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Zhou Q, Yang L, Wan Y, Li X, Zhu Z, Wang J, Huang J, Shen F, Tan Q, Dong L, Ni Q, Zhang S, Fu Y. Gender differences in symptom burden among people living with HIV/AIDS receiving antiretroviral therapy in Yunnan, China. AIDS Care 2024:1-11. [PMID: 38176025 DOI: 10.1080/09540121.2023.2300978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 12/26/2023] [Indexed: 01/06/2024]
Abstract
ABSTRACTLittle is known about gender differences in the symptom burden of people living with HIV/AIDS (PLWHA) on antiretroviral therapy in China. This study was conducted based on a biopsychosocial-medical model to describe gender differences in symptom burden among 1035 PLWHA in Yunnan Province, China. After propensity score matching, 798 PLWHA were included in this analysis. Feeling stressed, poor sleep, and memory loss were the most burdensome symptoms among men, while feeling stressed, memory loss, and dizziness were the most burdensome symptoms among women. Among men PLWHA, factors associated with symptom burden were being of the ethnic minority, CD4 count ≥ 500 cells/mm3, physical functioning, and social support. Among women PLWHA, factors associated with symptom burden were being an inpatient, physical functioning, psychological functioning, and social support. Our findings suggest that healthcare providers need to take into account gender differences when developing optimal prevention, treatment, and care programs that provide individualized care to reduce patients' symptom burden.
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Affiliation(s)
- Qiao Zhou
- School of Nursing, Dali University, Dali, People's Republic of China
| | - Liying Yang
- School of Nursing, Dali University, Dali, People's Republic of China
| | - Yu Wan
- Cardiothoracic surgery, The Second People's Hospital of Yibin, Yibin, People's Republic of China
| | - Xucheng Li
- School of Nursing, Dali University, Dali, People's Republic of China
| | - Zheng Zhu
- School of Nursing, Fudan University, Shanghai, People's Republic of China
| | - Jianhua Wang
- Department of Oncology, The First Affiliated Hospital of Dali University, Dali, People's Republic of China
| | - Jibiao Huang
- School of Nursing, Dali University, Dali, People's Republic of China
| | - Fang Shen
- School of Nursing, Dali University, Dali, People's Republic of China
| | - Qiu Tan
- School of Nursing, Dali University, Dali, People's Republic of China
| | - Liting Dong
- Thyroid and breast surgery, The First Affiliated Hospital of Air Force Medical University, Xian, People's Republic of China
| | - Qinmin Ni
- School of Health Science and Technology, West Yunnan University of Applied Technology, Dali, People's Republic of China
| | - Shixiao Zhang
- School of Nursing, Dali University, Dali, People's Republic of China
| | - Yanfen Fu
- School of Nursing, Dali University, Dali, People's Republic of China
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Wen H, Yang Z, Zhu Z, Han S, Zhang L, Hu Y. Psychometric properties of self-reported measures of health-related quality of life in people living with HIV: a systematic review. Health Qual Life Outcomes 2022; 20:5. [PMID: 35012574 PMCID: PMC8744327 DOI: 10.1186/s12955-021-01910-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 12/14/2021] [Indexed: 01/31/2023] Open
Abstract
Objective To identify and assess the psychometric properties of patient-reported outcome measures (PROMs) of health-related quality of life (HRQoL) in people living with HIV (PLWH). Methods Nine databases were searched from January 1996 to October 2020. Methodological quality was assessed by using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) Risk of Bias Checklist. We used the COSMIN criteria to summarize and rate the psychometric properties of each PROM. A modified Grading, Recommendations, Assessment, Development, and Evaluation (GRADE) system was used to assess the certainty of evidence. Results Sixty-nine studies reported on the psychometric properties of 30 identified instruments. All studies were considered to have adequate methodological quality in terms of content validity, construct validity, and internal consistency. Limited information was retrieved on cross-cultural validity, criterion validity, reliability, hypothesis testing, and responsiveness. High-quality evidence on psychometric properties was provided for the Medical Outcomes Study HIV Health Survey (MOS-HIV), the brief version of the World Health Organization's Quality of Life Instrument in HIV Infection (WHOQoL-HIV-BREF), 36-Item Short Form Survey (SF-36), Multidimensional Quality of Life Questionnaire for Persons with HIV/AIDS (MQoL-HIV), and WHOQoL-HIV. Conclusions The findings from the included studies highlighted that among HIV-specific and generic HRQoL PROMs, MOS-HIV, WHOQoL-HIV-BREF, SF-36, MQoL-HIV, and WHOQoL-HIV are strongly recommended to evaluate HRQoL in PLWH in research and clinics based on the specific aims of assessments and the response burden for participants. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-021-01910-w.
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Affiliation(s)
- Huan Wen
- Fudan University School of Public Health, Shanghai, China
| | - Zhongfang Yang
- School of Nursing, Fudan University, Shanghai, China.,Fudan University Centre for Evidence-Based Nursing: A Joanna Briggs Institute Centre of Excellence, 305 Fenglin Rd, Shanghai, 200032, China
| | - Zheng Zhu
- School of Nursing, Fudan University, Shanghai, China. .,Fudan University Centre for Evidence-Based Nursing: A Joanna Briggs Institute Centre of Excellence, 305 Fenglin Rd, Shanghai, 200032, China.
| | - Shuyu Han
- Peking University School of Nursing, Beijing, China
| | - Lin Zhang
- Shanghai Public Health Clinical Center, Shanghai, China
| | - Yan Hu
- School of Nursing, Fudan University, Shanghai, China. .,Fudan University Centre for Evidence-Based Nursing: A Joanna Briggs Institute Centre of Excellence, 305 Fenglin Rd, Shanghai, 200032, China.
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Han S, Hu Y, Pei Y, Zhu Z, Qi X, Wu B. Sleep satisfaction and cognitive complaints in Chinese middle-aged and older persons living with HIV: the mediating role of anxiety and fatigue. AIDS Care 2021; 33:929-937. [PMID: 33487030 DOI: 10.1080/09540121.2020.1844861] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Middle-aged and older persons living with HIV (PLWH) suffer from sleep distress and cognitive disorders due to HIV infection and aging. We aim to explore the relationship between sleep satisfaction and cognitive complaints, and the mediating role of anxiety and fatigue in this relationship among middle-aged and older PLWH. We used data from a multicenter cross-sectional study in China (Shanghai, Kunming, Nanning, Hengyang, and Changning) conducted in 2017. The data analysis included 435 PLWH aged 45 years and over. Multiple linear regression models showed that worse sleep satisfaction was significantly associated with lower cognitive complaints after controlling for anxiety, fatigue, demographic variables, and clinical variables (β = -0.246, p < 0.01). Both anxiety and fatigue were significant partial mediators in the relationship between sleep satisfaction and cognitive complaints. The serial multiple mediation models of sleep satisfaction-anxiety (M1)-fatigue (M2)-cognitive complaints were supported and the alternative model of sleep satisfaction-fatigue (M2)-anxiety (M1)-cognitive complaints were both supported. Our study indicates that it is important to improve sleep quality to promote cognitive function among Chinese middle-aged and older PLWH. Prevention and treatment programs for sleep satisfaction and cognitive function should include the assessment and reduction of fatigue and anxiety.
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Affiliation(s)
- Shuyu Han
- School of Nursing, Fudan University, Shanghai, People's Republic of China
| | - Yan Hu
- School of Nursing, Fudan University, Shanghai, People's Republic of China.,Fudan University Centre for Evidence-based Nursing: A Joanna Briggs Institute Centre of Excellence, Shanghai, People's Republic of China
| | - Yaolin Pei
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Zheng Zhu
- School of Nursing, Fudan University, Shanghai, People's Republic of China.,Fudan University Centre for Evidence-based Nursing: A Joanna Briggs Institute Centre of Excellence, Shanghai, People's Republic of China
| | - Xiang Qi
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, NY, USA
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Kalfoss MH, Reidunsdatter RJ, Klöckner CA, Nilsen M. Validation of the WHOQOL-Bref: psychometric properties and normative data for the Norwegian general population. Health Qual Life Outcomes 2021; 19:13. [PMID: 33413455 PMCID: PMC7792093 DOI: 10.1186/s12955-020-01656-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 12/17/2020] [Indexed: 12/05/2022] Open
Abstract
Background The World Health Organization’s Quality of Life Questionnaire (WHOQOL-Bref) is a frequently used instrument to assess the quality of life in both healthy and ill populations. Inquiries of the psychometric properties of the WHOQOL-Bref report that the validity and reliability is generally satisfactory. However, some studies fail to support a four-factor dimensionality; others report poor reliability of the social and environmental domain; and there may be some challenges of supporting construct validity across age. This paper evaluates the psychometric properties of the Norwegian WHOQOL-Bref and extends previous research by testing for measurement invariance across age, gender and education level. In addition, we provide updated normative data for the Norwegian population. Methods We selected a random sample of the Norwegian population (n = 654) aged 18–75 years. Participants filled out the WHOQOL-Bref, the Utrecht Work Engagement Scale and various sociodemographic variables. Results We found an acceptable convergent and discriminate validity and internal consistency of the physical, psychological and environmental domains, but a marginal reliability was found for the social domain. The factor loadings were invariant across gender, education and age. Some items had low factor loadings and explained variance, and the model fit for the age group 60–75 years were less satisfactory. Conclusions The original four-factor dimensionality of the WHOQOL-Bref displayed a better fit to the data compared to the one-factor solution and is recommended for use in the Norwegian population. The WHOQOL-Bref is suitable to use across gender, education and age, but for assessment in the oldest age group, the WHOQOL-Old module could be a good supplementary, but further studies are needed.
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Affiliation(s)
- Mary H Kalfoss
- Faculty of Health Studies, VID Specialized University, Campus Diakonova, Pb 184, Videren, 0319, Oslo, Norway
| | - Randi J Reidunsdatter
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Christian A Klöckner
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Marianne Nilsen
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway. .,Department of Social Work, Norwegian University of Science and Technology, Trondheim, Norway.
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Kruithof N, Haagsma JA, Karabatzakis M, Cnossen MC, de Munter L, van de Ree CLP, de Jongh MAC, Polinder S. Validation and reliability of the Abbreviated World Health Organization Quality of Life Instrument (WHOQOL-BREF) in the hospitalized trauma population. Injury 2018; 49:1796-1804. [PMID: 30154022 DOI: 10.1016/j.injury.2018.08.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 08/17/2018] [Indexed: 02/02/2023]
Abstract
INTRODUCTION While the number of trauma patients surviving their injury increase, it is important to measure Quality of Life (QoL). The Abbreviated World Health Organization Quality of Life (WHOQOL-BREF) questionnaire can be used to assess QoL. However, its psychometric properties in trauma patients are unknown and therefore, we aimed to investigate the validity and reliability of the WHOQOL-BREF for the hospitalized trauma population. METHODS Data were derived from the Brabant Injury Outcome Surveillance. Floor and ceiling effects and missing values of the WHOQOL-BREF were examined. Confirmatory factor analysis (CFA) was performed to examine the underlying 4 dimensions (i.e. physical, psychological, social and environmental) of the questionnaire. Cronbach's alpha (CA) was calculated to determine internal consistency. In total, 42 hypotheses were formulated to determine construct validity and 6 hypotheses were created to determine discriminant validity. To determine construct validity, Spearman's correlations were calculated between the WHOQOL-BREF and the EuroQol-five-dimension-3-level questionnaire, the Health Utility Index Mark 2 and 3, the Hospital Anxiety and Depression Scale and the Impact of Event Scale. Discriminant validity between patients with minor injuries (i.e. Injury Severity Score (ISS)≤8) and moderate/severe injuries (i.e. ISS ≥ 9) was examined by conducting Mann-Whitney-U-tests. RESULTS In total, 202 patients (median 63y) participated in this study with a median of 32 days (interquartile range 29-37) post-trauma. The WHOQOL-BREF showed no problematic floor and ceiling effects. The CFA revealed a moderate model fit. The domains showed good internal consistency, with the exception of the social domain. All individual items and domain scores of the WHOQOL-BREF showed nearly symmetrical distributions since mean scores were close to median scores, except of the 'general health' item. The highest percentage of missing values was found on the 'sexual activity' item (i.e. 19.3%). The WHOQOL-BREF showed moderate construct and discriminant validity since in both cases, 67% of the hypotheses were confirmed. CONCLUSION The present study provides support for using the WHOQOL-BREF for the hospitalized trauma population since the questionnaire appears to be valid and reliable. The WHOQOL-BREF can be used to assess QoL in a heterogeneous group of hospitalized trauma patients accurately. TRAIL REGISTRATION ClinicalTrials.gov identifier: NCT02508675.
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Affiliation(s)
- N Kruithof
- ETZ Hospital (Elisabeth-TweeSteden Ziekenhuis), Department Trauma TopCare, Tilburg, the Netherlands.
| | - J A Haagsma
- Erasmus MC University Medical Centre, Department of Public Health, Rotterdam, the Netherlands; Erasmus MC University Medical Centre, Department of Emergency Medicine, Rotterdam, the Netherlands
| | - M Karabatzakis
- ETZ Hospital (Elisabeth-TweeSteden Ziekenhuis), Department Trauma TopCare, Tilburg, the Netherlands
| | - M C Cnossen
- Erasmus MC University Medical Centre, Department of Public Health, Rotterdam, the Netherlands
| | - L de Munter
- ETZ Hospital (Elisabeth-TweeSteden Ziekenhuis), Department Trauma TopCare, Tilburg, the Netherlands
| | - C L P van de Ree
- ETZ Hospital (Elisabeth-TweeSteden Ziekenhuis), Department Trauma TopCare, Tilburg, the Netherlands
| | - M A C de Jongh
- ETZ Hospital (Elisabeth-TweeSteden Ziekenhuis), Department Trauma TopCare, Tilburg, the Netherlands; Brabant Trauma Registry, Network Emergency Care Brabant, Tilburg, the Netherlands
| | - S Polinder
- Erasmus MC University Medical Centre, Department of Public Health, Rotterdam, the Netherlands
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Rzeszutek M, Gruszczyńska E. Consistency of health-related quality of life among people living with HIV: Latent statetrait analysis. Health Qual Life Outcomes 2018; 16:101. [PMID: 29793544 PMCID: PMC5968481 DOI: 10.1186/s12955-018-0929-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 05/08/2018] [Indexed: 01/20/2023] Open
Abstract
Background The aim of this longitudinal study was to examine the consistency of health-related quality of life (HRQoL) among people living with HIV (PLWH) by breaking down the variance of repeated HRQoL measures into trait, state, and method components and to test the stability of HRQoL over time. In addition, we wanted to examine whether HRQoL trait components are related to personality traits, while controlling for selected socio-medical variables. Methods Three assessments were performed with a six-month lag on each assessment. Each participant filled out a World Health Organization (WHO) Quality of Life-BREF to assess HRQoL and a NEO-FFI to measure Big Five personality traits. Overall, 82 participants out of 141 (58.2% of the initial sample) participated in all the assessments. Results The HRQoL among PLWH represented a stable trait to a somewhat greater extent than a situational variability, although the proportions were domain and time variant. More specifically, psychological domain appeared to be the most consistent, whereas social domain appeared to be the most prone to situational influences. The trait component of HRQoL was positively related to being in a relationship, being employed, and being extraverted, and negatively related to neuroticism, which altogether explained 26% of the trait variance. Conclusions HRQoL among PLWH is rather distinct from personality and socio-medical data, which indicates its uniqueness in a clinical practise. Thus, there is a need for a more comprehensive assessment of HRQoL among this patient group to capture an additional source of variance in this important theoretical construct.
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Affiliation(s)
- Marcin Rzeszutek
- Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183, Warsaw, Poland.
| | - Ewa Gruszczyńska
- Faculty of Psychology, University of Social Sciences and Humanities, Chodakowska 19/31, 03-815, Warsaw, Poland
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Cho H, Iribarren S, Schnall R. Technology-Mediated Interventions and Quality of Life for Persons Living with HIV/AIDS. A Systematic Review. Appl Clin Inform 2017; 8:348-368. [PMID: 28401246 PMCID: PMC6241739 DOI: 10.4338/aci-2016-10-r-0175] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Accepted: 01/27/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND As HIV/AIDS is considered a chronic disease; quality of life (QoL) has become an important focus for researchers and healthcare providers. Technology-mediated interventions have demonstrated improved clinical effectiveness in outcomes, such as viral suppression, for persons living with HIV/AIDS (PLWH). However, the evidence to support the impact of these interventions on QoL is lacking. OBJECTIVES The aim of this paper was to assess the impact of technology-mediated interventions on QoL and to identify the instruments used to measure the QoL of PLWH. METHODS For this review we followed the PRISMA guidelines. A literature search was conducted in PubMed, CINAHL, Cochrane, and EMBASE databases in April 2016. Inclusion criteria limited articles to those with technology-mediated interventions as compared to usual care; articles with the population defined as HIV-infected patients; and articles with QoL measured as a health outcome in randomized controlled trials. The Cochrane Collaboration Risk of Bias Tool was used to assess study quality. RESULTS Of the 1,554 peer-reviewed articles returned in the searches, 10 met the inclusion criteria. This systematic review identified four types of technology-mediated interventions and two types of QoL instruments used to examine the impact of technology-mediated interventions on PLWH. Four studies of technology-mediated interventions resulted in improvement in QoL. Four studies considered QoL as a secondary outcome and resulted in a negative or neutral impact on QoL. Overall, four studies had a low risk of bias, one study had a moderate risk of bias, and the other five studies had a high risk of bias. CONCLUSIONS The evidence to support the improvement of QoL using technology-mediated interventions is insufficient. This lack of research highlights the need for increased study of QoL as an outcome measure and the need for consistent measures to better understand the role of technology-mediated interventions in improving QoL for PLWH.
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Affiliation(s)
- Hwayoung Cho
- Hwayoung Cho, MPhil, MSN, RN, Columbia University School of Nursing, 617 West 168th Street, New York, NY 10032, United States,
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Gozdowska J, Zatorski M, Torchalla P, Białek Ł, Bojanowska A, Tomaszek A, Serwańska-Świętek M, Kieszek R, Kwiatkowski A, Chmura A, Durlik M. Living-Donor Versus Deceased-Donor Kidney Transplantation: Comparison of Psychosocial Consequences for Recipients. Transplant Proc 2017; 48:1498-505. [PMID: 27496435 DOI: 10.1016/j.transproceed.2016.01.075] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 01/21/2016] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Health benefits of a living-donor kidney transplantation are numerous and well known. There is, however, a dearth of knowledge on postoperative quality of life among the living-donor (LD) compared to deceased-donor (DD) transplant recipients. MATERIALS AND METHODS The study involved 89 patients after renal transplantation: 48 from LDs and 41 from DDs. Interview data indirectly indicated the patients' health, whereas physiological parameters directly pinpointed the patients' health and the graft function. All study participants completed questionnaires to measure quality of life and the specificity of emotional and cognitive functioning. RESULTS LD kidney recipients were younger than DD recipients (40 years vs. 49 years). LD and DD transplantation patients were similar in health status assessed by indirect methods (data from an interview) and direct methods (laboratory tests results). They, however, differed in their psychosocial functioning. LD patients had a greater sense of happiness (P < .01) and of self-efficacy (P = .07). Moreover, these patients were more actively involved in their social lives (P < .02) and were more satisfied with their social relationships (P = .07). LD recipients also had a higher quality of life in terms of mental functioning (P < .01) and satisfaction with their environments (P < .01). Additionally, there were significant correlations between quality of life and the quality of cognitive and emotional functioning in the group of LD recipients. The perceived impact of health on physical and professional activity and daily routines was similar in LD and DD groups. CONCLUSIONS LD post-transplantation patients may derive greater psychosocial benefits from this form of treatment. This effect is not dependent on somatic parameters (comparable data from an interview and laboratory tests results). This study suggests that patients should be assisted by a multidisciplinary healthcare team, and receive continuous support from relatives during the post-transplantation adaptation process. This facilitates the patients' postoperative quality of life.
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Affiliation(s)
- J Gozdowska
- Department of Transplantation Medicine, Nephrology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland.
| | - M Zatorski
- University of Social Sciences and Humanities, Poznań, Poland
| | - P Torchalla
- Department of Transplantation Medicine, Nephrology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Ł Białek
- Department of Transplantation Medicine, Nephrology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - A Bojanowska
- University of Social Sciences and Humanities, Poznań, Poland
| | - A Tomaszek
- Clinic of General and Transplantation Surgery, Medical University of Warsaw, Warsaw, Poland
| | - M Serwańska-Świętek
- Clinic of General and Transplantation Surgery, Medical University of Warsaw, Warsaw, Poland
| | - R Kieszek
- Clinic of General and Transplantation Surgery, Medical University of Warsaw, Warsaw, Poland
| | - A Kwiatkowski
- Clinic of General and Transplantation Surgery, Medical University of Warsaw, Warsaw, Poland
| | - A Chmura
- Clinic of General and Transplantation Surgery, Medical University of Warsaw, Warsaw, Poland
| | - M Durlik
- Department of Transplantation Medicine, Nephrology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
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Brandt CP, Paulus DJ, Garza M, Lemaire C, Norton PJ, Zvolensky MJ. A Novel Integrated Cognitive-Behavioral Therapy for Anxiety and Medication Adherence Among Persons Living With HIV/AIDS. COGNITIVE AND BEHAVIORAL PRACTICE 2017; 25:105-118. [PMID: 29750006 DOI: 10.1016/j.cbpra.2017.01.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Persons living with HIV/AIDS (PLHIV) are able to live full lifespans after infection, however, rates of anxiety disorders among this population are elevated compared to national samples. Importantly, these anxiety symptoms and disorders have a negative effect on medication adherence, quality of life and other psychological disorders, such as depression. In order to reduce the impact of anxiety among PLHIV, a six-session transdiagnostic CBT-based treatment manual for anxiety among PLHIV named the HIV/Anxiety Management-Reduction Treatment (HAMRT) was developed and implemented. The current manuscript discusses the content of this manual as well as results from three cases examining the impact of HAMRT. Results indicated that HAMRT was effective in reducing symptoms of anxiety, anxiety sensitivity, depression, and negative affect among our sample. Additionally, results indicated that HAMRT was effective in increasing HIV medication adherence as well as quality of life. Results are discussed in terms of the potential utility of an anxiety-reduction therapy program aimed at increasing medication adherence among PLHIV.
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Dos Santos APC, Lazzari TK, Silva DR. Health-Related Quality of Life, Depression and Anxiety in Hospitalized Patients with Tuberculosis. Tuberc Respir Dis (Seoul) 2016; 80:69-76. [PMID: 28119749 PMCID: PMC5256348 DOI: 10.4046/trd.2017.80.1.69] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 07/21/2016] [Accepted: 09/19/2016] [Indexed: 12/14/2022] Open
Abstract
Background Much of the attention of tuberculosis (TB) programs is focused on outcomes of microbiological cure and mortality, and health related quality of life (HRQL) is undervalued. Also, TB patients have a significantly higher risk of developing depression and anxiety compared with those in the general population. We intend to evaluate the HRQL and the prevalence of symptoms of depression and anxiety in hospitalized patients with TB. Methods Cross-sectional study in a tertiary care hospital in Brazil. Adult patients with pulmonary TB that were hospitalized during the study period were identified and invited to participate. HRQL was measured using the Medical Outcomes Study Short Form-36 (SF-36) version 2. Hospital Anxiety and Depression Scale (HADS) was used to record symptoms of anxiety and depression. Results Eighty-six patients were included in the analysis. The mean age of all patients was 44.6±15.4 years, 69.8% were male, and 53.5% were white. Thirty-two patients (37.2%) were human immunodeficiency virus positive. Twenty-seven patients (31.4%) met study criteria for depression (HADS depression score ≥11) and 33 (38.4%) had anxiety (HADS anxiety score ≥11). Scores on all domains of SF-36 were significantly lower than the Brazilian norm scores (p<0.001). Conclusion The present study shows that TB patients may have a poor HRQL. Additionally, we found a possible high prevalence of depression and anxiety in this population. Health care workers should be aware of these psychological disorders to enable a better management of these patients. The treatment of these comorbidities may be associated with better TB outcomes.
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Affiliation(s)
- Ana Paula Ceré Dos Santos
- Graduate Program in Pneumological Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Tássia Kirchmann Lazzari
- Graduate Program in Pneumological Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Denise Rossato Silva
- Graduate Program in Pneumological Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.; Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.; Pulmonology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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Oliveira SEH, Carvalho H, Esteves F. Toward an understanding of the quality of life construct: Validity and reliability of the WHOQOL-Bref in a psychiatric sample. Psychiatry Res 2016; 244:37-44. [PMID: 27455149 DOI: 10.1016/j.psychres.2016.07.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Revised: 06/18/2016] [Accepted: 07/05/2016] [Indexed: 10/21/2022]
Abstract
This study tested the psychometric properties of the WHOQOL-Bref by examining its construct validity, predictive validity and reliability in a psychiatric sample. The sample consisted of 403 participants recruited from mental health care facilities. Construct validity was assessed through confirmatory factor analysis (CFA) and item-domains correlations. Predictive validity was evaluated via multiple regressions. Internal consistency was analyzed by using Cronbach's alpha. Results from CFA second-order hierarchical model and item-domain correlational analyses supported the construct validity of the WHOQOL-Bref. A 5-domain model (psychological, physical, social relationships, environment and level of independence) demonstrated good-fit and adequate internal consistency. Multiple regression analyses of the domains with overall quality of life (QOL), general health and general QOL were supportive of predictive validity. This study found support for the multidimensionality of the WHOQOL-Bref which demonstrated appropriate properties for the assessment of QOL in psychiatric inpatients and outpatients. Thus, a valuable tool to be incorporated as part of the routine clinical evaluation, monitoring and an important indicator of treatment outcome and research. Our findings suggest a conceptual distinction between the physical domain and level of independence domain in this short version of the WHOQOL, as proposed by the WHOQOL-100.
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Affiliation(s)
| | - Helena Carvalho
- Instituto Universitário de Lisboa (ISCTE-IUL), CIES-IUL, Lisboa, Portugal
| | - Francisco Esteves
- Mid Sweden University, Östersund, Sweden, & CIS-IUL, Lisboa, Portugal
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Tesfaye M, Olsen MF, Medhin G, Friis H, Hanlon C, Holm L. Adaptation and validation of the short version WHOQOL-HIV in Ethiopia. Int J Ment Health Syst 2016; 10:29. [PMID: 27064377 PMCID: PMC4826497 DOI: 10.1186/s13033-016-0062-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 03/29/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Quality of life of patients is an important element in the evaluation of outcome of health care, social services and clinical trials. The WHOQOL instruments were originally developed for measurement of quality of life across cultures. However, there were concerns raised about the cross-cultural equivalence of the WHOQOL-HIV when used among people with HIV in Ethiopia. Therefore, this study aimed at adapting the WHOQOL-HIV bref for the Ethiopian setting. METHODS A step-wise adaptation of the WHOQOL-HIV bref for use in Ethiopia was conducted to produce an Ethiopian version-WHOQOL-HIV-BREF-Eth. Semantic and item equivalence was tested on 20 people with HIV. One hundred people with HIV were interviewed to test for measurement equivalence (known group validity and internal consistency) of the WHOQOL-HIV-BREF-Eth. Confirmatory factor analysis was conducted using data from 348 people with HIV who were recruited from HIV clinics. RESULTS In the process of adaptation, new items of relevance to the context were added while seven items were deleted because of problems with acceptability and poor psychometric properties. The Cronbach's α for the final tool with twenty-seven items WHOQOL-HIV-BREF-Eth was 0.93. All six domains discriminated well between symptomatic and asymptomatic people with HIV (p < 0.001). Using confirmatory factor analysis, a second order factor structure with six first order indicator factors demonstrated moderate fit to the data ((χ(2) = 627.75; DF = 259; p < 0.001), CFI = 0.82, TLI = 0.77 and RMSEA = 0.064). CONCLUSION The WHOQOL-HIV-BREF-Eth has been shown to be a valid measure of quality of life for use in clinical settings among people with HIV in Ethiopia.
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Affiliation(s)
- Markos Tesfaye
- Department of Psychiatry, College of Health Sciences, Jimma University, Jimma, Ethiopia ; Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Mette Frahm Olsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Girmay Medhin
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Henrik Friis
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte Hanlon
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia ; Centre for Global Mental Health, Institute of Psychiatry, King's College London, London, UK
| | - Lotte Holm
- Department of Food and Resource Economics, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
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Levels of depressive symptoms may modify the relationship between the WHOQOL-BREF and its determining factors in community-dwelling older adults. Int Psychogeriatr 2016; 28:591-601. [PMID: 26674362 DOI: 10.1017/s1041610215002276] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Depression is closely associated with quality of life (QOL) in older adults. Being elderly and exhibiting mild depressive symptoms may not lead to a depression diagnosis, but these attributes are clinically important. However, the extent to which these factors influence QOL and its determinants in older adults remains unclear. METHODS Questionnaires were administered to people aged 65 years or older at community senior centers in Taiwan to collect socio-demographic information and to assess results from the brief version of the World Health Organization's Quality of Life instrument (WHOQOL-BREF), Modified Barthel Index (MBI), 15-item Geriatric Depression Scale (GDS), and Mini-Mental State Examination (MMSE). Levels of depressive symptoms were classified as no depressive symptoms (NDS), lower level of depressive symptoms (LLDS), and higher level of depressive symptoms (HLDS), corresponding to GDS = 0, 1≦GDS≦5, and GDS>5, respectively. Multiple linear regression analyses were conducted to assess associations between the WHOQOL-BREF and its covariates for different levels of depressive symptoms. RESULTS A total of 454 older adults participated. The GDS and MBI scores significantly affected the WHOQOL-BREF physical and psychological domain scores in the LLDS group. Gender influenced the WHOQOL-BREF scores in the NDS group, and increased age demonstrated protective effects on the three domains in the HLDS group. Moreover, the association between the WHOQOL-BREF and its covariates varied for different levels of depressive symptoms. CONCLUSIONS Treatment for depressive symptoms is of high priority, and early recognition of and appropriate intervention for mild depressive symptoms may improve community-dwelling older adults' QOLs.
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Chang YC, Yao G, Hu SC, Wang JD. Depression Affects the Scores of All Facets of the WHOQOL-BREF and May Mediate the Effects of Physical Disability among Community-Dwelling Older Adults. PLoS One 2015; 10:e0128356. [PMID: 26010571 PMCID: PMC4444229 DOI: 10.1371/journal.pone.0128356] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 04/25/2015] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Geriatric depression is associated with the overall quality of life (QOL). However, how depressive symptoms affect the different domains and facets of QOL in older adults, and whether depressive symptoms mediate the relationship between physical disability and QOL in older adults are unclear. METHODS A total of 490 ambulatory community-dwelling older adults aged 65 years or above were interviewed using the brief version of the World Health Organisation Quality of Life instrument (WHOQOL-BREF), the Modified Barthel Index (MBI), the 15-item Geriatric Depression Scale (GDS-15), and the Mini-Mental State Examination (MMSE). Sequential models for multiple linear regressions were analysed to determine if the MBI, GDS-15 and MMSE scores predict the WHOQOL-BREF scores. The potential mediation effects of depression (as determined by the GDS-15) on the relationship between MBI and WHOQOL-BREF were also analysed. RESULTS The GDS-15 score was predictive of the scores of the four domains and all 26 facets of the WHOQOL-BREF. The significant predictive effects of the MBI score on 15 of the 26 facets of the WHOQOL-BREF were reduced to three after the adjustment for the GDS-15 score. Depression (as assessed by the GDS-15) is a mediator of the relationship between MBI and the physical, psychological and environmental domains of the WHOQOL-BREF. CONCLUSIONS Depression (assessed by the GDS-15) may affect the scores of every domain and all facets of the WHOQOL-BREF in the elderly. Furthermore, it may mediate the relationship between the MBI and on QOL scores. We recommend taking depressive symptoms into consideration when measuring community-dwelling older adults' QOL and providing active ageing programs.
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Affiliation(s)
- Yu-Chen Chang
- Department of Community Health, Chia-Yi Christian Hospital, Chia-Yi, Taiwan
- Division of Geriatrics, Chia-Yi Christian Hospital, Chia-Yi, Taiwan
| | - Grace Yao
- Department of Psychology, National Taiwan University, Taipei, Taiwan
| | - Susan C. Hu
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jung-Der Wang
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Departments of Internal Medicine and Occuptional and Environmental Medicine, National Cheng Kung University, Tainan, Taiwan
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Yang CY, Chiou SL, Wang JD, Guo YL. Health related quality of life and polychlorinated biphenyls and dibenzofurans exposure: 30 years follow-up of Yucheng cohort. ENVIRONMENTAL RESEARCH 2015; 137:59-64. [PMID: 25490243 DOI: 10.1016/j.envres.2014.11.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 10/25/2014] [Accepted: 11/14/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Quality of life (QOL) can be affected by diseases, disasters, and exposure events to environmental factors. However, whether health-related QOL (HRQOL) might be adversely affected by exposure to dioxin-like chemicals 30 years ago is unknown. METHODS We studied people who were poisoned to polychlorinated biphenyls (PCBs) and dibebenzofurans (PCDFs) due to ingestion of contaminated rice oil in 1979 in central Taiwan, and were called Yucheng (oil-disease in Chinese) people. In 2008, we conducted a survey in 1305 exposed people by mailed questionnaire, which included HRQOL by World Health Organization (WHO) quality of life-BREF (WHOQOL-BREF) Taiwanese version. A total of 240 Yucheng subjects aged 18-65 years satisfactorily completed the Questionnaire. For comparison, we obtained information from the database of 2001 National Health Survey conducted by the National Health Research Institute and Bureau of Health Promotion, Department of Health, Taiwan. Data from age-, sex-, and county-matched background individuals were extracted using 1:3 match. HRQOL among Yucheng people with/without skin manifestation and unexposed referents were compared, while adjusting for other factors by multiple regression analyzes. RESULTS The Yucheng people had significantly reduced scores in the physical, psychological, social, and environmental domains as compared to the referents. Those with skin manifestations were more severely affected than those with no skin manifestations, suggesting a dose-related effect on QOL in exposed people. CONCLUSION We show for the very first time that poisoning due to persistent organic pollutants PCBs and PCDFs can affect QOL 30 years after the exposure, especially among those most severely poisoned.
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Affiliation(s)
- Chiu-Yueh Yang
- Department of Health Business Administration, Hung-Kuang University, Taichung, Taiwan, ROC
| | - Shiau-Ling Chiou
- Environmental and Occupational Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taiwan, ROC
| | - Jung-Der Wang
- Occupational Medicine and Industrial Hygiene, NTU College of Public Health, Taiwan, ROC; Department of Public Health, National Cheng Kung University College of Medicine, Tainan, Taiwan, ROC
| | - Yueliang Leon Guo
- Environmental and Occupational Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taiwan, ROC; Occupational Medicine and Industrial Hygiene, NTU College of Public Health, Taiwan, ROC.
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Factorial structural analysis of the Spanish version of WHOQOL-BREF: an exploratory structural equation model study. Qual Life Res 2014; 23:2205-12. [PMID: 24609387 DOI: 10.1007/s11136-014-0663-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2014] [Indexed: 01/23/2023]
Abstract
PURPOSE The purpose of this study was to analyze the factor structure of the abbreviated Spanish version of the World Health Organization Quality of Life (WHOQOL-BREF; WHOQOL Group in Psychol Med 28(3): 551-558, 1998b) questionnaire in a sample of individuals from several Spanish-speaking countries. METHOD The data were based on a sample of 1,972 undergraduates from nine Spanish-speaking countries. Within the framework of a somewhat wider research protocol, they were administered the WHOQOL-BREF. RESULTS The data were initially analyzed using a confirmatory factor analysis, which yielded a poor fit to the four-factor theoretical model. Based on these results, the best solution was estimated assuming structural invariance across countries. The data showed a four-factor structure that differed slightly from the model proposed. This four-factor model was subsequently analyzed using exploratory structural equation modeling (ESEM; Asparouhov and Muthén in Struct Equ Model 16(3): 397-438, 2009) to obtain the invariant structure across countries and an estimation of the relation between the four latent factors. The results obtained allowed us to establish that the factor structure of WHOQOL-BREF maintains the four-factor solution hypothesized for a Spanish-speaking population, although the solution has a different and more complex configuration than the original one with a clear tendency toward non-orthogonality of the latent factors. CONCLUSIONS As has been suggested by some studies on the application of ESEM, it is reasonable to think that the ESEM approximation is a useful approach for conducting the factor analysis of instruments measuring complex psychological phenomena.
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Liu J, Qu B, Hu B, Jiang N, Wang D. The quality of life of men who have sex with men in China: reliability and validity testing of the SF-36 questionnaire. PLoS One 2013; 8:e83362. [PMID: 24367592 PMCID: PMC3868567 DOI: 10.1371/journal.pone.0083362] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2013] [Accepted: 11/01/2013] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE The aim of the study was to assess the psychometric properties of the 36-Item Short Form Health Survey (SF-36) in the men who have sex with men (MSM) population in China. METHODS A cross-sectional survey was conducted among 373 MSM from September to December, 2012, in Zhengzhou and Huludao City, China. Internal reliability of the questionnaire was calculated by Cronbach's α coefficient. Validity was analyzed through construct validity, divisional validity, and collective validity testing. RESULTS The overall Cronbach's α coefficient of the SF-36 questionnaire was 0.943, while the Cronbach's α coefficients for each of the dimensions were all > 0.70. Results showed that the SF-36 questionnaire was reliable and valid. CONCLUSIONS This study provided evidence that the SF-36 is an acceptable, valid and reliable instrument in evaluating the quality of life of MSM in Mainland China.
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Affiliation(s)
- Jie Liu
- Faculty of Health Statistics, School of Public Health, China Medical University, Shenyang, China
| | - Bo Qu
- Faculty of Health Statistics, School of Public Health, China Medical University, Shenyang, China
| | - Bingxue Hu
- Faculty of Health Statistics, School of Public Health, China Medical University, Shenyang, China
| | - Nan Jiang
- Faculty of Health Statistics, School of Public Health, China Medical University, Shenyang, China
| | - Dongbo Wang
- Faculty of Health Statistics, School of Public Health, China Medical University, Shenyang, China
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A pilot study of screening, brief intervention, and referral for treatment (SBIRT) in non-treatment seeking smokers with HIV. Addict Behav 2013; 38:2541-6. [PMID: 23787030 DOI: 10.1016/j.addbeh.2013.05.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Revised: 03/06/2013] [Accepted: 05/07/2013] [Indexed: 11/23/2022]
Abstract
INTRODUCTION PLHIV have higher rates of smoking and lower motivation to quit smoking; thus to impact smoking rates, cessation interventions need to be acceptable to a wider range of PLHIV smokers as well as feasible to implement in a busy clinical setting. The purpose of this study was to evaluate the acceptability, feasibility, and effects of a Screening, Brief Intervention, and Referral for Treatment (SBIRT) model in an HIV/AIDS clinic among a sample of PLHIV. METHODS PLHIV smokers (N=40) were randomized at baseline, irrespective of their self-reported discrete smoking cessation motivation status, to receive either 8-weeks of combination nicotine replacement therapy (NRT) in conjunction with brief counseling (SBIRT framework) (n=23) or usual care (n=17). Smoking outcome measures included cigarettes smoked per day, nicotine dependence, smoking urge, and smoking withdrawal symptoms. RESULTS The SBIRT intervention appeared to be acceptable and feasible, and produced medium to large reductions in cigarettes smoked per day, physical nicotine dependence, smoking urge, and smoking withdrawal symptoms, even for smokers not ready to quit within 6months. CONCLUSIONS Findings provide preliminary support for the integration of an SBIRT model in an HIV/AIDS clinic setting to screen and provide active treatment to all smokers, regardless of readiness to quit smoking. Given the high prevalence and incredible health burden of continued smoking in this population, identifying brief and effective interventions that are easily translated into clinical practice represents an enormous challenge that if met, will yield significant improvements to overall patient outcomes.
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Giri S, Neupane M, Pant S, Timalsina U, Koirala S, Timalsina S, Sharma S. Quality of life among people living with acquired immune deficiency syndrome receiving anti-retroviral therapy: a study from Nepal. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2013; 5:277-82. [PMID: 24101885 PMCID: PMC3790835 DOI: 10.2147/hiv.s50726] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Purpose The present study was undertaken to determine the impact of acquired immune deficiency syndrome (AIDS) on the quality of life of affected individuals in Nepal. Patients and methods A cross sectional study was done among 70 individuals attending the Anti-Retroviral Therapy clinic of the University Hospital in Nepal. Quality of life (QOL) was evaluated using World Health Organization Quality of life questionnaire (WHO QOL-BREF) instrument. Statistical analysis was done using SPSS Version 17.0. Results The median scores with interquartile range (IQR) in four domains of QOL in descending order were physical (61; IQR 22), social (58; IQR 33), environmental (56; IQR 13), and psychological (54; IQR 8). Older age was associated with lower perceived overall QOL. Females were more likely to have lower QOL scores in the social and psychological domains. Higher CD4 counts and a married status were significant predictors of higher QOL scores in the environmental domain. Conclusion Being older, female, single, and having advanced clinical stage is associated with lower QOL scores in people living with AIDS. Lowest QOL scores were seen in the psychological domain suggesting the need of psychological interventions.
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Affiliation(s)
- Smith Giri
- Department of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
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Castro MMLD, Hökerberg YHM, Passos SRL. Validade dimensional do instrumento de qualidade de vida WHOQOL-BREF aplicado a trabalhadores de saúde. CAD SAUDE PUBLICA 2013; 29:1357-69. [DOI: 10.1590/s0102-311x2013000700010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O objetivo foi reavaliar a estrutura dimensional da versão brasileira do WHOQOL-BREF, consistência interna e validade fatorial convergente e discriminante. Estudo seccional em 386 trabalhadores de saúde. A análise fatorial confirmatória testou a estrutura do WHOQOL-BREF (24 e 26 itens) e a sugerida pela análise fatorial exploratória. Consistência interna foi aferida via confiabilidade composta; validade convergente e discriminante, pela variância média extraída e correlação entre fatores. O modelo de melhor ajuste foi o sugerido pela análise fatorial exploratória (26 itens) com seis fatores: quatro propostos teoricamente (geral, psicológico, relações sociais e meio ambiente) e dois pela subdivisão do domínio físico. Os itens "energia" e "segurança" (respectivamente, do físico e meio ambiente) foram remanejados para o psicológico. A confiabilidade composta foi boa (> 0,70), à exceção do fator geral. Validade convergente e discriminante foram adequadas para relações sociais e físico 2. Persistem controvérsias sobre a dimensionalidade do WHOQOL-BREF, particularmente sobre o domínio físico.
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Cook R, Jones DL, Nehra R, Kumar AM, Prabhakar S, Waldrop-Valverde D, Sharma S, Kumar M. HIV Clade-C Infection and Cognitive Impairment, Fatigue, Depression, and Quality of Life in Early-Stage Infection in Northern Indians. J Int Assoc Provid AIDS Care 2013; 15:332-7. [PMID: 23722088 DOI: 10.1177/2325957413488193] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
HIV disease progression is associated with declining quality of life and overall health status, although most research in this domain has been conducted among Western populations where B is the infecting clade. This study sought to determine the effects of early-stage clade-C HIV infection (CD4 count ≥400 cells/mm(3)) on neurocognitive functioning, cognitive depression, and fatigue by comparing a matched sample of HIV-positive and HIV-negative Northern Indians. This study also examined the impact of these factors on quality of life within the HIV-positive individuals. HIV-positive participants demonstrated reduced cognitive functioning, increased fatigue, and lower quality of life. Fatigue and cognitive impairment interacted to negatively impact quality of life. Results suggest that early-stage HIV clade-C-infected individuals may experience subclinical symptoms, and further research is needed to explore the benefit of therapeutic interventions to ensure optimal clinical outcomes and maintain quality of life in this vulnerable population.
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Affiliation(s)
- R Cook
- Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - D L Jones
- Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - R Nehra
- Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - A M Kumar
- Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - S Prabhakar
- Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - D Waldrop-Valverde
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - S Sharma
- Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
| | - M Kumar
- Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
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Li L, Liang LJ, Lee SJ, Iamsirithaworn S, Wan D, Rotheram-Borus MJ. Efficacy of an intervention for families living with HIV in Thailand: a randomized controlled trial. AIDS Behav 2012; 16:1276-85. [PMID: 22038079 DOI: 10.1007/s10461-011-0077-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
This study evaluates the efficacy of an intervention for persons living with HIV (PLH) and their family members in Thailand. A randomized controlled trial of 813 PLH and family members was carried out at four district hospitals in Thailand. Participants completed Computer Assisted Personal Interview assessments at baseline, 6, 12, 18, and 24 months. The primary outcome was quality of life (QoL); other measures included depressive symptoms and family functioning. Relative to the standard care condition, the intervention group reported significantly improved QoL at 6 months (P = 0.0014). When the intervention efficacy was stratified by baseline depressive symptoms (low vs. high), intervention efficacy was observed only among those with low depressive symptoms. Study findings suggest that the intervention was more efficacious for participants with less depressive symptoms and better family functioning. Extensive interventions may be optimal for those who have the capacity to learn the tools and skills.
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Calidad de vida relacionada con la salud en adultos con VIH/sida, Medellín, Colombia, 2009. BIOMEDICA 2011. [DOI: 10.7705/biomedica.v31i4.422] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Shan D, Ge Z, Ming S, Wang L, Sante M, He W, Zhou J, Liu S, Wang L. Quality of life and related factors among HIV-positive spouses from serodiscordant couples under antiretroviral therapy in Henan Province, China. PLoS One 2011; 6:e21839. [PMID: 21738797 PMCID: PMC3128110 DOI: 10.1371/journal.pone.0021839] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2011] [Accepted: 06/11/2011] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To describe the quality of life and related factors in HIV-positive spouses undergoing ART from discordant couples. METHODS A cross-sectional study was conducted among 1,009 HIV-positive spouses from serodiscordant couples in Zhumadian, Henan Province, between October 1, 2008 and March 31, 2009. HIV-positive spouses were interviewed by local health professionals. Quality of life was evaluated by WHOQOL (Chinese Version). A multiple linear regression model was used to analyze the related factors. RESULTS The majority of subjects were female (56.39%), had received a high school education (44%), were of Han ethnicity (98.41%), and were farmers (90.09%); the median time period of receiving ART was 3.92 years. The physical, psychological, social, and environmental QOL scores of the subjects were 12.91±1.95, 12.35±1.80, 13.96±2.43, and 12.45±1.91 respectively. The multiple linear regression model identified the physical domain related factors to be CD4 count, educational level, and occupation; psychological domain related factors include age, educational level, and reported STD symptom; social domain related factors included education level; and environmental domain related factors included education level, reported STD symptoms, and occupation. CONCLUSION Being younger, a farmer, having a lower level of education, a reported STD symptom, or lower CD4 count, could decrease one's quality of life, suggesting that the use of blanket ART programs alone may not necessarily improve quality of life. Subjects received lower scores in the psychological domain, suggesting that psychological intervention may also need to be strengthened.
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Affiliation(s)
- Duo Shan
- National Center for AIDS/STD Control & Prevention, Chinese Center for Disease Control & Prevention, Beijing, China
| | - Zeng Ge
- Fuwai Hospital and Cardiovascular Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shuai Ming
- National Center for AIDS/STD Control & Prevention, Chinese Center for Disease Control & Prevention, Beijing, China
| | - Lan Wang
- National Center for AIDS/STD Control & Prevention, Chinese Center for Disease Control & Prevention, Beijing, China
| | - Michael Sante
- National Center for AIDS/STD Control & Prevention, Chinese Center for Disease Control & Prevention, Beijing, China
| | - Wensheng He
- Zhumadian Center for Disease Control and Prevention, Zhumadian City, Henan Province, China
| | - Jianping Zhou
- Zhumadian Center for Disease Control and Prevention, Zhumadian City, Henan Province, China
| | - Shanglong Liu
- Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lu Wang
- National Center for AIDS/STD Control & Prevention, Chinese Center for Disease Control & Prevention, Beijing, China
- * E-mail:
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Canavarro MC, Pereira M, Simoes MR, Pintassilgo AL. Quality of life assessment in HIV-infection: validation of the European Portuguese version of WHOQOL-HIV. AIDS Care 2011; 23:187-94. [PMID: 21259131 DOI: 10.1080/09540121.2010.498870] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The assessment of quality of life (QOL) in HIV infection has emerged as being vital to research and clinical practice. This assessment is also a challenge due to the specific characteristics of the infection, the increased availability of therapeutics, as well as the epidemiological variability inherent to HIV infection. The purpose of this study was to investigate the psychometric properties of the European Portuguese version of the World Health Organization's QOL Instrument in HIV Infection (WHOQOL-HIV) and to test its performance in a sample of HIV-infected patients. The European Portuguese version of WHOQOL-HIV was administered in a sample of 200 HIV-positive patients. The patients also completed the Portuguese versions of Beck Depression Inventory (BDI) and Brief Symptom Inventory (BSI). The WHOQOL-HIV showed quite an acceptable internal consistency (Cronbach's α ranged from 0.86 to 0.95 across domains). Convergent validity with BDI and BSI was satisfactory for all domains (all r>0.50; p<0.001). Moreover, correlations between domains and between domains and overall QOL were all statistically significant (p<0.001). The reliability and validity studies of the European Portuguese version of the WHOQOL-HIV revealed good psychometric characteristics, which allows for the use of this version of WHOQOL in our country, and cross-cultural comparability.
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Pan AW, Chung L, Chen TJ, Hsiung PC, Rao D. Occupational Competence, Environmental Support and Quality of Life for People with Depression: A Path Analysis. AMERICAN JOURNAL OF PSYCHIATRIC REHABILITATION 2011. [DOI: 10.1080/15487768.2011.546282] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Punpanich W, Boon-yasidhi V, Chokephaibulkit K, Prasitsuebsai W, Chantbuddhiwet U, Leowsrisook P, Hays RD, Detels R. Health-related Quality of Life of Thai children with HIV infection: a comparison of the Thai Quality of Life in Children (ThQLC) with the Pediatric Quality of Life Inventory™ version 4.0 (PedsQL™ 4.0) Generic Core Scales. Qual Life Res 2010; 19:1509-16. [PMID: 20730627 PMCID: PMC2977060 DOI: 10.1007/s11136-010-9708-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2010] [Indexed: 11/22/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the reliability and validity of the Thai Quality of Life in Children (ThQLC) and compare it with the Pediatric Quality of Life Inventory (PedsQL™ 4.0) in a sample of children receiving long-term HIV care in Thailand. METHODS The ThQLC and the PedsQL™ 4.0 were administered to 292 children with HIV infection aged 8-16 years. Clinical parameters such as the current viral load, CD4 percent, and clinical staging were obtained by medical record review. RESULTS Three out of five ThQLC scales and three out of four PedsQL™ 4.0 scales had acceptable internal consistency reliability (i.e., Cronbach's alpha >0.70). Cronbach's alpha values of each scale ranged from 0.52 to 0.75 and 0.57 to 0.75 for the ThQLC and the PedsQL™ 4.0, respectively. Corresponding scales (physical functioning, emotional well-being, social functioning, and school functioning) of the ThQLC and the PedsQL™ 4.0 correlated substantially with one another (r = 0.47, 0.67, 0.59 and 0.56, respectively). Both ThQLC and PedsQL™ 4.0 overall scores significantly correlated with the child's self-rated severity of the illness (r = -0.23 for the ThQLC and -0.28 for the PedsQL™ 4.0) and the caregiver's rated overall quality of life (r = 0.07 for the ThQLC and 0.13 for the PedsQL™ 4.0). The overall score of the ThQLC correlated with clinical and immunologic categories of the United State-Centers for Disease Control and Prevention (US-CDC) classification system (r = -0.12), while the overall score of the PedsQL™ 4.0 significantly correlated with the number of disability days (r = -0.12) and CD4 percent (r = -0.15). However, the overall score from both instruments were not significantly different by clinical stages of HIV disease. A multitrait-multimethod analysis results demonstrated that the average convergent validity and off-diagonal correlations were 0.58 and 0.45, respectively. Discriminant validity was partially supported with 62% of validity diagonal correlations exceeding correlations between different domains (discriminant validity successes). The Hays-Hayashi MTMM quality index was 0.61. Multivariate regression analysis revealed that the ThQLC physical functioning scale provided unique information in predicting child self-rated severity of the illness and overall quality of life beyond that explained by the PedsQL™ 4.0 in Thai children with HIV infection. CONCLUSIONS We found evidence in support of the reliability and validity of the ThQLC and the PedsQL™ 4.0 for measuring the health-related quality of life of Thai children with HIV infection.
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Affiliation(s)
| | | | | | | | | | | | - Ron D. Hays
- UCLA School of Public Health, Los Angeles, CA USA
| | - Roger Detels
- UCLA School of Public Health, Los Angeles, CA USA
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Lu W, Zeng G, Luo J, Duo S, Xing G, Guo-Wei D, Jian-Ping Z, Wen-Sheng H, Ning W. HIV transmission risk among serodiscordant couples: a retrospective study of former plasma donors in Henan, China. J Acquir Immune Defic Syndr 2010; 55:232-238. [PMID: 21423851 PMCID: PMC3058178 DOI: 10.1097/qai.0b013e3181e9b6b7] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES: To estimate the HIV incidence and assess the behavioral, clinical, and quality-of-life risk factors for HIV transmission among serodiscordant couples from Henan Province, China. METHODS: Between January 2006 and December 2008, initially seronegative spouses were tested for HIV at six month intervals. Retrospectively identified subjects were interviewed through face-to-face questionnaire. Cox proportional-hazards model was used to assess the relationship between risk factors and HIV seroconversion. RESULTS: Out of 1927 couples, 84 (4.3%) seroconversions occurred, representing a seroconversion rate of 1.71 per 100 person-years. Seroconversion rates increased over time. Not always using condoms (RR=8.42; 95% CI, 4.83-14.67), sexual activity ≥ 4 times per month (RR=5.24; 95% CI, 2.55-10.77), not switching anti-retroviral treatment regimen (RR=1.99; 95% CI, 0.85-4.65), and a quality of life score <12 on the psychological domain (RR=2.33; 95% CI, 1.21-4.48) were associated with increased risk of seroconversion. Seventy one percent of index spouses were on ART. There was no association between rate of HIV seroconversion and last recorded CD4 cell count level of the index spouse. CONCLUSIONS: Effective HIV prevention interventions targeting discordant couples should focus on sustaining health education, increasing psychosocial support services, and increasing medication adherence monitoring.
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Affiliation(s)
- Wang Lu
- National Center for AIDS/STD Control & Prevention, Chinese Center for Disease Control & Prevention, Beijing, China
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Wang H, Zhou J, Huang L, Li X, Fennie KP, Williams AB. Effects of nurse-delivered home visits combined with telephone calls on medication adherence and quality of life in HIV-infected heroin users in Hunan of China. J Clin Nurs 2010; 19:380-8. [PMID: 20500277 DOI: 10.1111/j.1365-2702.2009.03048.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES This study aimed to examine the effects of nurse-delivered home visits combined with telephone intervention on medication adherence, and quality of life in HIV-infected heroin users. BACKGROUND Drug use is consistently reported as a risk factor for medication non-adherence in HIV-infected people. DESIGN An experimental, pretests and post-tests, design was used: baseline and at eight months. METHODS A sample of 116 participants was recruited from three antiretroviral treatment sites, and 98 participants completed the study. They were randomly assigned to two groups: 58 in the experimental group and 58 in the control group. The experimental group received nurse-delivered home visits combined with telephone intervention over eight months, while the control group only received routine care. The questionnaire of Community Programs for Clinical Research on AIDS (CPCRA) Antiretroviral Medication Self-Report was used to assess levels of adherence, while quality of life and depression were evaluated using Chinese versions of World Health Organization Quality of Life Instrument-Abbreviated version (WHOQOL-BREF) and Self-rating Depression Scale, respectively. Data were obtained at baseline and eight months. RESULTS At the end of eight months, participants in the experimental group were more likely to report taking 100% of pills (Fisher's exact = 14.3, p = 0.0001) and taking pills on time (Fisher's exact = 18.64, p = 0.0001) than those in the control group. There were significant effects of intervention in physical (F = 10.47, p = 0.002), psychological (F = 9.41, p = 0.003), social (F = 4.09, p = 0.046) and environmental (F = 4.80, p = 0.031) domains of WHOQOL and depression (F = 5.58, p = 0.02). CONCLUSIONS Home visits and telephone calls are effective in promoting adherence to antiretroviral treatment and in improving the participants' quality of life and depressive symptoms in HIV-infected heroin users. RELEVANCE TO CLINICAL PRACTICE It is important for nurses to recognise the issues of non-adherence to antiretroviral treatment in heroin users. Besides standard care, nurses should consider conducting home visits and telephone calls to ensure better health outcome of antiretroviral treatment in this population.
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Affiliation(s)
- Honghong Wang
- School of Nursing of Central South University, Changsha, Hunan, China.
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O'Brien KK, Bayoumi AM, Strike C, Young NL, King K, Davis AM. How do existing HIV-specific instruments measure up? Evaluating the ability of instruments to describe disability experienced by adults living with HIV. Health Qual Life Outcomes 2010; 8:88. [PMID: 20723244 PMCID: PMC2936441 DOI: 10.1186/1477-7525-8-88] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2010] [Accepted: 08/19/2010] [Indexed: 11/10/2022] Open
Abstract
Background Despite the multitude of health challenges faced by adults living with HIV, we know of no HIV-specific instrument developed for the purpose of describing the health-related consequences of HIV, a concept known as disability. In a previous phase of research, adults living with HIV conceptualized disability as symptoms/impairments, difficulties carrying out day-to-day activities, challenges to social inclusion, and uncertainty that may fluctuate on a daily basis and over the course of living with HIV. In this paper, we describe the extent to which existing HIV-specific health-status instruments capture the experience of disability for adults living with HIV. Methods We searched databases from 1980 to 2006 for English language, HIV-specific, self-reported questionnaires consisting of at least two items that were tested for reliability and validity. We then conducted a content analysis to assess how well existing questionnaires describe disability as defined by the Episodic Disability Framework, a framework that conceptualizes this experience from the perspective of adults living with HIV. We matched items of the instruments with categories of the framework to evaluate the extent to which the instruments capture major dimensions of disability in the framework. Results We reviewed 4274 abstracts, of which 30 instruments met the inclusion criteria and were retrieved. Of the four major dimensions of disability, symptoms/impairments were included in all 30 instruments, difficulties with day-to-day activities in 16, challenges to social inclusion in 16, and uncertainty in 9. Seven instruments contained at least 1 item from all 4 dimensions of disability (breadth) however, the comprehensiveness with which the dimensions were represented (depth) varied among the instruments. Conclusions In general, symptoms/impairments and difficulties carrying out day-to-day activities were the disability dimensions characterized in greatest depth while uncertainty and challenges to social inclusion were less well represented. Although none of the instruments described the full breadth and depth of disability as conceptualized by the Episodic Disability Framework, they provide a foundation from which to build a measure of disability for adults living with HIV.
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Affiliation(s)
- Kelly K O'Brien
- Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
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Rongkavilit C, Wright K, Chen X, Naar-King S, Chuenyam T, Phanuphak P. HIV stigma, disclosure and psychosocial distress among Thai youth living with HIV. Int J STD AIDS 2010; 21:126-32. [PMID: 20089999 DOI: 10.1258/ijsa.2009.008488] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The objective of the present paper is to assess stigma and to create an abbreviated 12-item Stigma Scale based on the 40-item Berger's Stigma Scale for Thai youth living with HIV (TYLH). TYLH aged 16-25 years answered the 40-item Stigma Scale and the questionnaires on mental health, social support, quality of life and alcohol/substance use. Sixty-two (88.6%) of 70 TYLH reported at least one person knowing their serostatus. Men having sex with men were more likely to disclose the diagnosis to friends (43.9% versus 6.1%, P < 0.01) and less likely to disclose to families (47.6% versus 91.8%, P < 0.01). Women were more likely to disclose to families (90.2% versus 62.1%, P < 0.01) and less likely to disclose to friends (7.3% versus 31%, P < 0.05). The 12-item Stigma Scale was reliable (Cronbach's alpha, 0.75) and highly correlated with the 40-item scale (r = 0.846, P < 0.01). Half of TYLH had mental health problems. The 12-item Stigma Scale score was significantly associated with mental health problems (beta = 0.21, P < 0.05). Public attitudes towards HIV were associated with poorer quality of life (beta = -1.41, P < 0.01) and mental health problems (beta = 1.18, P < 0.01). In conclusion, the12-item Stigma Scale was reliable for TYLH. Increasing public understanding and education could reduce stigma and improve mental health and quality of life in TYLH.
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Affiliation(s)
- C Rongkavilit
- Carman and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, Children's Hospital of Michigan, Detroit, MI 48201, USA.
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Yousefy AR, Ghassemi GR, Sarrafzadegan N, Mallik S, Baghaei AM, Rabiei K. Psychometric properties of the WHOQOL-BREF in an Iranian adult sample. Community Ment Health J 2010; 46:139-47. [PMID: 20063062 DOI: 10.1007/s10597-009-9282-8] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2008] [Accepted: 12/28/2009] [Indexed: 10/20/2022]
Abstract
To evaluate discriminant validity, reliability, internal consistency, and dimensional structure of the World Health Organization Quality of Life-BREF (WHOQOL-BREF) in a heterogeneous Iranian population. A clustered randomized sample of 2,956 healthy with 2,936 unhealthy rural and urban inhabitants aged 30 and above from two dissimilar Iranian provinces during 2006 completed the Persian version of the WHOQOL-BREF. We performed descriptive and analytical analysis including t-student, correlation matrix, Cronbach's Alpha, and factor analysis with principal components method and Varimax rotation with SPSS.15. The mean age of the participants was 42.2 +/- 12.1 years and the mean years of education was 9.3 +/- 3.8. The Iranian version of the WHOQOL-BREF domain scores demonstrated good internal consistency, criterion validity, and discriminant validity. The physical health domain contributed most in overall quality of life, while the environment domain made the least contribution. Factor analysis provided evidence for construct validity for four-factor model of the instrument. The scores of all domains discriminated between healthy persons and the patients. The WHOQOL-BREF has adequate psychometric properties and is, therefore, an adequate measure for assessing quality of life at the domain level in an adult Iranian population.
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Affiliation(s)
- A R Yousefy
- Medical Education Research Centre (MERC), Isfahan University of Medical Sciences, Isfahan, Iran
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Lauriola M, Murri R, Massella M, Mirra M, Donnini S, Fragola V, Ivanovic J, Pavoni M, Mancini G, Bucciardini R. A factor analytic study of the Italian National Institute of Health Quality of Life - Core Evaluation Form (ISSQoL-CEF). Patient Prefer Adherence 2010; 4:33-44. [PMID: 20361064 PMCID: PMC2846138 DOI: 10.2147/ppa.s6454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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
OBJECTIVES The Italian National Institute of Health Quality of Life - Core Evaluation Form (ISSQoL-CEF) is a specific questionnaire measuring health-related quality of life for human immunodeficiency virus-infected people in the era of highly active antiretroviral therapy. The main goal of this study was to examine the construct validity of this questionnaire by confirmation of its hypothesized dimensional structure. METHODS Baseline quality of life data from four clinical studies were collected and a confirmatory factor analysis of the ISSQoL-CEF items was carried out. Both first-order and second-order factor models were tested: Model 1 with nine correlated first-order factors; Model 2 with three correlated second-order factors (Physical, Mental, and Social Health); Model 3 with two correlated second-order factors (Physical and Mental/Social Health); Model 4 with only one second-order factor (General Health). RESULTS A total of 261 patients were surveyed. Model 1 had a good fit to the data. Model 2 had an acceptable fit to the data and it was the best of all hierarchical models. However, Model 2 fitted the data worse than Model 1. CONCLUSIONS The findings of in this study, consistent with the results of previous study, pointed out the construct validity of the ISSQoL-CEF.
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Affiliation(s)
- M Lauriola
- Department of Social and Developmental Psychology
| | - R Murri
- Catholic University of “Sacro Cuore”, Rome, Italy
| | - M Massella
- Istituto Superiore di Sanità, Rome, Italy
| | - M Mirra
- Istituto Superiore di Sanità, Rome, Italy
| | - S Donnini
- Istituto Superiore di Sanità, Rome, Italy
| | - V Fragola
- Istituto Superiore di Sanità, Rome, Italy
| | - J Ivanovic
- National Institute for Infectious Diseases Lazzaro Spallanzani, Rome, Italy
| | - M Pavoni
- Ospedale Civile Santa Maria delle Croci, Ravenna, Italy
| | - G Mancini
- Department of Infectious and Tropical Diseases, University of Rome “La Sapienza”, Rome, Italy
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Saddki N, Noor MM, Norbanee TH, Rusli MA, Norzila Z, Zaharah S, Sarimah A, Norsarwany M, Asrenee AR, Zarina ZA. Validity and reliability of the Malay version of WHOQOL-HIV BREF in patients with HIV infection. AIDS Care 2010; 21:1271-8. [PMID: 20024703 DOI: 10.1080/09540120902803216] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study determines the validity and reliability of the Malay version of the World Health Organization Quality of Life (WHOQOL) assessment instrument in patients with human immunodeficiency virus (HIV) infection. A cross-sectional study on 157 patients with HIV seen at the Infectious Disease Unit, Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan was conducted. Factor analysis identified five major domains: physical needs, spirituality, social relationship, psychological, and environment. Significant correlation was found between each domain scores and the general health questions. The instrument was able to discriminate between asymptomatic and symptomatic HIV positive patients for all domain scores except for the spirituality domain. The internal consistency of the five domains ranged from 0.70 to 0.83. The intraclass correlation coefficient (ICC) ranged from 0.60 to 0.87 across all domains. In conclusion, the Malay version of WHOQOL-HIV BREF is a valid and reliable instrument in assessing quality of life in HIV positive patients.
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Affiliation(s)
- N Saddki
- School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia.
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Deribew A, Tesfaye M, Hailmichael Y, Negussu N, Daba S, Wogi A, Belachew T, Apers L, Colebunders R. Tuberculosis and HIV co-infection: its impact on quality of life. Health Qual Life Outcomes 2009; 7:105. [PMID: 20040090 PMCID: PMC2809048 DOI: 10.1186/1477-7525-7-105] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2009] [Accepted: 12/29/2009] [Indexed: 11/15/2022] Open
Abstract
Background- Very little is known about the quality of life of tuberculosis (TB) and HIV co-infected patients. In this study in Ethiopia, we compared the quality of life HIV positive patients with and without TB. Methods- A cross sectional study was conducted from February to April, 2009 in selected hospitals in Oromiya Regional state, Ethiopia. The study population consisted of 467 HIV patients and 124 TB/HIV co-infected patients. Data on quality of life was collected by trained nurses through face to face interviews using the short Amharic version of the World Health Organization Quality of Life Instrument for HIV clients (WHOQOL HIV). Depression was assessed using a validated version of the Kessler scale. Data was collected by trained nurses and analyzed using SPSS 15.0 statistical software. Results TB/HIV co-infected patients had a lower quality of life in all domains as compared to HIV infected patients without active TB. Depression, having a source of income and family support were strongly associated with most of the Quality of life domains. In co-infected patients, individuals who had depression were 8.8 times more likely to have poor physical health as compared to individuals who had no depression, OR = 8.8(95%CI: 3.2, 23). Self-stigma was associated with a poor quality of life in the psychological domain. Conclusion- The TB control program should design strategies to improve the quality of life of TB/HIV co-infected patients. Depression and self-stigma should be targeted for intervention to improve the quality of life of patients.
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Affiliation(s)
- Amare Deribew
- Department of Epidemiology, Jimma University, Jimma, Ethiopia.
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Liang WM, Chang CH, Yeh YC, Shy HY, Chen HW, Lin MR. Psychometric evaluation of the WHOQOL-BREF in community-dwelling older people in Taiwan using Rasch analysis. Qual Life Res 2009; 18:605-18. [DOI: 10.1007/s11136-009-9471-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2007] [Accepted: 03/10/2009] [Indexed: 11/30/2022]
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Sakthong P, Schommer JC, Gross CR, Prasithsirikul W, Sakulbumrungsil R. Health utilities in patients with HIV/AIDS in Thailand. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2009; 12:377-84. [PMID: 20667064 DOI: 10.1111/j.1524-4733.2008.00440.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
OBJECTIVES We measured health utility (HU) in Thai HIV/AIDS patients using visual analog scale (VAS), EuroQOL (EQ-5D), and standard gamble (SG), determine the relationships between these HU measures and health-related quality of life (HRQOL) measures of HIV and patient characteristics, and assess the feasibility of the HU methods. METHODS A sample of 120 HIV/AIDS patients was identified at Bamrasnaradura Infectious Disease Institute, Thailand, during September to December, 2004. Face-to-face interviews included VAS, SG, and EQ-5D, HRQOL assessment using the Thai abbreviated version of the World Health Organization quality of life (WHOQOL-BREF THAI) and HIV-related symptom instruments, questions about ease of understanding HU approaches and sociodemographic items. Data were analyzed with repeated-measures ANOVA, followed by Dunn-Bonferroni t-test, intraclass coefficients (ICC), Spearman's rank correlation, and multiple linear regressions. RESULTS The mean (95% confidence interval) HUs were as follows: VAS, 0.79 (0.76-0.82); EQ-5D, 0.80 (0.77-0.84); and SG, 0.65 (0.60-0.70). A significant difference in HU by method was found (P < 0.001). Agreement by ICC was 0.71 for VAS versus EQ-5D, 0.41 for VAS versus SG, and 0.38 for EQ-5D and SG. The regression models showed that WHOQOL-BREF THAI, frequency of HIV symptoms, and patient characteristics could explain approximately 50% of the variation in the VAS and the EQ-5D and 20% in the SG(2). Among these three HU methods, the SG was the most difficult task. CONCLUSION VAS, EQ-5D and SG yielded different HUs for this sample. VAS and EQ-5D showed stronger construct validity with other health measures than SG. From a feasibility perspective, the SG was the least satisfactory of the three approaches.
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Affiliation(s)
- Phantipa Sakthong
- Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand.
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Chien CW, Wang JD, Yao G, Hsueh IP, Hsieh CL. Agreement Between the WHOQOL-BREF Chinese and Taiwanese Versions in the Elderly. J Formos Med Assoc 2009; 108:164-9. [DOI: 10.1016/s0929-6646(09)60047-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Santos ECMD, França I, Lopes F. [Quality of life of people living with HIV/AIDS in São Paulo, Brazil]. Rev Saude Publica 2008; 41 Suppl 2:64-71. [PMID: 18094788 DOI: 10.1590/s0034-89102007000900011] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2006] [Accepted: 05/23/2007] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To assess quality of life of people living with HIV/AIDS. METHODS Cross-sectional study conducted in an AIDS outpatient service based on consecutive sampling during the second half of the year 2002. There were selected 365 men and women aged 18 years or older who were attended by the infectious disease physician. Sociodemographic and recent drug use variables and data on clinical conditions were obtained using a questionnaire and quality of life was analyzed using WHOQOL-bref. RESULTS Scores of the four domains (physical, psychological, social relationships and environment) were very similar. There were statistically significant differences in mean scores for the environment domain according to skin color, with blacks and pardos having lower scores. Women also had the lowest scores for the psychological and environmental domains. Higher income was significantly associated to higher scores in all domains of quality of life, except for the social relationships domain. Subjects with CD4+ cell counts below 200 cells/mm(3) had lower scores for the physical domain. In all domains significantly lower scores were seen for those receiving psychiatric treatment or with an indication for such treatment. CONCLUSIONS Despite differences in sex, skin color, income, and mental and immunological status, people living with HIV/AIDS have better (physical and psychological) quality of life than other patients but lower quality in social relationships domain. The latter domain could reflect stigmatization and discrimination associated to the difficulties of disclosing their HIV status in social settings and for a safe sex life.
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The suitability of the World Health Organization Quality of Life Instrument-BREF in cancer relatives. Cancer Nurs 2008; 31:11-22. [PMID: 18176126 DOI: 10.1097/01.ncc.0000305678.21390.f4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The quality of life of cancer relatives should influence the justification, selection, and modification of nursing interventions in the cancer patient-family dyad. To justify these interventions, relevant, valid, and reliable quality of life assessments are needed. The purpose of this study was to examine the relevancy, validity, and reliability of the World Health Organization Quality of Life Instrument-BREF in a sample of 435 Norwegian cancer relatives. The World Health Organization Quality of Life Instrument-Short Form is a multidimensional, generic instrument designed for the assessment of quality of life cross-culturally. Cronbach alpha ranged from .59 in the social domain to .86 in the psychological domain. Correlational analysis confirmed the relevancy of the items and domains and lent partial support to the construct validity of the scale. Multivariate analyses showed that all domains were significant explanatory variables for overall quality of life and health satisfaction with the exception of the environmental domain. Subgroups effects were best shown by the physical domain. Factor analysis resulted in a 4-factor solution, with 24 items explaining 57% of the cumulative variance in this sample. Results of a confirmatory factor analyses showed reasonably good fit indices, although several covariates between the residuals had to be added, and the covariates between the factors were high. The World Health Organization Quality of Life Instrument-BREF has been translated into 40 languages. It is hoped that cancer nurses will continue to test the instrument in various groups of relatives so that scale validity and conceptual clarity can be improved and subgroup interactions confirmed.
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Miller SM, Chan F, Ferrin JM, Lin CP, Chan JYC. Confirmatory Factor Analysis of the World Health Organization Quality of Life Questionnaire—Brief Version for Individuals With Spinal Cord Injury. REHABILITATION COUNSELING BULLETIN 2008. [DOI: 10.1177/0034355208316806] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study examined the factorial structure of the World Health Organization Quality of Life Questionnaire—Brief Version in a community sample of Canadians with spinal cord injuries. A confirmatory factor analysis provides evidence that the instrument is a multidimensional measure of quality of life. Additionally, the questionnaire is correlated in the predicted directions with education, income, time since injury, self-esteem, and acceptance of disability. Implications of its use in rehabilitation counseling practice and research are discussed.
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Abstract
The aim of this study was to examine the validity and reliability of the WHOQOL-BREF, a generic quality of life scale, among older people in Canada and Norway. Very similar data from the Canadian and Norwegian Field Trial data (Canada n = 192; Norway, n = 469) were analyzed and compared. Higher negatively skewed mean scores were found for all WHOQOL-BREF domains in Canada. For both study samples, missing values were highest for the sex item from the social domain. Ceiling effects were found (Canada n = 21; Norway n = 11) primarily among items in the physical and environmental domains. In both study samples, a multitrait multimethod procedure indicated items correlated most strongly with their parent domains; however, equally appreciable correlations were observed between physical, psychological, and environmental items (r = 0.33-0.64; p < 0.01). The social domain had the lowest internal consistency (α = 0.67 Canada, α = 0.55 Norway). Confirmatory factor analyses (CFA) yielded marginal goodness-of-fit between the hypothesized WHOQOL-BREF measurement model and the sample data as well as differing patterns of domain misspecification. Patterns of correlations (p < 0.01) of WHOQOL-BREF domains with WHOQOL-OLD facets, a global QOL item, the SF-12, and the geriatric depression scale provided evidence of convergent and divergent validity. Domain scores also significantly discriminated between health and unhealthy populations and presence of morbidity. Empirical support was found, in part, for the construct validity of the WHOQOL-BREF in older adults. Despite some different patterns found in the CFA, possibly due to cultural or sampling differences, it appears that the instrument is reliable, valid, and facilitates cross-cultural comparisons.
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Fang CT, Chang YY, Hsu HM, Twu SJ, Chen KT, Chen MY, Huang LYL, Hwang JS, Wang JD. Cost-effectiveness of Highly Active Antiretroviral Therapy for HIV Infection in Taiwan. J Formos Med Assoc 2007; 106:631-40. [PMID: 17711796 DOI: 10.1016/s0929-6646(08)60020-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/PURPOSE Since the late 1980s, the Taiwanese government has provided all HIV-infected citizens with free access to antiretroviral therapy. Recently, there is controversy as to whether or not free access to expensive highly active antiretroviral therapy (HAART) should be continued for HIV-infected patients. This study aimed to evaluate the cost-effectiveness of HAART therapy. METHODS HAART-associated improvement in survival was obtained by analyzing the follow-up data of all HIV-positive patients identified during April 1984 to March 1997 (pre-HAART era) and May 1997 to April 2003 (HAART era) in Taiwan. Data on quality of life in HIV-positive patients was obtained from a cross-sectional survey of 224 patients using standard gamble method and World Health Organization Quality of Life-BREF instrument. Information regarding the cost of HAART was obtained from the National Health Insurance (NHI). RESULTS In 2000, the average annual NHI expenditure on HAART per HIV-positive patient receiving HAART was NT$210,018 (US$6177, at an exchange rate of 34.0 NT$/US$). In the AIDS group, the cost was NT$176,441 (US$5189) per life year gained and NT$241,700 (US$7109) per quality-adjusted life year gained. For non-AIDS patients, the corresponding costs were NT$226,156 (US$6652) and NT$332,582 (US$9782), respectively. These estimates have not yet included the additional cost savings from HAART-associated reduction in hospitalization and use of antimicrobial agents for opportunistic infections, and the additional life years gained from the reduction in HIV transmission under the universal availability of HAART. CONCLUSION HAART for HIV infection is cost-effective, especially when the societal and epidemiologic factors are considered. We recommend that the policy of providing free HAART to all HIV-infected citizens be continued.
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Affiliation(s)
- Chi-Tai Fang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Chien CW, Wang JD, Yao G, Sheu CF, Hsieh CL. Development and validation of a WHOQOL-BREF Taiwanese audio player-assisted interview version for the elderly who use a spoken dialect. Qual Life Res 2007; 16:1375-81. [PMID: 17638120 DOI: 10.1007/s11136-007-9236-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2007] [Accepted: 06/24/2007] [Indexed: 11/29/2022]
Abstract
A quality of life questionnaire is rarely adapted to an interview mode for people who mainly use spoken language in daily life. In Taiwan, the WHOQOL-BREF (Mandarin Chinese version) has been developed, as a self-administered questionnaire, but it cannot be applied to the majority of the elderly in Taiwan, who speak only Taiwanese (a dialect). This study adopted the audio player-assisted interview mode to develop a Taiwanese version of the WHOQOL-BREF specifically for Taiwanese-speaking elderly people, and followed with examinations of the reliability and validity of this version. Initially, the WHOQOL-BREF (English version) was translated into colloquial Taiwanese, and field tests confirmed the equivalence and appropriateness of the translation. A total of 228 Taiwanese-speaking elderly people were assessed using the Taiwanese interview version, of which 144 subjects were re-assessed two weeks later. Interviewers assessed each subject aided by an audio player on which all the translated WHOQOL-BREF contents were recorded. The Taiwanese interview version of the WHOQOL-BREF, except for the item related to dependence on medication, showed acceptable reliability (internal consistency, corrected item-domain correlation, and test-retest reliability) and validity (criterion-related, convergent, and discriminant validity). Confirmatory factor analyses supported the four-factor model of the Taiwanese interview version, providing evidence for construct validity. The results suggest that the Taiwanese audio player-assisted interview version of the WHOQOL-BREF was reliable and valid in assessing quality of life of elderly Taiwanese.
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Affiliation(s)
- Chi-Wen Chien
- Department of Occupational Therapy, School of Primary Health Care, Faculty of Medicine, Nursing, and Health Sciences, Monash University - Peninsula Campus, Frankston, VIC, Australia
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Paulik E, Belec B, Molnár R, Müller A, Belicza E, Kullmann L, Nagymajtényi L. [Applicability of the abbreviated version of the World Health Organization's quality of life questionnaire in Hungary]. Orv Hetil 2007; 148:155-60. [PMID: 17344129 DOI: 10.1556/oh.2007.27854] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Quality of life, as a subjective parameter of the general condition, is suitable for characterization of the health status of populations or patient groups, and for studying the effects of therapeutic or preventive interventions. AIMS To test the applicability and reliability in Hungary of the abbreviated form of the quality of life questionnaire developed by WHO, one of several ways to measure the quality of life. METHODS Questionnaire-based cross-sectional investigation was performed among altogether 814 persons, in small settlements of population under 1000 and 2000, and in a small town for control, in Csongrád county, Hungary. The reliability and validity of the quality of life questionnaire was tested, within each group of questions, by means of Cronbach's alpha, ANOVA and Kruskal-Wallis tests, and by Spearman's rho correlation coefficient. RESULTS The mean values of the four domains of quality of life - physical, psychological, social and environmental - showed no noteworthy differences. The Cronbach's alpha figures of the internal consistency test on separate groups of questions and on all questions were in all cases above the expected minimum of 0.7. The means calculated for each domain of quality of life were decreasing with increasing age. Healthy people estimated each aspect of quality of life as significantly better, compared to the sick. Correlation tests showed that all dimensions of the quality of life were in close positive correlation with the general quality of life, with the level of satisfaction with the own health, with the self-assessed health, and with the responses given on other questions related to the social or health situation of the questioned. CONCLUSION The variation of the questionnaire, adapted to Hungarian conditions, proved to be suitable for testing the quality of life of persons with various demographical, social and health conditions, and for distinction between the healthy and the sick. The sheet, which can be filled in quickly and easily, enables the measurement of quality of life in the Hungarian population, and the comparison of that with international data.
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Affiliation(s)
- Edit Paulik
- Szegedi Tudományegyetem, Altalános Orvostudományi Kar Népegészségtani Intézet Szeged Dóm tér 10. 6720.
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Jaracz K, Kalfoss M, Górna K, Baczyk G. Quality of life in Polish respondents: psychometric properties of the Polish WHOQOL-Bref. Scand J Caring Sci 2006; 20:251-60. [PMID: 16922978 DOI: 10.1111/j.1471-6712.2006.00401.x] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of this study was to examine the validity and reliability of the Polish WHOQOL - Bref in a sample of 908 respondents. The Bref is a generic quality of life (QoL) instrument designed for cross - cultural use. Correlational and multivariate analyses confirmed the relevancy of individual items and domains supporting the construct validity of the scale. Multiple regression analyses of the domain scores with two overall questions (dependent variable) showed that all four domains made a significant contribution in explaining the variance in overall QoL. The psychological domain made the strongest contribution (unstandardized B coefficient = 0.10, r2 = 0.41), followed by the social, environmental and physical domains. When overall health satisfaction was considered as the dependent variable, the physical domain contributed most strongly (unstandardized B coefficient = 0.21, r2= 0.43) followed by the psychological and environmental domains. Exploratory factor analyses resulted in a four factors solution with 24 items explaining 49.6% of the cumulative variance. Confirmatory factor analyses lended marginal support for the goodness of fit of the four-domain model. The physical domain was found to be strongest in differentiating between unhealthy and healthy subjects, followed by psychological and social domains. Acceptable internal consistency was shown with Cronbach's alpha coefficients being greater than 0.70 for all domains with the exception of the social domain. Further exploration of the scales validity and conceptual clarity need further testing in Polish and international samples.
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Affiliation(s)
- Krystyna Jaracz
- Department of Neurological and Psychiatric Nursing, Faculty of Health Sciences, University of Medical Sciences, Poznań, Poland.
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Torng PL, Chang WC, Hwang JS, Hsu WC, Wang JD, Huang SC, Chen CF, Su TC. Health-related quality of life after laparoscopically assisted vaginal hysterectomy: Is uterine weight a major factor? Qual Life Res 2006; 16:227-37. [PMID: 17033893 DOI: 10.1007/s11136-006-9123-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2006] [Accepted: 08/31/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To assess uterine size, symptom severity, and hemoglobin level as determinants of health-related quality of life (HRQOL) in women subsequently undergoing laparoscopically assisted vaginal hysterectomy (LAVH). METHODS Sixty-one consecutive women with uterine leiomyoma or adenomyosis undergoing LAVH were studied using a prospective cohort design. The Chinese version of the Uterine Fibroid Symptom and Quality of Life (UFS-QOL) questionnaire was assessed preoperatively. The Taiwan brief version of the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire and a self-assessment of the perceived health status were assessed preoperatively and 1 day, 1 week, 12 weeks, and 18 months postoperatively. RESULTS Women with a greater uterine weight did not report a greater severity of symptoms than those with lower uterine weight. Women with more severe symptoms had lower preoperative hemoglobin levels and were usually younger. Their perceived health status and their scores in physical domain of WHOQOL-BREF were also significantly lower, indicating a poorer HRQOL. The mixed-effects model found that a normal (higher) baseline hemoglobin level and a greater symptom severity were associated with a significant improvement of HRQOL in the physical domain of WHOQOL-BREF following LAVH. CONCLUSIONS Preoperative symptom severity, but not uterine weight, was associated with long-term improvement in HRQOL after LAVH. Women with severe symptoms could be considered for LAVH before development of anemia.
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Affiliation(s)
- Pao-Ling Torng
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
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Ackerman IN, Graves SE, Bennell KL, Osborne RH. Evaluating quality of life in hip and knee replacement: Psychometric properties of the World Health Organization Quality of Life short version instrument. ACTA ACUST UNITED AC 2006; 55:583-90. [PMID: 16874780 DOI: 10.1002/art.22107] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To evaluate the psychometric properties of the World Health Organization Quality of Life short version instrument (WHOQOL-BREF), and to determine its responsiveness in assessing early outcome after total hip or knee replacement surgery. METHODS At baseline (entry to an orthopedic waiting list), 279 participants completed the WHOQOL-BREF instrument, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Assessment of Quality of Life (AQOL) instrument, Kessler Psychological Distress (K10) scale, and the modified Health Assessment Questionnaire (MHAQ). A total of 74 patients completed reassessments 3 months after surgery. RESULTS The WHOQOL-BREF demonstrated acceptable internal consistency for all domains (Cronbach's alpha = 0.76-0.84) and moderate concurrent validity for the physical and psychological domains (r = 0.67 for physical versus AQOL; r = -0.71 for psychological versus K10). Minimal ceiling or floor effects were identified at baseline or 3 months, except for the social relationships domain. The disease-specific WOMAC subscales were most responsive to change (relative efficiency [RE] 0.66-1.00). Apart from social relationships, all WHOQOL-BREF scores improved significantly after surgery. The physical domain was more responsive than the AQOL (RE 0.50 versus 0.42) and was similar to the MHAQ (RE 0.55 for MHAQ). The responsiveness of the psychological domain was similar to that of the K10 scale (RE 0.11 versus 0.08). CONCLUSION The WHOQOL-BREF has good psychometric properties for use in persons with severe joint disease, and by providing complementary information, it offers clinicians and researchers an additional tool for comprehensively assessing quality of life in this patient group.
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Affiliation(s)
- Ilana N Ackerman
- University of Melbourne, Royal Melbourne Hospital, Parkville, Victoria, Australia.
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Lai JN, Hwang JS, Chen HJ, Wang JD. Finished herbal product as an alternative treatment for menopausal symptoms in climacteric women. J Altern Complement Med 2006; 11:1075-84. [PMID: 16398600 DOI: 10.1089/acm.2005.11.1075] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There is a paucity of scientific evidence supporting the efficacy of herbal medicines in treating menopausal symptoms. OBJECTIVE The aim of this study was to evaluate safety and efficacy of the finished herbal product TMN-1 in the treatment of menopausal symptoms in climacteric women. DESIGN AND SETTING A multicenter, prospective, observational follow-up study was conducted from July 2003 to December 2004 in four hospitals in Taiwan. PARTICIPANTS Initially, 126 women were included who were between 45 and 55 years of age, were experiencing hot flashes, and were without hormone replacement therapy. Women were excluded if they had any signs of active cancer. Of the participants, 82% completed the study. The reasons for withdrawal included adverse effects (n = 7), failed to return (n = 7), lack of efficacy (n = 6), and from protocol deviation (n = 3). INTERVENTION Every participant received TMN-1 treatment 4 g, 3 times per day, for 12 weeks. MAIN OUTCOME MEASURE Primary measures were change in frequency of hot flashes and severity of menopausal symptoms measured by Kupperman Index (KI). Secondary outcomes included changes in quality of life and adverse events. RESULTS Significant improvement in scores of hot flashes and KI were found at weeks 4 and 12 in the 50 peri- and 53 postmenopausal women who completed this study (p < 0.001). Logistic regression analyses showed that perimenopausal women with hot flashes had sevenfold (95% confidence interval [CI], 1.8-28.0) odds of improvement in favor of treatment, whereas that of the postmenopausal group was 1.5 (95% CI, 0.5 to 4.2). Further analyses showed that TMN-1 produced superior benefit in women with moderate and severe menopausal symptoms (KI > or = 21), compared to those with mild symptoms. It also improved symptoms of insomnia, nervousness, melancholia, and palpitation in perimenopausal women. Five (5) adverse drug reactions were detected: three single events of nausea, abdominal pain, and abdominal fullness; and two events of diarrhea. CONCLUSIONS This study provides evidence that 12 weeks of TMN-1 therapy is a viable alternative treatment to consider in perimenopausal women with hot flashes, particularly in those with palpitations, emotional disturbance, and insomnia.
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Affiliation(s)
- Jung-Nein Lai
- Department of Obstetrics and Gynecology; Department of Chinese Medicine, Taipei Municipal Yang Ming Hospital, Taipei, Taiwan
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von Steinbüchel N, Lischetzke T, Gurny M, Eid M. Assessing quality of life in older people: psychometric properties of the WHOQOL-BREF. Eur J Ageing 2006; 3:116-122. [PMID: 28794757 DOI: 10.1007/s10433-006-0024-2] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The World Health Organization has developed a brief generic questionnaire to assess quality of life, the WHOQOL-BREF. It has been studied in diverse groups, but not specifically in older people. The purpose of this study was to analyze the psychometric properties of the French version of the WHOQOL-BREF questionnaire in healthy older people and to compare the mean profiles of participants with the mean profile obtained in the international validation study of the WHOQOL-BREF. Of the total sample of 262 Swiss French speaking older participants, 122 completed a retest after 2 weeks. The WHOQOL-BREF items demonstrated high test-retest reliability and validity. The WHOQOL-BREF items were differentially related to physical and mental health measures (SF-12 components, morbidity, and depression), thereby demonstrating convergent and discriminant validity. Compared to the international validation sample of the WHOQOL-BREF, participants of the present study reported higher QOL on 22 of the 26 items. A comparison of item profiles between male and female participants revealed gender differences for two items only (social support and negative feelings). We conclude that the psychometric properties of the WHOQOL-BREF items in older adults are good. To consider the 24 specific facets that are assessed by the WHOQOL-BREF appropriately, we recommend using item profiles on the individual and the sample level.
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Affiliation(s)
- Nicole von Steinbüchel
- Department of Medical Psychology and Medical Sociology, University Clinic, University of Gottingen, 37099 Göttingen, Germany.,Center for Neurogerontopsychology, University Clinic, University of Geneva, Geneva, Switzerland.,Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Tanja Lischetzke
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Madeleine Gurny
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Michael Eid
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
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