Objective To determine the safety and efficacy of surgical biliary bypass on the elderly patients with unresectable pancreatic head cancer. Methods The clinical data of 55 cases with unresectable pancreatic head cancer treated with palliation methods from July 2002 to June 2009 in our hospital were retrospectively analyzed. The patients were divided into three groups according to different age and therapeutic program: Nineteen patients, 65 years of age or older, were managed with surgical biliary bypass (group A), 19 patients under 65 years of age were treated by surgical biliary bypass (group B) and 17 patients with the age of 65 years or older received percutaneous transhepatic biliary drainage (group C). Then the therapeutic results were compared.Results With respect to the postoperative level of serum bilirubin, the incidence of early complications, postoperative hospitalization and mean survival time, no statistically significant difference was found between group A and B (Pgt;0.05). There was one case of recurrent jaundice and one case of gastric output obstruction in group B, while no one suffered postoperative complication in group A, and the difference was statistically significant (Plt;0.01). Compared with group A, the postoperative level of serum bilirubin, the number of patient readmitted, the rate of recurrent jaundice and gastric output obstruction were higher in group C (Plt;0.05 or Plt;0.01). The mean postoperative hospitalization and overall survival time were significantly shorter in group C than group A (Plt;0.05 or Plt;0.01, respectively). Conclusion Surgical palliation does not increase the morbidity rate, but it does improve the quality of life in elderly patients with unresectable pancreatic head cancer.
Objective To systematically review the health utility scores for patients with breast cancer in China. Methods PubMed, EMbase, The Cochrane Library, Web of Science, CNKI, WanFang Data, CBM and VIP databases were searched from inception to November, 2016 to collect studies for health utility scores for breast cancer in China. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Meta-analysis was performed using Stata 12.0 software. Results A total of 6 studies were included. Compared with modeling studies, the range of utility scores from cross-sectional studies was narrower. The results of meta-analysis showed the utility scores for breast cancer were 0.77 (95%CI 0.67 to 0.87), 0.77 (95%CI 0.68 to 0.86) at stage 0 to Ⅰ, 0.76 (95%CI 0.66 to 0.85) at stage Ⅱ, 0.74 (95%CI 0.65 to 0.83) at stage Ⅲ and 0.73 (95%CI 0.65 to 0.81) at stage Ⅳ, respectively. Meanwhile, we descripted the median of utility scores of all studies, and the corresponding values were 0.81 (range 0.65 to 0.83), 0.82 (range 0.65 to 1.00) at stage 0, 0.82 (range 0.65 to 0.90) at stage Ⅰ, 0.77 (range 0.67 to 0.86) at stage Ⅱ, 0.70 (range 0.64 to 0.82) at stage Ⅲ and 0.70 (range 0.30 to 0.80) at stage Ⅳ, respectively. Conclusion Research on the health utility scores of breast cancer is still limited in China. Utility scores are decreasing among different clinical stages, with lowest score at late stage cancer. These findings can be used in further cost-utility evaluation on various breast cancer interventions.
Epilepsy is one of the most common neurological diseases, and symptomatic epilepsy patients are the main group of epilepsy patients, and their etiologies mainly include structural, infectious, metabolic and autoimmune, and the seizures caused by each etiology may have different degrees of impact on the quality of life of patients. The purpose of this article is to review the research on the quality of life of patients with symptomatic epilepsy caused by structural and infectious etiologies, including cerebrovascular diseases, neurodegenerative diseases, brain tumors, traumatic brain injuries and neurocysticercosis, in order to help clinicians understand the quality of life of patients with symptomatic epilepsy and benefit patients in clinical practice.
Objective To investigate the general situation of self-management behavior of patients with cirrhosis, and analyze its influencing factors. Method From January to June 2015, the in-patients with liver cirrhosis were recruited from Gastroenterology Ward of a comprehensive hospital in Chengdu city by convenience sampling method, and a series of questionnaires were used in the research, including self-management behavior scale, social support scale (SSRS), quality of life questionnaire (WHOQOL-BREF) and sociodemographic characteristics. Results One hundred and sixty-eight patients were enrolled. The self-management behavior of patients with cirrhosis scored an average of 50.4±11.3, which was in the medium level. Self management behavior was positively and significantly correlated with social support (r=0.488, P<0.001) and the overall quality of life (r=0.554, P<0.001). Multiple linear regression indicated that the gender and course of the disease were two influencing factors. Moreover, female experienced better self-management behavior than men (t=27.090, P<0.001); and the longer the course of the disease was, the better the self-management behavior could be found (t=34.057, P<0.001). Conclusion We should strengthen the health education of self-management in patients with cirrhosis, and make full use of the patients’ social support system, so as to improve the patients’ self-management behavior as well as the treatment of diseases and their quality of life.
Objective To evaluate the efficacy of Wechat combined with continuing nursing on the quality of life of epilepsy children with ketogenic diet, parents' mood and the time commitment of medical staff. MethodsData were collected from 140 children with intractable epilepsy with ketogenic diet admitted to the Department of Neurology, Children's Hospital Affiliated to Chongqing Medical University from November 2014 to June 2022, including 116 males and 24 females, with an average age of (8.42±2.44) years. The random sampling method was divided into control group (continuing nursing) 71 cases, intervention group (Wechat combined with continuing nursing) 69 cases. The quality of life of the children (QOLCE-16) in the two groups was compared before discharge and 3 months after discharge, as well as parental anxiety (SAS), depression (SDS), and the amount of time medical staff spent with both groups. ResultsThere was no difference in the quality of life and parental emotion between the two groups before intervention. After 3 months, the quality of life of the two groups was significantly improved [(43.59±10.00) vs. (40.14±10.44), P<0.05], and the QOLCE-16 score of the intervention group was higher than that of the control group (P<0.05). The parental mood SAS and SDS in both groups were significantly improved [(37.19±2.90) vs. (50.85±3.76), (40.14±3.52) vs. (49.29±3.37), P<0.01], and the SAS and SDS scores of anxiety and depression of parents in the intervention group were lower than that of the control group (P<0.01). Medical staff spent more time on intervention group [(136.17±7.43) vs. (65.55±7.48), P<0.01]. ConclusionContinuing nursing can improve the quality of life of children with ketogenic diet and the negative emotions of their parents. The combination of Wechat and continuing nursing can further strengthen this positive effect, and requires more time of medical staff.
Objective To investigate the general state, psychologic status and health related quality of life (HRQOL) in patients with post-herpetic neuralgia (PHN), and explore the influencing factors on HRQOL and their major and minor relationship. Methods From August 2014 to August 2015, a questionnaire survey was conducted to patients with PHN. The data of the patients’ general situation was colleted, the psychologic status was assessed by Self-rating Depression Scale (SDS), and the HRQOL of the patients was assessed by 36-item Short Form Survey. One-way ANOVA and stepwise regression analysis were used to analyze the influencing factors of HRQOL. Results A total of 177 questionnaires were issued, and 158 were recovered with a response rate of 89.3%. The average score of HRQOL of the 158 patients was 513.67±119.79, and the average score of SDS was 43.65±11.34. SDS scores showed no depression in 41 patients (25.9%), mild depression in 47 (29.7%), moderate depression in 39 (24.8%), and severe depression in 31 (19.6%). Whether receiving regular treatment, course of PHN, SDS score, physical exercise, sleep time and age were the main influencing factors of HRQOL. Conclusions Most patients with PHN suffer from depressive symptoms with poor HRQOL scores. Receiving early treatment with integrated traditional Chinese and western medicine, strengthening exercise, ensuring adequate sleep and receiving psychological counseling can significantly improve the HRQOL of PHN patients.
Objective To explore the burden situation among caregivers of stroke survivors, and analyze the association between burden and the quality of life among caregivers. Method In this cross-sectional study, a total of 230 stroke survivor-caregivers were investigated with basic demographic information, Zarit Burden Interview (ZBI) and the World Health Organization Quality of Life Instrument-Short Form (WHOQOL-BREF) from May 2015 to November 2015. Results The mean age of the caregivers of stroke survivors was (66.7±11.7) years, and the caregiver burden was in the mild level with the mean ZBI score of 21.11±6.96. The multiple linear regression analysis showed that the influencing factors of caregiver burden were the complications, self-care ability, residence of stroke survivors, and the self-rating health status of caregivers (P<0.05). And the total ZBI score was negatively correlated with the total WHOQOL-BREF scores (P<0.01), physiological dimensional scores (P<0.01), social dimensional scores (P<0.01), and environmental dimensional scores of caregivers (P<0.01). Conclusions The caregivers of stroke survivors suffer from general caregiver burden, and the heavier caregiver burden is, the poorer the quality of life of the caregivers is. According to the different conditions between urban and rural areas of China, it is reasonable to formulate a targeted program with the consideration of requirements referring to stroke survivors and their caregivers. It should involve physiological, psychological, social, environmental factors and so on to improve the caregivers’ quality of life finally.
Objective To compare quality of life for HIV infected people or AIDS patients and their family members of noninfected people in two counties (Zizhong and Zhaojue) with high AIDS morbidity and high HIV infective rates. Methods The quality of life for HIV infected people or AIDS patients and 162 of their family members and 97 people noninfected HIV/AIDS was measured by a questionnaire containing the generic quality of life inventory 74 (GQOLI-74) and the social support scale (SSS). Data were analyzed with SPSS. Results Total GQOLI-74 scores and each of the four dimensionality scores were significantly lower for HIV/AIDS people and their family members compared with noninfected people (total score for HIV/AIDS people 52.20 [9.41]; family members 60.46 [11.92]; noninfected people 66.36 [8.90] (Plt;0.01)). Scores for each of the disease status (physical function, psychological function, social function and material status) were all lower compared with noninfected people (all comparisons Plt;0.01). GQOLI-74 scores of HIV/AIDS people were significantly correlated with disease status and social support, but age, education level and substance abuse did not show significantly correlation. Conclusions The quality of life for HIV infected people or AIDS patients and their families is significantly lower than the general population, and this is particularly related to the severity of their disease and lack of social support.
ObjectiveTo investigate the quality of life of family caregivers of patients with Alzheimer's disease (AD) and to explore the related factors. MethodsTwenty family caregivers of patients with Alzheimer's disease were surveyed with short form 36 health survey questionnaire between October 2013 and August 2014. ResultsThe subjects who were over 60 years old had lower scores in the dimensions of physical functioning, role limitations due to physical problem and role limitations due to emotional problem than those below 60 years old. Female subjects scored better than male subjects in the dimension of vitality. The sons and daughters had higher scores than the wives and husbands in the dimensions of physical functioning, role limitations due to physical problem and role limitations due to emotional problem. The subjects whose patients had medical insurance scored better than those whose patients with no insurance. The differences above were all statistically significant. The scores of caregivers with senior middle school edudation or above were higher than the caregivers with lower education level in the dimensions of mental health, vitality and general health perceptions. ConclusionThe quality of life of the family members of AD patients is obviously affected by many factors. It is very important to implement planned, targeted, reasonable and effective interventions to enhance the quality of life of these people.
ObjectiveTo compare anal function and quality of life between partial longitudinal resection of the anorectum and sphincter (PLRAS) and intersphincteric resection (ISR) for rectal cancer. MethodsNinety-nine cases of very low rectal cancer were classified as PLRAS group (n=23) and ISR group (n=76) according to different surgical method. Anal function was assessed by Saito function questionnaire and the Wexner scale in 6, 12, and 24 months after operation. At the same time, quality of life was assessed by European Organization for research and treatment of cancer quality of life questionnaire CR29 (EORTC-QLQ-CR29). Results①Anastomosis stenosis:compared with ISR group, the situation on anastomosis stenosis was worse in 6 months (P < 0.001) and 12 months (P=0.003) after operation, but didn't significantly differed in 24 months after operation (P=0.230).②Results of the Saito function questionnaire:compared with ISR group, there were higher incidence on stool fragmentation (P=0.016), dyschesia (P=0.008), and feces-flatus discrimination (P < 0.001) in PLRAS group in 6 months after operation, and the incidence of feces-flatus discrimination was still higher in 12 months (P=0.017), but there was no any significant difference in 24 months after operation (P > 0.05).③Results of Wexner scale:there were no statistical difference between the 2 groups at all recorded times (P > 0.05).④Results of EORTC-QLQ-CR29 questionnaire:in 6 months after operation, the scores of flatulence (P=0.003), faecal incontinence (P=0.043), and sexual interest in women (P=0.023) of PLARS group were lower than ISR group but higher in buttock pain (P=0.031) and dyspareunia (P=0.006). In 12 months after operation, the scores of flatulence (P=0.012) and sexual interest in women (P=0.017) were both lower than ISR group, but score of dyspareunia was higher (P=0.012). In 24 months after operation, there was no any significant difference (P > 0.05). ConclusionsPLRAS surgery have worse situation of anastomosis stenosis and sexual function in women than ISR surgery before 12 months after operation, but have analogous effect in 24 months after operation.