社区肥胖儿童主观生活质量影响因素及健康干预研究

目的 探讨社区肥胖儿童主观生活质量状况、影响因察及干预效果,为提高其生活质量提供科学依据.方法 在深圳市3个社区随机抽取106名9～14岁肥胖儿童与122名正常体质量儿童,进行主观生活质量的评定,并采取综合措施对肥胖儿童进行1年的健康干预.比较干预前、干预后两组的主观生活质量满意度,分析肥胖儿童主观生活质量的影响因素.结果 肥胖儿童主观生活质鼍低于正常体质量儿童(P<0.01);肥胖儿童干预后主观生活质量总满意度高于干预前(P<0.01).逐步回归分析显示肥胖儿童年龄较大、肥胖程度越高、学习成绩越差、母亲文化程度越低者其主观生活质量越低(P(0.01或P<0.05);单亲家庭相对于扩展家庭,主观生活质量较低(P<0.01).结论 肥胖儿童的主观生活质量满意度比正常体质量儿童低,但干预后能明显提高;肥胖儿童主观生活质量满意度的影响因素包括:年龄、肥胖程度、学习成绩、家庭类型、母亲文化程度等.     

脑血管意外患者及家庭照料者生活满意度及影响因素研究

目的:探讨脑血管意外患者及家庭照料者生活满意度及影响因素.方法:采用生活质量综合自评问卷(GQOLI)对89例脑血管意外患者(患者组)、89名家庭照料者(照料者组)及178名正常人(对照组)进行问卷调查分析.结果:患者组与照料者组主观生活满意度均显著低于对照组(P<0.05,P<0.01);患者及照料者主观生活满意度下降原因主要与生活状态、对生活的期望值及家庭成员的生活满意度有关.结论:在药物治疗的基础上给予心理干预,设法降低患者及家庭照料者过高的生活期望值,以提高生活满意度.     

肾移植患者和维持性血液透析患者生活质量水平的对比研究

目的比较肾移植患者和维持性血液透析患者生活质量水平的差别。方法采用一般情况调查问卷和国际通用的生活质量调查问卷,对肾脏移植患者和维持血液透析患者生活质量水平的进行对比。结果所调查的肾移植患者及维持性血液透析患者的人口学特征无明显差异;维持性血液透析患者生活质量8个维度得分均低于肾移植术后患者;年龄、婚姻状况、家庭社会关系、家庭经济情况、睡眠质量、透析年限、文化程度7个因素是影响维持性血液透析患者和肾移植患者生活质量的因素。结论 2种治疗方法均能有效改善患者生活质量,肾移植患者总体生活质量高于维持性血液透析患者,影响维持性血液透析患者和肾移植患者生活质量的因素均为:年龄、婚姻状况、家庭经济情况、文化程度、家庭和社会支持、透析或移植年限、睡眠质量。     

家庭支持对维持性血液透析患者生活质量的影响

目的探讨血液透析患者家庭支持与生活质量的关系。方法采用问卷调查的方式,对75例血液透析患者的家庭支持状况和生活质量进行调查,并分析两者之间的关系。结果血液透析患者家庭支持得分高低对其总的生活质量、生活满意度、健康和功能有影响(P<0.05),而对自我概念和社会、经济因素的影响不明显(P>0.05)。结论家庭支持状况直接影响血液透析患者的生活质量。医护人员应重视对血液透析患者家庭成员的教育,以保证高质量家庭支持的提供,促进患者生活质量的提高。     

精神分裂症照顾者综合需求与社会支持调查分析

目的分析精神分裂症照顾者综合需求与社会支持情况。方法分层随机抽样选取精神分裂症患者108例(160名主要照顾者),对其综合需求及社会支持情况进行问卷调查,分析与一般资料的关系,并对精神分裂症主要照顾者综合需求与社会支持进行相关分析。结果精神分裂症主要照顾者综合需求各维度评分信息需求生活与经济需求情感需求健康与心理需求;不同性别、年龄、文化程度、主要照顾者人数、与患者关系、家庭居住地的精神分裂症主要照顾者的综合需求各维度评分比较,差异有统计学意义(P 0. 05);不同性别、年龄、文化程度、主要照顾者人数、与患者关系的主要照顾者的社会支持各维度评分比较,差异有统计学意义(P 0. 05);精神分裂症主要照顾者综合需求总分与社会支持总分呈负相关,健康与心理需求与社会支持总分、主观支持、客观支持呈负相关,信息需求与社会支持总分、对支持的利用度呈负相关,情感需求与社会支持总分、主观支持、客观支持呈负相关,生活与经济与社会支持总分、客观支持、对支持的利用度呈负相关(P 0. 05)。结论精神分裂症主要照顾者综合需求处于较高水平,其社会支持水平受主要照顾者性别、年龄、文化程度、主要照顾者人数、与患者关系影响,精神分裂症主要照顾者综合需求与社会支持呈负相关,主要照顾者得到的社会支持水平越高,综合需求水平越低。     

血液透析患者治疗依从性影响因素分析及护理干预

目的:调查并分析血液透析患者治疗依从性的影响因素,并制定护理干预对策。方法:采用自行设计的《血液透析治疗依从性调查研究问卷》对450例血液透析患者的治疗依从性影响因素进行调查、分析,根据其结果制定护理干预对策。结果:不同文化程度、医疗费用、医患关系、透析持续时间、对疾病认识、社会支持、家庭月收入及焦虑、抑郁情绪的患者间治疗依从性比较差异有统计学意义(P0.05);治疗依从性与文化程度、医患关系、对疾病认识、社会支持、家庭月收入呈正相关关系,与医疗费用、透析持续时间、HAMA评分、HAMD评分呈负相关关系(P0.05)。结论:文化程度、医疗费用、医患关系、透析持续时间、对疾病认识、社会支持、家庭月收入及焦虑、抑郁情绪是血液透析患者治疗依从性的影响因素,采用相应的护理干预措施有助于改善依从性。     

血液透析患者生活质量及其影响因素的调查

目的探讨血液透析患者的生活质量及其影响因素,为提高患者的生活质量提供依据。方法使用KDQOL-SFTM量表对200例血液透析患者的生活质量及其影响因素进行问卷调查。结果血液透析患者肾脏病和透析相关生活质量、一般健康相关生活质量各维度得分均低于一般人群（P〈0.01）;年龄、婚姻、文化程度、透析年限、医疗费用、家庭支持、血浆白蛋白和心理因素与患者的生活质量显著相关（P〈0.05或P〈0.01）。结论血液透析患者的生活质量总体水平较低,应积极而有针对性地为患者提供护理干预,以改善患者的生活质量。     

突发性耳聋合并耳鸣患者疾病不确定感及影响因素调查研究

目的:探讨并了解突发性耳聋合并耳鸣患者疾病不确定感的现状,分析其影响因素,旨在为临床护理管理提供理论依据。方法:采用随机抽查及调查问卷的形式,抽取本院105例突发性耳聋合并耳鸣患者作为调查对象,分析本组患者疾病不确定感现状及其影响因素。结果:本组患者疾病不确定感总评分(85.18±9.93)分;其中文化程度、家庭人均月收入、支付医疗费用与疾病不确定感呈相关性(P0.05);听力损失程度和耳鸣主观分级具有显著相关性(P0.01)。结论:突发性耳聋合并耳鸣患者疾病不确定感处于一种较高水平,文化程度、家庭人均月收入、支付医疗费用方式是影响疾病不确定感因素,因此,建议护理人员重视突发性耳聋合并耳鸣患者疾病不确定感现状,并采取有效的心理护理缓解患者主观情绪,从而降低其疾病不确定感,提高生活质量和满意度。     

中老年维持性血液透析患者主要照顾者负担水平及其影响因素分析

目的 调查中老年维持性血液透析患者主要照顾者负担现状,分析其相关的影响因素及探讨。方法 便利抽样某三级甲等医院,采用一般人口学问卷、应用Zait负担量表、社会支持量表、自我效能感量表对115例中老年血液透析患者主要照顾者进行调查分析,采用多元线性回归分析其影响的因素。结果 中老年血液透析患者主要照顾者负担总分为(41.50±13.85)分,回归分析显示：社会支持、自我效能、年龄、文化程度、婚姻状态、工作状态、家庭经济收入进入回归方程(P＜0.05)。结论 中老年维持性血液透析患者主要照顾者负担处于中等水平,受自社会支持、自我效能、婚姻状态、家庭经济收入影响。护理人员应及时评估主要照顾者负担的影响因素,扩大中老年维持性血液透析患者主要照顾者社会支持,提供相应的健康教育,增强信心,为今后干预提供依据,最终提高患者及照顾者的生活质量。     

血液透析患者生活质量及其影响因素的调查

目的探讨血液透析患者的生活质量及其影响因素．为提高患者的生活质量提供依据。方法使用KDQOL-SFTM量表对200例血液透析患者的生活质量及其影响因素进行问卷调查。结果血液透析患者肾脏病和透析相关生活质量、一般健康相关生活质请各维度得分均低于一般人群（P〈0．01）;年龄、婚姻、文化程度、透析年限、医疗费用、家庭支持、血浆白蛋白和心理因素与患者的生活质量显著相关（P〈0．05或P〈0．01）。结论血液透析患者的生活质量总体水平较低。应积极而有针对性地为患者提供护理干预,以改善患者的生活质量。     

Study on the Relationships between Nurses' Job Burnout and Subjective Well-being

Objective:To study factors influencing nurses' job burnout and their subjective well-being and to explore the relationships between these two phenomena.Methods:A total of 250 nurses from three hospitals in Shandong were evaluated with the Maslach Burnout Inventory and a subjective well-being scale.Results:Nursing staff showed significantly different levels of job burnout(P 0.05) according to the following characteristics:age,marital status,educational background,technical title,years of nursing experience,monthly income,manning quotas and parental status.Level of burnout is higher for nursing staff who are under the age of 30 years,are unmarried,had secondary education,had unofficial manning quota status,are childless,hold a primary title and whose years of nursing experience are less than five years.Statistical significance was found for life satisfaction(P0.05) with differences in age;marital status;technical title;years of nursing experience;monthly income;manning quota status;and parental status in positive emotion,negative emotion and degree.There is a significant negative correlation between every dimension of job burnout and life satisfaction and positive emotions for subjective well-being.Every component of job burnout was significantly positively correlated with negative emotions.(P 0.05)Conclusions:Age,marital status,educational background,technical title,years of nursing experience,monthly income,manning quotas and parental status have different influences on occupation burnout and subjective well-being.Dimensions of occupation burnout have functions of predicting subjective well-being.     

Predictors of depression and life satisfaction among spousal caregivers in hospice: application of a stress process model

Using a stress process model, risk factors (caregiving stressors, caregiver health, and negative social interactions) and protective factors (caregiving appraisals and social resources) were examined as predictors of family caregiver well-being (depression and life satisfaction). Eighty spousal caregivers of hospice patients with dementia or lung cancer completed structured interviews and self-report measures assessing components of the stress process model. Results suggest that objective measures of patient impairment or amount of care provided are not strong predictors of caregiver depression or life satisfaction. Female gender, caregiver health problems, and negative social interactions were risk factors for poorer caregiver well-being. Caregivers who subjectively appraised caregiving tasks as less stressful, who found meaning and subjective benefits from caregiving, and with more social resources had lower depression and higher life satisfaction, even after controlling for patient impairment and caregiver appraisal variables. Regression models accounted for 42% of variance in caregiver depression and 52% of variance in caregiver life satisfaction. Counseling for hospice family caregivers could utilize the stress process framework, and pay particular attention to finding meaning or subjective benefits from caregiving, and remaining active in social roles. Further research providing evidence on caregiver risk and protective factors could improve the conceptual and empirical basis for psychosocial interventions for hospice family caregivers.     

喉切除术后患者的生活质量评价

背景以往对头颈部恶性肿瘤的治疗重点强调提高患者术后的生存率,未充分考虑到患者术后回归社会的需求.随着医学模式的转变,评估肿瘤治疗效果的标准也发生了变化,除了生存率等生物学指标外,目前越来越强调重视患者的生活质量.喉是人们执行呼吸、交际、营养等重要功能的集中部位,喉切除术对患者的生活质量无疑会产生较大影响.目的研究喉切除术后患者的生活质量及其临床意义.设计以诊断为依据的调查研究.单位山东大学齐鲁医院耳鼻咽喉科.对象以1999-01/2000-12在山东大学齐鲁医院耳鼻咽喉科住院接受喉切除术的患者为研究对象,排除合并患有心肺等重大疾病的情况下,随机抽取50例,收集资料完整的42例作为最终研究对象进行统计处理.方法以综合生活质量评定问卷调查行喉切除术后患者的生活质量,研究生活质量主客观指标之间和各维度之间的相互关系及其对生活质量的影响.主要观察指标观察喉切除术后患者生活质量各指标间的关系.结果喉切除术后患者的生活质量在心理功能和社会功能维度主客观指标间呈现显著差异.主观满意度对生活质量的影响大于客观状态.客观状态较差时对主观生活满意度的影响较大,客观状态较好时对主观生活满意度的影响较小.影响躯体功能和社会功能的最重要的因素均为心理功能.影响心理功能最重要的因素为躯体功能.在对生存时间和生活质量做出选择时,多数患者首选生存时间.结论全面研究喉切除术后患者的生活质量可为临床决策提供重要依据,心理干预可望在提高患者生活质量方面起到重要作用.     

乳腺癌主要照顾者生活满意度调查及相关因素分析

目的调查乳腺癌主要照顾者的生活满意度状况及其影响因素。方法采用生活满意度指数A(LSIA)和自行设计的一般情况调查表对乳腺癌主要照顾者及乳腺良性肿瘤主要照顾者进行测评,比较他们的生活满意度,并对乳腺癌主要照顾者生活满意度的影响因素进行分析。结果乳腺癌主要照顾者LSIA评分明显低于乳腺良性肿瘤主要照顾者(P<0.01),乳腺癌疾病分期、病程、家属年龄和家庭月收入等影响其得分(P<0.05)。结论乳腺癌主要照顾者生活满意度较差,并受乳腺癌疾病分期、病程、家属年龄和家庭月收入等因素的影响。     

Relationship of health status and social support to the life satisfaction of older adults

We examined the relationship of health factors and social support to life satisfaction in older adults dwelling in a rural town. The gender difference in variables related to life satisfaction was also discussed in this study. One hundred and forty-two older adults (86 females and 56 males) who completed a self-administered questionnaire and participated in a health examination in 1998 or 1999 comprised the study participants. The t-test and chi-square test were used to assess the differences between the two genders. Correlation measure and multiple regression analysis were used to assess the relationship between life satisfaction and other health related or socially related factors for each gender. Significant gender differences were observed in living status and several health related factors. According to the results of the multiple regression analyses, life satisfaction was related to mental health and age in females, while it was related to mental health status and social support from others in males. Gender differences in the variables associated with life satisfaction were observed among the community-dwelling older adults. These data suggest the importance of mental health for older adults. When preparing health promotion strategies for older adults, results of gender differences as they related to social support and life satisfaction should be applied in practice.     

Life satisfaction of the elderly American Indian

This study examined the life satisfaction of 58 elderly American Indians and its relationship to selected external and internal environmental factors. Elderly Indians were 51-85 years of age and resided on two midwestern reservations. Data were collected through use of the Life Satisfaction Index Z-scale (LSI-Z), the Oars Multi-dimensional Functional Assessment Questionnaire (OARS) and a semi-structured interview schedule. Findings indicated that life satisfaction tended to be high. Six internal environmental variables explained 40% of the variance in life satisfaction scores. A higher correlation was found between self-perception of life satisfaction and mental health than objective ratings on these two variables. This study suggests that variables associated with the internal environment may be useful as indicators of life satisfaction in elderly reservation American Indians and that subjective measures of life satisfaction may be more predictive of mental health than objective measures.     

Temperament and satisfaction with health status among persons with rheumatoid arthritis

PURPOSE: Health-related quality of life is a subjective phenomenon shaped by personal attributes. Research has demonstrated links between temperament and health outcomes. Because temperament is relatively stable, it could function as a moderator of quality of life. This study examined relationships among temperament disposition and satisfaction with health status. DESIGN: The model developed by Sprangers and Schwartz was used to develop a secondary analysis of data collected in a cross-sectional, correlational study with stepwise linear regression analysis. Instruments used were MPQ (dispositions) and AMIS2 (health satisfactions). SETTING: Two rheumatology private practices and 3 rheumatology clinics. SAMPLE: One hundred fifty-three persons diagnosed with rheumatoid arthritis (mean age = 55.4). FINDINGS: Scores reflecting Negative Affectivity (intrapersonal orientation and perception) demonstrated significant positive correlation (r = .26-.58) with all health domain satisfaction scores (P < .001). Negative Affectivity and Positive Affectivity (interpersonal orientation) jointly predicted 8.2%-37.8% of score variance. CONCLUSION: Temperament dispositions are associated with health-related satisfaction. IMPLICATION: Assessment of temperament can facilitate early identification of potential problems in the 3 quality of life domains (meaningfulness, manageability), and comprehensibility, and is useful for selecting or designing tailored interventions.     

Gait analysis and WOMAC are complementary in assessing functional outcome in total hip replacement

OBJECTIVE: To investigate the correlation between objective and subjective evaluation of patients with total hip replacement. DESIGN: Prospective preliminary trial comparing the Western Ontario and McMaster University questionnaire (WOMAC) and gait analysis preoperatively and three months postoperatively. SETTING: A German academic orthopaedic centre specializing in total hip replacement surgery. SUBJECTS: Seventeen patients (median age 70 years) with hip osteoarthritis. Intervention: All patients had had a primary unilateral total hip replacement. MAIN MEASURES: WOMAC questionnaire to assess self-perceived health status and gait analysis to determine objective gait parameters. RESULTS: Performance of walking as well as subjective judgement of health status improved following surgery (gait speed P = 0.0222; stride length P = 0.038; stance phase ratio P = 0.0466; WOMAC P < 0.0001). However, the correlation between gait parameters and WOMAC was poor (r = -0.27 or less). Correlation between changes of walking parameters and WOMAC was bad to good (r = 0.01 to r = -0.72). CONCLUSION: The WOMAC questionnaire might not reflect walking performance. The addition of gait analysis is recommended to gain objective information about the quality of gait.