Positive functioning as an outcome in its own right.
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3401 to 3425 of 6,178Religious coping and physiological, psychological, social, and spiritual outcomes in patients with HIV/AIDS: cross-sectional and longitudinal findings.
The present study investigated the relationships between positive religious coping (e.g., seeking spiritual support) and spiritual struggle (e.g., anger at God) versus viral load, CD4 count, quality of life, HIV symptoms, depression, self-esteem, social support, and spiritual well-being in 429 patients with HIV/AIDS. Data were collected through patient interview and chart review at baseline and 12-18 months later from four clinical sites. At baseline, positive religious coping was associated with positive outcomes while spiritual struggle was associated with negative outcomes. In addition, high levels of positive religious coping and low levels of spiritual struggle were associated with small but significant improvements over time. These results have implications for assessing religious coping and designing interventions targeting spiritual struggle in patients with HIV/AIDS.
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Health-related quality of life and culture.
Objective: To clarify the relationship between quality of life (QOL) and culture.
Data source: Journal articles, proceedings, and clinical experience.
Conclusion: QOL is a subjective, multidimensional experience of well-being that is culturally constructed as individuals seek safety and security, a sense of integrity and meaning in life, and a sense of belonging in one's social network.
Implications for nursing practice: In a society where health disparities between diverse groups are known to exist, it is incumbent upon nurses to consider the impact of ethnicity/culture on the health care they deliver and on the QOL of their patients.
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Caregiver burden in Alzheimer disease: cross-sectional and longitudinal patient correlates.
Objectives: Alzheimer disease (AD) imposes a severe burden on patients and their caregivers. Although there is substantial evidence of the adverse impact of burden, considerably less is known about its specific correlates and potential causes.
Design: The authors use data from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE)-AD study to examine the relationship of burden and depression among AD caregivers to patient and caregiver sociodemographic characteristics, patients' cognitive status, psychiatric and behavioral symptoms, functional abilities, quality of life, and intensity of care provided by caregivers.
Setting: CATIE-AD included outpatients in usual care settings and assessed treatment outcomes during 9 months.
Participants: Data were examined from 421 ambulatory outpatients with a diagnosis of dementia of the Alzheimer type or probable AD with agitation or…
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Mindfulness-based stress reduction for chronic pain conditions: variation in treatment outcomes and role of home meditation practice.
Objective: This study compared changes in bodily pain, health-related quality of life (HRQoL), and psychological symptoms during an 8-week mindfulness-based stress reduction (MBSR) program among groups of participants with different chronic pain conditions.
Methods: From 1997-2003, a longitudinal investigation of chronic pain patients (n=133) was nested within a larger prospective cohort study of heterogeneous patients participating in MBSR at a university-based Integrative Medicine center. Measures included the Short-Form 36 Health Survey and Symptom Checklist-90-Revised. Paired t tests were used to compare pre-post changes on outcome measures. Differences in treatment effect sizes were compared as a function of chronic pain condition. Correlations were examined between outcome parameters and home meditation practice.
Results: Outcomes differed in significance and magnitude across commo…
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Post-traumatic growth: finding positive meaning in cancer survivorship moderates the impact of intrusive thoughts on adjustment in younger adults.
Objective: We examined whether post-traumatic growth would moderate the impact of intrusive thoughts on a range of dimensions of well-being in a sample of younger adult survivors of various types of cancer.
Methods: 167 participants completed questionnaires regarding intrusive thoughts, post-traumatic growth, mental and physical health-related quality of life, positive and negative affect, life satisfaction, and spiritual well-being. Multiple regression analyses controlling for relevant background and cancer-related variables tested the interaction effects of post-traumatic growth and intrusive thoughts.
Results: Intrusive thoughts were related to poorer adjustment on all indices except physical health-related quality of life. However, post-traumatic growth moderated the effects of intrusive thoughts on positive and negative affect, life satisfaction, and spiritual well-being in a protec…
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The development of the S-QoL 18: a shortened quality of life questionnaire for patients with schizophrenia.
Objective: The S-QoL 41 is a French self-administered questionnaire that assesses quality of life (QoL) among people with schizophrenia. This study aims to validate a shortened version of the S-QoL for more widespread use in clinical practice.
Methods: We used data from four studies conducted in four psychiatric hospitals in France (n=507). The item reduction and validation processes were based on both item response theory and classical test theory. The final version of the S-QoL was tested for construct validity, reliability, external validity, reproducibility and sensitivity to change. In addition, differential item functioning (DIF) analyses were performed to see whether all items behave in the same way in subgroups divided by age, gender, educational level and clinical form.
Results: The S-QoL 18 evaluates eight dimensions: psychological well-being, self-esteem, family relationships,…
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The benefits of prayer on mood and well-being of breast cancer survivors.
Objectives: Prayer is becoming more widely acknowledged as a way to cope with cancer. The goal of this study was to compare differences in use of prayer between breast cancer survivors from different ethnic groups and examine how use of prayer is related to mood and quality of life.
Methods: This study used a mixed methods design. One hundred and seventy-five breast cancer survivors participated in a longitudinal study of survivorship. Women completed in-depth qualitative interviews and a battery of measures including quality of life, spirituality, social support, and mood.
Results: Eighty-one percent of the women prayed. There were no significant differences between the groups for any of the psychological, social support, or quality of life variables with the exception of higher benefit finding and spiritual well-being among those who prayed. The data did show that women who prayed were…
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Development of a new patient-reported outcome measure for breast surgery: the BREAST-Q.
Background: Measuring patient-reported outcomes has become increasingly important in cosmetic and reconstructive breast surgery. The objective of this study was to develop a new patient-reported outcome measure to assess the unique outcomes of breast surgery patients.
Methods: Patient interviews, focus groups, expert panels, and a literature review were used to develop a conceptual framework and a list of questionnaire items. Three procedure-specific questionnaires (augmentation, reduction, and reconstruction) were developed and cognitive debriefing interviews used to pilot each questionnaire. Revised questionnaires were field tested with 1950 women at five centers in the United States and Canada (response rate, 72 percent); 491 patients also completed a test-retest questionnaire. Rasch measurement methods were used to construct scales, and traditional psychometric analyses, following cu…
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Spirituality as a core domain in the assessment of quality of life in oncology.
Objectives: This study investigated including spiritual wellbeing as a core domain in the assessment of quality of life (QOL) in an Australian oncology population.
Methods: Four hundred and ninety consecutive cancer patients with mixed diagnoses completed the Functional Assessment of Chronic Illness Therapy--Spiritual Well-Being (FACIT-Sp) and the Mental Adjustment to Cancer (MAC) scale.
Results: Overall, 449 patients completed assessments. Spiritual wellbeing demonstrated a significant, positive association with QOL (r=0.59), fighting spirit (r=0.49) and a significant, negative relationship with helplessness/hopelessness (r=-0.47) and anxious preoccupation (r=-0.26). A hierarchical multiple regression showed spiritual wellbeing to be a significant, unique contributor to QOL beyond the core domains of physical, social/family, and emotional wellbeing (R(2) change=0.08, p=0.000). However, …
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Mystical-type experiences occasioned by psilocybin mediate the attribution of personal meaning and spiritual significance 14 months later.
Psilocybin has been used for centuries for religious purposes; however, little is known scientifically about its long-term effects. We previously reported the effects of a double-blind study evaluating the psychological effects of a high psilocybin dose. This report presents the 14-month follow-up and examines the relationship of the follow-up results to data obtained at screening and on drug session days. Participants were 36 hallucinogen-naïve adults reporting regular participation in religious/ spiritual activities. Oral psilocybin (30 mg/70 kg) was administered on one of two or three sessions, with methylphenidate (40 mg/70 kg) administered on the other session(s). During sessions, volunteers were encouraged to close their eyes and direct their attention inward. At the 14-month follow-up, 58% and 67%, respectively, of volunteers rated the psilocybin-occasioned experience as being amo…
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The hidden cost of skin scars: quality of life after skin scarring.
Background: Surprisingly little is known about how skin scars affect patients' lives, though specialist clinical impressions suggest their impact is related to both their physical and psychosocial effects. Facial scars have been shown to cause high levels of anxiety and self-consciousness, but further work has been neglected. We aimed to explore the influence of skin scars on patients' quality of life (QoL) and identify potential implications for clinical practice.
Methods: We adopted a needs-based approach to QoL and conducted semi-structured interviews with scar patients at a specialist clinic. Transcribed data underwent interpretative phenomenological analysis to identify common themes in individuals' personal experiences.
Results: Thirty-four scar patients (24 women; aged 14-70 years, mean=35.7 years, SD=17.9 years) with a wide range of scar type, severity and onset were recruited. F…
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A psychoeducational intervention for sexual dysfunction in women with gynecologic cancer.
Treatment of early-stage cervical and endometrial cancer has been associated with significant sexual difficulties in at least half of women following hysterectomy. Despite the fact that women report such sexual side effects to be the most distressing aspect of their cancer treatment, evidence-based treatments for Female Sexual Arousal Disorder (FSAD), the most common sexual symptom in this group, do not exist. We developed and pilot tested a brief, three session psychoeducational intervention (PED) targeting FSAD in 22 women with early-stage gynecologic cancer. The PED consisted of three, 1-h sessions that combined elements of cognitive and behavioral therapy with education and mindfulness training. Women completed questionnaires and had a physiological measurement of genital arousal at pre- and post-PED (sessions 1 and 4) and participated in a semi-structured interview (session 4) durin…
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A 3-factor model for the FACIT-Sp.
Objective: The 12-item Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale (FACIT-Sp) is a popular measure of the religious/spiritual (R/S) components of quality of life (QoL) in patients with cancer. The original factor analyses of the FACIT-Sp supported two factors: Meaning/Peace and Faith. Because Meaning suggests a cognitive aspect of R/S and Peace an affective component, we hypothesized a 3-factor solution: Meaning, Peace, and Faith.
Methods: Participants were 240 long-term female survivors of cancer who completed the FACIT-Sp, the SF-12, and the BSI 18. We used confirmatory factor analysis to compare the 2- and 3-factor models of the FACIT-Sp and subsequently assessed associations between the resulting solutions and QoL domains.
Results: Survivors averaged 44 years of age and 10 years post-diagnosis. A 3-factor solution of the FACIT-Sp significantly improved…
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Bipolar disorders and quality of life: the impact of attention deficit/hyperactivity disorder and substance abuse in euthymic patients.
Patients with bipolar disorders (BPD) display high rates of comorbidities, especially substance abuse (20-40%) and attention deficit/hyperactivity disorder (ADHD) (6%-20%). However, there are virtually no data evaluating the role of current ADHD on the global functioning of patients with BPD. The recent literature suggests that impairments in quality of life are a key prognostic feature for predicting the long course of BPD. The aim of this study was to investigate the intrinsic impact of adult ADHD and substance abuse in patients with BPD on levels of social adaptation, functioning and vitality. Seventy-three outpatients with BPD I or II, all euthymic and being treated with mood stabilizers, were evaluated using the following measures: 1) the Diagnostic Interview of Genetics Study for DSM-IV criteria; 2) the ADHD Self-Report Scale (ASRS) (screening of adult ADHD); 3) measures of quality…
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Frequency, intensity and impact of premenstrual syndrome in medical students.
Objective: To determine the frequency and severity of Premenstrual Syndrome (PMS) in medical college students, evaluate the impact of the condition on the quality of life and find out the associated risk factors.
Study design: An observational study.
Place and duration of study: Isra University Hospital, Hyderabad, Sindh, Pakistan, from August to December 2006.
Methodology: Unmarried medical students aged 18-25 years with regular menstrual period for the last 06 months were recruited by convenience sampling. PMS-related data was collected on daily record of severity of problems (DRSP) for two prospective cycles. Health-related quality of life data was collected on medical outcome study Short Form 36 (Sf - 36) after taking informed consent from participants. Descriptive and inferential analysis was done by two-tailed t-test and multivariate logistic regression analysis.
Results: Study par…
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The salience of social relationships for resident well-being in assisted living.
Objectives: We examined how organizational characteristics, transition experiences, and social relationships impact three subjective measures of well-being among assisted living residents: life satisfaction, quality of life, and perception that assisted living feels like home.
Methods: Data were from 384 assisted living residents interviewed for the Florida Study of Assisted Living. Using ordinary least squares and logistic regression we estimated associations between resident well-being and organizational characteristics, transition experiences, and social relationships, controlling for gender, age, education, and physical functioning.
Results: To varying degrees depending on the measure used, higher resident well-being was associated with facility size, facility acceptance of payment from Florida's low income program, and resident perceptions of adequate privacy. Non-kin room sharing r…
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Karvinen KH, Courneya KS, North S, Venner P (2007)MEDLINE-indexed journal, not yet read by usCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology62 citations Associations between exercise and quality of life in bladder cancer survivors: a population-based study.
Background: Exercise has been shown to improve quality of life (QoL) in some cancer survivor groups, but it is unknown if the unique QoL issues faced by bladder cancer survivors are also amenable to an exercise intervention. This study provides the first data examining the association between exercise and QoL in bladder cancer survivors.
Methods: Bladder cancer survivors identified through a provincial cancer registry were mailed a survey that included the Godin Leisure Time Exercise Questionnaire, the Functional Assessment of Cancer Therapy-Bladder (FACT-Bl) scale, and the Fatigue Symptom Inventory.
Results: Of the 525 bladder cancer survivors (51% response rate) that completed the survey, 22.3% were meeting public health exercise guidelines in the past month, 16.0% were insufficiently active (i.e., some exercise but less than the guidelines), and 61.7% were completely sedentary. ANOVA …
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Spiritual well-being and depression in patients with heart failure.
Background: In patients with chronic heart failure, depression is common and associated with poor quality of life, more frequent hospitalizations, and higher mortality. Spiritual well-being is an important, modifiable coping resource in patients with terminal cancer and is associated with less depression, but little is known about the role of spiritual well-being in patients with heart failure.
Objective: To identify the relationship between spiritual well-being and depression in patients with heart failure.
Design: Cross-sectional study.
Participants: Sixty patients aged 60 years or older with New York Heart Association class II-IV heart failure.
Measurements: Spiritual well-being was measured using the total scale and 2 subscales (meaning/peace, faith) of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being scale, depression using the Geriatric Depression Scale-Sho…
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Social support during pregnancy: effects on maternal depressive symptoms, smoking and pregnancy outcome.
Background: The goal was to study the effects of social support during pregnancy on maternal depressive symptoms, quality of life and pregnancy outcomes.
Methods: Eight hundred ninety-six women were prospectively studied in the first trimester of pregnancy and following completion of the pregnancy. The sample was divided into quartiles yielding groups of low, medium and high social support based on perceived social support.
Results: Pregnant women with low support reported increased depressive symptoms and reduced quality of life. The effects of social support on pregnancy outcomes were particularly pronounced in women who had smoked during pregnancy, with significant main effects of social support in a two-way analysis of variance (smoking status and social support) for child body length (F = 4.26, P = 0.04; 50.43 +/- 2.81 cm with low support versus 51.76 +/- 2.31 cm with high support) …
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The patient's view on quality of life and eating disorders.
Objective: This study investigated the personal views of eating disorder (ED) patients on their quality of life (QOL).
Method: The views of 146 current ED patients and 146 former ED patients on their QOL were studied using a self-report questionnaire. Patients were requested to name the most important aspects of their life and they subsequently rated themselves on these aspects. Qualitative analysis clustered items into meaningful categories.
Results: A sense of belonging was mentioned most often (93.0%) by the participants. Work or education, health and well-being were also mentioned frequently. Furthermore, participants stated a sense of self, disease-specific psychopathology, life skills, leisure activities, a sense of purpose, financial situation, living condition, and pets. Current ED patients more frequently mentioned disease-specific psychopathology than former ED patients. Curren…
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Hostility, anger, and sense of coherence as predictors of health-related quality of life. Results of an ASCOT substudy.
Objective: The aim of this study was to investigate the relationship of hostility and anger expression to sense of coherence (SOC) and their role as predictors of health-related quality of life (HQL). It was hypothesised that SOC would mediate the impact of hostility and anger on HQL.
Methods: This is a substudy of the Anglo-Scandinavian Cardiac Outcomes Trial, which evaluates different treatment strategies to prevent cardiovascular disease in hypertensive patients. At baseline, SOC was assessed with a short form measure, and hostility-anger with the Cynical Distrust scale and with the Anger Expression scales. HQL was assessed at 6 months with the RAND-36. The sample comprised of 774 subjects (77.5% men).
Results: Results showed that strong SOC associates with ability to control expression of anger and with low levels of suppressed or openly expressed anger. Anger control and SOC were re…
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Graff LA, Walker JR, Lix L, Clara I, Rawsthorne P, Rogala L, Miller N, Jakul L, McPhail C, Ediger J, Bernstein CN (2006)MEDLINE-indexed journal, not yet read by usClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association212 citations The relationship of inflammatory bowel disease type and activity to psychological functioning and quality of life.
Background & aims: We aimed to assess the relationship of disease type and disease activity with psychological functioning and quality of life (QOL) in a population-based cohort of patients with recently diagnosed inflammatory bowel disease (IBD).
Methods: A total of 388 individuals diagnosed within 7 years were recruited from a population-based registry of IBD patients for the Manitoba IBD Cohort Study. Participants completed a clinical interview and standardized self-report measures of positive and negative psychological functioning, and QOL. Disease activity was determined by symptom self-report over the prior 6 months; Harvey-Bradshaw or Powell-Tuck disease activity indices also were used. Disease type was determined through chart verification.
Results: Seventy-four percent of Crohn's disease and 66% of ulcerative colitis participants had active disease during the previous 6 months. …
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Hahn S, Benson S, Elsenbruch S, Pleger K, Tan S, Mann K, Schedlowski M, van Halteren WB, Kimmig R, Janssen OE (2006)MEDLINE-indexed journal, not yet read by usHuman reproduction (Oxford, England)60 citations Metformin treatment of polycystic ovary syndrome improves health-related quality-of-life, emotional distress and sexuality.
Background: In polycystic ovary syndrome (PCOS), changes in physical appearance, menstrual disturbances and infertility result in psychological distress and reduced quality-of-life. Metformin improves biochemical, clinical and reproductive parameters in PCOS women. In a prospective, observational study, we analysed the effects of metformin treatment on health-related quality-of-life (HRQL), emotional well-being and sexuality in PCOS. No placebo-treated control group was included.
Methods: Before, during and after 6 months of treatment, changes in clinical and endocrine parameters, quality-of-life, psychological disturbances and sexuality were assessed in 64 PCOS patients using validated questionnaires (SF-36, SCL-90-R) and visual analogue scales. Patients were also compared with published normative data for the validated questionnaires.
Results: During treatment, HRQL, particularly the p…
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Understanding the breast cancer experience of Latina women.
Qualitative interviews were used to investigate the impact of breast cancer among Latina survivors. The findings revealed that Latina survivors were optimistic about their health, utilized cultural and religious recovery practices; and seemed to accept their diagnosis, fears and suffering as part of their personal journey. The survivors' narrative identified spirituality as central to their recovery and coping. Extended family and friends were the primary sources of support. Common issues were the impact of cancer on medical care problems, work concerns, the meaning of cancer, family well-being, emotional well-being, body image, and sexual health. Latina survivors, particularly those who are poor and speak limited English, often have inadequate insurance, receive unsatisfactory medical care, and experience poor physician-patient communication and relationship. These problems are directly…
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Quality of life in long-term cervical cancer survivors.
Objectives: To describe the quality of life (QOL) and long-term psychosocial sequelae of women of childbearing age diagnosed with cervical cancer 5-10 years earlier.
Methods: Utilizing a cross-sectional descriptive design, 51 cervical cancer survivors and 50 age-matched controls completed a comprehensive QOL interview.
Results: Participants were predominantly married, non-Hispanic White, with a mean age at diagnosis of 37 years and a mean age at interview of 45 years. This disease-free sample enjoys a good QOL, with physical, social, and emotional functioning comparable to or better than comparative norms. However, certain psychological survivorship sequelae and reproductive concerns persist. Participants reporting good QOL were less likely to report ongoing coping efforts related to having had this illness and were more likely to report greater social support, greater sexual pleasure, a…
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