会继续加强对患者的救治及关怀力度,加强对疾病的治疗,将有助于提高患者的生存质量。     

珠海市艾滋病抗病毒治疗患者生存质量及影响因素调查分析

目的了解珠海市已接受艾滋病抗病毒治疗患者的生存质量,探讨其影响因素。方法选择中山大学附属第五医院和遵义医学院第五附属医院接受艾滋病抗病毒治疗的患者318例,采用WHQOL-HIV-BEEF中文版测量生存质量简表对318例在治患者进行调查分析。结果治疗患者的生存质量在生理领域[(13.37±3.02)分]、心理领域[(12.60±2.85)分]、独立程度领域[(12.72±2.81)分]、社会关系领域[(12.38±2.62)分]得分低于全国常模,差异有统计学意义(P0.05),在精神领域[(12.59±3.77)分]高于全国常模(P0.05)。文化程度、居住地、职业、收入、年龄、性别、感染途径等是影响治疗患者的生存质量的主要因素。结论文化程度、就业和收入等社会经济特征对治疗患者生存质量有明显影响作用;应加大对艾滋病抗病毒治疗患者,特别是农村、女性和无业治疗患者的社会关怀支持力度。     

Living Conditions and Palliative Care Needs among End-of-Life Former Commercial Plasma Donors Affected with HlV/AIDS in Rural Henan of China

Objective China began providing antiretroviral therapy to people living with HIV/AIDS (PLWHA) in 2003. This study was to investigate the living conditions, including quality of life and happiness, and need for palliative care of end-of-life PLWHA in rural Henan. Methods One hundred end-of-life AIDS patients were selected from Weishi, Zhenping and Tanghe counties in Henan, using convenience sampling. The World Health Organization Quality of Life for HIV (WHOQOL-HIV)BREF Chinese Version was used to measure the quality of life and the Memorial University of Newfoundland Scale of Happiness (MUNSH) was employed to measure subjective welfare. Qualitative interviews and focus group discussions were undertaken to learn about the palliative care provided and the specific needs of the end-of-life patients. Results Patients,overall quality of life was moderate (12.62±1.97). Highest scores were in the spirituality/religion/personal beliefs, higher than the average scores in the Chinese population (P＜0.01), while psychological (13.58±2.06) and environment (12.50±3.28) domain scores were similar to the latter (P＞0.05). Both independence (12.15±2.15) and physiological (14.04+3.16) domain scores were lower than the average of the people living with HIV/AIDS in other studies (P＜0.01); however, all were in the moderate range.The average MUNSH score was 21.00±6.20, which was also moderate. The in-depth interviews indicated that the Henan Provincial Government's policy of treatment and care had a beneficial impact on end-of-life AIDS patients, although the care components could be improved. Conclusions Living conditions of the end-of-life AIDS patients were moderate, and the HIV/AIDS palliative care model used was beneficial to them. Care could be improved by assisting the family unit as a whole.     

安徽省芜湖市成年HIV感染者/AIDS患者生存质量及其相关因素

目的 了解芜湖市成年HIV感染者/AIDS患者的生存质量现状及其相关因素.方法 应用SF-36问卷对芜湖市2018年随访的869名成年HIV感染者/AIDS患者进行调查,了解8个维度得分情况和相关特征,关联艾滋病传染病报卡信息;采用两独立样本t检验和多元线性回归模型分析影响生理、心理及总体得分的因素.结果 869名成年...