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Family resources and parental health in families of children with Duchenne muscular dystrophy. J Nurs Res 2011; 18:239-48. [PMID: 21139443 DOI: 10.1097/jnr.0b013e3181fbe37b] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND This study was based on two models, namely, the resiliency model of family stress, adjustment, and adaptation and the model for family stressors, resources, and function. Family resources, such as family hardiness and support, have previously been shown to improve family adaptation. There is little evidence for the potential buffering effects of family resources on parental health in families of children with Duchenne muscular dystrophy (DMD). PURPOSE This article reports on relationships among family support, family hardiness, severity of child disability, and parental perceptions of child health status variables and their influence on parental health in families of children with DMD in Taiwan. METHODS A total of 126 parents, all with children suffering from DMD, were recruited for this study. Associations between child health status, age at diagnosis, demographics, and family resource variables were examined using Pearson linear correlation, linear regression, and causal modeling. RESULTS Parental employment and education, perceived child health, family hardiness, and family support were found to correlate with parental health. Age at diagnosis correlated with family hardiness but not directly with parental health. CONCLUSIONS/IMPLICATIONS FOR PRACTICE Nursing intervention to promote family hardiness and support can help maintain parental health and promote family adaptation in the face of a child's chronic disease. Caregiving programs should also promote parental health by enhancing family hardiness and support. Family members' support through health promotion, psychological and spiritual care, financial support, and convenient community services can lead to better parental health and contribute to overall family health and adaptation.
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Mezzich JE, Cohen NL, Ruiperez MA, Banzato CEM, Zapata-Vega MI. The Multicultural Quality of Life Index: presentation and validation. J Eval Clin Pract 2011; 17:357-64. [PMID: 21208350 DOI: 10.1111/j.1365-2753.2010.01609.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
RATIONALE AND OBJECTIVES Quality of life has emerged as a crucial concept for the assessment of health and the planning of health care. Desirable features for the evaluation of quality of life include comprehensiveness, self-ratedness, cultural sensitivity, practicality and psychometric soundness. An attempt to meet these challenges led to the development of a brief multicultural quality of life instrument and to the appraisal of its applicability, reliability and validity. METHODS The development of the proposed assessment instrument was based on a wide review of the literature and the engagement of a multicultural mental health scholarly team. Its validation was conducted on samples of psychiatric patients (n = 124) and hospital professionals (n = 53) in New York City. RESULTS A new generic culture-informed and self-rate instrument, the Multicultural Quality of Life Index, has been developed. Its 10 items cover key aspects of the concept, from physical well-being to spiritual fulfilment. Concerning its applicability, mean time for completion was less than 3 minutes and 96% of raters found it easy to use. Test-retest reliability was high (r = 0.87). A Cronbach's α of 0.92 documented its internal consistency and a factor analysis revealed a strong structure. With regard to discriminant validity, a highly significant difference was found between the mean total scores of professionals (x = 8.41) and patients (x = 6.34) presumed to have different levels of quality of life. CONCLUSIONS The Multicultural Quality of Life Index is a brief and culturally informed instrument that appears to be easy to complete, reliable, internally consistent and valid.
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Affiliation(s)
- Juan E Mezzich
- International Network for Person-centered Medicine, President 2005-2008, World Psychiatric Association and Mount Sinai School of Medicine, New York University, New York, USA.
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A review of the impact of occupational contact dermatitis on quality of life. J Allergy (Cairo) 2011; 2011:964509. [PMID: 21603173 PMCID: PMC3095907 DOI: 10.1155/2011/964509] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Accepted: 01/19/2011] [Indexed: 11/17/2022] Open
Abstract
Occupational contact dermatitis (OCD) is the most common occupational skin disease in many countries. We reviewed the current evidence on how OCD impacts on quality of life (QoL). The three commonly used QoL questionnaires in OCD were the Short-Form Health Survey (SF-36), the Dermatology Life Quality Index (DLQI), and the Skindex. Despite the availability of a variety of validated QoL instruments, none of them is specific to OCD or entirely adequate in capturing the impact of OCD on QoL. Nonetheless, the results of this paper do suggest a significant impact. Use of QoL measures in clinical settings will provide patients with an opportunity to express their concerns and assist clinicians to evaluate the effectiveness of management beyond the clinical outcomes. This paper also highlights the lack of a disease-specific QOL instrument and the importance of developing a validated measure to assess QOL in OCD, enabling comparison across countries and occupational groups.
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Karp BI, Sinaii N, Nieman LK, Silberstein SD, Stratton P. Migraine in women with chronic pelvic pain with and without endometriosis. Fertil Steril 2011; 95:895-9. [PMID: 21145540 PMCID: PMC3415219 DOI: 10.1016/j.fertnstert.2010.11.037] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2010] [Revised: 10/15/2010] [Accepted: 11/11/2010] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To examine the prevalence of migraine in women with chronic pelvic pain with and without endometriosis. DESIGN Prospective study of headache, pelvic pain, and quality of life before laparoscopic surgery for pelvic pain. Endometriosis was diagnosed pathologically. Headaches were classified as migraine or non-migraine using International Headache Society criteria. SETTING Clinical research hospital. PATIENT(S) 108 women in a clinical trial for chronic pelvic pain (NCT00001848). INTERVENTION(S) Laparoscopy to diagnose endometriosis, assessment by neurologist to assess headaches. MAIN OUTCOME MEASURE(S) Prevalence of migraine and other headaches in women with chronic pelvic pain with or without endometriosis. Headache frequency, severity and relationship to pelvic pain and endometriosis. RESULT(S) Lifetime prevalence of definite or possible migraine was 67% of women with chronic pelvic pain. An additional 8% met criteria for possible migraine. Migraine was no more likely in women with endometriosis than those without. Women with the most severe headaches had a lower quality of life compared with those with pelvic pain alone. CONCLUSION(S) Migraine headache is common in women with chronic pelvic pain, regardless of endometriosis, and contributes to disability in those with both conditions. The strong association suggests a common pathophysiology.
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Affiliation(s)
- Barbara Illowsky Karp
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - Ninet Sinaii
- Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Lynnette K. Nieman
- Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | | | - Pamela Stratton
- Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
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PRALIMAP: study protocol for a high school-based, factorial cluster randomised interventional trial of three overweight and obesity prevention strategies. Trials 2010; 11:119. [PMID: 21134278 PMCID: PMC3017023 DOI: 10.1186/1745-6215-11-119] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2010] [Accepted: 12/06/2010] [Indexed: 11/14/2022] Open
Abstract
Background Given the increase in overweight and obesity prevalence in adolescents in the last decade, effective prevention strategies for these conditions in adolescents are urgently needed. The PRALIMAP (Promotion de l'ALImentation et de l'Activité Physique) trial aims to evaluate the effectiveness for these conditions of 3 health promotion strategies -- educational, screening and environmental -- applied singly or in combination in high schools over a 2-year intervention period. Methods PRALIMAP is a stratified 2 × 2 × 2 factorial cluster randomised controlled trial including 24 state high schools in Lorraine, northeastern France, in 2 waves: 8 schools in 2006 (wave 1) and 16 in 2007 (wave 2). Students entering the selected high schools in the 4 academic years from 2006 to 2009 are eligible for data collection. Interventional strategies are organized over 2 academic years. The follow-up consists of 3 visits: at the entry of grade 10 (T0), grade 11 (T1) and grade 12 (T2). At T0, 5,458 (85.7%) adolescents participated. The educational strategy consists of nutritional lessons, working groups and a final party. The screening strategy consists in detecting overweight/obesity and eating disorders in adolescents and proposing, if necessary, an adapted care management program of 7 group educational sessions. The environmental strategy consists in improving dietary and physical activity offerings in high schools and facilities, especially catering. The main outcomes are body size evolution over time, nutritional behaviour and knowledge, health and quality of life. An evaluation process documents how each intervention strategy is implemented in the schools and estimates the dose of the intervention, allowing for a per protocol analysis after the main intention-to-treat analysis. Discussion PRALIMAP aims at improving the prevention and management of overweight and obesity in adolescents by translating current evidence into public health practice. Particular attention is paid to clustering, multiple factorials and long-term duration to address common pitfalls in health promotion trials. The results should inform how best to implement, in a school environment, effective nutrition prevention programs targeting adolescents who are at a point their lives when they develop responsibilities and empowerment for health attitude behaviours. Trial registration This trial is registered at ClinicalTrials.gov under NCT00814554.
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Wolak A, Jolly D, Dramé M, Boyer F, Morrone I, Aquino JP, Rouaud O, Perret Guillaume C, Ravenel E, Dantoine T, Ankri J, Blanchard F, Novella JL. Quality of life in dementia: Psychometric properties of a French language version of the Dementia Quality of Life questionnaire (DQoL). Eur Geriatr Med 2010. [DOI: 10.1016/j.eurger.2010.09.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Aghayev E, Sprott H, Bohler D, Röder C, Müller U. Sleep quality, the neglected outcome variable in clinical studies focusing on locomotor system; a construct validation study. BMC Musculoskelet Disord 2010; 11:224. [PMID: 20920152 PMCID: PMC3161400 DOI: 10.1186/1471-2474-11-224] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2010] [Accepted: 09/28/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In addition to general health and pain, sleep is highly relevant to judging the well-being of an individual. Of these three important outcome variables, however, sleep is neglected in most outcome studies.Sleep is a very important resource for recovery from daily stresses and strains, and any alteration of sleep will likely affect mental and physical health, especially during disease. Sleep assessment therefore should be standard in all population-based or clinical studies focusing on the locomotor system. Yet current sleep assessment tools are either too long or too specific for general use. METHODS Based on a literature review and subsequent patient-based rating of items, an expert panel designed a four-item questionnaire about sleep. Construct validation of the questionnaire in a random sample of the German-speaking Swiss population was performed in 2003. Reliability, correlation, and tests for internal consistency and validity were analyzed. RESULTS Overall, 16,634 (70%) out of 23,763 eligible individuals participated in the study. Test-retest reliability coefficients ranged from 0.72 to 0.87, and a Cronbach's alpha of 0.83 indicates good internal consistency. Results show a moderate to good correlation between sleep disturbances and health perception, and between sleep disturbances and overall pain. CONCLUSIONS The Sleep Standard Evaluation Questionnaire (SEQ-Sleep) is a reliable and short tool with confirmed construct validity for sleep assessment in population-based observational studies. It is easy to administer and therefore suitable for postal surveys of the general population. Criterion validity remains to be determined.
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Affiliation(s)
- Emin Aghayev
- Institute for Evaluative Research in Medicine, University of Bern, Switzerland.
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108
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Perret-Guillaume C, Briancon S, Guillemin F, Wahl D, Empereur F, Nguyen Thi PL. Which generic health related Quality of Life questionnaire should be used in older inpatients: comparison of the Duke Health Profile and the MOS Short-Form SF-36? J Nutr Health Aging 2010; 14:325-31. [PMID: 20306007 DOI: 10.1007/s12603-010-0074-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The objective of our study was to compare advantages and limitations of two generic Quality of Life questionnaires administered in older inpatients. DESIGN Two validated generic health-related Quality of Life instruments : the MOS Short-Form 36 (9 dimensions, 36 items) and the Duke Health Profile (6 dimensions, 4 dysfunctions, 17 items) were administered to inpatients over 65 years. SETTING AND PARTICIPANTS The sample was drawn from the CliniQualVie program that assessed systematically Quality of Life among hospitalized inpatients (18-79 years) in 10 medical and surgical wards at Nancy University Hospital. RESULTS The two self-administered questionnaires were completed by 701 patients over 65 years at admission (mean age 71 +/- 4, 63% men). The proportion of patients who completed all items were 72.5% for the Duke and 66.9% for the SF-36 (p < .001). The Duke's internal consistency was low as compared with the SF-36, but other psychometric properties were comparable. Good correlations (Spearman) were observed between the two questionnaires for physical health (0.59, p < .0001), mental health (0.68, p < .0001) and health perception (0.56, p < .0001) scores. Low correlations were observed for the social score. CONCLUSIONS This is the first study to our knowledge to assess the interest of using the Duke Health Profile in a general elderly inpatients population as compared with the SF-36 questionnaire. Although these two questionnaires have four comparable dimensions, they differ in their content and psychometric properties. The Duke questionnaire, due to its better completion rate and despite some psychometric limitations may be useful in this population, particularly in the more frail patients.
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Affiliation(s)
- C Perret-Guillaume
- Department of Internal Medicine, Unit of Geriatrics and Internal Medicine, CHU Nancy, Vandoeuvre-lès-Nancy, France.
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109
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Lang PO, Zekry D, Michel JP, Drame M, Novella JL, Jolly D, Blanchard F. Early markers of prolonged hospital stay in demented inpatients: a multicentre and prospective study. J Nutr Health Aging 2010; 14:141-7. [PMID: 20126963 DOI: 10.1007/s12603-009-0182-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Dementia is a serious, chronic, and costly public health problem. Prior studies have described dementia as increasing length of hospital stay, but so far no explanations have been proposed. METHODS To identify early markers for prolonged hospital stay in demented elderly inpatients, 178 community-dwelling or institutionalized subjects aged 75+, hospitalized through an emergency department in 9 teaching hospitals in France, were analyzed. Prolonged hospital stays were defined according a limit adjusted for Diagnosis Related Group. All patients underwent a comprehensive geriatric assessment at admission. Logistic regression multifactorial mixed model was performed. Center effect was considered as a random effect. RESULTS Of the 178 stays, 52 were prolonged. Most concerned community-dwelling patients (86%). Multifactor analysis demonstrated that demographic variables had no influence on the length of stay, while diagnosis of delirium (OR 2.31; 95% CI 1.77 - 2.91), walking difficulties (OR 1.94; 95% CI 1.62 - 2.43) and report by the informal caregiver of moderate or severe burden (OR 1.52; 95% CI 1.19 - 1.86) or low social quality-of-life score (OR 1.25; 95% CI 1.03 - 1.40), according to the Zarit's Burden Inventory short scale (12 items) and the Duke's Health Profile respectively, were identified as early markers for prolonged hospital stays. CONCLUSION At the time of the rising incidence of cognitive disorders, these results suggest that preventive approaches might be possible. In a hospital setting as well as in a community-dwelling population, more specific, specialized and coordinated care, using the expertise of multiple disciplines appears as a probable effective measure to limit prolonged hospital stay. Such approaches require (i) clear patient-oriented goal definition, (ii) understanding and appreciation of roles among various health care and social disciplines and, (iii) cooperation between partners in patient's management. However, the cost- and health-effectiveness of such approaches should be evaluated.
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Affiliation(s)
- P-O Lang
- Department of rehabilitation and geriatrics, Medical school and University Hospitals of Geneva, Geneva, Switzerland.
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110
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Perret-Guillaume C, Briancon S, Wahl D, Guillemin F, Empereur F. Quality of Life in elderly inpatients with atrial fibrillation as compared with controlled subjects. J Nutr Health Aging 2010; 14:161-6. [PMID: 20126966 DOI: 10.1007/s12603-009-0188-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Since few studies have investigated Health related Quality of Life (HRQoL) in older patients with atrial fibrillation, the aim of this cross-sectional study was to compare HRQoL in AF elderly inpatients of 65 and more with that of age-matched controlled subjects. DESIGN HRQoL was assessed with two generic HRQoL instruments: the MOS-SF 36, a largely recognized instrument, and the Duke Health Profile. SETTING AND PATIENTS Nancy University Hospital patients presenting with atrial fibrillation and three controls per patient free of cardiac arrhythmias, matched by age, sex and hospital department to atrial fibrillation patients. RESULTS Forty one atrial fibrillation patients and 123 controls were included. Both groups were comparable for associated disorders, other than coronary artery disease and chronic respiratory failure. After adjustment, scores among atrial fibrillation patients were lower than among controls in 8 of 10 Duke and 6 of 8 SF-36 subscales. In terms of Quality of Life, meaningful differences (>or= 5 points) were recorded in the Duke: Mental, Depression, Anxiety, General Score; and in the SF-36: Physical functioning, Role emotional, Social functioning and Vitality. Nevertheless statistically significant differences were only observed for the Duke Mental (p=0.01), Depression (p=0.003) and Anxiety (p=0.03) scores. CONCLUSIONS In our study HRQoL measured in elderly inpatients with atrial fibrillation as compared with matched controlled was mainly altered in the "psychological" domains of the Duke Health Profile. From the patient's point of view, atrial fibrillation appears to have more mental than physical consequences. This study pointed out the utility to assess HRQoL in the management and treatment of elderly hospitalised atrial fibrillation patients.
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Affiliation(s)
- C Perret-Guillaume
- Department of Internal Medicine, Unit of Geriatrics and Internal Medicine, CHU Nancy, Vandoeuvre-les-Nancy, France.
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111
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LaBrie JW, Kenney SR, Lac A. The use of protective behavioral strategies is related to reduced risk in heavy drinking college students with poorer mental and physical health. JOURNAL OF DRUG EDUCATION 2010; 40:361-78. [PMID: 21381463 PMCID: PMC3733380 DOI: 10.2190/de.40.4.c] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
The present study examined the moderating role of health status (physical, mental, and social health) and the relationships between protective behavioral strategies utilized to reduce high-risk drinking (e.g., avoiding drinking games, setting consumption limits, or having a designated driver) and alcohol use and negative consequences in a sample of heavy drinking college students (N = 1,820). In this high risk sample, multiple regression analyses showed that stronger social health was related to increased drinking, while poorer physical, mental, and social health were related to increased alcohol negative consequences. Further, moderation effects revealed that increasing the use of protective behaviors was associated with significantly less drinking in those with stronger social health, as well as significantly lower numbers of negative consequences among participants with poorer physical and mental health. Implications for college counselors and medical personnel are discussed.
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Affiliation(s)
- Joseph W LaBrie
- Department of Psychology, Loyola Marymount University, Los Angeles, California 90045, USA.
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112
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Bruneau A. Gravité du traumatisme et souffrance psychosociale chez le sportif aux urgences. Sci Sports 2009. [DOI: 10.1016/j.scispo.2009.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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113
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Alschuler KN, Hoodin F, Byrd MR. Rapid assessment for psychopathology in a college health clinic: utility of college student specific questions. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2009; 58:177-179. [PMID: 19892655 DOI: 10.1080/07448480903221210] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE The purpose of this study was to determine the utility and unique benefits of employing the College Health Questionnaire (CHQ) in a college health care setting. The CHQ is a newly designed measure to assess psychosocial issues commonly problematic among college students. PARTICIPANTS One hundred nine patients participated in the study during their medical appointments. METHODS Participants completed the study questionnaires (CHQ and Patient Health Questionnaire) in the waiting room. Their provider had the opportunity to use the responses in treatment decision making. RESULTS A majority (66.1%) endorsed at least one CHQ item. Patients who indicated traditional mental health problems were more likely to be prescribed psychotropic medications, whereas patients who endorsed psychosocial issues commonly problematic among college students were more likely to be referred for behavioral treatment. CONCLUSIONS Screening for behavioral problems in college primary care settings without the use of college-related questions would result in missing numerous important psychosocial problems.
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Affiliation(s)
- Kevin N Alschuler
- Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan 48197, USA.
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Qualité de vie de la fratrie d’enfants atteints de mucoviscidose : le point de vue des parents et des enfants. ANNALES MEDICO-PSYCHOLOGIQUES 2009. [DOI: 10.1016/j.amp.2007.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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115
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Multidisciplinary network in heart failure management in a community-based population: Results and benefits at 2 years. Int J Cardiol 2009; 134:120-2. [DOI: 10.1016/j.ijcard.2007.12.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2007] [Accepted: 12/11/2007] [Indexed: 11/19/2022]
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116
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Zhang NJ, Wan TT, Rossiter LF, Murawski MM, Patel UB. Evaluation of chronic disease management on outcomes and cost of care for Medicaid beneficiaries. Health Policy 2008; 86:345-54. [DOI: 10.1016/j.healthpol.2007.11.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2007] [Revised: 11/22/2007] [Accepted: 11/24/2007] [Indexed: 10/22/2022]
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117
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Return of chronic pelvic pain from endometriosis after raloxifene treatment: a randomized controlled trial. Obstet Gynecol 2008; 111:88-96. [PMID: 18165396 DOI: 10.1097/01.aog.0000297307.35024.b5] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate whether 6 months of raloxifene was effective in treatment of chronic pelvic pain in women with endometriosis. METHODS Women with chronic pelvic pain and no endometriosis treatment for 6 months underwent laparoscopy for excision of all lesions. Those with biopsy-proven endometriosis were randomly allocated to raloxifene (180 mg) or placebo daily. A second laparoscopy was performed at 2 years, or earlier, if pain returned. Return of pain was defined as 2 months of pain equal to or more severe than that at study entry. Menstrual cycles and adverse events were recorded. The log rank test was used to compare the time to return of pain by drug group. Analyses were done as intent-to-treat. RESULTS A total of 127 of 158 women underwent surgery. Of these, 93 had biopsy-confirmed endometriosis and were randomly assigned to study treatment. Menstrual cycle length, pelvic pain severity, quality of life, bone mineral density, and adverse events did not differ between treatment groups. The Data Safety Monitoring Committee terminated the study early when the raloxifene group experienced pain (P=.03) and had second surgery (P=.016) significantly sooner than the placebo group. Interestingly, biopsy-proven endometriosis was not associated with return of pain (P=.6). CONCLUSION Raloxifene significantly shortened the time to return of chronic pelvic pain. Because recurrence of endometriosis lesions did not correlate with return of pain, other factors are implicated in pelvic pain. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, www.cliicaltrials.gov, NCT00001848 LEVEL OF EVIDENCE I.
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Komorovsky R, Desideri A, Rozbowsky P, Sabbadin D, Celegon L, Gregori D. Quality of life and behavioral compliance in cardiac rehabilitation patients: a longitudinal survey. Int J Nurs Stud 2007; 45:979-85. [PMID: 17673241 DOI: 10.1016/j.ijnurstu.2007.06.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2006] [Revised: 06/06/2007] [Accepted: 06/08/2007] [Indexed: 10/23/2022]
Abstract
BACKGROUND Few data regarding inter-relations between health-related quality of life (HRQoL) and compliance are available. The aim of present study was to assess which aspects of HRQoL might predict patients' behavioral compliance to medical suggestions and whether questionnaires might be useful for patients undergoing cardiac rehabilitation. METHODS HRQoL and compliance were measured in 52 consecutive patients undergoing cardiovascular rehabilitation. The measurements were performed at the beginning, at the end of rehabilitation, and after 6 months follow-up. Baseline, demographic and HRQoL characteristics were linked to compliance by multiple regression modelling. RESULTS Over time no significant differences between HRQoL and compliance scores were observed. Age (odds ratio (OR) 1.37, 95% confidence interval (CI) 1.08-2.45), number of taken drugs (OR=1.45; 95% CI: 1.02-2.11), anxiety score (OR=0.32; 95% CI: 0.15-1.02), depression score (OR=0.48; 95% CI: 0.06-0.78), and social health score (OR=1.09; 95% CI: 1.01-1.24), appeared to be independent predictors of compliance. CONCLUSION Older age, higher number of drugs, high social health score, and low anxiety and depression scores predict better behavioral compliance in cardiac rehabilitation patients.
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Affiliation(s)
- Roman Komorovsky
- Cardiovascular Research Foundation, S. Giacomo Hospital, Castelfranco Veneto, Italy
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Lang PO, Meyer N, Heitz D, Dramé M, Jovenin N, Ankri J, Somme D, Novella JL, Gauvain JB, Couturier P, Lanièce I, Voisin T, de Wazières B, Gonthier R, Jeandel C, Jolly D, Saint-Jean O, Blanchard F. Loss of independence in Katz’s ADL ability in connection with an acute hospitalization: early clinical markers in French older people. Eur J Epidemiol 2007; 22:621-30. [PMID: 17653605 DOI: 10.1007/s10654-007-9150-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2007] [Accepted: 05/29/2007] [Indexed: 10/23/2022]
Abstract
BACKGROUND The preservation of autonomy and the ability of elderly to carry out the basic activities of daily living, beyond the therapeutic care of any pathologies, appears as one of the main objectives of care during hospitalization. OBJECTIVES To identify early clinical markers associated with the loss of independence in elderly people in short stay hospitals. METHODS Among the 1,306 subjects making up the prospective and multicenter SAFEs cohort study (Sujet Agé Fragile: Evolution et suivi-Frail elderly subjects, evaluation and follow-up), 619 medical inpatients, not disabled at baseline and hospitalized through an emergency department were considered. Data used in a multinomial logistic regression were obtained through a comprehensive geriatric assessment (CGA) conducted in the first week of hospitalization. Dependency levels were assessed at baseline, at inclusion and at 30 days using Katz's ADL index. Baseline was defined as the dependence level before occurrence of the event motivating hospitalization. To limit the influence of rehabilitation on the level of dependence, only stays shorter than 30 days were considered. RESULTS About 514 patients were eligible, 15 died and 90 were still hospitalized at end point (n = 619). Two-thirds of subjects were women, with a mean age of 83. At day 30 162 patients (31%) were not disabled; 61 (12%) were moderately disabled and 291 severely disabled (57%). No socio-demographic variables seemed to influence the day 30 dependence level. Lack of autonomy (odds ratio (OR) = 1.9, 95% confidence interval (CI) = 1.2-3.6), walking difficulties (OR = 2.7, 95% CI = 1.3-5.6), fall risk (OR = 2.1, 95% CI = 1.3-6.8) and malnutrition risk (OR = 2.2, 95% CI = 1.5-7.6) were found in multifactorial analysis to be clinical markers for loss of independence. CONCLUSIONS Beyond considerations on the designing of preventive policies targeting the populations at risk that have been identified here, the identification of functional factors (lack of autonomy, walking difficulties, risk of falling) suggests above all that consideration needs to be given to the organization per se of the French geriatric hospital care system, and in particular to the relevance of maintaining sector-type segregation between wards for care of acute care and those involved in rehabilitation.
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Affiliation(s)
- Pierre-Olivier Lang
- Department of Rehabilitation and Geriatrics, Hospital of Trois-Chêne, University Hospitals of Geneva, Chemin du Pont-Bochet 3, Thônex-Genève, 1226 Geneva, Switzerland.
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120
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Le AT, Albo D, Berger DH. Quality of Life in the Elderly with Rectal Cancer. J Am Coll Surg 2007; 205:124-31. [PMID: 17617341 DOI: 10.1016/j.jamcollsurg.2007.02.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2006] [Revised: 02/01/2007] [Accepted: 02/07/2007] [Indexed: 11/12/2022]
Affiliation(s)
- Anne T Le
- Michael E DeBakey, Department of Surgery, Baylor College of Medicine, and the Houston Center for Quality of Care and Utilization Studies and Operative Care Line, Michael E DeBakey Veterans Affairs Medical Center, Houston, TX 77030, USA
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121
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Lang PO, Heitz D, Meyer N, Dramé M, Jovenin N, Ankri J, Somme D, Novella JL, Gauvain JB, Colvez A, Couturier P, Lanièce I, Voisin T, de Wazières B, Gonthier R, Jeandel C, Jolly D, Saint-Jean O, Blanchard F. Indicateurs précoces de durée de séjour prolongée chez les sujets âgés. Presse Med 2007; 36:389-98. [PMID: 17321360 DOI: 10.1016/j.lpm.2006.12.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2005] [Accepted: 08/31/2006] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVES The aim of this study was to identify early indicators of prolonged hospital stays by elderly patients. METHODS This prospective pilot study, conducted at Strasbourg University Hospital, included patients aged 75 years or older who were hospitalized via the emergency department (SAFES cohort: Sujet Agé Fragile: Evaluation et suivi, that is, Frail Elderly Subjects: Evaluation and Follow-up). A gerontologic evaluation of these patients during the first week of their hospitalization furnished the data for an exact logistic regression. Two definitions were used for prolonged hospitalization: 30 days and a composite number adjusted for diagnosis-related group according to the French classification (f-DRG). RESULTS The analysis examined 137 hospitalizations. More than two thirds of the patients were women (73%), with a mean age of 84 years. Twenty-four hospitalizations (17%) lasted more than 30 days, but only 6 (4%) lasted beyond the DRG-adjusted limit. No social or demographic variables appeared to affect the length of stay, regardless of the definition of prolonged stay. No indicator was associated with the 30-day limit, but clinical markers were linked to prolongation assessed by f-DRG adjustment. A "risk of malnutrition" (OR=14.07) and "mood disorders" (OR=2,5) were both early markers for prolonged hospitalization. Although not statistically significant, "walking difficulties" (OR=2.72) and "cognitive impairment" (OR=5.03) appeared to be associated with prolonged stays. No association was seen with either the variables measured by Katz's Activities of Daily Living Index or its course during hospitalization. CONCLUSION Our study shows that when generally recognized indicators of frailty are taken into account, a set of simple items enables a predictive approach to the prolongation of emergency hospitalizations of the elderly.
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Affiliation(s)
- Pierre-Olivier Lang
- Département de Réhabilitation et Gériatrie, Hôpital des Trois-Chêne, Hôpitaux universitaires de Genève, Thonex-Genève, Suisse.
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122
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Perkins EA. Self- and Proxy Reports Across Three Populations: Older Adults, Persons With Alzheimer's Disease, and Persons With Intellectual Disabilities. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2007. [DOI: 10.1111/j.1741-1130.2006.00092.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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123
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Matheis EN, Tulsky DS, Matheis RJ. The relation between spirituality and quality of life among individuals with spinal cord injury. Rehabil Psychol 2006. [DOI: 10.1037/0090-5550.51.3.265] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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124
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Tomaka J, Thompson S, Palacios R. The relation of social isolation, loneliness, and social support to disease outcomes among the elderly. J Aging Health 2006; 18:359-84. [PMID: 16648391 DOI: 10.1177/0898264305280993] [Citation(s) in RCA: 369] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study examined relations between social isolation, loneliness, and social support to health outcomes in a sample of New Mexico seniors. METHOD We used random-digit dialing to obtain a random sample of 755 southern New Mexico seniors. Participants answered questions pertaining to demographics, social isolation and loneliness, social support, and disease diagnosis including diabetes, hypertension, heart disease, liver disease, arthritis, emphysema, tuberculosis, kidney disease, cancer, asthma, and stroke. The sample allowed for comparison of Caucasian and Hispanic participants. RESULTS Correlational and logistic analyses indicated that belongingness support related most consistently to health outcomes. Ethnic subgroup analysis revealed similarities and differences in the pattern of associations among the predictor and outcome variables. DISCUSSION The results demonstrate the importance of social variables for predicting disease outcomes in the elderly and across ethnic groups.
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Affiliation(s)
- Joe Tomaka
- Department of Health Promotion, University of Texas at El Paso, TX 79902, USA.
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125
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Viola KV, Ariyan C, Sosa JA. Surgical perspectives in gastrointestinal disease: A study of quality of life outcomes in esophageal, pancreatic, colon, and rectal cancers. World J Gastroenterol 2006; 12:3213-8. [PMID: 16718841 PMCID: PMC4087964 DOI: 10.3748/wjg.v12.i20.3213] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Outcomes assessment in surgery traditionally has included data regarding peri-operative mortality and morbidity, as well as long-term survival and recurrence in surgical oncology. However, quality of life (QOL) is another important patient-related outcome measure. QOL data can be used to tailor treatment and improve clinical outcomes by detecting physical or psychological problems in patients that otherwise might be overlooked, but which have profound implications for the effective delivery of care. We review several well-validated QOL instruments developed specifically for use in patients with gastrointestinal malignancies, including esophageal, pancreatic and colorectal cancers, and conclude that QOL assessment routinely should be included in clinical trials of novel treatments.
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Affiliation(s)
- Kate-V Viola
- Department of Surgery, Yale University School of Medicine, New Haven, CT 06520-8062, USA
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126
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Beebe LH. Describing the health parameters of outpatients with schizophrenia. Appl Nurs Res 2006; 19:43-7. [PMID: 16455441 DOI: 10.1016/j.apnr.2005.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2005] [Revised: 07/25/2005] [Accepted: 08/15/2005] [Indexed: 10/25/2022]
Abstract
Few studies have examined the physical health parameters of persons with schizophrenia. This pilot study describes the physical health and psychiatric symptoms in outpatients with schizophrenia. Participants (N = 11) were recruited from a population of persons with schizophrenia receiving care at an outpatient clinic in a Veterans Affairs hospital located in the southeast. Following the granting of medical clearance, data regarding sociodemographics and prescribed medications were collected via record review. Physical health parameters included 6-minute walking distance, body mass index, and percentage of body fat. Functional health status was measured using the Duke Health Profile. Psychiatric symptoms were measured using the Positive and Negative Syndrome Scale. A trained research assistant performed all measures in private offices at the study site. Most participants met the criteria for being classified as overweight or obese and demonstrated poor aerobic fitness. More research is needed to examine responses of veterans with schizophrenia to interventions designed to improve physical health parameters.
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127
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Vo TXH, Guillemin F, Deschamps JP. Psychometric Properties of the DUKE Health Profile-adolescent Version (DHP-A): A Generic Instrument for Adolescents. Qual Life Res 2005; 14:2229-34. [PMID: 16328902 DOI: 10.1007/s11136-005-7021-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2005] [Indexed: 11/25/2022]
Abstract
PURPOSE Quality of life in general population of adolescents has been scarcely documented. The study was aimed at evaluating the psychometric properties of the DUKE Health Profile-Adolescent version (DHP-A), an adaptation from the adult version. MATERIAL AND METHOD Feasibility and construct validity were assessed in a sample of 618 adolescents from school settings. Test-retest reliability was assessed in another sample of 100 adolescents at 2 weeks interval. Construct validity was assessed in groups by gender, age and existence of a health problem. RESULTS The DHP-A, a short instrument of HRQOL, easy to administer, proved its ability to discriminate between boys and girls, with or without a health problem, for all of health and dysfunction dimensions (p < 0.05). Its reliability is also acceptable for three health dimensions and anxiety, depression (ICC = 0.68-0.72), moderate for social, perceived health, self-esteem and pain (ICC = 0.43-0.59), and debatable for disability (ICC = 0.22) (single item). CONCLUSION The initial testing of the adolescent version (DHP-A) indicates that the psychometric properties are acceptable and will provide a useful tool for the assessment of health status in adolescents. Three single-item dimensions (perceived health, pain and disability) should be interpreted with caution.
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Affiliation(s)
- Thi Xuan Hanh Vo
- Public health department, University Training Center for health care professionals of Ho Chi Minh City, Vietnam
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128
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Dunderdale K, Thompson DR, Miles JNV, Beer SF, Furze G. Quality-of-life measurement in chronic heart failure: do we take account of the patient perspective? Eur J Heart Fail 2005; 7:572-82. [PMID: 15921797 DOI: 10.1016/j.ejheart.2004.06.006] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2004] [Revised: 04/19/2004] [Accepted: 06/09/2004] [Indexed: 11/19/2022] Open
Abstract
The modern management of chronic heart failure has led to improved life expectancy, functioning and health-related quality of life (HRQL). HRQL measures the effects of an illness or a treatment from the patient's perspective. It is now recognised that the patient's perspective is as legitimate and valid as the clinician's in monitoring health care outcomes. Although there are a number of quality-of-life measures, which can be separated into two types-generic and disease specific-many have been developed, with little or no account being taken of the patient's perspective. Because most of the widely used measures are not patient centred, they may lack sensitivity and specificity in determining those aspects of HRQL important to individual patients. This paper reviews the use of quality-of-life assessment tools in the evaluation of patients with heart failure.
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Affiliation(s)
- Karen Dunderdale
- Cardiac Rehabilitation, Scunthorpe General Hospital, Scunthorpe, DN15 7BH, UK.
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129
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Hanh VTX, Guillemin F, Cong DD, Parkerson GR, Thu PB, Quynh PT, Briançon S. Health related quality of life of adolescents in Vietnam: cross-cultural adaptation and validation of the Adolescent Duke Health Profile. J Adolesc 2005; 28:127-46. [PMID: 15683639 DOI: 10.1016/j.adolescence.2003.11.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Quality of life (QOL) of adolescents has been scarcely documented in a general population sample. The study was aimed at translating and adapting the Adolescent Duke Health Profile to Vietnamese, validating the questionnaire, determining reference value, and identifying determinants of poor QOL. Following a cross-cultural methodology, the Adolescent Duke Health Profile (ADHP) had content adapted to Vietnamese by alteration of 2 out of 17 items. Test-retest validity was checked in 408 adolescents. Construct validity and internal consistency were assessed in a 1408 probability sample of adolescents in Vietnam, and determinants were analysed by multiple linear regression. The ADHP showed satisfactory internal consistency (Cronbach's alpha=0.87-0.92) and satisfactory construct validity in relation with drug abuse or not, or with parent situation living in couple or alone. Test-retest reliability was acceptable (ICC=0.7-0.8) and major determinants were age, sex, education, chronic disease, alcohol and drug use. This works provide a validated, simple health related QOL scale suited to adolescent population with reference values. Taking into account determinants identified will help program prevention and intervention health policy and to evaluate the effect of these actions.
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Affiliation(s)
- Vo Thi Xuan Hanh
- Faculté de Médecine, School of Public Health of Nancy, Ecole de santé Publique, Université Henri Poincaré, Nancy 1, 9, avenue de la Forêt de Haye, B.P. 184, 54505 Vandoeuvre-Lès-Nancy Cedex, France
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130
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Parkerson GR, Hammond WE, Michener JL, Yarnall KSH, Johnson JL. Risk Classification of Adult Primary Care Patients by Self-Reported Quality of Life. Med Care 2005; 43:189-93. [PMID: 15655433 DOI: 10.1097/00005650-200502000-00013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND : Although patient-reported health-related quality of life (HRQOL) is known to predict health services utilization, most risk assessment systems use provider-reported diagnoses as predictors rather than HRQOL. OBJECTIVE : We sought to classify adult primary care patients prospectively by utilization risk based on age, gender, and HRQOL at a single clinic visit. RESEARCH DESIGN : Patients completed the Duke Health Profile. Providers completed the Duke Severity of Illness Checklist. Diagnoses were grouped with the Ambulatory Care Groups system. Predictive coefficients for 1-year primary care charges calculated from the age, gender, and HRQOL of 728 reference patients were used to classify 474 test patients into 4 risk classes. Comparisons were made with models that used diagnoses or severity of illness as predictors. RESULTS : The positive likelihood ratio for predicting highest risk was 2.2 for the HRQOL model, compared with 1.8 for the diagnoses model, 1.6 for the severity model, and 1.5 for age and gender alone. One-year actual primary care visits and charges increased step-wise from lowest to highest risk class. Highest risk patients were older and more likely to be women, black, or Medicaid recipients. Although the highest-risk patients represented only 18.6% of the test group, they accounted for 26.7% of the primary care clinic visits, 31.6% of the clinic charges, 34.6% of the hospital days, 35.1% of hospital charges, and 30.8% of total charges at all healthcare sites. CONCLUSION : The HRQOL risk classification system can identify primary care patients at risk for high future health services utilization.
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Affiliation(s)
- George R Parkerson
- Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA.
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131
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Wilkie R, Peat G, Thomas E, Croft PR. Measuring the consequences of osteoarthritis and joint pain in population-based studies: can existing health measurement instruments capture levels of participation? ACTA ACUST UNITED AC 2005; 51:755-62. [PMID: 15478153 DOI: 10.1002/art.20703] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To identify health measurement instruments to investigate levels of participation associated with joint pain in a population survey questionnaire. METHOD A comprehensive electronic search of the published literature was performed to identify potential instruments that could measure participation. All items from identified instruments were assessed for the ability to measure participation by 2 experienced and 2 inexperienced assessors. Agreement was determined in terms of actual agreement (%) and agreement beyond chance (kappa). RESULTS Twenty-seven instruments (912 items) were identified. Agreement between the experienced assessors occurred in 86% of items (kappa = 0.70, 95% confidence interval [95% CI] 0.65-0.75) and between the inexperienced assessors in 72% (kappa = 0.40, 95% CI 0.34-0.46). The greatest proportion of participation items in one instrument was 82%. CONCLUSION None of the identified instruments consisted entirely of participation items. The concept of participation and its translation into measurement for use in the general population is likely to need further development.
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Affiliation(s)
- R Wilkie
- Primary Care Sciences Research Centre, Keele University, UK.
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132
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Koopmans GT, Donker MCH, Rutten FHH. Length of hospital stay and health services use of medical inpatients with comorbid noncognitive mental disorders: a review of the literature. Gen Hosp Psychiatry 2005; 27:44-56. [PMID: 15694218 DOI: 10.1016/j.genhosppsych.2004.09.008] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2003] [Accepted: 09/16/2004] [Indexed: 11/26/2022]
Abstract
We reviewed 23 studies on the association between noncognitive mental disorders and the use of general health care services by medical patients admitted to a general hospital. Only studies with a prospective design and with a correction for possible confounding factors were included. In most studies, only service use during index admission was observed, but eight studies included a longer observation period during follow-up after hospital discharge. The 15 studies that were restricted to service use during index admission showed mixed results: length of hospital stay was related to common mental disorders in some studies, but other studies did not find such an association. The eight studies that used a longer observation period showed findings that are more consistent. They demonstrated mainly that symptoms or complaints of depression are related to a higher resource use within general medical services.
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Affiliation(s)
- Gerrit T Koopmans
- Department of Health Policy and Management, Erasmus University Medical Center, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands.
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133
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Hart J, Kanner H, Gilboa-Mayo R, Haroeh-Peer O, Rozenthul-Sorokin N, Eldar R. Tai Chi Chuan practice in community-dwelling persons after stroke. Int J Rehabil Res 2004; 27:303-4. [PMID: 15572994 DOI: 10.1097/00004356-200412000-00008] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Eighteen community-dwelling first-stroke survivors, aged 45 to 65, underwent following examinations: Romberg's Test, standing on the unaffected leg, Emory Fractional Ambulation Profile, the Berg Balance Test, the Timed 'Up and Go' Test and the Duke Health Profile. They were then randomly divided into two matched groups of 9 subjects each. The study group (SG) received Tai Chi exercises and the control group (CG) physiotherapy exercises focused on improvement of balance, both groups for 1 h twice weekly for 12 weeks. On completion of exercises, SG subjects showed improvement in social and general functioning whereas CG subjects showed improvement in balance and speed of walking. It is concluded that there are potential and no adverse effects in Tai Chi practice in stroke survivors.
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Affiliation(s)
- Jacob Hart
- Loewenstein Hospital Rehabilitation Center, Raanana, Israel
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134
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Rohrer JE, Rohland BM. Psychosocial risk factors for obesity among women in a family planning clinic. BMC FAMILY PRACTICE 2004; 5:20. [PMID: 15380026 PMCID: PMC521076 DOI: 10.1186/1471-2296-5-20] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/11/2004] [Accepted: 09/20/2004] [Indexed: 11/10/2022]
Abstract
Background The epidemiology of obesity in primary care populations has not been thoroughly explored. This study contributes to filling this gap by investigating the relationship between obesity and different sources of personal stress, mental health, exercise, and demographic characteristics. Methods A cross-sectional survey using a convenience sample. Five hundred women who attended family planning clinics were surveyed and 274 provided completed answers to all of the questions analyzed in this study. Exercise, self-rated mental health, stress, social support, and demographic variables were included in the survey. Multiple logistic regression analysis was performed. Results After adjusting for mental health, exercise, and demographic characteristics of subjects, analysis of the data indicated that that being having a large family and receiving no support from parents were related to obesity in this relatively young low-income primary care sample, but self-reported stress and most types of social support were not significant. Conclusion Obesity control programs in primary care centers directed at low-income women should target women who have large families and who are not receiving support from their parents.
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Affiliation(s)
- James E Rohrer
- Department of Family and Community Medicine Texas Tech University Health Sciences Center, USA
| | - Barbara M Rohland
- Associate Professor and Regional Chair of the Department of Psychiatry (Amarillo), Texas Tech University Health Sciences Center, 1400 Coulter Blvd, Amarillo TX 79106, USA
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135
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Lynch D, Tamburrino M, Nagel R, Smith MK. Telephone-based treatment for family practice patients with mild depression. Psychol Rep 2004; 94:785-92. [PMID: 15217028 DOI: 10.2466/pr0.94.3.785-792] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The need for treating milder forms of depression has recently been of increased interest. This was a randomized, controlled study to evaluate the effects of telephone-based problem-solving therapy for mild depression. Comparison groups were a treatment-as-usual group and another group receiving stress-management training by telephone. From 1,742 family practice patients screened for depression, 54 with mild depression entered the study. Treatment was provided by experienced family practice nurses, trained and supervised in the treatments. The Hamilton Rating Scale for Depression was administered before and after the intervention period, and the Beck Depression Inventory and Duke Health Profile were administered at the end of the intervention period. Of the 36 subjects assigned to the problem-solving and stress-management groups, half dropped out early in the study. Five from the treatment-as-usual group were lost to follow-up. In the remaining subjects, there was a significant decrease in depression scores. There were no significant differences in the amount of decrease between the groups on any scores. The small sample and high dropout rate limit the interpretation of the findings. However, since all subjects tended to improve, regardless of treatment received, mild levels of depression may generally remit even without focal intervention, and watchful waiting may be a reasonable alternative for management.
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Affiliation(s)
- Denis Lynch
- Department of Family Medicine, Medical College of Ohio, USA.
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136
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Rohrer JE, Young R. Self-esteem, stress and self-rated health in family planning clinic patients. BMC FAMILY PRACTICE 2004; 5:11. [PMID: 15176984 PMCID: PMC425579 DOI: 10.1186/1471-2296-5-11] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2004] [Accepted: 06/03/2004] [Indexed: 12/04/2022]
Abstract
Background The independent effects of stress on the health of primary care patients might be different for different types of clinic populations. This study examines these relationships in a low-income female population of patients attending a family planning clinic. Methods This study investigated the relevance of different sources of personal stress and social support to self-rated health, adjusting for mental health, health behavior and demographic characteristics of subjects. Five hundred women who attended family planning clinics were surveyed and 345 completed the form for a response rate of 72 percent. Results Multiple logistic regression analysis revealed that liking oneself was related to good self-rated health (Odds ratio = 7.11), but stress or support from children, parents, friends, churches or spouses were not significant. White non-Hispanic and non-white non-Hispanic respondents had lower odds of reporting good self-rated health than Hispanic respondents (odds ratios were 2.87 and 2.81, respectively). Exercising five or more days per week also was related to good self-rated health. Smoking 20 or more cigarettes per day, and obese III were negatively related to good self-rated health (odds ratios were .19 and .22, respectively with corresponding p-values equal to .0043 and .0332). Conclusions Among younger low-income women, addressing low self-esteem might improve health status.
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Affiliation(s)
- James E Rohrer
- Department of Family and Community Medicine, Texas Tech University Health Sciences Center, USA
| | - Rodney Young
- Department of Family Medicine, Texas Tech University Health Sciences Center-Amarillo, USA
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137
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Varroud-Vial M, Simon D, Attali J, Durand-Zaleski I, Bera L, Attali C, Letondeur C, Strauss K, Petit C, Charpentier G. Improving glycaemic control of patients with Type 2 diabetes in a primary care setting: a French application of the Staged Diabetes Management programme. Diabet Med 2004; 21:592-8. [PMID: 15154945 DOI: 10.1111/j.1464-5491.2004.01207.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
AIMS To assess the impact of a French adaptation of the Staged Diabetes Management (SDM) programme on glycaemic control of people with Type 2 diabetes in primary care. Secondary endpoints were blood pressure, blood lipids, healthcare costs and quality of life. METHODS Prospective, randomized controlled study, of 1 years' duration. General practitioners (GPs) were recruited in four separate districts of a French region. They enrolled consecutive patients with Type 2 diabetes. GPs in the intervention group were educated in the SDM programme. GPs in the control group were asked to provide usual care. Healthcare costs were collected by medical departments of the Health Insurance systems. Quality of life was assessed with the Duke Health Profile. RESULTS Three hundred and forty patients enrolled by 57 GPs completed the study, 192 in the intervention group and 148 in the control group. Patients in the intervention group were managed more adequately in accordance with the guidelines (P < 0.05 for nine out of 10 items). HbA(1c) decreased by 0.31% in the intervention group and increased by 0.56% in the control group, resulting in a difference of 0.87% by the end of the study (P = 0.001). Blood pressure and blood lipids did not differ between groups. Occurrence of major complications was low and identical in both groups. Incremental costs during the study in the intervention group were 35 euros per patient per month, and this was not significantly different in comparison with the control group. Quality of life was not affected by the intervention. CONCLUSIONS Educating GPs in the French adaptation of the SDM programme improves glycaemic control in a primary care setting, without significantly increasing healthcare costs.
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Affiliation(s)
- M Varroud-Vial
- Diabetes Department, Sud Francilien Hospital, Corbeil-Essonnes, France.
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138
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Rauch P, Miny J, Conroy T, Neyton L, Guillemin F. Quality of life among disease-free survivors of rectal cancer. J Clin Oncol 2004; 22:354-60. [PMID: 14722043 DOI: 10.1200/jco.2004.03.137] [Citation(s) in RCA: 158] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
PURPOSE To identify factors affecting the quality of life (QoL) of disease-free survivors of rectal cancer. PATIENTS AND METHODS One hundred twenty-one patients in complete remission more than 2 years after diagnosis were asked to complete three QoL questionnaires: the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30; its colorectal module, QLQ-CR38; and the Duke generic instrument. RESULTS Patients reported less pain (P =.002) than did controls drawn from the general population. EORTC QLQ-C30 physical scores were also higher among rectal cancer survivors than in the general Norwegian or German population (P =.0005 and P =.002, respectively). Unexpectedly, stoma patients reported better social functioning than did nonstoma patients (P =.005), with less anxiety (P =.008) and higher self-esteem (P =.0002). In the present authors' experience, the QLQ-CR38 does not discriminate between these groups. Residual abdominal or pelvic pain and constipation had the most negative influence on QoL. CONCLUSION QoL is high among rectal cancer survivors, including stoma patients. Simultaneous use of several QoL questionnaires appears to have value in follow-up and in monitoring the effects of therapy. The impact of residual pain and constipation on long-term QoL should be considered when establishing a treatment regimen.
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Affiliation(s)
- Philippe Rauch
- Surgical Department and Medical Oncology, Centre Alexis Vautrin, 54511 Vandoeuvre lès Nancy, France.
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139
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Luo X, George ML, Kakouras I, Edwards CL, Pietrobon R, Richardson W, Hey L. Reliability, validity, and responsiveness of the short form 12-item survey (SF-12) in patients with back pain. Spine (Phila Pa 1976) 2003; 28:1739-45. [PMID: 12897502 DOI: 10.1097/01.brs.0000083169.58671.96] [Citation(s) in RCA: 202] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Secondary analysis of data collected from spine patients' normal clinic visits from 1998 to 2001. OBJECTIVE To evaluate the reliability, validity, and responsiveness of the short form 12-item survey in patients with back pain. SUMMARY OF BACKGROUND DATA The reliability, validity, and responsiveness of the short form 12-item survey in patients with back pain has not been previously evaluated. METHODS Patients were asked to complete a comprehensive computerized survey questionnaire during their regular clinic visits. A total of 2520 patients who indicated in their first surveys that they had back pain were included in the study of the reliability and validity of the short form 12-item survey. Of these, 506 patients completed another survey within 3-6 months of follow-up and were included in the responsiveness evaluation. RESULTS The two summary scales of the short form 12-item survey, physical component summary and mental component summary, demonstrated internal consistency reliability, with Cronbach alpha for both scales exceeding the recommended level of 0.70. Correlation of physical component summary and mental component summary with six other measures theoretically related or unrelated to these scales performed as expected without exception, demonstrating the construct validity of the short form 12-item survey. The responsiveness of the short form 12-item survey was supported by several pieces of evidence. First, the changes in physical component summary and mental component summary scores were correlated with the changes in back pain intensity. Second, for patients whose back pain improved, there was a significant increase in the follow-up physical component summary and mental component summary scores as compared to the baseline. Third, small to moderate effect size was observed for patients whose back pain became improved or became worse. CONCLUSIONS The short form 12-item survey demonstrated good internal consistency reliability, construct validity, and responsiveness in patients with back pain.
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Affiliation(s)
- Xuemei Luo
- Center for Clinical Effectiveness, Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
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140
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Association of the Japanese Orthopaedic Association Score With the Oswestry Disability Index, Roland-Morris Disability Questionnaire, and Short-Form 36. Spine (Phila Pa 1976) 2003. [DOI: 10.1097/01.brs.0000077510.95462.39] [Citation(s) in RCA: 157] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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141
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Turner C, Boyle F, O'Rourke P. Mothers' health post-partum and their patterns of seeking vaccination for their infants. Int J Nurs Pract 2003; 9:120-6. [PMID: 12694481 DOI: 10.1046/j.1322-7114.2003.00410.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A cohort of 159 mothers were recruited post-partum and followed for seven months to examine the relationship between mothers' health post-partum and their patterns of seeking vaccination for their infants. Vaccination records for infants were obtained from a state-wide database. Only 44% of the mothers had maintained all age-appropriate vaccinations for their infant up to six months of age. Mothers who had two or more older children were four times more likely to have an infant who was not age-appropriately vaccinated at six months. Women experiencing mental health problems including anxiety and depression, seven months following the birth, were between three to five times more likely to have started the vaccination schedule late or not at all. The findings have implications for midwives and for nurses practising in maternal and child health, paediatrics and public health environments. Strategies focusing on enhancing mothers' psychosocial well-being postnatally through improved service delivery should improve their patterns of seeking vaccination for their infants.
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Affiliation(s)
- Cathy Turner
- School of Population Health, University of Queensland, Herston, Queensland, Australia.
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142
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Abstract
Evaluation of functional status plays a unique role in the assessment of older cancer patients. While performance status has been the traditional method for oncologists to assess the impact of a cancer patient's disease, older cancer patients may require a more thorough evaluation of their functional status. Evaluation of functional status provides information that can predict outcomes and may provide information that can be utilized to improve function. Functional status evaluation can be useful throughout the patient's illness, at the initial diagnostic evaluation, for determining appropriate therapies, for the monitoring of therapeutic effect and finally in the palliative phase. There are many different methods available to assess functional status. Individual assessment of functional status in the context of a geriatric assessment may be an important component of the care older cancer patients receive.
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Affiliation(s)
- Katherine S Garman
- Division of Geriatrics, Department of Medicine, Duke University Medical Center, Box 2885, Durham, NC 27710, USA.
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143
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Alla F, Briançon S, Guillemin F, Juillière Y, Mertès PM, Villemot JP, Zannad F. Self-rating of quality of life provides additional prognostic information in heart failure. Insights into the EPICAL study. Eur J Heart Fail 2002; 4:337-43. [PMID: 12034160 DOI: 10.1016/s1388-9842(02)00006-5] [Citation(s) in RCA: 124] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The relationship between quality of life (QoL) and survival have been poorly investigated. The aim of this study was to determine the value of QoL score as a prognostic factor in a prospective cohort of patients with advanced chronic heart failure (CHF). METHODS QoL assessment was performed with a generic questionnaire: the Duke Health Profile (DHP) and a disease-specific instrument: the Minnesota Living With Heart Failure Questionnaire (LIhFE), in a sample of 108 patients registered in the EPICAL program (hospitalised patients with severe CHF defined by a NYHA grade III/IV, oedema or hypotension, and LVEF < 30%). Prognostic value of general, physical, mental and social dimensions on survival and hospital-free survival were tested in a Cox model. RESULTS One-year survival rate was 76%, 1-year hospital-free survival 38%. QoL was significantly associated with outcomes: for both questionnaires, a 10-point decrement in baseline score was associated with a 23-36% increase in the risk of death or hospitalisation for heart failure. For hospital-free survival, this relationship remained significant after adjustment for others prognostic factors. CONCLUSION QoL score is a predictive factor of survival and an independent predictive factor of hospital-free survival in patients with advanced CHF. This assessment may provide additional information for clinical management and therapeutic decisions.
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Affiliation(s)
- François Alla
- Department of Epidemiology, University Hospital, Nancy, France.
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144
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Novella JL, Jochum C, Jolly D, Morrone I, Ankri J, Bureau F, Blanchard F. Agreement between patients' and proxies' reports of quality of life in Alzheimer's disease. Qual Life Res 2002; 10:443-52. [PMID: 11763206 DOI: 10.1023/a:1012522013817] [Citation(s) in RCA: 143] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Agreement between self reports and proxy reports of health-related quality of life (H RQoL) was examined in a sample of 76 patients with mild to moderate Alzheimer's disease and their proxies. Patients and proxies completed an '17-item Duke health profile'. The items were rephrased for the proxy. The proportion of exact agreement between patients and proxies on the 17 items ranged from 26.3 to 52.6%. Results reveal poor to moderate agreement (intraclass correlation coefficients (ICCs) from 0.00 to 0.61 for 10 subscales) between patients' and proxies' reports. Agreement was higher for measures of function that are directly observable (physical health, disability) and relatively poor for more subjective measures. Proxy reliability varied according to the relationship of the proxy to the index subject. Spouses and nurses agreed more closely with index subjects than did children or nurses' aides. Agreement decreased with increasing severity of dementia. Statistically significant differences in mean scores were noted for several dimensions, with proxies tending to rate the patients as having a lower quality of life than the patients themselves. This study indicates the importance of considering the information source of a patient's HRQoL. However, assessments by proxies should be used with caution.
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Affiliation(s)
- J L Novella
- Department of Internal Medicine and Gerontology, Hôpital Sébastopol, Reims, France.
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145
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Guillemin F, Virion JM, Escudier P, De Talancé N, Weryha G. Effect on osteoarthritis of spa therapy at Bourbonne-les-Bains. Joint Bone Spine 2001; 68:499-503. [PMID: 11808987 DOI: 10.1016/s1297-319x(01)00314-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Several studies suggest a beneficial overall effect of spa therapy in chronic musculoskeletal diseases. The present open controlled study investigated the effects of spa therapy at Bourbonne-Les-Bains, France, in patients with hip or knee osteoarthritis or low back pain. PATIENTS AND METHODS In 1998, 102 men and women older than 50 years were included in the study. All had low back pain or lower limb osteoarthritis, and none had contraindications to spa therapy. Quality of life was assessed three times at intervals of 4 weeks, twice before and once immediately after 3 weeks of spa therapy, using the Duke Health Profile (five dimensions and five dysfunctions). RESULTS Mean age was 66.4 years, and 67% of the patients were women. Quality of life was markedly decreased as compared to the population at large (1996, CFES). The two pretreatment evaluations produced similar quality-of-life scores. Spa therapy was associated with significant improvements in overall quality of life (P=0.004), self-esteem (P=0.009), and pain (P=0.01). CONCLUSION These findings support those of other studies conducted in France and in other European countries. They indicate that patients report meaningful improvements in their quality of life after spa therapy.
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Affiliation(s)
- F Guillemin
- Epidemiology and Clinical Evaluation Department, UPRES EA 1124, CHU de Nancy, Hôpital Marin, Nancy, France.
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146
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Parkerson GR, Harrell FE, Hammond WE, Wang XQ. Characteristics of adult primary care patients as predictors of future health services charges. Med Care 2001; 39:1170-81. [PMID: 11606871 DOI: 10.1097/00005650-200111000-00004] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Utilization risk assessment is potentially useful for allocation of health care resources, but precise measurement is difficult. OBJECTIVE Test the hypotheses that health-related quality of life (HRQOL), severity of illness, and diagnoses at a single primary care visit are comparable case-mix predictors of future 1-year charges in all clinical settings within a large health system, and that these predictors are more accurate in combination than alone. RESEARCH DESIGN Longitudinal observational study in which subjects' characteristics were measured at baseline, and their outpatient clinic visits and charges and their inpatient hospital days and charges were tracked for 1 year. SUBJECTS Adult primary care patients. MEASURES Duke Health Profile for HRQOL, Duke Severity of Illness Checklist for severity of illness, and Johns Hopkins Ambulatory Care Groups for diagnostic groups classification. RESULTS Of 1,202 patients, 84.4% had follow up in the primary care clinic, 63.2% in subspecialty clinics, 14.8% in the emergency room, and 9.6% in the hospital. Of $6,290,775 total charges, $779,037 (12.2%) was for follow-up primary care. The highest accuracy was found for predicting primary care charges, where R2 for predictors ranged from 0.083 for medical record auditor-reported severity of illness to 0.107 for HRQOL. When predictors were combined, the highest R2 of 0.125 was found for the combination of HRQOL and diagnostic groups. CONCLUSIONS Baseline HRQOL, severity of illness, and diagnoses were comparable predictors of 1-year health services charges in all clinical sites but most predictive for primary care charges, and were more accurate in combination than alone.
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Affiliation(s)
- G R Parkerson
- Department of Community and Family Medicine, Duke University Medical Center, Durham, NC 27710, USA.
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147
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Keller SD. Quantifying social consequences of occupational injuries and illnesses: state of the art and research agenda. Am J Ind Med 2001; 40:438-51. [PMID: 11598993 DOI: 10.1002/ajim.10004] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Quantitative methods for describing the social effects of occupational injury and illness are evaluated including surveys of prevalence and ratings of severity of social role disability. METHODS The reliability and validity for the injured worker population of the most commonly used general and condition-specific role disability measures is reviewed and summarized. This review is used to support the development of a prototype strategy for quantifying the social consequences of occupational injuries and to identify areas of need for further research and development. CONCLUSIONS Research is needed to: (a) determine which of existing measures is most precise in describing the severity of dysfunction due to a specific illness or injury, (b) expand the development of measures of specific role functioning (including paid work), and (c) develop item banks to support the construction of computer adaptive assessments of role functioning.
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Affiliation(s)
- S D Keller
- Health Care Quality and Outcomes Program, Research Triangle Institute, 3040 Cornwallis Road, Research Triangle Park, NC 27709-2194, USA.
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148
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Saliba Z, Butera G, Bonnet D, Bonhoeffer P, Villain E, Kachaner J, Sidi D, Iserin L. Quality of life and perceived health status in surviving adults with univentricular heart. BRITISH HEART JOURNAL 2001. [DOI: 10.1136/hrt.86.1.69] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVETo evaluate the quality of life in patients with univentricular heart and to determine the impact of sociodemographic and clinical characteristics.DESIGN AND SETTINGRetrospective, cross sectional study conducted in a regional paediatric cardiology centre.PATIENTSThe health records of 89 survivors with univentricular heart (median age 21 years; range 17–49 years) were reviewed. Sixty seven answered the Duke questionnaire. Sociodemographic and clinical variables were similar in the responders and non-responders. The impact of sociodemographic and clinical variables on individual Duke's measures was assessed.RESULTSThe Duke scores of adults with univentricular heart were similar to the normal population. Cyanosis predicted a worse score for physical (p = 0.05) and perceived health measures (p = 0.02). A higher educational level predicted a better score for physical (p = 0.004), mental (p = 0.01), and general health measures (p = 0.02). Orthopaedic problems worsened the social score (p = 0.05). Psychosocial problems worsened the pain score (p = 0.04). In comparison with the other anatomical types, mitral atresia worsened the perceived health score (p = 0.02). Patients younger than 23 years scored better for almost all health and dysfunction measures.CONCLUSIONSDespite repeated interventions and other disease related everyday stresses, a selected group of adults with univentricular heart had a satisfying quality of life.
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149
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Saliba Z, Butera G, Bonnet D, Bonhoeffer P, Villain E, Kachaner J, Sidi D, Iserin L. Quality of life and perceived health status in surviving adults with univentricular heart. Heart 2001; 86:69-73. [PMID: 11410565 PMCID: PMC1729833 DOI: 10.1136/heart.86.1.69] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To evaluate the quality of life in patients with univentricular heart and to determine the impact of sociodemographic and clinical characteristics. DESIGN AND SETTING Retrospective, cross sectional study conducted in a regional paediatric cardiology centre. PATIENTS The health records of 89 survivors with univentricular heart (median age 21 years; range 17-49 years) were reviewed. Sixty seven answered the Duke questionnaire. Sociodemographic and clinical variables were similar in the responders and non-responders. The impact of sociodemographic and clinical variables on individual Duke's measures was assessed. RESULTS The Duke scores of adults with univentricular heart were similar to the normal population. Cyanosis predicted a worse score for physical (p = 0.05) and perceived health measures (p = 0.02). A higher educational level predicted a better score for physical (p = 0.004), mental (p = 0.01), and general health measures (p = 0.02). Orthopaedic problems worsened the social score (p = 0.05). Psychosocial problems worsened the pain score (p = 0.04). In comparison with the other anatomical types, mitral atresia worsened the perceived health score (p = 0.02). Patients younger than 23 years scored better for almost all health and dysfunction measures. CONCLUSIONS Despite repeated interventions and other disease related everyday stresses, a selected group of adults with univentricular heart had a satisfying quality of life.
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Affiliation(s)
- Z Saliba
- Service de Cardiologie Pédiatrique and Institut de Cardiologie Congénitale des Adultes, Hôpital Necker-Enfants Malades, 149 rue de Sèvres, 75743 Paris Cedex 15, France
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150
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Abstract
It is always gratifying to be acknowledged by a colleague and asked to give a talk in a faraway land about a topic of one's particular interest. To be invited, however, to give the Harry Farfan Presidential Lecture at the 27th Meeting of the International Society for the Study of the Lumbar Spine is, for me, a special honor and privilege. Too many years ago, when I was a very junior faculty member at the School of Physical and Occupational Therapy at McGill University in Montreal, Canada, we offered our students a course in Orthopedic Conditions. This course was primarily taught by orthopedic surgeons, rheumatologists, and other members of the medical profession with special interest in disorders of the musculoskeletal system. Teaching in this course was considered to be a professional obligation at McGill, and, while most individuals accepted the invitation, they did so with varying degrees of enthusiasm. Each year, Dr. Harry Farfan graciously agreed and provided several lectures for our students. He told them about the surgical management of problems of the lumbar spine and the necessity of treating the "whole" patient, as well as about his theory as to the cause of low back pain. At that point in time, we were not talking about quality of life as an outcome of care for our patients, but I cannot help but believe that he would keenly approve of the subject of this presentation.
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Affiliation(s)
- S L Wood-Dauphinee
- McGill University, School of Physical and Occupational Therapy, Montreal, Quebec, Canada.
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