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Scott JET, Mazzucchelli TG, Luszcz MA, Walker R, Windsor TD. Self-Compassion, Stressor Exposure, and Negative Affect: A Daily Diary Study of Older Adults. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae101. [PMID: 38822622 DOI: 10.1093/geronb/gbae101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Indexed: 06/03/2024] Open
Abstract
OBJECTIVES Self-compassion has been identified as a psychological resource for aging well. To date, self-compassion among older adults has typically been conceptualized as a trait variable. This study examined whether day-to-day (state) variability in self-compassion was associated with negative affective reactivity to daily stressors. METHODS Daily diary assessment methods were used to examine the potential moderating role of between- and within-person self-compassion on the relationship between daily stressors and negative affect. A community-based sample of 107 older adults aged 65+ completed questionnaires once daily over 14 days. RESULTS Multilevel modeling revealed that 37% of the variance in self-compassion occurred within persons. Daily self-compassion moderated the relationship between daily stressor exposure and daily negative affect. On days with greater stressor exposure than usual, older adults showed less negative affective reactivity on days when self-compassion was higher, compared with days when self-compassion was lower. No moderating effects were observed for between-person (trait) self-compassion. DISCUSSION These findings suggest that self-compassion in older adults should be conceptualized as both state and trait variables and that state self-compassion may be protective in the stress-reactivity pathway. Future research should investigate whether brief self-compassion interventions might help older adults to avoid or downregulate negative emotions in response to stressors.
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Affiliation(s)
- Julia E T Scott
- College of Education, Psychology and Social Work, Flinders Institute for Mental Health and Wellbeing, Flinders University, Adelaide, South Australia, Australia
| | | | - Mary A Luszcz
- College of Education, Psychology and Social Work, Flinders Institute for Mental Health and Wellbeing, Flinders University, Adelaide, South Australia, Australia
| | - Ruth Walker
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
| | - Tim D Windsor
- College of Education, Psychology and Social Work, Flinders Institute for Mental Health and Wellbeing, Flinders University, Adelaide, South Australia, Australia
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Eagle SR, Basantani MK, Preszler J, Sherry N, McIntyre P, Kershaw EE, Puccio AM, Okonkwo DO. Interaction of obesity and proteins associated with the NLRP3 inflammasome following mild traumatic brain injury. Sci Rep 2024; 14:10178. [PMID: 38702410 PMCID: PMC11068868 DOI: 10.1038/s41598-024-61089-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 04/30/2024] [Indexed: 05/06/2024] Open
Abstract
The NOD-like receptor pyrin domain-containing protein 3 (NLRP3) inflammasome has been associated with worse outcomes from severe traumatic brain injury (TBI). The NLRP3 inflammasome is also strongly associated with other pro-inflammatory conditions, such as obesity. Little is known about the potential effect of mild TBI (mTBI) on the NLRP3 inflammasome and the extent to which modifying factors, such as obesity, may augment the inflammatory response to mTBI. The purpose of this study was to evaluate the association of NLRP3 inflammasome proteins with obese body mass index (BMI ≥ 30) within 24 h of mTBI after presenting to a level 1 trauma center emergency department. This is a secondary analysis of prospectively enrolled patients with mTBI who presented to the emergency department of one U.S. Level 1 trauma center from 2013 to 2018 (n = 243). A series of regression models were built to evaluate the association of NLRP3 proteins obtained from blood plasma within 24 h of injury and BMI as well as the potential interaction effect of higher BMI with NLRP3 proteins (n = 243). A logistic regression model revealed a significant association between IL-18 (p < 0.001) in mTBI patients with obese BMI compared to mTBI patients with non-obese BMI (< 30). Moderation analyses revealed statistically significant interaction effects between apoptotic speck-like protein (ASC), caspase-1, IL-18, IL-1β and obese BMI which worsened symptom burden, quality of life, and physical function at 2 weeks and 6 months post-injury. Higher acute concentrations of IL-1β in the overall cohort predicted higher symptoms at 6-months and worse physical function at 2-weeks and 6-months. Higher acute concentrations of IL-18 in the overall cohort predicted worse physical function at 6-months. In this single center mTBI cohort, obese BMI interacted with higher acute concentrations of NLRP3 inflammasome proteins and worsened short- and long-term clinical outcomes.
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Affiliation(s)
- Shawn R Eagle
- Department of Neurological Surgery, University of Pittsburgh, 3550 Terrace St, Pittsburgh, PA, 15261, USA.
| | - Mahesh K Basantani
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Natalie Sherry
- Department of Neurological Surgery, University of Pittsburgh, 3550 Terrace St, Pittsburgh, PA, 15261, USA
| | - Peyton McIntyre
- Department of Neurological Surgery, University of Pittsburgh, 3550 Terrace St, Pittsburgh, PA, 15261, USA
| | - Erin E Kershaw
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ava M Puccio
- Department of Neurological Surgery, University of Pittsburgh, 3550 Terrace St, Pittsburgh, PA, 15261, USA
| | - David O Okonkwo
- Department of Neurological Surgery, University of Pittsburgh, 3550 Terrace St, Pittsburgh, PA, 15261, USA
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Luo C, Deng Z, Li J, Li Z, Wang L, Ran L, Song Y, Huang S, Wang L, Ma L. Health-related Quality of Life (HRQOL) Outcomes of Selective/Nonselective Thoracic Fusion for Lenke 1C Adolescent Idiopathic Scoliosis (AIS) Patients with a Minimum 4-year Follow-up. Orthop Surg 2024; 16:429-436. [PMID: 38191983 PMCID: PMC10834217 DOI: 10.1111/os.13977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 11/23/2023] [Accepted: 11/27/2023] [Indexed: 01/10/2024] Open
Abstract
OBJECTIVE Both the selective thoracic fusion (STF) and nonselective thoracic fusion (NSTF) are treatments for Lenke 1C adolescent idiopathic scoliosis (AIS). To date, the impacts of the two surgical strategies on patients' long-term quality of life remain unclear. Therefore, the purpose of this study was to explore the long-term effects of STF/NSTF on the quality of life in Lenke 1C AIS patients through a 4-10-year follow-up. METHODS From January 2011 to April 2018, according to the inclusion and exclusion criteria, a retrospective single-center study of 75 surgical patients with Lenke 1C curves was performed (n = 75). They all underwent posterior fusion, and patients were divided into the selective thoracic fusion (STF) group (n = 42) and the nonselective thoracic fusion (NSTF) group (n = 33) based on their surgical approach. All participants received the survey of the visual analogue scale (VAS), SRS30, SF12, and Oswestry disability index (ODI) scales. Patients' gender, age, body mass index (BMI), surgical approach (STF/NSTF), surgical segments (UIV and LIV), follow-up time, complications, preoperative, postoperative, and last follow-up Cobb angles, and health-related quality of life (HRQOL) outcomes were collected, and analyzed through the Shapiro-Wilks test, Wilcoxon rank-sum test, t-test, and χ2 test. RESULTS The mean follow-up of the entire cohort was 73 ± 5.6 months. The lumbar Cobb angle in the STF group improved from 31.8 ± 6.5° to 11.5 ± 5.1° after the operation and 10.3 ± 6.9° at the last follow-up. The postoperative correction rate of the lumbar curve was 63.8%, which increased to 67.7% at the last follow-up. In the NSTF group, the lumbar Cobb angle improved from 34.3 ± 11.3° to 4.3 ± 3.7° after the operation, and was 5.1 ± 3.1° at the last follow-up. The postoperative correction rate of the lumbar curve was 87.4%, and 85.1% at the last follow-up. At the last follow-up, the STF group had higher overall HRQOL scores than the NSTF group, and there were statistically differences between the different groups (STF/NSTF) in SRS-30-Mental health (p = 0.03), SRS-30-Satisfaction with management (p = 0.02), SRS-30-Pain (p = 0.03), ODI (p = 0.01), SF-12 PCS (p = 0.03), VAS back pain (p = 0.005) and VAS leg pain (p = 0.001). No statistically differences were found in SF12 MCS, SRS-30-Self-image/Appearance and SRS-30 Function/activity. CONCLUSION After 4-10 years of follow-up, we found that the STF group achieved satisfactory correction results, and compared with the NSTF group, their overall HRQOL scores were higher, especially in terms of pain and satisfaction, where the STF group shows a significant advantage.
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Affiliation(s)
- Chuan Luo
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Zhipeng Deng
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Junhu Li
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Zhuhai Li
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Lihang Wang
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Liyu Ran
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Yueming Song
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Shishu Huang
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Lei Wang
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Litai Ma
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
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Greene ME, Goldman RE, Hutter MM. Selection of patient-reported outcomes measures for implementation in the Metabolic and Bariatric Surgery Accreditation Quality Improvement Program. Surg Obes Relat Dis 2023; 19:897-906. [PMID: 37037688 DOI: 10.1016/j.soard.2023.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/15/2022] [Accepted: 01/29/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND The Metabolic and Bariatric Surgery Accreditation Quality Improvement Program (MBSAQIP) assesses safety after metabolic and bariatric surgery and the impact on weight and obesity-related diseases. However, changes in quality of life are likely what matters most to patients, and these are not currently assessed. The best way to measure health-related quality of life (HRQoL) is to use validated patient-reported outcomes measures (PROMs), which capture patients' perspectives of their quality of life both before and after surgery. OBJECTIVES Identify the outcomes most important to bariatric surgery patients and identify the most appropriate validated PROMs to implement in a national program for the MBSAQIP. SETTING Five hospitals from a single healthcare system in New England. METHODS A series of 18 focus groups and/or interviews conducted with patients, patients' family members, and bariatric health providers determined the outcomes most important to bariatric patients and which validated PROMs would accurately measure those outcomes. Immersion crystallization was used to analyze focus group data and identify appropriate PROMs. RESULTS Focus group participants ranked health as the most important outcome for metabolic and bariatric surgery. Self-confidence, mobility, and everyday activities were the next highest ranked HRQoL domains. The Patient-Reported Outcomes Measurement Information System 10-Item Global Health Survey was selected as the general health measure. The Obesity-Related Problems scale and the Obesity and Weight-Loss Quality of Life Instrument were the disease-specific measures selected for inclusion in the MBSAQIP PROMs program. CONCLUSION The addition of PROMs to the MBSAQIP provides a unique opportunity to monitor HRQoL at the national level, which can foster improved shared decision-making before surgery.
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Affiliation(s)
- Meridith E Greene
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | | | - Matthew M Hutter
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.
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Craig LS, Cunningham-Myrie CA, Theall KP, Gustat J, Hernandez JH, Hotchkiss DR. Multimorbidity patterns and health-related quality of life in Jamaican adults: a cross sectional study exploring potential pathways. Front Med (Lausanne) 2023; 10:1094280. [PMID: 37332764 PMCID: PMC10272613 DOI: 10.3389/fmed.2023.1094280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 05/09/2023] [Indexed: 06/20/2023] Open
Abstract
Introduction Multimorbidity and health-related quality of life (HRQoL) are intimately linked. Multiple chronic conditions may adversely affect physical and mental functioning, while poorer HRQoL may contribute to the worsening course of diseases. Understanding mechanisms through which specific combinations of diseases affect HRQoL outcomes can facilitate identification of factors which are amenable to intervention. Jamaica, a middle-income country with high multimorbidity prevalence, has a health service delivery system dominated by public sector provision via a broad healthcare network. This study aims to examine whether multimorbidity classes differentially impact physical and mental dimensions of HRQoL in Jamaicans and quantify indirect effects on the multimorbidity-HRQoL relationship that are mediated by health system factors pertaining to financial healthcare access and service use. Materials and methods Latent class analysis (LCA) was used to estimate associations between multimorbidity classes and HRQoL outcomes, using latest available data from the nationally representative Jamaica Health and Lifestyle Survey 2007/2008 (N = 2,551). Multimorbidity measurement was based on self-reported presence/absence of 11 non-communicable diseases (NCDs). HRQoL was measured using the 12-item short-form (SF-12) Health Survey. Mediation analyses guided by the counterfactual approach explored indirect effects of insurance coverage and service use on the multimorbidity-HRQoL relationship. Results LCA revealed four profiles, including a Relatively Healthy class (52.7%) characterized by little to no morbidity and three multimorbidity classes characterized by specific patterns of NCDs and labelled Metabolic (30.9%), Vascular-Inflammatory (12.2%), and Respiratory (4.2%). Compared to the Relatively Healthy class, Vascular-Inflammatory class membership was associated with lower physical functioning (β = -5.5; p < 0.001); membership in Vascular-Inflammatory (β = -1.7; p < 0.05), and Respiratory (β = -2.5; p < 0.05) classes was associated with lower mental functioning. Significant mediated effects of health service use, on mental functioning, were observed for Vascular-Inflammatory (p < 0.05) and Respiratory (p < 0.05) classes. Conclusion Specific combinations of diseases differentially impacted HRQoL outcomes in Jamaicans, demonstrating the clinical and epidemiological value of multimorbidity classes for this population, and providing insights that may also be relevant to other settings. To better tailor interventions to support multimorbidity management, additional research is needed to elaborate personal experiences with healthcare and examine how health system factors reinforce or mitigate positive health-seeking behaviours, including timely use of services.
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Affiliation(s)
- Leslie S. Craig
- Department of Medicine, School of Medicine, Tulane University, New Orleans, LA, United States
| | | | - Katherine P. Theall
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
| | - Jeanette Gustat
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
| | - Julie H. Hernandez
- Department of International Health and Sustainable Development, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
| | - David R. Hotchkiss
- Department of International Health and Sustainable Development, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
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Huang W, Wu Q, Zhang Y, Tian C, Huang H, Huang S, Zhou Y, He J, Wang H. Preliminary evaluation of the Chinese version of the patient-reported outcomes measurement information system 29-item profile in patients with aortic dissection. Health Qual Life Outcomes 2022; 20:94. [PMID: 35701761 PMCID: PMC9195330 DOI: 10.1186/s12955-022-02000-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/29/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Patient-Reported Outcomes Measurement Information System 29-item Profile (PROMIS-29) has been widely used to measure health outcomes from the patient's perspective. It has not been validated in adults with aortic disease. The aim of this study was to explore the reliability and validity of the Chinese PROMIS-29 among patients undergoing surgery for aortic dissection (AD). METHODS A cross-sectional design was applied. Eligible patients completed a questionnaire that contained the PROMIS-29 and legacy measures, including the Short Form-12 Health Survey (SF-12), 8-item Somatic Symptom Scale (SSS-8), Generalized Anxiety Disorder-2 (GAD-2), and Patient Health Questionnaire-2 (PHQ-2). The structural validity of the PROMIS-29 was evaluated using confirmatory factor analysis (CFA). Reliability was evaluated with Cronbach's α. Construct validity was assessed by calculating Spearman's rank correlations and comparing known-group differences. RESULTS In total, a sample of 327 AD patients was included in the final analysis. Most of them were male (89%) with a mean age of 52.7 (± 10.3). CFA revealed good model fit of the seven-factor structure within PROMIS-29, as well as most domains in single-factor analysis. Reliability was confirmed with Cronbach's α > 0.90. Correlations between comparable domains of the PROMIS-29 and those of legacy questionnaires and most know-group comparisons were observed as hypothesized. CONCLUSIONS This study found evidence for acceptable structural validity, construct validity and internal consistency of the PROMIS-29 in a sample of AD patients. It can be applied to AD survivors by researchers or clinicians, measuring outcomes after surgery and identifying those with worse health status.
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Affiliation(s)
- Wanbing Huang
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jie Fang Avenue 1095, Qiaokou District, Wuhan, 430030, China.,School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Qiaokou District, Wuhan, 430030, China
| | - Qiansheng Wu
- Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jie Fang Avenue 1095, Qiaokou District, Wuhan, 430030, China
| | - Yufen Zhang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Qiaokou District, Wuhan, 430030, China
| | - Chong Tian
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Qiaokou District, Wuhan, 430030, China
| | - Haishan Huang
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jie Fang Avenue 1095, Qiaokou District, Wuhan, 430030, China
| | - Sufang Huang
- Department of Emergency, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jie Fang Avenue 1095, Qiaokou District, Wuhan, 430030, China
| | - Yanrong Zhou
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jie Fang Avenue 1095, Qiaokou District, Wuhan, 430030, China
| | - Jing He
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Qiaokou District, Wuhan, 430030, China
| | - Hui Wang
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jie Fang Avenue 1095, Qiaokou District, Wuhan, 430030, China.
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Lin Y, Yu Y, Zeng J, Zhao X, Wan C. Comparing the reliability and validity of the SF-36 and SF-12 in measuring quality of life among adolescents in China: a large sample cross-sectional study. Health Qual Life Outcomes 2020; 18:360. [PMID: 33168020 PMCID: PMC7654067 DOI: 10.1186/s12955-020-01605-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 10/20/2020] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE We compare the reliability and validity of the Short Form 36 (version 1, SF-36) and the Short Form 12 (version 1, SF-12) in adolescence, the period of life when a child develops into an adult, i.e., the period from puberty to maturity terminating legally at the age of majority (10-19 years), thus supplying evidence for the selection of instruments measuring the quality of life (QOL) and decision-making processes of adolescents in China. METHODS Stratified cluster random sampling was adopted according to geographical location, and the SF-36 was administered to assess QOL. The Pearson correlation coefficient was used to show correlation. Cronbach's alpha and construct reliability (CR) were used to evaluate the reliability of SF-36 and SF-12, while criterion validity and average variance extracted (AVE, convergence validity) were used to evaluate validity. Confirmatory factor analysis was used to calculate the load factors for the items of the SF-36 and SF-12, then to obtain the CR and AVE. The Semejima grade response model (logistic two-parameter module) in item response theory was used to estimate item discrimination, item difficulty, and item average information for the items of the SF-36 and SF-12. RESULTS 19,428 samples were included in the study. The mean age of respondents was 14.78 years (SD = 1.77). Reliability of each domain of the SF-36 was better than for the corresponding domain of the SF-12. The domains of PF, RP, BP, and GH in SF-36 had good construct reliability (CR > 0.6). The criterion validities of some domains of the SF-36 were a little higher in some corresponding dimensions of the SF-12, except for PCS. The convergence validities of the SF-12 were higher than the SF-36 in PF, RP, BP, and PCS. The items of BP, SF, RP, and VT in the SF-12 had acceptable discrimination of items that were higher than in the SF-36. The items' average amounts of information on BP, VT, SF, RE, and MH in the SF-36 and SF-12 were poor. CONCLUSION Two component (PCS and MCS) measurements of the SF-12 appeared to perform at least as well as the SF-36 in cross-sectional settings in adolescence, but the reliability and validity of the 8 domains of the SF-36 were better than those of the SF-12. Some domains, for instance SF and BP, were not suitable for adolescents or need to be studied further.
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Affiliation(s)
- Yanwei Lin
- Department of Health Sociology, School of Humanities and Management, Guangdong Medical University, 1#, Xincheng Avenue, Songshanhu District, Dongguan, 523808, Guangdong, China
- Research Center for Quality of Life and Applied Psychology, Key Laboratory for Quality of Life and Psychological Assessment and Intervention, Guangdong Medical University, 1#, Xincheng Avenue, Songshanhu District, Dongguan, 523808, Guangdong, China
| | - Yulan Yu
- Department of Psychology, School of Humanities and Management, Guangdong Medical University, 1#, Xincheng Avenue, Songshanhu District, Dongguan, 523808, Guangdong, China
| | - Jiayong Zeng
- Department of Psychology, School of Humanities and Management, Guangdong Medical University, 1#, Xincheng Avenue, Songshanhu District, Dongguan, 523808, Guangdong, China
| | - Xudong Zhao
- Institute of Psychosomatic Medicine, the East Translational Medicine Platform of Tongji University, 50#, Chifeng Avenue, Shanghai, 200092, China.
| | - Chonghua Wan
- Research Center for Quality of Life and Applied Psychology, Key Laboratory for Quality of Life and Psychological Assessment and Intervention, Guangdong Medical University, 1#, Xincheng Avenue, Songshanhu District, Dongguan, 523808, Guangdong, China.
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Ursenbach J, O'Connell ME, Kirk A, Morgan D. Evidence for measurement bias of the short form health survey based on sex and metropolitan influence zone in a secondary care population. Health Qual Life Outcomes 2020; 18:91. [PMID: 32245456 PMCID: PMC7118806 DOI: 10.1186/s12955-020-01318-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 03/09/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The 12-item Short Form Health Survey (SF-12) is a widely used measure of health related quality of life, but has been criticized for lacking an empirically supported model and producing biased estimates of mental and physical health status for some groups. We explored a model of measurement with the SF-12 and explored evidence for measurement invariance of the SF-12. RESEARCH DESIGN AND METHODS The SF-12 was completed by 429 caregivers who accompanied patients with cognitive concerns to a memory clinic designed to service rural/remote-dwelling individuals. A multi-group confirmatory factor analysis was used to compare the theoretical measurement model to two empirically identified factor models reported previously in general population studies. RESULTS A model that allowed mental and physical health to correlate, and some items to cross-load provided the best fit to the data. Using that model, measurement invariance was then assessed across sex and metropolitan influence zone (MIZ; a standardized measure of degree of rurality). DISCUSSION Partial scalar invariance was demonstrated in both analyses. Differences by sex in latent item intercepts were found for items assessing feelings of energy and depression. Differences by MIZ in latent item intercepts were found for an item concerning how current health limits activities. IMPLICATIONS The fitting model was one where the mental and physical health subscales were correlated, which is not provided in the scoring program offered by the publishers. Participants' sex and MIZ should be accounted for when comparing their factor scores on the SF-12. Additionally, consideration of geographic residence and associated cultural influences is recommended in future development and use of psychological measures with such populations.
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Affiliation(s)
- Jake Ursenbach
- Department of Psychology, University of Saskatchewan, 9 Campus Drive, Saskatoon, S7N 5A5, Saskatchewan, Canada
| | - Megan E O'Connell
- Department of Psychology, University of Saskatchewan, 9 Campus Drive, Saskatoon, S7N 5A5, Saskatchewan, Canada.
| | - Andrew Kirk
- College of Medicine, University of Saskatchewan, 9 Campus Drive, Saskatoon, S7N 5A5, Saskatchewan, Canada
| | - Debra Morgan
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 9 Campus Drive, Saskatoon, S7N 5A5, Saskatchewan, Canada
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Bracher M, Stewart S, Reidy C, Allen C, Townsend K, Brindle L. Partner involvement in treatment-related decision making in triadic clinical consultations - A systematic review of qualitative and quantitative studies. PATIENT EDUCATION AND COUNSELING 2020; 103:245-253. [PMID: 31477515 DOI: 10.1016/j.pec.2019.08.031] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 07/25/2019] [Accepted: 08/20/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Explore how partners are involved in treatment-related decision-making within triadic clinical encounters. METHODS Studies were identified via database searches and reference lists. One author assessed eligibility of studies, which were verified by an additional co-author. Data were extracted by one author and cross-checked for accuracy by a second. Quality of articles was assessed using Qualsyst. Retrieved studies were categorised by one author, and agreed through discussion. RESULTS From 2442 records, 14 studies were included and categorised as: (1) Descriptions of partner role and behaviour; (2) Role intentions of partners; (3) Relationship between partner and patient behaviour; (4) HCP-Partner interactions. CONCLUSION Partners are often involved in triadic clinical consultations that have implications for treatment-related decision making. Most studies offered general descriptions but lacked detailed investigation of communicative processes in triads and how these may operate with partners vs. other companions. PRACTICE IMPLICATIONS Existing studies lack detailed investigation through direct observation of the processes of partner involvement. Research in other areas of clinical communication suggests that future interventions could be informed by attention to the following areas: partner behaviour vs. other companion types in triads; relationships between partner involvement and decision-making processes; partner involvement in triads vs. other groups (e.g. quadratic).
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Affiliation(s)
- Mike Bracher
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.
| | - Simon Stewart
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.
| | - Claire Reidy
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.
| | - Chris Allen
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.
| | - Kay Townsend
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.
| | - Lucy Brindle
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.
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Valenzuela JFB, Monterola C, Tong VJC, Fülöp T, Ng TP, Larbi A. Degree and centrality-based approaches in network-based variable selection: Insights from the Singapore Longitudinal Aging Study. PLoS One 2019; 14:e0219186. [PMID: 31318894 PMCID: PMC6638841 DOI: 10.1371/journal.pone.0219186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 06/18/2019] [Indexed: 11/18/2022] Open
Abstract
We describe a network-based method to obtain a subset of representative variables from clinical data of subjects of the second Singapore Longitudinal Aging Study (SLAS-2), while preserving to a good extent the predictive performance of the full set with regards to a multi-faceted index of successful aging, SAGE. To examine differences in predictive performance of high-degree nodes (“hubs”) and high-centrality ones (“cores”), we implement four subsetting strategies (two degree-based, two centrality-based) and obtain four surrogate sets of variables, which we use as input features for machine learning models to predict the SAGE index of subjects. All four models have variables belonging to the physical, cardiovascular, cognitive and immunological domains among their fifteen most important predictors. A fifth domain (leisure-time activities, LTA) is also present in some form. From a comparison of the surrogate sets’ size and predictive performance, a centrality-based approach (selection of the most central variable-nodes within each cluster) yielded the smallest-sized surrogate set, while having high prediction accuracy (measured by its model’s area-under-curve, AUC) in comparison to its analogous degree-based strategy (selection of the highest-degree nodes per cluster). Inclusion of the next most-central variables yielded negligible changes in predictive performance while more than doubling the surrogate set size. The centrality-based approach thus yields a surrogate set which offers a good balance between number of variables and prediction performance, and can act as a representative subset of the SLAS-2 clinical dataset.
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Affiliation(s)
- Jesus Felix Bayta Valenzuela
- Computing Science Department, Institute of High Performance Computing, Singapore, Singapore
- Analytics, Computing and Complex Systems Laboratory, Asian Institute of Management, Makati City, Philippines
- Aboitiz School of Innovation, Technology and Entrepreneurship, Asian Institute of Management, Makati City, Philippines
- * E-mail: (JFBV); (CM)
| | - Christopher Monterola
- Computing Science Department, Institute of High Performance Computing, Singapore, Singapore
- Analytics, Computing and Complex Systems Laboratory, Asian Institute of Management, Makati City, Philippines
- Aboitiz School of Innovation, Technology and Entrepreneurship, Asian Institute of Management, Makati City, Philippines
- * E-mail: (JFBV); (CM)
| | - Victor Joo Chuan Tong
- Social and Cognitive Computing Department, Institute of High Performance Computing, Singapore, Singapore
- Yong Loo Lin School of Medicine, Department of Biochemistry, National University of Singapore, Singapore, Singapore
| | - Tamàs Fülöp
- Department of Medicine, University of Sherbrooke, Quebec, Canada
| | - Tze Pin Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Department of Psychological Medicine, Singapore, Singapore
| | - Anis Larbi
- Department of Medicine, University of Sherbrooke, Quebec, Canada
- Singapore Immunology Network, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Department of Microbiology and Immunology, Singapore, Singapore
- School of Biological Sciences, Nanyang Technological University (NTU), Singapore, Singapore
- Department of Biology, Faculty of Sciences, Tunis El Manar University, Tunis, Tunisia
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Martin C, Hinkley N, Stockman K, Campbell D. Resilience, health perceptions, (QOL), stressors, and hospital admissions-Observations from the real world of clinical care of unstable health journeys in Monash Watch (MW), Victoria, Australia. J Eval Clin Pract 2018; 24:1310-1318. [PMID: 30246430 PMCID: PMC6283274 DOI: 10.1111/jep.13031] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 08/20/2018] [Accepted: 08/21/2018] [Indexed: 01/31/2023]
Abstract
RATIONALE, AIMS, AND OBJECTIVES Monash Watch (MW) aims to reduce potentially preventable hospitalisations in a cohort above a risk "threshold" identified by Health Links Chronic Care (HLCC) algorithms using personal, diagnostic, and service data. MW conducted regular patient monitoring through outbound phone calls using the Patient Journey Record System (PaJR). PaJR alerts are intended to act as a self-reported barometer of stressors, resilience, and health perceptions with more alerts per call indicating greater risk. AIMS To describe predictors of PaJR alerts (self-reported from outbound phone calls) and predictors of acute admissions based upon a Theoretical Model for Static and Dynamic Indicators of Acute Admissions. METHODS Participants: HLCC cohort with predicted 3+ admissions/year in MW service arm for >40 days; n = 244. Baseline measures-Clinical Frailty Index (CFI); Connor Davis Resilience (CD-RISC): SF-12v2 Health Survey scores Mental (MSC) and Physical (PSC) and ICECAP-O. Dynamic measures: PaJR alerts/call in 10 869 MW records. Acute (non-surgical) admissions from Victorian Admitted Episode database. ANALYSIS Logistic regression, correlations, and timeseries homogeneity metrics using XLSTAT. FINDINGS Baseline indicators were significantly correlated except SF-12_MCS. SF12-MSC, SF12-PSC and ICECAP-O best predicted PaJR alerts/call (ROC: 0.84). CFI best predicted acute admissions (ROC: 0.66), adding CD-RISC, SF-12_MCS, SF-12_PCS and ICECAP-O with two-way interactions improved model (ROC: 0.70). PaJR alerts were higher ≤10 days preceding acute admissions and significantly correlated with admissions. Patterns in PaJR alerts in four case studies demonstrated dynamic variations signifying risk. Overall, all baseline indicators were explanatory supporting the theoretical model. Timing of PaJR alerts and acute admissions reflecting changing stressors, resilience, and health perceptions were not predicted from baseline indicators but provided a trigger for service interventions. CONCLUSION Both static and dynamic indicators representing stressors, resilience, and health perceptions have the potential to inform threshold models of admission risk in ways that could be clinically useful.
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Affiliation(s)
- Carmel Martin
- Monash Health Community, Monash Health, 122 Thomas Street, Dandenong, VIC, Australia.,Monash University, Melbourne, Australia
| | - Narelle Hinkley
- Monash Health Community, Monash Health, 122 Thomas Street, Dandenong, VIC, Australia
| | - Keith Stockman
- Monash Health Community, Monash Health, 122 Thomas Street, Dandenong, VIC, Australia
| | - Donald Campbell
- Monash Health Community, Monash Health, 122 Thomas Street, Dandenong, VIC, Australia.,Monash University, Melbourne, Australia
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12
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Fernandez A, Salvador-Carulla L, Choi I, Calvo R, Harvey SB, Glozier N. Development and validation of a prediction algorithm for the onset of common mental disorders in a working population. Aust N Z J Psychiatry 2018; 52:47-58. [PMID: 28403625 DOI: 10.1177/0004867417704506] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Common mental disorders are the most common reason for long-term sickness absence in most developed countries. Prediction algorithms for the onset of common mental disorders may help target indicated work-based prevention interventions. We aimed to develop and validate a risk algorithm to predict the onset of common mental disorders at 12 months in a working population. METHODS We conducted a secondary analysis of the Household, Income and Labour Dynamics in Australia Survey, a longitudinal, nationally representative household panel in Australia. Data from the 6189 working participants who did not meet the criteria for a common mental disorders at baseline were non-randomly split into training and validation databases, based on state of residence. Common mental disorders were assessed with the mental component score of 36-Item Short Form Health Survey questionnaire (score ⩽45). Risk algorithms were constructed following recommendations made by the Transparent Reporting of a multivariable prediction model for Prevention Or Diagnosis statement. RESULTS Different risk factors were identified among women and men for the final risk algorithms. In the training data, the model for women had a C-index of 0.73 and effect size (Hedges' g) of 0.91. In men, the C-index was 0.76 and the effect size was 1.06. In the validation data, the C-index was 0.66 for women and 0.73 for men, with positive predictive values of 0.28 and 0.26, respectively Conclusion: It is possible to develop an algorithm with good discrimination for the onset identifying overall and modifiable risks of common mental disorders among working men. Such models have the potential to change the way that prevention of common mental disorders at the workplace is conducted, but different models may be required for women.
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Affiliation(s)
- Ana Fernandez
- 1 Mental Health Policy Unit, Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia.,2 Public Health Agency of Barcelona, Barcelona, Spain
| | - Luis Salvador-Carulla
- 1 Mental Health Policy Unit, Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Isabella Choi
- 3 Brain and Mind Centre, Central Clinical School, Sydney Medical School, The University of Sydney, Camperdown, NSW, Australia
| | - Rafael Calvo
- 4 School of Electrical and Information Engineering, The University of Sydney, Sydney, NSW, Australia
| | - Samuel B Harvey
- 5 School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.,6 Black Dog Institute, Randwick, NSW, Australia
| | - Nicholas Glozier
- 3 Brain and Mind Centre, Central Clinical School, Sydney Medical School, The University of Sydney, Camperdown, NSW, Australia
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Hagell P, Westergren A, Årestedt K. Beware of the origin of numbers: Standard scoring of the SF-12 and SF-36 summary measures distorts measurement and score interpretations. Res Nurs Health 2017; 40:378-386. [DOI: 10.1002/nur.21806] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 05/16/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Peter Hagell
- The PRO-CARE Group; School of Health and Society; Kristianstad University; Kristianstad Sweden
| | - Albert Westergren
- The PRO-CARE Group; School of Health and Society; Kristianstad University; Kristianstad Sweden
| | - Kristofer Årestedt
- Faculty of Health and Life Sciences; Department of Research; Linnaeus University; Kalmar County Hospital; Kalmar Sweden
- Department of Medical and Health Sciences; Linköping University; Linköping Sweden
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Ernst J, Hinz A, Niederwieser D, Döhner H, Hönig K, Vogelhuber M, Mehnert A, Weissflog G. Dyadic coping of patients with hematologic malignancies and their partners and its relation to quality of life – a longitudinal study. Leuk Lymphoma 2016; 58:655-665. [DOI: 10.1080/10428194.2016.1194983] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Jochen Ernst
- Medical Psychology & Medical Sociology, Psychosocial Oncology, University Medical Center Leipzig, Leipzig, Germany
| | - Andreas Hinz
- Medical Psychology & Medical Sociology, Psychosocial Oncology, University Medical Center Leipzig, Leipzig, Germany
| | - Dietger Niederwieser
- Division of Hematology and Oncology, University Hospital of Leipzig, Leipzig, Germany
| | - Hartmut Döhner
- Department of Internal Medicine III, University Hospital of Ulm, Ulm, Germany
- Comprehensive Cancer Center Ulm (CCCU), Ulm, Germany
| | - Klaus Hönig
- Comprehensive Cancer Center Ulm (CCCU), Ulm, Germany
- Department of Psychosomatic Medicine and Psychotherapy, University of Ulm, Ulm, Germany
| | - Martin Vogelhuber
- Department of Internal Medicine III, University of Regensburg, Regensburg, Germany
| | - Anja Mehnert
- Medical Psychology & Medical Sociology, Psychosocial Oncology, University Medical Center Leipzig, Leipzig, Germany
| | - Gregor Weissflog
- Medical Psychology & Medical Sociology, Psychosocial Oncology, University Medical Center Leipzig, Leipzig, Germany
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15
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Generic and eating disorder-specific impairment in binge eating disorder with and without overvaluation of weight or shape. Behav Res Ther 2015. [DOI: 10.1016/j.brat.2015.07.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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16
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Interpreting SF-12 mental component score: an investigation of its convergent validity with CESD-10. Qual Life Res 2015; 24:2209-17. [DOI: 10.1007/s11136-015-0959-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2015] [Indexed: 10/23/2022]
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17
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Kiely KM, Butterworth P. Validation of four measures of mental health against depression and generalized anxiety in a community based sample. Psychiatry Res 2015; 225:291-8. [PMID: 25578983 DOI: 10.1016/j.psychres.2014.12.023] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 12/01/2014] [Accepted: 12/12/2014] [Indexed: 12/27/2022]
Abstract
There is a need to validate screening measures of affective and generalized anxiety disorders for use in epidemiological surveys of mental health in the general population. This study examined the diagnostic accuracy of the Patient Health Questionnaire (PHQ-9), Goldberg Anxiety and Depression Scales (GAS, GDS) and the 12-item Short Form Health Survey (SF-12) Mental Health Component Summary Scale (MCS-12) in a population based longitudinal study in Australia. We report analyses of two narrow age birth cohorts in the Personality and Total Health (PATH) through life study (ages 32-36 and 52-58). Depressive episodes (severe, moderate, and mild), dysthymia and generalized anxiety disorder were diagnosed according to International Classification of Diseases (ICD-10) criteria using the World Health Organisation (WHO) Composite International Diagnostic Interview (CIDI) as a criterion. All scales had high concordance with their target 30-day diagnoses, with area under the Receiver Operating Characteristic (ROC) curve (AUC) ranging between 0.85 and 0.90. The PHQ-9, GDS, GAS and MCS-12 were all valid instruments for identifying possible cases of depression and anxiety, and assessing the severity of these common mental disorders in the general population. We report recommended cut-points for each scale, though note that the optimal cut-point on mental health screening instruments may vary depending on the context of test administration.
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Affiliation(s)
- Kim Matthew Kiely
- Centre for Research on Ageing Health and Wellbeing, The Australian National University, Canberra, ACT, Australia.
| | - Peter Butterworth
- Centre for Research on Ageing Health and Wellbeing, The Australian National University, Canberra, ACT, Australia
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Weight and health-related quality of life: the moderating role of weight discrimination and internalized weight bias. Eat Behav 2014; 15:586-90. [PMID: 25215477 DOI: 10.1016/j.eatbeh.2014.08.014] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Revised: 07/01/2014] [Accepted: 08/21/2014] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Obesity is an increasingly prevalent public health concern, with associated medical comorbidities and impairment in health-related quality of life (HRQoL). Obese women are frequently victims of weight-related discrimination. The HRQoL impairments among obese people could be related to this discrimination and to internalized weight bias. Design We examined the potential moderating role of discrimination (from others) and self-directed (internalized) weight-based discrimination in the association between body mass index (BMI) and HRQoL. METHODS Eighty-one women (mean age=41.1years; mean BMI=43.40kg/m(2), 97% Caucasian) completed valid and reliable measures of weight bias internalization (weight bias internalization scale), perceived discrimination by others (everyday discrimination scale) and both physical and mental HRQoL (SF-36 Health Survey). Multiple regression analysis was used to test whether internalized weight bias or discrimination moderated the association between BMI and the summary scores for physical and mental HRQoL, controlling for age. RESULTS Significant associations were found between BMI and discrimination (r=.36, p=.002), between internalized weight bias and both mental (r=.61, p<.001) and physical HRQoL (r=.45, p<.001), and between discrimination and physical HRQoL (r=.29, p=.014). A statistically significant interaction was found between BMI and internalized weight bias (b=-.21, SE=.10, p<0.05) in accounting for the variance in physical HRQoL. CONCLUSIONS The association between higher BMI and poorer physical HRQoL was found only in individuals reporting high levels of internalized weight bias. Self-discrimination among overweight individuals may be a critical factor in their physical health impairment.
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19
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Edwards SL, McFadden M, Lanier AP, Murtaugh MA, Ferucci ED, Redwood DG, Tom-Orme L, Slattery ML. Construct validity of the SF-12 among American Indian and Alaska Native people using two known scoring methods. J Health Care Poor Underserved 2014; 23:1123-36. [PMID: 24212164 DOI: 10.1353/hpu.2012.0092] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE This study evaluated the construct validity of the 12-Item Short Form Survey Instrument (SF-12) in a cohort of American Indian and Alaska Native (AIAN) people. We evaluated two scoring methods to determine their utility in this population. METHODS Participants (N = 11,127) were aged 18 and older, self-identified as AIAN, and had complete SF-12 interview data. Physical and mental health summary scores were calculated using traditional SF-12 (PCS12 and MCS12) and RAND-12 (PHC and MHC) scoring methods. RESULTS Women scored lower than men on the PHC, PCS12, MHC, and MCS12, as did those with more medical conditions versus none. Those aged 55 and older scored lower on the PHC and PCS12 than younger people. There was no difference in the mean MCS12 score by age and for those 31-55 and aged older than 55 for the MHC. CONCLUSIONS This study demonstrates the construct validity of the PCS12/MCS12 and PHC/MHC in a cohort of AIAN people.
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20
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Feller S, Vigl M, Bergmann MM, Boeing H, Kirschbaum C, Stalder T. Predictors of hair cortisol concentrations in older adults. Psychoneuroendocrinology 2014; 39:132-140. [PMID: 24275012 DOI: 10.1016/j.psyneuen.2013.10.007] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 10/10/2013] [Accepted: 10/10/2013] [Indexed: 12/26/2022]
Abstract
People at older ages are at increased risk for developing stress-related diseases associated with chronically elevated cortisol secretion. However, the main factors contributing to such endocrine alterations in this age group are still largely unknown. This cross-sectional study examined patterns of long-term integrated cortisol secretion, as assessed in hair, in a sample of 654 participants in middle and old adulthood (mean age: 65.8 years; range: 47-82 years) from the German cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC) study in Potsdam. Hair cortisol concentrations (HCC) were determined from the first scalp-near 3 cm hair segment and several sociodemographic, lifestyle, anthropometric, disease-related, and psychological parameters were assessed. In simple linear regressions, HCC were found to increase with participants' age and to be higher in men compared to women. HCC also showed positive associations with waist-to-hip ratio, waist circumference, smoking, prevalent type 2 diabetes mellitus, mental health, daytime sleeping, and being unemployed or retired--as well as a negative association with diastolic blood pressure. After full mutual adjustment, only age and smoking remained independent predictors of HCC. The association between prevalent type 2 diabetes mellitus and HCC was attenuated but still persisted independently in women. Similar, a positive relationship between HCC and alcohol consumption was found in women. The current results confirm previous evidence of positive associations of HCC with age, sex, alcohol consumption, and type 2 diabetes mellitus and add new knowledge on factors--such as smoking--that may contribute to elevated cortisol levels in people at older ages.
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Affiliation(s)
- Silke Feller
- German Institute of Human Nutrition Potsdam-Rehbruecke, Department of Epidemiology, 14558 Nuthetal, Germany.
| | - Matthaeus Vigl
- German Institute of Human Nutrition Potsdam-Rehbruecke, Department of Epidemiology, 14558 Nuthetal, Germany
| | - Manuela M Bergmann
- German Institute of Human Nutrition Potsdam-Rehbruecke, Department of Epidemiology, 14558 Nuthetal, Germany
| | - Heiner Boeing
- German Institute of Human Nutrition Potsdam-Rehbruecke, Department of Epidemiology, 14558 Nuthetal, Germany
| | - Clemens Kirschbaum
- Technical University of Dresden, Department of Psychology, 01069 Dresden, Germany
| | - Tobias Stalder
- Technical University of Dresden, Department of Psychology, 01069 Dresden, Germany
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Duggleby W, Williams A, Holstlander L, Cooper D, Ghosh S, Hallstrom LK, McLean RT, Hampton M. Evaluation of the living with hope program for rural women caregivers of persons with advanced cancer. BMC Palliat Care 2013; 12:36. [PMID: 24106841 PMCID: PMC3852040 DOI: 10.1186/1472-684x-12-36] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Accepted: 09/16/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hope has been identified as a key psychosocial resource among family caregivers to manage and deal with the caregiver experience. The Living with Hope Program is a self-administered intervention that consists of watching an international award winning Living with Hope film and participating in a two week hope activity ("Stories of the Present"). The purpose of this study was to examine the effects of the Living with Hope Program on self-efficacy [General Self-Efficacy Scale], loss and grief [Non-Death Revised Grief Experience Inventory], hope [Herth Hope Index] and quality of life [Short-Form 12 version 2 (SF-12v2)] in rural women caring for persons with advanced cancer and to model potential mechanisms through which changes occurred. METHODS A time-series embedded mixed method design was used, with quantitative baseline outcome measures repeated at day 7, day 14, and 3, 6 and 12 months. Qualitative data from the hope activity informed the quantitative data. Thirty-six participants agreed to participate with 22 completing all data collection. General estimating equations were used to analyze the data. RESULTS Herth Hope Index scores (p=0.05) had increased significantly from baseline at day 7. General Self Efficacy Scale scores were significantly higher than baseline at all data time points. To determine the mechanisms of the Living with Hope Program through which changes occurred, results of the data analysis suggested that as General Self Efficacy Scale scores increased (p<0.001) and Non-death Revised Grief Experience Inventory scores decreased (p=0.01) Herth Hope Index scores increased. In addition as Herth Hope Index scores increased (p<0.001) and Non-death Revised Grief Experience Inventory scores decreased (p=0.01), SF-12v2 mental health summary scores increased. Qualitative data suggested that through the hope activity (Stories of the Present) the participants were able to find positives and hope in their experience. CONCLUSIONS The Living with Hope Program has potential to increase hope and improve quality of life for rural women caregivers of persons with advanced cancer. The possible mechanisms by which changes in hope and quality of life occur are by decreasing loss and grief and increasing self-efficacy. TRIAL REGISTRATIONS Registration ClinicalTrials.gov, NCT01081301.
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Affiliation(s)
- Wendy Duggleby
- Nursing Research Chair Aging and Quality of Life, Faculty of Nursing University of Alberta, 3rd Level ECHA 11403 87th Ave, Edmonton, AB T6G 1C9, Canada.
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Mond J, Mitchison D, Latner J, Hay P, Owen C, Rodgers B. Quality of life impairment associated with body dissatisfaction in a general population sample of women. BMC Public Health 2013; 13:920. [PMID: 24088248 PMCID: PMC3850528 DOI: 10.1186/1471-2458-13-920] [Citation(s) in RCA: 137] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Accepted: 09/25/2013] [Indexed: 11/26/2022] Open
Abstract
Background In order to elucidate the individual and community health burden of body dissatisfaction (BD), we examined impairment in quality of life associated with BD in a large, general population sample of women. Methods Self-report measures of BD, health-related quality of life (SF-12 Physical and Mental Component Summary scales) and subjective quality of life (WHOQOL-BREF Psychological Functioning and Social Relationships subscales) were completed by 5,255 Australian women aged 18 to 42 years. Results Most participants (86.9%) reported some level of dissatisfaction with their weight or shape and more than one third (39.4%) reported moderate to marked dissatisfaction. Higher levels of BD were associated with poorer quality of life for all items of both quality of life measures, the degree of impairment being proportional to the degree of BD. Associations were strongest for items tapping mental health and psychosocial functioning, although greater BD was associated with substantially increased risk of impairment in certain aspects of physical health even when controlling for body weight. Post-hoc analysis indicated that the observed associations between BD and quality of life impairment were not accounted for by an association between BD and eating disorder symptoms. Conclusions In women, BD is associated with marked impairment in aspects of quality of life relating to mental health and psycho-social functioning and at least some aspects of physical health, independent of its association with body weight and eating disorder symptoms. Greater attention may need to be given to BD as a public health problem. The fact that BD is “normative” should not be taken to infer that it is benign.
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Affiliation(s)
- Jonathan Mond
- Research School of Psychology, Australian National University, Canberra ACT 0200, Australia.
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Manuti B, Rizza P, Pileggi C, Bianco A, Pavia M. Assessment of perceived health status among primary care patients in Southern Italy: findings from a cross-sectional survey. Health Qual Life Outcomes 2013; 11:93. [PMID: 23758708 PMCID: PMC3686588 DOI: 10.1186/1477-7525-11-93] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Accepted: 05/29/2013] [Indexed: 11/23/2022] Open
Abstract
Background The primary aim of this study was to measure HRQOL of primary care patients in one of the poorest areas of Italy, using SF-12, whereas the secondary aim was to identify subgroups of this population, according to socio-demographics, clinical characteristics, behavioural risk factors, and health services utilization, that manifest poorer HRQOL. These data may be helpful to policy makers to implement health care policies and social interventions for improving HRQOL. Methods A cross-sectional survey was conducted in Southern Italy on primary care patients aged 18 and over. SF-12 was used to measure perceived health status. Physical component and mental summary scores were obtained. We performed univariate and multivariate analysis to evaluate eventual significant differences of mean PCS-12 and MCS-12 according to various characteristics (demographics, presence of chronic diseases, behavioral risk factors, and utilization of health services). Results Of the 1467 participating in our survey, more than one third evaluated their health as unsatisfactory, noted significant limitations and reported problems on all SF-12-scales. Physical and mental summary scores showed an overall mean of 45.9 (SD ± 10.8) and 44.9 (SD ± 11.6), respectively. Statistical analysis showed significant differences in perceived health status by socio-demographic characteristics, such as gender, age, education level and employment status, by behavioral risk factors, chronic diseases and health services utilization. Conclusions Our findings seem to indicate that primary care patients in Southern Italy have a poor HRQOL and this perception is even poorer in subgroups of the population, according to several sociodemographic, clinical characteristics, and behavioural risk factors. These results may have significant implications for health care policymakers, since they emphasize the need of developing effective and targeted strategies to improve HRQOL in Southern Italy.
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Affiliation(s)
- Benedetto Manuti
- Department of Health Sciences, Medical School, University of Catanzaro Magna Græcia, Catanzaro, Italy
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Latner JD, Durso LE, Mond JM. Health and health-related quality of life among treatment-seeking overweight and obese adults: associations with internalized weight bias. J Eat Disord 2013; 1:3. [PMID: 24764526 PMCID: PMC3776203 DOI: 10.1186/2050-2974-1-3] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Accepted: 11/15/2012] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Weight bias is widespread and has numerous harmful consequences. The internalization of weight bias has been associated with significant psychological impairment. Other forms of discrimination, such as racial and anti-gay bias, have been shown to be associated with physical health impairment. However, research has not yet examined whether internalized weight bias is associated with physical as well as psychological impairment in health-related quality of life. METHODS Participants included 120 treatment-seeking overweight and obese adults (mean body mass index = 35.09; mean age = 48.31; 68% female; 59% mixed or Asian ethnicity). Participants were administered measures of internalized weight bias and physical and mental health-related quality of life, and they were assessed for the presence of chronic medical conditions, use of prescription and non-prescription medications, and current exercise. RESULTS Internalized weight bias was significantly correlated with health impairment in both physical (r = -.25) and mental (r = -.48) domains. In multivariate analyses controlling for body mass index, age, and other physical health indicators, internalized weight bias significantly and independently predicted impairment in both physical (β = -.31) and mental (β = -.47) health. CONCLUSIONS Internalized weight bias was associated with greater impairment in both the physical and mental domains of health-related quality of life. Internalized weight bias also contributed significantly to the variance in physical and mental health impairment over and above the contributions of BMI, age, and medical comorbidity. Consistent with the association between prejudice and physical health in other minority groups, these findings suggest a link between the effects of internalized weight-based discrimination and physical health. Research is needed on strategies to prevent weight bias and its internalization on both a societal and individual level.
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Affiliation(s)
- Janet D Latner
- University of Hawai‘i at Manoa, 2350 Dole Street, Sakamaki C400, Honolulu, HI, 96822, USA
| | - Laura E Durso
- The Williams Institute at UCLA School of Law, Box 951476, Los Angeles, CA, 90095, USA
| | - Jonathan M Mond
- Centre for Rural and Remote Mental Health, School of Medicine and Public Health, University of Newcastle, Orange, NSW, 2800, Australia
- School of Sociology, Australian National University, Canberra, ACT, 0200, Australia
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French DJ, Sargent-Cox K, Luszcz MA. Correlates of subjective health across the aging lifespan: understanding self-rated health in the oldest old. J Aging Health 2012; 24:1449-69. [PMID: 23103451 DOI: 10.1177/0898264312461151] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To examine the determinants of self-rated health (SRH) in different age groups of older adults, including the oldest old. METHODS Variables assessing physical health, difficulty with self-care, depressive symptoms, and cognitive impairment were pooled and harmonized from three Australian longitudinal studies of ageing (N = 5,222). The association of these with SRH was examined in older adults aged 60 to 64 years, 65 to 74 years, 75 to 84 years, and 85 years and older. RESULTS SRH was not associated with cognitive impairment or difficulty with self-care in the oldest old, and its association with physical health was diminished compared with younger groups. Depression showed a significant relationship in all age groups, conferring an approximately fourfold increase in the likelihood of poorer SRH. DISCUSSION As old age progresses, self-reports of poor health become most closely related to psychological symptoms. This explains some of the paradoxes of past literature and offers important insights for health professionals working with the oldest old.
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Windsor TD, Burns RA, Byles JE. Age, Physical Functioning, and Affect in Midlife and Older Adulthood. J Gerontol B Psychol Sci Soc Sci 2012; 68:395-9. [DOI: 10.1093/geronb/gbs088] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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What is the use? Application of the short form (SF) questionnaires for the evaluation of treatment effects. Qual Life Res 2012; 22:1225-30. [DOI: 10.1007/s11136-012-0266-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2012] [Indexed: 10/27/2022]
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Positive components of mental health provide significant protection against likelihood of falling in older women over a 13-year period. Int Psychogeriatr 2012; 24:1419-28. [PMID: 22414541 DOI: 10.1017/s1041610212000154] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND In late life, falls are associated with disability, increased health service utilization and mortality. Physical and psychological risk factors of falls include falls history, grip strength, sedative use, stroke, cognitive impairment, and mental ill-health. Less understood is the role of positive psychological well-being components. This study investigated the protective effect of vitality on the likelihood of falls in comparison to mental and physical health. METHODS Female participants were drawn from the Dynamic Analyses to Optimise Ageing (DYNOPTA) harmonization project. Participants (n = 11,340) were aged 55-95 years (Mean = 73.68; SD = 4.31) at baseline and observed on up to four occasions for up to 13 years (Mean = 5.30; SD = 2.53). RESULTS A series of random intercept logistic regression models consistently identified vitality's protective effects on falls as a stronger effect in the reduction of the likelihood of falls than the effect of mental health. Vitality is a significant predictor of falls likelihood even after adjusting for physical health, although the size of effect is substantially explained by its covariance with mental and physical heath. CONCLUSIONS Vitality has significant protective effects on the likelihood of falls. In comparison with mental health, vitality reported much stronger protective effects on the likelihood to fall in comparison with the risk associated with poor mental health in a large sample of older female adults. Both physical health and mental health account for much of the variance in vitality, but vitality still reports a protective effect on the likelihood of falls.
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Deriving prevalence estimates of depressive symptoms throughout middle and old age in those living in the community. Int Psychogeriatr 2012; 24:503-11. [PMID: 22088681 PMCID: PMC3882019 DOI: 10.1017/s1041610211002109] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND There is considerable debate about the prevalence of depression in old age. Epidemiological surveys and clinical studies indicate mixed evidence for the association between depression and increasing age. We examined the prevalence of probable depression in the middle aged to the oldest old in a project designed specifically to investigate the aging process. METHODS Community-living participants were drawn from several Australian longitudinal studies of aging that contributed to the Dynamic Analyses to Optimise Ageing (DYNOPTA) project. Different depression scales from the contributing studies were harmonized to create a binary variable that reflected "probable depression" based on existing cut-points for each harmonized scale. Weighted prevalence was benchmarked to the Australian population which could be compared with findings from the 1997 and 2007 National Surveys of Mental Health and Well-Being (NSMHWB). RESULTS In the DYNOPTA project, females were more likely to report probable depression. This was consistent across age levels. Both NSMHWB surveys and DYNOPTA did not report a decline in the likelihood of reporting probable depression for the oldest old in comparison with mid-life. CONCLUSIONS Inconsistency in the reports of late-life depression prevalence in previous epidemiological studies may be explained by either the exclusion and/or limited sampling of the oldest old. DYNOPTA addresses these limitations and the results indicated no change in the likelihood of reporting depression with increasing age. Further research should extend these findings to examine within-person change in a longitudinal context and control for health covariates.
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Mond J, Rodgers B, Hay P, Owen C. Mental health impairment in underweight women: do body dissatisfaction and eating-disordered behavior play a role? BMC Public Health 2011; 11:547. [PMID: 21740596 PMCID: PMC3160375 DOI: 10.1186/1471-2458-11-547] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Accepted: 07/10/2011] [Indexed: 11/28/2022] Open
Abstract
Background We sought to evaluate the hypothesis that mental health impairment in underweight women, where this occurs, is due to an association between low body weight and elevated levels of body dissatisfaction and/or eating-disordered behaviour. Methods Subgroups of underweight and normal-weight women recruited from a large, general population sample were compared on measures of body dissatisfaction, eating-disordered behaviour and mental health. Results Underweight women had significantly greater impairment in mental health than normal-weight women, even after controlling for between-group differences in demographic characteristics and physical health. However, there was no evidence that higher levels of body dissatisfaction or eating-disordered behaviour accounted for this difference. Rather, underweight women had significantly lower levels of body dissatisfaction and eating-disordered behaviour than normal-weight women. Conclusions The findings suggest that mental health impairment in underweight women, where this occurs, is unlikely to be due to higher levels of body dissatisfaction or eating-disordered behaviour. Rather, lower levels of body dissatisfaction and eating-disordered behaviour among underweight women may counterbalance, to some extent, impairment due to other factors.
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Affiliation(s)
- Jonathan Mond
- School of Sociology, Australian National University, Canberra, Australia.
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Bartsch LJ, Butterworth P, Byles JE, Mitchell P, Shaw J, Anstey KJ. Examining the SF-36 in an older population: analysis of data and presentation of Australian adult reference scores from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project. Qual Life Res 2011; 20:1227-36. [DOI: 10.1007/s11136-011-9864-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2011] [Indexed: 11/30/2022]
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Phan A, IsHak WW, Shen BJ, Fuess J, Philip K, Bresee C, Czer L, Schwarz ER. Persistent Sexual Dysfunction Impairs Quality of Life after Cardiac Transplantation. J Sex Med 2010; 7:2765-73. [DOI: 10.1111/j.1743-6109.2010.01854.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Windsor TD, Ryan LH, Smith J. Individual well-being in middle and older adulthood: do spousal beliefs matter? J Gerontol B Psychol Sci Soc Sci 2009; 64:586-96. [PMID: 19608855 PMCID: PMC4303061 DOI: 10.1093/geronb/gbp058] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2008] [Accepted: 06/08/2009] [Indexed: 11/14/2022] Open
Abstract
Associations between health, control beliefs, and well-being in later life are frequently conceptualized in terms of the characteristics of individuals. However, spousal interdependencies in psychosocial characteristics are also likely to be relevant for well-being. The present study investigated associations of self-rated health, control, and relationship closeness with life satisfaction and positive and negative affect in a sample of 2,235 spousal dyads. A significant proportion of variance in health, control, closeness, and well-being occurred between dyads. Individuals' self-rated health, control, and relationship closeness were associated with higher well-being. Spouses' self-rated health and control beliefs were consistently and positively associated with individuals' well-being; however, effect sizes were small. Some evidence for individual's control beliefs buffering the association between health and well-being emerged, whereas spouses' perceived control was not a significant moderator of the health-well-being association. Results highlight the importance of couple interdependencies for contextualizing health and well-being in older adulthood.
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Affiliation(s)
- Tim D Windsor
- Centre for Mental Health Research, The Australian National University, Acton, ACT 0200, Australia.
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Goldney RD, Dunn KI, Air TM, Dal Grande E, Taylor AW. Relationships between body mass index, mental health, and suicidal ideation: population perspective using two methods. Aust N Z J Psychiatry 2009; 43:652-8. [PMID: 19530022 DOI: 10.1080/00048670902970825] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The aim of the present study was to examine the relationship between body mass index (BMI), mental health, and suicidal ideation in a general population. METHOD Two random and representative samples were drawn from the South Australian population. The interview techniques differed, as did the measures of depression and suicidality. One involved 3034 people in face-to-face interviews, and the other involved 30 214 persons providing information via a computer-assisted telephone interviewing (CATI) system. BMI was classified according to World Health Organization criteria. In face-to-face interviews, major depression was defined by the Primary Care Evaluation of Mental Disorders (PRIME-MD) and suicidal ideation by direct enquiry. In the CATI data, psychological distress was assessed on the Kessler 10 instrument and suicidal ideation by four items on the General Health Questionnaire (GHQ). Data analysis controlled for demographic and physical health variables. RESULTS In the face-to-face interviews, the combined obese and morbidly obese men were significantly less likely to have major depression or suicidal ideation than those of a healthy weight. For the telephone interview-derived data, the only significant finding was for overweight women to report less psychological distress than those of a healthy weight. CONCLUSIONS It is no longer tenable to assume that increased BMI is necessarily associated with major depression, psychological distress, or suicidal ideation. Indeed, it appears protective for some people.
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Affiliation(s)
- Robert D Goldney
- Discipline of Psychiatry, Royal Adelaide Hospital, Adelaide, SA, Australia.
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Jayasinghe UW, Proudfoot J, Barton CA, Amoroso C, Holton C, Davies GP, Beilby J, Harris MF. Quality of life of Australian chronically-ill adults: patient and practice characteristics matter. Health Qual Life Outcomes 2009; 7:50. [PMID: 19493336 PMCID: PMC2700088 DOI: 10.1186/1477-7525-7-50] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Accepted: 06/03/2009] [Indexed: 11/24/2022] Open
Abstract
Background To study health-related quality of life (HRQOL) in a large sample of Australian chronically-ill patients and investigate the impact of characteristics of patients and their general practices on their HRQOL and to assess the construct validity of SF-12 in Australia. Methods Cross sectional study with 96 general practices and 7606 chronically-ill patients aged 18 years or more using standard SF-12 version 2. Factor analysis was used to confirm the hypothesized component structure of the SF-12 items. SF-12 physical component score (PCS-12) and mental component score (MCS-12) were derived using the standard US algorithm. Multilevel regression analysis (patients at level 1 and practices at level 2) was applied to relate PCS-12 and MCS-12 to patient and practice characteristics. Results There were significant associations between lower PCS-12 or MCS-12 score and poorer general health (10.8 (regression coefficient) lower for PCS-12 and 7.3 lower for MCS-12), low socio-economic status (5.1 lower PCS-12 and 2.9 lower MCS-12 for unemployed, 0.8 lower PCS-12 and 1.7 lower MCS-12 for non-owner-occupiers, 1.0 lower PCS-12 for less well-educated) and having two or more chronic conditions (up to 2.7 lower PCS-12 and up to 1.5 lower MCS-12 than those having a single disease). Younger age was associated with lower MCS-12 (2.2 and 6.0 lower than middle age and older age respectively) but higher PCS-12 (4.7 and 7.6 higher than middle age and older age respectively). Satisfaction with quality of care (regression coefficient = 1.2) and patients who were married or cohabiting (regression coefficient = 0.6) was positively associated with MCS-12. Patients born in non-English-speaking countries were more likely to have a lower MCS-12 (1.5 lower) than those born in Australia. Employment had a stronger association with the quality of life of males than that of females. Those attending smaller practices had lower PCS-12 (1.0 lower) and MCS-12 (0.6 lower) than those attending larger practices. At the patient level (level 1) 42% and 21% of the variance respectively for PCS-12 and MCS-12 were explained by the patients and practice characteristics. At the practice level (level 2), 73% and 49% of the variance respectively for PCS-12 and MCS-12 were explained by patients and practice characteristics. Conclusion The strong association between patient characteristics such as socio-economic status, age, and ethnicity and SF-12 physical and mental component summary scores underlines the importance of considering these factors in the management of chronically-ill patients in general practice. The SF-12 appears to be a valid measure for assessing HRQOL of Australian chronically-ill patients.
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Affiliation(s)
- Upali W Jayasinghe
- Centre for Primary Health Care and Equity, School of Public Health & Community Medicine, University of New South Wales, Sydney, New South Wales, Australia.
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Consequences of using SF-12 and RAND-12 when examining levels of well-being and psychological distress. Aust N Z J Psychiatry 2008; 42:315-23. [PMID: 18330774 DOI: 10.1080/00048670701881579] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To explore the consequences of using the Short-Forum Health Survey (SF-12) and the RAND-12 Health Status Inventory (RAND-12) for estimation of associations between its component scores and the levels of well-being and psychological distress. METHODS Data from a rural community mental health survey of 5641 participants were analysed. Physical and mental health component scores of the SF-12 and RAND-12 were compared between participants with different rating on the Satisfaction with Life Scale and the Kessler-10. Descriptive graphical methods were utilized to explore the relationship between SF-12 and RAND-12 components scores against well-being and psychological distress. Proportional odds model was utilized to estimate the quantitative relationship between component scores of the SF-12 and RAND-12 against categories of well-being and psychological distress. RESULTS Both SF-12 and RAND-12 component scores were generally positively associated with well-being and negatively associated with psychological distress. Median scores were similar despite scoring techniques used. However, distribution of scores differed whereby the RAND-12 yielded wider spread of scores in measures of well-being and psychological distressed when compared to the SF-12. A larger proportion of participants was classified as having moderate and severe disability under the RAND-12 compared to the SF-12. CONCLUSION It is recommended that users of the SF-12 and the RAND-12 are aware of the implications of utilizing either of the scoring techniques. Scoring techniques used should ideally be based on the theoretical basis of the study with consideration of the target population. Researchers may wish to use the SF-12 if distinct uncorrelated physical and mental constructs are required and for studies on clinical populations. In contrast, RAND-12 should be used if correlated physical and mental constructs are required and if the study is on community or general populations.
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Mond JM, Rodgers B, Hay PJ, Darby A, Owen C, Baune BT, Kennedy RL. Obesity and impairment in psychosocial functioning in women: the mediating role of eating disorder features. Obesity (Silver Spring) 2007; 15:2769-79. [PMID: 18070768 DOI: 10.1038/oby.2007.329] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The objective was to test the hypothesis that, in women, the association between obesity and impairment in psychosocial functioning is mediated by levels of weight and shape concerns and/or binge-eating frequency. RESEARCH METHODS AND PROCEDURES Self-report measures of eating disorder psychopathology, mental health functioning, subjective quality of life in the psychological and social domains, and days "out-of-role" associated with any (physical or mental) health problem, were completed by a community sample of women classified as obese (BMI >or=30 kg/m(2), n = 639) or non-obese (BMI <30 kg/m(2), n = 4253). For each of the dependent measures, regression models were used to test the hypothesis of mediation by comparing the strength of the relationship between independent and dependent variables with and without inclusion of the putative mediator in the regression model. RESULTS On each measure, the conditions for perfect mediation were satisfied when weight or shape concerns acted as the putative mediator, indicating that there was no association between obesity and functional impairment after controlling for weight or shape concerns. In contrast, associations between obesity and impairment in psychosocial functioning remained highly significant when binge-eating frequency was the putative mediator. DISCUSSION The findings suggest that in women, weight and shape concerns are an important mediator of the relationship between obesity and impairment in psychosocial functioning, whereas binge eating may not be of primary importance. A greater focus on body acceptance in obesity treatment may be indicated.
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Affiliation(s)
- Jonathan M Mond
- School of Medicine, James Cook University, Townsville, Australia.
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Gill SC, Butterworth P, Rodgers B, Mackinnon A. Validity of the mental health component scale of the 12-item Short-Form Health Survey (MCS-12) as measure of common mental disorders in the general population. Psychiatry Res 2007; 152:63-71. [PMID: 17395272 DOI: 10.1016/j.psychres.2006.11.005] [Citation(s) in RCA: 203] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2006] [Revised: 09/04/2006] [Accepted: 11/08/2006] [Indexed: 11/16/2022]
Abstract
This study assessed the screening utility of the 12-item Short-Form Health Survey's (SF-12) mental health component scale (MCS-12) for diagnosable depression and anxiety disorders in a general population sample, and thus, the validity of this scale as a measure of mental health in epidemiological research. Data were from the Australian National Survey of Mental Health and Wellbeing (N=10,504). Diagnoses were made using the Composite International Diagnostic Interview. The MCS-12 was compared to other brief scales: the RAND Mental Health Component scale (RAND MHC-12, an alternative scoring method for the MCS-12), the 12-item General Health Questionnaire (GHQ-12), the Kessler Psychological Distress Scale (K10 and K6), and an estimate of the Mental Health Inventory (MHI-5). The MCS-12 and RAND MHC-12 were equally able to discriminate respondents with the target diagnoses. The MCS-12 performed better than the GHQ-12, and equally to the K6 for diagnoses of depression, though not anxiety disorders, where the K6 showed greater utility. The K10 out-performed the MCS-12 for all diagnoses. Areas under receiver operating characteristics curves (AUC) indicated that the MCS-12 is valid measure of mental health in epidemiological research, and a useful screening tool for both depression (AUC=0.92) and anxiety disorders (AUC=0.83).
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Affiliation(s)
- Sarah C Gill
- Centre for Mental Health Research, The Australian National University, Canberra, Australia.
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