Health-related quality of life among congestive heart failure patients with preserved and reduced ejection fraction

Objective:To determine factors that affect the health-related quality of life(HRQOL)of congestive heart failure(CHF)patients with preserved and reduced ejection fraction.Methods:A cross-sectional study design was used for this study.The stratified random sampling was applied for each subgroup.HRQOL was measured with the Minnesota Living with Hear t Failure Questionnaire.The data were analyzed using chi-square,Spearman's correlation analysis,and independent t-test.Results:A number of 67 respondents participated in the recent study.The total mean scores of HRQOL were significantly different(P=0.001)between heart failure(HF)patients with reduced and preserved ejection fractions,41.07±7.54 and 54.97±4.36,respectively.It related with the physical(mean±standard deviation[SD]=10.4±2.14;t=-10.08,95%CI=-12.46 to-8.34;P-value=0.001)and psychological(mean±SD=3.5±0.5;t=-6.68,95%CI=-4.55 to-2.45;P-value=0.001)domain.Strong correlation was found between age(r=-0.898,P<0.05),NYHA functional classes(r=-0.858,P<0.01),duration of HF(r=-0.807,P<0.01),family support(r=0.927,P<0.01),and quality of life(Qo L).Conclusions:HRQOL in HF patients with reduced ejection fraction was higher than in those with preserved ejection fraction.Family suppor t is a fur ther determinant factor that has a positive correlation to the Qo L.

Right to Family Life:Convergent Interpretation between Chinese Mainland and Hong Kong&Macao SARs

In the course of implementing the Constitution and theBasic Law in the Chinese mainland and the Hong Kong and MacaoSpecial Administrative Regions, the core content of “family life” (especiallythe part involving the parent-child relationship), which is abasic right at the constitutional level, has finally been recognized bythe competent authorities as “close ties between family members.”The convergent interpretation of basic rights by competent authoritiesin the Chinese mainland and the two special administrative regions,at least in terms of “family life,” is fundamentally due to the fact thatunder similar social, economic and population conditions, they havereached a consensus on understanding the core content of basic rightsunder the influence of international human rights law. On the basis ofthis convergent interpretation, there should be no longer significantdifferences in the basic rights enjoyed by Chinese citizens in the Chinesemainland and Hong Kong & Macao.

Assessment of Quality of Life, Family Function and Family Empowerment for Families Who Provide Home Care for a Child with Severe Motor and Intellectual Disabilities in Japan

Background: About 70% of Japanese children with severe motor and intellectual disabilities (SMID) live at home, and the number is increasing. Family members have an enormous burden of daily physical care for these children. A top priority is to understand quality of life (QoL), family function, and family empowerment to effectively support these families. We aimed to assess current living situations of families with a SMID child, and to reveal the relationships between QoL, family function, and family empowerment. Methods: Sixty-five family members from 34 families with a SMID child participated in this study. We assessed 5 parameters using the Japanese versions of the following instruments: World Health Organization Quality of Life 26 (WHOQOL26), Kinder Lebensqualitats Fragebogen (KINDL), Family Assessment Device (FAD), Family Adaptability and Cohesion Evaluation Scale KG-4 (FACESKG-4), and Family Empowerment Scale (FES). Correlation and multiple regression analyses were conducted;QoL score was the objective variable. Results: Participants included 54 parents (34 mothers, 20 fathers) and 11 siblings. The mean age of SMID children was 10.4 ± 5.03 years. Twenty-two children needed multiple types of medical care. The mean age of parents and siblings was 41.5 ± 6.16 years and 15.5 ± 2.35 years, respectively. The mean QoL score (3.28 ± 0.5) was similar to the Japanese average. The mean KINDL score (77.2 ± 12.1) was higher than those of previous studies. The mean FAD score was 1.97 ± 0.32. For FACEKG-4, the score of adaptability was correlated with WHOQOL score (r = 0.459, p < 0.05). The mean score of FES was 113.6 ± 14. As the result of multiple regression analysis, lower family FAD scores ([sb] = ?0.61, p < 0.01) indicated higher family function and greater age of participants (sb = 0.495, p < 0.01) was correlated with higher WHOQOL scores (F = 15.208, p < 0.01). Conclusions: Our results indicated that the individual QoL depended on the age of participants (equals the years of experience caring for a SMID child) and the recognition of family function as a whole. Thus, to improve family members’ QoL, we should focus on individuals and also approach the family as a whole.

Family empowerment and quality of life of parents raising children with Developmental Disabilities in 78 Japanese families

Objectives: The families of these children experience distress both at the time of diagnosis and afterward.A top priority is to understand family empowerment,family function,and family members' quality of life (QoL) and to effectively support these families in Japan.The objective of this study was to assess the actual conditions of families living with children having DDs and to explore the factors associated with family empowerment and parents' QoL.Methods: We surveyed ninety-three parents (78 mothers,15 fathers) from 78 families which lived with children with DDs in the capital region of Japan.We assessed two main outcomes using the Japanese versions of the following instruments: Family Empowerment Scale (FES),World Health Organization Quality of Life 26 (WHOQOL26),and other six outcomes.Correlation and multiple regression analyses were conducted.Results: No medication,cooperation with child rearing,assistance from a developmental support center,solved problems related to child rearing,and higher scores in Problem Solving contributed to higher FES scores.Higher WHOQOL26 scores were related to being a full-time housewife,higher self-esteem,no developmental support,a broad emotional support network,higher scores in Problem Solving and Role Function,and lower scores in Affective Reaction and General Function.Conclusions: We revealed that family empowerment and QoL of parents rearing children with DDs in Japan were affected by various subscales of family function and other family attributes.Effective interventions for improving family empowerment and QoL should be researched in the future.

Relation between Family Functioning and Quality of Life among Family Caregivers of Patients with Terminal Cancer Hospitalized in General Wards

Caring for a patient with terminal cancer poses difficulties for family caregivers. Although families of patients with cancer have been classified by type, little is known about the relation between family functioning and quality of life (QOL) in family caregivers. This study aimed to develop a typology of family functioning in family caregivers of patients with terminal cancer and then examine the relation between the family functioning and QOL of family caregivers. From December 2013 to August 2014, fifty-one family caregivers of patients with terminal cancer were recruited at three hospitals in Tokyo, Japan. Perceptions of family functioning were assessed with the Family Relationship Index, and its three subscores were classified into three groups by cluster analysis. Caregivers’ QOL was measured with the Caregiver Quality of Life Index-Cancer. The average total FRI score among 51 caregivers was 8.5 (SD = 2.8). Family functioning was categorized into three clusters: supportive (n = 12), communicative (n = 30), or conflictive (n = 8). Their QOL was categorized into two groups: the communicative group, with relatively high confliction, showed high QOL comparable to the supportive group. Family functioning in the families of patients with terminal cancer hospitalized in general wards was not good. For improving the QOL of family caregivers, it may be important for the family members to express their feelings and distress if they have conflicts.

Colorectal cancer’s burden attributable to a diet high in processed meat in the Belt and Road Initiative countries

BACKGROUND Colorectal cancer(CRC)plays a significant role in morbidity,mortality,and economic cost in the Belt and Road Initiative(“B and R”)countries.In addition,these countries have a substantial consumption of processed meat.However,the burden and trend of CRC in relation to the consumption of a diet high in processed meat(DHPM-CRC)in these“B and R”countries remain unknown.AIM To analyze the burden and trend of DHPM-CRC in the“B and R”countries from 1990 to 2019.METHODS We used the 2019 Global Burden of Disease Study to collate information regarding the burden of DHPM-CRC.Numbers and age-standardized rates(ASRs)of deaths along with the disability-adjusted life years(DALYs)were determined among the“B and R”countries in 1990 and 2019.Using joinpoint regression analysis,the average annual percent change(AAPC)was used to analyze the temporal trends of age-standardized DALYs rate(ASDALR)from 1990 to 2019 and in the final decade(2010–2019).RESULTS We found geographical differences in the burden of DHPM-CRC among“B and R”countries,with the three highest-ranking countries being the Russian Federation,China,and Ukraine in 1990,and China,the Russian Federation,and Poland in 2019.The burden of DHPM-CRC generally increased in most member countries from 1990 to 2019(all P<0.05).The absolute number of deaths and DALYs in DHPM-CRC were 3151.15[95%uncertainty interval(UI)665.74-5696.64]and 83249.31(95%UI 15628.64-151956.31)in China in 2019.However,the number of deaths(2627.57-2528.51)and DALYs(65867.39-55378.65)for DHPM-CRC in the Russian Federation has declined.The fastest increase in ASDALR for DHPM-CRC was observed in Vietnam,Southeast Asia,with an AAPC value of 3.90%[95%confidence interval(CI):3.63%-4.16%],whereas the fastest decline was observed in Kyrgyzstan,Central Asia,with an AAPC value of-2.05%(95%CI:-2.37%to-1.73%).A substantial upward trend in ASR of mortality,years lived with disability,years of life lost,and DALYs from DHPM-CRC changes in 1990-2019 and the final decade(2010-2019)for most Maritime Silk Route members in East Asia,South Asia,Southeast Asia,North Africa,and the Middle East,as well as Central Europe,while those of the most Land Silk Route members in Central Asia and Eastern Europe have decreased markedly(all P<0.05).The ASDALR for DHPM-CRC increased more in males than in females(all P<0.05).For those aged 50-74 years,the ASDALR for DHPM-CRC in 40 members exhibited an increasing trend,except for 20 members,including 7 members in Central Asia,Maldives,and 12 high or high-middle social development index(SDI)members in other regions(all P<0.05).CONCLUSION The burden of DHPM-CRC varies substantially across“B and R”countries and threatens public health.Relevant evidence-based policies and interventions tailored to the different trends of countries in SDIs or Silk Routes should be adopted to reduce the future burden of CRC in“B and R”countries via extensive collaboration.

Exploring the Experiences of Personal Recovery among Mental Health Consumers and Their Caregivers Receiving Strength- Based Family Interventions

Background:This study explored the personal recovery of consumers and their caregivers receiving the strength-based family intervention.Method:A three-year project was implemented with 43 dyads from 5 community psychiatric rehabilitation agencies in northern,central,and Southern Taiwan.This paper presents qualitative analysis with a focus on describing the experiences of personal recovery.To gain a deeper understanding of the participants’personal experiences and perspectives,semi-structured in-depth interviews were conducted on three occasions(six months after the inception of the experiment,18 months after,and when the participants left the services of this study).Over the three occasions,a total of 27 consumers and 28 caregivers were interviewed.Data analysis was conducted based on grounded theory.Results:Consumers expressed positive experiences in the domain of the recovery process(positive sense of self,taking responsibility,and better coping)and on the objective indicators of recovery(functioning,interpersonal interaction,and family relationship).Caregivers experienced lessened psychological burdens.They also revealed improvements to their sense of self(recovery process)and subjective indicators of recovery outcomes,including feeling empowered and having a better quality of life.Moreover,they had better interaction with consumers(objective domain of recovery).Conclusion:These findings suggest that the strength-based perspective is an acceptable,culturally-compatible approach among Chinese mental health consumers and their caregivers.The investigators suggest that additional resources would be necessary to support a change in the service system in Taiwan so that family-based services can be provided to promote the recovery of mental health consumers and their family caregivers.

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.

Research on the effects of family care degree on stigma and psychosocial adaptation among the patients with Parkinson’s disease

Objective:This study aimed to investigate the status quo of family care degree,stigma and psychosocial adaptation of the patients with Parkinson’s disease(PD),and discuss the effects of family care degree on stigma and psychosocial adaptation among the patients with PD.Methods:This study was conducted between September 2018 and April 2019 on patients with PD who were admitted to a Ter tiary Grade A hospital in Dalian city.A total of 246 PD patients were investigated by convenience sampling method using self-designed general information questionnaire,along with family care index(APGAR),24-item Stigma Scale for Chronic Illness(SSCI),and Psychosocial Adjustment Scale(PAS)for PD.And patients were divided into two groups according to the level of family care degree and compared with stigma and psychosocial adaptation.Results:The total score of family care for patients with PD was 6.97±2.46,family function was good in 132 cases(53.7%),moderate barrier in 92 cases(37.4%),and severe barrier in 22 cases(8.9%).The scores of stigma and psychosocial adaptability and their dimensions in the group with high degree family care were higher than the low degree group.Conclusions:The overall level of family care for PD patients was poor.Improving family care degree can help patients with PD to reduce stigma and improve psychosocial adaptation.

Quality of life of parents and siblings of children with cochlear implants

Objectives: This study examined the quality of life(QoL) of the parents and siblings of hearing-impaired children with cochlear implants(CIs).Design: This is a cross-sectional, questionnaire-based study. The questionnaire consists of three sub-domains-interaction, emotional well-being and support for the hearing-impaired child and the overall QoL – and two open-ended questions for participants to provide comments and suggestions to enhance their family's QoL. A total of 63 questionnaires were e-mailed or mailed to families who met the inclusion criteria.Setting: The study was conducted under the Center for Rehabilitation & Special Needs, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur.Participants: A total of 79 parents and 23 siblings from 44 families of children with CI participated in this study.Main outcome measures: The mean score for each of the sub-domain and the overall QoL for both subject groups were computed. The answers for the open-ended questions were listed and organized into themes.Results: There were significant correlations between the overall QoL score and each of the test domains for the parents' group(p < 0.01). For the siblings' group, only the interaction and support domains were significant.Interaction was the main sub-domain affecting the parents' QoL but for siblings, this could not be determined. A total of 60% of the pooled comments were classified as ‘concerns'. As for the suggestions, 38.7% requested some form of support, mainly financial(41.7%).Conclusions: Families with hearing impaired children with CI have numerous concerns that need to be addressed, even though, on average, they were satisfied with their overall QoL.

Roles and Hopes of Family Members Living with SMID Children in Japan

The number of children with Severe Motor and Intellectual Disabilities (SMID) receiving medical treatment/recovering at home is rising yearly. Although benefits of this care are emphasized, the stress and duties of family members in the household are extremely great, especially because Japan is becoming a society of nuclear families. In this study, we described the lifestyles of nuclear families providing in-home medical care for children with SMID, focusing on family members’ roles. Roles of mothers, fathers, and siblings of children with SMID were summarized from semi-structured inter-views. As a result, for “the roles of each family member living with a child with SMID”, mothers had five roles, fathers seven, and siblings five. For “the hopes of each family member living with a child with SMID”, parents desired the whole family collaboration in care for children with SMID, and as caregivers, parents’ common thoughts included wanting siblings in order to help care for the child with SMID and wanting siblings to treasure their own lives. Siblings wanted their mother to have some time for rest and expected their fathers to have two main roles. They also expected their grandparents and other siblings to fulfill roles.

The Investigation of Relative Efficacy Family Training and Life Strategies on Caring Chronic Mental Illness in Family

This research is a semi-empirical study aiming to examine the effect of family trainings and life skills among the families, if Mashhad with chronic mental disorders. In doing this research, a sample of 300 subjects has been chosen in the stratified random and systematic approach from the families of chronic mental disorders who have been admitted in round the clock centers in Mashhad and who have been in the waiting list and these subjects have been divided to two groups of experiment and control randomly and we introduce family trainings and life skills to the experiment group. There was no training to control group. These two groups were tested in period to the beginning of trainings and post training with instruments such as taking care and mental disorders attitude questionnaire, life skills attitude questionnaire, California social adjustment? questionnaire, Rosenberg self-esteem, general health questionnaire and epidemiological mental disorders questionnaire. The result indicated that training had no effect on the attitude of families toward taking care of mental disorder, but family member’s attitude toward mental disorder had been changed. These trainings have been influential on changing family member’s attitude toward life skills, social adjustment, self-esteem, mental health increase and reducing mental disorders.

Desired Lifestyle of Older Adults with Dementia Living at Home from Their Perspective and That of Their Families with Support from Care Providers

Objective: This study aimed to determine the lifestyle of older adults with dementia living at home, how their families perceive them, and how care providers support their desired lifestyle. Methods: Semi-structured interviews were conducted with 12 pairs of older adults with dementia, their families, and care providers followed by a qualitative descriptive study. Results: Older adults with dementia described their lifestyle as follows: “I continue to take pride in the way I have lived so far,” “I want to do what I can now even if I cannot do it well,” “I live peacefully with my family,” “I go out and interact with people,” and “I live this time today with care.” Families regarded the lifestyle of older adults with dementia as a desire “to continue living at home peacefully,” “to live on their own,” and that they “probably do not want anything.” Care providers’ support was based on “respect (for an older adult with dementia) as a person,” “drawing out and making use of what they can do with their current abilities through providing care,” “supporting families and confirming their sense of satisfaction with life,” and “predicting the future course and supporting decision-making.” Conclusions: To support the lifestyle of older adults with dementia, it is important to ensure that they continue to have dignity and are comfortable living with their families and in their communities without intimidation.

The level and influencing factors of quality of life in patients with brachial plexus injury

Purpose:To investigate the overall quality of life level and identify influencing factors in patients with traumatic brachial plexus injury.Methods:One hundred three patients with brachial plexus injury were assessed using the World Health Organization Quality of Life-BREF(WHOQOL-BREF)and Family Adaptability and Cohesion Evaluation Scale(FACESII-CV)questionnaires.Results:The overall quality of life score from patients with brachial plexus injury was 65.78
15.2.The scores for the physical,psychological and environmental factors were significantly lower than the norm(Ps<0.05).Regression analysis showed that age,injury located ipsilateral to the dominant hand,upper limb function score,score of family intimacy and family income were all factors influencing the of quality of life.Conclusions:A brachial plexus injury significantly compromises an individual’s quality of life.Multiple factors influence this quality,which should be targeted to augment the physical and psychological care provided.

On Practice of the Effect of Systematic Family Nursing Guidance on the Quality of Life of Elderly Patients with Implanted Cardiac Pacemaker

Objective: To inquire into the effect of systematic family nursing guidance on improving the Quality of Life for elderly patients with implanted cardiac pacemaker. Methods: 41 elderly patients in accordance with the corresponding requirements were studied after offering systematic family nursing guidance and surveyed through the questionnaires about the QOL (quality of life) respectively 1 month, 3 months and 6 months after leaving hospital. Results: Compared with that of 1 month and 3 months after the operation, the questionnaire scores for 6 months after the operation were found to have significant improvement, and the differences were statistically significant. Conclusion: Systematic family nursing guidance can effectively improve the QOL for elderly patients with implanted cardiac pacemaker, which makes them spend their old age in comfort and happiness.

基于ERAS理念的家庭参与式护理对斜视患儿术后恢复的影响

目的探讨基于加速康复外科(ERAS)理念的家庭参与式护理对斜视患儿术后恢复的影响。方法选择2022年7月至2023年1月郑州大学第一附属医院河医院区收治的200例斜视患儿为研究对象,按随机数表法将患儿分为观察组和对照组,每组各100例。对照组患儿给予常规护理,观察组患儿接受基于ERAS理念的家庭参与式护理,均连续护理3个月。比较两组患儿护理前及护理3个月后的视力、视觉模拟疼痛评分(VAS)、应激反应(收缩压、舒张压、心率),采用生活质量简表(SF-36)评估两组患儿护理前及护理3个月后的生活质量变化,并统计两组患儿的并发症发生情况。结果护理前,两组患儿的视力、VAS评分比较差异均无统计学意义;护理后,两组患儿的视力均显著升高,且观察组患儿的视力为0.98±0.16,明显高于对照组的0.76±0.14,而VAS评分均显著降低,且观察组患儿的VAS评分为(3.71±0.59)分,明显低于对照组的(4.89±0.62)分,差异均有统计学意义(P<0.05);护理前,两组患儿的应激反应指标比较差异均无统计学意义;护理后,两组患儿的舒张压、收缩压、心率均显著升高,但观察组患儿的舒张压、收缩压、心率分别为(95.10±4.19)mm Hg、(108.31±7.12)mm Hg、(109.45±5.93)次/min,明显低于对照组的(99.57±5.01)mm Hg、(121.45±6.09)mm Hg、(130.47±6.73)次/min,差异均有统计学意义(P<0.05);护理前,两组患儿的生理功能、生理职能、情感职能、精神健康评分比较差异均无统计学意义;护理后,两组患儿的上述指标均显著升高,且观察组分别为(72.09±4.18)分、(73.09±5.09)分、(70.19±5.29)分、(71.28±4.29)分,明显高于对照组的(63.29±4.21)分、(64.28±4.98)分、(63.28±4.87)分、(63.09±4.19)分,差异均有统计学意义(P<0.05);观察组患儿的并发症总发生率为6.00%,明显低于对照组的18.00%,差异有统计学意义(P<0.05)。结论基于ERAS理念的家庭参与式护理可促进斜视患儿术后视力恢复,缓解疼痛及应激反应,提高患儿生活质量,降低并发症,安全性高,值得临床推广运用。