Health Related Quality of Life and Mental Health in ICU Survivors: Post-Intensive Care Syndrome Follow-Up and Correlations between the 36-Item Short Form Health Survey (SF-36) and the General Health Questionnaire (GHQ-28)

We investigated the relationship between health-related quality of life (HRQOL) and psychological distress in intensive care unit (ICU) survivors 12 months after ICU discharge. The purpose of this study, conducted and completed before the onset of the COVID-19 pandemic, was to find correlations among psychiatric symptoms detected by a screening tool as the General Health Questionnaire-28 (GHQ-28) and the different domains of HRQOL measured with the SF-36 health survey (SF-36), in order to identify ICU survivors with Post-Intensive Care Syndrome (PICS) who need a specific psychiatric intervention to improve their HRQOL. Among 298 ICU survivors who stayed in the ICU for at least 72 hours, 48 patients were enrolled one year after discharge undergoing a clinical interview to assess their functional impairment (Barthel index), mental health (GHQ-28), and health-related quality of life (SF-36). 19% of those subjects had a GHQ-28 ≥ 5 and were identified as “psychiatric cases”, and they were older and experienced a greater impairment in HRQOL. Anxiety, insomnia, and depressive symptoms seemed to be particularly involved in the impairment of HRQOL. A negative correlation between GHQ-28 total scores and subscales and SF-36 subscales was found. Our findings highlighted that psychological distress in ICU survivors may negatively impact physical health recovery and quality of life;conversely, physical impairment and functional disability may trigger the onset of psychiatric symptoms after discharge. The present study is firstly to investigate the correlations between HRQOL and psychological distress in ICU survivors through the GHQ-28, and then affirms the need to carry out follow-up checks for psychiatric symptoms in ICU survivors.

Physical Activity Level and Adult Saudi Health Related Quality of Life

Purpose: Physical inactivity in Saudi Arabia is a growing challenge to public health. This study aimed to define the relationship between the physical activity level (PAL) and adult Saudi health-related quality of life (HRQoL). Methods: Participants of this study were 100 Saudi adult aged from 18 - 70 years. The 36-Item Short-Form Health Status Survey (SF-36) was used to measure the participant’s HRQoL. The SF-36 is comprised of 8 domains. The electronic version of the General Practice Physical Activity Questionnaire was used to categorize participants in terms of physical activity level into;inactive, moderately inactive, moderately active, and active. Descriptive and inferential statistical tests were used to treat the collected data. Results: Results showed that only 17% of the Saudi adults had active PAL. The PAL had significantly positive relationship with 4 domains of HRQoL including: physical functioning (P = 0.004), role limitations caused by physical health problems (P = 0.048), vitality (P = 0.009), and general health (P = 0.044). Results also confirmed that the younger the subject, the higher the PAL (P = 0.0001) and the better the HRQoL. This is true for all domains except the role limitations caused by emotional problems and emotional wellbeing. Conclusion: The poor physical activity level of adult Saudi negatively impacts their HRQoL.

Assessment of disease specific knowledge and health-relatedquality of life among United States military veterans withinflammatory bowel disease

AIM To evaluate the association between patientdisease knowledge of inflammatory bowel disease （IBD）and health related quality of life （HRQoL） and identifypatient and disease related predictors of patientknowledge of IBD.METHODS： We performed a cross-sectional study ofIBD patients with an established diagnosis of IBD longerthan 3 mo prior to enrollment. The Crohn＇s and colitisknowledge score （CCKNOW） and short inflammatorybowel disease questionnaire （SIBDQ） were selfadministeredto assess patient knowledge of IBDand HRQoL, respectively. Demographic and diseasecharacteristics were abstracted from the electronicmedical record. The correlation between CCKNOWand SIBDQ scores was assessed by a linear regressionmodel. Associations of patient knowledge and thevariables of interest were calculated using ANOVA.RESULTS： A total of 101 patients were recruited.Caucasian race, younger age at diagnosis, and having a college or post-graduate degree were significantlyassociated with higher CCKNOW scores. Patients withCD had higher CCKNOW scores compared to patientswith ulcerative colitis and inflammatory bowel diseasetype unclassified, P 〈 0.01. There was no significantcorrelation between overall CCKNOW and SIBDQ scores（r^2 = 0.34, P = 0.13）. The knowledge sub-domain ofdiet in CCKNOW was negatively correlated with HRQoL（r^2 = 0.69, P 〈 0.01）.CONCLUSION： IBD diagnosis at a younger age inaddition to Caucasian race and higher education weresignificantly associated with higher knowledge aboutIBD. However, patient knowledge of IBD was notcorrelated with HRQoL. Further studies are required tostudy the effect of patient knowledge of IBD on otherclinical outcomes.

Contribution of attachment insecurity to health-related quality of life in depressed patients

AIM: To examine the individual contributions of insecure attachment styles and depression symptom severity to health-related quality of life(HRQo L) in patients diagnosed with adjustment disorder(AJD) with depressed mood. METHODS: Participants were 67 patients diagnosed with International Classification of Diseases, Tenth edition AJD with depressed mood, who completed standardised self-report questionnaires measuring study variables. Mean scores and SDs were computed for the outcome and predictor measures. Pearson correlations among the measures were computed. The study hypotheses were tested using analysis of variance(ANOVA) and multiple regression analyses. All analyses were performed using the SPSS-17 software package(SPSS Inc., Chicago, IL, United States).RESULTS: ANOVA showed a significant main effect of the insecure attachment styles on depression symptom severity and life satisfaction scores. The results suggestthat depressive symptoms were more severe(F = 4.13, df = 2.67, P < 0.05) and life satisfaction was poorer(F = 5.69, df = 2.67, P < 0.01) in both anxious-ambivalently and avoidantly attached patients compared with their securely attached counterparts, whereas the two insecure groups did not significantly differ by these variables. The anxious/ambivalent attachment style and depression symptom severity significantly contributed to HRQo L, accounting for 21.4% and 29.7% of the total variance, respectively [R2 = 0.79; Adjusted R2 = 0.77; F(5, 67) = 33.68, P < 0.0001], even after controlling for gender, marital and employment status confounders.CONCLUSION: The results show that the anxious/ambivalent attachment style together with depression symptom severity substantially and independently predict the HRQo L outcome in AJD with depressed mood.

Health-related quality of life in Parkinson's disease patients in northeastern Sicily, Italy An ecological perspective

Parkinson＇s disease has a negative impact on health-related quality of life in Parkinson＇s disease patients. Depression, cognitive impairment, coping strategies, dyskinesia, gait disorders and complications of dopaminergic drugs are the variables that most affect health-related quality of life. The ecological model of human development focuses attention on both individual and social environmental factors as targets for health interventions. From this perspective, the aim of this cross-sectional survey was to evaluate the influence of gender, family size and perceived autonomy on health-related quality of life in Parkinson＇s disease patients in nOrtheastern Sicily, Italy. Ninety Parkinson＇s disease patients, attending the Movement Disorders Clinic at IRCCS Centro Neurolesi ＂Bonino-Pulejo＂ （Messina）, were consecutively enrolled. The Unified Parkinson Disease Rating Scale motor subscale （UPDRS-Ⅲ） scores, the Parkinson Disease Questionnaire-39 Item scores （as a disease-specific measure of health-related quality of life）, scores on the Short Form （36） Health Survey Questionnaire （as a generic measure）, and answers to a brief checklist were recorded. A total of 85 Parkinson＇s disease patients （49% males and 51% females; mean age 70.8 ± 8.6 years mean UPDRS-Ⅲ 24.15 ± 6.55; mean disease duration 5.52 ± 4.65 years） completed the booklet of questionnaires. In the multivariate regression analysis, we included clinical and social variables as independent predictors of health-related quality of life. Our results suggest a potential compounding effect of ecological intrapersonal and interpersonal levels on health-related quality of life outcomes. Gender, self-evaluated autonomy and family size significantly impacted health-related quality of life. If quality of life is used as an indicator of treatment outcomes, an ecological perspective of the case history will be important to disclose relevant prognostic information and trigger personalized health care interventions.

Relationship among Health Related Quality of Life, Quality of Sleep, and Oral Health Condition

Japan’s aging rate (ratio of elderly aged 65 and older to total population) has exceeded 20%. The aim of this study was to clarify the relationships between Health Related Quality of Life, Body Mass Index (BMI), and sleep quality. Subjects were 51 adults over 55 years old with chronic disease who living in the community. Instruments and structured interviews were used giving due consideration to privacy. Interviews were conducted within 10 - 20 minutes at the out-patient department. The evaluation instruments included bodymass index, Pittsburgh Sleep Quality Index (PSQI), Health Related Quality of Life (HRQOL), and Oral Health Impact Profile (OHIP-14). A significant positive correlation (ρ = 0.321, p < 0.05) between PSQI and QOL (OHIP-14) scores was confirmed with sleep quality being lower with lower QOL scores. A negative correlation (ρ = ?0.339, p < 0.05) between physical health component summary scores (PCS) and mental health component summary scores (MCS) of HRQOL was confirmed, demonstrating that PCS was low, and the level of MCS was high. Sleep quality was found lower among those with lower oral health-related QOL scores. Moreover, in subjects with lower MCS scores, the PCS scores were found to be higher. Accordingly, it was considered appropriate that dental treatment and care, support the maintenance of activities and sleep, and mental health promotion which are likely requisites critical for elderly persons’ maintenance of independent lifestyles in their familiar community.

Malnutrition negatively impacts the quality of life of patients with cirrhosis: An observational study

AIM To verify how malnutrition is related to health-related quality of life(HRQL) impairment in patients with cirrhosis.METHODS Data was retrospectively abstracted from medical records and obtained by direct interview. We included patients with cirrhosis from any etiology, evaluated at the Liver Clinic from Gastroenterology Department in a tertiary healthcare center, from June 2014 to June 2016. Child-Pugh score, data about complications, and demographic, clinical and anthropometric characteristics of patients were obtained. Nutritional status was evaluated by the Subjective Global Assessment(SGA). HRQL was evaluated through the Chronic Liver Disease Questionnaire. Patients were requested to assess their global HRQL with the following code: 0 = impairment of HRQL, when it was compared with other healthy subjects; 1 = good HRQL, if it was similar to the quality of life of other healthy subjects. To compare the primary outcome between malnourished and well-nourished groups, the χ~2 test, Fisher's exact test or Student's t-test were used, based on the variable type. Associations between predictor variables and deterioration of HRQL were determined by calculating the hazard ratio and 95% confidence interval using Cox proportional hazards regression. RESULTS A total of 127 patients with cirrhosis were included, and the mean age was 54.1 ± 12.3 years-old. According to Child-Pugh scoring, 25(19.7%) were classified as A(compensated), 76(59.8%) as B, and 26(20.5%) as C(B/C = decompensated). According to SGA, 58(45.7%) patients were classified as well-nourished. Sixty-nine patients identified HRQL as good, and 76 patients(59.8%) perceived impairment of their HRQL. Multivariate analysis to determine associations between predictor variables and self-perception of an impairment of HRQL found strong association with malnutrition(P < 0.0001). The most important impaired characteristics in malnourished patients were: Presence of body pain, dyspnea on exertion with daily activities, decreased appetite, generalized weakness, trouble lifting or carrying heavy objects, and decreased level of energy(P < 0.0001).CONCLUSION Malnutrition is a key factor related to impairment of HRQL in patients with cirrhosis.

Estimation of quality of life in Cypriot patients with inflammatory bowel disease

AIM To investigate the health-related quality of life(HRQoL)of patients suffering with idiopathic inflammatory bowel disease(IBD).METHODS The Greek validated version of the Short Inflammatory Bowel Disease Questionnaire was used for evaluating the quality of life of IBD patients.The questionnaire was distributed to 100 consecutive patients suffering from IBD and presenting for a clinic appointment at the endoscopy unit of Larnaca General Hospital during the period from October to November 2012.The criteria for participating in this study were constituted by the documented diagnosis of either ulcerative colitis(UC)or Crohn’s disease(CD)after endoscopy and histologic examination at least 6 months before the study,adult patients(18 years old or older),the capability of verbal communication and the patient’s written consent for attending this study.The majority of the questionnaires were completed by a nurse practitioner who specializesin IBD patient care.RESULTS Regarding the physical dimension in patients with UC,males scored significantly higher than females(4.2 vs3.4,P=0.023).Higher scores were also observed in UC patients younger than 35 or older than 50 years(4.0 and 4.2 vs 3.2,respectively,P=0.021).The psychological dimension revealed similar results in patients with UC,with males,and older ages scoring higher(5.0 vs 3.0,P=0.01 and 4.7 vs 2.7,P<0.5,respectively),whereas regarding CD higher scores were observed in married compared to unmarried(3.83vs 2.33,P=0.042).No statistical differences in any parameters in the social dimension were observed.Regarding the treatment of,patients with CD,overall higher scores were observed when treated with biological factors compared to standard therapy in all dimensions but with statistical significant difference in the social dimension(5.00 vs 3.25,P=0.045).CONCLUSION The study reveals a negative impact of IBD on HRQo L.Increased risks are age and gender in patients with UC and family status in patients with CD.

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.

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.

休闲活动对城市老年慢病患者生命质量的影响——基于社会支持、慢病数量的中介与调节作用分析

老年人患慢性病比例的上升使得我国人均预期寿命与老年人口平均健康寿命的差距不断扩大。利用2021年西安市老年慢病患者文化活动参与调查数据,通过有调节的中介效应模型,分析了社会支持及慢病数量在不同类型休闲活动对城市老年慢病患者生命质量影响中的作用机制。结果表明,个体休闲活动、团体休闲活动和社会支持对城市老年慢病患者生命质量具有显著提升作用。社会支持在团体休闲活动与生命质量之间起完全中介作用,同时,慢病数量在城市老年慢病患者“团体休闲活动-社会支持”和“社会支持-生命质量”影响路径中起调节作用。研究结果强调了改善社区休闲活动参与环境和构建多层次老年慢病患者社会支持网络对提升城市居民健康寿命的重要性。

成人体外膜肺氧合患者出院后健康相关生命质量的研究进展

健康相关生命质量指个体平常或期待的身体、心理及社会幸福感被疾病或其治疗所影响的程度。该文综述了健康相关生命质量在成人体外膜肺氧合患者出院后的研究益处、评估工具、现状及护理关键点等内容,提出医护人员应重视院内创伤性经历、院外不良症状和精神心理问题对患者的影响,并充分发挥家庭等支持性资源的作用,同时制订个性化护理方案。健康相关生命质量是成人体外膜肺氧合患者出院后的重要预后指标,但特异性评估工具及干预措施仍需进一步完善。

慢性病共病对中国老年人健康相关生命质量的影响研究

基于2018年中国健康与养老追踪调查数据,探讨慢性疾病数量及共病模式对老年人健康相关生命质量的影响。通过欧洲五维健康量表(EQ-5D)测量健康相关生命质量,分析老年人在五个维度(活动能力、自我照顾、日常活动、疼痛/不适和焦虑/沮丧)中的表现及各维度的等级,并计算综合得分来评估老年人的健康状态。结果发现,患有慢性共病数量越多的老年人,其健康效用值越低。心脏代谢型、呼吸系统型、内脏关节炎型和认知障碍型4种慢性病共病模式对老年人健康的影响程度差异具有显著性(p<0.05),其中,内脏关节炎型慢性病共病模式对老年人健康的影响最大。未来,应加强对患有多重慢性病尤其是患有内脏关节炎型共病模式的老年人的早期筛查,制定针对“多病共存”特点的老年慢性病健康管理方案和干预措施,为我国积极应对健康老龄化和主动健康提供策略建议。

生计资本视角下农村老年人健康生命质量的影响因素研究

目的:基于可持续生计理论框架,找寻影响我国农村老年人健康生命质量的关键性因素,进而提出相应对策。方法:采用2023年7~8月份课题组于浙江、重庆、甘肃三省(市)开展的实地调研数据,用EQ-5D-3L量表对60岁及以上农村老人健康生命质量进行调查,采用多元线性回归分析影响因素。结果:农村老年人总体健康效用值为0.86±0.19,回归结果显示:社会参与、就业状况、医药消费支出、生活期望、自信心、年龄、是否患有慢病以及体育锻炼均对农村老人健康效用值有影响(P<0.05)。结论:社会资本、人力资本、心理资本对农村老年人健康效用值具有影响,金融资本能够缓解农村老年焦虑和抑郁,数字资本对农村老年健康效用值影响机制尚不明确。基于以上结论,启示未来应以生计资本为着力点,通过统筹利用多维资源,全面提升农村老年人健康生命质量。

牙周内窥镜辅助龈下刮治和根面平整术的临床疗效及对牙周炎患者心理与生活质量的影响

目的探讨牙周内窥镜(periodontal endoscope,PE)辅助龈下刮治和根面平整术(scaling and root plan⁃ning,SRP)的临床疗效及对牙周炎患者心理和生活质量的影响,为临床应用牙周内窥镜提供参考。方法本研究已通过单位伦理委员会审查批准,并获得患者知情同意。收集2018年4月—2022年12月于南京大学医学院附属口腔医院牙周病科就诊的,传统SRP治疗6周后复查仍有残留牙周袋探诊深度(probing depth,PD)≥5 mm的牙周炎患者,进一步行PE辅助SRP(PE+SRP)。在传统SRP治疗后6周,PE+SRP治疗3个月后分别测量牙周临床指标包括菌斑指数(plaque index,PLI)、PD、临床附着丧失(clinical attachment loss,CAL)及探诊出血(bleeding on probing,BOP);同时分别收集传统SRP和PE辅助SRP治疗即刻视觉模拟评分量表(visual analogue scale,VAS);在传统SRP治疗和PE辅助SRP治疗3个月后分别收集牙周组织自我认知表、口腔健康影响程度量表⁃14(oral health impact profile⁃14,OHIP⁃14)以及牙科畏惧调查量表(dental fear scale,DFS)。结果共纳入牙周炎患者23例,患牙486颗,832个位点纳入临床研究。PE+SRP治疗后3个月,各项牙周临床指标:PLI(t=9.254,P<0.001)、PD(t=50.724,P<0.001)、CAL(t=22.407,P<0.001)以及BOP(t=9.217,P<0.001)均显著改善;与传统SRP(VAS:2.48±1.70)相比,PE+SRP(VAS:2.57±1.80)给患者带来的疼痛感无显著差异(t=0.192,P=0.850);两组牙周组织自我认知表得分无显著性差异(t=1.485,P=0.152);同时传统SRP完成后OHIP⁃14的得分为(12.13±7.63)分,PE+SRP完成后OHIP⁃14得分为(10.26±5.25)分,两者无显著差异(t=-1.589,P=0.126);传统SRP完成后DFS量表得分为(40.70±12.63)分,PE+SRP完成后DFS量表得分为(41.57±12.61)分,两者无显著差异(t=0.404,P=0.690)。结论PE辅助SRP治疗牙周炎患者残留牙周袋后各项牙周临床指标均显著改善,且与传统SRP相比,PE辅助SRP对牙周炎患者的生活质量和心理状况没有负面影响,可以临床广泛推广。

Identifying pain-related concerns in routine follow-up clinics following oral and oropharyngeal cancer

AIM:To describe clinical characteristics of head and neck cancer(HNC)patients with pain and those wishing to discuss pain concerns during consultation.METHODS:Cross-sectional,questionnaire study using University of Washington Quality of Life,version 4(UWQOL)and the Patients Concerns Inventory(PCI)in disease-free,post-treatment HNC cohort.Significant pain on UW-QOL and indicating"Pain in head and neck"and"Pain elsewhere"on PCI.RESULTS:One hundred and seventy-seven patientscompleted UW-QOL and PCI.The prevalence of selfreported pain issues was 38%(67/177)comprising25%(44/177)with significant problems despite medications and 13%(23/177)with lesser or no problems but wishing to discuss pain.Patients aged under 65years and patients having treatment involving radiotherapy were more likely to have pain issues.Just over half,55%(24/44)of patients with significant pain did not express a need to discuss this.Those with significant pain or others wanting to discuss pain in clinic had greater problems in physical and social-emotional functioning,reported suboptimal QOL,and also had more additional PCI items to discuss in clinic compared to those without significant pain and not wishing to discuss pain.CONCLUSION:Significant HNC-related pain is prevalent in the disease-free,posttreatment cohort.Onward referral to a specialist pain team may be beneficial.The UW-QOL and PCI package is a valuable tool that may routinely screen for significant pain in outpatient clinics.

Treatment of Irritable Bowel Syndrome with a Combination of Curcumin, Green Tea and Selenomethionine Has a Positive Effect on Satisfaction with Bowel Habits

Background: Irritable bowel syndrome (IBS) is a common disorder impairing patient’s quality of life. Currently, there is no effective treatment for this syndrome. Coltect is a dietary supplement containing curcumin, green tea and selenomethionine. Aim: To investigate the effects of Coltect on IBS symptoms. Methods: A randomized, prospective, placebo-controlled, double blinded, crossover study. The study population included patients diagnosed with IBS by Rome criteria. Subjects were randomized to receive either Coltect or placebo for 4 weeks, and then received the opposite treatment for 4 weeks following a washout period of 2 weeks. The placebo was a pill, identical in color and size to the Coltect pill, with no active ingredients. Patients completed IBS health-related quality of life, severity score and IBS symptom questionnaires before and after each treatment period. Results: The study included 22 patients, ages 22 – 77 years. Coltect had a positive effect on patients’ satisfaction with their bowel habits (as measured on a scale from 0—Very satisfied to 100—Very unsatisfied). Average score was 70.4 ± 33.1 before and 61.8 ± 29.3 after Coltect treatment (p = 0.037). Other parameters, including abdominal pain, bloating, and effects of IBS on daily activity, symptoms, IBS-related quality of life and general health quality of life were unchanged. Conclusion: Coltect seems to have a positive effect on satisfaction with bowel habits.

Science Letters:Crossover randomized controlled trial of the electronic version of the Chinese SF-36

Objectives:to verify the feasibility and reliability of the electronic version of Chinese SF-36 based on the Quality-of-Life-Recorder. Design: A crossover randomized controlled trial, comparing a paper-based and an electronic version of the Chinese SF-36, was conducted. According to generated random numbers, interviewees were asked to fill out either the electronic version or the paper version first. The second version was filled in after a pause of at least 10 min. Settings and participants: One group of 100 medical students at the School of Medicine of Zhejiang University and the other group of 50 outpatients at a clinic for general practice in Hangzhou City (China) were eventually recruited in this study. Results: The acceptance of the electronic version was good (60% of medical students and 84% of outpatients preferred the electronic version). At the level of eight-scale scores, the mean-difference for each scale (except for general health) between the two versions was less than 5%. At the level of 36 questions, the percentage of "exact agreement" ranged within 64%～99%; the percentage of "global agreement" ranged within 72%～99%; 77% of the kappa coefficients demonstrated "good/excellent agreement" and 23% of the kappa coefficients demonstrated "medium agreement". Conclusion: This study, for the first time, can provide empirical basis for the confirmation of the feasibility and reliability of the electronic version of the Chinese SF-36 and may provide an impulse towards widespread deployment of the Quality-of-Life-Recorder in Chinese populations.

成人心血管健康评分、生命质量与心脑血管病的关系研究

目的了解江苏省某市心脑血管疾病患病情况,探讨患病与不患病居民理想心血管健康水平(ideal cardiovascularhealth,ICVH)与健康相关生命质量(health-related quality of life,HRQoL)关系的特点,为开发心脑血管疾病风险防控的策略提供证据。方法本研究基于2019年宿迁市人群慢性病防控社会因素专项调查,纳入江苏省宿迁市18岁以上常住居民21815名。采用广义线性模型探讨ICVH水平和健康描述系统和欧洲健康量表(EQ-VAS)评分的相关关系。结果2.9%调查对象患有冠心病,4.2%患有卒中,0.9%同时患有冠心病和卒中。ICVH得分均数为(8.57±2.24)分,EQ-VAS均分为(75.70±11.62)分。广义线性模型结果显示,随着ICVH等级的升高,健康相关生命质量呈上升趋势;不同疾病组别中,无病组和脑卒中组ICVH得分及EQ-VAS得分差异有统计学意义。结论一般人群ICVH评分越高HRQoL越好,提示改善心脑血管健康可能有助于提高人群HRQoL。

不同左心室射血分数心力衰竭患者的健康相关生活质量变化趋势及差异分析

目的:分析不同左心室射血分数(LVEF)心力衰竭(心衰)患者的健康相关生活质量(HRQoL)变化趋势及差异。方法:基于重大慢病国家注册登记研究心衰前瞻性队列连续入选2016年8月至2018年5月全国52家医院≥18岁、因急性心衰入院的2222例患者,均完成入院48 h内及出院1个月、6个月、1年随访时堪萨斯城心肌病问卷-12(KCCQ-12)调查。纳入患者按LVEF分为射血分数降低的心衰(HFrEF,LVEF<40%)、射血分数轻度降低的心衰(HFmrEF,40%≤LVEF<50%)和射血分数保留的心衰(HFpEF,LVEF≥50%),采用KCCQ-12评分定量评估三类心衰患者的HRQoL。结果:2222例心衰住院患者的中位年龄65(55,74)岁,36.3%为女性,HFrEF患者942例(42.4%),HFmrEF患者470例(21.2%),HFpEF患者810例(36.5%)。与HFrEF患者相比,HFmrEF、HFpEF患者的年龄较大,女性比例较高(P均<0.017);HFmrEF、HFpEF患者中合并高血压、冠心病、心房颤动、贫血的患者比例均高于HFrEF患者(P均<0.017)。与基线相比,三类心衰患者出院1个月、6个月、1年时的KCCQ-12评分均增加(P均<0.01),且KCCQ-12评分随时间变化趋势相似,均在1个月时大幅度增加,在6个月时小幅度增加,此后6个月趋于稳定;HFpEF患者出院1个月、6个月、1年时的KCCQ-12评分均低于HFrEF、HFmrEF患者,HFmrEF患者的KCCQ-12评分低于HFrEF患者,差异均有统计学意义(P均<0.01)。多因素Logistic回归分析显示,合并高血压、慢性肾脏病、HFpEF、NYHA心功能分级Ⅲ级和Ⅳ级的患者出院后1年HRQoL差的可能性更大(P均<0.05)。结论:HFpEF患者年龄较大,合并症较多。在出院后1年存活的患者中,HFrEF、HFmrEF、HFpEF患者的HRQoL均在1个月随访时较基线明显改善,6个月小幅度改善,然后趋于稳定;出院后,HFrEF患者的HRQoL相对较好,HFpEF患者较差,HFmrEF患者介于两者之间。