肝肾移植患者生命质量量表研究进展

生命质量量表是评价肝肾移植患者术后生活质量的重要工具,对患者的治疗和预后起到监测与指导作用.生命质量量表包括普适性量表与特殊疾病量表,各自有其优势和不足.研究者在研究中要根据研究目的选择适合的量表,并结合现有量表优势特点与我国国情,积极研制适合我国肝肾移植患者的生命质量量表.     

Is the Evaluation of the Global Quality of Life Determined by Emotional Status?

The present study investigated relationships between global QOL perceptions and well-being dimensions. Especially our goal was to evaluate the impact of generally recognised four broad dimensions of QOL (physical, functional, social and emotional well-being) on global QOL perceptions, additionally person's satisfaction with life achievements and economical situation were measured as well as social demographic variables. The subjects were a representative sample of Finns (n = 4613, from 25 to 65 years) of the FINRISK-97 study. Correlation coefficients and models of hierarchical regression indicated that physical, functional and social well-being as well as sociodemographic factors and satisfaction with life achievements are important factors of global QOL perceptions both among males and females. However percentages of variances explained with these measures were only moderately high, ranging from 1 to 10%. After measures of emotional well-being were entered into the models of hierarchical analyses of regression, variances explained grew dramatically over 20%. The results of the study indicated that global QOL judgements are likely to be based on current emotional state.     

Comparison of two methods of calculating Quality-adjusted Life Years

This paper compares two methods for calculating QALYs using quality of life data from a clinical trial. The methods produced similar results in the population as a whole, but they gave different results in a large subset. Different methods for calculating QALYs may give different results, and care should be taken to select the correct method.Supported by grants RO1-HS-06098 from the Agency for Health Care Policy and Research, RO1-NS-24224 from the National Institute of Neurological Disorders and Stroke and from the UCSD Health Outcomes Assessment Program.     

特异性生命质量量表的制定及考评

随着医学科学的发展,生命质量评价的应用日趋广泛,对其方法的研究也越显重要。文章主要讨论生命质量评价方法中的一种常用方法:特异性生命质量量表的制定步骤及考评方法。     

广东开平、博罗农村老年人生活质量调查

为了解广东农村老年人生活质量现状，用多级，分层随机抽样方法，对开平，博罗两地１００８例农村老年人进行了生活质量调查，结果：９６．６４％的老年人具生活自理能力（ＡＤＬ量表评分）７８．０％的老年人具独立性生活能力（ＩＡＤＬ量表评分）；健康自评３６．３１％的老年人良好；５２．８％中等，１０．４２％差，５６．０５％的老年人有慢性病史，居一，二位的是关系炎，慢性头痛，对目前医疗条件满意的占３８．８％，一般占     

Psychometric evaluation of the Schizophrenia Quality of Life Scale (SQLS) in English- and Chinese-speaking Asians in Singapore

Objective To assess the psychometric properties of the Schizophrenia Quality of Life Scale (SQLS) in Asians with schizophrenia in Singapore. Methods A consecutive sample of outpatients with schizophrenia completed the English or Chinese version of the SQLS and the Short-Form 36 Health Survey (SF-36) twice during two different clinic visits. The patients were also assessed for presence or absence of 22 psychiatric symptoms. Results About 202 patients (English-speaking: 140) participated in the study. Correlations between SQLS scales and other measures assessing similar constructs ranged from 0.46 to 0.69 (P < 0.001 for all). For SQLS psychosocial and symptoms/side effects scales, item-to-scale correlations were >0.4, Cronbach’s alpha and intra-class correlation coefficient values were close to or exceed 0.7, and Cohen’s effect size, standardized response mean, and Guyatt’s responsiveness index values approximated or exceeded 0.2 for both SQLS language versions; however, for the energy/motivation scale, item-to-scale correlations (range: 0.08–0.51), reliability (range: 0.46–0.66) and responsiveness (range: 0.04–0.08) statistics were not satisfactory for both SQLS versions. Conclusions The SQLS psychosocial and symptoms/side effects scales are valid, reliable and responsive in Singaporean patients with schizophrenia; the appropriateness of energy/motivation scale requires further investigation.     

2009年山西省部分煤矿工人生存质量调查

[目的]了解山西省煤矿工人的生存质量状况。[方法]2009年7月,在山西省分层整群随机抽取7家煤矿部分班组的工人2 058名,应用SF-36生存质量量表进行测评。[结果]调查2 058人,SF-36生存质量得分,PF维度为87.5±15.9,RP维度为71.6±36.6,BP维度为77.2±20.2,GH维度为68.1±21.9,VT维度为61.8±19.4,SF维度为79.3±18.9,RE维度为72.6±37.7,MH维度为64.7±15.9;PF、GH、VT、MH维度得分。山西省煤矿工人PF、GH、VT和MH维度得分高于杭州市一般人群(P<0.01),RP、BP、SF、RE维度得分低于杭州市一般人群(P<0.01);山西省煤矿工人与四川省一般人群比较,GH维度得分的差异无统计学意义(P>0.05),其他7个维度得分均较低(P<0.01)。调查的2 058名煤矿工人中,与1年前相比,感觉自身健康好的占20.04%,差不多的占55.34%,差的占24.62%。[结论]山西省煤矿工人生存质量整体状况较差。     

Validation of the Chinese version of the Schizophrenia Quality of Life Scale Revision 4 (SQLS-R4) in Taiwanese patients with schizophrenia

We tested the reliability, sensitivity, and validity of a Chinese translation of the Schizophrenia Quality of Life Scale Revision 4 (SQLS-R4). One hundred Taiwanese individuals with schizophrenia were recruited. The internal consistency reliability was satisfactory for both the psychosocial and vitality domains (Cronbach’s α = 0.92, 0.84). The test–retest reliability was also high (psychosocial: ICC = 0.84, vitality: ICC = 0.84) for those individuals whose psychological conditions remained stable between the two-week interval. However, the responsiveness coefficient for those with considerable changes in psychological conditions ranged from very small to moderate, suggesting either low responsiveness for the vitality domain or a complex relationship between the change of psychological conditions and quality of life, and the need to estimate responsiveness more conclusively in a future intervention study. The convergent validity was supported by moderate-to-large correlations between domains measuring related constructs of the SQLS-R4 and SF-36 (r = −0.65 to −0.67). Overall, the results of this study provide preliminary evidence for the reliability and validity of the SQLS-R4 used in Taiwanese individuals with schizophrenia. This study provides a common ground for international researchers to understand quality of life in Taiwanese patients with schizophrenia.     

Assessing Quality of Life in Adult Cancer Survivors (QLACS)

This article describes development of a quality of life measure designed to assess issues relevant to long-term cancer survivors. In-depth semi-structured interviews were conducted with 58 long-term cancer survivors to identify domains most relevant to long-term survivors ( 5 years post-diagnosis). Self-report items were developed from these interviews and administered to a second sample of 242 long-term survivors. Domains and items were selected from the item pool by a combination of factor analysis and criterion-based item selection. Five cancer-specific domains were identified (appearance concerns, financial problems, distress over recurrence, family-related distress, and benefits of cancer) along with seven generic QOL domains (negative feelings, positive feelings, cognitive problems, sexual problems, physical pain, fatigue, and social avoidance). Cronbachs was 0.72 or greater for each domain. Correlations between domain scores and criterion measures were 0.72 or higher in all but one generic domain (social avoidance), but somewhat lower on cancer-specific domains. The new multidimensional measure has good internal consistency and validity and is appropriate for comparisons between cancer and non-cancer populations, as well as long-term follow-up of cancer patients.     

郴州市大学生生活质量研究

目的 了解大学生生活质量及其影响因素。方法 采用世界卫生组织生存质量测定量表简表(WHOQOL-BREF)对郴州市两所高校687名大学生进行问卷调查。结果 男生在社会关系领域得分高于女生，在环境领域得分低于女生；自述健康大学生在总的生存质量和总的健康状况及其它各领域得分均高于自述非健康学生；来自城市的学生在社会关系领域、环境领域得分高于农村学生；医学生在生理领域得分低于师范生。结论 大学生的生活质量存在差异，应采取针对性措施改善大学生的生活质量。     

The European Organisation for Research and Treatment of Cancer Quality of Life Utility-Core 10 Dimensions: Development and Investigation of General Population Utility Norms for Canada,France, Germany,Italy, Poland,and the United Kingdom

ObjectivesThe European Organisation for Research and Treatment of Cancer Quality of Life Utility-Core 10 Dimensions (EORTC QLU-C10D) is a cancer-specific preference-based measure, providing health utilities for use in economic evaluations derived from the widely used health-related quality of life measure, EORTC QLQ-C30. Several EORTC QLU-C10D country-specific value sets are available. This article aimed to provide EORTC QLU-C10D general population utility norms for Canada, France, Germany, Italy, Poland, and the United Kingdom, to aid interpretability of obtained utilities in these countries.MethodsData were collected in aforementioned countries via a quota-sampled, cross-sectional online survey (n = 100/age-sex group; N = approximately 1000/country). Participants were asked to complete the EORTC QLQ-C30 and provide sociodemographic data. Country-specific utility norms were calculated using the respective country tariff on the country’s EORTC QLQ-C30 data after weighting to achieve population representativeness for age and sex. Norm values are provided as means (SDs) by country, age, and sex groups. Tukey’s multiple comparison test investigated mean differences among countries. The impact of country, age, and sex on utility values was investigated with a multiple linear regression model.ResultsCountry-specific mean utilities range from 0.724 (United Kingdom) to 0.843 (Italy). Country-, sex-, and age-specific mean utilities range from 0.664 for 30- to 39-year-old male Canadians to 0.899 for > 70-year-old male Italians. Utilities were lower in females in 4 of 6 countries, and the impact of age differed among countries. Independent of the impact of age and sex, between-country differences were found (P ≤ .05).ConclusionResults showed a varying impact of age and sex on EORTC QLU-C10D utilities and significant between-country differences. Using national utility norms and utility decrements is recommended.     

The Population Perspective on Quality of Life among Americans with Diabetes

Quality of life (QOL) among Americans with diabetes was compared to Americans without diabetes using the Behavioral Risk Factor Surveillance System for 1996 through 2000. QOL was measured in terms of days in the last month of limited activity, poor physical health, poor mental health, pain, depression, stress, poor sleep, and high energy and perceived general health. Each of 42,154 diabetics was matched with one non-diabetic (control) respondent on age, sex, race, and ethnicity. Additional statistical adjustments were made for socio-economic status, marital status, and access to health care. Respondents with diabetes averaged more statistically adjusted impaired days than controls: 3.11 days (SE = 0.07) for physical health, 0.92 (SE = 0.06) for mental health, 1.69 (SE = 0.06) for limited activity, 1.86 (SE = 0.16) for pain, 1.14 (SE = 0.14) for depression, 1.11 (SE = 0.16) for stress, 1.47 (SE = 0.18) for inadequate rest or sleep, and 3.54 (SE = 0.21) fewer for high energy. General health was also lower. Diabetes compromised QOL a substantial proportion of time on every dimension tested. Across the board, lower education, being unable to work, unemployed, or retired and lacking funds to pay for needed medical care were associated with greater impairments among persons with diabetes.     

A Rasch Analysis of a Self-perceived Change in Quality of Life Scale in Patients with Mild Stroke

A Rasch analysis was used to assess the unidimensionality and appropriateness of the scoring level of a 13-item self-perceived change in quality of life scale (CQOL) for stroke patients. A total of 158 patients with mild stroke completed the CQOL themselves at home. The results showed that a unidimensional CQOL can be created by deleting the three items related to speaking, vision, and thinking. The 4 scoring categories of the shortened scale were deemed appropriate from the analysis. These results provide preliminary evidence of the 10-item CQOL in assessing self-perceived change in quality of life in stroke patients. Further studies are needed to examine the test-retest reliability, criterion validity, and responsiveness of the 10-item CQOL in stroke patients.     

Health-related Quality of Life in Preschool Children with Wheezing and Dyspnea: Preliminary Results from a Random General Population Sample

Respiratory symptoms have a high prevalence among preschool children (5–20%). This study evaluated the impact of parent-reported respiratory symptoms on health-related quality of life (HRQOL) using the TNO-AZL Preschool Children Quality of Life (TAPQOL) questionnaire. A random general population sample of 500 parents of 3-46-month old children was mailed a questionnaire containing the TAPQOL and questions on the prevalence of respiratory symptoms. The impact of respiratory symptoms on HRQOL was analysed using the Mann–Whitney test and linear regression analysis. Response rate was 83%. The prevalence of combined ‘wheezing and dyspnea’ during the past 4 weeks was 10%. For the sleeping, appetite, lung problems, skin problems, communication, and positive mood TAPQOL scales, HRQOL was significantly lower in the subgroup with ‘wheezing and dyspnea’ (n = 41) than in the subgroup without symptoms (n = 321); large effect sizes were observed for lung problems (2.06) and sleeping (0.80). In multivariate analysis, adjusted for age and gender of the child, ‘wheezing and dyspnea’ were associated with the scales sleeping, appetite, lung problems, communication, and positive mood (p < 0.05). In conclusion, decreases in HRQOL among preschoolers with parent-reported respiratory symptoms are measurable with the TAPQOL. We recommend studying the impact of doctor-diagnosed respiratory symptoms on HRQOL in future studies.     

Quality of life and psychological well-being in the early stages of multiple sclerosis (MS): Importance of adopting a biopsychosocial model

Background

Reductions in quality of life (QOL) exist among individuals with multiple sclerosis (MS).

江苏省大学生生命质量现状研究

目的 差异化评价江苏省大学生生命质量的现状,为大学生生命质量的干预提供依据.方法 采用分层随机抽样方法调查江苏3所高校6个学科门类的2 100名大学生,采用大学生生命质量评价专用量表通过现场调查.结果 回收1 950份有效问卷,有效回收率为92.86％.江苏省大学生生命质量各维度均值都低于60分,生理、社会支持、环境、心理、行为维度均值从高到低,分别为59.54,59.36,58.28,57.66,57.36;总分均值为58.50,和谐指数均值为58.11,总体自评均值为63.56;二级指标中,价值观念和学习管理评分均值非常低,分别为44.33和54.59.结论 江苏大学生生命质量的评分不高,其中心理维度中个人价值观、社会价值观、学习动机较差,社会支持维度中对学校和老师支持的利用不足表现得尤为突出.     

急性白血病长期生存患者生命质量调查

目的 了解上海市急性白血病（AL）长期生存病人的生命质量。方法 上海市1984．1－1994．12．31期间29家医院1379例上海市病人中选择生存时间≥5年的95例长期生存患者为研究对象。用统一的FACT－G量表了解长期生存病人的生命质量。结果和结论 发现大多数病人基本达到正常的生命质量,其总的生命质量评分为85分,年龄大于06岁和文盲病人的生命质量评分比较高。近50％病人恢复正常的全日工作和学习,12．6％病人有化疗后继发疾病,已婚病人中近一半病人对性生活不满意,所以预防继发疾病和保护性功能应引起足够的重视。复发和治疗经费是长期生存病人最担心的问题,建立医疗保健制度已成为社会问题。     

基于EQ-5D量表的深圳市居民健康相关生命质量研究

目的 了解深圳市居民的健康相关生命质量情况,并对其健康相关影响因素进行分析.方法 运用欧洲的五维健康量表(EQ-5D)对深圳市居民的健康状况进行测评,采用描述性分析、多元回归分析等对健康相关影响因素进行分析.结果 被调查居民的主要健康问题是疼痛/不适、焦虑/抑郁,这两维度有困难的比例分别为5.53％、2.14％;EQ-VAS评分平均为84.31±10.81分,年龄、就业状况、文化程度、是否饮酒、两周病伤情况和慢性病患病均是居民健康相关生命质量的独立影响因素.结论 关注高年龄、低文化程度、嗜酒和无业人群的健康,加强慢性病的防治管理是提高深圳市居民健康相关生命质量的关键.     

青岛市综合医院医务人员社会支持与生命质量相关性研究

目的 探讨青岛市医务人员社会支持和生命质量状况及两者的相关性.方法 采用随机分层抽样的方法,于2014年1—6月对青岛市761名医务人员进行《社会支持评定量表》和《生活质量综合评定量表(GQOLI-74)问卷》调查,并对结果进行统计分析.结果 医生客观支持维度得分低于职能部门人员(P<0.05);护士客观支持维度得分低...