体外冲击波与传统方法治疗腰椎间盘突出症疗效比较

比较放散式体外冲击波与传统保守治疗腰椎间盘突出症的临床疗效及生命质量评价。对2010年6月至fi013年6月收治且获得随访的257例腰椎间盘突出症患者进行分析,其中男139例,女118例。根据治疗方式不同随机分为两组,并在治疗前后应用日本骨科学会（JOA）下腰痛评分法及视觉模拟评分（VAS）进行疗效评价,应用健康调查评分量表SF-36进行生活质量评价。对患者进行随访1周～12周,平均（10．0±3．4）周,治疗组治疗后2周和4周VAS评分低于对照组,治疗后1周、2周及4周JOA评分高于对照组,治疗后4周、8周和12周的生理机能、生理职能、总体健康、情感职能和躯体疼痛得分高于对照组,差异有统计学意义（P〈0．05）。放散式体外冲击波治疗腰椎间盘突出症疗效较好,并能够较好地提高患者的生活质量。     

Salivary cortisol concentrations, stress and quality of life in women with endometriosis and chronic pelvic pain

The objective of this study was to evaluate the perceived stress index, quality of life, and hypothalamus-pituitary-adrenal axis activity in women with endometriosis and chronic pelvic pain. For the study, 93 women with endometriosis and 82 healthy women volunteered. The visual analogue scale (VAS) (0=no pain; 10=severe pain) was used to determine pain intensity; the perceived stress questionnaire (PSQ) defined stress index, and the health-related quality-of-life (HRQOL)-SF-36 questionnaire was used to evaluate quality of life. Salivary cortisol was measured at 0800, 1600, and 2000 h and the awakening cortisol response was assessed to evaluate the hypothalamus-pituitary-adrenal axis activity. The results show that women with endometriosis and chronic pelvic pain of moderate intensity (4.1+/-0.58, mean+/-SEM) have higher levels of perceived stress (0.55+/-0.01 versus 0.42+/-0.01, p<0.05), a poorer quality of life expressed as lower scores for all items of the inventory and hypocortisolism. Lower levels of salivary cortisol were observed in all three samples collected, as well as in the awakening cortisol response, for women with endometriosis (0.19+/-0.09 microg/dl) when compared with controls (0.78+/-0.08 microg/dl, p<0.05 l), and it was independent of pain intensity and Mental health (MH) scores in SF-36. We concluded that women with endometriosis and chronic pelvic pain show low concentrations of salivary cortisol and a high level of perceived stress, associated with a poor quality of life. Whether the hypocortisolism was an adaptive response to the aversive symptoms of the disorder or a feature related to the etiology of endometriosis remains to be elucidated.     

Quality of Life in Patients with Chronic Pain- A Study in Indian Population Using European Organization for Research and Treatment of Cancer(EORTC) Questionnaire

Quality of life in chronic pain Health-related quality of life was compared in patients of chronic pain with that of general population.We designed this study as a prospective, observational trial in a tertiary care centre. Quality of life was measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). The EORTC QLQ-C30 is a valid alternative to the SF-36 in the assessment of QOL in patients with chronic pain especially when a broader assessment of symptoms is desired. All participants completed a set of questionnaires on demographic variables, cause, pain intensity (VAS) and quality of life (EORTC qlq c30). A total of two hundred participants were enrolled including 100 patients with chronic pain. Chronic pain was defined as one which is persisting beyond 3 months. The study revealed significantly decreased quality of life in patients with chronic pain as compared to general population (p?<?0.001). Patients with chronic pain had significantly decreased score in Physical functioning, Role functioning, emotional and social functioning on functional scales and increased scores of pain, fatigue, sleep disturbances and financial difficulties on symptom scales. The study revealed sex-related differences on the QoL with females having a lower global QOL. It is thus concluded that patients with chronic pain especially females have decreased quality of life as compared to general population     

Efficient pain assessment in clinical settings.

The need for efficient and practical assessment techniques of the multidimensional nature of chronic pain remains paramount in clinical settings. Visual analogue scales (VASs) and simple behavioral observation methods have been proposed as efficient, reliable, and valid measures of the subjective (sensory and affective) and overt behavioral aspects of the pain experience. The relationships among VASs and the UAB Pain Behavior Scale were examined among 48 chronic pain patients. Ratings of overt behavior were significantly related to both the VAS sensory and VAS affective ratings. Regression analysis indicated that the VAS scores accounted for significant amount of the variance (27.7%) in UAB scores. Moreover, the affective dimension of self-reported pain tended to be more strongly related to the visible manifestations of pain than were ratings of pain intensity.     

The Effects of Psycho-Education on the Health-Related Quality of life on Mastalgia Patients

Mastalgia has been accepted as an issue which highly affects the daily life. Our primary purpose in this study is to research the effects of the pain in a group of women with mastalgia not depending on the organic etiology of the quality of life. The second purpose of ours is to depict whether psycho-education has an effect on the pain and the quality of life in these patients. In order to research the effect of Mastalgia on the quality of life, the data of the whole study group have been compared with the Turkey standard data of SF-36 scale. A randomized pre–post intervention study was conducted in Adana Numune Hospital General Surgical Department. The study consists of 98 mastalgia patients who do not have any organic etiology. Psycho-education was given to randomly allocated 66 patients (Psycho-Education Group: PEG) and not given to the other 32 patients (Non-Psycho-Education Group: Non-PEG). The Visual Analog Skala (VAS) and the quality of life scale (SF-36) were applied to all patients. All invantories were re-applied 2 months later. When compared SF-36 subscale data of the whole patient group with the norm results of SF-36 determined for Turkey, the difference in the quality of life of all subscales except for physical function subscale was found statistically significant. While no difference was found between the PEG and Non-PEG for the whole subscales before psycho-education, the difference in the whole subscales after psycho-education was found statistically significant. After psycho-education the difference in the VAS scores between PEG and Non-PEG was found statistically significant. Our study has shown that mastalgia has a negative effect on the quality of life. This study has also revealed that psycho-education must be considered as an effective alternative to reducing pain and increasing the quality of life on mastalgia patients.     

Comparing Quality of Life Instruments in a Population of Abused Women

The SF-36 Health Survey and the WHO Quality of Life Index—BREF (WHOQOL-BREF) were used to study quality of life among women who had experienced intimate partner violence (IPV). The aim was to determine how these instruments correlated with each other and with physical and psychological IPV, in order to find the best instrument to use. IPV was measured using the Severity of Violence against Women Scale (SVAWS) and the Psychological Maltreatment of Women Index (PMWI). A self-administrated questionnaire was given to women able to understand Norwegian who were staying at a women’s shelter in Norway for more than 1 week. 87 of 212 women asked to participate completed the questionnaire. The physical acts of violence in SVAWS correlated significantly (P<0.001) with both the general health and bodily pain dimensions in SF-36 and global overall health (OH) in WHOQOL-BREF. Most correlations between WHOQOL-BREF and SF-36 were moderate. The WHOQOL-BREF domains explained 46% of the variance in OH and 40% of the variance in the global overall quality of life (OQOL). The SF-36 domains explained 66% of the variance in OH and 27% of OQOL. The mean WHOQOL-BREF and SF-36 scores were all low. The SF-36 correlated better with physical and psychological IPV in this population than the WHOQOL-BREF. The significant correlations between the OH, general health and bodily pain domains and acts of violence show the importance of including questions concerning bodily symptoms in determining the quality of life in a population of abused women.     

Religiosity and Social Support: Implications for the Health-Related Quality of Life of African American Hemodialysis Patients

The purpose of this study was to determine whether sociocultural differences have any effect on the health-related quality of life among African American hemodialysis patients. This study examined relationships between religiosity, social support, and the health-related quality of life of African American hemodialysis patients. Four hemodialysis units were selected for the study. The study population consisted of 176 African American hemodialysis patients who had been receiving hemodialysis treatments for at least 1 month. The religiosity variable was measured by the Measure of Religious Involvement. Social Support was measured by the Medical Outcomes Study Social Support Survey, and health-related quality of life was measured by the Medical Outcomes Study 36 Short Form Health Survey (SF-36v2). The investigators found that social support contributed to the emotional and physical health of African American hemodialysis patients in the sample, whereas religiosity was inversely related to the physical health of these patients.     

Quality of Life,Personality and Use of Pain Medication in Patients with Chronic Back Pain

The aim of the study was to assess whether the functional disability and the quality of life in patients with chronic back pain was associated with some personality traits and whether the use of pain medication in patients with chronic back pain can be predisposed with some personality traits. The study sample comprised 262 older patients with chronic back pain of non-inflammatory origin. The level of disability related to chronic back pain was assessed by Roland-Morris Questionnaire, health-related quality of life was assessed by Short Form 36 and personality traits by Eysenck Personality Questionnaire. Among analyzed personality traits (psychoticism, extraversion, neuroticism, lie tendencies), only neuroticism significantly predicted self-reported disability caused by back pain. Patients on pain medication had significantly worse quality of life and disability caused by back pain, but they did not differ significantly in personality traits compared to patients without pain medication. There were no differences in disability due to back pain and in level of neuroticism between patients who had jobs with higher or lower physical demand. People with higher scores on neuroticism inclined more to report a lower functional disability and the quality of life caused by chronic back pain. Patients on pain medication reported more inferior physical than psychological concept of quality of life. Use of pain medication was not associated with personality traits assessed by Eysenck Personality Questionnaire. In our elderly patients with chronic back pain, lower quality of life was associated with elevated neuroticism score and more frequent use of pain medication.     

Alcohol and Quality of Life Among Social Groups for the Elderly in São José dos Campos,Brazil

This study aims to investigate alcohol consumption within social groups for the elderly in São José dos Campos-Brazil, and to check for a correlation between alcohol consumption and quality of life. A sample of 500 individuals participating on social groups for the elderly were interviewed by using the Alcohol Use Disorders Identification Test (AUDIT) to verify alcohol consumption; the Medical Outcomes Study 36 Item Short Form (SF-36), for evaluating quality of life; and the Oral Health Impact Profile short form (OHIP-14), for evaluating oral health-related quality of life. The average alcohol consumption was very low (1.48), being higher in men (2.23) than women (1.09). The SF-36 average score for the domain of physical function was 70.5; for role-physical function 64.9; for bodily pain,68.3; for general health 73.8; for vitality,72.4; for social function 82.8; for role-emotional function 72.3 and for mental health 75.0. The OHIP-14 average score was 3.87. AUDIT did not correlate with SF-36 domains, or with OHIP-14. However, there was a negative correlation between OHIP 14 and all SF-36 domains. This elderly sample has a very low consumption of alcohol, and no correlation was found between alcohol consumption and oral and medical quality of life.     

Subjective health complaints and health related quality of life in a population of health care workers

The aim of this study was to assess whether Subjective Health Complaints (SHC), demands and coping are associated with health-related quality of life in a population of health care workers. One hundred and nineteen employees in two nursing homes for the elderly filled in a questionnaire on health, exercise, psychological factors, and work conditions. Main outcome measures were SHC and quality of life measured by SF-36. High level of SHC was associated to low health-related quality of life. Low coping and high demands were related to low scores (low quality of life), and high coping and low demands to high scores on mental health. Pseudoneurological complaints (e.g. tiredness, sadness), high demands and low coping were associated with low mental health. The expected negative association between SHC and health-related quality of life was found. There was a positive association between coping and quality of life.     

Relation of perceived emotional intelligence and health-related quality of life of middle-aged women

This study examined the relationship between perceived emotional intelligence and health-related quality of life in middle-aged women. 99 middle-aged Spanish women, who studied in two adult schools, volunteered to participate. 49 were premenopausal and 45 were postmenopausal. These women completed the Trait Meta-Mood Scale and Health Survey SF-36. Scores were analyzed according to social, physical, and mental health, menopausal status, and scores on perceived emotional intelligence. Then, the data regarding the mental and physical health of the premenopausal and postmenopausal women were compared after controlling for age. No associations between menopausal status and health-related quality of life were found. Perceived skill at mood repair was significantly associated with scores on health-related quality of life in these middle-aged women. These findings provide empirical evidence that aspects of perceived emotional intelligence may account for the health-related quality of life in midlife including social, physical, and psychological symptoms.     

Cognitive Behavioral Therapy for Postamputation Chronic Pain: A Case Report

Limb amputation has a significant impact on an individual, not only physically but emotionally. Consequences of both traumatic and atraumatic amputations are vast and can result in functional disability, impaired emotional functioning, and changes in overall quality of life. These consequences may be further complicated by the development of chronic pain. Traditional management of postamputation chronic pain often involves invasive procedures and pharmacotherapy. While research notes behavioral interventions, such as cognitive-behavioral therapy (CBT) as a viable treatment alternative for chronic pain, there is no literature supporting CBT for postamputation chronic pain. In this case report, we present a 63-year-old male lower limb amputee complicated with chronic pain who experienced pain reduction and improved quality of life following manualized treatment with CBT for chronic pain. Treatment took place over 12 sessions with fidelity (93%) being measured throughout to ensure accurate utilization of the treatment manual. As part of the treatment manual, self-report measures (Pain Rating Scale, Pain Catastrophizing Scale, Pain Outcomes Questionnaire, and subjective units of distress) were used throughout to track patient progress. All measures showed improvement with the biggest gains being seen in pain ratings and pain catastrophizing.     

Obese, older adults with knee osteoarthritis: weight loss, exercise, and quality of life.

This study examined the effects of dietary weight loss and exercise on the health-related quality of life (HRQL) of overweight and obese, older adults with knee osteoarthritis. A total of 316 older men and women with documented evidence of knee osteoarthritis were randomly assigned to 1 of 4 18-month interventions: dietary weight loss, exercise, dietary weight loss and exercise, or healthy lifestyle control. Measures included the SF-36 Health Survey and satisfaction with body function and appearance. Results revealed that the combined diet and exercise intervention had the most consistent, positive effect on HRQL compared with the control group; however, findings were restricted to measures of physical health or psychological outcomes that are related to the physical self.     

Health-Related Quality of Life and Adaptive Behaviors of Adolescents with Sickle Cell Disease: Stress Processing Moderators

The objective of this study was to examine resilience among adolescents with sickle cell disease (SCD), focusing on the interaction of health-related quality of life with stress processing to explain adaptive behavior. Forty-four adolescents with SCD completed paper-and-pencil measures of health-related quality of life, appraisals (hope), pain coping strategies (e.g. adherence), and adaptive behavior. Self-reported health-related quality of life was significantly associated with adaptive behavior, as was adherence. Findings for moderation were mixed. Pain coping strategies moderated the association of health-related quality of life with adaptive behavior such that at lower levels of Coping Strategies Questionnaire (CSQ) Adherence, better quality of life was associated with higher adaptive behavior. Similarly, at higher levels of hope, better quality of life was associated with higher adaptive behavior, and poorer quality of life was associated with lower adaptive behavior. Adolescents with SCD showed resilience, particularly in terms of personal adjustment, that may be explained by their appraisals and stress processing strategies. Interventions to support an optimistic or hopeful outlook and improve adherence to recommendations for medical management of sickle cell pain may result in improved resilience/adaptive behavior.     

Neural basis of affective touch and pain: A novel model suggests possible targets for pain amelioration

Pain is one of the most common health problems and has a severe impact on quality of life. Yet, a suitable and efficient treatment is still not available for all patient populations suffering from pain. Interestingly, recent research shows that low threshold mechanosensory C-tactile (CT) fibres have a modulatory influence on pain. CT-fibres are activated by slow gentle stroking of the hairy skin, providing a pleasant sensation. Consequently, slow gentle stroking is known as affective touch. Currently, a clear overview of the way affective touch modulates pain, at a neural level, is missing. This review aims to present such an overview. To explain the interaction between affective touch and pain, first the neural basis of the affective touch system and the neural processing of pain will be described. To clarify these systems, a schematic illustration will be provided in every section. Hereafter, a novel model of interactions between affective touch and pain systems will be introduced. Finally, since affective touch might be suitable as a new treatment for chronic pain, possible clinical implications will be discussed.     

A Comparison of Quality of Life in Haemodialysis and Peritoneal Dialysis Patients

Decreased quality of life of end-stage renal disease is further compromised by renal function replacement treatments such as haemodialysis (HD) and peritoneal dialysis (PD). Poor quality of life negatively affects treatment outcome. This study compared quality of life between HD and PD patients. Quality of life in 15 HD and 15 PD patients at a South African renal unit was compared using the SF-36 short form. There was no significant difference between HD and PD patients for total SF-36 score, but HD subjects reported more pain. Quality of life is similar in HD and PD patients, with the exception of higher pain levels in HD patients.     

SF-36量表用于慢性乙型肝炎生命质量测定的效果评价

评价SF-36量表在慢性乙型肝炎患者中应用的效果;调查101名慢性乙肝患者,用重测信度、分半信度、内部一致性、结构效度和判别效度等对SF-36量表进行评判;该量表具有良好的分半信度和内部一致性,结构效度和判别效度较好;SF-36量表可用于慢性乙型肝炎患者生命质量评价。     

Affective and health-related outcome expectancies for physical activity in older adults

This study tests the effects of affective and health-related outcome expectancies on physical exercise, assuming stronger direct and indirect (via intention) effects from affective outcome expectancy to physical exercise than from health-related outcome expectancy to exercise. Physical exercise and social cognitive variables were assessed at baseline, and 6- and 12-month follow-up in 335 older adults (60-95 years of age). Applying structural equation modelling, there was a direct effect from affective, but not from health-related outcome expectancy on intentions and behaviour. Also, the indirect effect from self-efficacy on physical exercise via affective outcome expectancy was significant, whereas the mediation via health-related outcome expectancy was not. These findings emphasise the relative importance of affective versus health-related outcome expectancies in predicting intentions and physical exercise in older adults and highlight the importance to separate these facets at a conceptual level to enhance both theory development and health promotion.     

Affective and health-related outcome expectancies for physical activity in older adults

This study tests the effects of affective and health-related outcome expectancies on physical exercise, assuming stronger direct and indirect (via intention) effects from affective outcome expectancy to physical exercise than from health-related outcome expectancy to exercise. Physical exercise and social cognitive variables were assessed at baseline, and 6- and 12-month follow-up in 335 older adults (60–95 years of age). Applying structural equation modelling, there was a direct effect from affective, but not from health-related outcome expectancy on intentions and behaviour. Also, the indirect effect from self-efficacy on physical exercise via affective outcome expectancy was significant, whereas the mediation via health-related outcome expectancy was not. These findings emphasise the relative importance of affective versus health-related outcome expectancies in predicting intentions and physical exercise in older adults and highlight the importance to separate these facets at a conceptual level to enhance both theory development and health promotion.