Health-related quality of life and the ability to perform activities of daily living: a cross-sectional study on 1079 war veterans with ankle-foot disorders

Background:The ankle-foot injuries are among the war-related injuries that cause many serious secondary problems for a lifetime.This nationwide study aimed to assess health-related quality of life and the ability to perform activities of daily living in veterans with ankle-foot injuries due to the Iran-Iraq war.Methods:A total of 1079 veterans with ankle-foot injuries were enrolled in a cross-sectional study from 2014 to 2016.Demographic characteristics,including age,gender,marital status,disability percent,educational level,employment and additional injuries,were collected.The ability to perform daily activities was assessed using the Barthel activities of daily living(ADL)and Lawton instrumental activities of daily living(IADL)Indexes.Physical and mental health-related quality of life(HRQOL)data were measured via the SF-36 subscales.The data were compared with those of bilateral lower limb amputees(BLLAs)and of the general Iranian population.Statistical analyses,including Pearson’s correlation coefficient,one-sample t-test and analysis of variance(ANOVA),were performed using SPSS16.0.A multiple linear regression model was used to determine the contribution of independent variables to the Physical Component Summary(PCS)and Mental Component Summary(MCS).Results:The highest and lowest scores were observed for mental health(48.93±20.69)and bodily pain(28.16±21.74),respectively.The mean scores of veterans with ankle-foot injuries on the SF-36 were significantly lower on all eight measures than those of the general Iranian male population and of the bilateral lower limb amputees(P<0.001).The mean scores of ADLs and IADLs were 83.9±16.3 and 5.3±2.0,respectively.The higher dependency in ADLs(P<0.001)and IADLs(P<0.001),the higher disability rate(P<0.001)and additional injury(P<0.001)were significant determinants of the PCS.ADL(P<0.001)and IADL(P<0.001)limitations,additional injury(P<0.001),history of hospitalization in the year preceding the study(P=0.007)and employment(P=0.001)were reported as determinants of the MCS.Conclusion:The results strongly suggest that veterans with ankle-foot injuries suffer from critically poor healthrelated quality of life.The main predicting factors of HRQOL were the disability to perform ADLs/IADLs,suffering two or more injuries,a history of hospitalization in the year preceding the study and unemployment.

Effects of physical activity by the teach-back educational method on the physical ability and quality of life in hemodialysis patients:a clinical trial

Objective:To determine the effect of physical activity by using the teach-back educational method on hemodialysis patients’quality of life(QOL)and physical ability.Methods:This is a single-blind clinical trial study involving a control group.A total of 90 patients who admitted to the dialysis centers of Beheshti and Besat hospitals in Hamadan were selected using a convenience sampling method and were randomly assigned to intervention(n=45)and control(n=45)groups.Data were collected using a demographic information checklist,a kidney disease QOL questionnaire,and a 6-minute-walk distance(6MWD)checklist.The patients’QOL questionnaire was completed,and the 6MWD was recorded before and at the end of the 2nd,4th,6th,8th,and 12th weeks of the intervention.In the intervention group,the patients were taught to perform physical activities with Pilates stretches in different resistances using the teach-back educational method during dialysis sessions for 12 weeks.Data were analyzed by using the independent t-test and chi-square test using SPSS-22 software.Results:Before the intervention,no differences were observed between the experimental and control groups in terms of demographic characteristics,QOL,and physical ability(P>0.05).The physical ability and QOL levels of patients exercising in the test group were higher than those in the control group after the intervention(P<0.05).Based on the results,the 2 groups significantly differed with regard to the scores of various dimensions of QOL and physical ability after the intervention(P<0.05).Conclusions:Physical activity by using the teach-back method can effectively increase physical ability and improve QOL of hemodialysis patients.Therefore,the recommendations and inclusion of exercise in the dialysis care plan can effectively promote patients’health.

Relationship between activities of daily living and depression among older adults and the quality of life of family caregivers

Objective： The purposes of this study were to explore the associations of activities of daily living （ADL） and depression among older adults with family caregivers1 quality of life and provide evidence for improving family caregivers＇ quality of life.Methods： Older adults （n=395） and their family caregivers （n=395） were selected as participants. The ADL scale and Geriatric Depression Scale were used to assess ADL and depression among older adults, and the 36-Item Short Form Health Questionnaire （SF-36） was used to assess family caregivers1 quality of life. Descriptive statistics and multiple linear regression were used to analyze the data.Resslts： The older adults’ ADL and depression scores were 21 ±7 and 11 ±6, respectively. Approximately 69.9% of older adults had declining or severely impaired ADL, and 47.1% had mild or moderate-to-severe depression. Family caregivers＂ mean quality of life score was 529±100. There was a negative correlation of older adults＇ ADL and depression with caregivers＇ quality of life. The correlation coefficient between ADL and the SF-36 mental component summary score was stronger than it was with the SF-36 physical component summary score.Conclusions： The ADL and depression of older adults influenced family caregivers＇ quality of life. Psychological health deserves closer attention, especially that of caregivers of disabled older adults.

Botulinum toxin type A plus rehabilitative training for improving the motor function of the upper limbs and activities of daily life in patients with stroke and brain injury

BACKGROUND: Botulinum toxin type A (BTX-A) is mostly to be used to treat various diseases of motor disorders, whereas its effect on muscle spasm after stroke and brain injury needs further observation. OBJECTIVE: To observe the effect of BTX-A plus rehabilitative training on treating muscle spasm after stroke and brain injury. DESIGN: A randomized controlled observation. SETTINGS: Department of Rehabilitation, Department of Neurology and Department of Neurosurgery, the Second Hospital of Hebei Medical University. PARTICIPANTS: Sixty inpatients with brain injury and stroke were selected from the Department of Rehabilitation, Department of Neurology and Department of Neurosurgery, the Second Hospital of Hebei Medical University from January 2001 to August 2006. They were all confirmed by CT and MRI, and had obvious increase of spastic muscle strength in upper limbs, their Ashworth grades were grade 2 or above. The patients were randomly divided into treatment group (n =30) and control group (n =30). METHODS: ① Patients in the treatment group undertook comprehensive rehabilitative trainings, and they were administrated with domestic BTX-A, which was provided by Lanzhou Institute of Biological Products, Ministry of Health (S10970037), and the muscles of flexion spasm were selected for upper limbs, 20-25 IU for each site. ② Patients in the treatment group were assessed before injection and at 1 and 2 weeks, 1 and 3 months after injection respectively, and those in the control group were assessed at corresponding time points. The recovery of muscle spasm was assessed by modified Ashworth scale (MAS, grade 0-Ⅳ; Grade 0 for without increase of muscle strength; Grade Ⅳ for rigidity at passive flexion and extension); The recovery of motor function of the upper limbs was evaluated with Fugl-Meyer Assessment (FMA, total score was 226 points, including 100 for exercise, 14 for balance, 24 for sense, 44 for joint motion, 44 for pain and 66 for upper limb); The ADL were evaluated with Barthel index, the total score was 100 points, 60 for mild dysfunction, 60-41 for moderate dysfunction, < 40 for severe dysfunction). MAIN OUTCOME MEASURES: Changes of MAS grade, FMA scores and Barthel index before and after BTX-A injection. RESULTS: All the 60 patients with brain injury and stroke were involved in the analysis of results. ① FMA scores of upper limbs: The FMA score in the treatment group at 2 weeks after treatment was higher than that before treatment [(14.98±10.14), (13.10±9.28) points, P < 0.05], whereas there was no significant difference at corresponding time point in the control group. The FMA scores at 1 and 3 months in the treatment group [(23.36±10.69), (35.36±11.36) points] were higher than those in the control group [(20.55±10.22), (30.33±10.96) points, P < 0.01]. ② MAS grades of upper limbs: There were obviously fewer cases of grade Ⅲ in MAS at 2 weeks after treatment than before treatment in the treatment group (0, 9 cases, P < 0.05), whereas there was no obvious difference in the control group. There were obviously fewer cases of grade Ⅲ in MAS at 2 weeks and 1 month after treatment in the treatment group (0, 0 case) than the control group (5, 2 cases, P < 0.01). ③ Barthel index of upper limbs: The Barthel index at 2 weeks after treatment was higher than that before treatment in the treatment group [(30.36±22.25), (28.22±26.21) points, P < 0.05], whereas there was no significant difference in the control group. The Barthel indexes at 1 and 3 months after treatment in the treatment group were obviously higher than those in the control group [(20.55±10.22), (30.33±10.96) points, P < 0.01]. CONCLUSION: BTX-A has obvious efficacy on decreasing muscle tension after stroke and brain injury, and relieving muscle spasm; Meanwhile, the combination with rehabilitative training can effectively ameliorate the motor function of upper limbs and ADL of the patients.

The Relationship among Chronic Disease, Feeling-for-Their-Age, Sleep Quality, Health-Related Quality of Life and Activities of Daily Living of Community-Dwelling Persons over 55 Years of Age

Japan’s aging population rate is increasing and healthy life expectancy has decreases by 10 years shorter than average life expectancy. The aim of this study is to determine the relationship among chronic disease, sleep quality, health-related quality of life (HRQOL), and activities of daily living in people over 55 years old who live in the community. Subjects were 161 persons aged 57 to 90 years who were treated with chronic disease in the outpatient department of the A hospital. Exclusion criteria included patients with dementia, cancer and severe heart disease. The survey evaluation questionnaires included the Pittsburgh Sleep Quality Index (PSQI), HRQOL by Short-Form 8 Health Survey (SF-8), and activities of daily living. Variables associated with quality of sleep, HRQOL in univariate analysis with p < 0.05 were entered into multivariate analysis using logistic regression with a stepwise forward selection procedure to determine independent variables and their association with major causes. The logistic regression analysis was done using SPSS software and the post-hoc power of the study was estimated using G*power. The level of significance was set at p < 0.05. The risk factor of poor sleep quality was because of history of cancer [odds ratio (OR): 3.53, 95% confidence interval (CI): 1.06 - 11.77], and insomnia (OR: 3.25, 95% CI: 1.55 - 6.79). The risk factors of poor physical HRQOL were motor disease (OR: 2.62, 95% CI: 1.36 - 5.07), respiratory disease (OR: 3.24, 95% CI: 1.27 - 8.26) and having pain (OR: 11.71, 95% CI: 5.35 - 25.66). In addition, anemia was found to be a risk factor of poor mental HRQOL (OR: 4.87, 95% CI: 1.11 - 21.33). The feeling-for-their-body-age (OR: 0.30, 95% CI: 0.15-0.59) was as “younger than actual age” and advanced the risk factor of poor sleep quality. In addition, feeling-for-their-age (OR: 0.44, 95% CI: 0.21 - 0.92) resulted in reduced risk factor of poor physical HRQOL. The risk factor of poor sleep quality was due to a patient with history of cancer. The factor for good sleep quality and the good factor for physical HRQOL were indications of feeling younger than the actual age.

EFFECT OF ACUPUNCTURE ON NEUROLOGICAL DEFECTS AND DAILY LIFE ABILITY IN PATIENTS WITH ACUTE CEREBRAL HEMORRHAGE

Objective: To observe the effect of acupuncture of Shuigou (GV 26), Neiguan (PC 6), Zusanli (ST 36), etc. on neurological defects and daily life ability in patients with acute cerebral hemorrhage. Methods: Fifty eight cases of acute cerebral hemorrhage patients were randomized into control group (n=28) and treatment group (n=30). Patients of two groups were both treated with intravenous infusion of Mannitol and other expectant medicines. In addition, patients of treatment group were also treated with acupuncture therapy, once daily and continuously for one month. Before and after treatment, the scores of neurological defects and daily life ability (Barthel Index) were given for assessing the therapeutic effect. Results: Following treatment, both scores of neurological defects of two groups decreased significantly (P<0.05), and the score of treatment group was strikingly lower than that of control group (P<0.05). After treatment, values of Barthel Index (BI) of two groups increased considerably in comparison with pre treatment (P<0.01), and the value of BI of treatment group was bigger than that of control group (P<0.05). Conclusion: Acupuncture can improve acute cerebral hemorrhage patients’ nervous function and daily life ability.

Disability and Quality of Life among Elderly Persons with Self-Reported Hearing Impairment: Report from the Ibadan Study of Aging

Background: Despite a high prevalence of hearing impairment (HI) among the elderly, the effect on their quality of life (QOL) has not been well studied in this environment. Aim: To determine the prevalence of disability and profile of QOL among elderly persons (aged ≥65 years) with HI. Design of Study: Cross-sectional. Setting: Eight contiguousYoruba-speaking states in Nigeria. Methods: Face-to-face interviews of respondents selected using a multi-stage, stratified area probability sampling of households;HI was based on self report and observer confirmation and the QOL was measured with the World Health Organization brief version (WHOQOL-Bref). Results: The prevalence of disability in Activities of Daily Living (ADL) was 35.4% while it was 10.1% in Instrumental ADL. Prevalence increased significantly with increasing age (P = 0.05). Disability in ADL (P = 0.01), poor family interaction (P = 0.01), poor community involvement (P = 0.01) cognitive impairment (P = 0.05) and poor report of overall health (P = 0.05) were significantly more common among the elderly with HI than those without. No significant differences were found in regard to current depression or the likelihood of experiencing verbal, physical or emotional abuses. Logistic regression analyses adjusting for age, sex, chronic medical conditions and disability confirmed the salient effect of HI on the decrement in the physical domains (P = 0.05). Conclusion: HI is associated with high prevalence of disability and has adverse effect on the quality of life. This observation strengthens the need for hearing rehabilitation in the policy formulation on the care of the elderly in resource-poor settings.

The following-up observation of ability of living after senile fracture

Objective To investigate the effect of senile f racture on ability of daily life.Method Carry out effective surgery in early time and encourage early out-of-bed activity to prevent secondary aging under th e monitor of internal medicine.Result Follow up 208patients for 1-3years(mean 1.8years),13patients(6.25%)were dead,153(73.55%)resumed the ability of independent l ife,32(15.38%)resumed the ability partly,10(4.8%)patients lost ability of life.Conclusion For the aged fracture,the ability of living could be improved by early surgery,reducing complications and active functional training of lowe r limbs under the monitor of internal medicine.

Patient Life Experience and Activity of Daily Living before and after Total Knee Arthroplasty

Background: As the population ageing, more patients suffer from joint disease. Joint replacement surgery performed in Taiwan is about 10,000 to 20,000 cases yearly. Aims: The purpose of this study is to realize Total Knee Arthroplasty (TKA) patients’ views about life experiences and difficulty in daily life before and after the surgery. Methods: In this study, in-depth interview with interview guideline was used to analyze patients’ experience by using a qualitative research method, and questionnaires were used to collect quantity data. Results: 1) A total of 20 participants were recruited. Average age was 75.15 (SD = 6.468). Eighteen of the participants were female and the other two were male. The majority of participants indicated that their home facilities were convenient or very convenient. 2) Motivations of the participants to undergo TKA were joint pain, limited joint range of motion, and weakness in legs. Participants’ expectations after surgery were no more pain and ease in walking, and able to manage daily life. 3) Depending on the time after surgery, joint pain and walking ability had improved to some extent. The joint range of motion increased, but kneeling remained difficult, and the participants’ mood and exercise capacity were improved. Conclusions: The finding can be as a reference for clinical practitioner to provide preoperative education for total knee arthroplasty patients.

Health-Related Quality of Life of Children and Adolescents with Juvenile Idiopathic Arthritis in Western Saudi Arabia

Objectives: To evaluate the effect of Juvenile Idiopathic Rheumatoid Ar-thritis (JIA) on the health-related quality of life (HRQOL) in Saudi children. Methods: A cross-sectional study was conducted in a tertiary hospital in Jeddah, Saudi Arabia to evaluate the HRQOL of children aged ≤ 18 years who had JIA using the childhood health assessment questionnaire modified for Arab children (CHAQ-MAC). Such questionnaire investigates 34 activities of daily life (ADL) classified into 8 life domains. Children or their parents were invited for face-to-face interview, and a phone interview was done for patients who missed their appointments during the period between February and July 2017. A statistical model was used to calculate a total CHAQ.MAC score (range = 0 - 33;Cronbach’s alpha = 0.966);with higher values indicating poorer HRQOL. Results: Of a total of 44 children (male ratio = 0.63;mean ± SD age = 9.95 ± 5.44), Systemic-onset JIA was the most frequent type (27.3%), followed by polyarticular (15.9%) and oligoarticular (13.6%). Pain was reported among 43.2% (frequently in the knee, in 27.3%) whereas morning stiffness was reported in 20.5%. The mean CHAQ.MAC score = 2.89 (75th centile = 3.00). With respect of ADLs, up to 22.7% of the children complained of difficulty;and 31.8% reported a difficulty in at least one of the 34 investigated ADLs. With respect of the life domain, children reported difficulties for activities (27.3%), dressing & grooming and hygiene (13.6%), and eating (6.82%). According to the life domain, 4.5% to 13.6% of the children needed help to execute the related ADLs and up to 9.1% used aids or devices. Poor HRQOL was associated with articular pain (p = 0.003) and specific medication (p = 0.043). Con-clusion: Children with arthralgia and those on specific treatment are at higher risk of impaired QOL, which emphasizes the need for systematic screening for treatment adverse effects and joint pain and implementation of efficient management to improve HRQOL.

Clinical value of ankle flexion and extension exercises combined with a psychological intervention in knee osteoarthritis

BACKGROUND Considering the limited effectiveness of clinical interventions for knee osteoarthritis(KOA),it is necessary to continue to explore appropriate and effective treatment strategies to improve the condition of KOA patients.AIM To clarify the influence of ankle flexion and extension exercises combined with a psychological intervention on the psychological status and activities of daily living(ADLs)of patients with KOA.METHODS The research participants were 116 KOA patients admitted to The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine between May 2019 and May 2022,including 54 patients receiving routine treatment,care and psychological intervention(control group)and 62 patients additionally treated with ankle flexion and extension exercises(research group).The two groups were comparatively analyzed in terms of psychological status(Self-rating Anxiety/Depression Scale,SDS/SAS),ADLs,knee joint function(Lysholm Knee Scoring Scale),pain(Visual Analog Scale,VAS),fatigue(Multidimensional Fatigue Inventory,MFI),and quality of life(QoL;Short-Form 36 Item Health Survey,SF-36).RESULTS After evaluation,it was found that the postinterventional SDS,SAS,VAS,and MFI scores in the research group were significantly reduced compared with the baseline(before the intervention)values and those of the control group,while the postinterventional Lysholm,ADL and SF-36 scores were markedly elevated.CONCLUSION Therefore,ankle flexion and extension exercises are highly effective in easing negative psychological status,enhancing ADLs,daily living ability,knee joint function and QoL,and relieving pain and fatigue in KOA patients,thus warranting clinical promotion.

远程运动想象疗法结合Barthel评分层级居家护理对脑卒中病人的影响

目的:探究基于远程运动想象疗法联合Barthel评分分层级居家康复护理策略对脑卒中病人的影响。方法:选取在医院进行脑卒中治疗的120例病人,采用随机数字表法,将其分为常规组及研究组,对常规组病人行常规居家护理,对研究组病人在常规居家护理基础上实施基于远程运动想象疗法联合Barthel评分分层级居家康复护理,比较两组病人干预前后日常生活能力、神经功能及生活质量。结果:出院3个月研究组病人日常生活能力评分及生活质量评分分别为(65.28±5.74)分及(64.41±4.13)分,均显著高于常规组(P<0.001),且其神经功能评分为(5.69±1.06)分,显著低于常规组(P<0.001);出院3个月,研究组焦虑、抑郁及焦虑抑郁测试量表(HAD)总分显著低于对照组,差异存在统计学意义(P<0.001)。结论:在脑卒中病人出院后对其实施基于远程运动想象疗法居家康复护理,能够显著提高病人日常生活能力及生活质量,同时能够促进病人神经功能的改善。

虚拟现实情景认知康复训练联合音乐疗法在卒中后认知障碍患者中的应用研究

目的观察卒中后认知障碍患者行虚拟现实情景认知康复训练联合音乐疗法的临床效果。方法选取卒中后认知障碍患者106例为研究对象,随机分为对照组和观察组,每组53例。对照组应用常规康复护理干预,观察组在对照组基础上应用虚拟现实情景认知康复训练联合音乐疗法。比较2组患者干预前后认知功能、日常生活能力及生活质量变化,分析患者家属护理满意度。结果干预后,2组患者蒙特利尔认知量表(MoCA)及Barthel指数评分均高于干预前,且观察组各项评分均高于对照组,差异有统计学意义(P<0.05)。干预后,2组患者脑卒中影响量表(SIS)得分均提高,且观察组各维度得分及总分均高于对照组,差异有统计学意义(P<0.05)。观察组患者家属护理满意度为98.1%,高于对照组的86.8%,差异有统计学意义(P<0.05)。结论虚拟现实情景认知康复训练联合音乐疗法有利于改善卒中后认知障碍患者认知功能,提高患者日常生活能力及生活质量。

“互联网+居家护理”在志愿护理服务中的应用效果

目的探讨"互联网+居家护理"在志愿护理服务中的应用效果。方法选取2020年12月至2021年12月"党群服务365平台"82例需要服务人群作为研究对象,采用随机数字表法将其分为对照组(41例)和观察组(41例)。对照组实施常规医疗服务,观察组实施"互联网+居家护理"服务,两组均持续护理12个月。比较两组的医院看病次数、医疗花费情况、日常生活能力、精神状态、照护者照护技能水平以及生活满意度。结果观察组医院看病次数、医疗花费情况均少于对照组,差异有统计学意义(P<0.05);观察组护理后日常生活活动能力量表(ADL)评分低于对照组,简易精神状态检查量表(MMSE)评分、照护技能水平评分均高于对照组,差异有统计学意义(P<0.05);观察组护理后生活满意度调查表(LSR)各项评分均高于对照组,差异有统计学意义(P<0.05)。结论通过互联网平台,护理志愿者对服务人群进行居家护理,能够改善服务人群的精神状态,促使其保持身心健康,提高生活自理能力,还能提高照护者的护理技能,一定程度上减少看病次数和医疗花费,从而提升服务人员满意度。

SFBC联合TOT对急性脑卒中后偏瘫患者肢体功能康复及ADL能力的影响

目的探究焦点解决短期咨询(SFBC)联合任务导向性训练(TOT)对急性脑卒中后偏瘫患者肢体功能康复及日常生活活动(ADL)能力的影响。方法选取2021年1月至2023年1月于潜江市中心医院康复医学科收治的101例急性脑卒中后偏瘫患者为研究对象,采用随机数表法将其分为观察组(51例)和对照组(50例)。对照组采用常规TOT训练方法,观察组采用SFBC联合TOT训练方法。比较两组患者心理状况[焦虑自评量表(SAS)和抑郁自评量表(SDS)]、Fugl-Meyer运动功能评分量表(FMA)及Barthel指数(BI)。结果干预前两组心理状况、FMA评分及BI评分比较,差异无统计学意义(P>0.05),干预2个月后观察组SAS、SDS评分显著低于对照组,差异有统计学意义(P<0.05),上肢运动功能量表(FMA-UE)、下肢运动功能量表(FMA-LE)、BI评分均显著高于对照组,差异有统计学意义(P<0.05)。结论SFBC联合TOT的康复治疗训练可以改善急性脑卒中后偏瘫患者心理状况,提高患者肢体康复功能及ADL能力。

左归丸联合丁苯酞佐治帕金森病轻度认知障碍疗效评价

目的探讨左归丸联合丁苯酞佐治帕金森病轻度认知障碍的临床疗效。方法选取医院2023年1月至3月收治的帕金森病轻度认知障碍患者80例,按随机数字表法分为观察组和对照组,各40例。两组患者均予常规抗帕金森病西药治疗,并予丁苯酞软胶囊口服,观察组患者加服左归丸。两组均连续治疗8周。结果观察组总有效率为90.00%,显著高于对照组的70.00%(P<0.05)。治疗后,观察组患者的腰膝酸软、胁肋疼痛、头晕头痛中医证候积分均显著低于对照组(P<0.05);观察组患者的沉默信息调节因子1(SIRT1)蛋白表达水平显著高于对照组,核因子κB(NF-κB)蛋白表达水平显著低于对照组(P<0.05);观察组患者的蒙特利尔认知评估量表(MoCA)、简易精神状态量表(MMSE)及日常生活活动能力(ADL)量表评分均显著高于对照组(P<0.05);观察组患者的统一帕金森病评定量表(UPDRS)评分显著低于对照组(P<0.05)。观察组与对照组不良反应发生率相当(5.00%比2.50%,P>0.05)。结论常规抗帕金森病治疗基础上佐以左归丸联合丁苯酞,可降低帕金森病轻度认知障碍患者的中医证候积分,改善SIRT1及NF-κB蛋白表达水平,提升认知功能及日常生活能力。

“互联网+延续性护理”对轻度失能老年患者生活质量及家庭照顾者准备度的影响

目的探讨“互联网+延续性护理”服务在轻度失能老年患者及家庭照护者中的应用效果。方法本研究为随机对照研究,将80例轻度失能老年患者分为对照组和干预组,每组40例,干预组接受“互联网+延续性护理”服务,对照组接受传统的延续性护理服务。通过对两组患者进行生活质量评估(SF-36)、日常生活活动能力(Barthel指数)评估及对其家庭照护者进行照顾者准备度(GPS)评估来比较两组之间的差异。结果与对照组相比,干预后干预组轻度失能老年患者在整体健康、躯体功能、社会功能、情绪角色等方面的表现明显得到改善(P<0.01),且Barthel指数评分明显提高(P<0.01),其家庭照护者照顾者准备度(GPS)评分明显高于对照组(P<0.01)。结论“互联网+延续性护理”服务能有效改善轻度失能老年患者的生活质量,提高其日常生活活动能力。这种服务的引入可以弥补传统护理服务在时效性、渠道多样性和便捷程度上的不足,提供更加高效、便捷、形式丰富的护理服务,同时对提高其家庭照护者照顾者准备度也有积极的影响。

脊髓损伤康复患者同侪训练方案的设计及应用研究

目的 设计脊髓损伤(SCI)康复患者同侪训练方案并探讨该方案对日常生活活动能力(ADL)和生活质量(QOL)的影响。方法 选取2022年5-12月在我院住院的SCI康复期患者40例进行同侪训练,同侪训练方案包括基础体能训练、生活重建模拟训练、居家环境无障碍改造、驾驶证与出行、职业憧憬。采用改良Barthel指数评分(MBI)和生活质量测定量表(WHOQOL-BREF)评价干预前和干预10周(2个循环)后患者的ADL和QOL。结果 干预10周后,患者MBI评分高于干预前,WHOQOL-BREF的生理维度、心理维度、社会关系维度、环境维度4个维度得分均高于干预前,差异均有统计学意义(P<0.05)。结论 同侪训练应用于SCI康复期患者,能够有效提升患者ADL和QOL。

乌鲁木齐市社区老年人衰弱现状及其影响因素

目的探讨乌鲁木齐市社区老年人衰弱现状及其影响因素。方法采用便利抽样法,选取新疆乌鲁木齐市水磨沟区的223例老年人作为研究对象,采用基本信息资料调查问卷、ADLs量表、MMSE量表、GDS-15量表、SSRS量表和SF-36量表进行问卷调查,应用单因素分析和二分类logistic回归分析老年衰弱人群的影响因素。结果社区老年人群衰弱发生率为12.11%(27/223)。单因素分析结果显示:衰弱与非衰弱患者年龄、家庭收入、医疗费用支付方式、患疾病种类、SSRS得分、GDS-15得分及SF-36量表中的情感职能、社会功能得分比较差异有统计学意义(P均<0.05)。二分类logistic回归分析结果显示,年龄、患疾病种类(≥2种)、抑郁是衰弱发生的危险因素(P均<0.05),家庭收入(≥2000元)、医保、社会支持(客观支持、主观支持和对社会支持的利用度)、情感职能、社会功能是衰弱发生的保护因素(P均<0.05)。结论乌鲁木齐市社区老年人衰弱发生率较高,年龄、患疾病种类、抑郁、家庭收入、医保、社会支持、情感职能、社会功能是衰弱发生的影响因素。

增殖期糖尿病视网膜病变患者疾病感知与抑郁在日常生活能力与健康相关生活质量间的链式中介作用

目的:探讨增殖期糖尿病视网膜病变患者疾病感知、抑郁在日常生活能力与健康相关生活质量间的链式中介作用。方法:选择356名增殖期糖尿病视网膜病变患者为研究对象,采用日常生活能力量表、简易疾病感知问卷、抑郁自评量表及视功能损害眼病患者生存质量量表对患者进行测量,采用Process软件Bootstrap法进行链式中介作用检验。结果:日常生活能力受损水平与疾病感知、抑郁程度呈显著正相关(r=0.336,P<0.01;r=0.260,P<0.01),与健康相关生活质量呈显著负相关(r=-0.365,P<0.01);疾病感知与抑郁呈显著正相关(r=0.308,P<0.01),与健康相关生活质量呈显著负相关(r=-0.888,P<0.01);抑郁与健康相关生活质量呈显著负相关(r=-0.391,P<0.01);疾病感知、抑郁在日常生活能力与健康相关生活质量间链式中介作用显著(P<0.05),中介效应为-0.25,中介效应占比为83.33%。结论:日常生活能力是增殖期糖尿病视网膜病变患者健康相关生活质量的重要影响因素,疾病感知与抑郁在其间起链式中介作用。