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Wei X, Law YW. Quality of life of services users in psychotropic drug treatment and rehabilitation services: a qualitative study from service user and provider perspectives. SOCIAL WORK IN HEALTH CARE 2023; 62:321-344. [PMID: 37555388 DOI: 10.1080/00981389.2023.2238008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 07/11/2023] [Indexed: 08/10/2023]
Abstract
Quality of life (QoL) is a widely recognized and valuable social outcome measure in drug treatment and rehabilitation services, but the discrepancies in QoL perceptions between service users and providers remain under-explored. In this study, semi-structured interviews were conducted with service users (n = 22) and providers (n = 29) to capture their perceptions of QoL and explore the similarities and discrepancies between their views. A thematic analysis and contrast exploration revealed a shared understanding of QoL that extends beyond health to six dimensions and prioritizes empowerment and connection. However, divergent views emerged regarding the priorities of material conditions, emotional well-being, and physical health. Findings underscore the importance of using shared decision-making as a strategy to effectively address these discrepancies and promote a more patient-centered approach in treatment and rehabilitation services.
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Affiliation(s)
- Xinyi Wei
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Yik Wa Law
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
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Bonfils NA, Aubin HJ, Grall-Bronnec M, Caillon J, Perney P, Limosin F, Luquiens A. Development and Psychometric Properties of a New Patient-Reported Outcome Instrument of Health-Related Quality of Life Specific to Patients with Gambling Disorder: The Gambling Quality of Life Scale (GQoLS). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10806. [PMID: 36078519 PMCID: PMC9517863 DOI: 10.3390/ijerph191710806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Impairment or distress caused by gambling disorder can be subjectively assessed via quality of life. The aim of this study was to develop a new patient-reported outcome instrument to explore the health-related quality of life (HRQoL) in gambling disorders, the Gambling quality-of-life scale (GQoLS), and to document its psychometric properties. METHODS A previous qualitative study had been conducted using focus groups of problem gamblers to identify areas of HRQoL impacted by gambling. The seven domains identified served as the basis for the hypothetical structure of GQoLS. Draft items were generated from the patient's speeches to illustrate each of these domains. Cognitive debriefing interviews were realized to obtain a final hypothetical GQoLS. A validation study was then carried out to determine the final version of GQoLS and its psychometric properties (structural validity, construct validity, internal consistency). RESULTS The final GQoLS was composed of 21 items, with a total mean score of 38.3 (±13.6). Structural validity found a major dimension and four other minor dimensions. The five dimensions were: "emotion", "lifestyle", "loneliness", "taboo" and "preoccupation". GQoLS was moderately to strongly correlated with PGSI and EQ-5D visual analogic scale. Cronbach's alpha coefficient was 0.92. CONCLUSION GQoLS is the first HRQoL instrument specific to patients with a gambling disorder and developed from the patient's perspective. GQoLS presents good psychometric properties. GQoLS can be used in clinical research to demonstrate the effectiveness of an intervention on outcomes that are relevant from the patient's perspective.
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Affiliation(s)
- Nicolas A. Bonfils
- CESP, UVSQ, INSERM, Université Paris-Saclay, 94804 Villejuif, France
- Department of Psychiatry and Addictology, Assistance Publique-Hopitaux de Paris, Hôpitaux Universitaires Paris Ouest, 92130 Issy-les-Moulineaux, France
- Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, 75000 Paris, France
- Inserm, U894, Centre Psychiatrie et Neurosciences, 75013 Paris, France
| | - Henri-Jean Aubin
- CESP, UVSQ, INSERM, Université Paris-Saclay, 94804 Villejuif, France
- Assistance Publique-Hopitaux de Paris, Hôpitaux Universitaires Paris-Sud, 94804 Villejuif, France
- Faculté de Médecine Paris Sud, Université Paris XI, 91405 Orsay, France
| | - Marie Grall-Bronnec
- Addictology and Psychiatry Department, CHU Nantes, 44093 Nantes, France
- Inserm, U1246, Université de Nantes, Université de Tours, 44093 Nantes, France
| | - Julie Caillon
- Addictology and Psychiatry Department, CHU Nantes, 44093 Nantes, France
- Inserm, U1246, Université de Nantes, Université de Tours, 44093 Nantes, France
| | - Pascal Perney
- CESP, UVSQ, INSERM, Université Paris-Saclay, 94804 Villejuif, France
- Department of Addictions, CHU Nîmes, Université de Montpellier, 30000 Nîmes, France
| | - Frédéric Limosin
- Department of Psychiatry and Addictology, Assistance Publique-Hopitaux de Paris, Hôpitaux Universitaires Paris Ouest, 92130 Issy-les-Moulineaux, France
- Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, 75000 Paris, France
- Inserm, U894, Centre Psychiatrie et Neurosciences, 75013 Paris, France
| | - Amandine Luquiens
- CESP, UVSQ, INSERM, Université Paris-Saclay, 94804 Villejuif, France
- Assistance Publique-Hopitaux de Paris, Hôpitaux Universitaires Paris-Sud, 94804 Villejuif, France
- Faculté de Médecine Paris Sud, Université Paris XI, 91405 Orsay, France
- Department of Addictions, CHU Nîmes, Université de Montpellier, 30000 Nîmes, France
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Bertz JW, Smith KE, Panlilio LV, Stull SW, Reamer D, Murville ML, Sullivan M, Holtyn AF, Toegel F, Epstein DH, Phillips KA, Preston KL. Quality of life during a randomized trial of a therapeutic-workplace intervention for opioid use disorder: Web-based mobile assessments reveal effects of drug abstinence and access to paid work. DRUG AND ALCOHOL DEPENDENCE REPORTS 2021; 1:100011. [PMID: 36843907 PMCID: PMC9948824 DOI: 10.1016/j.dadr.2021.100011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/25/2021] [Accepted: 12/01/2021] [Indexed: 11/25/2022]
Abstract
Background Employment and improved quality of life (QOL) are, separately, valued outcomes of substance use disorder (SUD) treatment. It is also important to understand QOL changes caused by employment itself; therefore, we assessed QOL during a randomized trial of a contingency-management-based Therapeutic Workplace for people with opioid use disorder. Methods For 12 weeks, participants (n = 61) responded to QOL questionnaires in a mobile web app accessed with study-issued smartphones. At enrollment, participants were randomized to work in the Therapeutic Workplace immediately (immediate work group, IWG) or after a 3-week waitlist delay (delayed work group, DWG). Once both groups could work, wage-resetting contingencies were introduced for their opiate- and cocaine-urinalysis. Data were analyzed by (1) access to work with and without contingencies and (2) overall urinalysis-verified opiate- and cocaine-abstinence. Results DWG and/or IWG reported improvements in several QOL areas (sleep, transportation, recreation); however, they also reported increased money-related difficulties and less time spent with friends/family. These changes did not coincide with DWG's work access, but some (more sleep, money-related difficulties) coincided with the urinalysis contingencies. Greater opiate- and/or cocaine-abstinence was also associated with several improvements: sleep, paying bills, time spent with friends/family, and exercising. Surprisingly, intermediate cocaine abstinence was associated with reductions in work-capacity satisfaction and recreation. Conclusions Participants reported complex QOL differences during their experimental employment and associated with drug abstinence. Future work should help participants address issues that may be relevant to employment generally (e.g., time with friends/family) or contingency management specifically (e.g., money-related issues for non-abstinent participants).
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Affiliation(s)
- Jeremiah W. Bertz
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD 21224, United States,Corresponding author.
| | - Kirsten E. Smith
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD 21224, United States
| | - Leigh V. Panlilio
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD 21224, United States
| | - Samuel W. Stull
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD 21224, United States
| | - David Reamer
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD 21224, United States
| | | | | | - August F. Holtyn
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Forrest Toegel
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - David H. Epstein
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD 21224, United States
| | - Karran A. Phillips
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD 21224, United States
| | - Kenzie L. Preston
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD 21224, United States
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Heydarpour S, Jalali A, Baghaei F, Salari N. Validation and psychometric properties of the drug users' quality of life scale in Iranian population. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2020; 15:48. [PMID: 32698813 PMCID: PMC7374960 DOI: 10.1186/s13011-020-00289-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 07/14/2020] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Drug dependence and the resultant problems notably decrease the quality of life (QOL). Measuring the QOL in persons who use drugs (PWUDs) and planning to improve it can be helpful for rehabilitation programs. Given the absence of a standard tool to measure the quality of life of PWUD, the present study is an attempt to validate psychometric and cultural characteristics of non-injection drug users' QOL scale. METHOD The study was carried out as a validation and methodological work. The study population consisted of 273 PWUDs in Kermanshah-based drug clinics including outgoing and hospitalized patients. The participants were selected through convenient-quota sampling. After securing the required permission from the copyright owner of the tool, it was forward/backward translated. Face validity and content validity were determined quantitatively and qualitatively. To examine construct validity of the tool, explorative factor analysis and confirmatory factor analysis were used. Internal consistency was measured using Cronbach's alpha and statistical analyses were performed using SPSS (v.25) and LISREL (v.8). RESULTS Explorative factor analysis (EFA) and confirmatory factor analysis (CFA) results supported the tool with one factor and 22 items. The R2 index in the model was equal to 0.99, which means that 99% of the variation of dependent variable (total score of QOL) is attributed to independent variable (22 statements). In other words, 99% of the variation of dependent variable is due to the independent variables in the model. The main indices of the model based on CFA all were higher than 0.9, which indicates goodness of fit of the model (χ2/DF = 2.18, CFI, NFI, TLI = 0.93 GF = 0.84, REMSEA = 0.066, R2 = 0.99). The correlative coefficient was significant (p < 0.05). The reliability of the tool based on internal consistency (Cronbach's alpha) for the subscales ranged from 0.84 to 0.85 and equal to 0.84 for the whole tool. CONCLUSION The Farsi version of non-injection drug users' QOL scale had acceptable indices and it was applicable to assess QOL in the target population. The tool can be used in different fields of drug addiction.
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Affiliation(s)
- Sousan Heydarpour
- Department of Reproductive Health, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amir Jalali
- Substance Abuse Prevention Research Center, Research Institute for Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Fatemeh Baghaei
- Student Research Committee, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nader Salari
- Department of Biostatistics, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Maggio ID, Shogren KA, Wehmeyer ML, Nota L, Sgaramella TM. Career Adaptability, Self-Determination, and Life Satisfaction: A Mediational Analysis With People With Substance Use Disorder. JOURNAL OF CAREER DEVELOPMENT 2019. [DOI: 10.1177/0894845319847006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Living a satisfying life is an important goal for people with substance use disorder (SUD). However, making decisions about the future, imagining future scenarios, and setting and attaining goals related to that future after treatment is a complex task. As several studies have shown, people with SUD experience multiple barriers to designing their future life at the individual, program, and social support levels. Using a life design approach, the aim of this study was to investigate the role career adaptability and self-determination play in life satisfaction for adults with SUD. More specifically, a partial mediation model focused on career adaptability and life satisfaction through enhanced self-determination was tested in a sample ( n = 134) of people with SUD. Findings suggest that career adaptability is indirectly related to life satisfaction, mediated by self-determination. These results have important implications for practice in vocational rehabilitation and career counseling for people with SUD.
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Affiliation(s)
- Ilaria Di Maggio
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padova, Italy
| | - Karrie A. Shogren
- Department of Special Education, University of Kansas, Lawrence, KS, USA
| | | | - Laura Nota
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padova, Italy
| | - Teresa Maria Sgaramella
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padova, Italy
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Measuring quality of life in opioid-dependent people: a systematic review of assessment instruments. Qual Life Res 2017; 26:3187-3200. [PMID: 28762100 PMCID: PMC5681984 DOI: 10.1007/s11136-017-1674-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2017] [Indexed: 01/07/2023]
Abstract
Purpose Opioid dependence is a chronic relapsing disorder. Despite increasing research on quality of life (QOL) in people with opioid dependence, little attention has been paid to the instruments used. This systematic review examines the suitability of QOL instruments for use in opioid-dependent populations and the instruments’ quality. Methods A systematic search was performed in the databases Medline, PsycInfo, The Cochrane Library, and CINAHL. Articles were eligible if they assessed QOL of opioid-dependent populations using a validated QOL instrument. Item content relevance to opioid-dependent people was evaluated by means of content analysis, and instrument properties were assessed using minimum standards for patient-reported outcome measures. Results Eighty-nine articles were retrieved, yielding sixteen QOL instruments, of which ten were assessed in this review. Of the ten instruments, six were disease specific, but none for opioid dependence. Two instruments had good item content relevance. The conceptual and measurement model were described in seven instruments. Four instruments were developed with input from the respective target population. Eight instruments had low respondent and administrator burden. Psychometric properties were either not assessed in opioid-dependent populations or were inconclusive or moderate. Conclusions No instrument scored perfectly on both the content and properties. The limited suitability of instruments for opioid-dependent people hinders accurate and sensitive measurement of QOL in this population. Future research is in need of an opioid dependence-specific QOL instrument to measure the true impact of the disease on people’s lives and to evaluate treatment-related services. Electronic supplementary material The online version of this article (doi:10.1007/s11136-017-1674-6) contains supplementary material, which is available to authorized users.
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Strada L, Franke GH, Schulte B, Reimer J, Verthein U. Development of OSTQOL: A Measure of Quality of Life for Patients in Opioid Substitution Treatment. Eur Addict Res 2017; 23:238-248. [PMID: 29161720 DOI: 10.1159/000484239] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 10/13/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Quality of life (QOL) of patients in opioid substitution treatment (OST) is increasingly being addressed in research. However, no disease- or treatment-specific instrument is available to assess the QOL of this target population. The purpose of this project was to develop the first QOL instrument for OST patients. METHODS Focus groups with 60 OST patients were analyzed using thematic analysis to elicit key QOL themes as perceived by patients. Identified themes were developed into items and refined through pilot testing and cognitive debriefing. The resulting 82 items were tested in a large sample of OST patients (n = 577). Principal component analysis with varimax rotation was performed to explore a possible factor structure and reduce the number of items. Psychometric properties were assessed. RESULTS Factor analysis revealed 6 subscales accounting for 46.1% of the variance: Personal Development, Mental Distress, Social Contacts, Material Well-being, Opioid Substitution Treatment, and Discrimination. The 38-item instrument demonstrated good to acceptable internal consistency reliability for all subscales (Cronbach's alpha = 0.75-0.88), and good convergent and discriminant validity. CONCLUSION The Opioid Substitution Treatment Quality of Life scale (OSTQOL) is a multidimensional instrument with low respondent and administrator burden. A thorough validation is needed to assess its validity.
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Affiliation(s)
- Lisa Strada
- Centre for Interdisciplinary Addiction Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Gabriele Helga Franke
- Psychology of Rehabilitation, University of Applied Sciences Magdeburg and Stendal, Stendal, Germany
| | - Bernd Schulte
- Centre for Interdisciplinary Addiction Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Jens Reimer
- Centre for Interdisciplinary Addiction Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.,Gesundheit Nord, Bremen, Germany
| | - Uwe Verthein
- Centre for Interdisciplinary Addiction Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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Rojas AJ, Lozano O, Foresti K, Zolfaghari E, Zubaran C. Comparison and concordance of health-related quality of life tests among substance users. Health Qual Life Outcomes 2015; 13:186. [PMID: 26584849 PMCID: PMC4653834 DOI: 10.1186/s12955-015-0364-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 10/08/2015] [Indexed: 11/26/2022] Open
Abstract
Background In the field of drug and alcohol abuse, health-related quality of life (HRQoL) has been used as an important clinical and research outcome. The aim of this study was to establish score linkages (concordance) among three HRQoL assessment tools: WHOQOL-BREF, DUQOL and HRQOLDA scores, applying a Rasch-based common person equating procedure. Methods One hundred and twenty one adults were recruited from inpatient and outpatient treatment facilities in Sydney West Area Health Service. WHOQOL-BREF, DUQOL and HRQOLDA tests were administered. Item parameters were calculated applying Rating Scale Model, a Rasch model. Results Fit statistics suggest acceptable goodness-of-fit to the RSM for three instruments. Correlations between HRQOLDA and WHOQOL-BREF and between HRQOLDA and DUQOL scores were 0.719 and 0.613, and the RiU index was 30.4 % and 20.9 %, respectively. All three tests performed adequately for differentiating between individuals whose scores are located at different points along the continuum of the HRQoL construct. Conclusion The results demonstrated a higher concordance between the HRQoLDA and WHOQOL-BREF than between the HRQoLDA and the DUQOL. However, it cannot be established unequivocally that the scores of these tools are concordant. In this study, the utility of the application of the Rasch model to provide an empirical benchmark for the selection of measurement tools to be used in the context of health care and research is demonstrated.
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Affiliation(s)
- Antonio J Rojas
- Department of Psychology, University of Almería. Facultad de Psicología, 04120, Almería, Spain.
| | - Oscar Lozano
- Department of Clinical, Experimental and Social Psychology, University of Huelva, Facultad de Ciencias de la Educación, 21071, Huelva, Spain.
| | - Katia Foresti
- Department of Psychiatry, Hornsby Hospital, Northern Sydney Local Health District, Palmerston Rd, Hornsby, NSW, 2077, Australia.
| | - Elham Zolfaghari
- Department of Psychiatry, Blacktown Hospital, Western Sydney Local Health District, PO Box 762, Seven Hills, NSW, 2147, Australia.
| | - Carlos Zubaran
- Department of Psychiatry, Blacktown Hospital, Western Sydney Local Health District, PO Box 762, Seven Hills, NSW, 2147, Australia. .,School of Medicine, Western Sydney University, PO Box 6010, Blacktown, NSW, 2148, Australia.
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Lozano OM, Rojas Tejada AJ, Foresti K, Zubaran C. A polytomous rasch analysis of the english version of health-related quality of life for drug abusers test. THE SPANISH JOURNAL OF PSYCHOLOGY 2015; 18:E31. [PMID: 26037278 DOI: 10.1017/sjp.2015.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The specific aim of this study was to analyze the psychometric properties of the English version of the Health-Related Quality of Life for Drug Abusers Test (HRQoLDA Test) applying the Rasch model, and emphasizing fit between empirical data and theoretical Rasch model assumptions; item(s) category probability curve; and precision in terms of information function. In this study, the authors present the results of the translation and adaptation of the original Spanish version to English, as applied to a sample of substance users in Australia. The authors evaluated 121 adults recruited from inpatient and outpatient treatment facilities in Sydney, Australia. The Rating Scale Model was used in the psychometric analysis of the English version of the HRQoLDA Test. The items and persons revealed a fit between the reported data and the model. It was also demonstrated that respondents did not discriminate among the five response categories, which led to a reduction to three response categories. The adaptation of the TECVASP to the English language, renamed the HRQoLDA test, as developed with an Australian sample revealed adequate psychometric properties.
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Kalapatapu RK, Ho J, Cai X, Vinogradov S, Batki SL, Mohr DC. Cognitive-behavioral therapy in depressed primary care patients with co-occurring problematic alcohol use: effect of telephone-administered vs. face-to-face treatment-a secondary analysis. J Psychoactive Drugs 2014; 46:85-92. [PMID: 25052784 DOI: 10.1080/02791072.2013.876521] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This secondary analysis of a larger study compared adherence to telephone-administered cognitive-behavioral therapy (T-CBT) vs. face-to-face CBT and depression outcomes in depressed primary care patients with co-occurring problematic alcohol use. To our knowledge, T-CBT has never been directly compared to face-to-face CBT in such a sample of primary care patients. Participants were randomized in a 1:1 ratio to face-to-face CBT or T-CBT for depression. Participants receiving T-CBT (n = 50) and face-to-face CBT (n = 53) were compared at baseline, end of treatment (week 18), and three-month and six-month follow-ups. Face-to-face CBT and T-CBT groups did not significantly differ in age, sex, ethnicity, marital status, educational level, severity of depression, antidepressant use, and total score on the Alcohol Use Disorders Identification Test. Face-to-face CBT and T-CBT groups were similar on all treatment adherence outcomes and depression outcomes at all time points. T-CBT and face-to-face CBT had similar treatment adherence and efficacy for the treatment of depression in depressed primary care patients with co-occurring problematic alcohol use. When targeting patients who might have difficulties in accessing care, primary care clinicians may consider both types of CBT delivery when treating depression in patients with co-occurring problematic alcohol use.
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Affiliation(s)
- Raj K Kalapatapu
- a Department of Psychiatry , University of California , San Francisco , CA
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Morales-Manrique CC, Tomás-Dols S, Zarza-González M, Vidal-Infer A, Alvarez FJ, Valderrama-Zurián JC. Comparative study of the perceived quality of life of patients in treatment for cocaine and heroin dependence in Spain: differences by gender and time in treatment. Subst Use Misuse 2014; 49:1353-8. [PMID: 24712297 DOI: 10.3109/10826084.2014.880482] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This is a cross-sectional study in which we compared the perceived quality of life (QoL) of patients receiving outpatient treatment for cocaine (n = 727) and heroin dependence (n = 469), by analyzing differences by gender and time in treatment. Participants were recruited from addictive behavior centers in Spain in 2004. The World Health Organization Quality of Life Assessment Instrument (WHOQOL-Bref) was used as a measure. Analysis of covariance and multivariate linear regression were used. This study shows the relevance of considering the role of gender in QoL studies, and the need to evaluate the effectiveness of treatment in the improvement of QoL. Limitations of the study were noted.
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Lev-Ran S, Imtiaz S, Taylor BJ, Shield KD, Rehm J, Le Foll B. Gender differences in health-related quality of life among cannabis users: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Drug Alcohol Depend 2012; 123:190-200. [PMID: 22143039 DOI: 10.1016/j.drugalcdep.2011.11.010] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2011] [Revised: 11/04/2011] [Accepted: 11/09/2011] [Indexed: 11/17/2022]
Abstract
BACKGROUND Cannabis is the most widely used illicit substance worldwide. The aim of the present study was to assess self-reported Quality of Life (QoL) among cannabis users in a large representative sample. METHODS We analyzed data from the National Epidemiological Survey of Alcohol and Related Conditions (NESARC, n=43,093). Health-related QoL was assessed using the Short-form 12-item Health Survey (SF-12). The contribution of cannabis use and cannabis use disorders (CUD) to SF-12 scores was assessed using multiple linear regressions models. RESULTS The prevalence of cannabis use and CUD in the last 12 months was 4.1% and 1.5%, respectively. Mean SF-12 mental summary scores were significantly lower (indicating a lower QoL) among female and male cannabis users compared to non-users (by 0.6 standard deviations (SD) and 0.3 SD, respectively), and among females and males with CUD compared to those without CUD (by 0.9 SD and 0.4 SD, respectively). Controlling for sociodemographic variables and mental illness, each joint smoked daily was associated with a greater decrease in mental QoL summary scores in females (0.1 SD) compared to males (0.03 SD). CONCLUSIONS Cannabis use and CUD were associated with lower self-reported mental QoL. Specifically, our findings showed that cannabis use and CUD have a more significant effect on self-reported mental health QoL among female users. Assessing severity of cannabis use and impact of CUD should take into account functional and emotional outcomes. This may particularly aid in detecting the impact of cannabis use and CUD on mental health-related QoL among females.
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Affiliation(s)
- Shaul Lev-Ran
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada.
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Zubaran C, Emerson J, Sud R, Zolfaghari E, Foresti K. The application of the Drug User Quality of Life Scale (DUQOL) in Australia. Health Qual Life Outcomes 2012; 10:31. [PMID: 22424057 PMCID: PMC3349501 DOI: 10.1186/1477-7525-10-31] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Accepted: 03/18/2012] [Indexed: 11/17/2022] Open
Abstract
Background The concept of quality of life relates to the perceptions of individuals about their mental and physical health as well as non-health related areas. The evaluation of quality of life in the context of substance abuse has been conducted using generic instruments. The Drug Users Quality of Life Scale (DUQOL) is a specific assessment tool in which the most pertinent and salient areas to drug abusers are taken into consideration. In this study, the authors report the results of a validation study in which the DUQOL was used for the first time in Australia. Methods A sample of 120 participants from inpatient and outpatient treatment facilities completed a series of questionnaires, including the DUQOL and the World Health Organization Quality of Life Assessment-BREF (WHOQOL-BREF). Parameters investigated in this study included the demographic characteristics of the sample, internal structure, and convergent validity. Correlations between the DUQOL scale scores and the scores of the WHOQOL-Bref test were investigated via Pearson product-moment correlation analyses. Results The English version of the DUQOL attained a significant overall Cronbach's alpha of 0.868. The factorial analysis of the DUQOL identified one principal factor that accounted for 28.499% of the variance. Convergent validity analyses demonstrate significant correlations (p < 0.01) between the DUQOL scores and the scores of all four dimensions of the WHOQOL-BREF questionnaire. Conclusions This study demonstrates that the DUQOL constitutes a reliable research instrument for evaluating quality of life of substance users in Australia.
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Affiliation(s)
- Carlos Zubaran
- School of Medicine, University of Western Sydney, Department of Psychiatry, Western Sydney Local Health District, Blacktown Hospital, PO Box 6010, Blacktown, NSW 2148, Australia.
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Andrade LF, Alessi SM, Petry NM. The impact of contingency management on quality of life among cocaine abusers with and without alcohol dependence. Am J Addict 2011; 21:47-54. [PMID: 22211346 DOI: 10.1111/j.1521-0391.2011.00185.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The use of quality of life (QOL) measures in substance abuse treatment research is important because it may lead to a broader understanding of patients' health status and effects of interventions. Despite the high rates of comorbid cocaine and alcohol use disorders, little is known about the QOL of this population, and even less about the impact of an efficacious behavioral treatment, contingency management (CM), on QOL. In this study, data from three clinical trials were retrospectively analyzed to examine QOL in outpatient cocaine abusers with and without alcohol dependence (AD) and the impact of CM on QOL over time as a function of AD status. Patients were randomized to standard care (n = 115) or standard care plus CM (n = 278) for 12 weeks. QOL was assessed at baseline and Months 1, 3, 6, and 9. At treatment initiation, AD patients had lower QOL total scores and they scored lower on several subscale scores than those without AD. CM treatment was associated with improvement in QOL regardless of AD status. These data suggest that CM produces benefits that go beyond substance abuse outcomes, and they support the use of QOL indexes to capture information related to treatment outcomes.
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Affiliation(s)
- Leonardo F Andrade
- Calhoun Cardiology Center, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030-3944, USA
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Karow A, Verthein U, Pukrop R, Reimer J, Haasen C, Krausz M, Schäfer I. Quality of life profiles and changes in the course of maintenance treatment among 1,015 patients with severe opioid dependence. Subst Use Misuse 2011; 46:705-15. [PMID: 21047149 DOI: 10.3109/10826084.2010.509854] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Studies indicate that different areas of mental, physical, social and daily life functioning need to be considered in order to improve intervention outcomes in substance user patients. The aim of the study was to assess health-related quality of life (HRQOL) in patients diagnosed with opioid dependence as compared to healthy controls and patients diagnosed with depression and schizophrenia. METHODS A total of 1,015 outpatients diagnosed with opioid dependence were investigated during 12 months of maintenance treatment. HRQOL (MSQoL), addiction (EUROP-ASI), and sociodemographic characteristics were assessed. RESULTS HRQOL in opioid dependence improved significantly (p < .001), but was lower as compared to that of healthy controls and patients diagnosed with schizophrenia. HRQOL in opioid dependence comprises addiction-specific aspects, most importantly low material satisfaction, physical health, and social stability. CONCLUSIONS HRQOL measurement provides valuable information for course and outcome in opioid dependence treatment.
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Affiliation(s)
- A Karow
- University Medical Centre Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Hamburg, Germany.
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16
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Morales-Manrique CC, Palepu A, Castellano-Gomez M, Aleixandre-Benavent R, Valderrama-Zurián JC. Quality of life, needs, and interest among cocaine users: differences by cocaine use intensity and lifetime severity of addiction to cocaine. Subst Use Misuse 2011; 46:390-7. [PMID: 20735213 DOI: 10.3109/10826084.2010.501675] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We examined the quality of life (QoL) of 149 patients who were recruited in 2005 at outpatient treatment centers for cocaine dependence in Spain. Important life areas and life areas with potential need and interest to change in order to improve the QoL were analyzed in terms of patients? cocaine use intensity within the previous six months and lifetime severity addiction to cocaine. The Spanish versions of the Drug User Quality of Life Scale and the Lifetime Severity Index for Cocaine were used to measure QoL, needs and interest, and severity addiction to cocaine. The data analysis employed t-tests, linear regression, Mann?Whitney U tests, multivariate regression, and chi-square tests. Tailoring treatment programs to address the life areas that are considered relevant to cocaine users considering their intensity of consumption and lifetime severity addiction to cocaine may improve retention and treatment outcomes. Further research needs to consider patients of different ethnic backgrounds and cultural contexts. The study's limitations are noted.
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Affiliation(s)
- C C Morales-Manrique
- Unidad de Información e Investigación Social y Sanitaria (UISYS) (Universitat de València-CSIC), Valencia, Spain
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17
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Dietze P, Stoové M, Miller P, Kinner S, Bruno R, Alati R, Burns L. The self-reported personal wellbeing of a sample of Australian injecting drug users. Addiction 2010; 105:2141-8. [PMID: 20854337 DOI: 10.1111/j.1360-0443.2010.03090.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS To examine the self-reported personal wellbeing of a sample of Australian injecting drug users (IDU) using a standardized instrument and determine the key correlates of variations in self-reported personal wellbeing. DESIGN, SETTING AND PARTICIPANTS Cross-sectional survey of 881 Australian IDU. MEASUREMENTS Self-reported personal wellbeing collected using the Personal Wellbeing Index (PWI). FINDINGS IDU scored significantly lower than the general Australian population on the PWI and all subscales. Lower PWI scores were associated with a range of socio-demographic, drug use and other health and social characteristics. Across all PWI subscales, lower personal wellbeing scores were associated with unemployment, past 6-month mental health problems and more frequent injecting (all P < 0.05). CONCLUSIONS The PWI is sufficiently sensitive to distinguish between IDU and the general population, and to identify key correlates of PWI among IDU. Some domains canvassed within the scale, such as health, standard of living and life achievements, are well within the scope of current intervention strategies, such as pharmacotherapy maintenance treatment and housing and employment support services. This suggests that the PWI could be useful in clinical settings by allowing structured identification of the areas of a person's life to be addressed as a part of a treatment regimen. In order to inform targeted prevention and intervention efforts, longitudinal studies of PWI and its correlates among IDU are required.
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Affiliation(s)
- Paul Dietze
- Centre for Population Health, Macfarlane Burnet Institute for Medical and Public Health Ltd, 85 Commercial Road,Melbourne, Vic. 3004, Australia.
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18
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Karow A, Reimer J, Schäfer I, Krausz M, Haasen C, Verthein U. Quality of life under maintenance treatment with heroin versus methadone in patients with opioid dependence. Drug Alcohol Depend 2010; 112:209-15. [PMID: 20728288 DOI: 10.1016/j.drugalcdep.2010.06.009] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2009] [Revised: 03/22/2010] [Accepted: 06/17/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND There is increasing evidence that health-related quality of life (HRQOL) is associated with a successful treatment and better outcome in opioid addiction. The aim of the present study was the longitudinal investigation of HRQOL in patients with severe opioid dependence, who were randomly assigned to four groups of medical and psychosocial treatment: heroin (diacetylmorphine) versus methadone and case management (CM) versus psychoeducation (PSE) respectively. METHODS HRQOL (MSQoL) and physical health (OTI) were investigated in 938 subjects, who participated in the German multi-centre study examining the effects of heroin-assisted treatment in patients with severe opioid dependence. Data for the present analysis were taken from baseline and 12-month follow up. RESULTS Under both forms of maintenance and psychosocial treatment HRQOL improved significantly during the observation period. HRQOL improvement under maintenance with heroin exceeded improvement under methadone, especially with regard to subjective physical health. HRQOL improvement was significantly associated with better expert-rated physical health. Further analyses showed significant better improvement of HRQOL in subjects treated with PSE compared with CM. CONCLUSIONS The advantage of heroin with regard to the improvement of HRQOL may be partially explained by a better improvement of physical health under maintenance with heroin compared with methadone, which highlights the importance of a comprehensive model of health care for patients with severe opioid dependence. Future studies need to investigate the benefits of PSE for patients in maintenance therapy.
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Affiliation(s)
- A Karow
- University Medical Centre Hamburg Eppendorf, Department of Psychiatry and Psychotherapy, Martinistr. 52, 20246 Hamburg, Germany.
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19
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De Maeyer J, Vanderplasschen W, Broekaert E. Quality of life among opiate-dependent individuals: A review of the literature. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2010; 21:364-80. [DOI: 10.1016/j.drugpo.2010.01.010] [Citation(s) in RCA: 131] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2009] [Revised: 11/27/2009] [Accepted: 01/20/2010] [Indexed: 11/17/2022]
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20
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Exner H, Gibson EK, Stone R, Lindquist J, Cowen L, Roth EA. Worry as a window into the lives of people who use injection drugs: a factor analysis approach. Harm Reduct J 2009; 6:20. [PMID: 19640277 PMCID: PMC2724504 DOI: 10.1186/1477-7517-6-20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2009] [Accepted: 07/29/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The concept of risk dominates the HIV/AIDS literature pertaining to People Who Use Injection Drugs (PWUID). In contrast the associated concept of worry is infrequently applied, even though it can produce important perspectives of PWUID's lives. This study asked a sample (n = 105) of PWUID enrolled in a Victoria, British Columbia needle exchange program to evaluate their degree of worry about fourteen factors they may encounter in their daily lives. METHODS Exploratory factor analysis was used to analyze their responses. RESULTS Factor analysis delineated three factors: 1) overall personal security, 2) injection drug use-specific risks including overdosing and vein collapse and, 3) contracting infectious diseases associated with injection drug use (e.g. HIV/AIDS and hepatitis C). CONCLUSION PWUID in this study not only worry about HIV/AIDS but also about stressful factors in their daily life which have been linked to both increased HIV/AIDS risk behaviour and decreased anti-retroviral treatment adherence. The importance PWUID give to this broad range of worry/concerns emphasizes the need to place HIV/AIDS intervention, education, and treatment programs within a broader harm-reduction framework that incorporates their perspectives on both worry and risk.
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Affiliation(s)
- Heidi Exner
- AIDS Vancouver Island, 1601 Blanshard Avenue, Victoria, British Columbia, V8W 2J5, Canada
| | - Erin K Gibson
- AIDS Vancouver Island, 1601 Blanshard Avenue, Victoria, British Columbia, V8W 2J5, Canada
| | - Ryan Stone
- Department of Mathematics and Statistics, PO BOX 3060 STN CSC, Victoria, British Columbia, V8W 3R4, Canada
| | - Jennifer Lindquist
- Department of Mathematics and Statistics, PO BOX 3060 STN CSC, Victoria, British Columbia, V8W 3R4, Canada
| | - Laura Cowen
- Department of Mathematics and Statistics, PO BOX 3060 STN CSC, Victoria, British Columbia, V8W 3R4, Canada
| | - Eric A Roth
- Department of Anthropology, University of Victoria, PO Box 3050, STN CSC, Victoria, British Columbia, V8W 3P5, Canada
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Abstract
PURPOSE OF REVIEW Quality of life (QoL) has become an important clinical and research outcome in clinical drug and alcohol studies. Yet, further advancement in this field is hindered by the lack of a consensual definition of QoL in that often investigators use the constructs of health status and QoL interchangeably. This article reviews the conceptual definitions of QoL as a researchable construct. It also presents the most commonly used questionnaires to evaluate QoL in the context of substance use. RECENT FINDINGS In the area of substance use research, the evaluation of QoL has been conducted mainly via generic instruments. Most of the studies reporting results of QoL measurements have obtained their data from opiate users receiving different treatment modalities at various healthcare agencies. Recent studies have used the Injection Drug User QoL Scale as a specific assessment tool. Specific QoL instruments have also been developed in the area of alcohol and nicotine dependence. SUMMARY QoL is an important clinical and research outcome in the context of substance use. However, the indiscriminate use of nonspecific measurement tools may produce questionable results. A new generation of specific tools takes into particular consideration the life areas that have a greater influence on the QoL of substance users. It is hoped that the new impetus toward a specific QoL assessment in the context of substance use will promote further scientific advancement in this area.
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Gu J, Lau JTF, Chen H, Liu Z, Lei Z, Li Z, Lian Z, Wang R, Hu X, Cai H, Wang T. Validation of the Chinese version of the Opiate Addiction Severity Inventory (OASI) and the Severity of Dependence Scale (SDS) in non-institutionalized heroin users in China. Addict Behav 2008; 33:725-41. [PMID: 18221839 DOI: 10.1016/j.addbeh.2007.12.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2007] [Revised: 11/15/2007] [Accepted: 12/19/2007] [Indexed: 11/29/2022]
Abstract
No fully validated Chinese instrument measuring severity of drug dependence exists. The Chinese Opiate Addiction Severity Inventory (OASI) and the translated Chinese version of the Severity of Dependence Scale (SDS) were validated in this study. A total of 178 eligible participants were recruited using snowballing method. The 11-item revised version of OASI (OASI-R) exhibited good reliability (item-total correlation coefficients ranged from 0.50 to 0.73, Cronbach's alpha was 0.85, test-retest Intra-class Correlation Coefficient was 0.81, p < 0.001). Two factors were identified by principal component method and correlated significantly with the Quality of Life-Drug Addiction (QOL-DA). The 3-item revised version of SDS (SDS-R) was one of the two factors of SDS (item-total correlation coefficients were 0.79 to 0.86, Cronbach's alpha was 0.78, test-retest Intra-class Correlation Coefficient was 0.64, p < 0.001). It correlated significantly with QOL-DA. OASI-R and SDS-R were also significantly correlated with each other and with some heroin-related characteristics. The validation of the Chinese version of OASI-R and SDS-R would facilitate research in different Chinese populations. SDS has been translated to different languages and the Chinese version allows for international comparison.
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Affiliation(s)
- Jing Gu
- Centre for Epidemiology & Biostatistics, School of Public Health, the Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong
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Morales-Manrique CC, Valderrama-Zurián JC, Castellano-Gómez M, Aleixandre-Benavent R, Palepu A. Cross cultural adaptation of the Injection Drug User Quality Of Life Scale (IDUQOL) in Spanish drug dependent population, with or without injectable consumption: Drug User Quality of Life Scale-Spanish (DUQOL-Spanish). Addict Behav 2007; 32:1913-21. [PMID: 17240076 DOI: 10.1016/j.addbeh.2006.12.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2006] [Revised: 11/10/2006] [Accepted: 12/08/2006] [Indexed: 11/17/2022]
Abstract
The Injection Drug User Quality of life Scale (IDUQOL) measures the unique and individual circumstances that determine the quality of life of injection drug users. This paper reports the psychometric properties of the Spanish version, for drug dependent persons with or without injectable consumption using a revised instrument: Drug user Quality of Life Scale-Spanish (DUQOL-Spanish). We studied 169 outpatients in 9 Spanish drug treatment centers. Factor analysis, internal consistency, test-retest reliability and criterion-related validity were assessed. The results show the essential unidimensionality of the scale, which supports the use of a total score. Both internal consistency (Cronbach's alpha: 0.86), and test-retest reliability (r=0.79) of the total score were high. Criterion-related validity supports the interpretation of the DUQOL-Spanish total score as measuring a construct consistent with quality of life. This study suggests that the DUQOL-Spanish is a valid instrument to measure subjective quality of life in Spanish drug users, and allows the identification of life areas that are considered by the patient important to change in order to improve their quality of life.
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Affiliation(s)
- C C Morales-Manrique
- Instituto de Historia de la Ciencia y Documentación "López Piñero" (Universitat de Valencia-CSIC), Avda. Blazco Ibáñez, 15, 46010 Valencia, Spain
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Foley G, O'Mahony P, Hardiman O. Perceptions of quality of life in people with ALS: effects of coping and health care. ACTA ACUST UNITED AC 2007; 8:164-9. [PMID: 17538778 DOI: 10.1080/17482960601164532] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Few qualitative studies have explored the 'meaning' of life experiences for persons with ALS. We aimed to identify the meaning of QoL in five selected individuals, and to consider how their experience of health care affected perceived well-being, using a phenomenological approach. Four of the five participants were revisited. Themes that emerged included: importance of faith, search for control, importance of dignity, desire to maintain identity, importance of family, a sense of loss, importance of altruism and support, fighting amyotrophic lateral sclerosis, and appreciation of life. All participants felt that professional services contributed to their well-being. QoL remained individual and multi-dimensional and was defined by cognitive and behavioural strategies used to cope with ALS. Our findings highlight the need to consider how persons with ALS may adapt to progressive illness.
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Affiliation(s)
- Geraldine Foley
- Occupational Therapy Department, Beaumont Hospital, Beaumont, Dublin, Ireland.
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Hubley AM, Palepu A. Injection Drug User Quality of Life Scale (IDUQOL): findings from a content validation study. Health Qual Life Outcomes 2007; 5:46. [PMID: 17663783 PMCID: PMC1994946 DOI: 10.1186/1477-7525-5-46] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2007] [Accepted: 07/30/2007] [Indexed: 11/24/2022] Open
Abstract
Background Quality of life studies among injection drug users have primarily focused on health-related measures. The chaotic life-style of many injection drug users (IDUs), however, extends far beyond their health, and impacts upon social relationships, employment opportunities, housing, and day to day survival. Most current quality of life instruments do not capture the realities of people living with addictions. The Injection Drug Users' Quality of Life Scale (IDUQOL) was developed to reflect the life areas of relevance to IDUs. The present study examined the content validity of the IDUQOL using judgmental methods based on subject matter experts' (SMEs) ratings of various elements of this measure (e.g., appropriateness of life areas or items, names and descriptions of life areas, instructions for administration and scoring). Methods Six SMEs were provided with a copy of the IDUQOL and its administration and scoring manual and a detailed content validation questionnaire. Two commonly used judgmental measures of inter-rater agreement, the Content Validity Index (CVI) and the Average Deviation Mean Index (ADM), were used to evaluate SMEs' agreement on ratings of IDUQOL elements. Results A total of 75 elements of the IDUQOL were examined. The CVI results showed that all elements were endorsed by the required number of SMEs or more. The ADM results showed that acceptable agreement (i.e., practical significance) was obtained for all elements but statistically significant agreement was missed for nine elements. For these elements, SMEs' feedback was examined for ways to improve the elements. Open-ended feedback also provided suggestions for other revisions to the IDUQOL. Conclusion The results of the study provided strong evidence in support of the content validity of the IDUQOL and direction for the revision of some IDUQOL elements.
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Affiliation(s)
- Anita M Hubley
- Measurement, Evaluation, and Research Methodology, Department of Educational and Counselling Psychology, and Special Education, University of British Columbia, Vancouver, BC, Canada
| | - Anita Palepu
- Division of Internal Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Medicine, St. Paul's Hospital, Vancouver, BC, Canada
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Morales-Manrique CC, Valderrama-Zurián JC, Castellano-Gómez M, Aleixandre-Benavent R. Exploratory factor analysis and validation study of the lifetime severity index for cocaine, Spanish version (LSI-C-Spanish). J Nerv Ment Dis 2007; 195:532-6. [PMID: 17568302 DOI: 10.1097/nmd.0b013e318064e80e] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The purpose of the study was to do an exploratory factor analysis and to examine the criterion-related and discriminant validity of the Lifetime Severity Index for Cocaine (LSI-C), Spanish version. A sample of 171 outpatients from 10 drug centers in Spain participated in the study. We conducted the factor analysis with orthogonal rotation and examined correlations between the LSI-C total score and criterion variables as well as the score obtained by a quality of life measure. The factor analysis revealed 2 principal factors that explain 65.8% of the variance. Lower LSI-C scores were associated with taking medication, receiving social help, using cocaine fewer than 30 times during the previous 6 months, and with better scores on quality of life measures. Higher LSI-C scores were associated with unstable housing, overdose, hospitalization, cocaine consumption more than 100 times during the previous 6 months, and more years of drug consumption. The LSI-C Spanish version shows acceptable criterion-related and discriminant validity.
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Affiliation(s)
- Claudia C Morales-Manrique
- Instituto de Historia de la Ciencia y Documentación López Piñero (Universitat de Valencia-CSIC), Valencia, Spain
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Morales-Manrique C, Castellano-Gómez M, Valderrama-Zurián J, Aleixandre-Benavent R. Medición de la calidad de vida e importancia de la atención a las necesidades autopercibidas en pacientes drogodependientes. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/s1575-0973(06)75126-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Laudet AB, Morgen K, White WL. The Role of Social Supports, Spirituality, Religiousness, Life Meaning and Affiliation with 12-Step Fellowships in Quality of Life Satisfaction Among Individuals in Recovery from Alcohol and Drug Problems. ALCOHOLISM TREATMENT QUARTERLY 2006; 24:33-73. [PMID: 16892161 PMCID: PMC1526775 DOI: 10.1300/j020v24n01_04] [Citation(s) in RCA: 151] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Many recovering substance users report quitting drugs because they wanted a better life. The road of recovery is the path to a better life but a challenging and stressful path for most. There has been little research among recovering persons in spite of the numbers involved, and most research has focused on substance use outcomes. This study examines stress and quality of life as a function of time in recovery, and uses structural equation modeling to test the hypothesis that social supports, spirituality, religiousness, life meaning, and 12-step affiliation buffer stress toward enhanced life satisfaction. Recovering persons (N = 353) recruited in New York City were mostly inner-city ethnic minority members whose primary substance had been crack or heroin. Longer recovery time was significantly associated with lower stress and with higher quality of life. Findings supported the study hypothesis; the 'buffer' constructs accounted for 22% of the variance in life satisfaction. Implications for research and clinical practice are discussed.
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Affiliation(s)
| | - Keith Morgen
- Keith Morgen is Senior Research Associate, C-STAR at NDRI (E-mail: )
| | - William L. White
- William L. White is Senior Research Consultant, Chestnut Health Systems/Lighthouse Institute, 720 West Chestnut Street, Bloomington, IL 61701 (E-mail: )
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Hubley AM, Russell LB, Palepu A. Injection Drug Use Quality of Life scale (IDUQOL): a validation study. Health Qual Life Outcomes 2005; 3:43. [PMID: 16029504 PMCID: PMC1200562 DOI: 10.1186/1477-7525-3-43] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2005] [Accepted: 07/19/2005] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Existing measures of injection drug users' quality of life have focused primarily on health and health-related factors. Clearly, however, quality of life among injection drug users is impacted by a range of unique cultural, socioeconomic, medical, and geographic factors that must also be considered in any measure. The Injection Drug User Quality of Life (IDUQOL) scale was designed to capture the unique and individual circumstances that determine quality of life among injection drug users. The overall purpose of the present study was to examine the validity of inferences made from the IDUQOL by examining the (a) dimensionality, (b) reliability of scores, (c) criterion-related validity evidence, and (d) both convergent and discriminant validity evidence. METHODS An exploratory factor analysis using principal axis factoring in SPSS 12.0 was conducted to determine whether the use of a total score on the IDUQOL was advisable. Reliability of scores from the IDUQOL was obtained using internal consistency and one-week test-retest reliability estimates. Criterion-related validity evidence was gathered using variables such as stability of housing, sex trade involvement, high-risk injection behaviours, involvement in treatment programs, emergency treatment or overdose over the previous six months, hospitalization and emergency treatment over the subsequent six month period post data collection. Convergent and discriminant validity evidence was gathered using measures of life satisfaction, self-esteem, and social desirability. RESULTS The sample consisted of 241 injection drug users ranging in age from 19 to 61 years. Factor analysis supports the use of a total score. Both internal consistency (alpha = .88) and one-week test-retest reliability (r = .78) for IDUQOL total scores were good. Criterion-related, convergent, and discriminant validity evidence supports the interpretation of IDUQOL total scores as measuring a construct consistent with quality of life. CONCLUSION The findings from this study provide initial evidence to support the use of the IDUQOL total score. The results of the study also suggest the IDUQOL could be further strengthened with additional attention to how some IDUQOL domains are described and satisfaction is measured.
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Affiliation(s)
- Anita M Hubley
- Measurement Evaluation and Research Methodology, Dept of ECPS, 2125 Main Mall, The University of British Columbia, Vancouver, BC, Canada
| | - Lara B Russell
- Measurement Evaluation and Research Methodology, Dept of ECPS, 2125 Main Mall, The University of British Columbia, Vancouver, BC, Canada
| | - Anita Palepu
- Division of Internal Medicine, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Centre for Health Outcome and Evaluation Sciences, St. Paul's Hospital, Vancouver, BC, Canada
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