Objective To evaluate the effect of a nurse-supported patient self-managed home-based cardiac rehabilitation programme for promoting quality of life of patients with coronary heart disease. Methods 167 eligible patients were randomly assigned to an intervention group (n=83) and a control group(n=84). Patients in the intervention group joined a 12-week nurse-supported patient self-managed cardiac rehabilitation programme that included medication management, angina management, physical exercise, smoking cessation, dietary management, and family support besides the conventional care. Chinese Version SF-36 was used to assess the quality of life. Data collection was conducted at programme entry, programme exit, and three months follow-up. Results On completion of the programme, patients in the intervention group demonstrated significantly better improvements in six SF-36 quality of life domains, including general health, physical functioning, role-physical, bodily pain, mental health, and vitality. The effect on physical functioning and role-physical maintained at three months follow-up.Conclusions A nurse-supported patient self-managed home-based cardiac rehabilitation intervention has a positive impact on the quality of life of patients with coronary heart disease.
Objective To evaluate the effectiveness of exercise and rehabilitation program in improving shoulder function and quality of life for breast cancer patients after mastectomy. Method We searched the Cochrane Database of Systematic Reviews, JBI Database of Systematic Reviews, MEDLINE (1966 to 2008), EMbase (1989 to 2007), CINAHL (Cumulative Index to Nursing and Allied Health literature), CBMdisc (1978 to 2008), and CNKI (1994 to 2008) to collect randomized controlled trials (RCTs). The quality of RCTs was critically appraised and data were extracted by 3 reviewers independently. Meta-analyses were conducted for the eligible RCTs. Result Nineteen RCTs were included. Stepwise upper extremity exercise and body exercise were reported in the rehabilitation program. Nine studies indicated that the rehabilitation program significantly improved the shoulder function of breast cancer patients after mastectomy. Four studies demonstrated its effect on cardiopulmonary function and body endurance. Six RCTs proved the effect of rehabilitation program on health-related quality of life and fatigue alleviation. Conclusion Rehabilitation program consisting of stepwise upper extremity exercise and full-body exercise is effective in improving the shoulder function and enhancing the quality of life of breast cancer patients after mastectomy. It also has a positive effect in reducing fatigue for those undergoing chemotherapy or radiotherapy.
Objective To investigate the differences of postoperative quality of life （QOL） between proximal gas-trectomy （PG） and total gastrectomy （TG） in patients with adenocarcinoma of esophagogastric junction （AEG）. Methods Eighty five patients with AEG （Siewert type Ⅱ or Ⅲ） who were underwent PG or TG surgery between Jan. 2011 andMar. 2012 at West China Hospital of Sichuan University were enrolled， to measure the QOL by using the Chineseversion of quality of life questionnaire core-30 （QLQ-C30） and the site-specific module for gastric cancer （QLQ-STO22）which were drawed up by the European Organization for Research and Treatment of Cancer （EORTC） in 12 months afteroperation. Results There were no any difference of clinicopathological features between patients in 2 groups （P＞0.05），such as age， gender， and so on. The scores of eating restriction， diarrhea， and dyspnea in PG group were lower than those of TG group （P＜0.05）， but scores of reflux and taste change were higher （P＜0.05）， no other significant differ-ence was found between the patients of 2 groups （P＞0.05）. Conclusion Both of PG＋gastric tube reconstruction and TG＋Roux-en-Y anastomosis in treatment of patients with Siewert type Ⅱ or Ⅲ AEG may lead to complications， but patients who underwent former surgery have better situation in eating restriction， diarrhea， and dyspnea， and patients who underwent later surgery have better situation in reflux and taste change.
Objective To summarize the advances in the clinical application of the quality of life(QOL) assessment after surgery of rectal cancer.MethodsThe recent literatures on the advances in the studies on the QOL assessment following the treatment of rectal cancer were reviewed. Results After surgery of rectal cancer, the patients might suffer from short and/or long term of various complications affecting the physical, social and psychological aspects of their well-being. The QOL assessment included many aspects of the studies. Global QOL scores as measured by the specific questionnaires improved significantly after surgery. It had provided clinical evidences of therapeutic methods, operative treatment of choices and bowel reconstructed procedures for the patients with rectal cancer.Conclusion The QOL studies after surgery for rectal cancer are of increasing importance. Apart from the improvements of the survival rates and the recurrencefree period, it is essential to provide an acceptable QOL postoperatively. The QOL assessment for the guidance of clinical treatment should be discussed routinely for a patient with potentially curable rectal carcinoma so that the excellent outcome could be achieved.
Objective To evaluate short-term effects of percutaneous microwave coagulation therapy（PMCT） combined with chemotherapy in patients with advanced non-small cell lung cancer（NSCLC）.Methods Eighty cases with advanced NSCLC were randomly assigned to underwent chemotherapy plus PMCT(PMCT group，n=40) or single chemotherapy(chemotherapy group，n=40).The chemotherapeutics regimen was Taxotere plus Cisplatin.The preliminary results and quality of life score of two groups were compared.Results In PMCT group and chemotherapy group，the 3-month relieve rate was 52.5% and 32.5%，and the half-year survival rate was 87.5% and 62.5%，respectively.The differences between the two groups were both significant(Plt;0.05).The quality of life score in PMCT group was significantly higher than that in chemotherapy group (Plt;0.05).Conclusion PMCT combined with chemotherapy is effective and safe in the treatment of advanced NSCLC.
Objective To determine if supervised hospital-based exercise can maintain the benefits of functional exercise ability and quality of life gained from a pulmonary rehabilitation program in COPD.Methods A prospective and randomized study was carried out. Following completion of an eight-week pulmonary rehabilitation program in hospital, 43 COPD patients were recruited and randomized into either a supervised group ( supervised, every 10 days, hospital-based exercise, 22 cases ) or a control group ( unsupervised home exercise,21 cases) and followed for 12 months. Measurements were taken at baseline and 12 months later. Exercise measurements include six-minute walk test( 6MWT) and pulmonary function test. Quality of life was measured using the Chronic Respiratory Questionnaire ( CRQ) . Results After 12 months of different exercise program,6MWT in the supervised group was significantly longer than that in the unsupervised group[ ( 532. 0 ±168. 4) m vs ( 485. 0 ±151. 6) m, P lt; 0. 05] . There was no significant difference in pulmonary function between the two groups. The quality of life of the supervised group was higher than that of the unsupervised group( 114. 6 ±20. 8 vs 105. 6 ±21. 7, P lt;0. 05) . Conclusions After the completion of pulmonary rehabilitation program, a supervised, every 10 days, hospital-based following exercise program can maintain better functional exercise capacity and quality of life compared to home exercise in COPD patients.
Objective To evaluate the impacts of pulmonary rehabilitation at different levels of exercise intensity on health status of patients with moderate to severe COPD. Methods Thirty-two COPD patients treated with pulmonary rehabilitation by ergometry exercise were randomly assigned to exercise intensity level either by anaerobic threshold （AT group; n=15） or by maximum tolerate [high intensity group（HI group）; n=17]. Nine COPD patients without exercise training served as control. Bicycle exercise training was conducted in two separate days each week for 12 weeks. Spirometry，cardiopulmonary exercise testing，the St George’s Respiratory Questionnaire （SGRQ） were accessed before and after the rehabilitation program. Results Exercise intensity （%Wmax） was significantly higher in HI group than AT group （69%±14% vs 52%±7%，Plt;0.01）. Significant improvement of SGRQ scores after rehabilitation were found both in AT group （－11.91±15.48 U） and HI group （－8.39±9.49 U）. However，no significant difference was found between the two groups in the degree of improvement （Z=－0.540，P=0.589）. Symptoms and impacts subscale scores of SGRQ were decreased significantly in HI group，but only symptoms scores decreased significantly in AT group. The control group did not show any significant improvement in SGRQ scores. No statistically significant correlation was found between improvement of peak oxygen consumption per predicted (VO2peak%pre) and SGRQ scores. Conclusion Both pulmonary rehabilitation strategies by anaerobic threshold and by maximum tolerate can improve health status of COPD patients significantly with no significant difference between each other.
Objective To compare BODE index with GOLD staging for the severity evaluation in patients with chronic obstructive pulmonary disease ( COPD) . To investigate the relationship between BODE index and quality of life. Methods A total of 100 patients with stable COPD were enrolled. All participants were examined with lung function test and St George’s Respiratory Questionnaire ( SGRQ) for evaluation of quality of life. BODE index and it’s four components including body mass index( BMI) , airflow obstruction ( FEV1%pred) , dyspnea( MMRC) , and exercise capacity( 6MWD) were calculated. The participants were divided into four groups of severity using GOLD guidelines and BODE index quartiles. Results The associations between SGRQ total score and SGRQ subscales, and BODE index were significant( P lt;0. 01) .BODE index was a significant predictor of the quality of life, explaining 41. 3% of the total score of the SGRQ ( P lt;0. 01) . However, GOLD classification showed a correlation only with SGRQ activity score ( P lt;0. 05) but not with other SGRQ scores. There were significant differences in SGRQ total score and SGRQsubscales between different severity groups of BODE index( P lt;0. 01) . But there was no difference in SGRQ score between different severity groups of GOLD classification, except SGRQ activity score. Conclusion BODE scoring system is better correlated with the quality of life as assessed by the disease severity inpatients with COPD than the GOLD staging criteria.