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François C, Rahhali N, Chalem Y, Sørensen P, Luquiens A, Aubin HJ. The Effects of as-Needed Nalmefene on Patient-Reported Outcomes and Quality of Life in Relation to a Reduction in Alcohol Consumption in Alcohol-Dependent Patients. PLoS One 2015; 10:e0129289. [PMID: 26053024 PMCID: PMC4460126 DOI: 10.1371/journal.pone.0129289] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 05/06/2015] [Indexed: 11/15/2022] Open
Abstract
Background The objective of this article was to investigate the effect of as-needed nalmefene on health-related quality of life (HRQoL) in patients with alcohol dependence, and to relate changes in drinking behavior and status to HRQoL outcomes. Methods This post hoc analysis was conducted on a pooled subgroup of patients with at least a high drinking risk level (men: >60 g/day; women: >40 g/day) who participated in one of two randomized controlled 6-month studies, ESENSE 1 and ESENSE 2. Patients received nalmefene 18 mg or placebo on an as-needed basis, in addition to a motivational and adherence-enhancing intervention (BRENDA). At baseline and after 12 and 24 weeks questionnaires for the Medical Outcomes Study (MOS) 36-item Short-Form Health Survey (SF-36), European Quality of life-5 Dimensions (EQ-5D) and the Drinker Inventory of Consequences (DrInC-2R) were completed. Results The pooled population consisted of 667 patients (nalmefene: 335; placebo: 332), with no notable between-group differences in baseline patient demographics/characteristics. At week 24, nalmefene had a superior effect compared to placebo in improving SF-36 mental component summary scores (mean difference [95% CI], p-value: 3.09 [1.29, 4.89]; p=0.0008), SF-36 physical component summary scores (1.23 [0.15, 2.31]; p=0.026), EQ-5D utility index scores (0.03 [0.00, 0.06]; p=0.045), EQ-5D health state scores (3.46 [0.75, 6.17]; p=0.012), and DrInC-2R scores (-3.22 [-6.12, 0.33]; p=0.029). The improvements in SF-36 mental component summary scores at week 24, and the DrInC-2R total score change from baseline to week 24, were significantly correlated to reductions in heavy drinking days and total alcohol consumption at week 24. Conclusions As-needed nalmefene significantly improved almost all patient-reported HRQoL measures included in SF-36 and EQ-5D compared with placebo. These HRQoL gains were significantly correlated to reduced drinking behavior, as determined by reductions in heavy drinking days and total alcohol consumption.
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Affiliation(s)
| | - Nora Rahhali
- H. Lundbeck A/S, Issy les Moulineaux Cedex, France
| | - Ylana Chalem
- H. Lundbeck A/S, Issy les Moulineaux Cedex, France
| | | | - Amandine Luquiens
- Assistance Publique-Hôpitaux de Paris, Hôpital Paul Brousse, INSERM U669, Villejuif Cedex, France
| | - Henri-Jean Aubin
- Assistance Publique-Hôpitaux de Paris, Hôpital Paul Brousse, INSERM U669, Villejuif Cedex, France
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Dronavalli M, Thompson SC. A systematic review of measurement tools of health and well-being for evaluating community-based interventions. J Epidemiol Community Health 2015; 69:805-15. [PMID: 26041904 DOI: 10.1136/jech-2015-205491] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 05/10/2015] [Indexed: 11/03/2022]
Abstract
BACKGROUND Those interested in evaluating the effectiveness of community interventions on health and well-being need information about what tools are available and best suited to measure improvements that could be attributed to the intervention.This study evaluated published measurement tools of health and well-being that have the potential to be used before and after an intervention. METHODS A literature search of health and sociological databases was undertaken for articles that utilised measurement tools in community settings to measure overall health, well-being or quality of life. Articles were considered potentially relevant because they included use of measurement tools related to general health or well-being. These tools were evaluated by further searching of the literature to assess each tool's properties including: reliability; validity; responsiveness; length; use in cross-cultural settings; global health or well-being assessment; use of subjective measures; clarity and cost. A composite score was made based on the average rating of all fields. RESULTS Of 958 abstracts that were screened, 123 articles were extracted for review. From those articles, 27 measurement tools were selected and assessed. Based on the composite score assessing across all domains, five tools were rated as excellent. CONCLUSIONS While tools may need to be selected for particular aims and interventions, a range of potential well-described tools already exist and should be considered for use in preference to ad hoc or bespoke tools. Any of the five tools rated as excellent are recommended to assess the impact of a community intervention.
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Affiliation(s)
- Mithilesh Dronavalli
- Western Australian Centre of Rural Health, University of Western Australia, Geraldton, Western Australia, Australia
| | - Sandra C Thompson
- Western Australian Centre of Rural Health, University of Western Australia, Geraldton, Western Australia, Australia
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Abstract
OBJECTIVE To study the quality of life in adults aged 50+ with ADHD. METHOD An anonymous questionnaire survey was performed on 148 adults aged 50+ with ADHD. Quality of life was assessed with EuroQol and the Satisfaction With Life Scale. Age-matched Norwegian and Danish population samples served as reference groups. RESULTS Mean age of participants was 55.7 years, and mean age when diagnosed with ADHD was 50.2 years, while mean Adult ADHD Self-Report Scale Screener score was 15.2. Adults with ADHD reported significantly reduced health-related quality of life and reduced satisfaction with life compared with population norms. Nonemployment and severe ADHD were associated with poor quality of life. CONCLUSION Adults aged 50+ with ADHD diagnosed in late adulthood reported significantly reduced quality of life when compared with population norms. The negative impact of ADHD persists into late adulthood.
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Validity of EQ-5D in general population of Taiwan: results of the 2009 National Health Interview and Drug Abuse Survey of Taiwan. Qual Life Res 2015; 24:2541-8. [DOI: 10.1007/s11136-015-0978-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2015] [Indexed: 11/25/2022]
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205
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Pereira P, Buzek D, Franke J, Senker W, Kosmala A, Hubbe U, Manson N, Rosenberg W, Assietti R, Martens F, Barbanti Brodano G, Scheufler KM. Surgical data and early postoperative outcomes after minimally invasive lumbar interbody fusion: results of a prospective, multicenter, observational data-monitored study. PLoS One 2015; 10:e0122312. [PMID: 25811615 PMCID: PMC4374830 DOI: 10.1371/journal.pone.0122312] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 02/20/2015] [Indexed: 12/02/2022] Open
Abstract
Minimally invasive lumbar interbody fusion (MILIF) offers potential for reduced operative morbidity and earlier recovery compared with open procedures for patients with degenerative lumbar disorders (DLD). Firm conclusions about advantages of MILIF over open procedures cannot be made because of limited number of large studies of MILIF in a real-world setting. Clinical effectiveness of MILIF in a large, unselected real-world patient population was assessed in this Prospective, monitored, international, multicenter, observational study. Objective: To observe and document short-term recovery after minimally invasive interbody fusion for DLD. Materials and Methods: In a predefined 4-week analysis from this study, experienced surgeons (≥30 MILIF surgeries pre-study) treated patients with DLD by one- or two-level MILIF. The primary study objective was to document patients’ short-term post-interventional recovery (primary objective) including back/leg pain (visual analog scale [VAS]), disability (Oswestry Disability Index [ODI]), health status (EQ-5D) and Patient satisfaction. Results: At 4 weeks, 249 of 252 patients were remaining in the study; the majority received one-level MILIF (83%) and TLIF was the preferred approach (94.8%). For one-level (and two-level) procedures, surgery duration was 128 (182) min, fluoroscopy time 115 (154) sec, and blood-loss 164 (233) mL. Time to first ambulation was 1.3 days and time to study-defined surgery recovery was 3.2 days. Patients reported significantly (P < 0.0001) reduced back pain (VAS: 2.9 vs 6.2), leg pain (VAS: 2.5 vs 5.9), and disability (ODI: 34.5% vs 45.5%), and a significantly (P < 0.0001) improved health status (EQ-5D index: 0.61 vs 0.34; EQ VAS: 65.4 vs 52.9) 4 weeks postoperatively. One adverse event was classified as related to the minimally invasive surgical approach. No deep site infections or deaths were reported. Conclusions: For experienced surgeons, MILIF for DLD demonstrated early benefits (short time to first ambulation, early recovery, high patient satisfaction and improved patient-reported outcomes) and low major perioperative morbidity at 4 weeks postoperatively.
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Affiliation(s)
- Paulo Pereira
- Neurosurgery, Centro Hospitalar S. Joao, Porto, Portugal
- * E-mail:
| | - David Buzek
- Karvinska hornicka nemocnice, Karvina, Czech Republic
| | | | | | | | - Ulrich Hubbe
- Universitatsklinikum Freiburg, Freiburg, Germany
| | - Neil Manson
- Orthopaedic Surgery, Horizon Health Network, Saint John, NB, Canada
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van Hasselt FM, Krabbe PFM, Postma MJ, Loonen AJM. Evaluation of health promotion programmes in severe mental illness: theory and practice. Int J Methods Psychiatr Res 2015; 24:83-97. [PMID: 25488507 PMCID: PMC6878437 DOI: 10.1002/mpr.1456] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 04/23/2014] [Accepted: 05/20/2014] [Indexed: 12/13/2022] Open
Abstract
Health promotion programmes for patients with severe mental illness (HPP) are not uniformly evaluated. We discuss the evaluation of HPP in theory and practice, as a prerequisite for future uniform evaluation. We explored the expected outcome and mechanism of HPP in the current literature. Based on this theoretical exploration we selected measures assessing the expected outcome and mechanism in current practice. The individual properties of these measures were described. Based on our theoretical exploration the outcome of HPP can be expressed in several aspects of health. Health can be improved through several mechanisms. In the current evaluation of HPP only some of the expected outcomes were evaluated. The measures used for evaluation were not all representative for the constructs they should assess. Important aspects of HPP are currently not evaluated, based on a comparison between our theoretical exploration of expected outcome and mechanism and current practice. Additionally, not all measures in use are suitable for evaluation of HPP. Therefore, development and identification of suitable measures is necessary. Our framework offers valuable directions for the development of such measures and the future evaluation of HPP.
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Affiliation(s)
- Fenneke M van Hasselt
- Pharmacotherapy and Pharmaceutical Care, University of Groningen, Groningen, The Netherlands; GGZ WNB, Mental Health Hospital, Bergen op Zoom, The Netherlands
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207
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Bouwmans C, de Sonneville C, Mulder CL, Hakkaart-van Roijen L. Employment and the associated impact on quality of life in people diagnosed with schizophrenia. Neuropsychiatr Dis Treat 2015; 11:2125-42. [PMID: 26316759 PMCID: PMC4547637 DOI: 10.2147/ndt.s83546] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
A systematic review was conducted to assess the employment rate of people with schizophrenia. Additionally, information from the selected studies concerning factors associated with employment and health-related quality of life (HRQoL) was examined. Employment rates ranged from 4% to 50.4%. The studies differed considerably in design, patient settings, and methods of recruitment. The most frequently reported factors associated with employment were negative and cognitive symptoms, age of onset, and duration and course of the disease. Individual characteristics associated with unemployment were older age, lower education, and sex (female). Additionally, environmental factors, eg, the availability of welfare benefits and vocational support programs, seemed to play a role. Generally, being employed was positively associated with HRQoL. However, the causal direction of this association remained unclear, as studies on the bidirectional relationship between employment and HRQoL were lacking.
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Affiliation(s)
- Clazien Bouwmans
- Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Caroline de Sonneville
- Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Cornelis L Mulder
- Epidemiological and Social Psychiatric Research Institute, Erasmus Medical Center, Rotterdam, the Netherlands ; Parnassia Psychiatric Institute, Rotterdam, the Netherlands
| | - Leona Hakkaart-van Roijen
- Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, the Netherlands
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208
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Basson CA, Stewart A, Mudzi W. The effect of neural mobilisation on cervico-brachial pain: design of a randomised controlled trial. BMC Musculoskelet Disord 2014; 15:419. [PMID: 25492697 PMCID: PMC4295331 DOI: 10.1186/1471-2474-15-419] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Accepted: 11/21/2014] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Neck pain is a common musculoskeletal complaint and is often associated with shoulder or arm pain. There is a paucity of information on effective treatment for neck and arm pain, such as radiculopathy or cervico-brachial pain. Guidelines recommend neck mobilisation/ manipulation, exercises and advice as the treatment for neck pain, and neck and arm pain. There are a few studies that have used neural mobilisation as the treatment for cervico-brachial pain. Although results seem promising the studies have small sample sizes that make it difficult to draw definite conclusions. METHODS A randomised controlled trial will be used to establish the effect of neural mobilisation on the pain, function and quality of life of patients with cervico-brachial pain. Patients will be recruited in four physiotherapy private practices and randomly assigned to usual care or usual care plus neural mobilisation. DISCUSSION In clinical practice neural mobilisations is commonly used for cervico-brachial pain. Although study outcomes seem promising, most studies have small participant numbers. Targeting the neural structures as part of the management plan for a subgroup of patients with nerve mechano-sensitivity seems feasible. Patients with neuropathic pain and psychosocial risk factors such as catastrophising, respond poorly to treatment. Although a recent study found these patients less likely to respond to neural mobilisation, the current study will be able to assess whether neural mobilisation has any added benefit compared to usual care. The study will contribute to the knowledge base of treatment of patients with cervico-brachial pain. The findings of the study will be published in an appropriate journal. TRIAL REGISTRATION TRIAL REGISTRATION NUMBER PACTR201303000500157.
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Affiliation(s)
- Cato A Basson
- />Private practice, 407 Stonewall Avenue, Faerie Glen 0043, PO Box 74745, Lynnwood Ridge, 0040 South Africa
| | - Aimee Stewart
- />Physiotherapy Department, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Park Town, 2193 Johannesburg South Africa
| | - Witness Mudzi
- />Physiotherapy Department, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Park Town, 2193 Johannesburg South Africa
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209
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Kontodimopoulos N. The potential for a generally applicable mapping model between QLQ-C30 and SF-6D in patients with different cancers: a comparison of regression-based methods. Qual Life Res 2014; 24:1535-44. [DOI: 10.1007/s11136-014-0857-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2014] [Indexed: 11/12/2022]
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210
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Cruciger O, Schildhauer TA, Meindl RC, Tegenthoff M, Schwenkreis P, Citak M, Aach M. Impact of locomotion training with a neurologic controlled hybrid assistive limb (HAL) exoskeleton on neuropathic pain and health related quality of life (HRQoL) in chronic SCI: a case study (.). Disabil Rehabil Assist Technol 2014; 11:529-34. [PMID: 25382234 DOI: 10.3109/17483107.2014.981875] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Chronic neuropathic pain (CNP) is a common condition associated with spinal cord injury (SCI) and has been reported to be severe, disabling and often treatment-resistant and therefore remains a clinical challenge for the attending physicians. The treatment usually includes pharmacological and/or nonpharmacological approaches. Body weight supported treadmill training (BWSTT) and locomotion training with driven gait orthosis (DGO) have evolved over the last decades and are now considered to be an established part in the rehabilitation of SCI patients. Conventional locomotion training goes along with improvements of the patients' walking abilities in particular speed and gait pattern. The neurologic controlled hybrid assistive limb (HAL®, Cyberdyne Inc., Ibraki, Japan) exoskeleton, however, is a new tailored approach to support motor functions synchronously to the patient's voluntary drive. This report presents two cases of severe chronic and therapy resistant neuropathic pain due to chronic SCI and demonstrates the beneficial effects of neurologic controlled exoskeletal intervention on pain severity and health-related quality of life (HRQoL). Both of these patients were engaged in a 12 weeks period of daily HAL®-supported locomotion training. In addition to improvements in motor functions and walking abilities, both show significant reduction in pain severity and improvements in all HRQoL domains. Although various causal factors likely contribute to abatement of CNP, the reported results occurred due to a new approach in the rehabilitation of chronic spinal cord injury patients. These findings suggest not only the feasibility of this new approach but in conclusion, demonstrate the effectiveness of neurologic controlled locomotion training in the long-term management of refractory neuropathic pain. Implications for Rehabilitation CNP remains a challenge in the rehabilitation of chronic SCI patients. Locomotion training with the HAL exoskeleton seems to improve CNP in chronic SCI. HAL locomotion training is feasible and safe in the rehabilitation of chronic SCI patients.
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Affiliation(s)
| | | | | | - Martin Tegenthoff
- c Department of Neurology , BG University Hospital Bergmannsheil , Bochum , Germany
| | - Peter Schwenkreis
- c Department of Neurology , BG University Hospital Bergmannsheil , Bochum , Germany
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211
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Gow J, George G, Govender K. A comparison of quality of life between HIV positive and negative diamond miners in South Africa. SAHARA J 2014; 10:89-95. [PMID: 24405284 PMCID: PMC3914423 DOI: 10.1080/17290376.2013.870066] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Objective To analyse the health-related quality of life (HR-QOL) in two groups of diamond miners (HIV negative and positive) in South Africa using three instruments. Two hypotheses were to be tested. One, was that the HR-QOL of HIV positive miners would be lower than that of HIV negative miners; and two, the selected instruments would behave consistently and thus all would confirm hypothesis one. Methods In our study, workers were recruited during a voluntary counselling and testing programme for HIV. HR-QOL were estimated using the Assessment of Quality of Life (AQOL) Mark 2, EQ-5D (EuroQOL), and Health Utilities Index 3 (HUI3) instruments. The data were analysed for utility values and for correlations between variables of interest (in particular HIV status). Goodness of fit, Pearson's r coefficient and t-tests were the statistical tests applied to the data. Results Just over 1100 respondents were included in the analysis. HIV positive workers scored significantly lower on quality of life on the HUI3 as compared to HIV negative workers but this relationship did not (surprisingly) hold for the AQOL or EQ-5D. There was a significant positive correlation between all three instruments. Conclusion There was inconsistency among the instruments in measuring quality of life differences according to HIV status. The HUI3 confirmed the a priori expectation that the HR-QOL of HIV positive miners would be lower than HIV negative miners. There was no statistical difference for the AQOL and a confounding result was found for the EQ5D.
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Affiliation(s)
- Jeff Gow
- a PhD, Associate Professor, is affiliated to the School of Accounting, Economics and Finance , University of Southern Queensland , Toowoomba , Australia
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212
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Bamvita JM, Roy E, Zang G, Jutras-Aswad D, Artenie AA, Levesque A, Bruneau J. Portraying persons who inject drugs recently infected with hepatitis C accessing antiviral treatment: a cluster analysis. HEPATITIS RESEARCH AND TREATMENT 2014; 2014:631481. [PMID: 25349730 PMCID: PMC4199115 DOI: 10.1155/2014/631481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 09/18/2014] [Accepted: 09/18/2014] [Indexed: 01/27/2023]
Abstract
Objectives. To empirically determine a categorization of people who inject drug (PWIDs) recently infected with hepatitis C virus (HCV), in order to identify profiles most likely associated with early HCV treatment uptake. Methods. The study population was composed of HIV-negative PWIDs with a documented recent HCV infection. Eligibility criteria included being 18 years old or over, and having injected drugs in the previous 6 months preceding the estimated date of HCV exposure. Participant classification was carried out using a TwoStep cluster analysis. Results. From September 2007 to December 2011, 76 participants were included in the study. 60 participants were eligible for HCV treatment. Twenty-one participants initiated HCV treatment. The cluster analysis yielded 4 classes: class 1: Lukewarm health seekers dismissing HCV treatment offer; class 2: multisubstance users willing to shake off the hell; class 3: PWIDs unlinked to health service use; class 4: health seeker PWIDs willing to reverse the fate. Conclusion. Profiles generated by our analysis suggest that prior health care utilization, a key element for treatment uptake, differs between older and younger PWIDs. Such profiles could inform the development of targeted strategies to improve health outcomes and reduce HCV infection among PWIDs.
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Affiliation(s)
- Jean-Marie Bamvita
- CRCHUM (Centre de Recherche du Centre Hospitalier de l'Université de Montréal), Tour Saint-Antoine 850, Rue St-Denis, Montréal, QC, Canada H2X 0A9
- Département de Médecine Familiale, Faculté de Médecine, Université de Montréal, Pavillon Roger-Gaudry, Bureau S-711, 2900 boul. Édouard-Montpetit, Montréal, QC, Canada H3T 1J4
| | - Elise Roy
- Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Campus Longueuil 1111, Rue St-Charles Ouest, Bureau 500, Longueuil, QC, Canada J4K 5G4
| | - Geng Zang
- CRCHUM (Centre de Recherche du Centre Hospitalier de l'Université de Montréal), Tour Saint-Antoine 850, Rue St-Denis, Montréal, QC, Canada H2X 0A9
| | - Didier Jutras-Aswad
- CRCHUM (Centre de Recherche du Centre Hospitalier de l'Université de Montréal), Tour Saint-Antoine 850, Rue St-Denis, Montréal, QC, Canada H2X 0A9
- Département de Médecine Familiale, Faculté de Médecine, Université de Montréal, Pavillon Roger-Gaudry, Bureau S-711, 2900 boul. Édouard-Montpetit, Montréal, QC, Canada H3T 1J4
| | - Andreea Adelina Artenie
- CRCHUM (Centre de Recherche du Centre Hospitalier de l'Université de Montréal), Tour Saint-Antoine 850, Rue St-Denis, Montréal, QC, Canada H2X 0A9
- Family Medicine Department, McGill University, 5858 Chemin de la Côte des Neiges, 3e Étage, Montréal, QC, Canada H3S 1Z1
| | - Annie Levesque
- CRCHUM (Centre de Recherche du Centre Hospitalier de l'Université de Montréal), Tour Saint-Antoine 850, Rue St-Denis, Montréal, QC, Canada H2X 0A9
- Family Medicine Department, McGill University, 5858 Chemin de la Côte des Neiges, 3e Étage, Montréal, QC, Canada H3S 1Z1
| | - Julie Bruneau
- CRCHUM (Centre de Recherche du Centre Hospitalier de l'Université de Montréal), Tour Saint-Antoine 850, Rue St-Denis, Montréal, QC, Canada H2X 0A9
- Département de Médecine Familiale, Faculté de Médecine, Université de Montréal, Pavillon Roger-Gaudry, Bureau S-711, 2900 boul. Édouard-Montpetit, Montréal, QC, Canada H3T 1J4
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Gallagher J, McCarthy S, Byrne S. Economic evaluations of clinical pharmacist interventions on hospital inpatients: a systematic review of recent literature. Int J Clin Pharm 2014; 36:1101-14. [DOI: 10.1007/s11096-014-0008-9] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 08/21/2014] [Indexed: 11/25/2022]
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Brand C, Barry L, Gallagher S. Social support mediates the association between benefit finding and quality of life in caregivers. J Health Psychol 2014; 21:1126-36. [PMID: 25205775 DOI: 10.1177/1359105314547244] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The psychosocial pathways underlying associations between benefit finding and quality of life are poorly understood. Here, we examined associations between benefit finding, social support, optimism and quality of life in a sample of 84 caregivers. Results revealed that quality of life was predicted by benefit finding, optimism and social support. Moreover, the association between benefit finding and quality of life was explained by social support, but not optimism; caregivers who reported greater benefit finding perceived their social support be higher and this, in turn, had a positive effect on their overall quality of life. These results underscore the importance of harnessing benefit finding to enhance caregiver quality of life.
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215
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Nam HU, Huh JS, Yoo JN, Hwang JM, Lee BJ, Min YS, Kim CH, Jung TD. Effect of dominant hand paralysis on quality of life in patients with subacute stroke. Ann Rehabil Med 2014; 38:450-7. [PMID: 25229023 PMCID: PMC4163584 DOI: 10.5535/arm.2014.38.4.450] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 05/12/2014] [Indexed: 01/22/2023] Open
Abstract
Objective To evaluate the degree to which the paralysis of a dominant hand affects quality of life (QOL) in patients with subacute stroke. Methods We recruited 75 patients with subacute hemiplegic stroke. Patients were divided into two groups according to the location of the lesion and the side of the dominant hand. Group 1 consisted of patients whose strokes affected the dominant hand (i.e., right hemiplegia and right dominant hand or left hemiplegia and left dominant hand). Group 2 consisted of patients whose strokes affected the non-dominant hand (i.e., left hemiplegia and right dominant hand or right hemiplegia and left dominant hand). The primary outcome measure was the Short-Form 36-Item Health Survey (SF-36), which was used to evaluate health-related QOL. Secondary outcomes were scores on the Modified Barthel Index (MBI) and Beck Depression Inventory (BDI). Results We did not find any statistically significant differences between the groups in any SF-36 domain including the summaries of physical and mental component. Similarly, the MBI and BDI scores were not significantly different between the groups. Conclusion The effect of paralysis on the dominant hand and QOL in patients with subacute stroke was not significantly different from the effect of paralysis on the non-dominant hand.
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Affiliation(s)
- Hyeon Uk Nam
- Department of Rehabilitation Medicine, Kyungpook National University College of Medicine, Daegu, Korea
| | - Jin Seok Huh
- Department of Rehabilitation Medicine, Kyungpook National University College of Medicine, Daegu, Korea
| | - Ji Na Yoo
- Department of Rehabilitation Medicine, Kyungpook National University College of Medicine, Daegu, Korea
| | - Jong Moon Hwang
- Department of Rehabilitation Medicine, Kyungpook National University College of Medicine, Daegu, Korea
| | - Byung Joo Lee
- Department of Rehabilitation Medicine, Kyungpook National University College of Medicine, Daegu, Korea
| | - Yu-Sun Min
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Chul-Hyun Kim
- Department of Rehabilitation Medicine, Kyungpook National University College of Medicine, Daegu, Korea
| | - Tae-Du Jung
- Department of Rehabilitation Medicine, Kyungpook National University College of Medicine, Daegu, Korea. ; Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu, Korea
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Berg J, Lindgren P, Kahan T, Schill O, Persson H, Edner M, Mejhert M. Health-related quality of life and long-term morbidity and mortality in patients hospitalised with systolic heart failure. JRSM Cardiovasc Dis 2014; 3:2048004014548735. [PMID: 25396054 PMCID: PMC4228927 DOI: 10.1177/2048004014548735] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Health-related quality of life has been shown to impact prognosis in chronic heart failure, however with limited long-term follow-up. We analysed data spanning 8–12 years to assess the impact of health-related quality of life using the Nottingham Health Profile on first hospitalisation and mortality, for cardiovascular and all causes. Methods We included 208 patients aged ≥60 years with New York Heart Association class II–IV and left ventricular systolic dysfunction hospitalised in Stockholm during 1996–99. Data on hospital admissions, discharge diagnoses and date and cause of death were collected from administrative databases and medical records until 2007. Cox proportional hazard models were employed to analyse the time to event for mortality and hospitalisations. Results Mean age was 76 years, 58% were male and mean ejection fraction was 34%. Median survival was 4.6 years (range 6 days–11.9 years); 148 patients died. All-cause and cardiovascular mortality were determined by physical mobility (by Nottingham Health Profile), age, gender, diuretic dose and haemoglobin level. Glomerular filtration rate was significant for all-cause mortality, while atrioventricular plane displacement was predictive of cardiovascular mortality. Median time to first all-cause and cardiovascular hospitalisation was 5.7 and 11.2 months, respectively. Time to first all-cause hospitalisation was determined by physical mobility, emotional reactions, age, gender and haemoglobin level, while only physical mobility and diuretic dose predicted time to first cardiovascular hospitalisation. Conclusions In conclusion, in patients with systolic chronic heart failure, physical mobility as part of health-related quality of life is an independent prognostic marker for cardiovascular and all-cause readmissions and mortality over 12 years.
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Affiliation(s)
- Jenny Berg
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden ; OptumInsight, Stockholm, Sweden
| | - Peter Lindgren
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden ; IVBAR, Stockholm, Sweden
| | - Thomas Kahan
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Owe Schill
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Hans Persson
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Magnus Edner
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Märit Mejhert
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden ; Department of Medicine, Ersta Hospital, Stockholm, Sweden
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Abstract
OBJECTIVES Irritable bowel syndrome (IBS) is a chronic, disabling condition that greatly compromises patient functioning. The aim of this study was to assess the impact of a 6-week twice per week Iyengar yoga (IY) program on IBS symptoms in adolescents and young adults (YA) with IBS compared with a usual-care waitlist control group. METHODS Assessments of symptoms, global improvement, pain, health-related quality of life, psychological distress, functional disability, fatigue, and sleep were collected pre- and posttreatment. Weekly ratings of pain, IBS symptoms, and global improvement were also recorded until 2-month follow-up. A total of 51 participants completed the intervention (yoga = 29; usual-care waitlist = 22). RESULTS Baseline attrition was 24%. On average, the yoga group attended 75% of classes. Analyses were divided by age group. Relative to controls, adolescents (14-17 years) assigned to yoga reported significantly improved physical functioning, whereas YA (18-26 years) assigned to yoga reported significantly improved IBS symptoms, global improvement, disability, psychological distress, sleep quality, and fatigue. Although abdominal pain intensity was statistically unchanged, 44% of adolescents and 46% of YA reported a minimally clinically significant reduction in pain following yoga, and one-third of YA reported clinically significant levels of global symptom improvement. Analysis of the uncontrolled effects and maintenance of treatment effects for adolescents revealed global improvement immediately post-yoga that was not maintained at follow-up. For YA, global improvement, worst pain, constipation, and nausea were significantly improved postyoga, but only global improvement, worst pain, and nausea maintained at the 2-month follow-up. CONCLUSIONS The findings suggest that a brief IY intervention is a feasible and safe adjunctive treatment for young people with IBS, leading to benefits in a number of IBS-specific and general functioning domains for YA. The age-specific results suggest that yoga interventions may be most fruitful when developmentally tailored.
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Stavrou D, Weissman O, Tessone A, Zilinsky I, Holloway S, Boyd J, Haik J. Health Related Quality of Life in burn patients – A review of the literature. Burns 2014; 40:788-96. [DOI: 10.1016/j.burns.2013.11.014] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 11/12/2013] [Accepted: 11/22/2013] [Indexed: 12/01/2022]
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Chen CH, Yen M, Fetzer S, Lo LH, Lam P. The effects of tai chi exercise on elders with osteoarthritis: a longitudinal study. Asian Nurs Res (Korean Soc Nurs Sci) 2014; 2:235-41. [PMID: 25029961 DOI: 10.1016/s1976-1317(09)60005-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2008] [Revised: 09/12/2008] [Accepted: 11/24/2008] [Indexed: 02/02/2023] Open
Abstract
PURPOSE Tai Chi exercise has been proven to be beneficial among elders with osteoarthritis (OA). The long-term effects of this exercise remain unclear. The purpose of this study was to evaluate the effects of the Tai Chi exercise for Arthritis (TCEA) program on the physical status and quality of life of OA elders. METHODS This was a time series study with one group design. Subjects diagnosed with OA of the lower extremities, aged 60 years or over, were recruited from an outpatient clinic at a community teaching hospital. Thirteen participants joined a TCEA exercise class three times per week for 2 years. Physical status including body mass index (BMI), lean body mass, hand grasp strength, flexibility, and equilibrium were measured four times-at baseline, 3 months, 1 year, and 2 years of the TCEA exercise class. Quality of life was also measured at these time points. RESULTS Lean body mass was significantly decreased within the study period (p < .05). Participants experienced significant improvements in physical functioning, role limitations, and social functioning on the dimensions of quality of life (SF-36) (p < .05). CONCLUSION Elderly people with OA should be encouraged to exercise using Tai Chi for maintaining physical function and improving quality of life.
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Affiliation(s)
- Ching-Huey Chen
- Associate Professor, Department of Nursing & Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Miaofen Yen
- Associate Professor, Department of Nursing & Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Susan Fetzer
- Associate Professor, Department of Nursing, College of Health and Human Services, University of New Hampshire, New Hampshire, USA
| | - Li-Hua Lo
- Associate Professor, Department of Nursing, Oriental Institute of Technology, Taipei, Taiwan
| | - Paul Lam
- Lecturer of University of New South Wales and Family Physician, Sydney, Australia
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Garip Y. Functional assessment measures in rheumatologic disorders. World J Rheumatol 2014; 4:6-13. [DOI: 10.5499/wjr.v4.i2.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 06/12/2014] [Accepted: 07/17/2014] [Indexed: 02/06/2023] Open
Abstract
Rheumatologic disorders cause functional impairment and significantly affect health-related quality of life. Functional assessment and health-related quality of life scales are increasingly being used as outcome measures to assess the influence of the diseases and health outcome in clinical studies of patients with rheumatologic diseases. In this article, we review the functional assessment and health-related quality of life measures which have been commonly used as outcome measures in rheumatologic disorders. These measures are Short form-36 (SF-36), SF-12, Nottingham Health Profile, Sickness Impact Profile, EuroQol, SF-6D, Health Utilities Index mark 2 and 3, Stanford Health Assessment Questionnaire, Rheumatoid Arthritis Quality of Life Questionnaire, Arthritis Impact Measurement Scales, McMaster Toronto Arthritis Patient Preference Disability Questionnaire, Western Ontario and McMaster Universities Osteoarthritis Index, Lequesne Index, Knee Disability and Osteoarthritis Outcome Score, Knee Disability and Osteoarthritis Outcome Score-Physical Function Short-form, Hip Disability and Osteoarthritis Outcome Score, Hip Disability and Osteoarthritis Outcome Score-Physical Function SF, Fibromyalgia Impact Questionnaire, Psoriatic Arthritis Quality of Life Scale, Gout Assessment Questionnaires, Dougados Functional Index, Bath Ankylosing Spondylitis Functional Index, and Ankylosing Spondylitis Quality of Life Scale.
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221
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McPhail SM, Schippers M, Marshall AL. Age, physical inactivity, obesity, health conditions, and health-related quality of life among patients receiving conservative management for musculoskeletal disorders. Clin Interv Aging 2014; 9:1069-80. [PMID: 25031532 PMCID: PMC4099103 DOI: 10.2147/cia.s61732] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background Musculoskeletal conditions and insufficient physical activity have substantial personal and economic costs among contemporary aging societies. This study examined the age distribution, comorbid health conditions, body mass index (BMI), self-reported physical activity levels, and health-related quality of life of patients accessing ambulatory hospital clinics for musculoskeletal disorders. The study also investigated whether comorbidity, BMI, and self-reported physical activity were associated with patients’ health-related quality of life after adjusting for age as a potential confounder. Methods A cross-sectional survey was undertaken in three ambulatory hospital clinics for musculoskeletal disorders. Participants (n=224) reported their reason for referral, age, comorbid health conditions, BMI, physical activity levels (Active Australia Survey), and health-related quality of life (EQ-5D). Descriptive statistics and linear modeling were used to examine the associations between age, comorbidity, BMI, intensity and duration of physical activity, and health-related quality of life. Results The majority of patients (n=115, 51.3%) reported two or more comorbidities. In addition to other musculoskeletal conditions, common comorbidities included depression (n=41, 18.3%), hypertension (n=40, 17.9%), and diabetes (n=39, 17.4%). Approximately one-half of participants (n=110, 49.1%) self-reported insufficient physical activity to meet minimum recommended guidelines and 150 (67.0%) were overweight (n=56, 23.2%), obese (n=64, 28.6%), severely obese (n=16, 7.1%), or very severely obese (n=14, 6.3%), with a higher proportion of older patients affected. A generalized linear model indicated that, after adjusting for age, self-reported physical activity was positively associated (z=4.22, P<0.001), and comorbidities were negatively associated (z=−2.67, P<0.01) with patients’ health-related quality of life. Conclusion Older patients were more frequently affected by undesirable clinical attributes of comorbidity, obesity, and physical inactivity. However, findings from this investigation are compelling for the care of patients of all ages. Potential integration of physical activity behavior change or other effective lifestyle interventions into models of care for patients with musculoskeletal disorders is worthy of further investigation.
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Affiliation(s)
- Steven M McPhail
- Centre for Functioning and Health Research, Metro South Health, Brisbane, QLD, Australia ; Institute of Health and Biomedical Innovation, and School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Mandy Schippers
- Centre for Functioning and Health Research, Metro South Health, Brisbane, QLD, Australia ; Institute of Health and Biomedical Innovation, and School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Alison L Marshall
- Institute of Health and Biomedical Innovation, and School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
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Poole CD, Bannister CA, Andreasen JN, Andersen JS, Currie CJ. Estimation of health-related utility (EQ-5D index) in subjects with seasonal allergic rhinoconjunctivitis to evaluate health gain associated with sublingual grass allergen immunotherapy. Health Qual Life Outcomes 2014; 12:99. [PMID: 24927639 PMCID: PMC4094440 DOI: 10.1186/1477-7525-12-99] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 04/09/2014] [Indexed: 11/10/2022] Open
Abstract
Background Grass allergen immunotherapy (AIT) reduces symptom severity in seasonal allergic rhinoconjunctivitis (ARC) but its impact on general health-related utility has not been characterised for the purposes of economic evaluation. The aim of this study was to model the preferred measure of utility, EQ-5D index, from symptom severity and estimate incremental quality adjusted life years (QALYs) associated with SQ-standardised grass immunotherapy tablet (GRAZAX®, 75,000 SQ-T/2,800 BAU, ALK, Denmark). Methods Data were analysed from five consecutive pollen seasons in a randomised placebo controlled trial of GRAZAX®. Binomial and Gaussian mixed effects modelling related weekly EQ-5D index score to daily symptom and medication scores (DSS & DMS respectively). In turn, daily EQ-5D index was estimated from ARC symptoms and medication use. Results DSS and DMS were the principal predictors of ‘perfect’ health (EQ-5D = 1.000; binomial) and ‘imperfect’ health (EQ-5D < 1.000; Gaussian). Each unit increase in DSS and DMS reduced the odds of ‘perfect’ health (EQ-5D = 1.000) by 27% and 16% respectively, and reduced ‘imperfect’ health by 0.17 and 0.13, respectively. Gender remained the only other significant main fixed effect (Male odds ratio [OR] = 1.82). Incremental estimated EQ-5D index utility for GRAZAX® was observed from day -30 to day +70 of the pooled pollen season; mean daily utility for GRAZAX® = 0.938 units (95%CI 0.932-0.943) vs. 0.914 (0.907-0.921) for placebo, an incremental difference of 0.0238 (p < 0.001). This translates into an incremental 0.0324 Quality Adjusted Life Years over the five year study period. Conclusions ARC symptoms and medication use are the main predictors of EQ-5D index. The incremental QALYs observed for GRAZAX® may not fully describe the health benefits of this treatment, suggesting that economic modelling may be conservative.
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Affiliation(s)
| | | | | | | | - Craig J Currie
- Cochrane Institute of Primary Care and Public Health, Cardiff University, Cardiff, Wales, UK.
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Gomes JRDAA, Hamann EM, Gutierrez MMU. Application of the WHOQOL-BREF in a community segment as a subsidy for health promotion actions. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2014; 17:495-516. [PMID: 24918419 DOI: 10.1590/1809-4503201400020016eng] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Accepted: 03/07/2013] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION This article presents the results of a research whose objective was to verify the prevalence of the perception reports regarding quality of life of library attendees in the public libraries in the Brazilian capital Federal District (FD) and the surrounding region and to analyse the factors related to dissatisfaction. METHODS An epidemiological transversal study was conducted in 592 individuals aged above 12 years old through the application of the WHOQOL-BREF/WHO questionnaire. RESULTS Higher frequencies of dissatisfaction were observed among women with ages above 25, with lower personal income and lower educational level. Dissatisfaction regarding the physical domain was more prevalent in the surrounding region than in the FD. Under the psychological domain, dissatisfaction predominated in people in the FD. Negative feelings, concentration difficulties and dissatisfaction regarding personal safety were referred by more than 25% of participants in both regions. Regarding the environment domain, lack of money and of leisure opportunities were the main complaints. In spite of these findings, interviewees referred being very satisfied with their health and quality of life. CONCLUSIONS The results can be a sign that the quality of life in the study region is in alert level. A careful look at these data is needed to identify alternatives to change this situation, with effective actions for Health Promotion and development strategies for the study area. A planning and an intervention in the area of health education in public libraries is recommended, since these are very important social loci, that can be engaged in health promotion and disease prevention actions in the communities.
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Jensen KK, Henriksen NA, Harling H. Standardized measurement of quality of life after incisional hernia repair: a systematic review. Am J Surg 2014; 208:485-93. [PMID: 25017051 DOI: 10.1016/j.amjsurg.2014.04.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 04/02/2014] [Accepted: 04/02/2014] [Indexed: 12/17/2022]
Abstract
BACKGROUND Recent improvements in incisional hernia repair have led to lower rates of recurrence. As a consequence, increasing attention has been paid to patient-reported outcomes after surgery. However, there is no consensus on how to measure patients' quality of life after incisional hernia repair. The aim of this systematic review was to analyze existing standardized methods to measure quality of life after incisional hernia repair. DATA SOURCES A PubMed and Embase search was carried out together with a cross-reference search of eligible papers, giving a total of 26 included studies. CONCLUSIONS Different standardized methods for measurement of quality of life after incisional hernia repair are available, but no consensus on the optimal method, timing, or length of follow-up exist. International guidelines could help standardization, enabling better comparison between studies.
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Affiliation(s)
- Kristian K Jensen
- Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark.
| | - Nadia A Henriksen
- Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark
| | - Henrik Harling
- Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark
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Zhao ZM, Pan XF, Lv SH, Xie Y, Zhang SK, Qiao YL, Qi XR, Yang CX, Zhao FH. Quality of life in women with cervical precursor lesions and cancer: a prospective, 6-month, hospital-based study in China. CHINESE JOURNAL OF CANCER 2014; 33:339-45. [PMID: 24698497 PMCID: PMC4110466 DOI: 10.5732/cjc.013.10139] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The overall survival of patients with cervical cancer has improved due to detection at an early stage and availability of comprehensive treatments in China. As patients' lives prolonged, it is important to understand their health-related quality of life (QoL) during and after treatment. We used the EQ-5D questionnaire to assess QoL of 194 patients with cervical lesions at Sichuan University West China Second Hospital between May 2010 and January 2011. Patients were surveyed before primary treatment and at 1, 3, and 6 months after primary treatment. Results showed a consistent decline in EQ-5D scores in the spectrum of cervical lesions at each time point after treatment (all P < 0.05). For patients with precursor lesions, there was an increasing trend along the timeline of treatment (P < 0.01). For patients with early-stage cervical cancer, EQ-5D scores declined in the first month (P = 0.01) and gradually increased to higher levels at 6 months post-treatment than those before treatment (P < 0.01). EQ-5D scores followed a similar trend in patients with advanced cervical cancer (P = 0.04), though they did not statistically rebound after 6 months (0.84 ± 0.19 vs. 0.86 ± 0.11, P = 0.62). Regarding advanced cervical cancer, EQ-5D scores for women above 40 years of age appeared to recover more rapidly and reached higher levels than those for women below 40 years (P = 0.03). Caution and extra care are recommended in the early period of cervical cancer treatment given the slight deterioration in the QoL, and in particular, for younger cervical cancer patients. Our study implies that health care providers may need to improve the health-related QoL of cervical cancer patients.
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Affiliation(s)
- Zhi-Mei Zhao
- Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan 610041, P. R. China.
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Zubaran C, Zolfaghari E, Foresti K, Emerson J, Sud R, Surjadi J. A validation study of the English version of the AlQol 9 to measure quality of life. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2014; 40:131-6. [PMID: 24588420 DOI: 10.3109/00952990.2013.877919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Quality of life (QoL) is an important clinical and research outcome within the drug and alcohol abuse context. The AlQoL 9 is a specific questionnaire designed to assess health- and non-health-related consequences of alcoholism. The English version of the AlQoL 9 has not been validated using a larger sample. OBJECTIVES The aim of this study was to assess the psychometric properties of the English version of AlQoL 9 in a sample of treatment-seeking individuals in Australia. METHODS A sample of 138 participants from inpatient and outpatient treatments facilities completed the AlQoL 9 test and the World Health Organisation Quality of Life Assessment-BREF (WHOQOL-BREF). The study's investigative parameters included the demographic characteristics of the sample, internal structure, and convergent validity. Furthermore, correlations between the AlQoL 9 scale scores and the scores obtained from the WHOQOL-BREF test were investigated using Pearson product-moment correlation analyses. RESULTS The English version of the AlQoL 9 attained a significant Cronbach's alpha of 0.825. The mean score obtained in the test was 21.92 (SD = 6.79). Using Varimax rotation, the AlQoL 9 yielded one principal factor that had accounted for 37.85% of variance. Convergent validity analysis demonstrated significant correlations (p < 0.001) between the AlQoL 9 scores and the scores of all four dimensions of the WHOQOL-BREF questionnaire. CONCLUSION The present study demonstrated that the English version of the AlQoL 9 constitutes a valid and reliable research instrument for evaluating quality of life among alcohol-dependent individuals.
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Hoang-Kim A, Schemitsch E, Kulkarni AV, Beaton D. Methodological challenges in the use of hip-specific composite outcomes: linking measurements from hip fracture trials to the International Classification of Functioning, Disability and Health Framework. Arch Orthop Trauma Surg 2014; 134:219-28. [PMID: 23934168 DOI: 10.1007/s00402-013-1824-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The prevalence of hip-specific outcome measures in randomized trials reflects what directs our outcome assessment following a hip fracture. The present study provides an overview on the most commonly-used hip-specific outcome instruments used for postoperative assessment of hip fracture with respect to their covered contents. This can facilitate the selection of appropriate items for specific purposes in clinical as well as research settings. METHODS We used the International Classification of Functioning, Disability and Health (ICF) model to distinguish concepts within the instrument. All items from the questionnaires were categorized into one of three categories using the ICF linking rules for a standardized approach. The hip-specific composites measures were also compared to other types of prevalent measures: generic and patient-based instruments. RESULTS All of the items in the instruments could be mapped to the ICF. We report the highest frequency of ICF activity and participation (71%) within the Harris hip score (HHS) which is similar to the frequency of ICF content found in the generic measures (82%). Hip-specific composites focused mostly on walking and moving long and short distances, while in patient-reported measures there was a concentration on the concept of sensation of pain and pain in body parts. DISCUSSION AND CONCLUSION The prevalent use of the HHS, over the other hip-specific instruments, could be attributed to its likeness in concept to other generic measures. The dominance of the ICF category of activity and participation reflects what is important to clinicians treating a hip fracture. Composite scores remain problematic as they cut across different ICF concepts. As long as the popularity of composite scoring systems continues, an overall score may not represent the true patient preferences and concerns in clinical trials. Future studies could apply the results from this study for the creation of an ICF category-based item banking or investigators could operationalize the ICF categories within these candidate measures for specific interventions.
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Affiliation(s)
- Amy Hoang-Kim
- St. Michael`s Hospital, 30 Bond Street (193-6T Yonge Street), Toronto, ON, M5B 1W8, Canada,
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228
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Kim C, Bernstein SJ. Quality of life assessment for chronic stable angina. Expert Rev Pharmacoecon Outcomes Res 2014; 3:637-50. [DOI: 10.1586/14737167.3.5.637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Evans C, Mertzanis P, Abetz L. Measurement strategies for indirect costs in economic evaluations. Expert Rev Pharmacoecon Outcomes Res 2014; 3:703-16. [DOI: 10.1586/14737167.3.6.703] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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McPhail SM, Waite MC. Physical activity and health-related quality of life among physiotherapists: a cross sectional survey in an Australian hospital and health service. J Occup Med Toxicol 2014; 9:1. [PMID: 24405934 PMCID: PMC3896696 DOI: 10.1186/1745-6673-9-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 01/07/2014] [Indexed: 12/25/2022] Open
Abstract
Background Physiotherapists are a professional group with a high rate of attrition and at high risk of musculoskeletal disorders. The purpose of this investigation was to examine the physical activity levels and health-related quality of life of physiotherapists working in metropolitan clinical settings in an Australian hospital and health service. It was hypothesized that practicing physiotherapists would report excellent health-related quality of life and would already be physically active. Such a finding would add weight to a claim that general physical activity conditioning strategies may not be useful for preventing musculoskeletal disorders among active healthy physiotherapists, but rather, future investigations should focus on the development and evaluation of role specific conditioning strategies. Methods A questionnaire was completed by 44 physiotherapists from three inpatient units and three ambulatory clinics (63.7% response rate). Physical activity levels were reported using the Active Australia Survey. Health-related quality of life was examined using the EQ-5D instrument. Physical activity and EQ-5D data were examined using conventional descriptive statistics; with domain responses for the EQ-5D presented in a frequency histogram. Results The majority of physiotherapists in this sample were younger than 30 years of age (n = 25, 56.8%) consistent with the presence of a high attrition rate. Almost all respondents exceeded minimum recommended physical activity guidelines (n = 40, 90.9%). Overall the respondents engaged in more vigorous physical activity (median = 180 minutes) and walking (median = 135 minutes) than moderate exercise (median = 35 minutes) each week. Thirty-seven (84.1%) participants reported no pain or discomfort impacting their health-related quality of life, with most (n = 35,79.5%) being in full health. Conclusions Physical-conditioning based interventions for the prevention of musculoskeletal disorders among practicing physiotherapists may be better targeted to role or task specific conditioning rather than general physical conditioning among this physically active population. It is plausible that an inherent attrition of physiotherapists may occur among those not as active or healthy as therapists who cope with the physical demands of clinical practice. Extrapolation of findings from this study may be limited due to the sample characteristics. However, this investigation addressed the study objectives and has provided a foundation for larger scale longitudinal investigations in this field.
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Affiliation(s)
- Steven M McPhail
- Queensland University of Technology, School of Public Health and Social Work and Institute of Health and Biomedical Innovation, Victoria Park Road, Kelvin Grove 4059, Queensland, Australia.
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The reporting of functional outcome instruments in the Journal of Orthopaedic Trauma over a 5-year period. J Orthop Trauma 2014; 28:2-5. [PMID: 24164786 DOI: 10.1097/bot.0000000000000026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Orthopaedic journals, such as the Journal of Orthopaedic Trauma, frequently publish studies reporting functional outcome instruments, but little information has been provided regarding the validity and overall strength of these instruments. This study analyzes the trends in reported functional outcome instruments in articles published in the Journal of Orthopaedic Trauma over a 5-year period and examines the utilization rate, "overall" strength, and validity of these functional outcome instruments for the populations being studied. METHODS Articles that were published in the Journal of Orthopaedic Trauma from January 2006 to December 2010 were reviewed, and each article was assigned to 1 of 4 different categories, based on the subspecialty focus and body region. The total number of articles reporting the use of functional outcome instruments, articles with at least 1 functional outcome instrument found in the AO Handbook, and the total number of functional outcome instruments reported were recorded. Each functional outcome instrument was assigned to 1 of 3 categories (generic, nonvalidated, validated), and each validated instrument was also examined to determine whether the category of interest for which it was used was one in which it was previously validated in. RESULTS A total of 171 articles (34%) of the articles initially reviewed met the inclusion criteria. The average number of articles per year that reported functional outcome instruments was 56% (range, 47%-65%), and the average number of articles that reported at least 1 validated outcome instrument was 51% (range, 44%-61%). The average percentage of validated scores that were appropriately used within the category of interest was 23% (range, 13%-41%). CONCLUSIONS Even though the 56% utilization rate of functional outcome instruments in The Journal of Orthopaedic Trauma is much higher than other journals, it is still low given the importance of measuring and attaining excellent functional outcomes. It is clear that future effort should be given to validating outcome measures for correct evaluation of orthopaedic trauma patients.
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Bohman K, Stigson H, Krafft M. Long-term medical consequences for child occupants 0 to 12 years injured in car crashes. TRAFFIC INJURY PREVENTION 2014; 15:370-378. [PMID: 24471361 DOI: 10.1080/15389588.2013.826799] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE There is limited knowledge of the long-term medical consequences for children injured in car crashes. Thus, in the event of injury, the aim of the study was to specify patterns and risks of injuries resulting in permanent medical impairment of children (0-12 years) for different body regions and injury severity levels, according to Abbreviated Injury Scale (AIS). The aim was also to compare the impairment outcome with adults. METHODS Data were obtained from the Folksam insurance company, including reported car crashes from 1998 to 2010 with at least one injured child 0-12 years of age. In all, 2619 injured children with 3704 reported medical diagnoses were identified. All injuries were classified according to the AIS 2005 revision. If the child had not recovered within 1 year postinjury an assessment of permanent medical impairment (PMI) was made by one or several medical specialists. RESULTS In all, 55 children sustained 59 injuries resulting in PMI of which 75 percent were at AIS 1 or AIS 2. The head and cervical spine were the body regions sustaining the most injuries resulting in PMI. Sixty-eight percent of all injuries resulting in PMI were AIS 1 injuries to the cervical spine, with the majority occurring in frontal or rear impacts. Given an injury to the cervical spine, the risk of injuries resulting in PMI was 3 percent, and older children (≥6 years) had a significantly higher risk (3% versus 1%) than younger children. The head was the second most commonly injured body region with injuries resulting in PMI (12/59), which were predominantly AIS 2+. In addition, mild traumatic brain injuries at AIS 1 were found to lead to PMI. Whereas for children the injuries leading to PMI were primarily limited to the head and cervical spine, adults sustained injuries that led to PMI from a more diverse distribution of body regions. CONCLUSION The pattern of injuries resulting in permanent medical impairment is different for children and adults; therefore, safety priorities for children need to be based on child data. The majority of those injuries leading to PMI were at lower AIS levels. Furthermore, AIS 1 cervical spine and AIS 1+ head injuries should be given priority concerning mitigation of long-term consequences for children.
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The impact of influenza-like illness in young children on their parents: a quality of life survey. Qual Life Res 2013; 23:1651-60. [PMID: 24370954 PMCID: PMC7088548 DOI: 10.1007/s11136-013-0606-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2013] [Indexed: 11/21/2022]
Abstract
Background Influenza-like illness can cause excess paediatric morbidity and burden on parents.
Objectives We determined the quality of life (QoL) impact of children’s influenza-like illness (ILI) on their parents. Methods We conducted a prospective cohort study in childcare centres and a general practice in Sydney, Australia. Using PAR-ENT-QoL, we measured QoL of parents of children aged 6 months–3 years before the 2010 influenza season, then again for parents of children with ILI (ILI group) using SF-12v2 Acute Form and PAR-ENT-QoL, and contemporaneously for parents of aged-matched children without ILI (non-ILI group). Results Of 381 children enrolled from 90 childcare centres, 105 developed ILI. PAR-ENT-QoL scores of the ILI group were significantly lower in the post-ILI follow-up interviews than at baseline (60.99 vs. 79.77, p < 0.001), and those of non-ILI group at follow-up interviews (60.99 vs. 84.05, p < 0.001). SF-12v2 scores of the ILI group were also significantly lower than those of non-ILI group: physical component summary (50.66 vs. 53.16, p = 0.011) and mental component summary (45.67 vs. 53.66, p < 0.001). Two factors were significantly associated with parental QoL: total time spent caring child during ILI and whether the child had severe ILI or not. Correlations between PAR-ENT-QoL and SF-12v2 scores were satisfactory. Conclusions Parents had significantly lower QoL while their child had ILI, compared with before ILI and with parents of children without ILI. The public health impact of ILI in children on the QoL in families is far from negligible. QoL measurement can complement economic evaluation of ILI disease burden and provide a more complete picture of impact.
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Physiotherapists have accurate expectations of their patients' future health-related quality of life after first assessment in a subacute rehabilitation setting. BIOMED RESEARCH INTERNATIONAL 2013; 2013:340371. [PMID: 24350262 PMCID: PMC3853800 DOI: 10.1155/2013/340371] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 09/19/2013] [Indexed: 12/02/2022]
Abstract
Background. Expectations held by health professionals and their patients are likely to affect treatment choices in subacute inpatient rehabilitation settings for older adults. There is a scarcity of empirical evidence evaluating whether health professionals expectations of the quality of their patients' future health states are accurate. Methods. A prospective longitudinal cohort investigation was implemented to examine agreement (kappa coefficients, exact agreement, limits-of-agreement, and intraclass-correlation coefficients) between physiotherapists' (n = 23) prediction of patients' discharge health-related quality of life (reported on the EQ-5D-3L) and the actual health-related quality of life self-reported by patients (n = 272) at their discharge assessment (using the EQ-5D-3L). The mini-mental state examination was used as an indicator of patients' cognitive ability. Results. Overall, 232 (85%) patients had all assessment data completed and were included in analysis. Kappa coefficients (exact agreement) ranged between 0.37–0.57 (58%–83%) across EQ-5D-3L domains in the lower cognition group and 0.53–0.68 (81%–85%) in the better cognition group. Conclusions. Physiotherapists in this subacute rehabilitation setting predicted their patients' discharge health-related quality of life with substantial accuracy. Physiotherapists are likely able to provide their patients with sound information regarding potential recovery and health-related quality of life on discharge. The prediction accuracy was higher among patients with better cognition than patients with poorer cognition.
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Cerne A, Svab I, Kersnik J, Selic P. Did past economic prosperity affect the health related quality of life predictors? A longitudinal study on a representative sample of Slovenian family medicine patients. BMC Public Health 2013; 13:1160. [PMID: 24325279 PMCID: PMC4029188 DOI: 10.1186/1471-2458-13-1160] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 11/26/2013] [Indexed: 01/20/2023] Open
Abstract
Background Health related quality of life (HRQOL) as an important measure of medical outcomes has been shown to be associated with demographic factors and the most common mental and chronic somatic diseases. This study’s aim was to identify factors predicting changes in HRQOL over a follow-up period in a representative sample of Slovenian family medicine patients. Methods In a longitudinal multi-centred study between 2003 and 2005, data were collected from 1118 consecutive attendees from 60 family medicine practices in Slovenia on quality of life, socio-demographic factors and the presence of mental disorders, with follow-up after 6 and 24 months. Retrospective information on chronic diseases was obtained from patients` health records. In three time-sequential multiple linear regression models, data on 601 patients (53.8%) was analysed to determine factors associated with each component score of quality of life. Results At baseline the patients were 48.58 (SE = 0.58) years of age, over half were women (386 (64.2%)) and most were Slovenian (548 (91.2%)). Quality of life was seen to improve over the two-year period. Factors significantly and consistently associated with a better mental component score of quality of life were social support, satisfactory circumstances in patients` household and absence of anxiety. Major life events in the past year and depression were shown to be risk factors for mental and physical components, while level of education, absence of long-term disability and chronic pain were identified as predictors of the physical component. Conclusions Detection and successful treatment of depression and anxiety has a potential to lead to improved quality of life in family medicine attendees; family physicians should be alert for the early onset of these conditions, knowing that symptoms of chronic pain, depression and anxiety often overlap in patients. Poorly educated patients and those lacking social support and/or satisfactory household circumstances should be recognised and empowered, and appropriate coping mechanisms should be introduced.
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Affiliation(s)
| | | | | | - Polona Selic
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Poljanski nasip 58, Ljubljana, Slovenia.
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Atlas Argentino de Calidad de Vida Relacionada con la Salud: Análisis de los datos de la Encuesta Nacional de Factores de Riesgo por Provincias. Value Health Reg Issues 2013; 2:398-404. [PMID: 29702777 DOI: 10.1016/j.vhri.2013.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To describe general population health related quality of life (HRQOL) in Argentina and perform an Atlas showing the country's results using data from the first "National Risk Factors Survey" and local social values. METHODS Secondary cross-sectional study analyzing EQ-5D-3L responses. The variables of interest were self-reported visual analog scale in a 0-1 scale (SR-VAS), as well as time-trade off (TTO) and VAS preference values (PV). PV were assigned using weights derived from a previous local study. RESULTS The survey included 41.392 subjects; the expanded population represented 96% of the adult population of Argentina. 8.82% of the population reported excellent health, 24.6% very good, 43.9% good and 22.3% regular or bad. 42.8% reported limitations in at least one of the EQ-5D domain. SR-VAS had a mean of 0.75 (IC95% 0.75-0.76), while general population mean social TTO and VAS based weights were 0.90 (0.898-0.905) and 0.87 (IC95% 0.867-0.874) respectively. The Atlas showed small differences among the provinces. CONCLUSIONS This is a population based study aimed to describe in depth the HRQOL based in EQ-5D using local PV. It summarizes country level and geographic levels within the country, and constitutes a valuable resource and a starting point for future studies.
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Pietersma S, de Vries M, van den Akker-van Marle ME. Domains of quality of life: results of a three-stage Delphi consensus procedure among patients, family of patients, clinicians, scientists and the general public. Qual Life Res 2013; 23:1543-56. [PMID: 24241818 PMCID: PMC4031380 DOI: 10.1007/s11136-013-0578-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2013] [Indexed: 11/25/2022]
Abstract
Purpose Our key objective is to identify the core domains of health-related quality of life (QoL). Health-related QoL utility scales are commonly used in economic evaluations to assess the effectiveness of health-care interventions. However, health-care interventions are likely to affect QoL in a broader sense than is quantifiable with traditional scales. Therefore, measures need to go beyond these scales. Unfortunately, there is no consensus in the scientific literature on the essential domains of QoL. Methods We conducted a three-stage online Delphi consensus procedure to identify the key domains of health-related QoL. Five stakeholder groups (i.e., patients, family of patients, clinicians, scientists and general public) were asked, on three consecutive occasions, what they perceive as the most important domains of health-related QoL. An analysis of existing (health-related) QoL and well-being measurements formed the basis of the Delphi-procedure. Results In total, 42 domains of QoL were judged, covering physical, mental and social aspects. All participants rated ‘self-acceptance’, ‘self-esteem’ and ‘good social contacts’ as essential. Strikingly, mental and social domains are perceived as more essential than physical domains across stakeholders groups. Conclusions In traditionally used health-related QoL utility measures, physical domains like ‘mobility’ are prominently present. The Delphi-procedure shows that health-related QoL (utility) scales need to put sufficient emphasis on mental and social domains to capture aspects of QoL that are essential to people.
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Affiliation(s)
- Suzanne Pietersma
- Department of Medical Decision Making, Leiden University Medical Center, Post Zone J10-S, P.O. Box 9600, 2300 RC Leiden, The Netherlands
| | | | - M. Elske van den Akker-van Marle
- Department of Medical Decision Making, Leiden University Medical Center, Post Zone J10-S, P.O. Box 9600, 2300 RC Leiden, The Netherlands
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Auld G, Baker S, Bauer L, Koszewski W, Procter SB, Steger MF. EFNEP's impact on the quality of life of its participants and educators. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2013; 45:482-489. [PMID: 23981711 DOI: 10.1016/j.jneb.2013.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Revised: 06/20/2013] [Accepted: 06/23/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE Determine whether the Expanded Food and Nutrition Education Program (EFNEP) affects the quality of life (QOL) of its participants and educators. DESIGN Longitudinal, where QOL was measured 3 times for participants (pre, post, 3-month delayed post) and educators (before and 6 and 12 months after training). SETTING Participants' and educators' QOL was measured in Colorado, Kansas, Missouri, and Nebraska. Georgia and Texas measured educators; Minnesota and Virginia measured participants. PARTICIPANTS English speaking EFNEP participants and educators. MAIN OUTCOME MEASURES The investigators used the QOL Profile to measure QOL in 3 domains: Being (who one is), Belonging (connection with social and physical environment), and Becoming (achieving personal goals). ANALYSIS Chi-square and t tests compared group demographics; repeated-measures ANOVA detected changes over time; ANCOVA examined the influence of demographic variables. RESULTS Both groups had QOL Profile scores above 1.5, which is considered acceptable. Participants improved from pre to post in the Being domains including Overall Being (least square means [standard error of the mean], 3.1 [0.2] to 4.1 [0.3]), and in Social Belonging (3.5 [0.3] to 3.8 [0.3]); most improvements were sustained at 3 months. Educators improved in the Belonging domains, and a number of scores continued to improve at 1 year after training, for example, Social Belonging (4.2 [0.5], 5.0 [0.5], and 5.8 [0.6]); and Community Belonging (3.5 [0.5], 3.8 [0.5], and 4.7 [0.5]) at the 3 time points, respectively. CONCLUSIONS AND IMPLICATIONS EFNEP improved the QOL of participants, primarily in the Being domain, and of educators, primarily in the Belonging domain. The QOL profile has the potential to broaden the assessment of EFNEP impacts.
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Affiliation(s)
- Garry Auld
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
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Kristofferzon ML, Ternesten-Hasséus E. A study of two generic health-related quality of life questionnaires--Nottingham Health Profile and Short-Form 36 Health Survey--and of coping in patients with sensory hyperreactivity. Health Qual Life Outcomes 2013; 11:182. [PMID: 24168525 PMCID: PMC3842640 DOI: 10.1186/1477-7525-11-182] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Accepted: 10/22/2013] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Sensory hyperreactivity (SHR) is one explanation for airway symptoms induced by chemicals and scents. Little is known about health-related quality of life (HRQOL) and coping, in this group of patients. A study was done in patients with SHR to (1) compare the Nottingham Health Profile (NHP) and the Short-Form 36 Health Survey (SF-36) in regard to their suitability, validity, reliability, and acceptability; (2) evaluate how the patients cope with the illness; (3) assess whether there are differences between women and men with respect to HRQOL and coping; and (4) assess whether there are differences between patients and normative data with respect to HRQOL and coping. METHODS A total of 115 patients (91 women) with SHR were asked to answer five questionnaires: a study-specific questionnaire, the Chemical Sensitivity Scale for Sensory Hyperreactivity (CSS-SHR), the NHP, the SF-36, and the Jalowiec Coping Scale-60. RESULTS Eighty-three patients (72%; 70 women) completed all questionnaires. The SF-36 scores were less skewed and more homogeneously distributed and showed fewer floor and ceiling effects than the NHP scores. The SF-36 was also discriminated better between patients with high and low CSS-SHR scores. The reliability standard for both questionnaires was satisfactory. There were no gender differences in HRQOL. Patients with SHR had significantly lower HRQOL scores than the normative data in comparable domains of the NHP and the SF-36: emotional reactions/mental health, energy/vitality, physical mobility/functioning, and pain/bodily pain. In social isolation/functioning, the results were different; the NHP scores were similar to the normative data and the SF-36 scores were lower. The most commonly used coping styles were optimistic, self-reliant, and confrontational. Women used optimistic coping more than men. Compared with the normative group, patients with SHR used confrontational and optimistic coping more and emotive coping less. CONCLUSIONS The current findings showed that both the NHP and the SF-36 were reliable instruments; but the results suggest that the SF-36 is a more sensitive instrument than the NHP for elucidating HRQOL in patients with SHR. Patients with SHR experienced a poor HRQOL and they followed the Western tradition of preferring problem-focused coping strategies to palliative and emotive strategies.
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Affiliation(s)
| | - Ewa Ternesten-Hasséus
- Department of Respiratory Medicine and Allergology, Institution of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
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van Mierlo ML, Schröder C, van Heugten CM, Post MWM, de Kort PLM, Visser-Meily JMA. The Influence of Psychological Factors on Health-Related Quality of Life after Stroke: A Systematic Review. Int J Stroke 2013; 9:341-8. [DOI: 10.1111/ijs.12149] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Accepted: 04/16/2013] [Indexed: 01/08/2023]
Abstract
Background and purpose Many stroke patients experience problems with health-related quality of life, but much of the variance of health-related quality of life after stroke remains unexplained. Health-related quality of life may be influenced by psychological factors, as these factors reflect the way people approach situations and react to stressful situations. The aim of this study was to systematically examine the relationship between psychological factors and health-related quality of life after stroke. Summary of review A systematic literature search was conducted in online databases PubMed, Embase, PsycINFO, and CINAHL in November 2011. A total of nine studies were included. Personality (i.e. problems of temperament and personality functions and neuroticism) was moderately negatively associated with health-related quality of life ( r = 0·26–0·49). Coping (i.e. situational and personal adaptation), internal locus of control, self-worth (i.e. self-esteem and self-efficacy), and hope and optimism were moderately positively associated with health-related quality of life ( r = 0·026–0·81). No evidence was found for an association between extraversion and health-related quality of life. Conclusions There is still a paucity of studies on psychological determinants of poststroke health-related quality of life. The reviewed studies supported the importance of psychological factors, but further research is needed to supplement the available evidence and to examine how psychological factors can be modified to improve health-related quality of life, and at what moment after the stroke these interventions should be given.
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Affiliation(s)
- Maria L. van Mierlo
- Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Carin Schröder
- Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Caroline M. van Heugten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, The Netherlands
| | - Marcel W. M. Post
- Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Paul L. M. de Kort
- Department of Neurology, St Elisabeth Hospital, Tilburg, The Netherlands
| | - Johanna M. A. Visser-Meily
- Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
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Ayoub A, Nelson K, Wood P. Cultural relevance of the quality-of-life tools for people with kidney failure. J Ren Care 2013; 39:236-45. [PMID: 24034233 DOI: 10.1111/j.1755-6686.2013.12034.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Many tools are used to examine the Quality of Life (QOL) of patients with kidney disease, but little is known about how culturally relevant they are and why one should utilise one tool over another. As part of a larger study on the QOL of dialysis patients in United Arab Emirates, the cultural relevance of two tools (SF-36 and the QOL Index) was examined. This paper suggests a model to establish cultural relevance of QOL tools. METHOD A descriptive comparative survey design using a mixed method design was used in 2007 to study the QOL of 161 patients on dialysis and 350 people from the community. The cultural relevance of each tool was assessed by (i) examining missed questions, (ii) asking respondents about the cultural relevance of each tool, (iii) asking respondents what questions could be added or deleted to make the tools more culturally relevant and (iv) asking respondents to identify the factors that might contribute to their QOL. RESULTS Of respondents, 94.7% from the dialysis sample and 90.4% from the community sample considered both tools culturally relevant. The QOL Index tool had more missing data. Many of the themes generated from the analysis of the qualitative data were addressed by the subscales of both tools. Themes not addressed by either tool were concerned with values, safety and country. CONCLUSION Cultural adaptation of QOL tools needs to follow well-established guidelines. The target population should be involved in establishing the cultural relevance of QOL tools.
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Affiliation(s)
- Abdelbasit Ayoub
- Office of Academic Affairs, Dhahran Healthcare Center, Dhahran, Saudi Arabia
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Implantation of cardioverter-defibrillator: Effects on shoulder function. Int J Cardiol 2013; 168:294-9. [DOI: 10.1016/j.ijcard.2012.09.071] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Revised: 05/02/2012] [Accepted: 09/15/2012] [Indexed: 02/01/2023]
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Roset M, Badia X, Forsythe A, Webb SM. Mapping CushingQoL scores onto SF-6D utility values in patients with Cushing's syndrome. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2013; 6:103-11. [PMID: 23549927 PMCID: PMC3663200 DOI: 10.1007/s40271-013-0010-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Objectives To construct a prediction model of preference-adjusted health status (SF-6D) for Cushing’s syndrome using a disease-specific health-related quality of life (HRQOL) measure (CushingQoL). Methods Data were obtained from the original multicenter, multinational study to validate the CushingQoL questionnaire. HRQOL was measured using the CushingQoL and the SF-36 questionnaires. SF-6D scores were calculated from responses on the SF-36. Sociodemographic and clinical data were also collected. Various predictive models were tested and the final one was selected on the basis of four criteria: explanatory power, consistency of estimated coefficients, normality of prediction errors, and parsimony. Results For the mapping analysis, data were available from 116 of the 125 patients included in the original validation study. Mean (SD) age was 45.3 (13.1) years and the sample was predominantly (83 %) female. Patients had a mean (SD) CushingQoL score of 52.9 (21.9), whereas the SF-6D (derived from SF-36) was skewed towards better health with a mean of 0.71 (median 0.74) on a scale of −0.704 to 1. Of the various models tested, a model which included the intercept (0.61), CushingQoL overall score, level one in CushingQoL item 2 (always have pain preventing me from leading a normal life), and level one in CushingQoL item 10 (my illness always affects my everyday activities) best met the four criteria for model selection. The model had an adjusted R2 of 0.60 and a root mean square error of 0.084. Conclusions Although the mapping function finally selected appears to be able to accurately map CushingQoL scores onto SF-6D outcomes at the group level, further testing is required to validate the model in independent patient samples.
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Affiliation(s)
- Montse Roset
- Health Economics and Outcomes Research, IMS Health, Barcelona, Spain.
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Rizzoli R, Reginster JY, Arnal JF, Bautmans I, Beaudart C, Bischoff-Ferrari H, Biver E, Boonen S, Brandi ML, Chines A, Cooper C, Epstein S, Fielding RA, Goodpaster B, Kanis JA, Kaufman JM, Laslop A, Malafarina V, Mañas LR, Mitlak BH, Oreffo RO, Petermans J, Reid K, Rolland Y, Sayer AA, Tsouderos Y, Visser M, Bruyère O. Quality of life in sarcopenia and frailty. Calcif Tissue Int 2013; 93:101-20. [PMID: 23828275 PMCID: PMC3747610 DOI: 10.1007/s00223-013-9758-y] [Citation(s) in RCA: 268] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Accepted: 03/27/2013] [Indexed: 12/25/2022]
Abstract
The reduced muscle mass and impaired muscle performance that define sarcopenia in older individuals are associated with increased risk of physical limitation and a variety of chronic diseases. They may also contribute to clinical frailty. A gradual erosion of quality of life (QoL) has been evidenced in these individuals, although much of this research has been done using generic QoL instruments, particularly the SF-36, which may not be ideal in older populations with significant comorbidities. This review and report of an expert meeting presents the current definitions of these geriatric syndromes (sarcopenia and frailty). It then briefly summarizes QoL concepts and specificities in older populations and examines the relevant domains of QoL and what is known concerning QoL decline with these conditions. It calls for a clearer definition of the construct of disability, argues that a disease-specific QoL instrument for sarcopenia/frailty would be an asset for future research, and discusses whether there are available and validated components that could be used to this end and whether the psychometric properties of these instruments are sufficiently tested. It calls also for an approach using utility weighting to provide some cost estimates and suggests that a time trade-off study could be appropriate.
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Affiliation(s)
- René Rizzoli
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
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Dodel R, Jönsson B, Reese JP, Winter Y, Martinez-Martin P, Holloway R, Sampaio C, Růžička E, Hawthorne G, Oertel W, Poewe W, Stebbins G, Rascol O, Goetz CG, Schrag A. Measurement of costs and scales for outcome evaluation in health economic studies of Parkinson's disease. Mov Disord 2013; 29:169-76. [DOI: 10.1002/mds.25571] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2012] [Revised: 01/09/2013] [Accepted: 02/01/2013] [Indexed: 11/08/2022] Open
Affiliation(s)
- Richard Dodel
- Department of Neurology; Philipps-University Marburg; Marburg Germany
| | - Bengt Jönsson
- Department of Economics; Stockholm School of Economics; Stockholm Sweden
| | - Jens Peter Reese
- Department of Neurology; Philipps-University Marburg; Marburg Germany
| | - Yaroslav Winter
- Department of Neurology; Philipps-University Marburg; Marburg Germany
| | - Pablo Martinez-Martin
- Alzheimer Disease Research Unit and Center for Networked Biomedical Research on Neurodegenerative Diseases (CIBERNED), Research Center for Neurological Diseases (CIEN) Foundation, Carlos III Institute of Health, Alzheimer Center Reina Sofia Foundation; Madrid Spain
| | - Robert Holloway
- Department of Neurology; University of Rochester Medical Center; Rochester New York USA
| | - Cristina Sampaio
- Clinical Pharmacology and Therapeutics, Faculdade de Medicina de Lisboa; Lisbon Portugal
| | - Evžen Růžička
- Department of Neurology; First Medical Faculty, Charles University in Prague; Prague Czech Republic
| | - Graeme Hawthorne
- Department of Psychiatry; The University of Melbourne; Melbourne Australia
| | - Wolfgang Oertel
- Department of Neurology; Philipps-University Marburg; Marburg Germany
| | - Werner Poewe
- Department of Neurology; Medical University of Innsbruck; Innsbruck Austria
| | - Glenn Stebbins
- Department of Neurological Sciences, Rush University Medical Center; Chicago Illinois USA
| | - Oliver Rascol
- Laboratoire de Pharmacologie Medicale et Clinique; Toulouse France
| | - Christopher G. Goetz
- Department of Neurological Sciences, Rush University Medical Center; Chicago Illinois USA
| | - Anette Schrag
- Institute of Neurology, University College London; London United Kingdom
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246
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Bertolasi L, Frasson E, Turri M, Gajofatto A, Bordignon M, Zanolin E, Martini M, Pimazzoni F, Ferlisi M, Zanusso G, Rossi M, Monaco S. A randomized controlled trial of IV immunoglobulin in patients with postpolio syndrome. J Neurol Sci 2013; 330:94-9. [DOI: 10.1016/j.jns.2013.04.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Revised: 03/26/2013] [Accepted: 04/15/2013] [Indexed: 10/26/2022]
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247
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Liu L, Fiorentino L, Rissling M, Natarajan L, Parker BA, Dimsdale JE, Mills PJ, Sadler GR, Ancoli-Israel S. Decreased health-related quality of life in women with breast cancer is associated with poor sleep. Behav Sleep Med 2013; 11. [PMID: 23205513 PMCID: PMC3594390 DOI: 10.1080/15402002.2012.660589] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study examined the longitudinal relation between health-related quality of life (HR-QOL) and subjective and objective sleep quality in 166 women with newly diagnosed Stage-1 through Stage-3 breast cancer, who were scheduled to receive ≥ 4 cycles of adjuvant/neoadjuvant chemotherapy. HR-QOL was assessed with the Medical Outcomes Study 36-item Short Form, Physical Component Scale (PCS), and Mental Component Scale (MCS) scores; subjective sleep was assessed with the Pittsburgh Sleep Quality Index; and objective sleep was measured with actigraphy. Data were collected before starting chemotherapy and during the last week of Cycle 4 of chemotherapy. Patients reported poor HR-QOL and poor sleep quality before and during chemotherapy. Short sleep time and long naps were recorded at both time points. The MCS score was related to reports of poor sleep, but not to recorded sleep; worse PCS scores were associated with reports of poor sleep and less recorded naptime, suggesting sleep plays an important role in cancer patients' HR-QOL.
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Affiliation(s)
- Lianqi Liu
- Department of Psychiatry, University of California, San Diego
| | | | | | - Loki Natarajan
- Department of Family and Preventive Medicine, University of California, San Diego,Moores UCSD Cancer Center, La Jolla
| | - Barbara A. Parker
- Moores UCSD Cancer Center, La Jolla,Department of Medicine, University of California, San Diego
| | - Joel E. Dimsdale
- Department of Psychiatry, University of California, San Diego,SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego,Moores UCSD Cancer Center, La Jolla
| | - Paul J. Mills
- Department of Psychiatry, University of California, San Diego,SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego,Moores UCSD Cancer Center, La Jolla
| | - Georgia Robins Sadler
- Moores UCSD Cancer Center, La Jolla,Department of Surgery, University of California, San Diego
| | - Sonia Ancoli-Israel
- Department of Psychiatry, University of California, San Diego,SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego,Moores UCSD Cancer Center, La Jolla,Department of Medicine, University of California, San Diego,Correspondence: Sonia Ancoli-Israel, Ph.D, Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, #0733, La Jolla, CA 92093-0733; Telephone: 858 822-7710; Fax: 858 822-7712;
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248
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Mason KE, Baker E, Blakely T, Bentley RJ. Housing affordability and mental health: does the relationship differ for renters and home purchasers? Soc Sci Med 2013; 94:91-7. [PMID: 23931950 DOI: 10.1016/j.socscimed.2013.06.023] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 06/17/2013] [Accepted: 06/19/2013] [Indexed: 01/05/2023]
Abstract
There is increasing evidence of a direct association between unaffordable housing and poor mental health, over and above the effects of general financial hardship. Type of housing tenure may be an important factor in determining how individuals experience and respond to housing affordability problems. This study investigated whether a relationship exists between unaffordable housing and mental health that differs for home purchasers and private renters among low-income households. Data from 2001 to 2010 of the longitudinal Household, Income and Labour Dynamics in Australia (HILDA) survey were analysed using fixed-effects linear regression to examine change in the SF-36 Mental Component Summary (MCS) score of individuals aged 25-64 years, associated with changes in housing affordability, testing for an interaction with housing tenure type. After adjusting for age, survey year and household income, among individuals living in households in the lower 40% of the national income distribution, private renters in unaffordable housing experienced somewhat poorer in mental health than when their housing was affordable (difference in MCS = -1.18 or about 20% of one S.D. of the MCS score; 95% CI: -1.95,-0.41; p = 0.003) while home purchasers experienced no difference on average. The statistical evidence for housing tenure modifying the association between unaffordable housing and mental health was moderate (p = 0.058). When alternatives to 40% were considered as income cut-offs for inclusion in the sample, evidence of a difference between renters and home purchasers was stronger amongst households in the lowest 50% of the income distribution (p = 0.020), and between the 30th and 50th percentile (p = 0.045), with renters consistently experiencing a decline in mental health while mean MCS scores of home purchasers did not change. In this study, private renters appeared to be more vulnerable than home purchasers to mental health effects of unaffordable housing. Such a modified effect suggests that tenure-differentiated policy responses to poor housing affordability may be appropriate.
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Affiliation(s)
- Kate E Mason
- Centre for Women's Health, Gender & Society, Melbourne School of Population Health, University of Melbourne, Melbourne, VIC 3010, Australia.
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249
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Liddle J, Parkinson L, Sibbritt D. Health-related factors associated with participation in creative hobbies by Australian women aged in their eighties. Arts Health 2013. [DOI: 10.1080/17533015.2013.808253] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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250
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Laudański K, Nowak Z, Niemczyk S. Age-related differences in the quality of life in end-stage renal disease in patients enrolled in hemodialysis or continuous peritoneal dialysis. Med Sci Monit 2013; 19:378-85. [PMID: 23685340 PMCID: PMC3665666 DOI: 10.12659/msm.883916] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background The aim of the present study was to compare the experience elderly and younger patients in terms of emotional status, disease perception, methods of coping with the end-stage renal disease (ESRD) stress, and health-related quality of life in 2 different settings of renal replacement therapy: hemodialysis (HD) and continuous ambulatory peritoneal dialysis programs (CAPD). Specifically, we hypothesized that younger people will more frequently use goal-oriented strategies to cope with illness-related stress and elderly patients will use more strategies related to the control of emotion. Material/Methods A total of 69 HD patients, 40 CAPD patients, and 89 healthy volunteers were analyzed. The Situation and Trait Anxiety Inventory, the Profile of Mood States, the Cognitive Stress Appraisal Questionnaire, and the Nottingham Health Profile were used to assess anxiety, long-term emotional status, coping mechanisms, and health-related quality of life. Data were collected on several biochemical and demographic variables. Results Our study revealed that younger and elderly people on dialysis faced quite different problems. Younger people in both RRT groups had statistically higher assessment of ESRD as loss or challenge and they more frequently used distractive and emotional preoccupation coping strategies. Depression, confusion, and bewilderment dominate the emotional status of both patient populations, especially in the younger cohort. Both HDyoung and CAPDyoung patients complained more about lack of energy, mobility limitations, and sleep disturbances as compared to their elderly HD and CAPD counterparts. Conclusions There are different needs and problems in younger and elderly patients on renal replacement therapy. Younger people required more ESRD-oriented support to relieve their health-related complaints to the level observed in their peers and needed extensive psychological assistance in order to cope with negative emotions related to their disease.
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Affiliation(s)
- Krzysztof Laudański
- Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA, U.S.A
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