This study is aimed to assess the long-term health-related quality of life(HRQL) of patients after esopha-gectomy for esophageal cancer in comparison with es-tablished norms,and to evaluate changes in HRQL during the ...This study is aimed to assess the long-term health-related quality of life(HRQL) of patients after esopha-gectomy for esophageal cancer in comparison with es-tablished norms,and to evaluate changes in HRQL during the different stages of follow-up after esopha-geal resection. A systematic review was performed bysearching medical databases(Medline,Embase andthe Cochrane Library) for potentially relevant studiesthat appeared between January 1975 and March 2011.Studies were included if they addressed the questionof HRQL after esophageal resection for esophage alcancer. Two researchers independently performed the study selection,data extraction and analysis processes.Twenty-one observational studies were included witha 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 OES18 or its previous version OES24) .The analysis of long-term generic HRQL with SF-36showed pooled scores for physical,role and socialfunction after esophagectomy similar to United Statesnorms,but lower pooled scores for physical function,vitality and general health perception. The analysis of HRQL conducted using the Global EORTC C30 globalscale during a 6-mo follow-up showed that global scaleand physical function were better at the baseline. The symptom scales indicated worsened fatigue,dyspneaand diarrhea 6 mo after esophagectomy. In contrast,however,emotional function had significantly improved after 6 mo. In conclusion,short- and long-term HRQLis deeply affected after esophagectomy for cancer. The impairment of physical function may be a long-termconsequence 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 operationsmay be attributed to the impression that they have survived a near-death experience.展开更多
AIM: To investigate and evaluate the change in healthrelated quality of life (HRQoL) by tumor node metastasis (TNM) staging system in patients with hepatocellular carcinoma (HCC). METHODS: A total of 140 patients diag...AIM: To investigate and evaluate the change in healthrelated quality of life (HRQoL) by tumor node metastasis (TNM) staging system in patients with hepatocellular carcinoma (HCC). METHODS: A total of 140 patients diagnosed with HCC between June 2008 and April 2009 in our department were enrolled to this study. One hundred and thirty-five (96.5%) patients had liver cirrhosis secondary to hepatitis B virus (HBV) infection, 73 (54.07%) of them being HBV DNA positive; the other etiologies of liver cirrhosis were alcoholic liver disease (1.4%), hepatitis C (1.4%) or cryptogenic (0.7%). All subjects were fully aware of their diagnosis and provided informed consent. HRQoL was assessed before treatment using the functional assessment of cancer therapy-hepatobiliary (FACT-Hep) questionnaire. Descriptive statistics were used to evaluate demographics and disease-specific characteristics of the patients. One-way analysis of variance and independent samples t tests were used to compare the overall FACT-Hep scores and clinically distinct TNM stages. Scores for all FACT-Hep items were analyzed by frequency analyses. The mean scores obtained from the FACT-Hep in different Child-Pugh classes were also evaluated. RESULTS: The mean FACT-Hep scores were reduced significantly from TNM StageⅠto Stage Ⅱ, Stage ⅢA, Stage ⅢB group (687 ± 39.69 vs 547 ± 42.57 vs 387 ± 51.24 vs 177 ± 71.44, P = 0.001). Regarding the physical and emotional well-being subscales, scores decreased gradually from Stage Ⅰ to Stage ⅢB (P = 0.002 vs Stage Ⅰ; P = 0.032 vs Stage Ⅱ; P = 0.033 vs Stage ⅢA). Mean FACT-Hep scores varied by Child-Pugh class, especially in the subscales of physical well-being, functional well-being and the hepatobiliary cancer (P = 0.001 vs Stage I; P = 0.036 vs Stage Ⅱ; P = 0.032 vs Stage ⅢA). For the social and family well-being subscale, only Stage ⅢB scores were significantly lower as compared with Stage Ⅰ scores (P = 0.035). For the subscales of functional well-being and hepatobiliary cancer, there were significant differences for Stages ⅡΙ, ⅢA and ⅢB (P = 0.002vs StageⅠ). CONCLUSION: HRQoL of patients with HCC worsens gradually with progression of TNM stages. The most impaired subscales of HRQoL, as measured by FACT-Hep, were physical and emotional well-being.展开更多
Health-related quality of life (HRQOL) has not been investigated among Iranian industrial workers. The present paper aimed to study the influence of the socio-demographic, health and work-related factors on HRQOL amon...Health-related quality of life (HRQOL) has not been investigated among Iranian industrial workers. The present paper aimed to study the influence of the socio-demographic, health and work-related factors on HRQOL among Iranian industrial workers. In this cross-sectional study, participants were 280 workers of two factories. The Persian version of World Health Organization Quality of Life-Brief (WHOQOL-BREF) was used to assess the HRQOL. A questionnaire was developed to assess the socio-demographic, health and work-related factors. Results showed that the means (SD) of physical health, psychological health, social relationships, and environment domains of HRQOL were 13.2 (2.7), 13.3 (2.6), 14.2 (3.5) and 12.6 (2.5), respectively. A multiple linear regression showed that types of job, exercise activity, working schedule, sleep quality, smoking, and conflict between work and social life were significantly associated with physical health domain;whereas, working schedule, marital status, working demand, sleep quality, BMI, and conflict between work and individual life were significantly associated with psychological health domain. Working schedule, working demand, sleep quality, conflict between work and individual life, and having children over two years were significantly associated with social relationship domain;however, working demand, working schedule, smoking, sleep quality, working hour, job satisfaction, marital status and exercise activity were significantly associated with environment domain. Collectively, work-related factors including unhealthy working conditions, unsafe working environments, long working hours, irregular working schedules, and the lack of occupational training may negatively influence the HRQOL of workers. To improve workers’ HRQOL, intervention programs should focus on improving work environment, working schedule, occupational training and restricting working hours.展开更多
BACKGROUND Mortality after hepatectomy has decreased,and the quality of various surgical approaches to hepatectomy have been evaluated.Various assessments of quality of life(QOL)after hepatectomy have been developed a...BACKGROUND Mortality after hepatectomy has decreased,and the quality of various surgical approaches to hepatectomy have been evaluated.Various assessments of quality of life(QOL)after hepatectomy have been developed and investigated in different clinical settings.AIM To conduct a systematic review and meta-analysis to examine two clinical topics:Laparoscopic hepatectomy vs open hepatectomy,and preoperative QOL status vs postoperative QOL status.METHODS A systematic literature search was performed using PubMed and MEDLINE,including the Cochrane Library Central.The following inclusion criteria were set for inclusion in this meta-analysis:(1)Studies comparing preoperative QOL and postoperative QOL;and(2)Studies comparing QOL between laparoscopic hepatectomy and open hepatectomy.RESULTS A total of 8 articles were included in this meta-analysis.QOL was better after laparoscopic hepatectomy than after open hepatectomy.CONCLUSION The outcomes of evaluations of QOL after hepatectomy can depend on the type of questionnaire used,the timing of the assessment,and the etiology of the hepatic disease.展开更多
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 affec...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.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
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
Depressed patients with scores of 17 or more on the 17 items of the Hamilton Depression Rating Scale were treated with the antidepressant drug paroxetine. They also underwent verum acupuncture or electroacupuncture at...Depressed patients with scores of 17 or more on the 17 items of the Hamilton Depression Rating Scale were treated with the antidepressant drug paroxetine. They also underwent verum acupuncture or electroacupuncture at Baihui (GV20) and Yintang (GV29). The World Health Organization Quality of Life Scale Brief Version showed a significant increase in the total scores of patients who underwent verum acupuncture and electroacupuncture for 6 weeks compared with those who were given paroxetine only; significantly increased physical domain and social relationship scores in verum acupuncture patients compared with paroxetine only; and significantly elevated psychological domain scores with electroacupuncture compared with paroxetine only. These results indicate that both verum acupuncture and electroacupuncture can improve quality of life in depressed patients undergoing paroxetine treatment,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
质量调整生命年(quality adjusted life years,QALYs)作为多维健康效用指标的1种,它在卫生经济学评价和疾病负担评价中的应用越来越广泛。目前,未见详细归纳阐述不同研究类型下QALYs测算方法的报道。该文主要探讨了QALYs计算的基本原理...质量调整生命年(quality adjusted life years,QALYs)作为多维健康效用指标的1种,它在卫生经济学评价和疾病负担评价中的应用越来越广泛。目前,未见详细归纳阐述不同研究类型下QALYs测算方法的报道。该文主要探讨了QALYs计算的基本原理和过程,并进一步归纳总结在具体研究中如何根据研究设计来选择合适的QALYs计算方法,以期为研究者提供参考依据,促进其在我国卫生领域研究中的应用。展开更多
Objective: To measure the possible magnitude of the role nurse staffing has on increasing life expectancy at birth and at 65 years old.Methods: The statistical technique of panel data analysis was applied to investiga...Objective: To measure the possible magnitude of the role nurse staffing has on increasing life expectancy at birth and at 65 years old.Methods: The statistical technique of panel data analysis was applied to investigate the relationship from the number of practicing nurses' density per 1000 population to life expectancy at birth and at 65 years old.Five control variables were used as the proxies for the levels of medical staffing,health care financial and physical resources,and medical technology.The observations of 35 member countries of Organization for Economic Co-operation and Development (OECD) were collected from OECD Health Statistics over 2000-2016 period.Results: There were meaningful relationships from nurse staffing to life expectancy at birth and at 65 years with the long-run elasticities of 0.02 and 0.08,respectively.Overall,the role of nursing characteristics in increasing life expectancy indicators varied among different health care systems of OECD countries and in average were determined at the highest level in Japan (0.25),followed by Iceland (0.24),Belgium (0.21),Czech Republic (0.21),Slovenia (0.20) and Sweden (0.18).Conclusion: A higher proportion of nursing staff is associated with higher life expectancy in OECD countries and the dependency of life expectancy to nursing staff would increase by aging.Hence,the findings of this study warn health policy makers about ignoring the effects nursing shortages create e.g.increasing the risk of actual age-specific mortality,especially in care of elderly people.展开更多
AIM To develop a scale of domains associated with the health-related quality-of-life(HRQOL) in patients with cirrhosis-related ascites.METHODS We initially undertook literature searches and a qualitative study in orde...AIM To develop a scale of domains associated with the health-related quality-of-life(HRQOL) in patients with cirrhosis-related ascites.METHODS We initially undertook literature searches and a qualitative study in order to design a cirrhosis-associated ascites symptom(CAS) scale describing symptoms with a potential detrimental impact on health related quality of life(HRQL)(the higher the score, the worse the symptoms). Discriminatory validity was assessed in a validation cohort including cirrhotic patients with(1) tense/severe;(2) moderate/mild; or(3) no ascites(controls). Patients also completed chronic liver disease questionnaire(CLDQ) and the Euro QoL 5-Dimensions 5-Level(EQ-5D-5L) questionnaire evaluating HRQL. The relation between scale scores was analysed using Spearman correlations. RESULTS The final CAS scale included 14 items. The equivalent reliability was high(Chronbach's alpha 0.88). The validation cohort included 103 patients(72% men, mean age 62.4 years). The mean scores for each question in the CAS scale were higher for patients with severe/tense ascites than for mild/moderate ascites and controls. Compared with controls(mean = 9.9 points), the total CAS scale score was higher for severe/tense ascites(mean = 23.8 points) as well as moderate/mild ascites(mean = 18.6 points)(P < 0.001 both groups). We found a strong correlation between the total CAS and CLDQ score(rho = 0.82, P < 0.001) and a moderate correlation between the CAS and the EQ-5D-5L score(0.67, P < 0.001). CONCLUSION The CAS is a valid tool, which reflects HRQOL in patients with ascites.展开更多
Bariatric surgery is the branch of surgery aimed at helping a person with obesity lose weight.The implementation of surgical treatment of obesity is growing at an impressive rate.As expected,the expanding implementati...Bariatric surgery is the branch of surgery aimed at helping a person with obesity lose weight.The implementation of surgical treatment of obesity is growing at an impressive rate.As expected,the expanding implementation of bariatric procedures has progres-sively revealed critical issues that were not evident when the number of obese patients treated with surgery was relatively small.One critical issue is the importance of mental health assessment and care of bariatric patients.The aim of this review is to provide readers with an up-to-date summary of the goals,methods,and clinical strategies of bariatric psychiatry.The aims can be grouped into three distinct categories.First,to ascertain that there are no psychiatric contraindications to safe bariatric surgery.Second,to diagnose and treat pre-surgery mental conditions that could predict poor weight loss.Third,to diagnose and treat post-surgery mental conditions associated with poor quality of life.Although bariatric psychiatry has gained the status of a new subspecialty within the field of mental health and psychopathology,many clinical questions remain unsolved.We need more long-term data on outcome measures such as quality of life,adherence to behavioral guidelines,risk of suicide,and postsurgery prevalence of psychological disturbances and mental disorders.展开更多
Low back pain remains a most common clinical entity among musculoskeletal disorders. Pain reducing modalities, Manual therapy various specific techniques were widely used physiotherapeutic means as part of treatment f...Low back pain remains a most common clinical entity among musculoskeletal disorders. Pain reducing modalities, Manual therapy various specific techniques were widely used physiotherapeutic means as part of treatment for subjects with low back pain. An emerging trend with Independent physiotherapy practice, knowing red flags, conditions requiring investigations and experts treatment were to be recognized and adhered for maximizing patients care and benefits. Prostate cancer among men above 50 years were more found to be linked with Low back pain. This original research presentation where a subject having chronic low back pain found to have prostate cancer were analyzed and discussed with scientific evidence on clinical manifestations, investigations and medical management. Underlines the importance of recognizing, directing and getting treated of the root cause of subjects suffering with Low back pain due to prostate cancer and not just keep treating the symptoms alone were major purpose of this study.展开更多
文摘This study is aimed to assess the long-term health-related quality of life(HRQL) of patients after esopha-gectomy for esophageal cancer in comparison with es-tablished norms,and to evaluate changes in HRQL during the different stages of follow-up after esopha-geal resection. A systematic review was performed bysearching medical databases(Medline,Embase andthe Cochrane Library) for potentially relevant studiesthat appeared between January 1975 and March 2011.Studies were included if they addressed the questionof HRQL after esophageal resection for esophage alcancer. Two researchers independently performed the study selection,data extraction and analysis processes.Twenty-one observational studies were included witha 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 OES18 or its previous version OES24) .The analysis of long-term generic HRQL with SF-36showed pooled scores for physical,role and socialfunction after esophagectomy similar to United Statesnorms,but lower pooled scores for physical function,vitality and general health perception. The analysis of HRQL conducted using the Global EORTC C30 globalscale during a 6-mo follow-up showed that global scaleand physical function were better at the baseline. The symptom scales indicated worsened fatigue,dyspneaand diarrhea 6 mo after esophagectomy. In contrast,however,emotional function had significantly improved after 6 mo. In conclusion,short- and long-term HRQLis deeply affected after esophagectomy for cancer. The impairment of physical function may be a long-termconsequence 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 operationsmay be attributed to the impression that they have survived a near-death experience.
基金Supported by Grants from the E-Institute of Shanghai Municipal Education Commission, No. E03008Shanghai Municipal Health Bureau of Traditional Chinese Medicine Research Project Fund 2010-2011, No. 2010L052B
文摘AIM: To investigate and evaluate the change in healthrelated quality of life (HRQoL) by tumor node metastasis (TNM) staging system in patients with hepatocellular carcinoma (HCC). METHODS: A total of 140 patients diagnosed with HCC between June 2008 and April 2009 in our department were enrolled to this study. One hundred and thirty-five (96.5%) patients had liver cirrhosis secondary to hepatitis B virus (HBV) infection, 73 (54.07%) of them being HBV DNA positive; the other etiologies of liver cirrhosis were alcoholic liver disease (1.4%), hepatitis C (1.4%) or cryptogenic (0.7%). All subjects were fully aware of their diagnosis and provided informed consent. HRQoL was assessed before treatment using the functional assessment of cancer therapy-hepatobiliary (FACT-Hep) questionnaire. Descriptive statistics were used to evaluate demographics and disease-specific characteristics of the patients. One-way analysis of variance and independent samples t tests were used to compare the overall FACT-Hep scores and clinically distinct TNM stages. Scores for all FACT-Hep items were analyzed by frequency analyses. The mean scores obtained from the FACT-Hep in different Child-Pugh classes were also evaluated. RESULTS: The mean FACT-Hep scores were reduced significantly from TNM StageⅠto Stage Ⅱ, Stage ⅢA, Stage ⅢB group (687 ± 39.69 vs 547 ± 42.57 vs 387 ± 51.24 vs 177 ± 71.44, P = 0.001). Regarding the physical and emotional well-being subscales, scores decreased gradually from Stage Ⅰ to Stage ⅢB (P = 0.002 vs Stage Ⅰ; P = 0.032 vs Stage Ⅱ; P = 0.033 vs Stage ⅢA). Mean FACT-Hep scores varied by Child-Pugh class, especially in the subscales of physical well-being, functional well-being and the hepatobiliary cancer (P = 0.001 vs Stage I; P = 0.036 vs Stage Ⅱ; P = 0.032 vs Stage ⅢA). For the social and family well-being subscale, only Stage ⅢB scores were significantly lower as compared with Stage Ⅰ scores (P = 0.035). For the subscales of functional well-being and hepatobiliary cancer, there were significant differences for Stages ⅡΙ, ⅢA and ⅢB (P = 0.002vs StageⅠ). CONCLUSION: HRQoL of patients with HCC worsens gradually with progression of TNM stages. The most impaired subscales of HRQoL, as measured by FACT-Hep, were physical and emotional well-being.
文摘Health-related quality of life (HRQOL) has not been investigated among Iranian industrial workers. The present paper aimed to study the influence of the socio-demographic, health and work-related factors on HRQOL among Iranian industrial workers. In this cross-sectional study, participants were 280 workers of two factories. The Persian version of World Health Organization Quality of Life-Brief (WHOQOL-BREF) was used to assess the HRQOL. A questionnaire was developed to assess the socio-demographic, health and work-related factors. Results showed that the means (SD) of physical health, psychological health, social relationships, and environment domains of HRQOL were 13.2 (2.7), 13.3 (2.6), 14.2 (3.5) and 12.6 (2.5), respectively. A multiple linear regression showed that types of job, exercise activity, working schedule, sleep quality, smoking, and conflict between work and social life were significantly associated with physical health domain;whereas, working schedule, marital status, working demand, sleep quality, BMI, and conflict between work and individual life were significantly associated with psychological health domain. Working schedule, working demand, sleep quality, conflict between work and individual life, and having children over two years were significantly associated with social relationship domain;however, working demand, working schedule, smoking, sleep quality, working hour, job satisfaction, marital status and exercise activity were significantly associated with environment domain. Collectively, work-related factors including unhealthy working conditions, unsafe working environments, long working hours, irregular working schedules, and the lack of occupational training may negatively influence the HRQOL of workers. To improve workers’ HRQOL, intervention programs should focus on improving work environment, working schedule, occupational training and restricting working hours.
基金Supported by Grant-in-Aid from JSPS KAKENHI,No.JP 20K10404(to Mizuguchi T)the Hokkaido Hepatitis B Litigation Orange Fund,No.2059198+9 种基金Terumo Life Science Foundation,No.2000666Pfizer Health Research Foundation,No.2000777Daiichi Sankyo Company,No.2109540Shionogi and Co.,No.2109493MSD,No.2099412Takeda,No,2000555Sapporo Doto Hospital,No.2039118Noguchi Hospital,No.2029083Doki-kai Tomakomai Hospital,No.2059203and Tsuchida Hospital,No.2069231.
文摘BACKGROUND Mortality after hepatectomy has decreased,and the quality of various surgical approaches to hepatectomy have been evaluated.Various assessments of quality of life(QOL)after hepatectomy have been developed and investigated in different clinical settings.AIM To conduct a systematic review and meta-analysis to examine two clinical topics:Laparoscopic hepatectomy vs open hepatectomy,and preoperative QOL status vs postoperative QOL status.METHODS A systematic literature search was performed using PubMed and MEDLINE,including the Cochrane Library Central.The following inclusion criteria were set for inclusion in this meta-analysis:(1)Studies comparing preoperative QOL and postoperative QOL;and(2)Studies comparing QOL between laparoscopic hepatectomy and open hepatectomy.RESULTS A total of 8 articles were included in this meta-analysis.QOL was better after laparoscopic hepatectomy than after open hepatectomy.CONCLUSION The outcomes of evaluations of QOL after hepatectomy can depend on the type of questionnaire used,the timing of the assessment,and the etiology of the hepatic disease.
文摘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.
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.
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 Science and Technology Support Project No.2006BAI12B05-2the Key Subject Construction Program"211 Project"of Guangdong Province
文摘Depressed patients with scores of 17 or more on the 17 items of the Hamilton Depression Rating Scale were treated with the antidepressant drug paroxetine. They also underwent verum acupuncture or electroacupuncture at Baihui (GV20) and Yintang (GV29). The World Health Organization Quality of Life Scale Brief Version showed a significant increase in the total scores of patients who underwent verum acupuncture and electroacupuncture for 6 weeks compared with those who were given paroxetine only; significantly increased physical domain and social relationship scores in verum acupuncture patients compared with paroxetine only; and significantly elevated psychological domain scores with electroacupuncture compared with paroxetine only. These results indicate that both verum acupuncture and electroacupuncture can improve quality of life in depressed patients undergoing paroxetine treatment,
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.
文摘质量调整生命年(quality adjusted life years,QALYs)作为多维健康效用指标的1种,它在卫生经济学评价和疾病负担评价中的应用越来越广泛。目前,未见详细归纳阐述不同研究类型下QALYs测算方法的报道。该文主要探讨了QALYs计算的基本原理和过程,并进一步归纳总结在具体研究中如何根据研究设计来选择合适的QALYs计算方法,以期为研究者提供参考依据,促进其在我国卫生领域研究中的应用。
文摘Objective: To measure the possible magnitude of the role nurse staffing has on increasing life expectancy at birth and at 65 years old.Methods: The statistical technique of panel data analysis was applied to investigate the relationship from the number of practicing nurses' density per 1000 population to life expectancy at birth and at 65 years old.Five control variables were used as the proxies for the levels of medical staffing,health care financial and physical resources,and medical technology.The observations of 35 member countries of Organization for Economic Co-operation and Development (OECD) were collected from OECD Health Statistics over 2000-2016 period.Results: There were meaningful relationships from nurse staffing to life expectancy at birth and at 65 years with the long-run elasticities of 0.02 and 0.08,respectively.Overall,the role of nursing characteristics in increasing life expectancy indicators varied among different health care systems of OECD countries and in average were determined at the highest level in Japan (0.25),followed by Iceland (0.24),Belgium (0.21),Czech Republic (0.21),Slovenia (0.20) and Sweden (0.18).Conclusion: A higher proportion of nursing staff is associated with higher life expectancy in OECD countries and the dependency of life expectancy to nursing staff would increase by aging.Hence,the findings of this study warn health policy makers about ignoring the effects nursing shortages create e.g.increasing the risk of actual age-specific mortality,especially in care of elderly people.
文摘AIM To develop a scale of domains associated with the health-related quality-of-life(HRQOL) in patients with cirrhosis-related ascites.METHODS We initially undertook literature searches and a qualitative study in order to design a cirrhosis-associated ascites symptom(CAS) scale describing symptoms with a potential detrimental impact on health related quality of life(HRQL)(the higher the score, the worse the symptoms). Discriminatory validity was assessed in a validation cohort including cirrhotic patients with(1) tense/severe;(2) moderate/mild; or(3) no ascites(controls). Patients also completed chronic liver disease questionnaire(CLDQ) and the Euro QoL 5-Dimensions 5-Level(EQ-5D-5L) questionnaire evaluating HRQL. The relation between scale scores was analysed using Spearman correlations. RESULTS The final CAS scale included 14 items. The equivalent reliability was high(Chronbach's alpha 0.88). The validation cohort included 103 patients(72% men, mean age 62.4 years). The mean scores for each question in the CAS scale were higher for patients with severe/tense ascites than for mild/moderate ascites and controls. Compared with controls(mean = 9.9 points), the total CAS scale score was higher for severe/tense ascites(mean = 23.8 points) as well as moderate/mild ascites(mean = 18.6 points)(P < 0.001 both groups). We found a strong correlation between the total CAS and CLDQ score(rho = 0.82, P < 0.001) and a moderate correlation between the CAS and the EQ-5D-5L score(0.67, P < 0.001). CONCLUSION The CAS is a valid tool, which reflects HRQOL in patients with ascites.
文摘Bariatric surgery is the branch of surgery aimed at helping a person with obesity lose weight.The implementation of surgical treatment of obesity is growing at an impressive rate.As expected,the expanding implementation of bariatric procedures has progres-sively revealed critical issues that were not evident when the number of obese patients treated with surgery was relatively small.One critical issue is the importance of mental health assessment and care of bariatric patients.The aim of this review is to provide readers with an up-to-date summary of the goals,methods,and clinical strategies of bariatric psychiatry.The aims can be grouped into three distinct categories.First,to ascertain that there are no psychiatric contraindications to safe bariatric surgery.Second,to diagnose and treat pre-surgery mental conditions that could predict poor weight loss.Third,to diagnose and treat post-surgery mental conditions associated with poor quality of life.Although bariatric psychiatry has gained the status of a new subspecialty within the field of mental health and psychopathology,many clinical questions remain unsolved.We need more long-term data on outcome measures such as quality of life,adherence to behavioral guidelines,risk of suicide,and postsurgery prevalence of psychological disturbances and mental disorders.
文摘Low back pain remains a most common clinical entity among musculoskeletal disorders. Pain reducing modalities, Manual therapy various specific techniques were widely used physiotherapeutic means as part of treatment for subjects with low back pain. An emerging trend with Independent physiotherapy practice, knowing red flags, conditions requiring investigations and experts treatment were to be recognized and adhered for maximizing patients care and benefits. Prostate cancer among men above 50 years were more found to be linked with Low back pain. This original research presentation where a subject having chronic low back pain found to have prostate cancer were analyzed and discussed with scientific evidence on clinical manifestations, investigations and medical management. Underlines the importance of recognizing, directing and getting treated of the root cause of subjects suffering with Low back pain due to prostate cancer and not just keep treating the symptoms alone were major purpose of this study.