quality of life (qol)

生活质量 ( QoL )
  • 文章类型: Journal Article
    背景:已知心房颤动(AF)与负面情绪状态有关。患者报告结果(PRO)是评估AF管理终点的重要工具。本研究旨在研究房颤患者的人格类型与PRO之间的相关性。
    方法:所有纳入的受试者新诊断为房颤少于1个月,使用艾森克人格问卷(EPQ)评估他们的人格类型。使用心房颤动对生活质量的影响(AFEQT)问卷测量生活质量(QoL)。使用一般焦虑量表(GAD-7)和9项患者健康问卷(PHQ-9)评估焦虑和抑郁,分别。我们对与房颤患者的QoL和情绪状态相关的因素进行了逐步线性回归分析。
    结果:共有531名房颤患者完成了调查,并根据他们的人格类型分为四组。在这些患者中(平均年龄:67.12±10.93岁,50.28%男性),357(67.23%)有阵发性房颤,16.95%(n=90)具有乐观的性格。与其他人格类型的患者相比,性格乐观者的平均AFEQT评分最高(P<0.001),GAD-7和PHQ-9评分最低(P<0.05).此外,多元线性回归分析显示,乐观的人格也与较好的QoL和情绪状态独立相关(P<0.05)。
    结论:房颤患者的人格类型和PRO之间存在显著关联。
    BACKGROUND: Atrial Fibrillation (AF) is known to be associated with a negative emotional state. Patient-reported outcomes (PROs) are important tools for evaluating the endpoints of AF management. This study aims to examine the correlation between personality types and PROs in patients with AF.
    METHODS: All included subjects were newly diagnosed with AF fewer than one month, and their personality types were assessed using the Eysenck Personality Questionnaire (EPQ). Quality of life (QoL) was measured using the Atrial Fibrillation Effect on Quality of Life (AFEQT) questionnaire. Anxiety and depression were assessed using the General Anxiety Scale (GAD-7) and the 9-item Patient Health Questionnaire (PHQ-9), respectively. We constructed stepwise linear regression analyses for factors related to the QoL and emotional state in patients with AF.
    RESULTS: A total of 531 AF patients completed the survey and were categorized into four groups based on their personality types. Of these patients (mean age: 67.12 ± 10.93 years, 50.28% male), 357 (67.23%) had paroxysmal AF, and 16.95% (n = 90) had a sanguine personality. Compared to patients with other personality types, those with a sanguine personality had the highest average AFEQT scores (P < 0.001) and the lowest scores of GAD-7 and PHQ-9 scales (P < 0.05). Furthermore, multiple linear regression analyses suggested that sanguine personality was also independently associated with better QoL and emotional states (P < 0.05).
    CONCLUSIONS: There is a significant association between the personality types and PROs in AF patients.
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  • 文章类型: Journal Article
    肺癌患者的术后恢复是一个复杂的过程,其中呼吸练习可能在提高肺功能和生活质量(QoL)方面发挥关键作用。本研究系统回顾和荟萃分析了呼吸锻炼对肺癌患者术后肺功能和生活质量的影响。
    在PubMed进行了广泛的文献检索,科克伦,WebofScience,和使用“肺肿瘤”等术语的Embase数据库,“呼吸练习”,和“随机对照试验”,辅以医学主题词(MeSH)和自由词。使用Cochrane偏倚风险工具进行质量评估。对肺癌手术后呼吸锻炼的影响进行系统评价和荟萃分析,然后进行数据提取和质量评估。
    从384项检索的研究中,10名符合纳入标准,并被选中进行详细分析。评估的主要结果是术后肺功能指标和QoL指标。大多数研究被认为是随机序列生成和分配隐藏的“低风险”。然而,由于干预的性质,在大多数情况下,致盲是“高风险”。荟萃分析显示,关键肺功能指标显着改善:用力肺活量(FVC%)平均增加1.73%,最大自主通气量(MVV)提高了7.58L/min,最大吸气压力(MIP)提高了0.95cmH2O。此外,术后呼吸困难明显减轻,QoL增强,焦虑评分平均降低3.42分,并发症发生率相应降低。然而,干预措施对6分钟步行测试(6WMT)的身体活动水平或表现没有显着影响,这些结果的效应大小不显著。
    这项研究表明,呼吸锻炼可以显着改善肺癌患者的术后肺功能和QoL。未来的研究应该深入研究这些运动背后的机制,并评估其长期康复效果。定制程序可以进一步优化恢复并提高患者QoL。
    UNASSIGNED: Postoperative recovery in lung cancer patients is a complex process, where breathing exercises may play a crucial role in enhancing pulmonary function and quality of life (QoL). This study systematically reviews and meta-analyzes the impact of breathing exercises on post-surgical lung function and QoL in lung cancer patients.
    UNASSIGNED: An extensive literature search was conducted across PubMed, Cochrane, Web of Science, and Embase databases using terms like \"Lung Neoplasms\", \"breathing exercises\", and \"randomized controlled trial\", supplemented by Medical Subject Headings (MeSH) and free words. The Cochrane risk of bias tool was used for quality assessment. A systematic review and meta-analysis on the effects of breathing exercises post-lung cancer surgery followed by data extraction and quality evaluation.
    UNASSIGNED: From 384 retrieved studies, 10 met the inclusion criteria and were selected for detailed analysis. The main outcomes assessed were postoperative pulmonary function indices and QoL measures. The majority of studies were deemed \'low risk\' for random sequence generation and allocation concealment. However, due to the nature of the interventions, blinding was a \'high risk\' in most cases. The meta-analysis revealed significant improvements in key pulmonary function indices: forced vital capacity (FVC%) increased by an average of 1.73%, maximal voluntary ventilation (MVV) improved by 7.58 L/min, and maximal inspiratory pressure (MIP) enhanced by 0.95 cmH2O. Additionally, there was a notable alleviation of postoperative dyspnea and an enhancement in QoL, with anxiety scores decreasing by an average of 3.42 points and complication rates reducing correspondingly. However, the interventions did not significantly affect physical activity levels or performance on the 6-minute walk test (6WMT), with effect sizes for these outcomes being non-significant.
    UNASSIGNED: This study indicates that breathing exercises significantly improve postoperative pulmonary function and QoL in lung cancer patients. Future research should delve into the mechanisms behind these exercises and evaluate their long-term rehabilitation effects. Customized programs could further optimize recovery and enhance patient QoL.
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  • 文章类型: Journal Article
    目的:这项前瞻性研究旨在通过评估舌下免疫疗法(SLIT)在诊断为过敏性鼻炎(AR)伴/不伴结膜炎(AR/C)的患者中使用含屋尘螨(HDM)提取物的疫苗的持续有效性和安全性,提供进一步的支持性证据。
    方法:对HDM过敏的AR/C患者(n=111,SLIT组:57,对照组:54)于2020年10月至12月接受标准SLIT滴剂或对症药物治疗。研究人员指示患者参加年度医院就诊,以评估各种参数,包括鼻结膜炎生活质量问卷(RQLQ)。视觉模拟量表(VAS),总鼻部症状评分(TNSS),总眼部症状评分(TOSS)和总药物评分(TMS)。在学习期间,所有参与者都被要求在日记卡上保留任何不良事件(AE)的全面记录,然后通过电话传达给调查人员。
    结果:在基线(2020年),TNSS,TOSS,TMS,VAS,SLIT组和对照组的RQLQ评分具有可比性(P>0.05)。经过一年的治疗(2021年),与基线相比,两组所有评分均显著降低(P<0.001).在治疗的第二年(2022年)结束时,与2021年相比,SLIT组的TNSS和RQLQ评分继续显著降低(P<0.05)。第三年(2023年),对照组显示TNSS反弹,TOSS,TMS,和RQLQ分数,与2022年或2021年相比差异显著(P<0.05)。此外,与对照组相比,SLIT组RQLQ所有领域的评分均显著较低(P<0.001).对症治疗影响鼻部症状评分,眼部症状,实际问题,和情感领域在2023年与2021年或2022年相比显著(P<0.05)。在SLIT组中,TNSS没有显著差异,TMS,VAS,在整个治疗的三年中,单敏和多敏患者的RQLQ评分均观察到(P>0.05)。所有AE均为轻度至中度。
    结论:HDM-SLIT的3年疗程在AR/C患者中显示出显着的治疗效果和良好的安全性。重要的是,我们的研究提供了初步证据,表明AR/C对生活质量(QoL)的更大影响可能主要源于鼻部症状,眼部症状,实际问题,和情感幸福。
    OBJECTIVE: This prospective study aims to provide further supportive evidence by assessing the sustained effectiveness and safety of sublingual immunotherapy (SLIT) using a vaccine containing house dust mite (HDM) extracts in patients diagnosed with allergic rhinitis (AR) with/without conjunctivitis (AR/C).
    METHODS: AR/C patients (n = 111, SLIT group: 57, control group: 54) allergic to HDM were treated with standardized SLIT drops or symptomatic drugs from October to December in 2020. The patients were directed by the investigators to attend annual hospital visits for the assessment of various parameters including the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), visual analog scale (VAS), total nasal symptom score (TNSS), total ocular symptom score (TOSS) and total medication score (TMS). During the study period, all participants were mandated to maintain comprehensive records of any adverse events (AEs) on diary cards, which were then communicated to the investigators via telephone.
    RESULTS: At baseline (2020), TNSS, TOSS, TMS, VAS, and RQLQ scores were comparable between SLIT and control groups (P > 0.05). After one year of treatment (2021), significant reduction in all scores compared to the baseline for both groups (P < 0.001). At the end of the second year of treatment (2022), TNSS and RQLQ score in the SLIT group continued to decrease significantly compared to 2021 (P < 0.05). In the third year (2023), the control group showed a rebound in TNSS, TOSS, TMS, and RQLQ scores, significant differences compared to 2022 or 2021 (P < 0.05). Besides, the SLIT group had significantly lower scores across all domains of RQLQ compared to the control group (P < 0.001). Symptomatic treatment influenced the scores of Nasal Symptoms, Eye Symptoms, Practical Problems, and Emotions domains significantly in 2023 compared to 2021 or 2022 (P < 0.05). Within the SLIT group, no significant differences in TNSS, TMS, VAS, and RQLQ scores were observed between monosensitized and polysensitized patients throughout the three years of treatment (P > 0.05). All AEs were mild to moderate.
    CONCLUSIONS: The 3-year course of HDM-SLIT has shown significant therapeutic efficacy and a favorable safety profile in patients with AR/C. Importantly, our study presents initial evidence suggesting that the greater impact of AR/C on quality of life (QoL) may primarily stem from nasal symptoms, eye symptoms, practical issues, and emotional well-being.
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  • 文章类型: Journal Article
    骨转移是晚期癌症的常见和衰弱的后果,通常需要姑息性放射治疗(RT)来缓解疼痛。骨转移的再照射(reRT)通常被认为是在最初的RT疗程后缺乏疼痛缓解后,在对最初的放射治疗过程产生部分但不令人满意的疼痛反应后,或在对初始疗程完全或部分疼痛反应后疼痛复发。NCICCTGSC.20试验,具有里程碑意义的多中心,随机化,非致盲,非劣性对照试验,解决了该患者人群中reRT的最佳剂量分割的关键问题。该试验比较了850例需要reRT的疼痛性骨转移患者中单个8Gy部分与总计20Gy的多个部分的疗效和毒性。主要终点是2个月时的总体疼痛反应,在次要终点的生活质量(QoL)测量中,功能干扰,使用患者报告的问卷和欧洲癌症研究与治疗组织(EORTC)QLQ-C30评估毒性谱。意向治疗分析显示,两臂之间的疼痛反应没有显着差异,符合预先规定的非劣效性标准。符合方案的分析表明,接受多个部分的患者子集具有潜在的益处,尽管这在统计学上并不稳健。急性毒性在多部分臂中更为普遍,对患者舒适度和医疗保健利用率有影响。重要的是,reRT的应答者报告了功能干扰和QoL的显着改善。该试验的发现支持使用以患者为中心的方法来姑息性RT,强调单一8Gy部分作为毒性更低且更方便的治疗选择的可行性,尽管考虑到患者的个别情况。这些结果对临床实践具有重要意义,在疼痛性骨转移姑息治疗期间,有可能减轻医疗负担,同时优化患者便利性。
    Bone metastases are a common and debilitating consequence of advanced cancer, often necessitating palliative radiation therapy (RT) for pain relief. Reirradiation (reRT) of bone metastases is often considered after lack of pain relief following an initial course of RT, after a partial but unsatisfying pain response to an initial course of radiotherapy, or after pain recurrence following a complete or partial pain response to an initial course of RT. The NCIC CTG SC.20 trial, a landmark multicenter, randomized, non-blinded, controlled non-inferiority trial, addressed the critical question of optimal dose fractionation for reRT in this patient population. This trial compared the efficacy and toxicity of a single 8 Gy fraction to multiple fractions totaling 20 Gy in 850 patients with painful bone metastases requiring reRT. The primary endpoint was overall pain response at 2 months, with secondary endpoints of quality of life (QoL) measures, functional interference, and toxicity profiles assessed using patient-reported questionnaires and the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30. The intention-to-treat analysis revealed no significant difference in pain response between the two arms, meeting the pre-specified non-inferiority criteria. The per-protocol analysis suggested a potential benefit for a subset of patients receiving multiple fractions, although this was not statistically robust. Acute toxicities were more prevalent in the multiple fractions arm, with implications for patient comfort and healthcare utilization. Importantly, responders to reRT reported significant improvements in functional interference and QoL. The trial\'s findings support the use of a patient-centric approach to palliative RT, highlighting the viability of a single 8 Gy fraction as a less toxic and more convenient treatment option, albeit with consideration for individual patient circumstances. These results have significant implications for clinical practice, potentially reducing healthcare burdens while optimizing patient convenience during palliative care for painful bone metastases.
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  • 文章类型: Journal Article
    慢性阻塞性肺疾病(COPD)患者的生活质量(QOL)越来越受到关注。然而,面对成千上万的相关临床文献,研究人员和机构越来越难以识别有影响力的研究。文献计量学可以帮助研究者快速、有条不紊地分析临床研究的影响和热点趋势,加强团队合作,解决相关挑战。因此,我们使用文献计量学来分析和可视化过去31年COPD患者的生活质量数据,以了解主要作者,研究领域,和未来趋势。
    我们在WebofScienceCoreCollection中搜索了自数据库建立以来发表的文献。使用的主要术语是“慢性阻塞性肺疾病”,“生活质量”及其不同的组合。选择文章并以纯文本格式导出,以及引用信息。使用R包“bibliometrix”进行文献计量分析和数据可视化,并结合出版物数量等统计指标,核心作者的引文和产出,作者合作,主要期刊,主要研究国家和合作,和关键研究主题。
    文献计量分析包括9,219篇文章。文档类型无限制。所有出版物都在1992年至2022年之间出版,在过去十年中,发表的文章数量每年都在不断增加。周期性波动。《欧洲呼吸杂志》和《国际慢性阻塞性肺疾病杂志》成为该领域中最常被引用的期刊。在这一领域做出贡献的主要作者包括WedzichaJA,琼斯PW,辛格D,荷兰AE,和WoutersEFM。美国和英国展出了大量出版物,高引用率,以及相关领域相对密集的国际合作,其次是中国,西班牙,加拿大,和澳大利亚在这些指标中。值得注意的是,这个领域的突出主题包括肺气肿,肺康复,呼吸困难,急性加重,生活状态,和死亡率,在其他人中。未来在这一领域的研究将集中在微生物,颗粒物,家庭康复,还有太极.
    这项文献计量分析突出了QOL研究在COPD领域的重要性,这可以通知临床医生,研究人员,和政策制定者优先考虑未来调查的领域,以便制定全面的,以患者为中心的策略。同时,建议研究人员应该更多地关注核心作者,加强国际合作和团队交流,积极探索太极拳、家庭康复等特色临床特色治疗措施,开展中西医结合和自我管理的临床研究,更多地关注QOL,患者的心理健康和经济和社会负担,并最终提高患有慢性呼吸系统疾病的人的福祉。
    UNASSIGNED: The quality of life (QOL) of patients with chronic obstructive pulmonary disease (COPD) is garnering increasing attention. However, faced with thousands of relevant clinical literature, it is becoming increasingly difficult for researchers and institutions to identify impactful research. Bibliometrics can help researchers quickly and methodically analyze the impact and hot trends of clinical research, strengthen teamwork, and solve related challenges. Therefore, we used bibliometrics to analyze and visualize data on the QOL of patients with COPD over the past 31 years to understand the key authors, research areas, and future trends.
    UNASSIGNED: We searched the Web of Science Core Collection for literature published since the establishment of the database. The main subject terms used were \"chronic obstructive pulmonary disease\", \"quality of life\" and their different combinations. Articles were selected and exported in plain text format along with citation information. Bibliometric analysis and data visualization were performed using the R package \"bibliometrix\" and by incorporating statistical indicators such as the number of publications, citations and outputs of core authors, author collaborations, major journals, major research countries and collaborations, and key research themes.
    UNASSIGNED: The bibliometric analysis included 9,219 articles. Document type is unlimited. All publications were published between 1992 and 2022, and the number of published articles increased consistently each year over the past decade, with periodic fluctuations. The European Respiratory Journal and the International Journal of Chronic Obstructive Pulmonary Disease emerged as the most frequently cited journals within this domain. Key authors contributing to this field include Wedzicha JA, Jones PW, Singh D, Holland AE, and Wouters EFM. The United States and the United Kingdom exhibited a high volume of publications, high citation rates, and relatively intense international collaboration in related areas, followed by China, Spain, Canada, and Australia in these metrics. Notably, prominent topics within this field included emphysema, pulmonary rehabilitation, dyspnea, acute exacerbation, living status, and mortality, among others. Future research in this field will focus on microorganisms, particulate matter, family rehabilitation, and Tai Chi.
    UNASSIGNED: This bibliometric analysis highlights the growing importance of QOL research in the field of COPD, which can inform clinicians, researchers, and policymakers to prioritize areas for future investigation in order to develop comprehensive, patient-centered strategies. At the same time, it is suggested that researchers should pay more attention to the core authors, strengthen international collaboration and team exchanges, actively explore characteristic clinical featured treatment measures such as Tai Chi and family rehabilitation, carry out clinical research on the integration of traditional Chinese and Western medicine and self-management, focus more on the QOL, mental health and economic and social burden of patients, and ultimately enhance the well-being of individuals with chronic respiratory diseases.
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  • 文章类型: Meta-Analysis
    目的:探讨音乐干预是否能改善造血干细胞移植(HSCT)患者的生活质量,并评价其对患者抑郁、焦虑和疲劳症状的影响。
    方法:本系统综述和荟萃分析按照系统综述和荟萃分析(PRISMA)指南的首选报告项目进行。数据库PubMed,科克伦中部,和EMBASE从成立到2022年9月30日进行了搜索。搜索策略使用关键字“音乐”和“造血干细胞移植”或“HSCT”的组合。“评估的结果是QOL,抑郁和焦虑,和疲劳。计算了具有95%置信区间的标准化平均差异,以比较音乐干预组和对照组之间的结果。使用基于卡方的检验评估了研究中的异质性,以及I2和Q统计量。
    结果:对纳入研究人群的Meta分析显示,对接受HSCT的患者进行音乐干预与患者的生活质量改善有关。与没有音乐干预的患者相比,抑郁/焦虑和疲劳减少。
    结论:音乐干预有利于HSCT结局,包括更好的QOL,减少抑郁/焦虑,术后疲劳减少。未来仍有必要进行更大样本的试验,以加强支持音乐干预对该患者人群的益处的证据。
    OBJECTIVE: To explore whether music intervention improves the quality of life (QOL) of patients undergoing hematopoietic stem cell transplantation (HSCT) and to evaluate its impact on patients\' symptoms of depression/anxiety and fatigue.
    METHODS: This systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items of Systematic reviews and Meta-Analyses (PRISMA) guidelines. The databases PubMed, Cochrane CENTRAL, and EMBASE were searched from inception to September 30, 2022. The search strategy used a combination of the keywords \"music\" and \"hematopoietic stem cell transplantation\" or \"HSCT.\" The outcomes assessed were QOL, depression and anxiety, and fatigue. Pooled standardized mean differences with 95% confidence intervals were calculated to compare the outcomes between the music intervention and control groups. Heterogeneity across the studies was assessed using a chi-square-based test, and the I2 and Q statistics.
    RESULTS: Meta-analysis of the included study population showed that music intervention for patients undergoing HSCT was associated with patients\' improved QOL, and resulted in reduced depression/anxiety and fatigue compared to patients without music intervention.
    CONCLUSIONS: Music intervention benefits HSCT outcomes, including better QOL, less depression/anxiety, and less fatigue postoperatively. Future trials with larger samples are still warranted to strengthen the evidence supporting the benefits of music intervention in this patient population.
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  • 文章类型: Observational Study
    目的:探讨原发性醛固酮增多症(PA)患者规范化治疗后健康相关生活质量(HRQoL)的变化。并找出不同变量对患者HRQoL变化的影响。
    方法:前瞻性纳入2020年11月至2022年3月的116例PA患者。在初次诊断和治疗12个月后随访时收集数据,包括人口统计数据,临床数据和来自健康调查(SF-36)的MOS项目得分。比较患者治疗前后SF-36各维度评分,并对影响其生活质量变化的因素进行多元线性回归分析。
    结果:标准化治疗后,醛固酮与肾素的比值(Z=-4.967,P<0.001),PA患者收缩压(t=8.985,P<0.001)和舒张压(t=7.233,P<0.001)较基线下降,低钾血症得到有效纠正(χ2=69.014,P<0.001)。在生活质量方面,随访1年的SF-368个维度中的6个维度和SF-36的总分与基线相比显著提高,所有P<0.05;多元线性回归结果显示,PA患者规范化治疗后HRQoL的改善与血钾(P=0.007)和收缩压(P=0.003)的变化相关。
    结论:无论接受何种标准化治疗,纠正低钾血症和控制舒张压都是PA患者HRQoL改善的重要因素。
    OBJECTIVE: To explore the changes in the health-related quality of life (HRQoL) in patients with primary aldosteronism (PA) after standardized treatment and determine the effects of different variables on the change in the HRQoL of patients.
    METHODS: A total of 116 patients with PA were prospectively included from November 2020 to March 2022. Data were collected at their initial diagnosis and the follow-up after 12 months of treatment, including demographic and clinical data and the scores of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). The scores of each dimension of SF-36 of patients before and after treatment were compared, and the factors affecting their change in the quality of life were analyzed using multiple linear regression.
    RESULTS: After standardized treatment, the aldosterone-to-renin ratio (Z = -4.967, P < .001), systolic blood pressure (t = 8.985, P < .001), and diastolic blood pressure (t = 7.233, P < .001) of patients with PA decreased compared with baseline, and hypokalemia was effectively corrected (χ2 = 69.014, P < .001). In terms of quality of life, 6 of 8 dimensions of SF-36 and the total score of SF-36 significantly improved at 1-year follow-up compared with baseline (all P < .05). The results of multiple linear regression showed that the improvement in the HRQoL in patients with PA after standardized treatment was correlated with the change in the blood potassium level (P = .007) and systolic blood pressure (P = .003).
    CONCLUSIONS: Correction of hypokalemia and control of diastolic blood pressure are essential factors contributing to the improvement in the HRQoL in patients with PA regardless of the standardized treatment received.
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  • 文章类型: Journal Article
    本研究旨在确定影响MDS患者生活质量(QOL)和功能状态的因素。
    我们回顾了过去30年来发表在PUBMED上的文献,并搜索了诸如“生活质量”和“骨髓增生异常综合征”等关键词。通过观察他们症状的影响,通过改善这些相关因素来考虑改善患者生活质量的可能性。同时,根据MDS患者独特的疾病特征进行相关临床治疗对患者生活质量的影响,在临床实践中考虑了生活方式因素,为改善MDS患者的生活质量和功能状态提供了重要途径。
    这篇综述总结了可以提高MDS患者生存质量的几个领域,并进行了深入的讨论。尽管临床益处可能很小,我们仍然希望以最小的成本改善患者的日常生活结果,提高他们的生活质量。此外,我们希望将来有更多的研究人员将重点放在这方面,以找到可能存在的更多因素来补充这些理解和思考的局限性,并在临床工作中提供协助。
    This study aimed to identify the factors affecting the quality of life (QOL) and functional status of patients with MDS.
    We reviewed the literature published in PUBMED over the past 30 years and searched for keywords such as \'quality of life\' and \'myelodysplastic syndromes\'. By observing the influence of their symptoms, the possibility of improving patients\' QOL was considered by improving these related factors. Concurrently, the effects of related clinical treatments based on the unique disease characteristics of MDS on the patients\' QOL were examined, and lifestyle factors were considered in clinical practice, providing an important path to improve the QOL and functional status of patients with MDS.
    This review summarized several areas that can improve the quality of survival of MDS patients and discusses them in depth. Although the clinical benefits may be minimal, we still hope to improve patients\' daily life outcomes and enhance their quality of life at minimal cost. Also, we hope more researchers will focus on this area in the future to find more factors that may exist to supplement the limitations of these understanding and thinking, and to provide assistance in clinical work.
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  • DOI:
    文章类型: Journal Article
    这项研究调查了在FOLFIRI贝伐单抗作为一线治疗失败后,转移性结直肠癌(mCRC)患者接受或不接受靶向药物(贝伐单抗或雷莫鲁单抗)作为二线治疗的1年内的成本效益和生活质量(QoL)。这项前瞻性队列研究包括在2015年3月至2020年5月期间接受mCRC诊断的患者。在治疗前以及治疗后6个月和1年评估QoL。所有相关变量均使用治疗加权逆概率方法进行控制。采用差分差分方法的广义估计方程用于探索QoL的变化。使用年周期马尔可夫决策树模型对两组的增量成本效用比(ICUR)进行了模拟。最后,39例和76例患者被纳入靶向和非靶向药物组,分别。治疗后6个月,两组QoL均有明显改善,但在治疗后1年,靶向药物组的QoL明显优于非靶向药物组(P<0.05)。当时间框架设定为20年时,与非靶向药物组相比,靶向药物组的ICUR为每质量调整生命年32,052美元.在二线mFOLOFX6方案中添加靶向药物不仅改善了患者的生活质量,而且当支付意愿阈值设定为33,004美元(台湾人均国内生产总值)时,成本效益更高。这些患者应该由台湾的国民健康保险计划报销这些目标代理商。
    This study investigated the cost-effectiveness and quality of life (QoL) within 1 year of receiving mFOLOFX6 with or without a targeted drug (bevacizumab or ramucirumab) as second-line treatment among patients with metastatic colorectal cancer (mCRC) following the failure of FOLFIRI + bevacizumab as first-line treatment. This prospective cohort study included patients who received a diagnosis of mCRC between March 2015 and May 2020. QoL was evaluated before treatment and at 6 months and 1 year posttreatment. All related variables were controlled using the inverse probability of treatment weighting method. Generalized estimating equations with the difference-in-difference method was used to explore changes in QoL. The incremental cost-utility ratio (ICUR) of the two groups was simulated using the annual-cycle Markov decision tree model. Finally, 39 and 76 patients were included in the targeted and nontargeted agent groups, respectively. At 6 months after treatment, QoL of the two groups improved significantly, but the targeted agent group had significantly better QoL than did the nontargeted agent group at 1 year posttreatment (P < 0.05). When the time frame was set to 20 years, the ICUR of the targeted agent group compared with the nontargeted agent group was US$32,052 per quality-adjusted life years. Addition of a targeted drug to the second-line mFOLOFX6 regimen not only improved the patients\' QoL but was also more cost effective when the willingness-to-pay threshold was set at US$33,004 (the per capita gross domestic product of Taiwan). These patients should be reimbursed for these targeted agents by the National Health Insurance scheme in Taiwan.
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  • DOI:
    文章类型: English Abstract
    目的:探讨2019年冠状病毒病(COVID-19)大流行对泌尿系结石术后患者生活质量(QoL)和心理健康的影响。
    方法:收集2019年12月至2020年6月在泌尿外科内镜碎石术后行输尿管支架置入术患者的人口学和临床资料。收集输尿管支架症状问卷(USSQ)评分和结果20项焦虑自评量表(SAS)和抑郁自评量表(SDS),以评估QoL和精神状态。USSQ由6个领域的44个问题组成(包括泌尿症状,身体疼痛,一般健康,工作表现,性功能,和输尿管支架相关感染)。对于每个领域的大多数问题,其评分为1~5分的Likert型5分量表,小部分问题用1~4或1~7量表量化.SAS和SDS均包含20个问题,用于评估患者的焦虑和抑郁水平。每个项目的评分均为1至4的4分Likert型评分。总分(20至80分)是主要统计指标。通过使用标准分数(总分乘以1.25以产生整数)来量化临床焦虑和抑郁的水平。并通过矩结构分析(AMOS)分析构建了多组结构方程模型。
    结果:总体而言,71例患者被纳入分析。结果发现,对照组和延迟组的输尿管支架时间中位数差异显着,分别为32(30,33)d和94.5(88,103)d,分别。延迟组导致USSQ多维分数更高,其中包括泌尿症状,一般健康,工作表现和输尿管支架相关感染。延迟组的焦虑和抑郁也明显比对照组严重。输尿管支架留置时间越长,尿路症状和躯体疼痛对工作表现的影响越严重(P=0.029<0.05)。其中,尿路症状严重导致工作表现不佳的患者受输尿管支架持续时间延长的影响最大(CR=2.619>1.96).
    结论:因COVID-19导致输尿管支架拔除延迟的患者导致QoL和精神状态恶化。在COVID-19期间,焦虑和抑郁程度较高的患者支架相关症状更严重。为改善COVID-19期间泌尿系结石术后患者的生活质量和心理健康状况,仍不建议延长支架持续时间或采取相应干预措施。
    OBJECTIVE: To explore the impacts of delayed ureteral stent removal on the quality of life (QoL) and mental health of urinary calculi postoperative patients due to the corona virus disease 2019(COVID-19) pandemic.
    METHODS: The demographic and clinical data of patients with ureteral stent placement after urinary endoscopic lithotripsy and returned to Peking University People\'s Hospital for stent removal from December 2019 to June 2020 were collected. Ureteral stent symptoms questionnaire (USSQ) score and the outcome 20-item self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were collected to estimate the QoL and mental status. The USSQ consisted of 44 questions in 6 domains (including urinary symptom, physical pain, general health, work performance, sexual function, and ureteral stent related infection). For most questions in each domain, its score was a five-point Likert-type scale from 1 to 5, and a small proportion of questions was quantified by 1 to 4 or 1 to 7 scale. SAS and SDS both contained 20 questions used to assess a patient\'s level of anxiety and depression. Its scoring for each item was on a four-point Likert-type scale from 1 to 4. A total score (ranging from 20 to 80) was the main statistical indicator. The level of clinical anxiety and depression was quantified by using standard scores (total score multiplied by 1.25 to produce integers). And the multi-group structural equation model was constructed by analysis of moment structure (AMOS) analysis.
    RESULTS: Overall, 71 patients were enrolled for analysis. It was found that the median duration of ureteral stent time differed significantly between the control and delayed groups for 32 (30, 33) d and 94.5 (88, 103) d, respectively. The delayed group resulted in higher scores in the USSQ multidimensional, which included urinary symptoms, general health, work performance and ureteral stent related infections. Anxiety and depression were also significantly serious in the delayed group than in the control group. A longer indwelling time of a ureteral stent could exacerbate the effects of urinary symptoms and physical pain on work performance (P=0.029 < 0.05). Among them, the patients with severe urinary symptoms leading to poor work performance were most significantly affected by prolonged ureteral stent duration time (CR=2.619>1.96).
    CONCLUSIONS: Patients with delayed ureteral stent removal due to the COVID-19 had resulted in worse QoL and mental status. Stents related symptoms are more severe in patients with higher anxiety and depression degree during COVID-19. To improve the QoL and mental health of patients after urinary calculi surgery during COVID-19, it is still not recommended to prolong the stent duration time or corresponding intervention measures should be taken.
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