Abstract:Objective To investigate and analyze the correlation of negative emotions and self-perceived burden with quality of life in the elderly patients with chronic heart failure (CHF). Methods A total of 94 non-elderly patients with CHF (non-elderly group) and 122 elderly patients with CHF (elderly group) admitted to the First Affiliated Hospital of Nanjing Medical University from February 2020 to December 2022 were enrolled in the study. The clinical characteristics, negative emotions [self-rating anxiety scale (SAS), self-rating depression scale (SDS)], and self-perceived burden [Chinese Version of Self-Perceived Burden Scale (SPBS)] and quality of life [Minnesota Living with Heart Failure Questionnaire (MLHFQ)] were compared between the two groups. SPSS 22.0 was used for data analysis. According to the data type, t test, analysis of variance, or Chi-square test was employed for comparison between groups. Pearson linear correlation analysis was used to analyze the correlation between negative emotions, self-perceived burden, and quality of life in the elderly CHF inpatients, and multivariate linear regression analysis was employed to analyze the factors affecting their quality of life. Results Compared with the non-elderly group, the elderly group had a higher comorbidity, higher New York Heart Association (NYHA) classes and longer hospital stay; in medication, the elderly group had a lower rate of β-blocker use, a higher rate of digoxin use, and a higher proportion of users of ≥ 3 drugs; the differences were statistically significant (P<0.05). Pearson correlation analysis showed that the scores of SAS, SDS and SPBS in the elderly group were positively correlated with total MLHFQ scores (P<0.05). Multivariate linear regression analysis showed that NYHA classes, CHF course, annual hospitalization frequency, exercise frequency, anxiety, depression, and self-perceived burden were factors affecting the quality of life in the elderly CHF patients (P<0.05). Conclusion Compared with the non-elderly patients, the etiology and comorbidity of the elderly CHF inpatients are more complex, and the CHF is more serious. Anxiety, depression, and self-perceived burden have negative predictive effects on the quality of life in elderly CHF patients.

Abstract:Objective To investigate the physical activity in the elderly patients with chronic kidney disease (CKD) and to analyze the mediating effect of psychological distress on the relationship between physical activity and quality of life. Methods A total of 512 elderly patients with stage 1-3 CKD admitted to Zhongnan Hospital of Wuhan University from January 2020 to January 2023 were selected as the subjects (CKD group). In addition, 120 elderly people who were admitted to the hospital for physical examination were collected as the control group. The international physical activity questionnaire short form Chinese version (IPAQ-S-C) was used to investigate the amount of physical activity in the two groups. Of 632 questionnaires distributed, 598 (94.62%) were recovered as valid, including 490 in the CKD group and 108 in the control group. SPSS 24.0 was used for data analysis. According to the data type, t test, Chi-square test or rank sum test was employed for between-group comparison. The influencing factors of low physical activity in the elderly CKD patients were analyzed by logistic regression analysis. Spearman rank correlation analysis was used to evaluate the correlation between physical activity and quality of life in the elderly CKD patients. Three-step mediating effect test was used to evaluate the mediating effect of psychological distress on the relationship between physical activity and quality of life. Results The physical activity in the CKD group was significantly lower than that in the control group, and the difference was statistically significant (P<0.05). Logistic regression analysis showed that primary school education or below (OR=3.397,95%CI 2.016-5.726), unmarried/divorced/widowed (OR=2.442,95%CI 1.264-4.720), severe fatigue (OR=2.038,95%CI 1.037-4.005) and significant psychological distress (OR=8.265,95%CI 6.001-11.382) were risk factors for low physical activity in the CKD elderly patients(P＜0.05). Three-step mediating effect test showed that psychological distress played a mediating role in the effect of physical activity on quality of life, with a mediating effect of 0.09, and the mediating effect accounted for 26.8% of the total effect. Conclusion Insufficient physical activity is obvious in the elderly patients with stage 1-3 CKD and affect the quality of life, and psychological distress plays a mediating role in it.

Abstract:Objective To explore the correlation of emotional disorders and social status with quality of life in elderly patients with hemifacial spasm. Methods A total of 220 elderly patients with hemifacial spasm admitted to our hospital from June 2021 to June 2023 were recruited and surveyed with related questionnaires. Finally, 204 valid questionnaires were collected. Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD) were used to evaluate the emotional disorders of patients, social avoidance and distress scale (SADS) was employed to assess the social status, and hemifacial spasm scale 8 items (HFS-8) was performed to estimate the quality of life. The patients were divided into mild-to-moderate group (grade 1-2,120 cases) and severe group (grade 3-4, 84 cases) according to the severity of spasm. SPSS statistics 24.0 was used for data analysis. According to data type, student′s t test or Chi-square test was applied for intergroup comparison. Logistic regression analysis was conducted to identify the influencing factors of severe spasm in elderly patients with hemifacial spasm. Pearson correlation analysis was utilized to evaluate the correlation of emotional disorders and social status with quality of life in elderly patients with hemifacial spasm. Results Logistic regression analysis showed that disease course >5 years (OR=4.332,95%CI 2.622-7.158; P<0.05) and significant increase of radial diffusivity (RD) of right lower longitudinal tract and lower fronto-occipital tract (OR=5.109,95%CI 3.173-8.225; P<0.05) were risk factors of severe spasm in elderly patients with hemifacial spasm. Pearson correlation analysis indicated that in the elderly patients with hemifacial spasm, HAMA score was positively correlated with HAMD score, social avoidance, social distress, SADS total score and HFS-8 score (r=0.566,0.602,0.597,0.632,0.649; P<0.05); HAMD score was also positively correlated with social avoidance, social distress, total SADS score and HFS-8 score (r=0.681,0.655,0.703,0.684; P<0.05); social avoidance score of SADS was positively correlated with social distress, total SADS score and HFS-8 score (r=0.766,0.795,0.633; P<0.05); social distress score was positively correlated with total SADS score and HFS-8 score (r=0.801,0.608; P<0.05); total SADS score was positively correlated with HFS-8 score (r=0.655; P<0.05). Conclusion Emotional disorders and social disorders are significantly correlated with poor quality of life in elderly patients with hemifacial spasm. Patients with significantly increased RD of right lower longitudinal tract and lower fronto-occipital tract and disease course >5 years are more prone to severe spasm, which can provide new ideas for clinical treatment.

Abstract:Objective To determine the effect of self-efficacy on self-management behavior in type 2 diabetes mellitus (T2DM) patients based on propensity score matching (PSM). Methods All T2DM patients who were consecutively hospitalized in the endocrinology departments of 3 tertiary grade A hospitals in Xi′an City from December 2022 to June 2023 were recruited in this study. All the participants were surveyed with Self-Efficacy for Diabetes and Summary of Diabetes Self Care Activities. PSM was used to balance covariates related to self-management behavior, and logistic regression was used to analyze the impact of self-efficacy on self-management behavior. Results A total of 356 T2DM patients were enrolled, of which 285 (80.0%) had a low-to-medium self-efficacy level and 297 (83.4%) had a low-to-medium self-management behavior. There were significant differences between the low-to-medium level and high level patients in self-management behavior in terms of self-efficacy, marital status, years of illness, exercise or not, drinking or not (P<0.05). After PSM for the covariates at a ratio 1∶1, no statistical differences were observed in marital status and years of illness between the two groups. But significant difference was observed in the score of self-care activities among the patients with different levels of self-efficacy no matter before or after PSM (all P<0.05). Logistic regression analysis showed that before PSM, self-efficacy level, exercise or not, and drinking or not were independent risk factors for self-management behaviors (P<0.05); after PSM, self-efficacy level was an independent risk factor for self-management behaviors(P<0.05). Conclusion The level of self-efficacy affects self-management behavior in T2DM patients. And physicians should highlight the importance of their relationship in clinical practice.

Abstract:Objective To analyze the correlation between emotional disorders and body nutrition and quality of life in the elderly after acute stroke. Methods A total of 160 elderly patients with acute stroke in subacute stage were included in the Second Affiliated Hosoital of Xi′an Jiaotong University from March 2021 to June 2023. The Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), mini nutritional assessment (MNA), and MOS 36-item short-form health survey scale (SF-36) were used to evaluate anxiety, depression, nutritional status and quality of life respectively. The relationship between post-stroke comorbid anxiety and depression (PSCAD) and objective indicators of nutritional status, MNA and SF-36 was analyzed. SPSS 22.0 was used for statistical analysis. Data comparison between two groups was perfomed using t test, Rank sum test or χ² test, depending on data type. Results The 160 patients scored (15.57±3.67) points on HAMA and (13.54±4.23) points on HAMD, and 56 were classified as having PSCAD. Body mass index, upper arm muscle mass circumference, prealbumin and NMA score in the PSCAD group were lower than those in the non-PSCAD group (P<0.05). The difference between the two groups in NMA grading was statistically significant (P<0.05). The PSCAD group scored lower in physical strength, physical pain, general health, vitality, social function, emotional function, and mental health of SF-36 scale than the non-PSCAD group (P<0.05). Pearson correlation analysis showed that HAMA and HAMD were negatively correlated with NMA, physical strength, physical pain, general health, vitality, social function, emotional function, and mental health (P<0.05). Conclusion The nutritional status and quality of life of the elderly patients with acute stroke and PSCAD are significantly affected in multiple dimensions. Anxiety and depression are closely related to nutritional status and quality of life.

Abstract:Objective To investigate the changes in the intestinal neurotransmitters, mental and psychological state, and quality of life in the elderly patients with slow-transit constipation (STC). Methods A total of 115 elderly STC patients in the Department of Anorectal Surgery of Guang′an Hospital of West China Hospital affiliated to Sichuan University from December 2020 to December 2022 were included in the observation group, and 90 age-matched elderly individuals without gastrointestinal diseases in the Physical Examination Department during the same period were enrolled as the control group. Peripheral venous blood was collected from the subjects to detect the levels of intestinal neurotransmitters including serum substance P (SP), nitric oxide (NO), and 5-hydroxytryptophan (5-HT). The symptom check-list 90 (SCL-90) was used to assess the mental and psychological status of the subjects, and MOS short-form-36 health survey (SF-36) was used to assess their quality of life. The patients in the observation group were given mental and psychological intervention for 6 months, and the serum intestinal neurotransmitters, SCL-90 scores and SF-36 scores were evaluated before and after the intervention. SPSS 20.0 was used for data processing and analysis. Pearson correlation coefficient was used to analyze the correlation between levels of serum neurotransmitters and SCL-90 dimensions in the elderly STC patients. Results The levels of serum SP and 5-HT in the observation group were significantly lower than those in the control group, the NO level was significantly higher than that in the control group, and the differences were statistically significant (P<0.05). The scores for somatization, interpersonal sensitivity, depression and anxiety and total score on SCL-90 in the observation group were significantly higher than the control group, the scores for RP, GH, VT and MH and total score on SF-36 were significantly lower than those in the control group, and the diffe-rences were statistically significant (P<0.05). Pearson correlation analysis indicated that serum SP in the observation group was negatively correlated with scores for somatization, interpersonal sensitivity, and anxiety of SCL-90 (r=-0.243, -0.276, -0.311; P<0.05), that serum NO level was positively correlated with scores for somatization and anxiety (r=0.247,0.283; P<0.05), and that serum 5-HT level was negatively correlated with interpersonal sensitivity and anxiety (r=-0.369, -0.363; P<0.05). After mental and psychological intervention, the levels of serum SP and 5-HT in the observation group increased significantly, the serum NO level decreased significantly, and the average SCL-90 score decreased significantly, and the total SF-36 score increased significantly (P<0.05 for all). Conclusion The quality of life in the elderly STC patients declined significantly compared with that of the control group without gastrointestinal diseases, and the mental and psychological disorders worsen, featuring decreased secretions of intestinal excitatory transmitters and increased secretion of inhibitory transmitters. There is a correlation between serum neurotransmitters levels and mental and psychological disorders in the elderly STC patients. Adjusting the patient′s mental and psychological status can improve the abnormal levels of intestinal neurotransmitters and improve the quality of life of the patient.

Abstract:Objective To explore the differences in negative emotions and quality of life between gastric ulcer patients and healthy volunteers, compare the clinical characteristics of elderly patients and young and middle-aged patients with gastric ulcer, and analyze the factors affecting the quality of life of gastric ulcer patients in different age groups. Methods A total of 315 patients with gastric ulcers admitted to the Department of General Medicine of Qionghai Traditional Chinese Medicine Hospital from January 2020 to January 2022 were included in the observation group, and 180 healthy examinees at the Health Examination Department were included in the healthy control group. According to age, the patients in the observation group were divided into the young and middle-aged group (aged 33-59 years; n=163) and the elderly group (aged ≥ 60 years; n=152). The short-form-36 health survey (SF-36) and hospital anxiety and depression scale (HADS) were used to evaluate the quality of life and emotions of anxiety and depression in the subjects. The clinical characteristics were analyzed in the young, middle-aged and elderly patients with chronic gastric ulcers. SPSS 22.0 was used for data analysis. A multiple linear regression model was employed to analyze the factors affecting the quality of life of the young, middle-aged and elderly patients with gastric ulcer. Results The scores for physical function, body pain, general health, social function, emotional funciton, mental health, and total score on SF-36 scale in the observation group were lower than those in the healthy control group; the scores for anxiety and depression, and the detection rates of anxiety, depression and anxiety coupled with depression were higher than those in the healthy control group; and the differences were statistically significant (P<0.05). The scores for body pain, emotional function, mental health, and total score on SF-36 scale in the elderly group were higher than those in the young and middle-aged group; the scores for anxiety and depression, and the detection rates of anxiety, depression and anxiety coupled with depression were lower than those in the young and middle-aged group; the differences were statistically significant (P<0.05). Compared with the young and middle-aged group, the proportion of patients with concurrent underlying disease in the elderly group was higher; the proportion of patients with abdominal pain was lower; the proportions of patients with hematemesis or melena, anemia/fatigue, atypical symptom helicobacter pylori infection and gastrointestinal bleeding were higher; the differences were statistically significant (P<0.05). Multivariate linear regression analysis indicated that the social life event over load (β=-0.135, P<0.001) and anxiety (β=-0.213, P<0.001) were factors affecting the quality of life in the young and middle-aged patients with gastric ulcer, and that the family monthly income (β=0.175, P<0.001) and gastric ulcer-related complication (β=-0.278, P<0.001) were factors affecting the quality of life in the elderly patients with gastric ulcer. Conclusion The quality of life in patients with gastric ulcer is significantly lower than that in healthy people, and the detection rates of anxiety and depression are higher. Compared with young and middle-aged patients, the disease has less impact on body pain, emotional function of elderly patients with gastric ulcer, and the detection rates of anxiety and depression are lower in elderly patients with gastric ulcer, but the overall quality of life of patients with gastric ulcer in different age groups does not differ significantly. The influencing factors of quality of life in patients with gastric ulcer in different age groups are also different.

Abstract:Objective To evaluate the vision-related quality of life in the elderly patients with diabetic retinopathy (DR) and analyze its influencing factors. Methods A total of 330 elderly DR patients (DR group) and 310 elderly non-DR patients with type 2 diabetes mellitus (non-DR group) were selected from Department of Ophthalmology of the First Affiliated Hospital of Hebei North University from May 2020 to May 2023. The scores of 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) were compared between the two groups. The multivariate linear regression model was used to analyze the independent influencing factors of NEI-VFQ-25 scores in the DR patients, and the correlation between anxiety, depression, self-management ability and vision-related quality of life in them was analyzed. SPSS 22.0 was used for statistical analysis. and t- or F-test was used for comparison of quantitative data. Pearson correlation coefficient was used to analyze the correlation between anxiety, depression, self-management ability, and visual related quality of life. A multiple linear regression model was used to analyze the influencing factors of vision-related quality of life in the DR elderly patients. Results Totally, 640 questionnaires were distributed, and 560 valid questionnaires were collected. The analysis found that the total score of NEI-VFQ-25 in the DR group was (64.79±14.21) points, and the subscale scores and total score of NEI-VFQ-25 were lower than those in the non-DR group (P<0.05). Multivariate linear regression analysis showed that severe lesion (β=-0.253; P<0.001), complicated diabetic macular edema (DME) (β=-0.224; P<0.001), anxiety (β=-5.207; P=0.005), depression (β=-5.534; P=0.004), and low self-management ability (β=-6.942; P<0.001) could significantly negatively predict vision-related quality of life in the elderly DR patients, and that blood glucose control (β=4.406; P=0.009) could significantly positively predict vision-related quality of life in the DR elderly patients, and the regression equation was significant (F=24.817; P<0.001). Pearson correlation analysis showed that NEI-VFQ-25 score in the elderly DR patients was negatively correlated with Hamilton anxiety scale score and Hamilton depression scale score (r=-0.512, -0.488; P<0.001) and was positively correlated with the score of adult health self-management skill rating scale (r=0.652; P<0.001). Conclusion The vision-related quality of life in the elderly DR patients is reduced. The severity of lesion, DME, anxiety, depression and low self-management ability are negative predictors, and blood glucose control standard is a positive predictor.