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...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.展开更多
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...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.展开更多
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 dopam...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.展开更多
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 lif...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.展开更多
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...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.展开更多
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 Questionnai...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.展开更多
<strong>Purpose:</strong> We explored parents’ perceptions and judgment formation processes concerning their infants’ health-related quality of life (HRQOL). <strong>Method:</strong> The Peds...<strong>Purpose:</strong> We explored parents’ perceptions and judgment formation processes concerning their infants’ health-related quality of life (HRQOL). <strong>Method:</strong> The PedsQL<sup>TM</sup> Infant Scales—an instrument specifically designed for infants aged 1 - 24 months—were translated into Japanese. Forward and backward translations were performed, evaluating the semantic and conceptual equivalencies. Parents with infants younger than two-years-old were recruited and interviewed using think-aloud and probing techniques. Participants completed the questionnaire while speaking aloud about what came to their mind, what they thought each question meant, and how they reached each answer. <strong>Results:</strong> Seven mothers and three fathers participated. The median age was 33.4 (28 - 43) years. Four had infants younger than six-months-old. All infants were healthy. Parents’ perceptions of their infants’ HRQOL varied across their ages. Some parents with infants younger than six months experienced difficulty discussing “emotional functioning” and “cognitive functioning” because their infants were too young to articulate the actions mentioned in the items. In those cases, the parents responded, “never a problem”. Seventy-five percent of parents recalled their infants’ daily “physical functioning”, while only 58% recalled “physical symptoms”. Some parents’ perceptions and judgment formation were compromised by their own perceptions. For example, they answered “often a problem” when the items were problematic to themselves instead of to their child. However, many distinguished their infants’ HRQOL from their own perceptions, indicating they understood the intention of the questionnaire. <strong>Conclusion:</strong> Parents’ formed judgement may compromise by their own perceptions. The result of this study will be helpful in improving healthcare communication and interpreting parents’ judgments of their infants’ HRQOL in future studies.展开更多
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...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。展开更多
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 Wa...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.展开更多
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, ...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.展开更多
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 ...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.展开更多
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...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.展开更多
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 ser...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.展开更多
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 el...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.展开更多
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...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。展开更多
文摘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.
基金Supported by American College of Gastroenterology Junior Faculty Development Award(Hou)and with resources at the VA HSRD Center for Innovations in Quality,Effectiveness and Safety No.CIN 13-413,at the Michael E DeBakey VA Medical Center,Houston,TX(Hou)
文摘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.
基金supported by a grant from the Ministry of Health (Research for the Strategic Program 2007)
文摘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.
文摘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.
文摘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.
文摘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.
文摘<strong>Purpose:</strong> We explored parents’ perceptions and judgment formation processes concerning their infants’ health-related quality of life (HRQOL). <strong>Method:</strong> The PedsQL<sup>TM</sup> Infant Scales—an instrument specifically designed for infants aged 1 - 24 months—were translated into Japanese. Forward and backward translations were performed, evaluating the semantic and conceptual equivalencies. Parents with infants younger than two-years-old were recruited and interviewed using think-aloud and probing techniques. Participants completed the questionnaire while speaking aloud about what came to their mind, what they thought each question meant, and how they reached each answer. <strong>Results:</strong> Seven mothers and three fathers participated. The median age was 33.4 (28 - 43) years. Four had infants younger than six-months-old. All infants were healthy. Parents’ perceptions of their infants’ HRQOL varied across their ages. Some parents with infants younger than six months experienced difficulty discussing “emotional functioning” and “cognitive functioning” because their infants were too young to articulate the actions mentioned in the items. In those cases, the parents responded, “never a problem”. Seventy-five percent of parents recalled their infants’ daily “physical functioning”, while only 58% recalled “physical symptoms”. Some parents’ perceptions and judgment formation were compromised by their own perceptions. For example, they answered “often a problem” when the items were problematic to themselves instead of to their child. However, many distinguished their infants’ HRQOL from their own perceptions, indicating they understood the intention of the questionnaire. <strong>Conclusion:</strong> Parents’ formed judgement may compromise by their own perceptions. The result of this study will be helpful in improving healthcare communication and interpreting parents’ judgments of their infants’ HRQOL in future studies.
文摘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。
文摘目的 观察头穴丛刺长留针法治疗偏头痛的临床疗效。方法 将88例偏头痛患者随机分为观察组(44例,脱落2例)和对照组(44例,脱落3例)。观察组采用常规针刺联合头穴丛刺长留针法治疗,对照组采用常规针刺方法治疗。比较两组临床疗效,观察两组治疗前后的视觉模拟量表(visual analog scale, VAS)评分、偏头痛特异性生活质量问卷(migraine-specific quality of life questionnaire, MSQ)、血清5-羟色胺(5-hydroxytryptamine, 5-HT)浓度。结果 观察组总有效率为92.9%,高于对照组的78.0%,差异有统计学意义(P>0.05)。两组治疗后VAS评分较治疗前降低(P<0.05),两组随访时VAS评分较治疗前和治疗后降低(P<0.05);观察组治疗后及随访时,VAS评分均低于对照组(P<0.05)。两组治疗后MSQ评分较治疗前升高(P<0.05),两组随访时MSQ评分较治疗前和治疗后升高(P<0.05);观察组治疗后及随访时,MSQ评分均高于对照组(P<0.05)。两组治疗后血清5-HT浓度均升高,且观察组高于对照组,差异有统计学意义(P<0.05)。结论 在常规针刺基础上,头穴丛刺长留针法治疗偏头痛临床疗效优于常规针刺方法,且在减轻偏头痛患者疼痛程度,改善其生活质量及提高5-HT浓度方面优于常规针刺方法。
文摘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.
文摘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.
基金supported by the National Natural Science Foundation of China (Project Grant No. 81073163)
文摘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.
基金supported by the National Natural Science Foundation of China(No.81073163)
文摘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.
文摘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.
基金Project (No. WKJ2006-2-016) supported by the project of "Effect of Chronic Disease and Health-Related Quality of Life on Health Service Utilization" from the Ministry of Health, China
文摘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.
文摘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。