Long-Term Health-Related Quality of Life in German Patients with Juvenile Idiopathic Arthritis in Comparison to German General Population

ObjectiveAims of the study were to investigate health-related quality of life (HRQOL) in adult patients with former diagnosis of Juvenile Idiopathic Arthritis (JIA), to compare their HRQOL with the general population and to identify factors related to a poor outcome.MethodsIn 2012, a cross-sectional survey was performed by mailing a questionnaire to a large cohort of former and current patients of the German Centre for Rheumatology in Children and Adolescents. Only adult patients (≥18 years) with a diagnosis compatible with JIA were included (n = 2592; response 66%). The questionnaire included information about HRQOL (EQ5D), disease-related questions and socio-demographics. Prevalence and 95% confidence intervals (CI) of problems with mobility, self-care, usual activities, pain and anxiety/depression were standardized to the German general population. Factors associated with low HRQOL in JIA patients were identified using logistic regression models.ResultsSixty-two percent of the study population was female; age range was 18–73 years. In all dimensions, JIA patients reported statistically significantly more problems than the general population with largest differences in the pain dimension (JIA patients 56%; 95%CI 55–58%; general population 28%; 26–29%) and the anxiety/depression dimension (28%; 27–29% vs. 4%; 4–5%). Lower HRQOL in JIA patients was associated with female sex, older age, lower level of education, still being under rheumatic treatment and disability.ConclusionsHRQOL in adult JIA patients is considerably lower than in the general population. As this cohort includes historic patients the new therapeutic schemes available today are expected to improve HRQOL in future.     

Clinical Correlates of Health Preference and Generic Health-Related Quality of Life in Patients with Colorectal Neoplasms

Background

The aims of the study were to assess the health preference and health-related quality of life (HRQOL) in patients with colorectal neoplasms (CRN), and to determine the clinical correlates that significantly influence the HRQOL of patients.

Methods

Five hundred and fifty-four CRN patients, inclusive of colorectal polyp or cancer, who attended the colorectal specialist outpatient clinic at Queen Mary Hospital in Hong Kong between October 2009 and July 2010, were included. Patients were interviewed with questionnaires on socio-demographic characteristics, and generic and health preference measures of HRQOL using the SF-12 and SF-6D Health Surveys, respectively. Clinical information on stage of disease at diagnosis, time since diagnosis, primary tumour site was extracted from electronic case record. Mean HRQOL and health preference scores of CRN patients were compared with age-sex matched controls from the Chinese general population using independent t-test. Multiple linear regression analyses were conducted to explore the associations of clinical characteristics with HRQOL measures with the adjustment of socio-demographic characteristics.

Results

Cross-sectional data of 515 eligible patients responded to the whole questionnaires were included in outcome analysis. In comparison with age-sex matched normative values, CRN patients reported comparable physical-related HRQOL but better mental-related HRQOL. Amongst CRN patients, time since diagnosis was positively associated with health preference score whilst patients with rectal neoplasms had lower health preference and physical-related HRQOL scores than those with sigmoid neoplasms. Health preference and HRQOL scores were significantly lower in patients with stage IV colorectal cancer than those with other less severe stages, indicating that progressive decline from low-risk polyp to stage IV colorectal cancer was observed in HRQOL scores.

Conclusion

In CRN patients, a more advanced stage of disease was associated with worse HRQOL scores. Despite potentially adverse effect of disease on physical-related HRQOL, the mental-related HRQOL of CRN patients were better than that of Chinese general population.     

乳腺癌术后患者创伤后成长与心理弹性和生命质量的相关性研究

摘要 目的：探讨乳腺癌术后患者创伤后成长（PTG）的影响因素,并分析其与心理弹性和生命质量的关系。方法：选择2020年1月~2021年8月在山东省立第三医院接受手术治疗的乳腺癌患者80例作为研究对象。采用创伤后成长量表（PTGI）评价乳腺癌术后患者PTG情况。采用乳腺癌患者生命质量测定量表（FACT-B）评价生命质量。采用心理弹性量表（CD-RISC）评价心理弹性。采用单因素及多因素Logistic回归分析乳腺癌术后患者PTG的影响因素,采用Pearson相关性分析PTGI评分与CD-RISC评分和FACT-B评分的关系。结果：乳腺癌术后患者PTGI评分为（50.38±13.39）分,根据PTGI评分将其分为PTG高分组（n=32）和PTG低分组（n=48）。乳腺癌术后患者PTG水平与文化程度、家庭月收入、疾病发现方式、工作状况、手术方式、临床分期、术后并发症、基础疾病有关（P<0.05）。多因素Logistic回归分析结果显示：家庭月收入<3000元、临床分期为II期、文化程度为小学及其以下、手术方式为乳房切除、有术后并发症、有基础疾病均是乳腺癌术后患者PTG的危险因素（P<0.05）。PTG高分组患者的CD-RISC、FACT-B评分高于PTG低分组,组间对比有统计学差异（P<0.05）。Pearson相关性分析结果显示,PTGI评分与CD-RISC评分、FACT-B评分呈正相关（P<0.05）。结论：乳腺癌术后患者PTG水平一般,受到临床分期、文化程度、手术方式等多种因素的影响,临床工作中应对相关因素予以重视并及时干预。同时PTG会影响患者的心理弹性和生命质量,PTG水平越高,心理弹性越好,生命质量亦越高。     

非小细胞肺癌化疗患者应对方式与生活质量的相关性研究

目的:调查非小细胞肺癌(NSCLC)化疗患者应对方式与生活质量的相关性。方法:选择2016年5月-2018年5月在我院接受化疗的NSCLC患者共110例,分别采用肺癌生命质量量表(EORTC-QLQ.C30)、肺癌患者生活质量调查问卷(EORTC-QLQ.LC13)和医学应对方式问卷(MCMQ)对患者生活质量与应对方式进行调查,分析其相关性,并采用多元逐步回归分析整体生活质量的影响因素。结果:不同化疗阶段,患者功能维度得分和整体生活质量得分显著下降,差异有统计学意义(P0.05),症状维度得分和化疗相关副反应得分显著升高,差异有统计学意义(P0.05)。肺癌表现得分的差异和三种应对方式得分的差异均无统计学意义(P0.05)。患者采取面对方式和回避方式的得分均高于屈服方式(P0.05)。面对方式与患者整体生活质量呈正相关,回避方式、屈服方式与患者整体生活质量呈负相关。多元逐步回归分析显示:年龄、疾病转移及面对方式是NSCLC化疗患者整体生活质量的影响因素(P0.05)。结论:NSCLC化疗患者应对方式与生活质量存在一定的相关性,应有效的发挥积极应对方式对生活质量的促进作用,提高患者生活质量。     

早期康复护理对肠内营养治疗的高血压颅内出血 患者预后的影响

目的：研究早期康复护理对肠内营养治疗的高血压颅内出血患者预后的影响。方法：选取2010 年1 月~2012 年10 月间入 院诊治的高血压颅内出血并应用肠内营养支持治疗的患者120 例,随机分为实验组（60 例）和对照组（60 例）。对照组应用常规护 理办法,实验组在其基础上应用早期康复护理,随访1 年后观察两组患者预后的生活质量情况、GCS（格拉斯哥昏迷指数）评分以 及并发症的发生情况。结果：随访1 年后,实验组的生活质量显著高于对照组（P<0.05）;护理干预前两组患者的GCS 评分无差异, 护理干预后实验组的GCS 评分显著高于对照组（P<0.05）;实验组在肺部感染、下肢静脉血栓、肩手综合征等并发症的发生例数均 显著低于对照组（P<0.05）。结论：针对肠内营养支持治疗的高血压颅内出血患者应用早期康复护理可有效改善患者的昏迷程度、 预防并发症,有助于提高患者的生活质量。     

精神心理干预对慢性肛周湿疹患者治疗效果、心理状态及生活质量的影响

目的:探讨精神心理干预对慢性肛周湿疹患者治疗效果、心理健康及生活质量的影响,为临床治疗提供新的切入点。方法:选取122例慢性肛周湿疹患者为研究对象,采用随机数字表法分为干预组和对照组各61例。对照组接受常规治疗,干预组在对照组的基础上接受精神心理干预,两组患者均治疗8周。对比两组患者的临床疗效,观察并比较两组患者治疗前后的心理状态以及生活质量的变化情况。结果:干预组的总有效率为85.25%,明显高于对照组的62.30%(P0.05)。治疗8周后,两组患者焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、皮肤病生活质量指数(DLQI)评分和匹兹堡睡眠质量指数(PSQI)评分均降低,且干预组患者治疗后的SAS评分、SDS评分、DLQI评分和PSQI评分均明显低于对照组(P0.05)。两组患者治疗后的心理弹性量表(CD-RISC)评分升高,且与对照组相比,干预组患者治疗后的CD-RISC评分显著升高(P0.05)。结论:精神心理干预联合常规治疗对慢性肛周湿疹具有较好的疗效。对患者实施精神心理干预可有效减轻患者焦虑、抑郁等负性情绪,提高患者心理韧性水平,促进患者生活质量的提升。     

Not Early Referral but Planned Dialysis Improves Quality of Life and Depression in Newly Diagnosed End Stage Renal Disease Patients: A Prospective Cohort Study in Korea

BackgroundHealth-related quality of life (HRQOL) has recently become an important issue. It reportedly affects morbidity and mortality in patients with end-stage renal disease (ESRD). In this study, we investigated whether early referral and planned dialysis improve the HRQOL and depression of patients with ESRD.MethodsWe prospectively enrolled newly diagnosed patients with ESRD, from 31 hospitals in Korea, who completed questionnaires at 3 months after dialysis. We also got follow-up survey at 1 year after dialysis. To measure HRQOL and depression, Kidney Disease Quality of Life Short Form 36 (KDQOL-36) and Beck’s Depression Inventory (BDI) were utilized.ResultsA total of 643 patients were analyzed. Referral type did not affect either KDQOL-36 or BDI scores. However, the planned dialysis group showed significantly better scores in 4 of 5 KDQOL-36 domains than did the unplanned group at 3 months after dialysis and partly, the effect was sustained for 1 year after dialysis. The benefit of planned dialysis was significant after adjusting for age, sex, type of dialysis, marital status, educational attainment, occupation, modified Charlson comorbidity index, albumin, and hemoglobin levels. BDI scores were also lower which indicate less depressive mood in planned dialysis group than those in unplanned group both at 3 months and 1 year after dialysis.ConclusionsNot early referral but planned dialysis improved both the short- and long-term HRQOL and depression of patients with ESRD. Nephrologists should try to help patients to initiate dialysis in a planned manner.     

埃克替尼联合化疗治疗EGFR突变型晚期非小细胞肺癌的疗效及对生活质量和血清肿瘤标志物的影响

目的:观察表皮生长因子受体(EGFR)突变型晚期非小细胞肺癌(NSCLC)经化疗联合埃克替尼治疗后的临床效果。方法:122例研究对象均为我院于2015年3月~2019年3月期间收治的晚期NSCLC患者且为EGFR突变型。采用随机数字表法将患者分为对照组(单药埃克替尼靶向药物治疗)和实验组(埃克替尼联合化疗),各61例。观察两组疗效、生活质量、血清肿瘤标志物、毒副反应的变化,比较两组患者的无进展生存期(PFS)和总生存期(OS)。结果:实验组治疗后的客观缓解率、疾病控制率均高于对照组(P<0.05)。实验组治疗后整体生活质量和健康状况总得分高于对照组,功能及症状总得分低于对照组(P<0.05)。实验组治疗后癌胚抗原(CEA)、癌抗原125(CA125)与角蛋白19片段(CYFRA21-1)低于对照组(P<0.05)。实验组毒副反应总发生率高于对照组(P<0.05)。两组间PFS、OS生存率比较均有统计学差异(P<0.05)。结论:埃克替尼联合化疗治疗EGFR突变型晚期NSCLC患者疗效较好,可有效阻止疾病进展,提高患者生活质量,改善患者预后。     

Health-Related Quality of Life in Chinese Patients with Mild and Moderately Active Ulcerative Colitis

Background

Ulcerative colitis (UC) impairs the health-related quality of life (HRQOL). The difference in HRQOL between patients with mild and moderately active UC is not well-defined. Few studies have been conducted to explore the factors that influence HRQOL in Chinese patients. Our study aims were to (1) compare HRQOL of mildly active UC patients with moderate patients; (2) explore the factors that influence HRQOL in Chinese patients with UC; and (3) analyze demographic and disease characteristics of UC in China.

Methods

A total of 110 mild and 114 moderate patients with UC were enrolled. The demographic and disease characteristics were recorded. HRQOL was measured by the Chinese version of the inflammatory bowel disease questionnaire (IBDQ) between mild and moderate patients, male and female patients, and different disease distributions. Stepwise regression analysis was used to assess factors influencing the IBDQ score.

Results

Patients with moderate UC had significantly lower IBDQ total scores compared to patients with mild UC (P=0.001). The IBDQ total score had a negative correlation with the Mayo score (r=–0.263, P<0.001). Stepwise regression analysis showed that the disease activity index and gender had an influence on the IBDQ total score (P<0.05). The female patients had a lower score than the male patients (P<0.05), especially in the emotional function domain (P=0.002). Different disease distributions were not statistically significant in the IBDQ total score (P=0.183).

Conclusions

UC has a negative influence on HRQOL. HRQOL in patients with moderate UC was lower than HRQOL in patients with mild UC, as measured by the IBDQ. UC disease activity has a negative correlation with HRQOL. Gender and the disease activity index are important factors involved in the impairment of HRQOL in Chinese patients with UC. Chinese females may benefit from increased psychological care as part of UC therapy.     

心肺康复训练联合冬病夏治穴位贴敷对慢性阻塞性肺疾病稳定期患者肺功能、免疫功能和生活质量的影响

摘要 目的：探讨冬病夏治穴位贴敷联合心肺康复训练对慢性阻塞性肺疾病（COPD）稳定期患者免疫功能、肺功能和生活质量的影响。方法：将2021年3月至2022年3月湖北民族大学附属民大医院接收的80例COPD稳定期患者纳为研究对象。按照随机数字表法分为研究组（n=40,接受心肺康复训练联合冬病夏治穴位贴敷）和对照组（n=40,接受心肺康复训练）。对比两组6 min步行试验（6MWT）、COPD急性加重住院次数、住院时间、肺功能、免疫功能和生活质量。结果：研究组治疗后6MWT长于对照组（P<0.05）,研究组的COPD急性加重住院次数少于对照组,住院时间短于对照组（P<0.05）。研究组治疗后咳嗽、睡眠、咳痰、情绪、运动耐力、胸闷、精力和日常运动评分低于对照组（P<0.05）。研究组治疗后CD4⁺、CD4⁺/CD8⁺、免疫球蛋白（Ig）A、IgG、IgM高于对照组,CD8⁺低于对照组（P<0.05）。研究组治疗后用力肺活量（FVC）、呼气峰值流速（PEF）、第1秒用力呼气容积（FEV₁）高于对照组（P<0.05）。结论：冬病夏治穴位贴敷联合心肺康复训练治疗COPD稳定期患者,可有效提高患者的免疫功能和肺功能,提高患者的生活质量。     

Awareness of Memory Deficits in Early Stage Huntington's Disease

Patients with Huntington''s disease (HD) are often described as unaware of their motor symptoms, their behavioral disorders or their cognitive deficits, including memory. Nevertheless, because patients with Parkinson''s disease (PD) remain aware of their memory deficits despite striatal dysfunction, we hypothesize that early stage HD patients in whom degeneration predominates in the striatum can accurately judge their own memory disorders whereas more advanced patients cannot. In order to test our hypothesis, we compared subjective questionnaires of memory deficits (in HD patients and in their proxies) and objective measures of memory dysfunction in patients. Forty-six patients with manifest HD attending the out-patient department of the French National Reference Center for HD and thirty-three proxies were enrolled. We found that HD patients at an early stage of the disease (Stage 1) were more accurate than their proxies at evaluating their own memory deficits, independently from their depression level. The proxies were more influenced by patients'' functional decline rather than by patients'' memory deficits. Patients with moderate disease (Stage 2) misestimated their memory deficits compared to their proxies, whose judgment was nonetheless influenced by the severity of both functional decline and depression. Contrasting subjective memory ratings from the patients and their objective memory performance, we demonstrate that although HD patients are often reported to be unaware of their neurological, cognitive and behavioral symptoms, it is not the case for memory deficits at an early stage. Loss of awareness of memory deficits in HD is associated with the severity of the disease in terms of CAG repeats, functional decline, motor dysfunction and cognitive impairment, including memory deficits and executive dysfunction.     

淋巴瘤幸存者复发恐惧的影响因素及认知行为干预对患者生活质量和心理状态的影响

摘要 目的：分析淋巴瘤幸存者复发恐惧（FCR）的影响因素,并分析认知行为干预对患者生活质量和心理状态的影响。方法：本次研究为回顾性调查研究,选取2018年7月~2021年6月期间我院收治的淋巴瘤患者80例,根据病历资料获取患者婚姻状况、疾病分期、工作状况、年龄、治愈时间、文化程度、疾病类型、性别、医疗费用承担情况、家庭人均月收入。采用多因素Logistic回归分析淋巴瘤幸存者FCR的影响因素。将80例淋巴瘤患者分为对照组和干预组,各为40例。对照组给予常规处理,干预组在此基础上接受认知行为干预,对比两组生活质量和心理状态变化。结果：淋巴瘤幸存者FCR总分为（86.90±5.96）分。不同婚姻状况、年龄、疾病分期、家庭人均月收入的患者FCR总分对比差异有统计学意义（P<0.05）。多因素Logistic回归分析显示家庭人均月收入、婚姻状况、疾病分期、年龄是淋巴瘤幸存者FCR的影响因素（P<0.05）。干预后,两组生理职能、躯体疼痛、精神健康、生理功能、总体健康、情感职能、活力、社会功能维度评分均较干预前升高,且干预组高于对照组（P<0.05）。干预组干预后的恐惧疾病进展简化量表（FoP-Q-SF）评分低于对照组（P<0.05）。结论：淋巴瘤幸存者的FCR应得到重视,尤其针对年龄偏低、婚姻状况为离异/未婚/丧偶、家庭人均月收入偏低、疾病分期高的人群,给予认知行为干预后,可提高患者的生活质量和心理状态。     

慢性阻塞性肺疾病急性加重对患者生活质量的影响

目的:探讨慢性阻塞性肺疾病急性加重对患者生活质量的影响。方法:以中国中医科学院广安门医院呼吸科长期慢病管理计划中确诊的慢性阻塞性肺疾病患者为研究对象,记录其在2013年1月至12月间发生的慢性阻塞性肺疾病急性加重事件的情况,并采用面对面访谈式问卷调查方法,在2013年12月对患者进行肺疾病评估测试、焦虑自评量表评分及抑郁自评量表评分,以探讨急性加重发生对患者健康的影响。结果:504例慢性阻塞性肺疾病患者中,过去1年间220例(43.7%)有急性加重发作,其CAT评分、SAS评分、SDS评分均高于未发生急性加重患者,差异均有统计学意义(P0.05)。急性加重发作患者中,66.4%的生活质量均受到中等程度及以上影响,高于无急性加重发生组(52.1%),差异有统计学意义(P0.05)。此外,有急性加重发作的患者合并焦虑和/或抑郁状态的患病率也高于无急性加重发作的患者,差异有统计学意义(P0.05)。结论:慢性阻塞性肺疾病急性加重对患者生活质量、精神状态均可能产生不利影响。     

Postoperative deterioration in health related quality of life as predictor for survival in patients with glioblastoma: a prospective study

Background

Studies indicate that acquired deficits negatively affect patients'' self-reported health related quality of life (HRQOL) and survival, but the impact of HRQOL deterioration after surgery on survival has not been explored.

Objective

Assess if change in HRQOL after surgery is a predictor for survival in patients with glioblastoma.

Methods

Sixty-one patients with glioblastoma were included. The majority of patients (n = 56, 91.8%) were operated using a neuronavigation system which utilizes 3D preoperative MRI and updated intraoperative 3D ultrasound volumes to guide resection. HRQOL was assessed using EuroQol 5D (EQ-5D), a generic instrument. HRQOL data were collected 1–3 days preoperatively and after 6 weeks. The mean change in EQ-5D index was −0.05 (95% CI −0.15–0.05) 6 weeks after surgery (p = 0.285). There were 30 patients (49.2%) reporting deterioration 6 weeks after surgery. In a Cox multivariate survival analysis we evaluated deterioration in HRQOL after surgery together with established risk factors (age, preoperative condition, radiotherapy, temozolomide and extent of resection).

Results

There were significant independent associations between survival and use of temozolomide (HR 0.30, p = 0.019), radiotherapy (HR 0.26, p = 0.030), and deterioration in HRQOL after surgery (HR 2.02, p = 0.045). Inclusion of surgically acquired deficits in the model did not alter the conclusion.

Conclusion

Early deterioration in HRQOL after surgery is independently and markedly associated with impaired survival in patients with glioblastoma. Deterioration in patient reported HRQOL after surgery is a meaningful outcome in surgical neuro-oncology, as the measure reflects both the burden of symptoms and treatment hazards and is linked to overall survival.     

微血管减压术联合感觉根部分切断术对原发性三叉神经痛患者疼痛评分、生活质量及睡眠状况的影响

目的:探讨微血管减压术(MVD)联合感觉根部分切断术(PSR)对原发性三叉神经痛(TN)患者疼痛评分、生活质量及睡眠状况的影响。方法:回顾性分析2015年2月~2019年3月期间我院收治的80例原发性TN患者的临床资料,根据手术方式的不同将患者分为对照组(n=40,MVD治疗)和研究组(n=40,MVD联合PSR治疗),比较两组患者疼痛评分、生活质量、围术期指标、睡眠状况、并发症发生情况以及复发率。结果:两组患者治疗后视觉疼痛模拟量表(VAS)评分均较治疗前下降,且研究组低于对照组(P<0.05)。两组患者治疗后生活质量量表(SF-36)各维度评分均较治疗前升高,且研究组高于对照组(P<0.05)。两组患者治疗后匹兹堡睡眠质量指数表(PSQI)各项目评分均较治疗前升高,且研究组高于对照组(P<0.05)。研究组住院时间短于对照组,手术时间长于对照组(P<0.05);两组术中出血量比较无统计学差异(P>0.05)。研究组的并发症总发生率低于对照组(P<0.05)。两组随访期间复发率比较差异无统计学意义(P>0.05)。结论:MVD联合PSR治疗原发性TN,虽然手术时间较长,但是在减轻患者疼痛、改善患者生活质量及睡眠状况等方面效果显著,能够降低并发症发生率。     

The Association between Alcohol Consumption Patterns and Health-Related Quality of Life in a Nationally Representative Sample of South Korean Adults

This study examined the relationship between alcohol consumption and health-related quality of life (HRQOL) in a nationally representative sample of middle-aged to older South Koreans. Data collected from 3,408 men and 3,361 women aged ≥ 40 years were obtained from the 2010 and 2011 Korea National Health and Nutrition Examination Survey. Based on the World Health Organization guidelines, the participants were categorized into zones I (0–7), II (8–15), III (16–19), or IV (20–40) according to their Alcohol Use Disorders Identification Test (AUDIT) scores, with a higher zone indicating a higher level of alcohol consumption. Data collected from the AUDIT and EuroQol 5-Dimension (EQ-5D) test were subjected to multiple regression analysis in order to examine the relationship between alcohol consumption patterns and health-related quality of life, and to identify intersex and interzone differences. Significant intersex differences were found for the mean total AUDIT and EQ-5D scores and the proportion of participants rating their pain/discomfort and impairment in mobility and usual activities as “moderate” or “severe” (p < 0.001). The analysis of the EQ-5D scores by alcohol consumption pattern and sex suggested the existence of an inverted U-shaped relationship between the total AUDIT and EQ-5D scores. The HRQOL of moderate alcohol drinkers was higher than that of non-drinkers and heavy drinkers. The results of this study will be valuable in designing appropriate interventions to increase the HRQOL impaired by the harmful use of alcohol, in comparing HRQOL among different countries, and in implementing alcohol-related health projects.     

87例系统性硬化症患者健康相关生活质量的评价与分析

目的:采用short-form 36(SF-36)量表评估87例系统性硬化症患者的健康相关生活质量(HRQOL),与健康人群的生活质量进行比较,评价系统性硬化症患者的病情变化情况及预后。方法:在搜集人口学信息及临床信息的基础上,对87例系统性硬化症患者(45例局限型、42例弥漫型)及50例健康对照进行SF-36量表的自评打分;统计学方法计算与比较患者组与对照组的得分情况。结果:SF-36量表的各项计分中,局限型组与弥漫型组在生理机能、生理职能、躯体疼痛、一般健康状况、精力、社会功能、情感职能、精神健康状况等各项得分均低于正常对照组,其中弥漫型组得分更低;健康变化一项得分不具有差异。结论:系统性硬化症患者(局限型、弥漫型)与健康人群比较,生活质量均存在不同程度的下降。这种下降与病情严重程度、生理机能下降情况、躯体疼痛程度、心理状况变化及社会适应能力减退等存在显著关联性。     

康复运动对冠脉支架植入术后患者相关因素的影响

目的：研究心脏康复运动对冠脉支架植入术后患者血脂、血糖、体重指数及生活质量的影响。方法：对实施冠脉支架植入术的 146例患者进行比较分析，根据随机原则分为试验组76 例及对照组70 例。对照组患者给予常规的健康教育及冠心病二级预防指 导，给予定期随访。试验组患者在此基础上给予规律的康复运动指导。经过6 个月随访，比较两组患者血脂、HbA1C、体重指数及 生活质量情况。结果：试验组患者通过为期6 个月的规律的心脏康复运动指导，其血脂、HbA1C等冠心病危险因素控制情况优于 对照组，差异有统计学意义(P<0.05)。同时，6个月后，试验组康复运动六月后sF 量表各项评分与对照组同期比较，差异均有统计 学意义(P<0.05)。结论：规范的心脏康复运动指导能够有效改善冠脉支架植入术后患者血脂、血糖情况，提高患者生活质量。     

Frequency of poor quality of life and predictors of health related quality of life in cirrhosis at a tertiary care hospital Pakistan

ABSTRACT: BACKGROUND: Cirrhosis produces variety of symptoms which eventually lead to a negative impact on Health Related Quality of Life (HRQOL). The general aim of this study was to evaluate the magnitude of poor HRQOL and to assess factors related with HRQOL in patients with CLD in Pakistan. FINDINGS: This was a cross sectional study conducted in gastroenterology outpatient clinics of Aga Khan University Hospital, Karachi on adult patients with cirrhosis. In this study chronic liver disease questionnaire (CLDQ) was used to assess HRQOL of these patients and CLDQ score was used as an outcome measure to determine factors related with HRQOL. 273 participants were recruited in the study; 155 (57%) were males. Mean age of participants was 49 [PLUS-MINUS SIGN] 11 years. The most common cause for cirrhosis was viral infection 247(91.5%). Mean Model for End Stage Liver Disease (MELD) score was 12.6 [PLUS-MINUS SIGN] 6.8 and 2/3 of patients 209 (76.6%) had advanced cirrhosis in Child Turcot Pugh (CTP) B or C stage. Poor HRQOL was seen in 187(69%; 95% C.I.: 63%, 74%) of the participants. Mean CLDQ score was 4.36 [PLUS-MINUS SIGN]1.1. Amongst all of the domains, fatigue domain had lower CLDQ score. Hemoglobin (beta = 0.09 [SE = 0.04]), Albumin (beta = 0.32[SE = 0.09]), Diastolic Blood Pressure (DBP) (beta = 0.01[0.005) prior history of decompensation (beta = 0.98[SE = 0.39] were significant factors associated with HRQOL in patients with liver cirrhosis. CONCLUSION: Frequency of poor health related quality of life determined by CLDQ score is high in patients with liver cirrhosis. Hemoglobin, serum albumen, prior history of decompensation (like encephalopathy and upper gastro intestinal bleed), are associated with health related quality of life.     

Quality of Life Outcomes of Antiretroviral Treatment for HIV/AIDS Patients in Vietnam

Objective

This study assessed health-related quality of life (HRQOL) and its related factors in HIV/AIDS patients taking antiretroviral treatment (ART) in Vietnam.

Methods

A cross-sectional study was conducted with 1016 patients (36.2% women, mean age = 35.4) in three epicenters of Vietnam, including Hanoi, Hai Phong, and Ho Chi Minh City. HRQOL was assessed using the Vietnamese version of the WHOQOL-HIV BREF. Factor analysis classified measure items into six HRQOL dimensions, namely Physical, Morbidity, Social, Spirituality, Performance, and Environment. Tobit censored regression models were applied to determine associations of patient’s characteristics and HRQOL domain scores.

Results

Internal consistency reliability of the six domains ranged from 0.69 to 0.89. The WHOQOL-HIV BREF had a good discriminative validity with patient’s disease stages, CD4 cell counts, and duration of ART. In a band score of (4, 20), six domains were moderate; “Environment” had the highest score (13.8±2.8), and “Social” had the lowest score (11.2±3.3). Worse HRQOL were observed in patients at provincial and district clinics. Those patients who were male, had higher educational attainment, and are employed, reported better HRQOL. In reduced regression models, poorer HRQOL was found in patients who had advanced HIV infection and had CD4 cell count <200 cells/mL. Patients reported significantly poorer Physical and Social in the 1^st year ART, but moderately better Performance, Morbidity, Spirituality, and Environment from the 2^nd year ART, compared to those not-yet-on ART.

Conclusion

Strengthening the quality of ART services at the provincial and district levels, gender-specific impact mitigation, and early treatment supports are recommended for further expansion of ART services in Vietnam. Regular assessments of HRQOL may provide important indicators for monitoring and evaluating HIV/AIDS services.