基于EQ-5D-5L量表的住院肺癌患者健康相关生命质量及其影响因素分析

目的 以山东省肿瘤医院为例,测量住院肺癌患者的健康相关生命质量,并分析其影响因素。方法 采用EQ-5D-5L量表及自编问卷对2020年8—9月山东省肿瘤医院符合纳排标准的住院肺癌患者进行调查,使用Mann-Whitney检验或Kruskal-Wallis检验进行单因素分析,采用Tobit回归模型分析调查对象健康相关生命质量的影响因素。结果 最终收集到189份有效问卷,住院肺癌患者的健康效用值平均值为(0.81±0.16),EQ视觉模拟评分刻度尺(EQ-VAS)评分的平均值为(76.61±13.99)分。Tobit回归分析显示,居住地、癌症分期以及是否转移是肺癌患者健康效用值的影响因素。农村患者的健康效用值低于城市患者(β=-0.006,P=0.049);疾病分期为Ⅲ期(β=-0.114,P=0.013)、Ⅳ期(β=-0.180,P<0.01)的患者的健康效用值均低于疾病分期Ⅰ期组;癌症发生转移的患者的健康效用值低于未转移组(β=-0.038,P=0.033)。结论 本研究住院肺癌患者健康效用值较低,农村、癌症分期较晚以及发生转移的患者健康相关生命质量较差。     

基于EQ-5D-3L和ICECAP-A量表的我国普通人群生命质量研究

目的:分析EQ-5D-3L和ICECAP-A量表评价我国普通人群生命质量的差异以及对干预方案价值评价的影响,为研究者选择合适的生命质量测量工具提供参考。方法:采用配额抽样选取802名受访者进行生命质量评价,并分别采用因子分析、多分格相关性和Bland-Altman plot一致性分析等方法探讨两量表测量结果的差异。结果:Wilcoxon秩和检验表明EQ-5D-3L量表的健康效用均值高于ICECAP-A量表的测量结果;ICECAP-A量表五个维度均主要加载于反映社会心理健康的因子1,而EQ-5D-3L量表的大部分维度主要加载于反映生理健康的因子2。部分维度之间也存在显著的相关性,但均较弱。两量表效用值的ICC为0.32,一致性分析显示5.74%的受访者超出了95%的一致性界限。结论:前者的测量内涵是健康相关生命质量,而后者则反映的是幸福感、可行能力等更广义的生命质量,其对于旨在提升公众广义幸福感和社会福祉的干预措施效果评估方面具有较好的适用性。研究者可根据测量目的及量表属性选择合适的量表,鉴于两个量表在测量内涵中的互补性,也可以在研究中同时采用两种量表以便更全面地反映干预措施的效果或受访者的生命质量。     

云南省居民健康相关生命质量及影响因素研究

目的 了解云南省居民健康相关生命质量及影响因素.方法 采用多阶段分层抽样的方法,抽取云南省312个街道/乡镇15 ～ 69岁居民进行问卷调查.结果 共调查45 000人,有效问卷44 909份,有效率99.80％.云南省居民EQ-5D健康效用值平均为(0.89 ±0.09),EQ-5D VAS评分的平均得分为(80.3...     

健康相关生命质量对基层部队军人卫生服务利用的影响

目的：探讨健康相关生命质量对基层部队军人卫生服务利用的影响,为基层部队卫生服务研究工作提供新的思路和手段。方法：采用多阶段分层整群随机抽样方法,抽取5支基层部队2500名军人进行问卷调查。应用结构化的多阶段Logis-tic回归模型来构建基层部队军人卫生服务利用的影响模型。结果：进入2周就诊率模型三的变量为任务种类、自述健康情况、军种和文化程度、生理领域得分、环境领域得分6个,进入年住院率模型三的变量为任务种类、自述健康情况、军种、文化程度、慢性病患病情况和生理领域得分6个。结论：体现主观健康指标的健康相关生命质量是影响卫生服务利用的有意义的独立影响因素,有理由提出将主观指标健康相关生命质量也纳入到基层部队军人卫生服务研究中去,在基层部队中积极的进行探索实践,为基层部队卫生服务研究开辟新的手段和思路,使得健康相关生命质量成为基层部队军人卫生服务利用研究的新维度。     

海南省2型糖尿病患者生命质量评价与分析

目的 探讨海南省2型糖尿病患者生命质量及其影响因素，为有效提高糖尿病患者生命质量和制定防治策略提供参考依据。方法 本研究采用多阶段分层随机抽样，均衡地理、经济等情况选取海南省4个市县的糖尿病患者作为研究对象，使用二元logistic回归分析EQ-5D-5L量表中不同维度出现问题的影响因素，用Tobit回归分析海南省2型糖尿病患者生命质量的影响因素。结果 EQ-5D-5L中健康效用值中位数为0.907(0.782,1)。生命质量的五个维度中“疼痛或不舒服”(52.0%)和“焦虑或沮丧”(46.7%)维度存在问题占比较高。Tobit回归表明，年龄(β=-0.042,P<0.05)、婚姻状态(β=-0.030,P<0.01)、文化程度(β=0.039,P<0.01)、医保类型(β=0.071,P<0.01)、BMI值(β=0.049,P<0.01)、病程(β=-0.003,P<0.05)、疾病危害知晓情况(β=-0.075,P<0.000)、是否患有慢性肾脏疾病(β=0.076,P<0.05)、是否患有心力衰竭(β=0.132,P<0.0...     

基于EQ-5D量表分析老年人高血压患者健康相关生命质量及其影响因素

目的 探讨老年人高血压患者的健康相关生命质量(health-related quality of life, HRQoL)状况及影响因素,为提高老年人高血压患者HRQoL提供针对性建议。方法 采用多阶段分层整群随机抽样的方法对广州、苏州和青岛的社区老年高血压患者进行问卷调查。单因素分析使用Wilcoxon秩和检验和Kruskal-Wallis H检验,多因素分析使用Tobit回归模型。结果 老年人高血压患者健康效用值为0.847(0.569,1.000),在EQ-5D量表的5个维度中的疼痛或不舒服(40.5%)存在的问题最突出。Tobit回归模型结果显示,婚姻状况(已婚：β=0.127,P=0.005<0.05;丧偶：β=-0.069,P=0.003<0.05)和外出频率(1次/d:β=0.106,P<0.001;1次/周：β=0.204,P<0.001;更长时间：β=0.312,P<0.001;不确定：β=-0.423,P<0.001)是影响高血压老年人健康相关生命质量的因素。结论 老年人高血压患者生命质量低于普通人群,政府及相关部门可根据主要因素...     

基于EQ-5D量表的深圳市居民健康相关生命质量研究

目的 了解深圳市居民的健康相关生命质量情况,并对其健康相关影响因素进行分析.方法 运用欧洲的五维健康量表(EQ-5D)对深圳市居民的健康状况进行测评,采用描述性分析、多元回归分析等对健康相关影响因素进行分析.结果 被调查居民的主要健康问题是疼痛/不适、焦虑/抑郁,这两维度有困难的比例分别为5.53％、2.14％;EQ-VAS评分平均为84.31±10.81分,年龄、就业状况、文化程度、是否饮酒、两周病伤情况和慢性病患病均是居民健康相关生命质量的独立影响因素.结论 关注高年龄、低文化程度、嗜酒和无业人群的健康,加强慢性病的防治管理是提高深圳市居民健康相关生命质量的关键.     

深圳市2型糖尿病及合并症患者健康相关生命质量研究

目的 分析深圳市糖尿病人群健康相关生命质量及其影响因素。方法 于2021年9—12月对深圳市罗湖区各大医院及社区卫生中心展开调研,最终确定634名18～92岁的2型糖尿病患者为研究对象。采用欧洲质量-5维度-5水平健康量表（European quality-5 dimension-5 levels questionnaire,EQ-5D-5L）、视觉检查评分（visual analogue scale,VAS）测算患者健康效用值。利用t检验及方差分析进行单因素检验,Tobit回归探究影响因素。结果 本研究人群平均EQ-5D-5L效用值为0.888±0.205,VAS得分为（76.471±17.682）分。此外,研究测算了糖尿病合并其他疾病患者的效用值,高血压为0.873±0.014,高血脂为0.886±0.012,心力衰竭为0.792±0.083,心肌梗死为0.887±0.083,中风为0.569±0.070,冠心病心绞痛为0.765±0.067,慢性胃肠道疾病为0.840±0.036,生殖器疾病为0.847±0.043,视网膜病变为0.809±0.041,肾衰竭为0.699±0.11...     

健康相关生命质量的研究概况

健康相关生命质量已在发达国家广泛应用，对健康相关生命质量的历史，内涵，测定方法，应用和资料的统计分析进行阐述。研究显示，现有的健康相关生命质量测定表发展较快，其趋势越来趋向疾病专门化，但其效度，信度还有待提高。     

城市育龄妇女生命质量评价及相关因素分析

目的:应用EQ-5D量表评价城市育龄妇女生命质量状况,分析影响其生命质量的相关因素。方法:采用多阶段分层整群随机抽样方法确定调查对象。应用欧洲五维度健康量表EQ-5D对城市育龄妇女的生命质量进行问卷调查,并对影响其生命质量的相关因素进行分析。结果:城市育龄妇女EQ-5D指数和EQ-VAS平均得分分别为(0.981±0.085)分、(86.290±11.735)分。在量表的五个维度测量中,维度2(自我照顾)方面没有困难的人最多,占98.8%,困难报告率较高的是维度4(疼痛/不舒服)和维度5(焦虑/抑郁),分别为3.8%和4.1%。单因素分析表明,不同年龄、婚姻状况、文化程度、就业状况以及患慢性病情况的城市育龄妇女在EQ-5D指数和EQ-VAS得分方面差异有统计学意义(P<0.05)。多因素Logistic回归分析表明,行动能力维度影响因素是患慢性病情况;自我照顾维度影响因素是婚姻状况和患慢性病情况;日常活动维度影响因素是文化程度和患慢性病情况;疼痛/不舒服维度影响因素主要为年龄、婚姻状况以及患慢性病情况;焦虑/抑郁维度影响因素主要为年龄、婚姻状况、就业状况以及患慢性病情况。结论:年龄、婚姻状态、文化程度、就业状况以及是否患有慢性病可影响城市育龄妇女的生命质量。     

Assessing Health-Related Quality of Life in Cataract Patients: The Relationship between utility and Health-Related Quality of Life Measurement

The relationship between health-related quality of life (HQL) measures and patient preference for their health status was studied. Study subjects consisted of 132 patients at four hospitals who were scheduled for cataract surgery. Generic and disease-specific health status measures were determined in study subjects. The Medical Outcomes Study Short-form 36 (SF-36) item health status instrument was used to measure generic health status and the Visual Function 14 (VF-14) item visual health status instrument was used as the disease-specific health measure. Preference for general health and visual health was measured by assessing utilities assigned by patients to certain health states. Utilities assigned for general health were correlated with all categories of the SF-36 and VF-14 scores. Utilities assigned for visual health were correlated with four categories of the SF-36 (role limitation due to emotional health, general health, physical functioning, and vitality) and VF-14 scores. Utilities assigned for visual health were more strongly correlated with VF-14 scores than generic measures of health. Verbal ratings for visual health were correlated with Snellen visual acuity (SVA) (r=0.20), utilities assigned for visual health (r=0.58), VF-14 scores (r=0.74), all categories of the SF-36 (r values ranging from 0.21 to 0.28), utilities assigned for general health (r=0.19), and verbal ratings for general health (r=0.29). Utility measures and verbal ratings for general and visual health were shown to be appropriate HQL measures. These measures were strongly correlated with other established generic and disease-specific health measures and should be included in the array of health status measures. This revised version was published online in June 2006 with corrections to the Cover Date.     

宝山区958例心脑血管病患者相关情况调查分析

目的为了进一步确定主要危险因素对心脑血管病的影响及各类疾病的预后情况,以采取相应的有效措施干预危险人群。方法对医院报告的患有心脑血管疾病的存活病例进行调查,统计调查结果并作相关的描述性分析。结果在心脑血管病患者的疾病构成中,脑卒中者为总患病人数的93.95%,且70岁以上患者所占比例最高;64.09%的患者有高血压病史。结论在老年人中防治缺血性脑卒中将是心脑血管病防治的重点,对高血压进行积极治疗将是预防脑卒中的有效手段。     

The Impact of Health Literacy on Health-Related Quality of Life (HRQoL) and Utility Assessment among Patients with Rheumatic Diseases

Objectives:  The objective of this study was to investigate the impact of health literacy (HL) on health-related quality of life (HRQoL) and utility assessment among patients with rheumatic diseases.
Methods:  HL was measured by the rapid estimate of adult literacy in medicine (REALM) and was characterized as low or adequate. HRQoL and utility scores were assessed using the SF-36, SF-6D, and EQ-5D. Comparisons of sociodemographics and HRQoL in patients with low or adequate HL were made using t test, chi-square, or Mann–Whitney U tests. Spearman's correlation and partial correlations were used to study the relationship between HL, HRQoL, and utility scores, with significant correlations further explored using multiple linear regression models.
Results:  Data were analyzed from 199 subjects. Patients with adequate HL had significantly higher education levels, better dwelling status, lower disease activity, and better physical functioning (PF). There was a significant although weak correlation between HL level and PF. After adjustment, HL level was shown to independently explain 3.7% of the variance in the PF score. Nevertheless, there was no impact of HL on utility assessment or other HRQoL domains.
Conclusion:  HL did not impact HRQoL in general, but was found to have a weak impact on the PF of patients with rheumatic diseases.     

Relationship Between Multimorbidity and Health-Related Quality of Life of Patients in Primary Care

Previous studies about the association of multimorbidity and the health-related quality of life (HRQOL) in primary-care patients are limited because of their reliance on simple counts of diseases from a limited list of diseases and their failure to assess the severity of disease. We evaluated the association while taking into account the severity of the medical conditions based on the Cumulative Illness Rating Scale (CIRS) score, and controlling for potential confounders (age, sex, household income, education, self-perception of economic status, number of people living in the same dwelling, and perceived social support). We randomly selected 238 patients to construct quintiles of increasing multimorbidity (CIRS). Patients completed the 36-item Medical Outcomes study questionnaire (SF-36) to evaluate their HRQOL. Applying bivariate and multivariate linear regression analyses, we used the CIRS as either a continuous or a categorical (quintiles) variable. Use of the CIRS revealed a stronger association of HRQOL with multimorbidity than using a simple count of chronic conditions. Physical more than mental health deteriorated with increasing multimorbidity. Perceived social support and self-perception of economic status were significantly related to all scales of the SF-36 (p < 0.05). Increased multimorbidity adversely affected HRQOL in primary-care adult patients, even when confounding variables were controlled for.     

健康教育对改变心血管病患者不良生活行为的效果分析

随着社会的发展和人们生活水平的不断提高,我国疾病谱、死因顺位也随之发生了变化,心血管疾病已成为危害人们健康的主要疾病,严重地影响了人们的健康状况和生活质量。因此,向人们普及心血管疾病防治知识,帮助他们建立健康的行为和生活方式已成为当务之急。本文通过对1 0 0位心血管病患者开展教育咨询,重点改变他们不健康的行为和生活方式,收到了显著的效果,现报道如下。对象与方法1 对象　均经临床确诊为患心血管病的患者,年龄在40～65岁之间,教育组1 0 0人,对照组1 0 0人。2 方法　①健康教育指导,与患者面对面交谈,每名患者每周咨询2次,…     

分析心脑血管疾病的关系链

目前我国社区居民第一位的死因是心脑血管疾病，引起死亡的人数已占总死亡构成比的45％左右，每年因心脑血管疾病死亡的人数有260万，平均每小时死亡约300人；近年来心脑血管疾病的发病趋势升高更快，自1958年以来，我国心脑血管疾病的发病率已上升了4倍，尤其是脑卒中的发生率速高于欧美国家；Poulter指出WHO在1999年公布，尽管采取了多种预防措施，冠心病的负担处于第6位，脑卒中处于第7位。     

Health Literacy and Health-Related Quality of Life Among a Population-Based Sample of Cancer Patients

Health-related quality of life is an important outcome in cancer care. A few studies indicate that health literacy influences cancer patients’ health-related quality of life, but additional investigation is needed. The authors examined the relation between health literacy and health-related quality of life among cancer patients. A cross-sectional survey was conducted with cancer patients in Wisconsin during 2006–2007. Data on sociodemographics, clinical characteristics, health-related quality of life, and health literacy were obtained from the state's cancer registry and a mailed questionnaire. Regression analyses were used to characterize the association between health-related quality of life and health literacy. The study sample included 1,841 adults, newly diagnosed with lung, breast, colorectal, or prostate cancer in 2004 (response rate = 68%). Health-related quality of life was measured with the Functional Assessment of Cancer Therapy-General. Adjusting for confounders, higher health literacy was associated with greater health-related quality of life (p < .0001). Controlling for covariates, we found significant differences between those in the highest and lowest health literacy categories (p < .0001) and in the physical (p < .0001), functional (p < .0001), emotional (p < .0001), and social (p = .0007) well-being subscales. These associations exceeded the minimally important difference threshold for overall health-related quality of life and functional well-being. Health literacy is positively and independently associated with health-related quality of life among cancer patients. These findings support adoption of health literacy best practices by cancer care systems.     

Relationship between Health-Related Quality of Life, Pain, and Functional Disability in Neuropathic Pain Patients with Failed Back Surgery Syndrome

Objectives:  Patients with failed back surgery syndrome (FBSS) and chronic neuropathic pain experience levels of health-related quality of life (HRQoL) that are considerably lower than those reported in other areas of chronic pain. The aim of this article was to quantify the extent to which reductions in (leg and back) pain and disability over time translate into improvements in generic HRQoL as measured by the EuroQoL-5D and SF-36 instruments.
Methods:  Using data from the multinational Prospective, Randomized, Controlled, Multicenter Study of Patients with Failed Back Surgery Syndrome trial, we explore the relationship between generic HRQoL—assessed using two instruments often used in clinical trials (i.e., the SF-36 and EuroQol-5D)—and disease-specific outcome measures (i.e., Oswestry disability index [ODI], leg and back pain visual analog scale [VAS]) in neuropathic patients with FBSS.
Results:  In our sample of 100 FBSS patients, generic HRQoL was moderately associated with ODI (correlation coefficient: −0.462 to −0.638) and mildly associated with leg pain VAS (correlation coefficient: −0.165 to −0.436). The multilevel regression analysis results indicate that functional ability (as measured by the ODI) is significantly associated with HRQoL, regardless of the generic HRQoL instrument used. On the other hand, changes over time in leg pain were significantly associated with changes in the EuroQoL-5D and physical component summary scores, but not with the mental component summary score.
Conclusions:  Reduction in leg pain and functional disability is statistically significantly associated with improvements in generic HRQoL. This is the first study to investigate the longitudinal relationship between generic and disease-specific HRQoL of neuropathic pain patients with FBSS, using multinational data.     

Psychosocial Factors and Health-Related Quality of Life in Hemodialysis Patients

Several sociodemographic and clinical variables are known to influence the health-related quality of life (HRQOL) of patients with kidney disease, yet the relationship between psychological factors and the HRQOL measured by the Kidney Disease Quality of Life Short-Form (KDQOL-SF) is incompletely understood. The objective of this study was to examine the relationship between psychosocial status (depressive symptoms, trait anxiety, and social support) and KDQOL-SF scales in hemodialysis (HD) patients by controlling the effects of sociodemographic and clinical variables. The HRQOL of 194 patients from 43 dialysis centers in Spain was assessed by completing the KDQOL-SF, and evaluating depressive symptoms (Cognitive Depression Index), trait anxiety (Trait Anxiety Inventory) and degree of social support (Scale of Perceived Social Support). We also recorded several sociodemographic and clinical variables. Two regression models were estimated for each of the 19 scales in the KDQOL-SF. In the first model, we only included sociodemographic and clinical-factors, while the second model also took into consideration psychosocial variables. These last factors (trait anxiety and depressive symptoms, not social support) were found to increase the proportion of explained variability, with highest standardized regression coefficients observed for most KDQOL-SF scales. Depressive symptoms were related to a poor HRQOL when there was a strong physical component, while trait anxiety was mainly related to emotional upset and social relationships. We were able to conclude that trait anxiety and depressive symptoms are strongly associated with the HRQOL assessed by the KDQOL-SF in HD patients. The effects of these factors should therefore be considered when evaluating the quality of life of this type of patient.     

二硫化碳与心血管疾病关系的Meta分析

通过系统的文献检索搜集所有相关文献后,按照评分系统筛选出9篇文献进行Mate分析。计算合并RR值及其95％可信区间,以综合分析评价二硫化碳（CS2）暴露对心血管系统的毒性作用。结果,合并RRDL＝1.285,95%Cl为（1.127-1.462),表达CS2暴露与心血管疾病呈弱相关关系,且发现影响各独立研究结果的主要因素为暴露强度与暴露时间,尤其是暴露强度。