The psycho‐social dimension of pain and health‐related quality of life in the oldest old

Background: Chronic pain has an impact on the physical and social functioning of older people which in turn may worsen their health‐related quality of life. Research with focus on prolonged extensive pain in the most elderly and how pain may interfere with their life situation is scarce. Aims: The aims were to describe and investigate pain from a multidimensional point of view (duration, location, psycho‐social) and health‐related quality of life as well as to compare sex and age groups in people aged 80 years and over. Methods: In this cross‐sectional study, a total of 225 of 282 people responded to a questionnaire consisting of two instruments and background questions. The psycho‐social dimension of pain was measured using the Multidimensional Pain Inventory–Swedish language version (MPI‐S) with five scales: Pain Severity, Interference, Life Control, Affective Distress and Social Support. Health‐related quality of life was measured using the Short Form Health Survey‐12 (SF‐12). Results: Median duration of pain was 9.0 years, and the mean number of pain locations was 2.04. The MPI‐S scale Interference with a negative orientation had the highest mean score, while the mean score for Social Support was the highest for the scales with a positive orientation. The duration of pain was significantly greater for women, and those aged 80–85 years had higher pain severity than those aged ≥86. Participants with a lower health‐related quality of life experienced significantly more severe pain, were more troubled with pain and had less control of their life. Conclusions: Older people with prolonged pain suffered from a low health‐related quality of life. Pain interfered with their lives and contributed to diminished control in their daily lives. Nurses are essential for the identification and prevention of pain and should be aware of how pain affects older people’s physical, mental and social health.     

Maternal concern, social support, and health-related quality of life across childhood

Mothers play a critical role in child and family health yet little is known about the concerns and health-related quality of life (HRQOL) of mothers beyond early childhood. The purpose of this study of 234 mothers of children up to 18 years of age was to examine relationships among maternal concern, social support, and HRQOL. Mothers reported a low level of concern, but concern was a significant predictor of HRQOL. The health burden for mothers was demonstrated primarily in the mental health components of HRQOL. The effect of social support was minimal and limited to the mental health domain of HRQOL. Results suggest regular assessment of maternal concerns and mental health coupled with education regarding coping strategies to support HRQOL for all mothers.     

生存质量及其相关观念

本文介绍了生存质量的含义和主要内容,并对其相关概念作了详细的阐述,它们包括健康、健康状态、健康相关生存质量、功能状态、情绪、症状等.了解这些概念有助于加深我们对生存质量的理解,并更好地在临床工作中加以运用.     

Evolution of the caregiving experience in the initial 2 years following stroke

Relationships between stroke survivor and family caregiver factors and the caregiver's health-related quality of life (HRQL) and overall quality of life (QoL) were examined in 97 dyads during the first and second years after stroke. Compared to age- and sex-matched population norms, caregivers scored significantly lower on the mental subscales of HRQL, and differences were greater for women than for men. Caregiver characteristics (older age, less burden, and fewer physical symptoms) were associated with better HRQL (mental summary scale) in the first year, with similar findings in the second year. Moderate stroke survivor physical impairment and caregiver characteristics (younger age and better HRQL) were associated with better QoL in the first year. During the second year poorer caregiver physical and mental health and caring for a stroke survivor with communication difficulties were associated with diminished QoL.     

Health-related quality of life of Chinese people with schizophrenia in Hong Kong and Taipei: a cross-sectional analysis

Health-related quality of life is an important outcome indicator of mental health. We assessed the perception of health-related quality of life of persons with schizophrenia in Hong Kong and Taipei. In-person survey interviews were conducted using the Chinese World Health Organization Quality of Life Scale--Brief Version. A convenience sample was recruited from psychiatric outpatient departments: 176 from Hong Kong and 80 from Taipei. We found that both groups were significantly less satisfied with their psychological and social relationship domains compared to other domains. Poor mental health predicted poor perception of health-related quality of life. Schizophrenia has an impact on many aspects of a person's functioning. A rehabilitation model that takes into account symptoms, financial situation, family support, and social functioning is required.     

健康相关生命质量

健康相关生命质量 (HRQOL)是近年来发展起来的一种全新的医学概念 ,在国外已得到广泛的应用。现综述其研究内容、测定方法及其用途方面的最新进展。     

Associations between symptoms, functioning, and perceptions of mastery with global self-rated health in patients with COPD: a cross-sectional study

BACKGROUND: Self-rated health has been shown to be a significant predictor of mortality. However, there is limited knowledge on what factors contribute to the global perception of self-rated health in patients with chronic obstructive pulmonary disease (COPD). OBJECTIVE: To describe the associations between physical and psychological symptoms, physical and mental health functioning, and perceptions of mastery with concurrent and longitudinal global self-rated health (GSRH) in patients with COPD and to determine if gender modifies these relationships. DESIGN: Cross-sectional analysis of data from a longitudinal clinical trial. SETTING: University medical center in the United States. PARTICIPANTS: 115 patients with moderate to severe COPD. METHODS: GSRH was measured using one question from the Medical Outcomes Study, SF-36 which states, "In general, would you say your health is: excellent, very good, good, fair, or poor". Physical and psychological symptoms were measured with the Shortness of Breath Questionnaire, Chronic Respiratory Questionnaire (CRQ), and Center for Epidemiologic Studies Depression Scale (CESD); the SF-36 was used to measure physical and mental health functioning; mastery was measured by a sub-scale of the CRQ. The BODE index, a multidimensional disease severity grading system, was also included. Stepwise logistic regression analyses were performed. RESULTS: In cross-sectional analyses, only disease severity as measured by the BODE index was associated with GSRH [odds ratio, 1.52; 95% confidence interval, CI (1.08, 2.15)]. Stratified analyses by gender showed that the association between the BODE index and the GSRH held up for men, but not for women. Higher perception of symptom control was associated with positive health ratings in women. Subjects with less fatigue at baseline had a lower risk of reporting poor health 12 months later [OR 0.84; 95% CI (0.72, 0.98)]. CONCLUSIONS: For patients with COPD, ratings of global health were mostly influenced by measures that reflect their physical state, e.g. disease severity and fatigue. While additional work is needed to better understand gender differences in factors that contribute to GSRH, therapeutic nursing interventions might place greater focus on symptom management if the goal is to improve patients' perceptions of their global health.     

护理干预对维持性血液透析病人自我管理行为的影响

[目的]探讨护理干预对维持性血液透析病人的自我管理行为的影响。[方法]以方便抽样方法将研究对象分为实验组和对照组各24例,实验组病人接受护理干预,对照组接受常规健康教育,采用自行设计的自我管理行为问卷和简明健康调查问卷(SF-36)于干预前、干预后6个月调查病人的自我管理行为和健康相关生活质量(HRQOL)。[结果]干预后两组病人自我管理行为、HRQOL比较有统计学意义(P<0.05或P<0.01)。[结论]护理干预可以改善病人的自我管理行为,提高其HRQOL。