精神病患者家属心理健康状况调查研究

目的:探讨精神病患者家属的心理健康状况,并找出相关的影响因素.方法:对中山市91位住院以及门诊精神科病人家属进行问卷调查和访谈,采用的是症状自评量(SCL-90)和家庭疾病负担量表(Family Burden Scale of Disease).结果:家属心理健康状况与患者给家庭带来的负担存在明显的相关,患者患病对配偶的心理健康的影响明显大于对其他亲人或者朋友的影响(F=5.358,P＜0.001),15-30岁年龄段的SCL-90的得分要明显的高于其他年龄段(F=1.436,P＜0.01),而精神分裂症患者的家属SCL-90的得分也要明显高于其他疾病家属的得分.结论:影响家属心理健康的因素有多个方面,应该有针对性的采取家庭护理措施并加强家庭健康教育.     

肝癌术后患者心理弹性水平调查及与生存质量、应对方式和创伤后成长的相关性分析

摘要 目的：调查肝癌术后患者心理弹性水平现状,并探讨其与生存质量、应对方式和创伤后成长的相关性。方法：选取2018年11月-2021年3月我院收治的120例原发性肝癌术后住院患者,采用中文版Conner-Davidson心理弹性量表（CD-RICS）对患者心理弹性水平进行调查,另分别采用肝癌患者生活质量测定量表（QOL-LC）、医学应对方式问卷（MCMQ）、创伤后成长评定量表（PTGI）对患者进行问卷调查。采用Spearman法分析原发性肝癌术后患者心理弹性水平与生存质量、应对方式和创伤后成长的相关性。结果：肝癌术后患者心理弹性总分、乐观、自强、坚韧各维度评分均明显低于中国常模得分（P<0.05）;肝癌术后患者各生存质量维度评分均明显低于中国常模得分（P<0.05）;肝癌术后患者面对应对方式得分较中国常模得分低,回避和屈服应对方式得分较中国常模得分高（P<0.05）;肝癌术后患者创伤后成长总分、各维度评分均明显低于中国常模得分（P<0.05）。肝癌术后患者心理弹性总分与各生存质量维度得分呈正相关（P<0.05）。肝癌术后患者心理弹性总分与回避、屈服应对方式呈负相关,与面对应对方式得分呈正相关（P<0.05）。肝癌术后患者心理弹性总分与创伤后成长总分、各维度得分均呈正相关（P<0.05）。结论：肝癌术后患者具有较低的心理弹性水平,心理弹性水平与积极应对方式、生存质量和创伤后成长呈正相关,应采取针对性措施提高肝癌术后患者心理弹性水平,促进患者术后康复。     

长沙市护士工作压力与生活质量的相关性研究

目的:调查湖南省长沙市护士工作压力与生活质量现状,探讨护士工作压力与生活质量的相关性.方法:运用李小妹修订的护士工作压力源量表和世界卫生组织的生存质量评定量表(WHOQOL-BREF),分别采取分层-随机和整群-随机抽样法对长沙市5个城区中三级、二级、一级医院各1所及社区卫生服务站10所的600名护士进行问卷调查.结果:护士工作压力总均分为(11.51±1.99)分,各维度中得分最高的是护理专业及工作方面(2.58±0.56)分,得分最低的是管理及人际关系方面(1.86±0.42)分;护士生活质量总得分为(273.31±43.52)分,各维度中得分最高的是社会领域(65.17±13.34)分,得分最低的是环境领域(44.70±14.24)分;护士工作压力各维度与生活质量各维度之间大多呈负相关.结论:长沙市护士整体工作压力处于中度水平,护士生活质量不容乐观.     

糖尿病患者睡眠质量与心理健康的相关性研究

目的:探讨糖尿病患者睡眠质量与其心理健康状况的关系.方法:应用匹兹堡睡眠质量指数量表(PSQI)和症状自评量(SCL-90)对唐山市200名糖尿病患者进行问卷调查.结果:(1)不同睡眠质量的糖尿病患者在健康状况的各因子得分和总分均有非常显著差异(P＜0.001).(2)除了睡眠质量和睡眠效率,糖尿病患者睡眠质量各成分得分及总分与健康状况各子量表得分和总分绝大多数呈显著的正相关(P＜0.01).结论:糖尿病患者的睡眠质量对其健康状况有显著影响,睡眠质量越差,其健康水平越低.提高糖尿病患者的睡眠质量有助于改善他们健康状况.     

长沙地区县级医院中年慢性病患者健康商数及其影响因素的研究

目的:探讨长沙地区县级医院中年慢性病患者健康商数指数及其影响因素,帮助中年人群提升健康自我管理能力.方法:采用随机抽样的方法对长沙地区4所县级医院的808名中年慢性疾病患者进行一般情况和健商问卷调查,所有资料均采用SPSS13.0统计软件进行分析.结果:(1)健康商数状况调查结果中各维度得分均较低,在相应临界值水平左右,其中自我保健、生活方式、精神状态维度未低于相应,临界值,精神状态维度得分相对较高,为24.73±5.49;健康知识维度的得分较低,为21.47±5.89,甚至低于安全健康商数维度的临界值.(2)不同年龄段、不同家庭住址、不同文化程度、不同体检频度患者在健康商数四个维度的得分均具有统计学意义(P<0.05);不同体质指数的患者在健康知识和精神状态维度的得分有统计学意义(P<0.05).结论:(1)长沙地区县级医院中年慢性病患者健康商数状况总体不容乐观,尤其是健康知识维度较为薄弱,提示此类患者应成为护理工作针对性健康教育的重点对象,而健康知识普及应成为健康教育的重点内容.(2)年龄段、家庭住址、文化程度和体检频度是住院中年慢性病患者健康商数的重要影响因素,据此可为护理工作中开展个体化的干预策略提供参考依据.     

强化降糖治疗对2型糖尿病患者生存质量及血糖的影响研究

目的:探讨强化降糖治疗对2型糖尿病(T2DM)患者生存质量及血糖的影响.方法:将120例T2DM患者随机分为观察组和对照组.对照组按照<中国糖尿病防治指南>给予标准降糖治疗,治疗组给予强化降糖治疗.两组患者在治疗前和随访3年后分别进行生存质量评价和血糖指标测查.结果:治疗后,治疗组生存质量各维度评分及总分与治疗前和对照组比较显著下降(P＜0.05),对照组治疗前后生存质量各维度评分及总分差异无统计学意义(P＞0.05);两组治疗后血糖水平均明显降低,与治疗前比较有显著性差异(P＜0.05),且治疗组与对照组比较显著降低(P＜0.05).结论:采用强化降糖治疗,可以达到血糖的理想控制,提高患者的生存质量.     

癌症病人护理者医院生物生存状态分析

调查住院癌症病人护理者医院生物生存状态,并对其影响因素进行研究.采用癌症病人护理者医院生物生存状态调查表和病人日常生活能力量表进行问卷调查.结果可见,护理工作使癌症病人护理者医院生物生存状态各维度得分及总分受到了不同程度的影响;作为配偶及父母的护理者生物生存状态较差,病人日常活动能力越差者,护理者的生物生存状态越差,有工作的护理者生物生存状态较高.改善护理者生物生存状态的措施应当针对减轻护理的客观工作量以及向护理者提供更多的信息和应对策略.     

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。     

冠状动脉支架植入患者心理弹性状况调查及与生活质量的关系研究

目的:调查冠状动脉支架植入(ICS)患者心理弹性状况,并分析心理弹性与生活质量的关系。方法:选取2019年3月~2021年4月我院收治的ICS患者120例作为观察组,另选取同期来我院进行健康体检的志愿者80例作为对照组,对比两组患者的生活质量评分,以心理弹性量表(CD-RICS)调查ICS患者的心理弹性状况,采用Pearson相关分析ICS患者生活质量与心理弹性的相关性,采用Logistic回归分析ICS患者心理弹性水平的影响因素。结果:观察组36条目健康调查简表(SF-36)各维度评分及总评分均低于对照组(P<0.05)。120例ICS患者的心理弹性总分为(64.41±5.73)分,心理弹性各维度得分由低到高分别为乐观、力量、坚韧。Pearson相关分析结果表明,ICS患者的生活质量平均分与心理弹性总分呈正相关(P<0.05)。冠心病病程、文化程度、家庭月收入、兴趣爱好数量、居住地对ICS患者的心理弹性得分有影响(P<0.05)。冠心病患病时间≥10年、文化程度为初中及其以下、家庭月收入≤3000元、兴趣爱好为1~2个、居住地为农村是ICS患者心理弹性水平的影响因素(P<0.05)。结论:ICS患者的心理弹性水平一般,且可影响患者生活质量,受到冠心病病程时长、文化程度、家庭收入水平、兴趣爱好、居住地等多种因素影响,应制定合理措施来提高ICS患者的心理弹性,促进患者身心健康。     

授权教育辅助奥瑞姆自理模式对治疗UC有着积极的辅助作用

为探讨授权教育联合奥瑞姆自理模式对溃疡性结肠炎患者自我效能及生活质量的影响,本研究选取116例溃疡性结肠炎患者,采用随机数表法分为研究组和对照组各58例。研究组患者采取授权教育联合奥瑞姆自理模式对患者进行干预指导,对照组仅采取常规的健康教育进行干预;对比两组干预前后的自我效能、生存质量评分差异。研究结果显示,干预前研究组和对照组的自我效能总分、压力和情绪管理、医疗护理管理维度、病症管理维度、缓解期的维持管理维度评分差异均无统计学意义(p0.05),干预后,研究组的自我效能总分、压力和情绪管理、医疗护理管理维度、病症管理维度、缓解期的维持管理维度评分均高于对照组(p0.05);干预前,研究组和对照组的一般健康状况、机体疼痛、心理健康、躯体功能、躯体角色、情感角色、社会功能、活力及总均分差异均无统计学意义(p0.05),干预后,研究组的一般健康状况、机体疼痛、心理健康、躯体功能、躯体角色、情感角色、社会功能、活力及总均分均显著高于对照组(p0.05);干预前,研究组和对照组的用药依从性评分差异均未达到显著水平(p0.05),干预后,研究组的用药依从性评分显著高于对照组(p0.05)。本研究表明,授权教育联合奥瑞姆自理模式对溃疡性结肠炎患者自我效能及生活质量具有显著的改善作用。     

The Croatian Health Survey--SF-36: I. General quality of life assessment

The objective of the Croatian Health Survey was the assessment of population health related quality of life in the transitional environment of Croatia. Health status measures incorporate dimensions such as physical, psychological, and social functioning, role performance and perception of wellbeing. In order to assess health status, "The medical outcome study 36-item short-form health survey (SF-36) model" was used. A total sample of 5048 inhabitants (1983 males and 3065 females), 18 years and over, represents approximately 1% of the general population of Croatia. Mean scores were as follows: physical functioning (PF) 69.94, role-physical (RP) 63.01, bodily pain (BP) 64.51, general health (GH) 53.40, vitality (VT) 51.85, social functioning (SF) 72.96, role-emotional (RE) 72.42, mental health (MH) 61.71 and health transition (HT) 44.79. Results of the SF-36 health survey in Croatia are very much like the results in other European countries with indication that general quality of life is lower in Croatia.     

Influence of Self-Reported Chronic Rhinosinusitis on Health-Related Quality of Life: A Population-Based Survey

Chronic rhinosinusitis (CRS) is a frequently occurring chronic respiratory disease. There is evidence that effective treatment of CRS can improve patients’ quality of life, but the data regarding the extent to which CRS impairs patients’ quality of life (QoL) is sparse. This study aimed to evaluate the effect of self-reported CRS on health-related QoL and to determine whether the influence was associated with gender, age and socio-economic status. A four-stage random sampling method was used to select the participants from the general population in Guangzhou, China. All participants were interviewed face-to-face at their homes using a standardized questionnaire. The health-related QoL of each participant was assessed using the SF-36 Health Survey. The scores of the SF-36 after adjusting for gender, age, socioeconomic conditions, smoking and some important comorbid conditions were compared between the CRS group and the non-CRS group using analysis of covariance. A multiple linear regression model with interaction terms was established to determine whether CRS affected QoL to the same degree across the different subpopulations. Among a total of 1,411 participants aged at least 15 years, 118 persons (8.4%) had self-reported CRS. Subjects with CRS had an increased prevalence of allergic rhinitis, chronic obstructive pulmonary disease and gout than subjects without CRS. The CRS group had lower scores in all eight domains and the physical and mental component summary than those without CRS (P<0.05), and the greatest differences were in role emotional function (RE), general health (GH) and role physical function (RP). The impairments of the CRS participants in RE and RP were greater among the females than the males. Moreover, physical domains were affected to greater degrees among the elderly and those with high-level education. In conclusion, CRS is a common chronic disorder. Persons with self-reported CRS perceived themselves as having impaired QoL in both the physical and mental domains. These findings shed new light on the health burden of CRS and should be taken into account by clinicians involved in the care of CRS patients.     

直肠癌切除术患者永久性与临时性造口术后生活质量变化及其与排便症状的相关性研究

摘要 目的：探讨直肠癌切除术患者永久性与临时性造口术后生活质量变化,并分析其生活质量与排便症状的相关性。方法：纳入我院2017年4月～2020年4月收治的直肠癌切除术患者110例,所有纳入者均行造口术。根据造口方式,分成永久性造口组（简称永久组,n=41）、临时性造口组（简称临时组,n=69）。记录两组造口并发症发生率,分别在患者术后1、3、6个月,采用简明生活质量量表（SF-36）评估其生活质量,采用排便症状量表评估患者排便症状的变化。经Pearson线性相关分析患者生活质量评分与排便症状评分的相关性。结果：临时组造口并发症发生率（8.90%）与永久组（12.20%）比较无差异（P＞0.05）。两组术后3、6个月SF-36各维度评分均高于术后1个月,术后6个月各评分高于术后3个月,且临时组术后3个月SF-36各维度评分高于永久组（P＜0.05）,但两组术后6个月各评分比较无差异（P＞0.05）。两组术后3、6个月大便症状各评分均低于术后1个月,术后6个月的排便急迫感、排便费力、里急后重评分及总分低于术后3个月,且临时组术后3个月的排便急迫感、排便费力、里急后重评分及总分低于永久组（P＜0.05）,但两组术后6个月排便症状各评分比较未见差异（P＞0.05）。Pearson线性相关分析显示,排便症状总分与机体疼痛、躯体功能、躯体角色受限、情感角色受限、心理健康、社会功能、总体健康评分呈负相关（P＜0.05）。结论：直肠癌切除术患者临时性造口能够进一步促进术后3个月生活质量、排便功能的改善,在术后6个月,永久性造口患者的生活质量、排便功能基本达到临时性造口患者的状态,且排便功能与生活质量具有相关性。     

Doctors and patients don't agree: cross sectional study of patients' and doctors' perceptions and assessments of disability in multiple sclerosis.

OBJECTIVES: To compare the judgments of clinicians on which domains of health in the short form questionnaire (SF-36) would be most important to patients with multiple sclerosis with the opinions of patients themselves; to compare assessment of physical disability in multiple sclerosis by a clinician using Kurtzke''s expanded disability status scale and a non-clinically qualified assistant using the Office of Population Census and Surveys'' (OPCS) disability scale with self assessment of disability and other domains of health related quality of life by patients using the SF-36 and the EuroQol questionnaire; and to compare the scores of patients for each domain of the SF-36 with control data matched for age and sex. DESIGN: Cross sectional study. SETTING: Clinical department of neurology, Edinburgh. SUBJECTS: 42 consecutive patients with multiple sclerosis attending a neurology outpatient clinic for review or a neurology ward for rehabilitation. MAIN OUTCOME MEASURES: Scores on the SF-36; EuroQol; Kurtzke''s expanded disability status scale; the OPCS disability scale. RESULTS: Patients and clinicians disagreed on which domains of health status were most important (chi 2 = 21, df = 7, P = 0.003). Patients'' assessment of their physical disability using the physical functioning domain of the SF-36 was highly correlated with the clinicians'' assessment (r = -0.87, P < 0.001) and the non-clinical assessment (r = -0.90, P < 0.001). However, none of the measures of physical disability correlated with overall health related quality of life measured with EuroQol, Quality of life correlated with vitality, general health, and mental health in the SF-36, each of which patients rated as more important than clinicians and for each of which patients scored lower than the controls. CONCLUSIONS: Patients with multiple sclerosis and possibly those with other chronic diseases are less concerned than their clinicians about physical disability in their illness. Clinical trials in multiple sclerosis should assess the effect of treatment on the other elements of health status that patients consider important, which are also affected by the disease process, are more closely related to overall health related quality of life, and may well be adversely affected by side effects of treatment.     

Differences in Quality of Life,Anxiety and Depression in Patients with Paroxysmal Atrial Fibrillation and Common Forms of Atrioventricular Reentry Supraventricular Tachycardias

Introduction

The aim of this study was to evaluate the differences in quality of life and psychosocial stress parameters among patients with paroxysmal atrial fibrillation (AF) and common forms of atrioventricular reentry supraventricular tachycardias (SVTs).

Methods and Results

The total study population included 106 patients, 54 patients with paroxysmal AF (32 males, age 56.64±12.50 years) and 52 with SVTs (25 males, age 40.46±14.96 years). General health (p<0.01), physical function (p=0.004), role emotion (p=0.002) and role physical (p<0.01) scores were lower in patients who suffered AF. SF-36 physical and mental health summary measures were also significantly lower in the AF group compared to those in SVT group (p<0.01 and p=0.001, respectively). Lower SF-36 total score was observed in patients with AF compared to those with SVTs (p<0.01). Comparing the anxiety and depression scores all the values were higher in patients with AF. Higher STAI-state scores (p<0.01), STAI-trait scores (p=0.039) and BDI scores (p=0.077) were seen in patients who suffered AF comparing to those with SVTs.

Conclusions

Quality of life is significantly impaired and the level of anxiety is significantly higher in patients with AF comparing to those with common forms of SVTs.     

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。     

肺癌患者心理弹性的影响因素及与社会支持和生活质量的关系研究

摘要 目的：探讨肺癌患者心理弹性的影响因素,分析肺癌患者心理弹性与社会支持和生活质量的关系。方法：选取2018年6月至2019年12月期间我院收治的173例肺癌患者（肺癌组）和同期于我院进行体检的116例健康者（对照组）,分别采用心理弹性量表（CD-RISC）、社会支持评定量表（SSRS）、健康状况调查简表（SF-36）评估所有受试者心理弹性、社会支持、生活质量。收集患者临床资料,分析肺癌患者心理弹性的影响因素。相关性分析采用Pearson检验。结果：肺癌组CD-RISC、SSRS、SF-36评分均低于对照组（P＜0.05）。不同年龄、性别、教育程度、性格特征、SSRS评分、治疗阶段、复发情况、转移情况患者之间CD-RISC评分比较差异显著（P＜0.05）。多重线性回归分析结果显示性别、教育程度、性格特征、SSRS评分、治疗阶段、复发、转移均为肺癌患者心理弹性的影响因素（P＜0.05）。Pearson相关分析结果显示肺癌患者CD-RISC评分与SSRS、SF-36评分均呈正相关（r=0.567、0.617,P=0.047、0.346）。结论：肺癌患者心理弹性较正常人降低,性别、教育程度、性格特征、SSRS评分、治疗阶段、复发、转移是影响肺癌患者心理弹性的主要因素。肺癌患者心理弹性与社会支持、生活质量均有关。     

Social life factors affecting the mortality, longevity, and birth rate of total Japanese population: effects of rapid industrialization and urbanization

To expand upon the findings that lower mortality was found in Japanese urban areas in contrast to the Western model where in the US and Britain the risk of death was higher in metropolitan areas and conurbations, 22 social life indicators are examined among 46 prefectures in Japan in terms of their effect on age specific mortality, life expectancy, and age adjusted marriage, divorce, and birth rates. The effects of these factors on age adjusted mortality for 8 major working and nonworking male populations, where also analyzed. The 22 social life factors were selected from among 227 indicators in the system of Statistical Indicators on Life. Factor analysis was used to classify the indicators into 8 groups of factors for 1970 and 7 for 1975. Factors 1-3 for both years were rural or urban residence, low income and unemployment, and prefectural age distribution. The 4th for 1970 was home help for the elderly and for 1975, social mobility. The social life indicators were classified form 1 to 8 as rural residence in 1970 and 1975, urban residence, low income, high employment, old age, young age, social mobility, and home help for the elderly which moved from 8th place in 1970 to 1st in 1975. Between 1960-75, rapid urbanization took place with the proportion of farmers, fishermen, and workers declining from 43% in 1960 to 19% in 1975. The results of stepwise regression analysis indicate a positive relationship of urban residence with mortality of men and women except school-aged and middle-aged women, and the working populations, as well as life expectancy at birth for males and females and ages 20 and 40 years for males. Rural residence was positively associated with the male marriage rate, whereas the marriage rate for females was affected by industrialization and urbanization. High employment and social mobility were positively related to the female marriage rate. Low income was positively related to the divorce rate for males and females. Rural residence and high employment were positively related to the birth rate. The birth rate is higher in rural areas. Mortality of professional, engineering, and administrative workers was slightly lower than the total working population, while sales workers, those in farming, fishing, and forestry, and in personal and domestic service had significantly higher mortality. The mortality of the nonworking population was 6-8 times higher than sales, transportation, and communication, and personal and domestic service as well as the total population.     

中国汉族乡村成年人的身高与体质量的地理性分布

目前尚未见大样本的中国乡村汉族人随纬度、经度增长,身高、体质量值的变化规律的报道。为此,2009～2013年测量了16501例汉族人(共36个调查地区)乡村成人的身高、体质量等13项指标值,并计算了3项指数。研究不同纬度、经度地区汉族乡村成人的身高、体质量值变化规律以及这种规律形成的原因。研究发现,汉族人的身高、体质量与纬度、经度均呈正相关。随纬度增加,男性和女性的躯干、下肢的高度值均增大是身高与纬度呈正相关的原因。随纬度增加,男性身高的增加、躯干的增粗共同促进体质量与纬度呈正相关,女性身高、躯干围度、四肢围度、背部皮下脂肪厚度值的增大是体质量与纬度呈正相关的原因。男性随经度增加,身高增大,躯干部的增粗是导致体质量与经度相关的原因。而四肢和躯干的皮下脂肪、四肢的围度并不随经度的增加而线性增大。随经度增加,女性的身高、臀围呈线性增大,这是导致女性体质量与经度相关的主要原因。遗传、环境、经济发展水平的差异是导致身高、体质量与纬度、经度呈正相关的因素。