Objective:To evaluate and compare the quality of life(QoL)in patients with multidrug-resistant(MDR-TB)and drug-sensitive(DS-TB)as well as to investigate factors associated with QoL among MDR-TB patients in real-world ...Objective:To evaluate and compare the quality of life(QoL)in patients with multidrug-resistant(MDR-TB)and drug-sensitive(DS-TB)as well as to investigate factors associated with QoL among MDR-TB patients in real-world scenarios at the Haji Hospital,Surabaya.Methods:We conducted a case-control study from June to December 2024.MDR-TB and DS-TB patients were classified into case and control groups,respectively.We used the World Health Organization’s Quality of Life Brief(WHOQOL-BREF)instrument and Patient Health Questionnaire-9(PHQ-9)to assess QoL and depression levels,respectively.Multivariate analysis was used to analyze factors associated with QoL of patients with MDR-TB.Results:Forty-one patients with MDR-TB and 43 with DS-TB were enrolled in the study.A mean score for all domains(physical,psychological,social relationship,environmental)and total mean score of WHOQOL-BREF was significantly lower in MDR-TB than those with DS-TB(P<0.05).The prevalence of depression and the mean score of PHQ-9 were significantly higher in MDR-TB than in DS-TB(P<0.05).PHQ-9 negatively correlates with the WHOQOL-BREF score(r=-0.502,P<0.05)among MDR-TB patients.MDR-TB patients with depression were significantly associated with low QoL in the physical(OR 3.611;95%CI 2.393-6.951;P=0.029),psychological(OR 1.672;95%CI 1.179-5.941;P=0.021),social relationship(OR 2.586;95%CI 1.611-2.909;P=0.014),and environmental domains(OR 1.926;95%CI 1.047-2.147;P=0.048).Conclusions:MDR-TB patients had worse QoL than DS-TB.Those with depression were associated with low QoL.Strategies that identify and tackle alterations in the QoL for MDR-TB patients are necessary during TB treatment.展开更多
High maternal and child deaths in developing countries are frequently linked to poor health services provided to pregnant women and children. To improve the quality of maternal, neonatal and child health (MNCH) servic...High maternal and child deaths in developing countries are frequently linked to poor health services provided to pregnant women and children. To improve the quality of maternal, neonatal and child health (MNCH) services, the government and other stakeholders in MNCH emphasize the importance of quality assessment. However, effective quality assessment approaches are mostly lacking in most developing countries, particularly in Tanzania. This study, therefore, aimed at developing a quality assessment approach that can effectively assess and report on the quality of MNCH services. Due to the need for a good quality assessment approach that suits a resource-constrained environment, machine learning-based approach was proposed and developed. K-means algorithm was used to develop a clustering model that groups MNCH data and performs cluster summarization to discover the knowledge portrayed in each group on the quality of MNCH services. Results confirmed the clustering model’s ability to assign the data points into appropriate clusters;cluster analysis with the collaboration of MNCH experts successfully discovered insights on the quality of services portrayed by each group.展开更多
In order to more effectively assess the health status of a project, the monitoring indices in a project＇s life cycle are divided into quality index, cost index, time index, satisfaction index, and sustainable develop...In order to more effectively assess the health status of a project, the monitoring indices in a project＇s life cycle are divided into quality index, cost index, time index, satisfaction index, and sustainable development index. Based on the feature of qualitative and quantitative indices combining, the PCA-PR （principal component analysis and pattern recognition） model is constructed. The model first analyzes the principal components of the life-cycle indices system constructed above, and picks up those principal component indices that can reflect the health status of a project at any time. Then the pattern recognition model is used to study these principal components, which means that the real time health status of the project can be divided into five lamps from a green lamp to a red one and the health status lamp of the project can be recognized by using the PR model and those principal components. Finally, the process is shown with a real example and a conclusion consistent with the actual situation is drawn. So the validity of the index system and the PCA-PR model can be confirmed.展开更多
Multiple studies have demonstrated that oral health quality of life(OHQOL)in patients with type 2 diabetes(T2DM)is affected by multiple factors.Therefore,during this study the related factors of OHQOL for T2DM was rev...Multiple studies have demonstrated that oral health quality of life(OHQOL)in patients with type 2 diabetes(T2DM)is affected by multiple factors.Therefore,during this study the related factors of OHQOL for T2DM was reviewed,and analyzed them from the aspects of socio-demographic factors,T2DM related factors and oral health related factors.This was to provide basis for nursing workers to develop personalized nursing measures.展开更多
AIM: To investigate the effect of vitamin D (VD) concentrations and VD supplementation on health related quality of life in inflammatory bowel disease (IBD) patients.
BACKGROUND Alterations in health-related quality of life(HRQoL)and neuropsychological disorders were described in the hepatitis C virus(HCV)patients.Although several studies investigated the modifications of HRQoL aft...BACKGROUND Alterations in health-related quality of life(HRQoL)and neuropsychological disorders were described in the hepatitis C virus(HCV)patients.Although several studies investigated the modifications of HRQoL after HCV eradication,no data exists on the modifications of neuropsychological symptoms.AIM To investigate the effect of directly acting antivirals(DAAs)treatment on HRQoL and neuropsychological symptoms.METHODS Thirty nine patients with HCV infection underwent a neuropsychological assessment,including Zung-Self Depression-Rating-Scale,Spielberg State-Trait Anxiety Inventory Y1-Y2 and the Toronto-Alexithymia Scale-20 items before and after DAAs treatment.HRQoL was detected by Short-Form-36(SF-36).RESULTS All HRQoL domains,but role limitation physical and bodily pain,significantly improved after treatment.Interestingly,after DAAs treatment,all domains of HRQoL returned similar to those of controls.Each neuropsychological test significantly improved after HCV eradication.A significant correlation was observed among each psychological test and the summary components of SF-36.At multiple linear regression analysis including each psychological test as possible covariates,Zung-Self Depression Rating Scale(Zung-SDS)score was independently and significantly related to summary components of the SF-36 in the basal state and the difference between Zung-SDS score before and after treatment was the only variable significantly and independently related to the modification of HRQoL induced by the treatment.CONCLUSION Neuropsychological symptoms strongly influenced HRQoL in HCV patients and there was a significant improvement of neuropsychological tests and HRQoL after DAAs treatment.展开更多
In this paper</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> we present a thorough review of one of the most</span><span style...In this paper</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> we present a thorough review of one of the most</span><span style="font-family:Verdana;"> life-threatening autoimmune diseases, Systemic lupus erythematosus (lupus). Symptoms, risk factors, including genetic and epidemiological factors are discussed. Treatment, life expectancies, and Health Related Quality of Life of patients with SLE will be discussed as well. Special attention will be given to Lupus Nephritis.展开更多
Diverticular disease(DD) of the colon is very common in developed countries and is ranked the fifth most important gastrointestinal disease worldwide.The management of acute diverticulitis without perforation and peri...Diverticular disease(DD) of the colon is very common in developed countries and is ranked the fifth most important gastrointestinal disease worldwide.The management of acute diverticulitis without perforation and peritonitis is still debated.Health related quality of life(HRQL),subjectively perceived by patients,is becoming a major issue in the evaluation of any therapeutic intervention,mainly in patients with chronic disease.To date only a few published studies can be found on Medline examining HRQL in patients with DD.The aim of this study was to review the impact of surgery for DD on HRQL.All Medline articles regarding HRQL after surgery for colonic DD,particularly those comparing different surgical approaches,were reviewed.DD has a negative impact on HRQL with lower scores in bowel function and systemic symptoms.Both surgery-related complications and disease activity have a significant impact on patients' HRQL.While no signif icant differences in HRQL between different operations for DD in non-randomized studies were revealed,the only prospective double-blind randomized study that compared laparoscopic and open colectomy found that patients undergoing laparoscopic colectomy had signif icantly reduced major postoperative complication rates and subsequently had better HRQL scores.Formal assessment of HRQL could be a good instrument in the selection of appropriate patients for elective surgery as well as in the assessment of surgical outcome.展开更多
Objective:To investigate individual characteristics related to satisfaction with the quality of First Health Facility Services(FHFS)in Indonesia.Methods:This cross-sectional study analyzes national representation data...Objective:To investigate individual characteristics related to satisfaction with the quality of First Health Facility Services(FHFS)in Indonesia.Methods:This cross-sectional study analyzes national representation data.Meanwhile,the study involved 9846 representative respondents in 2019.Respondent’s satisfaction with FHFS based on the five dimensions of service quality(SERVQUAL)is a dependent variable.Independent variables consist of sex,marital status,age,education,employment,insurance ownership,and economics.The study used multivariate logistic regression to explain the relationship between individual characteristics and FSHS quality.Results:77.3%Respondents were satisfied with FHFS,with the highest order of satisfaction dimensions being assurance(59.4%),empathy(57.3%),reliability(53.6%),responsiveness(52.7%),and then tangibility(49.1%).Multivariate logistic analysis showed that divorce was 1.48 more likely than never-married to be satisfied(95%CI 1.17-1.87).Employees were 0.77 less likely than the unemployed to get satisfied(95%CI 0.70-0.86).Respondents with higher education was 0.82 less likely than those with primary education to be satisfied(95%CI 0.67-0.99).Meanwhile,respondents who had government-run insurance were 1.61 more likely than uninsured to be satisfied(95%CI 1.42-1.80).Moreover,the rich were 0.82 less likely than the poor to get satisfied(95%CI 0.73-0.92).Conclusions:Community satisfaction with FHFS is generally high,though some areas could be improved.Demographic factors are still strongly related to satisfaction ratings.The government can assess the quality of services in accordance with standards and disseminate information about service standards for primary facilities to all levels of society,ensuring that service satisfaction is rated as good by all groups.展开更多
Introduction: The health related quality of life (HRQoL) has an important role in adults suffering from diabetes. Objective: To assess the health related quality of life in adult with type 2 diabetes mellitus. Materia...Introduction: The health related quality of life (HRQoL) has an important role in adults suffering from diabetes. Objective: To assess the health related quality of life in adult with type 2 diabetes mellitus. Materials and methods: A cross-sectional study was conducted to assess diabetic patient’s HRQoL on 119 purposively selected type-2 DM patients (aged ≥ 18 years and duration of diabetes ≥ 1 year). Data were collected by face-to-face interview and by medical record review through a Bangle version of SF-36 semi-structured questionnaire and a checklist. Place and period of study: The study was conducted at outpatient department in Gopalganj 50 bedded diabetic hospital from 1<sup>st</sup> January, 2018 to 31<sup>st</sup> December 2018. Results: The mean age of the respondents was 52.34 (SD ± 10.19) years. Age group shows a significant difference associated with all domains of quality of life except role emotion (>0.05), gender shows the significant in social and pain domain (0.05) respectively co-morbidity shows the significant difference with all domains expect pain (>0.05). Physical functioning, emotional, pain and general health of the quality of life show the significant difference associated with use of insulin (Conclusion: The overall QoL of type-2 DM patients was poor and had lower score of health related quality of life.展开更多
Objective:The objective of this study was to investigate the frequency of acute and late toxicities,as well as changes in the quality of life(QOL)for breast cancer patients following radiotherapy(RT).Materials and Met...Objective:The objective of this study was to investigate the frequency of acute and late toxicities,as well as changes in the quality of life(QOL)for breast cancer patients following radiotherapy(RT).Materials and Methods:A total of 108 breast cancer women were recruited for this prospective study.Data were collected at various intervals;prior to,and 1,3,6 months,and 1 year after radiation therapy.The primary outcomes were toxicity radiation therapy oncology group/European Organization for Research and Treatment of Cancer(EORTC)criteria.Our secondary outcome was QOL,measured using EORTC QLQ-C30 and Edmonton Symptom Assessment Scale.We employed Friedman’s two-way analysis to evaluate the changes in QOL over the course of 1 year.Results:The early toxicities that are most commonly experienced include pharyngeal,skin,and mucous membrane toxicity.Late toxicities frequently involve skin and submucosal toxicity.To measure patient functionality,all functional subscale scores except for the patient’s emotional state increased over time compared to pre-RT.Symptoms of the patients,which were included in the QOL symptom scale,decreased during the follow-up period,except for fatigue;however,changes in pain,insomnia,and loss of appetite did not significantly change.We identified the analogous symptom profiles in Edmonton.Although patients’overall health scores declined in the 1st and 3rd months after radiotherapy(RT),they rebounded at 6 and 12 months.Conclusion:For breast cancer patients,RT did not adversely affect functional capacity or exacerbate symptoms,but persistent fatigue did increase during the observation period.Health-care professionals ought to devise strategies to assist patients with skin toxicity and fatigue.展开更多
Background The thesis is to study the influence of anxiety/depression on health related quality of life （HRQoL） of patients with various pacing modes a month after they have had a pacemaker implanted. Methods HRQoL ...Background The thesis is to study the influence of anxiety/depression on health related quality of life （HRQoL） of patients with various pacing modes a month after they have had a pacemaker implanted. Methods HRQoL was assessed consecutively in patients （50 men, 48 women, mean age 52.7±14.1 years） with implanted pacemaker （PM） from June to December 2009 in our hospital （22 patients received VVI pacemaker, 26 received VVIR pacemaker, 26 received DDD pacemaker, 24 received DDDR pacemaker）. HRQoL was measured by the SF-36 and Aquarel questionnaires, anxiety by Zung anxiety scale （SAS） and depression by Zung depression scale （SDS）. Results Patients with rate-adaptive pacing had higher scores in SF-36 scales （health perception, vitality, social functioning and mental health） and Aquarel （chest pain, dyspnea and arrhytmia）; they also presented lower degree of anxiety and depression compared with those with non-rate-adaptive pacing. Differences were shown only in the group with dual chamber pacemakers, but not in the group with single chamber pacemakers. Significant differences were observed between patients with single chamber and dual chamber PM in rate-adaptive pacing. There was a strong correlation between the degree of anxiety and depression and the HRQoL for pacemaker patients. Conclusion Dual chamber rate-adaptive pacing offers better HRQoL and psychological profile than dual chamber non-rate-adaptive pacing. Significant improvement in five SF-36 subscales was observed with DDDR pacing compared with VVIR pacing. Anxiety and depression are important factors in the HRQoL of patients with implanted pacemakers. Early detection and intervention in patients with psychological problems are imperative.展开更多
Background: Total quality management (TQM) plays a major role in quality health services improvement. The aims of the study are to identify the concepts of total quality management in health institutions to know the n...Background: Total quality management (TQM) plays a major role in quality health services improvement. The aims of the study are to identify the concepts of total quality management in health institutions to know the nature of the relationship between the application of TQM and improving the quality of health services in Sana’a Governorate. Method: This applied research is a descriptive cross-sectional study in which the TQM of 13 affiliated Sana’a Governorate hospitals during “2017-2020”, were evaluated based on self-administered questionnaires. Data were collected by questionnaires including demographical variables, TQM dimensions variables. Data were analyzed by using SPSS version 16. Results: A total of 281 users 98.6% had responded. The employee’s responses for sixth study dimensions were the top manager’s commitment (TMC) 80.46%, customers focusing CF 81.55%, continuous improvement (CI) 82.32%, training (T) 71.51%, and strategic planning of the quality (SPQ) 74.76%, health services quality improvement (HSQI) 74.25%. There is a strong relationship between TQM and HSQI. There is no relationship between demographic factors gender, profession, years of experience, except age with TMC, T, HSQI, qualification with the TMC, CI, T, HSQI and job with all study variables. Conclusion: The application of TQM at hospitals in quality of health services improvement has several challenges, lacking staff experience and lacking leadership support, weakness of the training, customers focusing, continuous improvement, and strategic planning of the quality. Therefore, benefiting from the experiences of leading hospitals in implementing total quality management programs by sending some cadres to these hospitals for training and gaining experience or by hosting experienced cadres to conduct training courses is recommended.展开更多
Introduction: Lifelong Anti-Retroviral Therapy (ART) promotes good quality of life and health among HIV-positive men and women. However, simplified newer and effective ART has not increased retention in care, or long-...Introduction: Lifelong Anti-Retroviral Therapy (ART) promotes good quality of life and health among HIV-positive men and women. However, simplified newer and effective ART has not increased retention in care, or long-term ART adherence, especially among women. There are many factors that impede long-term adherence in women. This includes among other things female gender, depression, greater than once-daily dosing, longer time since HIV diagnosis, and patient beliefs. This study measures the quality of life in women whose ART durations range from one to fifteen years, using the standardized WHO Quality of Life questionnaire. Material and Methods: One hundred and fourteen women were divided into three groups based on ART duration. Group 1 had 37 women on ART for less than five years, Group 2 had 48 women on ART from 5 to 10 years and Group 3 had 29 women on ART for more than ten years. They were administered the WHO Quality of Life (QOL) questionnaire, which assesses QOL in six domains. QOL was considered poor in scores between 4 - 9.9, medium in scores of 10 - 14.9 and good in scores of 15 - 20. Results: Scores in all 3 groups were more than 85% in five domains and around 74.5% in the psychological domain. Domain mean scores were Physical 18 (CI 17.63 - 18.37), Psychological 14.9 (CI 14.55 - 15.25), Independence 18.6 (CI 18.33 - 18.87), Social relationships 17.5 (CI 17.07 - 17.93), Environmental 17.6 (CI 17.25 - 17.95), Spiritual, Religious, Personal beliefs, 17.4 (CI 16.93 - 17.87). Scores for women on long-term ART (Group 3) are not different from the other 2 groups and the p-values were not statistically significant. Conclusion: Women on long-term ART fare extremely well compared to other groups with more than 93% showing good QOL and none showing poor Quality of Health in spite of being on ART for a longer period of time than the other two groups. Despite a multitude of impeding factors, women who continue ART faithfully and consistently enjoy a good quality of health and life. Adequate preparation and a supportive health system are essential for ensuring long-term adherence, but the attitude and commitment of women are also critical.展开更多
Purpose: To evaluate personality characteris- tics’ impact upon outcome after silicone-based MP arthroplasty in RA patients. Methods: 40 RA patients who had undergone operations on their MP joints were investigated i...Purpose: To evaluate personality characteris- tics’ impact upon outcome after silicone-based MP arthroplasty in RA patients. Methods: 40 RA patients who had undergone operations on their MP joints were investigated in a one-year fol- low-up. Objective measurement to assess grip strength and active range of motion—Paper- pencil-tests to assess pain during activity and at rest performance, QoL, and personality. Results: Significant improvement was observed in func- tion and pain related scores except for the pain related VAS and in several QoL facets and do- mains. Patients who experienced improvement reported higher scores on the activities of daily living facet of the WHO QoL questionnaire. Those with lower pain showed more independ- ence. The variance of the QoL domain scores, other than social and physical domains, could substantially and meaningfully be explained by variance of objective measures combined with personality scores. Conclusions: Most RA pa- tients’ QoL can be improved by MP arthroplasty despite remaining substantial level of pain. NS and HA seem to play an important role in the adaptation process during the long term, chronic illness;whereas SD represents a tool of coping with the burden of pain and disability. Personal- ity characteristics are highly predictive for QoL suggesting their important mediating role be- tween experienced pain and disability and HR QoL.展开更多
Objective:To investigate the oral health related quality of life in elderly diabetic patients and analyze its influencing factors.Methods:Convenience sampling was used to select 190 elderly patients with diabetes unde...Objective:To investigate the oral health related quality of life in elderly diabetic patients and analyze its influencing factors.Methods:Convenience sampling was used to select 190 elderly patients with diabetes under the Department of Endocrinology and Department of Integrated Traditional Chinese and Western Medicine in the Affiliated Hospital of Hebei University as the research subjects.The Chinese version of the Oral Health Influence Scale(OHIP-14)was used to conduct a questionnaire survey,and univariate analysis and multiple stepwise regression analysis were used to analyze the influencing factors of oral health related quality of life in elderly diabetic patients.Results:The elderly diabetic patients'oral health related quality of life score was 34.48±3.23,which is in the middle-lower range.The findings of multivariate stepwise regression analysis revealed that the course of disease,regular visits to the dentist,sleep quality,oral health knowledge,and oral health attitude together explained 58.9%of the total variance in elderly diabetic patients in terms of their oral health related quality of life(p<0.05).Conclusion:The oral health related quality of life of elderly diabetic patients is generally low,and is affected by the duration of diabetes,sleep quality,and oral health knowledge,attitude,and behavior(regular visits to the dentist).Improving patientsJ attention to oral health problems by improving sleep as well as their own oral health knowledge,attitude,and behavior is an effective way to enhance oral health related quality of life.展开更多
Zhang Weiqing, director of the National Population and Family Planning Commission (NPFPC), disclosed at the inaugural meeting of the China Reproductive Health Industry Association (CRIA), held on March 26, 2007, t... Zhang Weiqing, director of the National Population and Family Planning Commission (NPFPC), disclosed at the inaugural meeting of the China Reproductive Health Industry Association (CRIA), held on March 26, 2007, that China will create an inspection system, a quality accreditation system, and an industry access system for better population structure and family planning.……展开更多
Purpose:This study aimed to develop quality indicators for the care of older adults with disabilities in long-term care facilities(LTCFs)based on Maslow’s hierarchy of needs.Methods:The draft of the quality indicator...Purpose:This study aimed to develop quality indicators for the care of older adults with disabilities in long-term care facilities(LTCFs)based on Maslow’s hierarchy of needs.Methods:The draft of the quality indicators was drawn up based on a literature review and research group discussion.The quality indicators were finalized by two rounds of expert consultation(involving 15 experts)using the Delphi method.The Analytic Hierarchy Process was applied to calculate the indicators’weight.Results:The response rates of the two rounds of consultation were 100%and 93%,and the expert authority coefficients were 0.86 and 0.87.After two rounds of consultation,the expert opinion coordination coefficients of the first-,second-and third-level indicators were 0.42,0.25,and 0.96,respectively(P<0.05),and the variation coefficient was0.25.The final quality indicators for the care of older adults with disabilities in LTCFs included 7 first-level,19 second-level,and 107 third-level indicators.Conclusion:The quality indicators for the care of older adults with disabilities in LTCFs are reliable,scientific,comprehensive,and practical and specify the content of person-centered care needs.This can provide a reference for evaluating and improving care quality in LTCFs.展开更多
Health related quality of life(HRQOL) is increasingly recognized as an important clinical parameter and research endpoint in patients with hepatocellular carcinoma(HCC). HRQOL in HCC patients is multifaceted and affec...Health related quality of life(HRQOL) is increasingly recognized as an important clinical parameter and research endpoint in patients with hepatocellular carcinoma(HCC). HRQOL in HCC patients is multifaceted and affected by medical factor which encompasses HCC and its complications, oncological and palliative treatment for HCC, underlying liver disease, as well as the psychological, social or spiritual reaction to the disease. Many patients presented late with advanced disease and limited survival, plagued with multiple symptoms, rendering QOL a very important aspect in their general well being. Various instruments have been developed and validated to measure and report HRQOL in HCC patients, these included general HRQOL instruments, e.g., Short form(SF)-36, SF-12, Euro Qo L-5D, World Health Organization Quality of Life Assessment 100(WHOQOL-100), World Health Organization Quality of Life Assessment abbreviated version; general cancer HRQOL instruments, e.g., the European Organisation for Research and Treatment of Cancer(EORTC) QLQ-C30, Functional Assessment of Cancer Therapy(FACT)-General, Spitzer Quality of Life Index; and liver-cancer specific HRQOL instruments, e.g., EORTC QLQ-HCC18, FACT-Hepatobiliary(FACT-Hep), FACT-Hep Symptom Index, Trial Outcome Index. Important utilization of HRQOL in HCC patients included description of symptomatology and HRQOL of patients, treatment endpoint in clinical trial, prognostication of survival, benchmarking of palliative care service and health care valuation. In this review, difficulties regarding the use of HRQOL data in research and clinical practice, including choosing a suitable instrument, problems of missing data, data interpretation, analysis and presentation are examined. Potential solutions are also discussed.展开更多
文摘Objective:To evaluate and compare the quality of life(QoL)in patients with multidrug-resistant(MDR-TB)and drug-sensitive(DS-TB)as well as to investigate factors associated with QoL among MDR-TB patients in real-world scenarios at the Haji Hospital,Surabaya.Methods:We conducted a case-control study from June to December 2024.MDR-TB and DS-TB patients were classified into case and control groups,respectively.We used the World Health Organization’s Quality of Life Brief(WHOQOL-BREF)instrument and Patient Health Questionnaire-9(PHQ-9)to assess QoL and depression levels,respectively.Multivariate analysis was used to analyze factors associated with QoL of patients with MDR-TB.Results:Forty-one patients with MDR-TB and 43 with DS-TB were enrolled in the study.A mean score for all domains(physical,psychological,social relationship,environmental)and total mean score of WHOQOL-BREF was significantly lower in MDR-TB than those with DS-TB(P<0.05).The prevalence of depression and the mean score of PHQ-9 were significantly higher in MDR-TB than in DS-TB(P<0.05).PHQ-9 negatively correlates with the WHOQOL-BREF score(r=-0.502,P<0.05)among MDR-TB patients.MDR-TB patients with depression were significantly associated with low QoL in the physical(OR 3.611;95%CI 2.393-6.951;P=0.029),psychological(OR 1.672;95%CI 1.179-5.941;P=0.021),social relationship(OR 2.586;95%CI 1.611-2.909;P=0.014),and environmental domains(OR 1.926;95%CI 1.047-2.147;P=0.048).Conclusions:MDR-TB patients had worse QoL than DS-TB.Those with depression were associated with low QoL.Strategies that identify and tackle alterations in the QoL for MDR-TB patients are necessary during TB treatment.
文摘High maternal and child deaths in developing countries are frequently linked to poor health services provided to pregnant women and children. To improve the quality of maternal, neonatal and child health (MNCH) services, the government and other stakeholders in MNCH emphasize the importance of quality assessment. However, effective quality assessment approaches are mostly lacking in most developing countries, particularly in Tanzania. This study, therefore, aimed at developing a quality assessment approach that can effectively assess and report on the quality of MNCH services. Due to the need for a good quality assessment approach that suits a resource-constrained environment, machine learning-based approach was proposed and developed. K-means algorithm was used to develop a clustering model that groups MNCH data and performs cluster summarization to discover the knowledge portrayed in each group on the quality of MNCH services. Results confirmed the clustering model’s ability to assign the data points into appropriate clusters;cluster analysis with the collaboration of MNCH experts successfully discovered insights on the quality of services portrayed by each group.
基金The Social Science Fund of Hebei Province (No.200607011)the Key Science and Technology Project of Hebei Province(No.07213529)
文摘In order to more effectively assess the health status of a project, the monitoring indices in a project＇s life cycle are divided into quality index, cost index, time index, satisfaction index, and sustainable development index. Based on the feature of qualitative and quantitative indices combining, the PCA-PR （principal component analysis and pattern recognition） model is constructed. The model first analyzes the principal components of the life-cycle indices system constructed above, and picks up those principal component indices that can reflect the health status of a project at any time. Then the pattern recognition model is used to study these principal components, which means that the real time health status of the project can be divided into five lamps from a green lamp to a red one and the health status lamp of the project can be recognized by using the PR model and those principal components. Finally, the process is shown with a real example and a conclusion consistent with the actual situation is drawn. So the validity of the index system and the PCA-PR model can be confirmed.
基金supported by Hebei Provincial Administration of Traditional Chineseit was used in the research project of Chinese medicine in 2019,the item number:2019178.
文摘Multiple studies have demonstrated that oral health quality of life(OHQOL)in patients with type 2 diabetes(T2DM)is affected by multiple factors.Therefore,during this study the related factors of OHQOL for T2DM was reviewed,and analyzed them from the aspects of socio-demographic factors,T2DM related factors and oral health related factors.This was to provide basis for nursing workers to develop personalized nursing measures.
基金Supported by Grant from the Slovak APVV agency,No.APVV-0672-11
文摘AIM: To investigate the effect of vitamin D (VD) concentrations and VD supplementation on health related quality of life in inflammatory bowel disease (IBD) patients.
文摘BACKGROUND Alterations in health-related quality of life(HRQoL)and neuropsychological disorders were described in the hepatitis C virus(HCV)patients.Although several studies investigated the modifications of HRQoL after HCV eradication,no data exists on the modifications of neuropsychological symptoms.AIM To investigate the effect of directly acting antivirals(DAAs)treatment on HRQoL and neuropsychological symptoms.METHODS Thirty nine patients with HCV infection underwent a neuropsychological assessment,including Zung-Self Depression-Rating-Scale,Spielberg State-Trait Anxiety Inventory Y1-Y2 and the Toronto-Alexithymia Scale-20 items before and after DAAs treatment.HRQoL was detected by Short-Form-36(SF-36).RESULTS All HRQoL domains,but role limitation physical and bodily pain,significantly improved after treatment.Interestingly,after DAAs treatment,all domains of HRQoL returned similar to those of controls.Each neuropsychological test significantly improved after HCV eradication.A significant correlation was observed among each psychological test and the summary components of SF-36.At multiple linear regression analysis including each psychological test as possible covariates,Zung-Self Depression Rating Scale(Zung-SDS)score was independently and significantly related to summary components of the SF-36 in the basal state and the difference between Zung-SDS score before and after treatment was the only variable significantly and independently related to the modification of HRQoL induced by the treatment.CONCLUSION Neuropsychological symptoms strongly influenced HRQoL in HCV patients and there was a significant improvement of neuropsychological tests and HRQoL after DAAs treatment.
文摘In this paper</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> we present a thorough review of one of the most</span><span style="font-family:Verdana;"> life-threatening autoimmune diseases, Systemic lupus erythematosus (lupus). Symptoms, risk factors, including genetic and epidemiological factors are discussed. Treatment, life expectancies, and Health Related Quality of Life of patients with SLE will be discussed as well. Special attention will be given to Lupus Nephritis.
文摘Diverticular disease(DD) of the colon is very common in developed countries and is ranked the fifth most important gastrointestinal disease worldwide.The management of acute diverticulitis without perforation and peritonitis is still debated.Health related quality of life(HRQL),subjectively perceived by patients,is becoming a major issue in the evaluation of any therapeutic intervention,mainly in patients with chronic disease.To date only a few published studies can be found on Medline examining HRQL in patients with DD.The aim of this study was to review the impact of surgery for DD on HRQL.All Medline articles regarding HRQL after surgery for colonic DD,particularly those comparing different surgical approaches,were reviewed.DD has a negative impact on HRQL with lower scores in bowel function and systemic symptoms.Both surgery-related complications and disease activity have a significant impact on patients' HRQL.While no signif icant differences in HRQL between different operations for DD in non-randomized studies were revealed,the only prospective double-blind randomized study that compared laparoscopic and open colectomy found that patients undergoing laparoscopic colectomy had signif icantly reduced major postoperative complication rates and subsequently had better HRQL scores.Formal assessment of HRQL could be a good instrument in the selection of appropriate patients for elective surgery as well as in the assessment of surgical outcome.
文摘Objective:To investigate individual characteristics related to satisfaction with the quality of First Health Facility Services(FHFS)in Indonesia.Methods:This cross-sectional study analyzes national representation data.Meanwhile,the study involved 9846 representative respondents in 2019.Respondent’s satisfaction with FHFS based on the five dimensions of service quality(SERVQUAL)is a dependent variable.Independent variables consist of sex,marital status,age,education,employment,insurance ownership,and economics.The study used multivariate logistic regression to explain the relationship between individual characteristics and FSHS quality.Results:77.3%Respondents were satisfied with FHFS,with the highest order of satisfaction dimensions being assurance(59.4%),empathy(57.3%),reliability(53.6%),responsiveness(52.7%),and then tangibility(49.1%).Multivariate logistic analysis showed that divorce was 1.48 more likely than never-married to be satisfied(95%CI 1.17-1.87).Employees were 0.77 less likely than the unemployed to get satisfied(95%CI 0.70-0.86).Respondents with higher education was 0.82 less likely than those with primary education to be satisfied(95%CI 0.67-0.99).Meanwhile,respondents who had government-run insurance were 1.61 more likely than uninsured to be satisfied(95%CI 1.42-1.80).Moreover,the rich were 0.82 less likely than the poor to get satisfied(95%CI 0.73-0.92).Conclusions:Community satisfaction with FHFS is generally high,though some areas could be improved.Demographic factors are still strongly related to satisfaction ratings.The government can assess the quality of services in accordance with standards and disseminate information about service standards for primary facilities to all levels of society,ensuring that service satisfaction is rated as good by all groups.
文摘Introduction: The health related quality of life (HRQoL) has an important role in adults suffering from diabetes. Objective: To assess the health related quality of life in adult with type 2 diabetes mellitus. Materials and methods: A cross-sectional study was conducted to assess diabetic patient’s HRQoL on 119 purposively selected type-2 DM patients (aged ≥ 18 years and duration of diabetes ≥ 1 year). Data were collected by face-to-face interview and by medical record review through a Bangle version of SF-36 semi-structured questionnaire and a checklist. Place and period of study: The study was conducted at outpatient department in Gopalganj 50 bedded diabetic hospital from 1<sup>st</sup> January, 2018 to 31<sup>st</sup> December 2018. Results: The mean age of the respondents was 52.34 (SD ± 10.19) years. Age group shows a significant difference associated with all domains of quality of life except role emotion (>0.05), gender shows the significant in social and pain domain (0.05) respectively co-morbidity shows the significant difference with all domains expect pain (>0.05). Physical functioning, emotional, pain and general health of the quality of life show the significant difference associated with use of insulin (Conclusion: The overall QoL of type-2 DM patients was poor and had lower score of health related quality of life.
文摘Objective:The objective of this study was to investigate the frequency of acute and late toxicities,as well as changes in the quality of life(QOL)for breast cancer patients following radiotherapy(RT).Materials and Methods:A total of 108 breast cancer women were recruited for this prospective study.Data were collected at various intervals;prior to,and 1,3,6 months,and 1 year after radiation therapy.The primary outcomes were toxicity radiation therapy oncology group/European Organization for Research and Treatment of Cancer(EORTC)criteria.Our secondary outcome was QOL,measured using EORTC QLQ-C30 and Edmonton Symptom Assessment Scale.We employed Friedman’s two-way analysis to evaluate the changes in QOL over the course of 1 year.Results:The early toxicities that are most commonly experienced include pharyngeal,skin,and mucous membrane toxicity.Late toxicities frequently involve skin and submucosal toxicity.To measure patient functionality,all functional subscale scores except for the patient’s emotional state increased over time compared to pre-RT.Symptoms of the patients,which were included in the QOL symptom scale,decreased during the follow-up period,except for fatigue;however,changes in pain,insomnia,and loss of appetite did not significantly change.We identified the analogous symptom profiles in Edmonton.Although patients’overall health scores declined in the 1st and 3rd months after radiotherapy(RT),they rebounded at 6 and 12 months.Conclusion:For breast cancer patients,RT did not adversely affect functional capacity or exacerbate symptoms,but persistent fatigue did increase during the observation period.Health-care professionals ought to devise strategies to assist patients with skin toxicity and fatigue.
文摘Background The thesis is to study the influence of anxiety/depression on health related quality of life （HRQoL） of patients with various pacing modes a month after they have had a pacemaker implanted. Methods HRQoL was assessed consecutively in patients （50 men, 48 women, mean age 52.7±14.1 years） with implanted pacemaker （PM） from June to December 2009 in our hospital （22 patients received VVI pacemaker, 26 received VVIR pacemaker, 26 received DDD pacemaker, 24 received DDDR pacemaker）. HRQoL was measured by the SF-36 and Aquarel questionnaires, anxiety by Zung anxiety scale （SAS） and depression by Zung depression scale （SDS）. Results Patients with rate-adaptive pacing had higher scores in SF-36 scales （health perception, vitality, social functioning and mental health） and Aquarel （chest pain, dyspnea and arrhytmia）; they also presented lower degree of anxiety and depression compared with those with non-rate-adaptive pacing. Differences were shown only in the group with dual chamber pacemakers, but not in the group with single chamber pacemakers. Significant differences were observed between patients with single chamber and dual chamber PM in rate-adaptive pacing. There was a strong correlation between the degree of anxiety and depression and the HRQoL for pacemaker patients. Conclusion Dual chamber rate-adaptive pacing offers better HRQoL and psychological profile than dual chamber non-rate-adaptive pacing. Significant improvement in five SF-36 subscales was observed with DDDR pacing compared with VVIR pacing. Anxiety and depression are important factors in the HRQoL of patients with implanted pacemakers. Early detection and intervention in patients with psychological problems are imperative.
文摘Background: Total quality management (TQM) plays a major role in quality health services improvement. The aims of the study are to identify the concepts of total quality management in health institutions to know the nature of the relationship between the application of TQM and improving the quality of health services in Sana’a Governorate. Method: This applied research is a descriptive cross-sectional study in which the TQM of 13 affiliated Sana’a Governorate hospitals during “2017-2020”, were evaluated based on self-administered questionnaires. Data were collected by questionnaires including demographical variables, TQM dimensions variables. Data were analyzed by using SPSS version 16. Results: A total of 281 users 98.6% had responded. The employee’s responses for sixth study dimensions were the top manager’s commitment (TMC) 80.46%, customers focusing CF 81.55%, continuous improvement (CI) 82.32%, training (T) 71.51%, and strategic planning of the quality (SPQ) 74.76%, health services quality improvement (HSQI) 74.25%. There is a strong relationship between TQM and HSQI. There is no relationship between demographic factors gender, profession, years of experience, except age with TMC, T, HSQI, qualification with the TMC, CI, T, HSQI and job with all study variables. Conclusion: The application of TQM at hospitals in quality of health services improvement has several challenges, lacking staff experience and lacking leadership support, weakness of the training, customers focusing, continuous improvement, and strategic planning of the quality. Therefore, benefiting from the experiences of leading hospitals in implementing total quality management programs by sending some cadres to these hospitals for training and gaining experience or by hosting experienced cadres to conduct training courses is recommended.
文摘Introduction: Lifelong Anti-Retroviral Therapy (ART) promotes good quality of life and health among HIV-positive men and women. However, simplified newer and effective ART has not increased retention in care, or long-term ART adherence, especially among women. There are many factors that impede long-term adherence in women. This includes among other things female gender, depression, greater than once-daily dosing, longer time since HIV diagnosis, and patient beliefs. This study measures the quality of life in women whose ART durations range from one to fifteen years, using the standardized WHO Quality of Life questionnaire. Material and Methods: One hundred and fourteen women were divided into three groups based on ART duration. Group 1 had 37 women on ART for less than five years, Group 2 had 48 women on ART from 5 to 10 years and Group 3 had 29 women on ART for more than ten years. They were administered the WHO Quality of Life (QOL) questionnaire, which assesses QOL in six domains. QOL was considered poor in scores between 4 - 9.9, medium in scores of 10 - 14.9 and good in scores of 15 - 20. Results: Scores in all 3 groups were more than 85% in five domains and around 74.5% in the psychological domain. Domain mean scores were Physical 18 (CI 17.63 - 18.37), Psychological 14.9 (CI 14.55 - 15.25), Independence 18.6 (CI 18.33 - 18.87), Social relationships 17.5 (CI 17.07 - 17.93), Environmental 17.6 (CI 17.25 - 17.95), Spiritual, Religious, Personal beliefs, 17.4 (CI 16.93 - 17.87). Scores for women on long-term ART (Group 3) are not different from the other 2 groups and the p-values were not statistically significant. Conclusion: Women on long-term ART fare extremely well compared to other groups with more than 93% showing good QOL and none showing poor Quality of Health in spite of being on ART for a longer period of time than the other two groups. Despite a multitude of impeding factors, women who continue ART faithfully and consistently enjoy a good quality of health and life. Adequate preparation and a supportive health system are essential for ensuring long-term adherence, but the attitude and commitment of women are also critical.
文摘Purpose: To evaluate personality characteris- tics’ impact upon outcome after silicone-based MP arthroplasty in RA patients. Methods: 40 RA patients who had undergone operations on their MP joints were investigated in a one-year fol- low-up. Objective measurement to assess grip strength and active range of motion—Paper- pencil-tests to assess pain during activity and at rest performance, QoL, and personality. Results: Significant improvement was observed in func- tion and pain related scores except for the pain related VAS and in several QoL facets and do- mains. Patients who experienced improvement reported higher scores on the activities of daily living facet of the WHO QoL questionnaire. Those with lower pain showed more independ- ence. The variance of the QoL domain scores, other than social and physical domains, could substantially and meaningfully be explained by variance of objective measures combined with personality scores. Conclusions: Most RA pa- tients’ QoL can be improved by MP arthroplasty despite remaining substantial level of pain. NS and HA seem to play an important role in the adaptation process during the long term, chronic illness;whereas SD represents a tool of coping with the burden of pain and disability. Personal- ity characteristics are highly predictive for QoL suggesting their important mediating role be- tween experienced pain and disability and HR QoL.
基金Research Project of Traditional Chinese Medicine in Bureau of Hebei Provincial Traditional Chinese Medicine Administration in 2019(Project Number:2019178)。
文摘Objective:To investigate the oral health related quality of life in elderly diabetic patients and analyze its influencing factors.Methods:Convenience sampling was used to select 190 elderly patients with diabetes under the Department of Endocrinology and Department of Integrated Traditional Chinese and Western Medicine in the Affiliated Hospital of Hebei University as the research subjects.The Chinese version of the Oral Health Influence Scale(OHIP-14)was used to conduct a questionnaire survey,and univariate analysis and multiple stepwise regression analysis were used to analyze the influencing factors of oral health related quality of life in elderly diabetic patients.Results:The elderly diabetic patients'oral health related quality of life score was 34.48±3.23,which is in the middle-lower range.The findings of multivariate stepwise regression analysis revealed that the course of disease,regular visits to the dentist,sleep quality,oral health knowledge,and oral health attitude together explained 58.9%of the total variance in elderly diabetic patients in terms of their oral health related quality of life(p<0.05).Conclusion:The oral health related quality of life of elderly diabetic patients is generally low,and is affected by the duration of diabetes,sleep quality,and oral health knowledge,attitude,and behavior(regular visits to the dentist).Improving patientsJ attention to oral health problems by improving sleep as well as their own oral health knowledge,attitude,and behavior is an effective way to enhance oral health related quality of life.
文摘 Zhang Weiqing, director of the National Population and Family Planning Commission (NPFPC), disclosed at the inaugural meeting of the China Reproductive Health Industry Association (CRIA), held on March 26, 2007, that China will create an inspection system, a quality accreditation system, and an industry access system for better population structure and family planning.……
基金This study was funded by the National Natural Science Foundation of China (Grant No. 72074164)Chinese Academy of Medical Sciences(Grant No. 2020-JKCS-024).
文摘Purpose:This study aimed to develop quality indicators for the care of older adults with disabilities in long-term care facilities(LTCFs)based on Maslow’s hierarchy of needs.Methods:The draft of the quality indicators was drawn up based on a literature review and research group discussion.The quality indicators were finalized by two rounds of expert consultation(involving 15 experts)using the Delphi method.The Analytic Hierarchy Process was applied to calculate the indicators’weight.Results:The response rates of the two rounds of consultation were 100%and 93%,and the expert authority coefficients were 0.86 and 0.87.After two rounds of consultation,the expert opinion coordination coefficients of the first-,second-and third-level indicators were 0.42,0.25,and 0.96,respectively(P<0.05),and the variation coefficient was0.25.The final quality indicators for the care of older adults with disabilities in LTCFs included 7 first-level,19 second-level,and 107 third-level indicators.Conclusion:The quality indicators for the care of older adults with disabilities in LTCFs are reliable,scientific,comprehensive,and practical and specify the content of person-centered care needs.This can provide a reference for evaluating and improving care quality in LTCFs.
文摘Health related quality of life(HRQOL) is increasingly recognized as an important clinical parameter and research endpoint in patients with hepatocellular carcinoma(HCC). HRQOL in HCC patients is multifaceted and affected by medical factor which encompasses HCC and its complications, oncological and palliative treatment for HCC, underlying liver disease, as well as the psychological, social or spiritual reaction to the disease. Many patients presented late with advanced disease and limited survival, plagued with multiple symptoms, rendering QOL a very important aspect in their general well being. Various instruments have been developed and validated to measure and report HRQOL in HCC patients, these included general HRQOL instruments, e.g., Short form(SF)-36, SF-12, Euro Qo L-5D, World Health Organization Quality of Life Assessment 100(WHOQOL-100), World Health Organization Quality of Life Assessment abbreviated version; general cancer HRQOL instruments, e.g., the European Organisation for Research and Treatment of Cancer(EORTC) QLQ-C30, Functional Assessment of Cancer Therapy(FACT)-General, Spitzer Quality of Life Index; and liver-cancer specific HRQOL instruments, e.g., EORTC QLQ-HCC18, FACT-Hepatobiliary(FACT-Hep), FACT-Hep Symptom Index, Trial Outcome Index. Important utilization of HRQOL in HCC patients included description of symptomatology and HRQOL of patients, treatment endpoint in clinical trial, prognostication of survival, benchmarking of palliative care service and health care valuation. In this review, difficulties regarding the use of HRQOL data in research and clinical practice, including choosing a suitable instrument, problems of missing data, data interpretation, analysis and presentation are examined. Potential solutions are also discussed.
