The Significance of Importance: An Evaluation of Ferrans and Powers’ Quality of Life Index

Primary caregiver burden and undiagnosed mental health illness in out-patients with inflammatory bowel disease-A multicentric prospective survey from the IBD Emerging Nations' Consortium

BACKGROUND

Mental health is an overlooked aspect of inflammatory bowel disease (IBD) patient care with limited data from the developing world. The primary caregiver burden is expected to be high, but has not been evaluated.

METHODS

We conducted a questionnaire-based survey of consecutive out-patients with no diagnosed mental health illness (n = 289) and their primary caregivers (n = 247) from 10 centers across eight countries (Bangladesh, India, Iran, Malaysia, Myanmar, Nepal, Pakistan, Thailand) of IBD-Emerging Nations' Consortium (ENC). Patients were assessed for anxiety (PHQ-9), depression (GAD-7), quality of life (SIBDQ, IBDCOPE) and medication adherence (MMAS-8). Caregiver burden was assessed by Zarit-Burden Interview (ZBI), Ferrans and Power Quality of Life (QOL) scores and coping strategies (BRIEF-COPE). Multivariate logistic regression and correlation analyses were performed to identify risk factors and the impact on QOL in patients and caregivers.

RESULTS

Moderate to severe depression and anxiety were noted in 33% (severe 3.5%) and 24% (severe 3.8%) patients, respectively. The risk factor for depression was active disease (p < 0.001, OR6.3), while male gender (p = 0.01, OR0.45) and medication adherence (p = 0.003, OR0.75) were protective. Risk factors for anxiety were unmarried status (p = 0.015, OR2.3), female gender (p = 0.004, OR0.41), steroid use (p = 0.016, OR2.1) and active disease (p < 0.001, OR7.97). High GAD-7 and PHQ-9 scores positively correlated with high disease activity (r = 0.55, p < 0.001, Crohn's disease; r = 0.52, p < 0.001 ulcerative colitis) and negatively with SIBDQ (r =  - 0.63, p < 0.001; r =  - 0.64, p < 0.001 CD; r = 0.36, p = 0.001,UC). Sixty-five per cent (159/249) primary caregivers reported high burden (ZBI ≥ 21), which positively correlated with low educational status and low-income and negatively with QOL(r =  - 0.33, p < 0.001). The primary adaptive coping strategy among caregivers was religion, while maladaptive strategy was self-distraction.

CONCLUSION

Nearly two-thirds of primary caregivers reported high burden of care. There was also high prevalence of undiagnosed depression and anxiety in IBD out-patients. This highlights the need for patient-caregiver integrated mental-health services in the developing world.

Bilateral rectus muscle turning-over for complicated and eventrated abdominal wall hernias: results of a novel method

PURPOSE

We present a technique for covering large midline loss of abdominal wall using a novel method by autologous tissues.

METHODS

Twenty-two patients (body mass index = 35,6 ± 6,9 kg/m2) were involved in the prospective cohort study. Acute and elective cases were included. The gap area was 450.1 ± 54 cm2. The average width of the midline gap was 16,3 ± 3,2 cm. The rectus muscles were mobilized from its posterior sheath. Both muscles were turned by180º medially, so that the complete abdominal wall gap could be covered without considerable tension. Changes in intra-abdominal pressure, quality of life and hernia recurrency were determined.

RESULTS

There was no significant increase in the intra-abdominal pressure. Wound infection and seroma occurred in four cases. Bleeding occurred in one case. Pre- and post-operative quality of life index significantly improved (23 ± 13 vs. 47 ± 6; p = 0,0013). One recurrent hernia was registered. The procedure could be performed safely and yielded excellent results. The method was applied in acute cases. The intact anatomical structure of rectus muscles was essential.

CONCLUSIONS

The midline reconstruction with bilateral turned-over rectus muscles provided low tension abdominal wall status, and it did not require synthetic mesh implantation.

Structure and factorial invariance of a brief version of the Eating Attitudes Test in Peruvian university students

Background

University students often experience significant changes in their eating habits, which can increase the risk of developing eating disorders (ED). This situation calls for the creation of brief assessment tools to identify college students who may be most at risk. The aim of the study was to determine the psychometric properties of the Eating Attitudes Test-8 (EAT-8) in a Peruvian university population; additionally, the possible differences in the scores of the instrument according to sociodemographic variables, such as gender and age, were examined.

Methods

A psychometric study was conducted on 610 participants (M = 24.3, SD = 2.16, and 61.5% female), aged 19 to 31 years, belonging to four universities of different professional careers.

Results

The unidimensional eight-item model was found to have fit indices that confirm acceptable factorial validity (X2/df = 3.23, CFI = 0.984, TLI = 0.977, RMSEA = 0.061, SRMR = 0.049) and an internal consistency of 0.833 for the Cronbach's alpha coefficient and 0.838 for the McDonald's omega coefficient. In addition, the EAT-8 was reported to be invariant according to gender and age; likewise, there were no significant differences in the age and gender categories.

Conclusion

The EAT-8 has solid psychometric properties, including validity, reliability, and invariance, in the Peruvian university population, which supports its ability to assess the risk of developing ED in this specific group.

Psychological impact of COVID-19: A cross-lagged network analysis from the English Longitudinal Study of Aging COVID-19 database

Background

The COVID-19 pandemic and its subsequent health restrictions had an unprecedented impact on mental health, contributing to the emergence and reinforcement of various psychopathological symptoms. This complex interaction needs to be examined especially in a vulnerable population such as older adults.

Objective

In the present study we analyzed network structures of depressive symptoms, anxiety, and loneliness from the English Longitudinal Study of Aging COVID-19 Substudy over two waves (Months of June-July and November-December 2020).

Methods

For this purpose, we use measures of centrality (expected and bridge-expected influence) in addition to the Clique Percolation method to identify overlapping symptoms between communities. We also use directed networks to identify direct effects between variables at the longitudinal level.

Results

UK adults aged >50 participated, Wave 1: 5,797 (54% female) and Wave 2: 6,512 (56% female). Cross-sectional findings indicated that difficulty relaxing, anxious mood, and excessive worry symptoms were the strongest and similar measures of centrality (Expected Influence) in both waves, while depressive mood was the one that allowed interconnection between all networks (bridge expected influence). On the other hand, sadness and difficulty sleeping were symptoms that reflected the highest comorbidity among all variables during the first and second waves, respectively. Finally, at the longitudinal level, we found a clear predictive effect in the direction of the nervousness symptom, which was reinforced by depressive symptoms (difficulties in enjoying life) and loneliness (feeling of being excluded or cut off from others).

Conclusion

Our findings suggest that depressive, anxious, and loneliness symptoms were dynamically reinforced as a function of pandemic context in older adults in the UK.

Relationships Between Colorectal Cancer Survivors' Positive Psychology, Symptoms, and Quality of Life

This cross-sectional study examined colorectal cancer (CRC) survivors' symptom and symptom cluster characteristics (occurrence, frequency, and severity), positive psychology (benefit-finding and post-traumatic growth), and quality of life (QoL), and determined whether positive psychology moderates symptoms and QoL relationship during acute cancer survivorship, time from diagnosis to treatment completion. A total of 117 CRC survivors completed demographics, symptoms, QoL, and positive psychology questionnaires. Descriptive statistics, multiple linear regression, and moderation analyses were performed. Participants reported high QoL (94%, M = 5.15) and moderate-high positive psychology (75%, M = 3.21). Nineteen symptoms and five symptom clusters were inversely related to QoL (p < .05). Positive psychology (M = ~≥3.24) moderated the relationship of QoL (p < .05) with symptoms occurrence (n = 10), symptom severity (n = 1), and with the generalized symptom cluster (weakness, fatigue, dizziness, drowsy, sleep disturbances, and pain). Positive psychology aids in symptom management and improves QoL. Nurses are poised to identify, prevent, promote, and advocate self-management skills to improve health-related outcomes.

Two Sides of a Coin: Parental Disease-Specific Training as Seen by Health Care Practitioners and Parents in Pediatric Liver Transplantation

In the absence of widely accepted education standards for parents of children after liver transplantation (LTx), the content and structure of parental training are influenced by health care practitioners’ (HCP) individual knowledge and assessment of the relevance of its contents. This study examines the hypothesis that expectations towards training differ between HCPs and parents, and that the quality of parental training affects the job-satisfaction of HCPs. Attitudes towards disease-specific education were assessed by tailor-made questionnaires in HCPs (n = 20) and parents of children with chronic liver disease or after LTx (n = 113). These were supplemented by focused interviews in n = 7 HCPs and n = 16 parents. Parents were more satisfied with current counseling than HCP. Language barriers and low parental educational background were perceived as obstacles by 43% of HCPs. The quality of parental knowledge was felt to have a strong influence on HCPs job satisfaction. The expectations towards the content of disease-specific education largely overlap but are not synonymous. HCP and parents agreed with regards to the importance of medication knowledge. Parents rated the importance about the meaning of laboratory values and diagnostic procedures significantly higher (3.50 vs. 2.85, p < 0.001 and 3.42 vs. 2.80, p < 0.001) than HCPs. Parents and HCPs would prefer a structured framework with sufficient staff resources for disease-specific counseling.

Is QUOTE-IBD a valid questionnaire for measurement of quality of care in IBD? A validation study of the Swedish version

Background: Quality of care has gained increased attention in IBD. The questionnaire Quality of Care Through the Patient's Eyes - Inflammatory Bowel Disease (QUOTE-IBD) was the first published validated IBD-specific quality of care questionnaire. The aim of this study was to validate the Swedish version of the QUOTE-IBD.Methods: Adult outpatients (n = 400) at a gastroenterology clinic in the south-east of Sweden were asked to fill in the questionnaire. For evaluation of construct validity, patients also responded to one global item for each health care dimension in the QUOTE-IBD, as well as for their overall experience of quality of health care.Results: All quality of care dimensions (QI) correlated significantly (p < .05) with their respective global dimensional item (r = 0.016-0.43), except for accommodation (r = -0.02. Test-retest (n = 32) gave significant results for all the dimensions r = 0.31-0.80 (p < .05), except for accommodation (-0.15, p = ns).Conclusions: The construct validity of the Swedish version of QUOTE-IBD is moderate. This indicates that the QUOTE-IBD may not fully cover the health care aspects important to patients. The high number of item non-response for Performance may be related to the questions being too specific, which may also contribute to the moderate level of construct validity. The reliability is moderate and the internal consistency is good.

Quality of life profile in three cohorts of community-dwelling Swiss older people

Background

Quality of life (QoL) is a subjective and dynamic concept resulting from an interplay between importance of and satisfaction with different aspects of life. However, it is unclear whether social contexts experienced by individuals born at specific times in history (cohort effects) may influence QoL in old age. This study aimed to compare among older persons born before, during, and at the end of World War II: a) satisfaction with QoL, overall and per domains; b) importance of QoL domains.

Methods

This repeated cross-sectional study included representative samples of community-dwelling adults born in 1934–1938 (pre-war), 1939–1943 (war), and 1944–1948 (baby-boom) from the Lausanne cohort 65+. QoL was assessed overall, and in seven domains in 2011 and 2016. Two-by-two cohort comparisons were performed at ages 68–72 (war versus baby-boom) and 73–77 years (pre-war versus war).

Results

Overall satisfaction with QoL did not differ between cohorts despite increased education level across cohorts and a shift between pre-war and war cohorts towards lower morbidity and higher proportion living alone. However, “Feeling of safety” consistently showed significant improvements from earlier to later-born cohorts. Furthermore, the war cohort reported higher satisfaction than pre-war cohort in “Autonomy”. Conversely, no significant difference was observed between cohorts in importance of QoL domains, except increased importance given to “Health and mobility” in the war compared to pre-war cohort.

Conclusions

Societal changes reflected in the profile of successive elders’ cohorts did not appear to modify the overall satisfaction with QoL.

Electronic supplementary material

The online version of this article (10.1186/s12877-019-1112-4) contains supplementary material, which is available to authorized users.

The quality of care questionnaire: development of a valid measure for persons with inflammatory bowel disease

BACKGROUND AND AIMS

Quality of care is important in lifelong illnesses such as inflammatory bowel disease (IBD). Valid, reliable and short questionnaires to measure quality of care among persons with IBD are needed. The aim of this study was to develop a patient-derived questionnaire measuring quality of care in persons with IBD.

METHODS AND RESULTS

The development of the questionnaire The Quality of Care -Questionnaire (QoC-Q) was based on a literature review of studies measuring quality of care, and the results of two qualitative studies aiming to identify the knowledge need and perception of health care among persons with IBD. Further development and evaluation was done by focus groups, individual testing and cognitive interviews with persons with IBD, as well as evaluation by a group of professionals. After the development, the questionnaire was tested for validity and test-retest reliability in 294 persons with IBD.

CONCLUSIONS

The QoC-Q is showing promising validity and reliability for measuring the subjective perception of quality of care. Further testing in clinical practice is suggested to assess if the QoC-Q can be used to evaluate care and areas of improvement in health care for persons living with IBD.

Effects of Activity-Based Therapy Interventions on Mobility, Independence, and Quality of Life for People with Spinal Cord Injuries: A Systematic Review and Meta-Analysis

The aim of this study was to review the literature about the effects of activity-based therapy (ABT) interventions on mobility, functional independence, and quality of life for people with a spinal cord injury (SCI). A systematic review with meta-analysis of randomized and non-randomized trials was performed, including adults with a non-progressive SCI at any level. The intervention of interest was ABT, defined as any intervention that sought to improve muscle activation or sensory function below the level of injury in the spinal cord and does not rely on compensatory mechanisms for improving function. The comparison was either no intervention or conventional physical interventions targeted to regions above the level of injury. The outcome measures were quality-of-life questionnaires, mobility assessments, and functional independence scales. Nineteen trials were included in this systematic review. Three compared ABT to no intervention and 16 to conventional physical rehabilitation. The methodological quality of the trials was assessed using the PEDro scale as moderate. Six studies investigated the effects of ABT interventions for the upper limbs, 11 investigated gait-related interventions, and two applied multi-modal interventions. Compared with no intervention, the meta-analysis found that ABT was not more effective for improving independence or lower limb mobility, but conferred a large positive effect on upper limb function. Compared with conventional physical interventions, there was no significant effect of ABT on lower limb mobility, independence, or quality of life; however, it had positive effects on upper limbs. In conclusion, there is evidence that ABT can improve independence and functional ability when applied to the upper limbs in people with SCI. However, it is not superior to conventional physical interventions when applied to the lower limbs.

Domains of importance to the quality of life of older people from two Swiss regions

BACKGROUND

Quality of life (QoL) is a subjective perception whose components may vary in importance between individuals. Little is known about which domains of QoL older people deem most important.

OBJECTIVE

This study investigated in community-dwelling older people the relationships between the importance given to domains defining their QoL and socioeconomic, demographic and health status.

METHODS

Data were compiled from older people enrolled in the Lc65+ cohort study and two additional, population-based, stratified random samples (n = 5,300). Principal components analysis (PCA) was used to determine the underlying domains among 28 items that participants defined as important to their QoL. The components extracted were used as dependent variables in multiple linear regression models to explore their associations with socioeconomic, demographic and health status.

RESULTS

PCA identified seven domains that older persons considered important to their QoL. In order of importance (highest to lowest): feeling of safety, health and mobility, autonomy, close entourage, material resources, esteem and recognition, and social and cultural life. A total of six and five domains of importance were significantly associated with education and depressive symptoms, respectively. The importance of material resources was significantly associated with a good financial situation (β = 0.16, P = 0.011), as was close entourage with living with others (β = 0.20, P = 0.007) and as was health and mobility with age (β = -0.16, P = 0.014).

CONCLUSION

The importance older people give to domains of their QoL appears strongly related to their actual resources and experienced losses. These findings may help clinicians, researchers and policy makers better adapt strategies to individuals' needs.

The often overlooked issue of statistical power: this and other issues regarding assessing importance weighting in quality of life measures

In the area of quality of life research, researchers may ask respondents to rate importance as well as satisfaction of various life domains (such as job and health) and use importance ratings as weights to calculate overall, or global, life satisfaction. The practice of giving more important domains more weight, known as importance weighting, has not been without controversy. Several previous studies assessed importance weighting using the analytical approach of moderated regression. This study discusses major issues related to how importance weighting has been assessed. Specifically, this study highlights that studies on importance weighting without considering statistical power are prone to type II error, i.e., failing to reject the null hypothesis of no significant weighting effect when the null hypothesis is actually false. The sample size required for adequate statistical power to detect importance weighting functions appeared larger than most previous studies could offer.

Liver transplantation: a systematic review of long-term quality of life

BACKGROUND & AIMS

Liver transplantation is the only curative intervention for terminal liver disease. Accurate long-term quality of life (QOL) data are required in the context of improved surgical outcomes and increasing post-transplant survival. This study reviews the long-term QOL after primary liver transplantation in adult patients surviving 5 or more years after surgery.

METHODS

A literature search was conducted on PubMed for all studies matching the eligibility criteria between January 2000 and October 2013. Bibliographies of included studies were also reviewed. Two authors independently performed screening of titles and abstracts. Consensus for studies included for review was achieved by discussion between authors based on predetermined eligibility criteria. Quality appraisal and data tabulation were performed using predetermined forms. Results were synthesized by narrative review.

RESULTS

Twenty-three studies (5402 patients) were included. QOL following liver transplantation remains superior to preoperative status up to 20 years post-operatively. More post-operative complications predicted worse QOL scores especially in physical domains. Benefits in functional domains persist long-term with independence in self-care and mobility. Employment rates recover in the short-term but decline after 5 years, and differ significantly between various aetiologies of liver disease. Overall QOL improves to a similar level as the general population, but physical function remains worse. Participation in post-operative physical activity is associated with superior QOL outcomes in liver transplant recipients compared to the general population. QOL improvements are similar compared to lung, kidney and heart transplantation. Heterogeneity between studies precluded quantitative analysis.

CONCLUSIONS

Liver transplantation confers specific long-term QOL and functional benefits when compared to preoperative status. This information can assist in providing a more complete estimate of the overall health of liver transplant recipients and the effectiveness of surgery. Guidelines for future studies are provided.

Quality of life in women with coronary artery disease

Background:

Coronary artery disease (CAD) as a chronic disease can affect physical, mental, and social aspects of health as well as the perception of wellbeing. Advanced treatments of the disease emphasize on functionality and quality of life (QOL).

Objectives:

The present study aimed to investigate the QOL and its related factors among women with CAD.

Patients and Methods:

This was a descriptive cross-sectional study conducted on 200 women with CAD, referring to the Heart Clinic of Shahid Rajaei Cardiovascular Center in Tehran, Iran. The participants were selected by convenient sampling method. Data were collected using the Persian version of Ferrans and Powers QOL index (QLI) cardiac version and then analyzed using descriptive statistics and statistical tests (independent t-test, one-way ANOVA, and Scheffe’s test).

Results:

The mean score of overall QOL was 16.91 ± 3.54, ranging between 7.17-27.63. Regarding the instrument subscales, the mean scores were as follows: health and functioning: 15.48 ± 4.32, social and economic: 16.18 ± 3.65, psychological/spiritual: 18.04 ± 4.36, and familial: 20.12 ± 4.57. There was a significant relationship between QOL and marital status (P = 0.004), education (P = 0.007), income (P < 0.001) and disease duration (P = 0.047). However, there was no significant association between QOL and age, job and comorbidity.

Conclusions:

Based on the findings, participants had average levels of overall QOL. Some domains showed the need to improve QOL of women with CAD. Results of the present study revealed the necessity of designing and performing educational and supportive interventions to improve the QOL in women with CAD, especially among patients with low socio-economic status.

Psychometric assessment of the Persian version of the Ferrans and Powers 3.0 index in hemodialysis patients

BACKGROUND

This study aimed to assess the psychometric properties of the Persian version of the Ferrans and Powers 3.0 quality of life index (dialysis type) in patients receiving hemodialysis (HD) in order to describe their health-related quality of life (HRQOL).

METHODS

The sample (n = 150) consisted of adult HD patients receiving HD for at least 6 months from the establishment of the study. A total of 88 men and 62 women, with an average age of 50.47, from Shiraz, southern Iran, were enrolled in this study. The questionnaire was translated into Persian language using back translation and bilingual techniques. Convergent, discriminant, and construct validity of the Ferrans and Powers 3.0 dialysis version was evaluated. To check the internal consistency of the data, Cronbach's alpha, which indicates the reliability of the data, was used for the entire questionnaire and for the subscales.

RESULTS

The convergent and discriminant validity and success scaling rate for both sexes were 100 %. Cronbach's alpha was 0.95 overall, which was greater than 0.7 for all the subscales except for the family subscale. Our results suggest that HD patients in southern Iran have higher HRQOL scores when compared with those in other countries. Despite the higher mean HRQOL score for men compared with women, men had significantly higher HRQOL scores only in the health and functioning subscale. There was no significant correlation between HD patients' HRQOL and educational level.

CONCLUSION

The Persian version of Ferrans and Powers 3.0 has sufficient reliability and validity for measuring the quality of life of Persian-speaking HD patients. Female HD patients need more support and attention from family and society.

Qualidade de vida de idosos da área urbana e rural do município de Concórdia, SC

O estudo visou a analisar a qualidade de vida (QV) entre idosos da área urbana e rural, avaliando a influência de dois fatores (zona de residência e existência ou não de patologia). Pesquisa de delineamento epidemiológico transversal, foi realizada com idosos (homens) residentes no perímetro urbano e rural do município de Concórdia, SC. A amostra consistiu de 60 idosos: grupo da área urbana (GU; n=30; idade= 68±8 anos) e rural (GR; n=30; idade: 67±7,88 anos). Os dados de QV foram coletados através do formulário Medical Outcomes Study Questionnaire Health Survey (SF 36). Os resultados demonstraram que apenas as variáveis saúde (∆= 12,60; p<0,0001) e aspectos sociais (∆= 28,53; p<0,0001) obtiveram diferença significativa (p<0,05) intergrupos, sendo os valores do GR superiores (mais favoráveis) aos do GU. O teste do qui-quadrado revelou diferença significativa (χ²: 4,34; p= 0,037) intergrupos, sendo o GR o grupo que possuiu menor quantitativo de indivíduos com patologia. Desta forma infere-se que, na amostra analisada, o GR obteve melhora na qualidade de vida, em relação à saúde e aos aspectos sociais, quando comparados ao GU.

Quality of life among the elderly with locomotor disabilities in Sweden and Poland in the 1990s

PURPOSE

To estimate the proportion of locomotor disabilities in two elderly populations in Sweden and Poland, respectively. To estimate the perceived quality of life (QoL) in the disabled groups in samples from each country using a model developed by Carol Estwing Ferrans.

METHODS

The study comprised three parts: an epidemiological screening test for identification of individuals with a locomotor disability, an analysis of background data of importance and home visits with evaluations of quality of life and functional capacity. Home visits were made using the Quality of Life Index, (QLI) of Ferrans and Powers and a functional scale, the Standardized Practical Equipment (SPE). Data were collected for the period 1991-1996.

RESULTS

In the population part of the study, with 1,380 respondents (78%) comprising elderly Swedish persons, 288 reported a locomotor disability. This can be compared with 425 among 1,045 respondents (52%) in a Polish elderly group. The tests at the home visits (Sweden, n = 89; Poland, n = 84) showed that both men and women in the Swedish group reported significantly higher scores for the total QLI (max. 30.00) with men reporting 26.68 points compared to 19.73 and women reporting 21.39 points compared to 19.40 and for three of the four subscales. Also, the Polish group scored lower for balance and mobility (SPE).

CONCLUSION

The study provides an important view of the life situation measured with the QLI tool and the SPE for elderly persons with locomotor disorders in Sweden and Poland during the mid-1990s. The results are congruent with epidemiological reports on the poor health situation in Poland, particularly during that time. A new investigation among the elderly with locomotor disorders in the two countries today might provide different results.

Alters- und geschlechtspezifische Neunormierung der Fragen zur Lebenszufriedenheit (FLZM) für die Altersspanne von 14 bis 64 Jahre

Zusammenfassung. Theoretischer Hintergrund: Der FLZM-Fragebogen (Fragen zur Lebenszufriedenheit) ist ein ökonomisches, reliables Verfahren zur Erfassung der allgemeinen Lebenszufriedenheit. Fragestellung: Die vorhandenen Normwerte sind über 10 Jahre alt, zudem fehlen bislang Angaben über Prozentränge. Methode: Die vorliegende Studie stellt eine alters- und geschlechtsspezifische Neunormierung anhand einer bevölkerungsrepräsentativen Stichprobe aus Deutschland für den Altersbereich 14 bis 64 Jahre vor (N = 3877). Ergebnisse: Mittelwerte, Standardabweichungen, Trennschärfeindices und Prozentränge werden für Alter und Geschlecht getrennt berichtet. Die Ergebnisse zeigen gute interne Konsistenzen für die gewichtete (Cronbachs Alpha = 0,83) wie auch für die ungewichtete Lebenszufriedenheit (Cronbachs Alpha = 0,82). Schlussfolgerungen: Für die FLZM liegen aktualisierte Normdaten vor. Für einen Einsatz des Messinstruments können nun aktuelle Vergleichsdaten der gesamtdeutschen Bevölkerung zwischen 14–64 Jahren herangezogen werden.

Perceived social support and quality of life in Iranian hemodialysis patients

PURPOSE

To describe the relationship between perceived social support and the quality of life in hemodialysis patients from an Islamic cultural background in Iran.

DESIGN

A cross-sectional, correlational design was used. Data were collected in hemodialysis units affiliated to Iran University of Medical Sciences. Two hundred and two Muslim hemodialysis patients were selected by census during 2007.

METHODS

The Persian versions of the Personal Resources Questionnaire 85 (PRQ-85) Part II and the Ferrans and Powers Quality of Life Index-dialysis version were used. The data were analyzed using chi-square test and Spearman's rho correlation coefficients.

FINDINGS

There were a statistically significant relationship between perceived social support and health-functioning (r = .65, p < or = .05), socioeconomic (r = .67, p < or = .05), psychological-spiritual (r = .63, p < or = .05), and family subscales of quality of life (r = .51, p < or = .05). Total quality of life was also significantly correlated with perceived social support (r = 0.72, p= .00).

CONCLUSIONS

Perceived social support is associated with quality of life in Iranian hemodialysis patients.

CLINICAL RELEVANCE

It is important to reflect on the impact of culture and religion of Iran on quality of life of hemodialysis patients and their perceived social support.

Reference values for the Quality of Life Index in the general Swedish population 18-80 years of age

PURPOSE

The aim in the present study was to establish underlying dimensions of quality of life in Sweden, measured by QLI, and to obtain reference values among a representative sample between 18 and 80 years of age from the general Swedish population.

METHOD

A total of 1,680 randomly selected persons completed the questionnaire (57% response rate). All data were coded and entered into the statistical software. Factor analysis, maximum-likelihood method with oblique rotation, was employed to explore and reveal underlying dimensions of the QLI. To describe QLI total and subscale reference values for different age groups and men and women, respectively, means and 95% CI as well as medians and quartiles were used. For comparisons related to demographic and background variables, parametric and non-parametric analyses were used (alpha=0.01). All data were analysed using SPSS 14.0 statistical software.

RESULTS

Four underlying dimensions emerged: Family and friends, Health and functioning, Social and economic and Psychological/spiritual. Mean values for the total QLI and the four subscales ranged between 17.2 and 23.7 (possible range=0.0-30.0).

CONCLUSIONS

The overall QLI and subscale scores correspond with those presented by other researchers. Population-based measures of generic quality of life and underlying dimensions are important considering the gain when results from specific patient groups are viewed.

Prevalence of depression, its correlates among students, and its effect on health-related quality of life in a Turkish university

OBJECTIVE

The aims were to investigate the prevalence of depression among university students, and to determine some of the risk factors connected to depression, and also to evaluate its effect on health-related quality of life (HRQoL).

METHODS

This cross-sectional survey was conducted between 1 December 2007 and 31 January 2008 at Osmangazi University, Eskisehir, in western Turkey. The study group consisted of 822 students. The questionnaire included the students' socio-demographic characteristics, the Beck Depression Inventory, and the Medical Outcomes Study Short Form-36 (SF-36). The data were analyzed by using chi-square, Student's t test, percent (%) ratios, and backward logistic regression analysis with a significant value of P<0.05.

RESULTS

Of the students, 377 (45.9%) were males and 445 (54.1%) females. Overall, the prevalence of depression was 21.8% (n=179/822). Family history of depression, acne on face, any physical defect on body, smoking, alcohol consumption, and future-related occupational preoccupation were all deemed important risk factors for depression (P <0.05, for each one). It was found that, in those with depression, all the mean domain scores of SF-36 scale were lower than those without depression (P <0.05, for each one).

CONCLUSIONS

The prevalence of depression among the university students in this region of Turkey was wide-spread, affecting negatively the HRQoL of the students. For prevention and control of depression, depression information and knowledge need to be addressed by health education programs.

The measurement of body-image dissatisfaction-satisfaction: is rating importance important?

Some researchers have argued that evaluative body image may be better assessed by measures that weight dissatisfaction-satisfaction ratings by their subjective importance to individuals. The Body Areas Satisfaction Scale (BASS) is a frequently used, standardized assessment of evaluative body image, albeit one that does not use differential item weights. This investigation, with 410 female and male college students, examined whether an importance-weighted revision of the BASS would have incremental validity relative to the original version in the prediction of multiple criterion variables. Results confirmed the reliability and validity of unweighted and weighted versions. However, the validity of weighted versions did not surpass that of the original BASS. The extremity of individuals' satisfaction and dissatisfaction ratings appears inherently to reflect the importance placed on physical attributes for self-evaluation. Moderated regression analyses offered only weak support for the interaction of average satisfaction and average importance ratings beyond their main effects. The simpler, unweighted BASS is an acceptable assessment of evaluative body image.

Nutrition and its relation to mealtime preparation, eating, fatigue and mood among stroke survivors after discharge from hospital - a pilot study

Eating difficulties and nutritional deficits are common among persons with acute stroke and during rehabilitation. Little is known about such problems after discharge from hospital. In addition the relationship between fatigue and nutritional status among stroke survivors living in the community remains to be explored. The aim of this pilot study was to describe mealtime preparation, eating, fatigue, mood and nutritional status among persons with stroke six months after discharge from hospital and to explore associations between these factors. Patients were interviewed six months poststroke. Standardised questions and methods were used. The mean age of the 89 respondents was 77.2 (SD 6.6) years, 44 were women and 45 men. Difficulties with swallowing, ingestion and energy to eat occurred among 27%, 20% and 7% respectively. Difficulties with cooking and buying food occurred among 57% and 56% respectively and 41% were at nutritional risk. Feeling full of energy less than some of the time was experienced by 61% while 15% had felt gloomy and sad at least some of the time during the previous four weeks. Considering activities of daily living (ADL), having a less favourable nutritional status was significantly predicted by difficulties with buying food, difficulties with ingestion and being a woman. Considering psychological state (mood and energy), having a less favourable nutritional status was significantly predicted by a lack of energy and high age. This study supports the occurrence of a nutritionally related fatigue by means of “lack of energy”. The associations between poor nutritional status and fatigue can work in both directions. Thus persons with fatigue are more prone to have poor nutritional status and those with poor nutritional status are at greater risk of fatigue. Besides fatigue also difficulties with buying food and ingestion are associated with nutritional risk. As nutritional deficits occur a long time after stroke onset it is important to assess aspects of mealtime preparation and the eating process and when necessary provide food delivery service and eating assistance in order to prevent a vicious circle of undernourishment and fatigue to develop.