WHO生存质量量表老年模块在我国前列腺增生症患者中的适用性研究

目的评价WHO生存质量老年模块量表(WHOQOL-OLD)是否适用于我国老年前列腺增生症(BPH)患者的生存质量测定。方法采用中文版的WHO生存质量测定量表简表(WHOQOL-BREF)和WHOQOL-OLD量表对广州市BPH患者139例,广州市社区居民155名进行调查,采用自填或由调查员协助填写的方法。中文版WHOQOL-OLD量表的性质采用Cronbach sα评价条目间的内部一致性信度,用Pearson相关系数r评价不同方面的信度,量表的结构效度用证实性的因子分析。两独立样本用t检验或非参数秩和检验比较两组人群在各个领域的生存质量。结果WHOQOL-OLD量表中文版的Cronbach sα为0.74,其6个领域的Cronbach sα均大于0.7,各领域与总分之间的相关系数均大于它们与其他领域间的Pearson相关系数,均在0.5以上,表明该表具有非常好的内部一致性。因子分析中,产生7个公因子,基本与原量表一致,累积解释变异量为77.90%。用不同量表比较两组人群的生存质量,用WHOQOL-BREF量表比较,总分和生理领域差异有统计学意义,其余领域均无意义;用WHOQOL-OLD量表比较,自主和亲密关系领域差异无统计学意义,其余领域均有统计学意义。结论WHOQOL-OLD量表具有较好的信度和效度,与生存质量普适性量表WHOQOL-BREF比较,WHOQOL-OLD量表更加适用于我国老年前列腺增生症患者生存质量的评价。     

某部队生命质量研究预调查结果分析

目的:为应急机动作战部队生命质量和影响因素研究正式调查进行前期理论、方法和基础资料的准备。方法:采用自制问卷及世界卫生组织生命质量测定量表简表(WHOQOL-BREF)对某军区某应急机动部队215名指战员进行问卷调查。结果:WHOQOL-BREF量表中文版可接受性良好,用于测量应急机动部队生命质量信度、效度较好。应急机动部队指战员的生命质量中等。影响应急机动部队指战员生命质量的主要因素有:自述健康、兵源地、兵种和是否独生子女,相互之间生命质量得分的差别均有统计学意义。结论:WHOQOL-BREF量表中文版完全适用于应急机动部队生命质量评估。应急机动部队指战员的生命质量存在差异,应根据不同情况采取针对性措施加以改善。     

夜班护士WHOQOL-BREF量表测试及信、效度评价

目的对中文版世界卫生组织生存质量测定量表简表(WHOQOL-BREF)应用于夜班护士健康生命质量评价时的信度和效度进行验证。方法采用整群随机抽样方法对在天津市1所三级甲等医院抽取的385名夜班护士进行中文版WHOQOL-BREF问卷调查;采用分半信度、Cronbach's α系数和各领域得分与总分间的相关系数评价量表的信度,采用内容效度、区分效度、结构效度和判别效度评价量表的效度。结果中文版WHOQOL-BREF量表的分半信度和Cronbach's α系数分别为0.77和0.91;生理、心理、社会关系和环境4个领域的分半信度为0.61~0.72,Cronbach's α系数为0.75~0.78,各领域得分与总分的相关系数为0.72~0.84(P<0.001),量表的内部一致性较好;除生理领域外,每个条目与所属领域总分的相关系数均>0.50,且高于该条目与其他领域的相关系数(P<0.001),量表具有较好的内容效度和区分效度;因子分析结果表明,24个条目在提取的6个公因子中的分布与量表的理论结构假设大体一致,方差累积贡献率为60.76%,量表具有较好的结构效度;不同年龄、工作年限、文化程度夜班护士生理和心理领域得分不同(P<0.01),量表具有良好的判别效度。结论中文版WHOQOL-BREF量表具有较好的信度和效度,适用于夜班护士健康生命质量的评价。     

用世界卫生组织生存质量量表评价中风患者的生存质量

目的对中风病患者生理状态、心理状态、社会关系领域和环境诸领域的生存质量进行评价。方法采用世界卫生组织编制的生存质量量表(WHOQOL-BREF)对随机入组的134例病程在3个月以内的中风病患者进行评估,并与80例正常人进行比较。结果中风病患者的心理状态、生理状况以及对自身健康状况总的主观感觉比正常人差(P<0.05)。结论WHOQOL-BREF能反映中风病患者的生存质量,为中风病的中医药干预疗效评价的生存质量评价尺度提供依据。     

Factors affecting quality of life after pelvic fracture

IntroductionFunctional outcome and health-related quality of life (HRQOL) after pelvis fracture is suboptimal; majority of the patients do not return to their preinjury activities. Many researchers reported that late morbidity in pelvis fracture is associated with severity of the fracture, associated trauma, pelvic fracture-related complications and methods of treatment.Material and methodsOne hundred and twelve patients with pelvis fracture who were treated either conservatively (n = 88) or surgically (n = 24) with a minimum of two years follow up were evaluated clinically and radiologically. The clinical outcome was evaluated using Majeed score and self-reported Short Musculoskeletal Function Assessment (SMFA). Their HRQOL was evaluated using the 36-item Short Form Survey (SF-36) and WHOQOL-BREF questionnaires. The fracture-displacement in the anterior or posterior pelvis ring was measured from the anteroposterior radiograph or inlet/outlet view.ResultsThe average Majeed score was 76.65 ± 14.73 (range, 36 to 96). There were 81 patients with good to excellent outcomes and 31 patients with poor to fair outcomes. The average SF-36 Physical Component Summary (PCS) score was 47.71 ± 7.88 (range, 27.3 to 61.5) and SF-36 Mental Component Summary (MCS) was 49.20 ± 9.37 (range, 23.1 to 56.8). The functional level of the general population in the physical and mental domain was achieved in 48.23% and 65.3% of pelvic-fractured patients respectively. General population norms were achieved in 56.3%, 63.4%, 65.2% and 84.8% of patients in WHOQOL-BREF domain one, two, three and four respectively. The patients had significantly worse functional outcome and HRQOL if residual displacement was > 1 cm. Age, sex, associated injuries and injury mechanism were not affecting the HRQOL in patients with acceptable residual displacement of ≤ 1 cm.ConclusionPelvic fracture with the residual displacement of ≤ 1 cm in the sacroiliac joint/symphysis pubis result in better functional outcome and HRQOL. Injury mechanism and associated injury have no impact on the HRQOL if the residual displacement is within the acceptable limit.     

武汉市矽肺病患者的生存质量

目的了解武汉市矽肺病患者的生存质量现况及其影响因素。方法以武汉市职业病防治院确诊的矽肺病患者为研究对象,采用世界卫生组织生存质量测定量表简表中文版(WHOQOL-BREF)评价其生存质量。同时,通过随机抽样的方法抽取武汉市汽轮发动机厂100名健康工人作为参照组,并且以全国一般水平作为更普通的参照。通过拟合多元线性回归模型来分析各因素与量表4个领域得分的关系。结果调查中矽肺病患者43例,健康工人100例,各人群生存质量得分及其影响因素有所不同。健康工人生理、心理、社会关系和环境4个领域的得分(x珋±s)依次为(13.68±1.54)、(13.14±2.02)、(14.35±2.43)和(10.85±2.17)分,均高于矽肺病患者;生理、心理和环境领域得分均低于全国一般水平,社会关系领域则高于全国一般水平。矽肺病患者生理、心理、社会关系和环境4个领域的得分(x珋±s)依次为(9.8l±2.25)、(10.40±3.27)、(12.34±2.24)和(8.80±2.45)分,均低于全国一般水平,并且均低于健康工人。矽肺病患者生存质量影响因素包括性别、年龄、个人收入、工龄、既往病史、家庭摩擦对生活的影响程度、食欲情况。结论相对于全国一般水平来说,矽肺病患者和健康工人的生存质量较差,影响矽肺病患者生存质量的因素是多方面的,疾病是其中一个重要的因素。     

和胃安神汤对失眠症患者睡眠及生活质量的影响

目的观察和胃安神汤对失眠症患者睡眠及生活质量的影响。方法采用前瞻性、自身对照方法,以匹兹堡睡眠质量指数量表（PSQI）、世界卫生组织生活质量测定量表简表（WHOQOL-BREF）、微动敏感床垫睡眠监测系统（MSMSMS）为研究工具,观察52例失眠症患者服用和胃安神汤前后睡眠及生活质量变化情况。结果和胃安神汤可以降低患者PSQI总分以及睡眠质量、入睡时间、睡眠时间、睡眠效率、日间功能障碍评分（P〈0.01）;缩短患者入睡潜伏期、觉醒时间,增加患者深睡眠时间和REM睡眠时间（P〈0.05或0.01）;提高患者WHOQOL-BREF生理、心理、社会领域评分（P〈0.05或0.01）。结论和胃安神汤可以调整失眠症患者的睡眠结构,改善其睡眠质量以及生活质量。     

1714名城市更年期女性生存质量现状分析

目的:了解中国城市更年期女性生存质量状况。方法:采取横断面调查,在全国8个城市1 714例41～60岁女性中进行方便抽样和问卷调查,调查包括一般资料、Kupperman Index(KI)和世界卫生组织生存质量量表简表(WHOQOL-BREF)。结果:KI平均为(18.16±8.57)分,其中KI≥15分1 183例,<15分531例。所有人群在WHOQOL-BREF生理、心理、社会、环境维度得分分别为12.46±1.48、12.50±1.53、14.56±2.02、13.23±1.95,在生理和心理领域较中国常模下降,差异有统计学意义(P<0.01)。中、重度程度的更年期综合征患者(KI≥15分)比轻度的更年期人群(KI<15分)生存质量下降,在WHOQOL-BREF 4个领域差异均有统计学意义(P<0.01)。已绝经女性较未绝经女性生存质量下降,在心理、社会和环境领域差异有统计学意义(P<0.05)。结论:更年期女性生存质量下降,绝经后较绝经前下降明显,且症状越重生存质量越差。     

Estimation of Quality of Life in Haemodialysis Patients

Since haemodialysis is an expensive treatment modality for chronic renal failure patients, it is very essential to assess the outcome of therapy in terms of quality of life. The primary objective of the study was to estimate the effect of patient counselling in quality of life of end stage renal disease patients opting haemodialysis using World Health Organisation Quality of life scale and to assess the variables affecting the quality of life of these patients. Quality of life was determined by World Health Organisation Quality of life scale questionnaire comprised of 26 items which measures four domains: physical, psychological, social and environmental domain. A total of 81 patients were selected and divided into test and control group and the test group patients received counselling regarding their disease, use of medications, importance of adherence and the complications experienced during and after dialysis. The quality of life data was collected at the interval of 1, 2, 3, 6 and 12 months and the patients were counselled at each interval. The demographic profiles revealed that majority of the patients were in the age group of 31-50 and there exists a male predominance. About the socioeconomic status, upper middle class people were mostly affected. Assessment of impact of patient counselling in the quality of life of haemodialysis indicated a significant improvement in each domain after counselling. And also found that the psychological domain showed a significant increase in the score compared to others. Patient counselling helped to gain benefits in terms of improvement in quality of life and delayed progression of renal failure. Early recognition and prevention is necessary to improve the quality of life of chronic renal failure patients. Patient counselling should be made mandatory by incorporating clinical pharmacist in the nephrology team to make the patient understand his illness and modifications in lifestyle also create a positive environment and result in better quality of life.