Value of quality of life analysis in liver cancer: A clinician's perspective

Health related quality of life(HRQOL) is increasingly recognized as an important clinical parameter and research endpoint in patients with hepatocellular carcinoma(HCC). HRQOL in HCC patients is multifaceted and affected by medical factor which encompasses HCC and its complications, oncological and palliative treatment for HCC, underlying liver disease, as well as the psychological, social or spiritual reaction to the disease. Many patients presented late with advanced disease and limited survival, plagued with multiple symptoms, rendering QOL a very important aspect in their general well being. Various instruments have been developed and validated to measure and report HRQOL in HCC patients, these included general HRQOL instruments, e.g., Short form(SF)-36, SF-12, Euro Qo L-5D, World Health Organization Quality of Life Assessment 100(WHOQOL-100), World Health Organization Quality of Life Assessment abbreviated version; general cancer HRQOL instruments, e.g., the European Organisation for Research and Treatment of Cancer(EORTC) QLQ-C30, Functional Assessment of Cancer Therapy(FACT)-General, Spitzer Quality of Life Index; and liver-cancer specific HRQOL instruments, e.g., EORTC QLQ-HCC18, FACT-Hepatobiliary(FACT-Hep), FACT-Hep Symptom Index, Trial Outcome Index. Important utilization of HRQOL in HCC patients included description of symptomatology and HRQOL of patients, treatment endpoint in clinical trial, prognostication of survival, benchmarking of palliative care service and health care valuation. In this review, difficulties regarding the use of HRQOL data in research and clinical practice, including choosing a suitable instrument, problems of missing data, data interpretation, analysis and presentation are examined. Potential solutions are also discussed.

Systematic review of health-related quality of life after esophagectomy for esophageal cancer

This study is aimed to assess the long-term healthrelated quality of life （HRQL） of patients after esophagectomy for esophageal cancer in comparison with established norms, and to evaluate changes in HRQL during the different stages of follow-up after esophageal resection. A systematic review was performed by searching medical databases （Medline, Embase and the Cochrane Library） for potentially relevant studies that appeared between January 1975 and March 2011. Studies were included if they addressed the question of HRQL after esophageal resection for esophageal cancer. Two researchers independently performed the study selection, data extraction and analysis processes. Twenty-one observational studies were included with a total of 1282 （12-355） patients. Five studies were performed with short form-36 （SF-36） and 16 with European Organization for Research and Treatment of Cancer （EORTC） QLQ c30 （14 of them also utilized the disease-specific OESI8 or its previous version OES24）.The analysis of long-term generic HRQL with SF-36 showed pooled scores for physical, role and social function after esophagectomy similar to United States norms, but lower pooled scores for physical function, vitality and general health perception. The analysis of HRQL conducted using the Global EORTC C30 global scale during a 6-mo follow-up showed that global scale and physical function were better at the baseline. The symptom scales indicated worsened fatigue, dyspnea and diarrhea 6 mo after esophagectomy. In contrast, however, emotional function had significantly improved after 6 mo. In conclusion, short- and long-term HRQL is deeply affected after esophagectomy for cancer. The impairment of physical function may be a long-term consequence of esophagectomy involving either the respiratory system or the alimentary tract. The short- and long-term improvement in the emotional function of patients who have undergone successful operations may be attributed to the impression that they have survived a near-death experience.

Impact of biliary complications on quality of life in live-donor liver transplant recipients

BACKGROUND Despite significant advancements in liver transplantation(LT)surgical procedures and perioperative care,post-LT biliary complications(BCs)remain a significant source of morbidity,mortality,and graft failure.In addition,data are conflicting regarding the health-related quality of life(HRQoL)of LT recipients.Thus,the success of LT should be considered in terms of both the survival and recovery of HRQoL.AIM To assess the impact of BCs on the HRQoL of live-donor LT recipients(LDLT-Rs).METHODS We retrospectively analysed data for 25 LDLT-Rs who developed BCs post-LT between January 2011 and December 2016 at our institution.The Short Form 12 version 2(SF 12v2)health survey was used to assess their HRQoL.We also included 25 LDLT-Rs without any post-LT complications as a control group.RESULTS The scores for HRQoL of LDLT-Rs who developed BCs were significantly higher than the norm-based scores in the domains of physical functioning(P=0.003),role-physical(P<0.001),bodily pain(P=0.003),general health(P=0.004),social functioning(P=0.005),role-emotional(P<0.001),and mental health(P<0.001).No significant difference between the two groups regarding vitality was detected(P=1.000).The LDLT-Rs with BCs had significantly lower scores than LDLT-Rs without BCs in all HRQoL domains(P<0.001)and the mental(P<0.001)and physical(P=0.0002)component summary scores.CONCLUSION The development of BCs in LDLT-Rs causes a lower range of improvement in HRQoL.

The Impact of Gastroesophageal Reflux on the Quality of Life: About a Series of 100 Patients at Fez University Hospital

The gastroesophageal reflux disease (GERD) represents a major problem for public health because of its high prevalence. The chronic character of the symptoms can have a very important impact on the quality of life (QoL). The purpose of this study is to assess the impact of the GERD on the quality of life of our patients and to determine the main aggravating factors. Patients and Methods: This is a cross-sectional, observational study of 100 patients presenting signs of GERD in the gastroenterology department of the university medical center Hassan II-Fez, for a period of 3 months (October to December 2014). We used the Reflux-Qual short form (RQS&#174) to evaluate the QoL of our patients. Results: Over the study period, 100 patients were included. The average age of our patients was 47 years [20 - 75 years] with a sex-ratio F/M in 2.12. Among our patients, 20% (n = 20) were chronic cigarette smokers. The diagnosis of GERD was clinical in 75% of the cases (n = 75) and based on 24-hour pH monitoring in the remaining 25% (n = 25). Approximately 2/3 of the patients were receiving proton pump inhibitors (PPIs) treatment at the time of the questionnaire. The impairment of QoL was moderated to severe (RQS&#174 p = 0.01), female sex (p = 0.03) and the frequency of symptoms (p = 0.001). Moreover, patients having a GERD that requiring a daily and continuous administration of PPIs had a lower index of RQS&#174 (p = 0.001). The quality of life impairment was not associated with chronic cigarette smoking (p = 0.3). Conclusion: The impairment of the QoL was moderated to severe (RQS&#174 < 16) for 2/3 of the patients (n = 62). This impairment was associated with elderly, female sex, frequency and in case of GERD requiring continuous administration of PPIs.

Quantities of comorbidities affects physical, but not mental health related quality of life in type 1 diabetes with confirmed polyneuropathy

BACKGROUND A large number of adults with long-term type 1 diabetes are affected by symmetrical peripheral neuropathy.These complications increase socioeconomic expenses and diminish the individual quality of life.The 36-Item Short Form Health Survey(SF-36)is a generic patient reported questionnaire,measuring mental and physical health related quality of life.We hypothesized that diabetic neuropathy would decrease physical and mental quality of life measured with SF-36,and that clinical appearance may be associated with the decline.AIM To investigate if diabetic neuropathy would decrease physical and mental quality of life measured with SF-36,and if clinical appearance may be associated with the decline.METHODS Forty-eight adults[age 50±9 years,10 females,disease duration 32(14-51)years]with verified diabetic symmetrical peripheral neuropathy and 21 healthy participants(age 51±6 years,6 females)underwent standardised nerve conduction testing and completed the SF-36 questionnaire.Furthermore,disease duration,number of comorbidities,both diabetes related and nondiabetes related,vibration perception threshold,number of hypoglycaemic events,HbA1c and administration way of insulin was notified.RESULTS In comparison to healthy subjects,patients’mental composite score was not significantly diminished(51.9±8.9 vs 53.1±5.5,P=0.558),while the physical composite score was(46.3±11.7 vs 54.6±3.3,P=0.002).As expected,the overall physical health related symptoms in patients were associated to total number of comorbidities(P<0.0001),comorbidities relation to diabetes(P=0.0002)and HbA1c(P=0.005)as well as comorbidities not related to diabetes(P=0.0006).CONCLUSION The finding of this study emphasises the importance of focusing on quality of life in adults with diabetes and especially in those with multiple comorbidities as well as the possibility of HbA1c as a biomarker for severe complication.

Predictors of Chronic Physical and Mental Quality of Life Following Traumatic Brain Injury

Objective and Background: This study aimed at determining the predictors of chronic physical and mental quality of life (QOL) in patients with traumatic brain injury (TBI) focusing on neuropsychological functions post trauma. Materials and Methods: This is a longitudinal study in which 257 patients having inclusion criteria were enrolled. Neuropsychological tasks including logical memory, verbal paired associates, visual memory, verbal expression, auditory comprehension, semantic judgment and semantic categories were implemented. The appearance of psychiatric disorder, Agnosia, Apraxia, Dysarthria and pragmatic linguistic disorder post trauma were evaluated at discharge. QOL was studied 6 months after injury by filling SF-36 questionnaire via phone interview with patients. Results: Appearance of some post-traumatic disorders including agnosia, pragmatic linguistic disorder and psychiatric disorder were significantly correlated to poor QOL. The final step of logistic regression model showed that TBI severity, verbal memory, auditory comprehension and semantic acceptability scores were predictors of unfavorable mental QOL as well as TBI severity, injury severity scale (ISS) score and multifocal lesions for unfavorable physical QOL. Discussion: Thus, it is recommended that clinicians choose medical therapeutic priorities to improve the verbal neuropsychological sequela and provide preliminaries for a chronic favorable mental QOL. Furthermore, to prevent of chronic unfavorable physical QOL, early care of organic injuries should be considered especially in patients with severe and multifocal TBI.

Impact of Post Hepatitis C Chronic Liver Disease and Hepatocellular Carcinoma on Health Related Quality of Life

Background: Post hepatitis C virus chronic liver disease (CLD) is prevalent among the Egyptian population with a bad impact upon their quality of life (QOL). Hepatocellular carcinoma (HCC) is one of the long term and fatal complications of CLD and it also has its negative impact on patient’s quality of life. Aim: To assess impact of CLD and HCC on the quality of life of group of hospitalized elderly patients. Methodology: Ninety elderly patients were divided into three groups: 30 elderly with post hepatitis C virus CLD, 30 elderly with HCC and 30 others free of liver disease as control group (Cn), all were recruited from the in-patient ward and the outpatient clinic of the Geriatric Department, Ain-Shams University Hospital. After giving consent, comprehensive geriatric assessment was done with assessment of their quality of life by using the Short Form-36 health survey (SF-36). Investigations including liver enzymes, serum albumin, serum bilirubin and abdominal ultrasound were done. Results: All QOL domains were the highest among control group, followed by HCC group and the least among CLD group. The differences were statistically significant in most subscales and total score [Mean of Cn = 81.9 ± 12.4, Mean of CLD = 47.5 ± 21.9, Mean of HCC = 62.3 ± 16.1;P Cn/CLD ≤ 0.001, P Cn/HCC ≤ 0.001, P CLD/HCC = 0.004]. Albumin was the only biochemical marker correlated positively with total SF score and two subscales (PF and EF) [r = 0.408;P = 0.025]. Conclusion & Recommendation: Our study showed a decrease in the QOL of Egyptian post hepatitis C virus CLD and HCC patients compared with Egyptian population norms. The results showed that CLD were more affected than HCC patients. This had a particularly serious negative impact on their life. The findings indicate a need for updated counseling and educational materials designed to provide adequate information and consistent healthcare service to this patient setting.

Influence of Metabolic Syndrome versus Musculoskeletal Disorders on Saudi Health-Related Quality of Life

Aim: This work aimed to study the influence of two chronic health conditions, metabolic syndrome (MetS) and musculoskeletal disorders (MSDs), on the health-related quality of life (HRQoL) of Saudis. Method: The Medical Outcomes Study Short Form-36 (SF-36) health status questionnaire was used to measure the HRQoL and compare the mean scores of the questionnaire subscales and physical and mental component summaries (PCS and MCS) of 33 patients with MetS, 18 patients with MSDs, and 30 apparently healthy (AH) subjects. Regression analysis was used to measure the prediction power of the study group, age and gender of the participants in estimating the HRQoL. Results: Results showed that the mean scores of the physical subscales, the PCS, the mental subscales and MCS were arranged in descending order from AH subjects, patients with MetS, to patients with MSDs. The mean scores difference among the 3 study groups were statistically significant with the only exception for the general mental health (GMH) subscale (P = 0.404). The study group and age accounted for 41.8% of the variability of PCS while the study group accounted for 19.6% of the variability in the MCS. The resulted equation to estimate the PCS score was as follows: PCS = 113.18 - 12.85 (Group: 0 for AH, 1 for MetS, and 2 for MSDs) - 0.67 age. On the other hand the resulted equation to estimate the MCS score was as follows: MCS = 76.203 - 10.426 (Group: 0 for AH, 1 for MetS, and 2 for MSDs). Conclusion: Patients with MetS and patients with MSDs had lower HRQoL than AH subjects. All the physical and mental dimensions of HRQoL are negatively influenced with MetS and with MSDs with the only exception for the GMH subscale. The physical and mental burden of MSDs is more dominant. The study group and age can be used to predict the PCS while the study group can be used to predict the MCS.

Health Related Quality of Life among Osteoarthritis Patients: A Comparison of Traditional Non-Steroidal Anti-Inflammatory Drugs and Selective COX-2 Inhibitors in the United Arab Emirates Using the SF-36

Objectives: Osteoarthritis (OA) has a dramatic impact on patients’ health related quality of life (HRQoL). Chronic use of analgesics and anti-inflammatory medications for pain management may improve symptoms but on long term may affect HRQoL negatively. The objective of the present study was to compare the impact of two different classes of analgesics, traditional non-steroidal anti-inflammatory drugs (NSAIDs) and selective cyclo-oxygenase-2 (COX-2) inhibitors on HRQoL among osteoarthritis patients using the SF-36 questionnaire. Methods: Clinic based cross-sectional study conducted at Al-Qassimi Hospital, Sharjah, United Arab Emirates (UAE), over a period of six months. Ethical Approval was obtained from the ethics committee at Al-Qassimi Clinical Research Center. Total of 200 osteoarthritis patients fulfilling the inclusion and exclusion criteria were involved in the study. Patients’ demographics were collected from their medical records. The Medical Outcome Study Short-Form 36 (SF-36) questionnaire was used to measure patients’ HRQoL. SF-36 data were scored using health outcomes scoring software 4.5. Results: Mean age of the subjects was 62.19 ± 9.81 years with females constituting 151 (75.5%) of the patients. In general, females scored lower in most of the HRQoL domains compared to males and there was significant difference between the two groups in the mental health (p = 0.005) & mental component (p = 0.042) domains. Compared to selective COX-2 inhibitors, patients on NSAIDs scored higher on all domains of SF-36 except physical functioning. There was significant difference in mental health domain for patients treated with NSAIDs (p = 0.02). Celecoxib was only better than NSAIDs in osteoarthritis patients with more than one musculoskeletal disorders in the domain of bodily pain (p = 0.009). Conclusion: NSAIDs-treated patients did not differ significantly from celecoxib-treated patients in all domains of the SF-36 except for the mental health domain.

综合干预改善肺癌晚期患者疼痛及睡眠质量的价值研究

目的:探讨综合干预对肺癌晚期患者疼痛及睡眠质量的改善价值。方法:选取2023年2月至2024年2月厦门大学附属第一医院收治的肺癌晚期患者80例作为研究对象,按照随机数字表法分为对照组和观察组,每组40例。对照组进行常规护理干预,观察组进行综合护理干预。对比2组疼痛、睡眠改善效果、睡眠质量、生命质量评分。结果:干预前,2组患者在视觉模拟量表(VAS)评分、睡眠改善效果(睡眠时长、睡眠效率、入睡时间、觉醒次数)、匹兹堡睡眠质量指数(PSQI)评分,以及36条目简明健康量表(SF-36)评分的数据比较,差异无统计学意义(P>0.05);干预后,在疼痛VAS评分、睡眠改善效果(睡眠时长、睡眠效率、入睡时间、觉醒次数)、睡眠质量PSQI评分,以及SF-36评分的数据上观察组均显著优于对照组,差异有统计学意义(P<0.05)。结论:对肺癌晚期患者采取综合干预能够有效缓解患者疼痛情况,改善患者的睡眠质量和生命质量,值得推广。

SF-36量表应用于老年一般人群的信度和效度研究

目的评价SF-36量表在老年一般人群的信度和效度。方法采用SF-36生存质量量表,由经过统一培训的调查员对济南市60岁及以上的老年人1386人进行面对面访谈,并计算8项内容的评分。信度包括重测信度、分半信度和内部信度;效度包括判别效度和结构效度。采用相关分析、信度分析和因子分析方法对SF-36量表的信度和效度进行评价。结果各项重测信度的组内相关系数(ICCs)均>0.5;各项分半信度系数均>0.7;各项内部信度的Cronbach'a系数均>0.70。在判别效度的评价中,实际结果与理论推断和以往研究结果相一致,表明量表的判别效度较好;在结构效度的评价中,因子分析所产生的两个公共因子可解释总变异的66.25%,并在相应项目上有较强的因子负荷,表明量表的结构效度较好。结论SF-36量表具有较好的信度和效度,适于评价老年一般人群的生存质量。

SF-36简明健康问卷在几种骨关节疾病患者中的应用研究

目的:①明确SF-36简明健康问卷在颈椎病、常见腰椎疾病、膝骨性关节炎、老年性骨质疏松症等疾病患者生存质量(QOL)评价中的适用性;②了解颈椎病、常见腰椎疾病、膝骨性关节炎、老年性骨质疏松症等几种疾病患者的QOL。方法:2009年4月—2011年4月间随机抽取在我科就诊的明确诊断为颈椎病、常见腰椎疾病(腰椎间盘突出症、腰椎管狭窄症、脊柱椎弓峡部裂、腰椎脊柱滑脱)、膝骨性关节炎、老年性骨质疏松症患者各50例,同时抽取居住在北京军区总医院家属区的本院退休健康职工50例作为对照组,利用SF-36量表对其QOL进行对照研究;分别采用内部一致性信度、结构效度和判别效度对其信度、效度进行评价。结果:①除老年性骨质疏松症组外,其他各组SF-36总分明显低于对照组;各组对QOL的影响主要涉及反应生理健康的生理功能、生理职能、总体健康、躯体疼痛维度,且各组受损维度受损程度不一;其中,颈椎病患者QOL受损维度最多,包括生理功能(PF)、生理职能(RP)、总体健康(GH)、活力(VT)和社会功能(SF)维度;腰椎疾病组受损维度包括PF、RP、GH和躯体疼痛(BP)维度,以BP维度受损最明显;膝骨性关节炎组主要涉及PF、RP、GH维度;老年性骨质疏松症组生存质量受损较小,仅涉及GH维度。②SF-36用于评价上述患者时总的内部信度为0.726,PF、BP、GH、情感职能(RE)维度的Cronbach'α系数>0.7;RP、活力(VT)、社会功能(SF)、精神健康(MH)维度的Cronbach'α系数>0.6,各维度间除PF、RE及MH与PF相关性无显著性意义外,各维度均具有良好的相关性(具有显著性差异)。结论:①老年性骨质疏松症、颈椎病、常见腰椎疾病(腰椎间盘突出症、腰腰椎管狭窄症、腰椎脊柱椎弓峡部裂、腰椎脊柱滑脱)、膝骨性关节炎患者QOL出现不同程度下降,主要表现在反应生理健康的维度评分下降;②SF-36简明健康问卷中文版用于评价上述常见骨关节病患者时具有良好的信度、效度和适用性。

SF-36在慢性心力衰竭患者中的信度和效度评价

目的探讨中文版36条简明健康问卷(SF-36)在慢性心力衰竭患者的健康相关生存质量(HRQOL)评价中的信度、效度和反应度。方法采用中文版SF-36量表及明尼苏达州心衰生活质量问卷同时对128例慢性心衰患者的HRQOL进行评价,并对部分患者进行随诊观察。结果SF-36具有较好的内部一致性(8个维度的Cronbach'sα均>0.70)和重复性。因子分析产生的两个因子与量表的原理论结构假设基本一致。4—8周内共有78例完成随访,对40例病情好转的随访患者进行再次评价时,应用SF-36可从总体上及心理健康内容方面辨别出患者HRQOL的变化。结论中文版SF-36用于慢性心力衰竭患者生存质量评价时具有较好的信度、效度和反应度。

银屑病对患者生活质量的影响

目的研究银屑病对患者健康相关生活质量(health-related quality of life,HRQOL)的影响,以及银屑病严重程度与生活质量的关系。方法对本院2013年2月-2014年3月124例(进行期53例,稳定期71例)门诊银屑病患者进行调查,对银屑病患者的严重程度进行皮损面积和严重程度指数(psoriasis area and severity index,PASI)评估,采用皮肤病生活质量量表(dermatology life quality index,DLQI)和简明健康状况量表(generic 36-item short-form,SF-36)评估患者生活质量。结果银屑病患者PASI平均11.6±6.1,平均DLQI得分7.4±5.8,平均SF-36得分53.8±15.0;进行期患者PASI、DLQI得分显著高于稳定期患者(P<0.01),SF-36得分显著低于稳定期患者(P<0.01),表明进行期患者生活质量显著低于稳定期;银屑病患者DLQI得分与PASI呈显著正相关(r=0.645,P=0.000),SF-36得分与PASI呈负相关(r=-0.209,P=0.020),DLQI与SF-36无相关性(r=-0.114,P=0.208)。结论银屑病会降低患者生活质量;进行期患者生活质量显著低于稳定期患者;生活质量与疾病严重程度显著相关。

慢性乙型肝炎病人生活质量及影响因素分析

目的分析慢性乙型肝炎病人生活质量的主要影响因素,为增进慢性乙型肝炎病人生活质量提供参考依据。方法用SF-36量表评价441名慢性乙型肝炎病人的生活质量,同时调查可能影响生活质量的社会经济、文化因素,以及被调查对象的个人特征和患病情况。用t检验、方差分析和逐步回归对每一种影响因素分别分析,找出主要影响因素。结果单因素分析时,性别、年龄、文化程度、职业、是否在岗、婚姻状况、经济收入、医疗费用负担形式、医疗花费、家庭住房面积、疾病的炎症程度、病程、住院次数、病情进展情况、是否共患其他疾病等15种因素与生活质量的各领域或大多数领域均有关系。进一步多因素分析,在排除了各因素之间的相互影响后,对生活质量的主要影响因素是文化程度、医疗费用、职业、病情进展情况、病程、婚姻状况。结论对疾病本身的积极治疗,遏制过高的医疗费用,建立有效的社会医疗保障体系,改善医疗水平,提高人民的文化教育水平,倡导和谐稳定的婚姻观念,是提高慢性乙型肝炎病人生活质量的关键。

不同起搏方式对病态窦房结综合征患者生活质量的长期影响

目的:本研究旨在评价两种起搏方式[单心房按需(AAI)起搏和双腔按需(DDD)起搏]对患者起搏器植入术后生活质量的长期影响。方法:采用多中心随机对照方法,将患者分入AAI组(57例)和DDD组(86例)。在起搏器植入前、植入后6个月,之后每年1次的随访中,根据随访期间的健康状况填写36条简明健康问卷(SF-36量表)。38例完成3年随访,且SF-36量表资料完整的患者被纳入生活质量研究。结果:与起搏器植入前相比,起搏器植入术后6个月,患者除躯体疼痛稍下降外,生活质量其余各维度均较起搏器植入术前提高,但差异未达到统计学意义;术后1年患者总体健康评分增高,同时AAI组总体健康评分也高于DDD组(P均<0.05);起搏器植入术后2年,起搏器患者生理功能、总体健康、活力及社会功能的评分均较起搏器术前显著增高(P均<0.05);两两比较显示,除了AAI组总体健康评分显著优于DDD组外(P<0.05),两组患者其他各维度的评分差异仍无统计学意义。结论:心脏起搏治疗能明显提高患者的生活质量,而AAI起搏方式对生活质量的改善明显优于DDD起搏方式。

健康调查简表用于库欣综合征患者生活质量评价的信效度检验

目的评价健康调查简表(36-item short form,SF-36)用于测量库欣综合征患者生活质量的信度和效度。方法 2011年1月至2012年4月便利选取上海市瑞金医院内分泌科的73例库欣综合征患者,采用SF-36对研究对象进行调查,信度检验包括内部一致性信度和折半信度,结构效度检验采用因子分析法。结果 SF-36内部一致性信度的Cronbachα系数为0.822,折半信度Spearman-Brown系数为0.771;将8个维度的得分进行因子分析,提取2个公因子,累计方差贡献率为64.587%。结论中文版SF-36用于评价国内库欣综合征患者的生活质量具有较好的信度和效度,接受性好;在目前国内库欣综合征患者的生活质量研究尚处于初级阶段的前提下,可推广应用。

垂体瘤术后患者生活质量的影响因素调查

目的了解垂体瘤术后患者生活质量(Quality oflife,QOL)及其影响因素,为改善垂体瘤患者QOL提供依据。方法应用自行设计的一般资料调查表、健康调查简表(SF-36),对225例垂体瘤术后患者进行调查。结果垂体瘤患者QOL躯体健康总评(Physical Component Summary,PCS)得分为(42.13±7.99)分、心理健康总评(Mental Component Summary,MCS)得分为(40.27±6.71)分。单因素分析结果显示:不同年龄、婚姻和生育状况、职业、肿瘤类型和大小、是否再入院患者QOL差异有统计学意义(P<0.05);多因素分析结果显示:年龄、肿瘤类型和大小、再入院是垂体瘤术后患者QOL躯体功能方面主要影响因素,生育和婚姻状况、再入院是垂体瘤术后患者QOL心理健康方面主要影响因素。结论垂体瘤术后患者的躯体功能和心理健康均有受损,医护人员应更多关注年龄偏大、不同类型垂体瘤、巨大腺瘤、生育能力受损、心理压力大的已婚患者、再入院的患者,干预可控因素,针对性地给予心理干预,可减少负性情绪,增强患者自我管理能力,帮助患者改善QOL。

中医解毒祛瘀滋阴法对SLE患者生存质量的影响研究

目的:应用SF-36量表评价中医解毒祛瘀滋阴法治疗系统性红斑狼疮(SLE)对其生存质量的影响。方法:147例女性SLE患者被随机分为中西结合组(79例)和西药组(68例),西药组口服强的松为主治疗,中西结合组在强的松基础上结合解毒祛瘀滋阴药治疗。两组均以3个月为1个疗程,连续治疗观察2个疗程。先对SF-36量表的信度和效度进行评价,然后开展SLE患者治疗前后的生存质量调查评估。结果:SF-36各维度得分及总分两次评估的相关系数均≥0.85以上,Cronbach’α系数均>0.8,生理因子和心理因子的实际结构与量表的理论结构基本一致。治疗前比较,两组SLE患者的各维度得分和综合评分均显著低于中国常模(P<0.05);治疗前后比较,中西结合组各维度得分和综合评分均显著升高(P<0.05),而西药组中总体健康(GH)和社会功能(SF)得分差异无显著性(P>0.05),其它也均显著提高(P<0.05);治疗后比较,两组间躯体疼痛(BP)和心理健康(MH)得分差异无显著性(P>0.05),其它均有显著性差异(P<0.05)。结论:SF-36量表的信度和效度良好,适用于对SLE生存质量的评价。中医解毒祛瘀滋阴法结合激素治疗SLE在改善患者生命质量方面,与单用西药相比存在明显优势,值得临床推广应用。

慢性疾病对老干部生活质量的影响研究

目的研究老年人群的生活质量现况及慢性疾病对老年人生活质量的影响,为老年人医疗护理服务提供依据。方法采用美国简明健康测量量表(SF-36)对驻西安地区部队干休所的934名老干部进行生活质量评估,并调查其患病情况。结果心脏病、高血压、卒中、关节炎或风湿性疾病、肺气肿或慢性支气管炎、肿瘤、直肠疾病、前列腺疾病、糖尿病等对老年人生活质量有显著影响。结论实施老年卫生保健服务应充分考虑老年人所患慢性疾病的情况,有针对性地开展危险因素的早期干预,促进预防与医疗两大系统的协作,提高老年人的生活质量。