Responsiveness and minimal clinically important difference of the Chinese version of the Low Vision Quality of Life Questionnaire after cataract surgery

AIM: To investigate the Chinese version of the Low Vision Quality of Life Questionnaire(CLVQOL) as an instrument for obtaining clinically important changes after cataract surgery.METHODS: Patients underwent cataract surgery in Shanghai General Hospital, Shanghai Jiao Tong University, who fit the inclusion criteria were recruited. Two CLVQOLs were administered, including a preoperative CLVQOL and a CLVQOL at the end of the 3 mo follow-up period, and were completed using face-to-face interviews or phone interviews conducted by trained investigators. The minimal clinically important difference(MCID) was calculated using an anchor-based method and a distribution method. In addition, the responsiveness of the questionnaire was measured.RESULTS: A total of 155 residents were enrolled. The average visual acuity(VA) preoperatively was 0.08(SD=0.05), and it increased to 0.47(SD=0.28) at the end of followup. Statistically significant positive changes in the CLVQOL scores indicated significant improvement of vision related quality of life after cataract surgery. With the larger value between the two results as the final value, the MCID values of the CLVQOL(scores of the four scales as well as the total score) were 8.94, 2.61, 4.34, 3.10 and 17.63, respectively. The CLVQOL has both good internal and external responsiveness.CONCLUSION: CLVQOL scores are appropriate instruments for obtaining clinically important changes after cataract surgery. This study is an effective exploration for establishingcataract surgery efficacy standards, which helps clinical and scientific research workers in ophthalmology to gain a more in-depth understanding when using CLVQOL.

Impact of personality and coping mechanisms on health-related quality of life in liver transplantation recipients

With the great development of liver transplantation in China, long survival and quality of life after liver transplantation have been matters of growing interest. This study was designed to investigate the impact of personality and coping skills on the quality of life after liver transplantation. METHODS:Fifty-five outpatients who had been followed up after liver transplantation at our center were assessed by general quality of life inventory (GQOLI-74 ), a medical coping modes questionnaire (MCMQ), an eysenck personality questionnaire (EPQ), and a general condition questionnaire (GCQ). RESULTS: The score for material well-being was the lowest (63.22±12.67) and for psychological well-being the highest (73.43±12.60) in 4 dimensions of the GQOLI in post transplantation patients. Their main coping method was confrontation (21.40±3.70). The main characteristics of their personality were extraversation (E score 12.96±4.13) and neuroticism (N score 8.20±4.90) . The total score of the GQOLI was positively correlated with confrontation and E score, and it was negatively correlated with acceptance and N score. The physical well-being positively associated with the E score. The psychological well-being was positively correlated with confrontation and L score, and was negatively correlated with acceptance, P and N score. Social well-being was positively correlated with confrontation and E score, and was negatively correlated with acceptance and N score. Material well-being was not correlated with coping methods and personality. CONCLUSION:The quality of life in post liver transplantation patients is associated with their psychological characteristics.

Literature review and analysis of the application of health outcome assessment instruments in Chinese medicine

OBJECTIVE： To evaluate the application of health assessment instruments in Chinese medicine. METHODS： According to a pre-defined search strategy, a comprehensive literature search for all articles published in China National Knowledge Infrastructure databases was conducted. The resulting articles that met the defined inclusion and exclusion criteria were used for analysis. RESULTS： A total of 97 instruments for health outcome assessment in Chinese medicine have been used in fundamental and theoretical research, and 14 of these were also used in 29 clinical trials that were randomized controlled trials, or descriptive or cross-sectional studies. In 2 152 Chinese medicine-based studies that used instruments in their methodology, more than 150 questionnaires were identified. Among the identified questionnaires, 51 were used in more than 10 articles （0.5%）. Most of these instruments were developed in Western countries and few studies （4%） used the instrument as the primary evidence for their conclusions. CONCLUSION： Usage of instruments for health outcome assessment in Chinese medicine is increasing rapidly; however, current limitations include selection rationale, result interpretation and standardization, which must be addressed accordingly.

Literature review and analysis of the development of health outcomes assessment instruments in Chinese medicine

OBJECTIVE： To evaluate the development of health outcomes assessment instruments in Chinese medicine. METHODS： A comprehensive literature search for all published articles in China National Knowledge Infrastructure Database, Chongqing VIP Database and WANFANG Data was conducted. The studies that met the inclusion and exclusion criteria were used to extract information according to a predesigned assessment instrument. RESULTS： A total of 97 instruments for health outcome assessment in Chinese medicine were identified. Of these questionnaires, 7 were generic, 12 were condition-specific and 78 were disease-specific. All instruments were suitable for adults, children, and both men and women. These instruments aimed to evaluate the health-related quality of life, signs and symptoms as well as patient satisfaction and doctor-reported outcome. However, the descriptions were poorly constructed for some of the most basic parameters, such as the domains and items, administrative mode, response options, memory recall periods, burden evaluation, format, copyright, content validity, and other properties. CONCLUSION： The instrument development for health outcomes assessment in Chinese medicine is increasing rapidly; however, there are many limitations in current methodologies and standards, and further studies are needed.

中医药特色的医养结合养老健康模式应用效果评价

目的评价中医药特色的医养结合养老健康模式的应用效果。方法选择2023年1月—2024年1月入住眉山市中医医院龚村养护中心接受养老服务的102例老年人为研究对象,实施中医药特色医养结合养老健康模式。采用SF-36生存质量评分表评估实施前后生活质量,评价养老服务满意度。结果实施后老年人生活质量评分高于实施前,差异有统计学意义(P<0.05)。实施后养老服务满意度较实施前提高,差异有统计学意义(P<0.05)。结论在医养结合背景下开展中医药健康养老服务模式,能提高老年人的生活质量,提升养老服务满意度。

中医护理对脑卒中后便秘患者的便秘改善及生活质量影响的meta分析

目的探讨中医护理对脑卒中后便秘患者的便秘改善及生活质量影响。方法采用网上检索的方式收集国内外相关数据库文献,并采用方法质量学对收集到的文献进行严格评价,再以RevMan5.3软件进行分析。结果本研究最终纳入10篇文献,均采用随机对照的方法进行研究,文献发表时间在2014-2023年,样本量共826例,其中对照组进行常规护理,研究组在常规护理基础上进行中医护理,中医护理包括耳部全息铜砭刮痧、耳尖放血、耳穴埋豆、手指点穴、火龙罐、神阙灸法、针刺、药棒穴位按摩、神阙穴贴敷、盆底生物反馈干预、艾灸、闪罐及情志护理等。纳入的文献在随机序列方法、文献结果的盲法、选择性报告方面偏倚发生的风险较低,文献质量等级均评为B级。经Meta分析,两组便秘临床症状积分比较存在明显异质性(I2=99%,P<0.00001),以随机效应模型进行分析,结果为SMD=-2.02,95%CI[-7.22,3.19],P>0.05,差异不明显;两组患者护理干预后疗效存在明显的异质性差异(I2=68%,P<0.001),以随机效应模型进行分析,结果为OR=2.76,95%CI[1.29,5.88],存在明显差异(P<0.05);生活质量比较存在明显的异质性差异(I2=98%,P<0.00001),以随机效应模型进行分析,结果为SMD=10.51,95%CI[-17.09,-3.93],存在明显差异(P<0.05)。根据脑卒中后便秘患者经护理干预后的疗效、便秘临床症状积分及生活质量的情况制作漏斗图,其漏斗图两侧均有较好的对称性,发表偏倚较小。结论中医护理可有效预防脑卒中后便秘,提高脑卒中患者的生活质量水平,该项干预措施可纳入术后常规干预措施。

The Application of Assessment of the Quality of Life in the Clinical Efficacy Evaluation System and the Selection of Questionnaires of Chinese Medicine Treating Tumors

In China, CM has been applied to treat almost every cancer patient, especially during the observation period after surgery, routine radiotherapy and chemotherapy. Several decades of CM treatment results have shown that CM treatment could be helpful in improving patients＇ physical rehabilitation, relieving symptoms and strengthening immunity. CM also could aid in the decline of rates of recurrence and metastasis, prolong the survival time, and especially, have significant effects on relieving symptoms such as relieving fatigue, improving syndromes caused by conventional therapies （surgery, radiotherapy, chemotherapy and biological treatment）, and indescribable discomforts caused by the unknown reason. It has been found in several studies that conventional medical treatment combined with CM could significantly improve QOL, and reduce treatment-related and disease-related symptoms. Patients treated with CM and Western medicine have higher scores in the fields of psychology, society,

基于中医特色快速康复外科护理对胆囊结石患者术后生活质量的改善探讨

目的研究胆囊结石患者应用基于中医特色快速康复外科护理价值。方法回顾性选取2021年12月—2023年10月济南市第七人民医院收治的100例胆囊结石患者的临床资料,根据护理方式的不同分为参照组(常规护理)、研究组(基于中医特色快速康复外科护理),各50例,比较两组生活质量、负性情绪、遵医行为及护理不良事件。结果护理前两组生活质量及负性情绪评分比较,差异无统计学意义(P均>0.05);护理后,与参照组比较,研究组简明健康问卷简表评分更高,焦虑自评量表、抑郁自评量表评分更低,差异有统计学意义(P均<0.05);研究组遵医率(98.00%)高于参照组(86.00%),研究组护理不良事件发生率(4.00%)低于参照组(16.00%),差异有统计学意义(χ^(2)=4.891、5.120,P均<0.05)。结论基于中医特色快速康复外科护理可提高胆囊结石患者的生活质量、稳定情绪,优化遵医行为,避免发生护理不良事件发生。

The effects of Chinese Yam-Epimedium mixture on respiratory function and quality of life in patients with chronic obstructive pulmonary disease

OBJECTIVE:To examine the clinical effects of a mixture of Chinese Yam and Epimedium in patients with stable moderate or severe chronic obstructive pulmonary disease(COPD).METHODS:Forty-nine patients with COPD were randomly allocated to a group whose usual treatment was supplemented with oral Chinese Yam-Epimedium mixture,or a control group given placebo.For each patient,body mass index,airflow obstruction,dyspnea,and exercise capacity were measured and converted into the BODE index before treatment and at one and three months after initiation of treatment.Participants also completed the St George's Respiratory Questionnaire(SGRQ) at the same intervals.RESULTS:After one month,improvements were seen in the BODE index and SGRQ of participants taking Chinese Yam-Epimedium mixture compared to controls.There were statistically significant differences in the SGRQ:three of its components and the total SGRQ scores were significantly decreased(P<0.05),respiratory symptom scores had improved(P<0.01),and the dyspnea component of the BODE index had significantly decreased(P<0.05).Similar improvements were observed after three months of treatment,but exercise tolerance had also improved:the six-minute walking distance had significantly increased(P<0.05) in the treatment group when compared with controls.CONCLUSION:Chinese Yam-Epimedium mixture can significantly improve dyspnea,exercise capacity,and the quality of life of patients with stable moderate or severe COPD.

Single-site Baseline and Short-term Outcomes of Clinical Characteristics and Life Quality Evaluation of Chinese Wet Age-related Macular Degeneration Patients in Routine Clinical Practice

Background：Age-related macular degeneration （AMD） is the leading cause of irreversible vision loss among the older population.In China,treatment of age-related ocular diseases is becoming a priority in eye care services.This study was to investigate the clinical characteristics and quality of life of Chinese patients with wet AMD and current treatment types,to evaluate short-term gains in different treatments,and to investigate associations between visual function and vision-related quality of life （VRQoL）.Methods：A prospective,observational,noninterventional study was conducted.Basic data were collected from patients with clinical diagnoses of wet AMD before clinical assessments at baseline.VRQoL was measured with the Chinese version of the National Eye Institute Visual Function Questionnaire-25 （NEI VFQ-25）.Correlations of the NEI VFQ-25 subscale scores with best-corrected visual acuity （BCVA） and between-group differences were analyzed.Results：A total of 80 wet AMD patients were enrolled,with the mean age of 68.40 years.About one-quarter ofwetAMD patients received intravitreal （IVT） ranibizumab treatment,and 67％ of them were treated on apro re nata basis.The visual acuity of patients treated with IVT ranibizumab at month 3 after treatment was significantly increased,whereas patients treated with traditional Chinese medicine achieved no significant improvement.Cronbach＇s α for the NEI VFQ-25 subscales ranged from 0.697 to 0.843.Eight subscale and overall composite scores were moderately correlated with the BCVA of the better-seeing eye.Significant differences in the overall NEI VFQ-25 scores and other subscales were observed between patients with BCVA in the better-seeing eye of less than 50 letters and the others.Conclusions：Patients treated with IVT ranibizumab experienced better vision improvement at short-term follow-up.The Chinese version of the NEI VFQ-25 is a valid and reliable tool for assessing the VRQoL of Chinese wet AMD patients.

电针缓解癌痛患者阿片耐受的临床观察

目的观察电针缓解癌痛患者阿片耐受的临床疗效。方法将60例癌痛患者随机分为电针组和对照组,每组30例。两组均使用阿片类药物进行镇痛治疗,电针组取双侧内关和足三里穴进行电针治疗,对照组取双侧内关和足三里穴旁开15 mm处非穴位点进行电针治疗。观察两组阿片耐受指数、爆发痛的次数和疼痛缓解持续时间,比较两组治疗前后数字等级评定量表(numeric rating scale,NRS)和欧洲癌症研究与治疗组织生命质量核心量表(European Organization for Research and Treatment of Cancer quality of life questionnaire-C30,EORTC QLQ-C30)评分变化,并比较两组不良反应发生率。结果电针组阿片耐受指数低于对照组(P<0.05),爆发痛次数低于对照组(P<0.05),疼痛缓解持续时间长于对照组(P<0.05)。电针组治疗后情绪、躯体、认知和社会功能及总体健康评分高于治疗前和对照组(P<0.05);电针组治疗后疲倦、恶心呕吐、疼痛、气促、失眠、食欲丧失和便秘评分低于治疗前和对照组(P<0.05)。电针组恶心呕吐和便秘的发生率低于对照组(P<0.05)。结论电针可减少癌痛患者镇痛治疗期间阿片耐受的发生,减轻疼痛,提高生活质量。

中医辨证施护在老年病科患者护理中的应用效果

目的探讨中医辨证施护在老年病科患者护理中的应用效果。方法选取我院2021年1月至2023年1月收治的350例老年病科患者,以抽签法分为两组。对照组给予常规护理,试验组实施常规护理联合中医辨证施护。比较两组护理前后生存质量评分、护理满意度、遵医行为评分、病情恶化率。结果试验组生存质量评分高于对照组,护理满意度高于对照组,遵医行为评分高于对照组,病情恶化率低于对照组,P<0.05。结论老年病科患者实施常规护理联合中医辨证施护的效果确切,可有效提高患者的遵医行为,预防病情恶化,改善患者生存质量,提高患者满意度。

椎针通督循经疗法对脑梗死后偏瘫患者的作用效果

目的探讨椎针通督循经疗法对脑梗死后偏瘫患者的作用效果。方法选择医院2021年10月至2022年10月接诊的166例脑梗死后偏瘫患者,随机分为观察组与对照组,各83例。对照组接受常规处理,观察组在对照组基础上联合椎针通督循经疗法治疗,均持续治疗8周。比较两组临床疗效、美国国立卫生院卒中量表(NIHSS)评分、Fugl-Meyer运动功能评定量表(FMA)评分、Barthel指数(BI)、中医证候积分、功能综合评定量表(FCA)评分。结果治疗后,与对照组相比,观察组临床疗效较好(P<0.05);治疗后,与对照组相比,观察组NIHSS评分、中医证候积分更低,FMA、BI、FCA评分均更高(P<0.05)。结论椎针通督循经疗法治疗脑梗死后偏瘫患者可促进肢体功能康复,改善患者生活质量。

白癜风患者生活质量评估的电子问卷调查分析

目的评估白癜风患者生活质量,并评价中文版白癜风专用生活质量量表(VitiQoL)的信度和效度。方法将白癜风患者的一般情况问卷、皮肤病生活质量指数(DLQI)、中文版VitiQoL通过电子问卷的形式进行调查,对调查结果进行统计分析。结果共回收有效问卷151份,其中21.19%的患者合并自身免疫性疾病及其他系统疾病,16.56%患者有阳性家族史,患者DLQI均值(4.66±4.74)分,中文版VitiQoL均值(51.19±19.96)分;DLQI因素分析提示病情严重程度与DLQI呈正相关(P<0.05);中文版VitiQoL多因素分析提示,该评分与年龄、受累部位及病情严重程度均有关(均P<0.05),其中病情严重程度与中文版VitiQoL评分呈正相关。中文版VitiQoL的校正后克朗巴赫α系数为0.955,信度较好;各问题间的相关系数均小于各问题与量表总评分的[(0.106~0.805)比(0.405~0.881)],有较好的内容效度。因子分析获得特征根>1的因子共2个,累计贡献率69.85%,提示该量表有较好的结构效度。中文版VitiQoL评分与DLQI评分相关性分析结果显示二者Spearman相关系数r值为0.599(P<0.01)。结论中文版VitiQoL有良好的信度和效度,可用于中国白癜风患者生存质量的评估。

Determinants for asthma control, quality of life and use of complementary and alternative medicine in asthmatic pediatric patients in four cities

Background Asthma is a significant chronic health problem worldwide. Management aims at disease control by reducing functional impairment and exacerbations and improving quality of life (QoL). We report a multi-center study to survey asthma control and QoL in four cities in the Pearl River Delta. Methods The conjoint survey involved ten Hong Kong pediatric hospitals/units, two Shenzhen hospitals, two Macao hos-pitals, and two Guangzhou hospitals on asthma control (using Asthma Control Test) and QoL (Pediatric Allergic Disease Quality of Life Questionnaire, PADQLQ). Acceptability of a treatment is graded as very good/good/fair/poor. Results Good asthma control was only reported in 80% subjects in Hong Kong, but higher in sister cities (85–94%, P<0.001). Allergic rhinitis, 'incense burning', and 'smoker in family' were prevalent among the four cities. Logistic regres-sion showed better control of asthma was associated with better PADQLQ (B=?0.029, P < 0.001), better acceptability of bronchodilator (B=?1.488, P = 0.025), negatively with 'smoker in family' (B=?0.83, P = 0.015) and various PADQLQ domains. Conversely, worse PADQLQ was associated with allergic rhinitis severity (B=4.77, P <0.001), poor control of asthma (B=7.56, P <0.001), increased frequency of traditional Chinese medicine use (B=1.7, P < 0.05), increased fre-quency of bronchodilator usage (B=1.05, P < 0.05), 'smoker in family' (B=4.05, P < 0.05), and incense burning at home (B=3.9, P < 0.05). Conclusions There are some clinical and cultural differences among the four southern Chinese cities within the Guangdong province. This study identifies potentially modifiable environmental and treatment factors associated with poor asthma control and QoL for health-care interventions. Having a smoker in the family is independently associated with poor asthma control and QoL.

综合康复训练联合早期中医情志干预对脑卒中抑郁患者的应用效果

目的探讨综合康复训练联合早期中医情志干预对脑卒中抑郁患者的应用效果。方法选取2021年8月至2022年8月驻马店市中心医院收治的86例脑卒中抑郁患者,按随机数字表法分为对照组、试验组,各43例,对照组接受常规护理结合综合康复训练,试验组在对照组干预基础上接受早期中医情志干预。对比两组干预前后心理状态、生活质量及康复依从性。结果两组干预前焦虑、抑郁、生活质量评分差异无统计学意义(P>0.05);干预后,两组焦虑、抑郁评分均降低,试验组低于对照组;生活质量各维度评分均升高,试验组高于对照组(P<0.05)。试验组康复依从性高于对照组(P<0.05)。结论综合康复训练联合早期中医情志干预可减轻脑卒中抑郁患者焦虑、抑郁情绪,提高生活质量和康复依从性。

中医情志疗法联合知信行干预在脑梗死恢复期患者中的应用

目的探讨中医情志疗法联合知信行干预在脑梗死恢复期患者中的应用效果。方法本研究为前瞻性随机对照试验,纳入河南省中西医结合医院2020年2月至2022年2月86例脑梗死患者,根据随机数字表法分为对照组(n=43)和研究组(n=43)。两组均接受常规护理,对照组在此基础上实施知信行干预,研究组在对照组基础上应用中医情志疗法,所有患者均随访6个月。分别于干预前、患者出院6个月返院复查时采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评估患者心理状态,遵医行为量表(健康生活行为、并发症预防、系统治疗、功能锻炼)评估患者遵医行为,卒中专用生活质量量表(SS-QOL)评估患者生活质量。结果干预前,两组患者SAS、SDS、健康生活行为、并发症预防、系统治疗、功能锻炼、遵医行为量表总分、SS-QOL评分比较,差异无统计学意义(P>0.05);干预后,两组患者SAS、SDS评分均较干预前降低,且研究组患者低于对照组(P<0.05);两组患者健康生活行为、并发症预防、系统治疗、功能锻炼、遵医行为量表总分、SS-QOL评分均较干预前提高,且研究组患者高于对照组(P<0.05)。结论中医情志疗法联合知信行干预能减轻脑梗死恢复期患者焦虑抑郁情绪,提高遵医行为,改善生活质量。

结直肠癌术后患者中医生存质量量表的研制及条目筛选

目的研制结直肠癌术后患者中医生存质量量表(quality of life questionnaire of Chinese medicine for postoperative patients with colorectal cancer,QLQ-CMPPCC),以全面、客观地评价中医药在结直肠癌术后的临床疗效。方法根据WHO生存质量量表制定原则,结合中医基础理论,提出量表的理论结构模型,广泛查阅国内外多种普适性及结直肠癌专用生存质量量表,采用结构化决策的方法,编制初始量表。用调查方式对205例结直肠癌术后患者进行测试,运用专家重要性评分法、条目分布考察法、离散趋势法、t检验法、相关系数法、因子分析法、克朗巴赫α系数法联合进行条目筛选。结果研制出含有生理、心理、独立性和社会功能4个领域、20个方面及54个条目的QLQ-CMPPCC。其中,非造口手术患者回答43条,造口手术患者回答46条,生存质量总评价1条。结论 QLQ-CMPPCC具有中医特色,全面反映了结直肠癌术后患者生存质量的内涵,可作为结直肠癌术后中医临床疗效评价的工具。

8448例一般人群的中医体质类型与健康状况关系的分层分析

目的:以性别或年龄为分层因素,探讨一般人群的中医体质类型与健康状况的关系。方法:从中国9省市(江苏、安徽、甘肃、青海、福建、北京、吉林、江西、河南)横断面中医体质和健康状况调查21948例数据库中,随机抽取性别和年龄结构与2005年中国15岁以上人口比例基本一致的8448例组成本研究样本。采用Nemenyi检验,研究不同性别或年龄人群的9种基本中医体质类型(平和质之外的气虚质、阳虚质、阴虚质、痰湿质、湿热质、血瘀质、气郁质、特禀质8种体质类型均为偏颇体质)与健康相关生命质量量表简明健康状况调查问卷(Medical Outcomes Study36-ItemShort-Form Health Survey,MOS SF-36)得分的关系。结果:不同性别或年龄人群的8种偏颇体质MOS SF-36得分显著低于平和质(P<0.05)。以性别为分层因素,男性气虚质(生理领域以及生理机能、生理职能、一般健康状况和精力4个维度)、气郁质(心理领域以及社会功能、情感职能和精神健康3个维度)、血瘀质(躯体疼痛维度)MOS SF-36得分最低,女性痰湿质(生理领域以及生理机能、生理职能、躯体疼痛、一般健康状况和社会功能5个维度)、气郁质(心理领域以及情感职能和精神健康2个维度)、气虚质(精力维度)MOS SF-36得分最低。以年龄分层,15～34岁年龄组特禀质(生理领域以及生理机能、生理职能和一般健康状况3个维度)、气郁质(心理领域以及精力、社会功能、情感职能和精神健康4个维度)、血瘀质(躯体疼痛维度)MOS SF-36得分最低,35～59岁年龄组气虚质(生理领域以及生理机能、生理职能和一般健康状况3个维度)、气郁质(心理领域以及精力、社会功能、情感职能和精神健康4个维度)、血瘀质(躯体疼痛维度)MOS SF-36得分最低,60岁以上年龄组气虚质(生理领域以及生理机能、生理职能和一般健康状况3个维度)、气郁质(心理领域以及精力、社会功能、情感职能和精神健康4个维度)、痰湿质(躯体疼痛维度)MOS SF-36得分最低。结论:不同性别或年龄人群的8种偏颇体质与平和质比较,MOS SF-36得分均显著降低,健康状况较差;不同中医体质类型的健康状况因性别或年龄呈现出不同的特点。