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。     

Impact of Weight Loss and Regain on Quality of Life: Mirror Image or Differential Effect?

Objective: To compare the impact of weight regain and weight loss on health‐related quality of life. Research Methods and Procedures: Subjects were 122 (106 women, 16 men) overweight and obese participants in a weight reduction program (phentermine‐fenfluramine and dietary counseling) who had initially lost at least 5% of their total body weight and then regained at least 5% of their weight during the follow‐up period. Follow‐up periods ranged from 10 to 41 months (mean, 28 months). Participants completed the Impact of Weight on Quality of Life‐Lite, an obesity‐specific health‐related quality of life (HRQOL) measure, at 3‐month intervals. Results: Mean BMI at baseline was 40.9 ± 6.6 kg/m² (range, 29.2 to 63.7 kg/m²). Average weight loss from entry was 18.8 ± 6.7% (range, 6.0% to 43.7%), and average regain was 10.1 ±4.4% of baseline weight (range, 5.0% to 30.6%). The effects of weight regain on HRQOL mirrored the effects of weight loss—rates of HRQOL change were similar in magnitude but different in direction for comparable weight loss and regain. Those with more severe initial impairments in HRQOL experienced greater improvements in HRQOL during weight loss as well as greater deterioration during weight regain than those with less severe impairments. Discussion: Weight loss and regain produced mirror image changes in HRQOL. The initial severity of HRQOL impairment had a greater impact on the magnitude of HRQOL change than the direction of weight change. Findings underscore the importance of maintaining weight loss for the purposes of retaining obesity‐specific HRQOL benefits.     

Self-reported dry mouth in Swedish population samples aged 50, 65 and 75 years

doi: 10.1111/j.1741‐2358.2010.00420.x Self‐reported dry mouth in Swedish population samples aged 50, 65 and 75 years Background: Reduced salivary flow may have a negative impact on general well‐being, quality of life and oral health. Objectives: To examine xerostomia in 50‐, 65‐ and 75‐year‐olds, background factors and effect on Oral Impacts on Daily Performances (OIDP). Methods: In 1992, a questionnaire was sent to all 50‐year‐old persons (n = 8888) in two Swedish counties. In 2007, the same questionnaire was sent to all 65‐year‐olds (n = 8313) in the two counties and to all 75‐year‐olds (n = 5195). Response rate was for the 50, 65 and 75 year olds 71.4, 73.1 and 71.9%, respectively. Results: Xerostomia was higher in women than in men in all age groups. There was higher prevalence of xerostomia with increasing age in both sexes and it was more frequent at night than during daytime. ‘Often mouth dryness’ was 2.6–3.4 times more prevalent in those who reported an impact from OIDP. The highest odd ratios were for daytime xerostomia and for the variables burning mouth (17.1), not feeling healthy (4.5), daily smoking (4.4), and medication (4.1). Conclusions: The dramatic increase of xerostomia between age 50 and 75, especially amongst women, needs to be considered in the management of this age group.     

Oral health-related quality of life: a critical appraisal of assessment tools used in elderly people

Objective: The purpose of this study was to undertake a critical appraisal of oral health‐related quality of life (OHRQoL) measurements used for research in the elderly. Background: A variety of OHRQoL measurements have been developed in the past 20 years as a result of increased concern about the impact of oral conditions on a person’s quality of life. There is need for an assessment aimed at prioritising the recommended measurements to be used for different purposes in the elderly. Materials and methods: Original English language papers using measurements to assess OHRQoL in the elderly were identified from Web of Science, EMBASE, PubMed, Medline and Lilacs databases. The search included all papers published from 1985 to February 2007. The criteria of assessment were: (i) measurement criteria (number of items and domains, and classification of the results found for each measurement); (ii) quantitative–qualitative criteria (frequency, acceptability, reproducibility, reliability, sensitivity and capability of being reproduced in other language versions). Results: In a total of 152 papers selected, 20 measurements were identified. However, only seven fulfilled all the measurement and quantitative–qualitative criteria. Conclusion: Geriatric Oral Health Assessment Index, Subjective Oral Health Status Indicators, Oral Health Impact Profile‐49, Dental Impact on Daily Living, Oral Health Impact Profile‐14, Oral Impact on Daily Performances and German Version of the Oral Heath Impact Profile were considered as instruments of choice to assess OHRQoL in the elderly. The other 13 instruments identified require further research aimed at a validation process and the use of a language other than English.     

Oral health‐related quality of life in hospitalised stroke patients

doi:10.1111/j.1741‐2358.2009.00330.x
Oral health‐related quality of life in hospitalised stroke patients Objective: The aim of this study was to test the hypothesis that impairment of orofacial function following stroke affects the patients’ oral health‐related quality of life (OHRQoL). Material and methods: From the University Hospitals of Geneva, 31 stroke patients (18 men, 13 women, mean age 69.0 ± 12.7 years) with unilateral facial and limb palsy were recruited (patient group, PG). In the study, the Oral Health Impact Profile (OHIP)‐EDENT was utilised to assess OHRQoL. Further examinations comprised a test of masticatory efficiency and lip force, stroke severity National Institute of Health Stroke Scale and dental state. The control group (CG) consisted of 24 subjects with similar age, gender and dental state. Results: The PG mean OHIP‐EDENT sum score was 18.8 ± 15.5 and proved higher than one of the CG, indicating a lower OHRQoL in the PG (p < 0.01). The score of the sub‐domains ‘functional limitation’ and ‘physical pain’ were significantly higher in PG (p < 0.03 and p < 0.02, respectively). The masticatory efficiency was significantly lower in the PG (p < 0.0001) and was associated with the OHIP‐EDENT sum score and its sub‐domains, except for ‘physical disability’. This effect was not present in the CG. Conclusion: The OHRQoL is significantly reduced in hospitalised stroke patients whereby functional impairment seems predominant when compared with psychological and psycho‐social aspects.     

A cross-sectional analysis of the prevalence of dental anxiety and its relation to the oral health-related quality of life in patients with dental treatment needs at a university clinic in Switzerland

doi: 10.1111/j.1741‐2358.2011.00465.x A cross‐sectional analysis of the prevalence of dental anxiety and its relation to the oral health‐related quality of life in patients with dental treatment needs at a university clinic in Switzerland Objectives: The aim of this observational, cross‐sectional study was to analyse the relationship between dental anxiety (DA) and health‐related quality of life aspects associated with oral conditions of a population with dental treatment needs in Switzerland. Methods: The measurements of DA were collected by means of two questionnaires, the Dental Anxiety Scale (DAS) and a Visual Analogue Scale (VAS). Oral health‐related quality of life (OHRQoL) was assessed with the Oral Health Impact Profile (OHIP). The sample included 223 patients enrolled at a university clinic which specialises in oral prosthetic rehabilitation and temporomandibular disorders. Of them, 78.9% were at or above the age of 50. Results: No gender or age dependencies were observed. A comparison of answers regarding OHRQoL and DA revealed a significant interdependence (p = 0.0118); highly anxious patients were 3.55 times more likely to suffer from poor quality of life compared with less anxious ones. Conclusion: This cross‐sectional study of mostly elderly patients seeking dental treatment in Switzerland found that increased DA was associated with an impaired OHRQoL. The average DA was slightly higher than the results of other industrialised countries and the average OHRQoL was reduced.     

Perceived sleep quality among edentulous elders

doi: 10.1111/j.1741‐2358.2010.00426.x Perceived sleep quality among edentulous elders Background: Anatomical changes associated with edentulism are thought to disturb seniors’ sleep. Objectives: (1) To determine sleep quality and daytime sleepiness of edentulous elders. (2) To examine the association between oral health‐related quality of life and sleep quality. Methods: Data were collected at a 1‐year follow‐up from 173 healthy edentulous elders who had participated in a randomised controlled trial and randomly received two types of mandibular prosthesis. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI, range 0–21), with higher scores indicating poorer sleep quality. The Epworth Sleepiness Scale (ESS) was used to measure the level of perceived daytime sleepiness, and scores ≥10 indicated sleepiness. Results: The mean global PSQI and ESS scores were 4.7 ± 3.5 and 5.3 ± 3.9. There were no differences in sleep quality or sleepiness between those who wore their dentures at night and those who did not. Elders with frequent denture problems were sleepier during the day than those with fewer problems (p = 0.0034). General health (p = 0.02) and oral health‐related quality of life (p = 0.001) are significant predictors of sleep quality. Conclusion: Healthy edentulous elders, independent of nocturnal wearing of their prosthesis, are good sleepers. Maintaining high oral health quality of life could contribute to better sleep.     

Construct Validity of the Impact of Weight on Quality of Life Questionnaire

KOLOTKIN, RONETTE L, SUSAN HEAD, ALAN BROOKHART. Construct validity of the Impact of Weight on Quality of Life questionnaire. The Impact of Weight on Quality of Life questionnaire (IWQOL) is a 74-item self-report, condition-specific instrument that (1) assesses the effect of weight on quality of life in eight key areas, and (2) may be used as a treatment outcome measure and/or an evaluation tool for healthcare policy makers and third-party payers. This study explores IWQOL construct validity and provides new information on internal consistency, treatment effects, and differences between men and women. IWQOL total scores correlated highly with other measures of overall quality of life, and subscale scores correlated well with counterparts in the assessment battery. Internal consistency estimates for the IWQOL scales generally were high. For the women, 4-week participants, and the total sample, pretreatment-posttreatment differences were significant for all IWQOL scales and total score. For men, treatment differences were significant for the total score and all subscales except for Work and Mobility. Treatment differences for 2-week participants were significant for all scales except for Work. Consistent with previous IWQOL study results, the Comfort With Food scale scores reflected more discomfort at posttreatment as compared with pretreatment. The IWQOL, already translated into French and Italian, currently is demonstrating clinical and research utility as a quality-of-life outcome measure for clinical trials of antiobesity drugs and surgical treatments for patients with obesity.     

Arabic version of the Geriatric Oral Health Assessment Index

Objectives: The purpose of this study was to translate the original English version of the Geriatric Oral Health Assessment Index (GOHAI) into an Arabic version, and to test the validity and reliability of the translated instrument (GOHAI‐Ar) for use among the elderly in Saudi Arabia. Methods: The 12‐item GOHAI was translated into Arabic using the back‐translation technique and performing a preliminary test to determine the comprehensibility and readability of the Arabic language version. A total of 156 elderly patients answered the questionnaire, and underwent a clinical examination by one calibrated dentist. Information on subjects’ socio‐demographic background and oral health conditions was collected. Convergent validity was evaluated by identifying the associations between perceived oral health status, general health status, perceived need for dental care and GOHAI‐Ar scores. Discriminant validity was examined by comparing the GOHAI‐Ar scores and six oral health parameters. Internal consistency was measured by Cronbach’s alpha. Test–retest reliability was assessed by intra‐class correlation coefficient (ICC) and weighted kappa. Factor structure of GOHAI‐Ar was evaluated using principal component factor analysis. Results: The mean GOHAI‐Ar was 32.1 (SD 12.2; range 11–59). Mean GOHAI‐Ar scores were higher for the elderly who rated their oral and general health as good. Subjects with perceived dental treatment needs had a lower mean GOHAI‐Ar score than those without any such needs. The caries experience, number of missing teeth, OHI‐S score, number of pathologically mobile teeth and number of oral lesions were negatively correlated with the GOHAI‐Ar score. The Cronbach’s alpha (0.93) indicated a high degree of internal consistency and homogeneity between items. The ICC for GOHAI‐Ar was 0.95, the weighted kappa coefficient for individual items varied between 0.42 and 0.71, and the correlation coefficients for the 12 items were above 0.70. Factor analysis didn’t support the expected dimensions of the index, and only one factor was found at eigenvalue greater than 1. Conclusions: The findings suggest an excellent reliability and validity of GOHAI‐Ar. Further research is needed to assess the value of this instrument in oral health‐related quality of life studies in Arabic elderly population.     

Health-related quality of life in patients with primary Sjögren's syndrome and xerostomia: a comparative study

Objective: To compare the health status of groups of Primary Sjögren's and Xerostomia patients, using the Medical Outcomes Short Form 36 (SF‐36). The SF‐36 is a generic measure, divided into eight domains, used in the assessment of health‐related quality of life. Patients and methods : The SF‐36 was given to 2 groups: Group 1 comprised 43 patients diagnosed with Primary Sjögren's Syndrome (1SS) and an unstimulated whole salivary flow rate (UFR) of <0.1 ml/min). Group 2 (n = 40) reported Xerosiomia but had an UFR >0.2 ml/min. Sub groups of patients in Groups 1 and 2 were compared with community normative data, for the SF‐36 Results: There were trends to suggest lower SF36 scores for 1SS patients but there were no significant differences between the mean domain scores of Groups 1 and 2. 1SS and Xerostomia patients registered lower mean scores across all 8 domains, compared with normative community data. Conclusion: The SF‐36 was unable to detect significant differences between subjects with 1SS and Xerostomia but a larger sample size is required to confirm these findings. The results of this limited study suggest that a disease‐specific measure is required to assess the impact 1SS on health‐related Quality of life (QOL).