Influencing Factors In Elderly Patients Research Articles

Follow-up analysis of quality of life in elderly patients with bone trauma: a longitudinal observational study

BackgroundThe quality of life (QoL) of elderly patients with bone trauma is significantly decreased and is affected by many complex factors. This study aims to conduct a half-year follow-up survey to clarify QoL and its influencing factors in elderly patients with bone trauma in order to provide targeted care measures for elderly patients with bone trauma.MethodsThis was a longitudinal observational study. We used the 36-Item Short Form Health Survey (SF-36) to investigate and evaluate the QoL of 100 patients with bone trauma at the time of hospital discharge and 1 month, 3 months, and 6 months after discharge. Our previous study confirmed that the SF-36 had higher reliability and validity for evaluating the QoL of elderly patients with bone trauma. At the same time, we also investigated the age, gender, location of bone trauma, and destination after discharge of those patients. Those factors that might affect the QoL of elderly patients with bone trauma were identified by univariate and multivariate analyses.ResultsThe total physiological function, role-physical, bodily pain, vitality, social functioning, role-emotional, and mental health scores of elderly patients with bone trauma gradually increased from the time of discharge to 1 month, 3 months, and 6 months after discharge, and there were significant differences (p < 0.001). However, there was no significant difference in the general health score in the different periods (P = 0.095). The total QoL scores also significantly differed (F = 118.61, P < 0.001) at the time of discharge (335.252 ± 127.572) and 1 month (285.149 ± 112.827), 3 months (479.344 ± 153.663), and 6 months after discharge (544.396 ± 166.536). The univariate analysis results showed that the location of bone trauma (P < 0.005) and the destination after discharge (P < 0.001) were the main factors affecting QoL in different periods. The results of the multivariate analysis showed that the location of bone trauma was an important factor affecting QoL (P < 0.005 in different periods). Whether to undergo surgery was a factor affecting the patients’ long-term QoL (P < 0.005 at 6 months after discharge).ConclusionsAlthough the QoL of elderly patients with bone trauma gradually improves after injury, their recovery time is long, and the influencing factors are complex. Follow-up services should continue for at least six months for these patients, and comprehensive treatment and long-term rehabilitation services should be provided.

Current Status and Influencing Factors of Readiness for Discharge of Elderly Patients with Chronic Obstructive Pulmonary Disease.

Readiness for hospital discharge is an important indicator of patients' transition from illness to health and can predict rehabilitation and prognosis. Identifying factors that influence readiness for discharge is crucial for developing effective nursing interventions. Therefore, this study aims to investigate the current status of discharge readiness and its influencing factors in elderly patients with chronic obstructive pulmonary disease (COPD). A total of 311 elderly inpatients diagnosed with COPD were enrolled in this investigation at a tertiary hospital in Chengdu between December 2021 and June 2022. Questionnaires were designed to collect general information, disease-related information, and responses to the Readiness for Hospital Discharge Scale (RHDS) and the Quality of Discharge Teaching Scale (QDTS). Univariate and multivariate linear regression analyses were employed to further analyze factors related to discharge readiness and the correlation between discharge readiness and the quality of discharge guidance. The total score of discharge readiness of elderly COPD patients was 77.72 ± 11.86 with a mean score of 6.48 ± 0.19 for each item. The quality of discharge instructions was 110.54 ± 15.66, with a mean score of 6.12 ± 0.15 for each item. Discharge preparation was positively correlated with the quality of discharge guidance. Multivariate analysis showed that marital status, admission mode, length of stay in hospital, Classification of Severity of Airflow Limitation, mMRC classification, number of medications taken with discharge, presence of inhalers in medication orders, mode of home oxygen therapy, and quality of discharge guidance were independent factors of discharge readiness in elderly COPD patients (P < 0.05). Both discharge readiness and the quality of discharge guidance for elderly COPD patients in China are currently suboptimal and need further improvement. The survey findings provide valuable insights that can guide future management practices and interventions aimed at improving discharge readiness.

Depression status of elderly patients with metabolic syndrome in three provinces of China

Objective: To understand the depression status and its influencing factors in elderly patients with MS in China and to explore the correlation between various components of elderly MS and depression. Methods: This study is based on the "Prevention and Intervention of Key Diseases in Elderly" project. We used a multi-stage stratified cluster random sampling method to complete 16 199 elderly aged 60 years and above in 16 counties (districts) in Liaoning, Henan, and Guangdong Provinces in 2019, excluding 1 001 missing variables. Finally, 15 198 valid samples were included for analysis. The respondents' MS disease was obtained through questionnaires and physical examinations, and the respondents' depression status within the past half month was assessed using the PHQ-9 Depression Screening Scale. The correlation between elderly MS and its components and depression and its influencing factors were analyzed by logistic regression. Results: A total of 15 198 elderly aged 60 years and above were included in this study, with the prevalence of MS at 10.84% and the detection rate of depressive symptoms in MS patients at 25.49%. The detection rates of depressive symptoms in patients with 0, 1, 2, 3, and 4 MS abnormal group scores were 14.56%, 15.17%, 18.01%, 25.21%, and 26.65%, respectively. The number of abnormal components of MS was positively correlated with the detection rate of depressive symptoms, and the difference between groups was statistically significant (P<0.05). The risk of depression symptoms in patients with MS, overweight/obesity, hypertension, diabetes, and dyslipidemia was 1.73 times (OR=1.73, 95%CI:1.51-1.97), 1.13 times (OR=1.13, 95%CI:1.03-1.24), 1.25 times (OR=1.25, 95%CI:1.14-1.38), 1.41 times (OR=1.41, 95%CI:1.24-1.60), 1.81 times (OR=1.81,95%CI:1.61-2.04), respectively, more than those without the disease. Multivariate logistic regression analysis showed that the detection rate of depressive symptoms in patients with sleep disorders was higher than that with normal sleep (OR=4.89, 95%CI: 3.79-6.32). The detection rate of depressive symptoms in patients with cognitive dysfunction was 2.12 times higher than that in the average population (OR=2.12, 95%CI: 1.56-2.89). The detection rate of depressive symptoms in patients with impaired instrumental activities of daily living (IADL) was 2.31 times (OR=2.31, 95%CI: 1.64-3.26) higher than that in the average population. Tea drinking (OR=0.73, 95%CI: 0.54-0.98) and physical exercise (OR=0.67, 95%CI: 0.49-0.90) seemed to be protective factors for depression in elderly MS patients (P<0.05). Conclusions: Older patients with MS and its component abnormalities have a higher risk of depression than the average population. Sleep disorders, cognitive impairment, and IADL impairment are important influencing factors for depression in elderly MS patients, while tea drinking and physical exercise may help to reduce the risk of the disease.

Postoperative delirium and its influencing factors in elderly patients with lung cancer in the intensive care unit.

In 2020, there were 2,206,771 new cases of lung cancer worldwide, ranking first in mortality rate postoperative delirium (POD) is a common surgical complication and typically occurs 1-3 days after surgery which leads to prolonged hospital stay. The currently available research on POD in elderly patients was mainly carried out in cardiac surgery, orthopedic, and gastroenterology departments. It is necessary to study the incidence and risk factors of delirium in intensive care unit (ICU) elderly patients after lung cancer surgery. This study is a single-center and singe-arm observational study which examined the incidence of and factors affecting POD in elderly patients with lung cancer in ICU at our center from September 2019 to May 2020. 22 relevant variables including arterial oxygen partial pressure, postoperative sedative drug use, and other data were collected. The Confusion Assessment Method of Intensive Care Unit was used to assess the occurrence of POD, the Chinese version of the Richards-Campbell Sleep Questionnaire was used to assess patients' postoperative sleep quality, and the Mini-Mental State Examination was used to assess patients' preoperative cognitive level. Univariate and multivariate logistic regression analyses were conducted to identify the factors affecting POD in elderly ICU patients with lung cancer. Among the 208 elderly ICU patients who underwent surgery for lung cancer, 32 (15.38%) had POD. The results showed that postoperative blood oxygen level, preoperative cognitive level score and postoperative sleep quality score in delirium group were significantly lower than those in non-delirium group (P values were 0.002, 0.000, 0.000, respectively). The proportion of previous coronary heart disease and postoperative sedation use in delirium group was significantly higher than that in non-delirium group (P=0.008 and 0.008, respectively). It was observed that the preoperative Mini-Mental State Examination (MMSE) score and postoperative Richards-Campbell Sleep Questionnaire (RCSQ) score of the delirium group were significantly lower than those of the non-delirium group, and this trend was still observed after adjusting for influencing factors. It is suggested that the difference of cognitive level in elderly lung cancer population has a significant effect on the occurrence of POD. In clinical work, we should pay more attention to patients with preoperative cognitive impairment, hypoxic state, and postoperative sleep disturbance.

Care Burden and Influencing Factors of Elderly Patients Receiving Home Health Care: Perspectives of Patients and Caregivers

Care Burden and Influencing Factors of Elderly Patients Receiving Home Health Care: Perspectives of Patients and Caregivers

Factors of Negative Affect in Elderly Patients With Substance Use Disorders During COVID-19 Pandemic.

Background: The outbreak of the novel coronavirus disease 2019 (COVID-19) has become the greatest public health emergency and has attracted global attention. During the COVID-19 pandemic, the negative affect (NA) of elderly patients with substance use disorders (SUDs) has also become a more serious public concern. The current study aims to clarify the NA and its influencing factors in elderly patients with SUDs during the pandemic.Methods: Two psychiatrists conducted semi-structured interviews with 77 SUD patients aged above 50 years to collect their demographical information and certain drug use characteristics. Barratt Impulse Scale and the Positive and Negative Affect Scale were used to obtain information about patients' self-reported impulsivity and NA.Results: Univariate linear regression analysis showed that NA was positively correlated with the frequency of drug use, type of SUDs, cravings during COVID-19, and impulsivity. Multiple linear regression analysis showed that being female, higher frequency of drug use, stronger cravings, and greater impulsiveness jointly accounted for the variation of NA in elderly patients with SUDs.Conclusions: This study confirmed that, during the COVID-19 pandemic, gender, frequency of drug use, cravings, and impulsivity were associated with NA in elderly patients with SUDs. This study provided a theoretical basis for clinicians to reduce the patients' NA.

Study on the level of daily living function and its influencing factors in elderly patients after hip fracture surgery

To analyze the short-term prognosis of elderly patients with hip fracture after operation, and to explore the main factors affecting the recovery of daily life function. From November 2015 to November 2016, 130 elderly patients with hip fracture were analyzed, including 43 males and 87 females, aged from 60 to 95 (77.54±8.49) years. The death, fall and complications were recorded 3 months after operation. The daily life function of the patients was followed up 3 months after operation with the functional recovery of daily life scale (FRS). T-test, analysis of variance and single factor linear regression analysis were used to analyze the general clinical data. The factors with P<0.05 were analyzed by multi factor linear regression method, and the influencing factors of postoperative ADL were obtained. Among 130 patients, 7 died (5.4%), 4 fell (3.1%), 103 (79.2%) had postoperative complications, and the FRS score of 123 patients was 65.92±22.79. The results showed that gender, age, fracture site, pre fracture Basel rating, frailty index, postoperative hospital stay and total number of postoperative complications had significant differences in the recovery of daily life function (P<0.05);multiple linear regression analysis showed that pre fracture Basel rating (t=-2.727, P=0.007), frailty index (t=-2.573, P=0.011) and postoperative hospital stay had significant differences. The days of hospital stay (t=-3.391, P=0.001) and the total number of postoperative complications (t=-3.281, P=0.001) were the independent risk factors for postoperative ADL in elderly patients with hip fracture (R2=0.411). The short term rehabilitation level of elderly patients with hip fracture after operation is poor. Basel rating before fracture, frailty index, postoperative hospital stay and total number of postoperative complications may be related risk factors affecting the recovery of daily life function of patients after operation.

Perioperative Hidden Blood Loss in Elderly Osteoporotic Vertebral Compression Fracture Patients With Percutaneous Vertebroplasty and Influencing Factors.

Introduction:To analyze perioperative hidden blood loss (HBL) and its influencing factors in elderly patients with osteoporotic vertebral compression fracture (OVCF) treated with percutaneous vertebroplasty (PVP).Materials and Methods:From January 2016 to December 2018, 103 elderly patients with OVCF (age > 85 years) treated with PVP were selected. The patient’s height, weight, duration of symptoms, previous medical history and other basic information were recorded. The hemoglobin (Hb) and hematocrit (Hct) immediately after admission and the next day postoperative were recorded. The operation time, surgical bleeding, Kummell’s disease, vertebral height preoperative and postoperative, and bone cement leakage was recorded. The total blood loss (TBL) was calculated according to Gross’s formula, and HBL was calculated based on the TBL and surgical bleeding. The influential factors were analyzed by multivariate linear regression analysis and single factor correlation analysis.Results:The mean surgical bleeding was 11.83 ± 5.37 mL, and HBL was 306.19 ± 185.92 mL, with a statistically significant difference (P = 0.000). According to the multiple linear regression analysis, the duration of symptoms (P = 0.030), number of fracture segments (P = 0.016), operation time (P = 0.004), loss of vertebral height (P = 0.026), recovery of vertebral height (P = 0.004), Kummell’s disease (P = 0.040) and cement leakage (P = 0.004) were correlated with an increased amount of HBL. Sex (P = 0.077), body mass index (BMI) (P = 0.486), hypertension (P = 0.734), diabetes (P = 0.769), fracture level (P = 0.518) and surgical bleeding (P = 0.821) had no correlation with the amount of HBL.Conclusions:There was obvious HBL during the perioperative period of PVP in elderly patients with OVCF. A fresh fracture, multi-segment vertebral fracture, longer operation time, presence of Kummell’s disease, loss of vertebral height, recovery of vertebral height and cement leakage the increased perioperative HBL during PVP.

Investigation and analysis of influencing factors of frailty in elderly patients with coronary heart disease after PCI

Objective To explore the current status of frailty and its influencing factors in elderly patients with coronary heart disease after PCI. Methods Using convenient sampling method, 300 elderly coronary heart disease patients, who were underwent PCI in the Department of Cardiology of the Second People's Hospital of Lianyungang and Department of Cardiology of the First People's Hospital of Lianyungang from July 2018 to July 2019 were selected as the subjects. A questionnaire survey was used to collect demographic and disease data within 24 hours after PCI, and patients were evaluated by the Frailty Index. Results The incidence of frailty in elderly patients with coronary heart disease was 80.67% (242/300) . The univariate analysis showed that there were statistically significant differences in the incidence of frailty among patients with different ages, education background, financial status, insurance status, marital status, combined disease types, cardiac function classification, number of stents inserted, and whether smoking and consuming alcohol (P<0.05) . Multiple linear regression analysis showed that age, education, financial status, consuming alcohol, medical insurance status, number of comorbidities, and cardiac function classification were the influencing factors of frailty for elderly patients with coronary heart disease after PCI (P<0.05) . Conclusions Elderly patients with coronary heart disease have a high incidence of frailty after PCI. We should strengthening the frailty assessment in clinical practice, and take intervention in the high-risk population, so as to reduce the incidence of frailty amongelderly patientsafter PCI. Key words: Aged; Coronary heart disease; Percutaneous coronary intervention; Frailty; Factors

Quantification and influencing factors of perioperative hidden blood loss during intramedullary fixation for intertrochanteric fractures in the elderly.

We aimed to quantify perioperative hidden blood loss (HBL) and investigate its influencing factors in elderly patients with intertrochanteric fractures (IFs) undergoing intramedullary fixation surgery. We prospectively collected the clinical data of 200 elderly patients with IFs treated with intramedullary fixation surgery in our hospital between December 1, 2014 and August 31, 2018. The intraoperative visible blood loss, blood transfusion rate, and pre- and postoperative hemoglobin (Hb) levels as well as the general characteristics of the enrolled patients were recorded. A multiple linear regression analysis model (stepwise) was used to identify independent factors affecting perioperative HBL. The mean perioperative HBL was 614.72 ± 368.14mL, which accounted for 84.05% of the mean total perioperative blood loss (731.37 ± 391.50mL). The mean preoperative HBL was 368.33 ± 325.57mL, which accounted for 50.36% of the mean total perioperative blood loss. Patients with fracture types AO/OTA 31-A2.2 to A3.3 had more severe preoperative HBL (median 580.10mL), and most of them developed mild-to-moderate anemia before the operation, and 27.63% of them received preoperative blood transfusion. Compared with patients operated within 5days after injury, patients operated over 5days had lower Hb value at admission (101.56 ± 19.49 vs. 107.28 ± 16.53; P = 0.026) and higher preoperative transfusion rate (25.84% vs. 9.01%; P = 0.001). Multiple linear regression analysis revealed that fracture types AO/OTA 31-A2.2 to A3.3, male sex, right-sided injury, and operation time > 60min were independently associated with increased perioperative HBL. Tranexamic acid treatment was negatively correlated with perioperative HBL. IFs in elderly patients undergoing intramedullary fixation surgery were associated with significant perioperative HBL and anemia. Persistent HBL occurred before the operation and on the first few postoperative days. Surgeons should pay more attention to preoperative HBL in patients with fracture types AO/OTA 31-A2.2 to A3.3 and regularly measure Hb levels preoperatively to avoid anemia. Shortening preoperative time may helps to reduce preoperative blood loss.

Quality of life and its influencing factors in elderly patients with functional dyspepsia in a tertiary hospital in Jinhua

Quality of life and its influencing factors in elderly patients with functional dyspepsia in a tertiary hospital in Jinhua

THE CURRENT SITUATION AND INFLUENTIAL FACTORS OF FRAILTY IN ELDERLY PATIENTS WITH DIABETES IN CHINA

Patient with diabetes may increase the incidence of frailty. Frailty cause chronic inflammation and insulin resistance. The purpose of this study is to investigate the current situation of frailty and its influencing factors in elderly patients with diabetes. Totally 300 elderly patients with diabetes were selected from a tertiary hospital in Zhengzhou of China via convenience sampling method，and were investigated by self-designed general information questionnaire，TFI (Tilburg Frailty Indicator) and SDSCA(Scale of Diabetes Self-care Activities). Totally 296 valid questionnaires were collected. A total of 137 elderly patients with diabetes suffered from frailty and the prevalence was 46.3%. The mean score of total frailty was (5.26±2.87) and the scores for each dimension were as follows: physical frailty (2.79±2.08), psychological frailty (1.40±0.94) and social frailty (1.07±0.75). Multiple linear regression showed that comorbidity, self-management behavior, glycosylated hemoglobin, educational degree, polypharmacy and smoking were the major influential factors (P<0.05). The prevalence of frailty in elderly patients with diabetes was at a high level, containing different degrees of physical, psychological and social frailty. Medical staff should attach great importance to the assessment of frailty among elderly patients with diabetes, take targeted and holistic interventions timely to prevent or delay the development of frailty.

Self-management status and influencing factors of elderly patients with chronic heart failure in Inner Mongolia

Objective To investigate the level of self-management and identify the influencing factors in elderly patients in Inner Mongolia with chronic heart failure (CHF) . Methods By convenience sampling, a total of 1 051 elder patients with CHF from 9 Class Ⅱ & Ⅲ hospitals in 5 cities of Inner Mongolia Autonomous Region were recruited to participate in this study from December of 2015 to July of 2018. The elderly CHF patients were investigated with General Data Questionnaire and Self-management Scale for Heart Failure Patients. Results The total score of Self-management Scale for Heart Failure Patientsof 1 051 elderly patients with CHF was (47.9±7.7) with a scoring rate of 59.9%. Multivariate linear regression analysis showed that ethnicity, work status and marital status were the influencing factors of self-management level of elderly CHF patients. Conclusions The self-management status of elderly CHF patients in Inner Mongolia is not ideal. Corresponding intervention measures should be formulated according to the influencing factors of self-management level of elderly CHF patients in Inner Mongolia. Key words: Chronic heart failure; Self-management; Influencing factors

Occurrence of fall and its influencing factors in elderly patients with knee osteoarthritis

Objective To investigate the occurrence and influencing factors of falls in elderly patients with knee osteoarthritis (KOA) , and provide scientific reference for the prevention of falls in elderly patients with KOA. Methods Using convenience sampling method, 104 elderly patients diagnosed as KOA in orthopaedic wards of four ClassⅢ Grade A hospitals in Hangzhou from November 2017 to August 2018 were selected as subjects. General Information Questionnaire, Morse Fall Scale (MFS) and the Barthel Index (BI) for Activities of Daily Living (ADL) were applied in the investigation. Single factor analysis and multiple factor Logistic regression were used to analyze the influencing factors of falls in elderly KOA patients. Results A total of 104 questionnaires were sent out in this study, and 95 valid questionnaires were recovered, yielding an effective recovery rate of 91.35%. The incidence of falls in elderly KOA patients was 45.26% (43/95) , of which 62.79% (27/43) had fallen twice or more. There were significant differences in knee injury history, staircase climbing and falls among elderly KOA patients (P< 0.05) . There were significant differences in the risk of falls between elderly KOA patients in whether taking drugs , whether using walking , status of self-care ability , and age (P< 0.05) . Logistic regression analysis showed that history of knee injury, frequent staircase climbing and use of walking aids were the influencing factors of falls in elderly KOA patients (OR=4.028, 25.569, 3.191; P< 0.05) . Conclusions In view of the influencing factors of falls in elderly KOA patients, individualized nursing measures should be taken to strengthen falls risk assessment, carry out fall prevention related education and improve patients' social support, which will help to reduce the incidence of falls and further improve patients' quality of life. Key words: Aged; Knee osteoarthritis; Falls; Influencing factors; Questionnaire survey; Morse Fall Scale; Barthel Index for Activities of Daily Living; Prevention

Level of hope and its influencing factors in elderly patients with total knee anthroplasty

Objective To investigate the hope level of elderly patients undergoing total knee arthroplasty (THA) and analyze its influencing factors, so as to provide evidence for improving the hope level and quality of life of patients after THA. Methods A cluster random sampling method was used to select 308 patients with bilateral THA for the first time who were admitted to two ClassⅢ Grade A general hospitals in Harbin from January 2017 to July 2018. Questionnaire surveys were conducted using Herth Hope Scale, the Second Edition of Beck Depression Scale and Social Support Scale. Results The total score of hope level in elderly THA patients was (29.96±8.72) . Among them, 76.62% (236/308) had moderate to high level of hope and the total score of depression was (19.20±11.75) which was at a moderate level. There were significant differences in the hope level of patients with different gender, place of residence, educational level, marital status and family per capita monthly income (P< 0.05) . The results of multiple stepwise regression analysis showed that age, sex, family income per capita, depression, negative coping style, subjective support and objective support were the influencing factors of elderly THA patients' hope level (P < 0.05) . Conclusions The THA patients' hope are at a medium level. Medical staff should pay attention to the relevant factors affecting the level of hope, adopt targeted nursing intervention measures, give psychological guidance to patients, provide social support, and further improve the level of hope of the THA patients. Key words: Arthroplasty, replacement, knee; Total knee replacement; Hope; Coping method; Depression; Social support; Influencing factors; Questionnaire survery

Family caregivers' burden and its influencing factors in elderly patients with hip fracture and cognitive impairment

Objective To investigate the burden level and influencing factors among the family caregivers of elderly hip fracture patients with cognitive impairment, and to provide a theoretical basis for the intervention study on reducing the burden of family caregivers. Methods This study was a cross-sectional survey. A total of 130 elderly hip fracture patients with cognitive impairment who were admitted to a ClassⅢ Grade A hospital in Shanghai from January to November 2018 as well as their family caregivers (n=130) were selected by convenient sampling. Patient and Caregiver General Information Questionnaire, Montreal Cognitive Assessment Scale (MoCA) , Barthel Index Assessment Scale (BI) , Caregiver Burden Inventory (CBI) , Neuropsychiatric Inventory-Questionnaire (NPI-Q) , Simple Coping Style Questionnaire (SCSQ) , Social Support Rating Scale (SSRS) were used in the investigation. Single factor analysis and multiple stepwise regression analysis were used to analyze the influencing factors of caregiver burden. A total of 130 questionnaires were sent out and 121 valid questionnaires were collected, yielding an effective recovery rate of 93.08%. Results The CBI score of family caregivers of elderly hip fracture patients with cognitive impairment was (38.58±16.46) , and the overall level of caregivers was medium. Univariate analysis showed that there were statistically significant differences in the burden level among caregivers of patients in terms of the following 7 factors: different level of cognitive impairment, self-care ability, caregiver's past history, whether living with patients, whether multiple caregivers or not, daily care time and total care time (P<0.05) . Multivariate stepwise regression analysis showed that self-care ability and cognitive impairment, caregiver's NPI-Q pain degree, negative coping style and daily care time were the main influencing factors of family caregiver burden in elderly hip fracture patients with cognitive impairment (R2=0.564, F=29.726, P<0.01) . Conclusions Care burden exists in family caregivers of elderly hip fracture patients with cognitive impairment. Medical workers should provide individual professional support and humanistic care to the caregivers according to the specific conditions of the patients' families, so as to improve the overall burden level of family caregivers. At the same time, it calls on the government, medical institutions and other relevant support policies to improve the care ability of caregivers, shorten their daily care time, reduce their burden, and promote their physical and mental health. Key words: Aged; Hip fracture; Cognition disorders; Caregivers; Burden; Infuencing factors

Current situation and influencing factors of self-perceived burden in elderly patients with cancer

Objective To investigate the current situation of self-perceived burden and the related influencing factors in elderly patients with cancer. Methods A total of 240 elderly patients with cancer who were treated in Harbin Medical University Cancer Hospital from 1st May 2016 to 30th September 2017 were collected in the cross-sectional survey. The general survey questionnaire and Self-Perceived Burden Scale (SPBS) were used to investigate the participants. The multivariate regression analysis was performed to explore the influencing factors for self-perceived burden. Results The total score of self-perceived burden was at a moderate level of (37.11±5.15) . The multivariate analysis showed that the main influencing factors for self-perceived burden included medical expenses payment, treatment method, duration of disease, and number of combined chronic diseases. Conclusions The self-perceived burden of elderly cancer patients is generally at a moderate level. Medical staffs should formulate individualized plans to reduce the self-perceived burden of cancer in elderly patients and improve the quality of life according to their specific conditions. Key words: Aged; Neoplasms; Self-perceived burden; Influencing factors

Research of quality of life, emotion symptoms and its influencing factors in elderly patients with tumors of head and neck after treatment

目的 探讨老年头颈部肿瘤患者回归社区后生命质量和情绪状态及其影响因素。 方法 以门诊随访的老年头颈部恶性肿瘤患者为研究对象，采用问卷方式调查其生活质量及负面情绪，调查表包括癌症患者生命质量测定量表(EORCT QLQ-C30)中文版、头颈部特殊问卷(QLQ-H&N35)中文版、Zung抑郁自评量表(SDS)、Zung焦虑自评量表(SAS)评分及自行设计的老年头颈部肿瘤患者一般情况问卷调查表，对288例头颈部恶性肿瘤老年患者(研究组)进行调查，并与同期103例健康体检老年人群(对照组)进行时照研究。 结果 EORCT QLQ-C30调查显示：研究组总体健康状况得分为(50.23±5.33)分，明显低于对照组的(88.65±11.69)分(t＝9.826，P＝0.002)；研究组SAS、SDS评分分别为(52.47±11.41)分、(52.01±15.27)分，明显高于对照组的(36.49±14.42)分、(39.32±12.35)分(t＝19.606，P＝0.000；t＝6.861，P＝0.009)。研究组功能领域中躯体功能、角色功能、情绪功能、认知功能、社会功能得分均低于对照组，差异均有统计学意义(t＝130.426、240.87、153.039、95.063、54.965，均P<0.05)。QLQ-H&N35调查显示，研究组疼痛、吞咽功能、味觉和嗅觉、发声、进食、社会接触、张口受限、口干、口黏症状及感觉不适得分均高于对照组的得分，差异均有统计学意义(t＝27.521、200.099、261.893、736.860、485.938、177.727、115.952、239.33、83.715、53.119，均P<0.05)。BMI、居住方式、家庭收入、教育程度、婚姻情况、医疗费用来源、肿瘤所在部位、TNM临床分期、术后功能重建、社会支持情况、复发、并发症情况及伴随疾病数目对老年头颈部癌症患者总体健康(t＝3.613～63.339，均P<0.05)及焦虑抑郁有影响(t＝2.884～20.916，均P<0.05)。多元线性回归分析显示：社会支持、居住方式、婚姻状况、家庭收入、BMI、教育程度、复发、并发症与老年晚期癌症患者生活质量总体健康状况得分呈正相关(t＝2.621～8.187，均P<0.05)；TNM临床分期及伴随疾病数目与老年晚期癌症患者生命质量总体健康状况得分呈负相关(t＝－2.086、－6.025，均P<0.05)。而伴随疾病数目、家庭收入、复发及并发症与老年晚期癌症患者焦虑抑郁得分呈正相关(t＝1.134～4.930，均P<0.05)；教育程度及TNM临床分期与老年晚期癌症患者虑抑郁得分呈负相关(t＝－5.059～－2.103，均P<0.05)。 结论 老年头颈部肿瘤患者生命质量及精神健康状态差，伴随着明显的焦虑、抑郁负面心理问题，且两者之间相互影响。教育程度、婚姻状况、家庭收入、是否复发、有无并发症、TNM分期及伴随其他慢性疾病数目是影响老年头颈部肿瘤生命质量及导致负面情绪增加的重要因素。可通过心理疏导、家庭关怀、社会支持及健康教育来提高老年头颈部肿瘤患者临床干预后生命质量和改善负面情绪。

Investigation and analysis of influencing factors of quality of life in elderly patients with malignant tumors in rehabilitation period

Objective To analyze the quality of life and its influencing factors in elderly patients with malignant tumors in rehabilitation period. Methods A comprehensive questionnaire on the quality of life of the elderly patients with malignant tumors was designed with reference to the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 scale. The quality of life of patients with malignant tumor diagnosed in Shanxi Cancer Hospital from November 2009 to November 2013 was investigated and evaluated. All data were analyzed by SPSS 13.0 software, and SAS9.2 software was used for statistical analysis. The influencing factors were analyzed by multiple linear regression analysis. Results Sex, marriage and other factors had no influence on the quality of life in elderly patients with malignant tumors (P > 0.05). The social and medical factors, such as age, educational level, number of children, medical form (economic status), discharge time, treatment style, etc were the main factors affecting the quality of life of patients (all P < 0.05). Conclusions Poor physical condition, social relationship, psychological factors and medical factors have effect on quality of life in elderly patients with malignant tumor. Strict adherence to doctor's advice and popularization of relevant knowledge, providing family warmth, social support and economic support can improve the quality of life of patients with malignant tumor. Key words: Neoplasms; Patients; Quality of life

Clinical prognosis of myelodysplastic syndrome in the elderly and its influencing factors

Objective To analyze the clinical prognosis and its influencing factors in elderly patients with myelodysplastic syndrome. Methods A total of 36 elderly patients with myelodysplastic syndrome were included in this study, who were diagnosed and treated at our hospital from January 2013 to August 2016.The Kaplan-Meier method was used to analyzed the survival of these patients, and the effects of gender, age, WHO classification, white blood cell count, platelet count, hemoglobin and IPSS grouping on survival were analyzed.The independent risk factors associated with the clinical prognosis of patients were identified by using multivariate Cox regression analysis. Results Patients were followed up until March 31, 2017 with a follow-up time ranging from 8 to 31 months.During the follow-up period, 19(58.3%)deaths and 17(41.7%)survivals were reported.The average survival time was(19.17±1.47)months.Kaplan-Meier survival analysis showed that age, WHO classification, white blood cell count, platelet count and IPSS grouping were closely associated with survival in elderly patients with myelodysplastic syndrome.Multivariate Cox regression analysis showed that age and IPSS grouping were independent prognostic factors in elderly patients with myelodysplastic syndrome. Conclusions Age, WHO classification, white blood cell count, platelet count and IPSS grouping are closely related to the prognosis of myelodysplastic syndrome in elderly patients. Key words: Myelodysplastic syndrome; Clinical prognosis; Risk factors