Positive functioning as an outcome in its own right.
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3951 to 3975 of 6,178Effects of chronic pain on quality of life and depression in patients with spinal cord injury.
Design: A cross-sectional study.
Objective: To assess the effects of pain on quality of life (QoL), functional independence and depression in patients with spinal cord injury (SCI).
Setting: An inpatient rehabilitation center.
Methods: A total of 140 patients (104 M, 36 F) with SCI who underwent inpatient rehabilitation treatment were examined. A questionnaire including clinical variables was applied. Motor score of Functional Independence Measure was used to assess daily-life activities, the 36-Item Medical Outcomes Short-Form Health (SF-36) for QoL and Beck Depression Inventory (BDI) for depression. Patients were then divided into those having chronic pain (Group I) and those without any pain (Group II), and groups were compared according to demographic and clinical variables.
Results: The most common causes of SCI were falls (35.0%) and motor vehicle accidents (34.2%). Chronic pain wa…
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Sexual problems, communication patterns, and depressive symptoms in couples coping with metastatic breast cancer.
Background: The treatment of breast cancer tends to result in physical side effects (e.g., vaginal dryness, stomatitis, and atrophy) that can cause sexual problems. Although studies of early-stage breast cancer have demonstrated that sexual problems are associated with increased depressive symptoms for both patients and their partners, comparatively little is known about these associations in metastatic breast cancer (MBC) and how patients and partners cope together with sexual problems. We examined the links between sexual problems, depressive symptoms, and two types of spousal communication patterns (mutual constructive and demand-withdraw) in 191 couples in which the patient was initiating treatment for MBC.
Methods: Patients and partners separately completed paper-and-pencil surveys.
Results: Multilevel models indicated that high levels of sexual problems were significantly associate…
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The patient-physician relationship in patients with chronic low back pain as a predictor of outcomes after rehabilitation.
For patients with chronic diseases, especially those with chronic low back pain, the patient-physician relationship is significant for treatment adherence. In a sample of N = 688 low back pain patients, we examined the hypothesis that aspects of the patient-physician relationship (e.g. satisfaction with care, trust in the physician, patient participation) have a significant association with outcomes (pain, disability, quality of life, pain-related psychological impairment) after a multimodal treatment program (rehabilitation) after adjusting for a number of sociodemographic, medical, and psychological factors. Results show that the patient-physician relationship is significantly associated with the outcome. In the medium term (6 months after rehabilitation), the effect of the patient-physician relationship is clearer than in the short term (end of rehabilitation). In addition, risk facto…
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Mental health and quality of life in patients with chronic otitis media.
The present study focused on the comparison of mental health and quality of life (QoL) between chronic otitis media (COM) patients and the hearing population. The patients with chronic otitis media and healthy control group were enrolled in the study. The duration and severity of the auditory impairment were recorded. In addition to hearing loss (HL), the findings of each patient's other ear disorders (ear discharge and tinnitus) were also recorded. In both the groups, psychological symptom profile and health-related QoL were evaluated and compared using a sociodemographic questionnaire, the Symptom Check List 90-Revised Form (SCL-90-R), and the Short Form-36 (SF-36). According to SCL-90-R, somatization (p < 0.001), interpersonal sensitivity (p < 0.001), depression (p < 0.001), phobic anxiety (p < 0.001), and other subscores, and also global severity index score (p < 0.001) were signific…
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Measuring and valuing quality of life for public health research: application of the ICECAP-O capability index in the Australian general population.
Objectives: To assess the applicability of the newly developed ICECAP-O capability index in the measurement and valuation of quality of life in a large community based sample of the Australian general population. With origins in Sen's capability theory, the ICECAP-O may more fully encapsulate the multi-dimensional outcomes of public health policies and interventions than traditional health economic constructs.
Methods: 2,937 Australian residents participated in face-to-face interviews. The relationships between ICECAP-O scores according to age groups (<65 or >65 years) and socio-economic status were investigated using descriptive statistics and multivariable linear regression models.
Results: Lower income levels and being unemployed or physically unable to work were negatively associated with capability for both age groups. Capability was strongly and positively associated with marriage …
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Lim JW, Ashing-Giwa KT (2013)MEDLINE-indexed journal, not yet read by usQuality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation23 citations Is family functioning and communication associated with health-related quality of life for Chinese- and Korean-American breast cancer survivors?
Purpose: This study aims to investigate direct and indirect pathways of family flexibility, social support, and family communication on health-related quality of life (HRQOL) for Chinese- and Korean-American breast cancer survivors (BCS).
Methods: A total of 157 Chinese (n = 86)- and Korean-American (n = 71) BCS were recruited from the California Cancer Surveillance Program and area hospitals in Los Angeles County. The present study was guided by the Resiliency Model of Family Stress, Adjustment, and Adaptation.
Results: Structural equation modeling demonstrated that (1) family communication was directly associated with HRQOL for both groups; (2) family flexibility was indirectly associated with HRQOL through family communication for Korean-Americans only; (3) social support mediated the relationship between family flexibility and family communication for Chinese-Americans only; and (4) …
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A survey of resilience, burnout, and tolerance of uncertainty in Australian general practice registrars.
Background: Burnout and intolerance of uncertainty have been linked to low job satisfaction and lower quality patient care. While resilience is related to these concepts, no study has examined these three concepts in a cohort of doctors. The objective of this study was to measure resilience, burnout, compassion satisfaction, personal meaning in patient care and intolerance of uncertainty in Australian general practice (GP) registrars.
Methods: We conducted a paper-based cross-sectional survey of GP registrars in Australia from June to July 2010, recruited from a newsletter item or registrar education events. Survey measures included the Resilience Scale-14, a single-item scale for burnout, Professional Quality of Life (ProQOL) scale, Personal Meaning in Patient Care scale, Intolerance of Uncertainty-12 scale, and Physician Response to Uncertainty scale.
Results: 128 GP registrars respond…
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Association between unmet needs and quality of life of cancer patients: a population-based study.
Background: Two conceptually different morbidity outcomes unmet needs and health-related quality of life are used to identify cancer patients in need of clinical attention and to evaluate rehabilitation programmes. The knowledge on the interrelation between unmet needs and health-related quality of life is scarce. This paper studies the hypothesis that patient-perceived unmet needs of rehabilitation during the cancer trajectory are associated with decreased quality of life.
Material and methods: Based on registers, a Danish population-based cohort of adult, incident, mixed-site cancer patients diagnosed between 1 October 2007 and 30 September 2008 was established. At 14 months following diagnosis participants completed a questionnaire including health-related quality of life (EORTC QLQ C-30), psychological distress (POMS-SF), and unmet needs with regard to physical, emotional, family-ori…
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Mediators of the socioeconomic gradient in outcomes of adult asthma and rhinitis.
Objectives: We estimated the extent to which socioeconomic status (SES) gradients in adult asthma and rhinitis outcomes can be explained by home and neighborhood environmental factors.
Methods: Using survey data for 515 adults with either asthma or rhinitis, or both, we examined environmental mediators of SES associations with disease severity, using the Severity of Asthma Scale, and health-related quality of life (HRQL), using the Rhinasthma Scale. We defined SES on the basis of education and household income. Potential environmental mediators included home type and ownership, exposures to allergens and irritants, and a summary measure of perceived neighborhood problems. We modeled each outcome as a function of SES, and controlled for age, gender, and potential mediators.
Results: Gradients in SES were apparent in disease severity and HRQL. Living in a rented house partially mediated th…
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The quality of life of adolescents with menstrual problems.
Objective: To date, very few publications have examined the health related quality of life (HRQL) in the younger population with menstrual problems, despite their high prevalence in adolescent girls. We describe the health-related quality of life (HRQL) among adolescents with menstrual problems and identified factors that have an impact on it.
Methods: The study was a questionnaire study (using PedsQL 4.0) of adolescents aged 13-18 referred to a tertiary gynecology center for menstrual problems between June 2009 and August 2010.
Results: One hundred eighty-four adolescents completed the questionnaires. The mean age was 15.10 ± 1.49 with the mean body mass index (BMI) of 22.83 ± 4.82 kg/m(2). The most common menstrual problems seen in the clinic were dysmenorrhea (38.6%) followed by heavy bleeding (33.6%), oligomenorrhea (19.6%), and amenorrhea (8.2%). The mean overall score was 70.40 ± 1…
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The stigma of migraine.
Background: People who have a disease often experience stigma, a socially and culturally embedded process through which individuals experience stereotyping, devaluation, and discrimination. Stigma has great impact on quality of life, behavior, and life chances. We do not know whether or not migraine is stigmatizing.
Methods: We studied 123 episodic migraine patients, 123 chronic migraine patients, and 62 epilepsy patients in a clinical setting to investigate the extent to which stigma attaches to migraine, using epilepsy as a comparison. We used the stigma scale for chronic illness, a 24-item questionnaire suitable for studying chronic neurologic diseases, and various disease impact measures.
Results: Patients with chronic migraine had higher scores (54.0±20.2) on the stigma scale for chronic illness than either episodic migraine (41.7±14.8) or epilepsy patients (44.6±16.3) (p<0.001). Su…
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Caring for a child with type 1 diabetes: links between family cohesion, perceived impact, and parental adjustment.
This study analyzed the psychological adjustment of parents of children and adolescents with type 1 diabetes (T1D) and examined whether family cohesion and parental adjustment were connected through the perceived impact of this condition on family functioning, as well as whether these links varied according to the child's age. In total, 104 parents of children (8-12 years old) and adolescents (13-18 years old) with T1D and 142 parents of healthy children and adolescents completed self-report measures of family cohesion, parental stress, quality of life (QOL), anxious and depressive symptoms, and perceived impact of chronic illness. The results indicated that the parents of children and adolescents with T1D were more anxious and perceived less family cohesion than the parents of healthy children and adolescents. No significant differences were found on depressive symptoms, QOL, and parent…
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Variability of sleep duration is related to subjective sleep quality and subjective well-being: an actigraphy study.
While there is a large body of evidence that poor subjective sleep quality is related to lower subjective well-being, studies on the relation of objective sleep measures and subjective well-being are fewer in number and less consistent in their findings. Using data of the Survey of Mid-Life in the United States (MIDUS), we investigated whether duration and quality of sleep, assessed by actigraphy, were related to subjective well-being and whether this relationship was mediated by subjective sleep quality. Three hundred and thirteen mainly white American individuals from the general population and 128 urban-dwelling African American individuals between 35 and 85 years of age were studied cross-sectionally. Sleep duration, variability of sleep duration, sleep onset latency, and time awake after sleep onset were assessed by actigraphy over a period of 7 days. Subjective sleep quality was as…
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Acceptance and Commitment Therapy (ACT) for improving the lives of cancer patients: a preliminary study.
Background: This preliminary study examined the effectiveness of an Acceptance and Commitment Therapy (ACT) intervention at improving the quality of life among cancer patients. It was hypothesised that over the course of the intervention, patients would report increased psychological flexibility through acceptance of unpleasant thoughts and feelings, and that increased psychological flexibility would lead to improvements in distress, mood, and quality of life.
Method: Forty-five cancer patients participated in an ACT intervention. Outcome measures included self-reported distress, mood disturbance, psychological flexibility, and quality of life. Data were collected at pre, mid, and post-intervention and at 3-month follow-up.
Results: The data showed significant improvements on outcome measures from pre to post and from pre to follow-up. Regression analyses showed that changes in psycholog…
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Facebook use predicts declines in subjective well-being in young adults.
Over 500 million people interact daily with Facebook. Yet, whether Facebook use influences subjective well-being over time is unknown. We addressed this issue using experience-sampling, the most reliable method for measuring in-vivo behavior and psychological experience. We text-messaged people five times per day for two-weeks to examine how Facebook use influences the two components of subjective well-being: how people feel moment-to-moment and how satisfied they are with their lives. Our results indicate that Facebook use predicts negative shifts on both of these variables over time. The more people used Facebook at one time point, the worse they felt the next time we text-messaged them; the more they used Facebook over two-weeks, the more their life satisfaction levels declined over time. Interacting with other people "directly" did not predict these negative outcomes. They were also …
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The effectiveness of an educational program on preventing and treating compassion fatigue in emergency nurses.
The purpose of this qualitative study was to examine the treatment effectiveness of a multifaceted education program to decrease compassion fatigue (CF) and burnout (BO) symptoms and increase compassion satisfaction of emergency nurses participating in the training. The goal of the CF multifaceted intervention program was to demonstrate a statistically significant improvement in the 3 CF subscales: an increase on the Compassion Satisfaction (CS) subscale and a decrease on the Secondary Traumatic Stress (STS) and BO subscales in the participants' pretest and posttest scores as measured by The Professional Quality of Life test (B. H. , ). The study sites were 2 emergency departments in Colorado Springs, CO. A convenience sample consisted of emergency nurses who self-selected to participate in the study. Univariate statistics were used, and data were examined for normalcy of distribution. B…
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Assessment of the minimum clinically important difference in pain, disability, and quality of life after anterior cervical discectomy and fusion: clinical article.
Object: Treatment effectiveness following spine surgery is usually gauged with the help of patient-reported outcome (PRO) questionnaires. Although these questionnaires assess pain, disability, and general health state, their numerical scores lack direct, clinically significant meaning. Thus, the concept of minimum clinically important difference (MCID) has been introduced, which indicates the smallest change in an outcome measure that reflects clinically meaningful improvement to patients. The authors set out to determine anterior cervical discectomy and fusion (ACDF)-specific MCID values for the visual analog scale (VAS), Neck Disability Index (NDI), 12-Item Short-Form Health Survey (SF-12), and EQ-5D (the EuroQol health survey) in patients undergoing ACDF for cervical radiculopathy.
Methods: Data on 69 patients who underwent ACDF for cervical radiculopathy were collected in the authors…
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Efficacy of psychoeducation on symptomatic and functional recovery in bipolar disorder.
Objective: To evaluate the efficacy of psychoeducation in the symptomatic and functional recovery, and quality of life (QoL) in a sample of patients with bipolar disorder (BD).
Method: The sample comprised 55 patients with BD I and II in remission (Young Mania Rating Scale ≤6 and Hamilton Depression Rating Scale ≤7). Out-patients were matched assigned to receive 16 sessions of psychoeducation [experimental group (EG)] or 16 sessions of placebo without psychoeducation [control group (CG)]. Groups were evaluated at study baseline, midpoint, endpoint, and at 6- and 12-month follow-ups.
Results: No significant differences between the groups were found for the variables evaluated (mood symptoms, functioning and QoL), except for overall clinical improvement, subjectively perceived by EG subjects. Both groups showed a trend toward improved clinical global impression and QoL (environmental). No …
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Training in and implementation of Acceptance and Commitment Therapy for depression in the Veterans Health Administration: therapist and patient outcomes.
Objective: The U.S. Department of Veterans Affairs has implemented a national dissemination and training initiative to promote the availability of Acceptance and Commitment Therapy for depression (ACT-D). This paper reports on therapist and patient outcomes associated with competency-based training in and implementation of ACT-D.
Method: Therapist and patient outcomes were assessed on eleven cohorts of therapists (n = 391) and their patients (n = 745).
Results: Three-hundred thirty four therapists successfully completed all requirements of the Training Program. Ninety-six percent of therapists achieved competency by the end of training, compared to 21% at the outset of training. Mixed effects model analysis indicated therapists' overall ACT-D competency scores increased from 76 to 112 (conditional SD = 6.6), p < 0.001. Moreover, training was associated with significantly increased therap…
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Exercising control: exercise intention and perceived constraints in older adults with osteoarthritis.
Purpose of the study: Maintaining perceived psychological control in older adulthood is beneficial for health, well-being, and adjustment to chronic illness. Theoretically, control over specific, personally meaningful domains should inform general control beliefs. Thus, the objective of the present study was to examine perceived control over the exercise domain (operationalized as exercise intention belief) for its ability to predict general control beliefs in a sample of older adults with chronic illness over 1 year.
Design and methods: Longitudinal survey responses from 133 older adults with osteoarthritis (OA) were examined.
Results: Longitudinal hierarchical multiple regression analyses revealed that higher baseline exercise intention beliefs predicted a lower perception of constraints on control 9-12 months later, but did not predict changes in mastery beliefs.
Implications: Results…
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The dynamic interplay of social network characteristics, subjective well-being, and health: the costs and benefits of socio-emotional selectivity.
This study investigated the interacting dynamics of different aspects of the social network, specifically network structure (size and frequency of contact), social activity engagement, and emotional support, and different aspects of health and subjective well-being in a representative sample of 2034 older adults across 6 years of development. The analysis, using latent change score models, revealed that older age at Time 1 was related to steeper declines in network structure and social engagement, but was unrelated to changes in emotional support. Furthermore, levels of social engagement and levels of emotional support predicted changes in functional health and life satisfaction with equal strength. Changes in social engagement were associated with changes in life satisfaction, positive affect, functional health, and subjective health. Changes in emotional support were only associated wi…
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An observational study of patient versus parental perceptions of health-related quality of life in children and adolescents with a chronic pain condition: who should the clinician believe?
Background: Previous pediatric studies have observed a cross-informant variance in patient self-reported health-related quality of life (HRQoL) versus parent proxy-reported HRQoL. This study assessed in older children and adolescents with a variety of chronic pain conditions: 1) the consistency and agreement between pediatric patients' self-report and their parents' proxy-report of their child's HRQoL; 2) whether this patient-parent agreement is dependent on additional demographic and clinical factors; and 3) the relationship between pediatric patient HRQoL and parental reported HRQoL.
Methods: The 99 enrolled patients (mean age 13.2 years, 71% female, 81% Caucasian) and an accompanying parent completed the PedsQLTM 4.0 and 36-Item Short-Form Health Survey Version 2 (SF-36v2) at the time of their initial appointment in a pediatric chronic pain medicine clinic. Patients' and parents' tota…
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Taylor C (2012)MEDLINE-indexed journal, not yet read by usJournal of pain and symptom management4 citations Rethinking hopelessness and the role of spiritual care when cure is no longer an option.
Increasingly in the U.S., health care clinicians fail to recognize and accept when curative goals are no longer realistic. At this point, futile efforts at cure can fuel false hopes in patients and their loved ones. The clinician's need to be "doing something" may result in treatment that violates the dignity and well-being of the patient and this can lead to the patient's ultimate hopelessness and despair. This article uses a personal narrative to explore the hopelessness of a patient diagnosed with nonresectable pancreatic cancer and the challenge it raised for the author, who was a friend and a nurse to the patient. Hope is described as a virtue that takes as its object "a future good, difficult but possible to obtain," and that sits squarely between false hopes and despair. Spiritual care that addresses three universal spiritual needs (meaning and purpose, love and relatedness, and f…
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Ethnic differences in caregiver quality of life in pediatric asthma.
Objective: The aim of this study was to determine ethnic and site differences in quality of life (QOL) in a sample of Latino (Puerto Rican [PR] and Dominican) and non-Latino white caregivers of children with asthma in mainland US and Island PR. We also investigated ethnic and site differences in associations between caregiver QOL and indicators of asthma morbidity.
Method: Seven hundred and eighty-seven children with asthma (7-16 years of age) and their primary caregivers participated in the study. Primary caregivers completed a measure of QOL, child asthma control, and emergency department utilization, among other measures.
Results: Ethnic and site differences were found on total QOL scores (ΔF(1,783) = 29.46, p < .001). Island PR caregivers reported worse QOL scores than Rhode Island (Rl) Latino and non-Latino white caregivers; Rl Latino caregivers reported significantly worse QOL scor…
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Internet-based psychoeducation for bipolar disorder: a qualitative analysis of feasibility, acceptability and impact.
Background: In a recent exploratory randomised trial we found that a novel, internet-based psychoeducation programme for bipolar disorder (Beating Bipolar) was relatively easy to deliver and had a modest effect on psychological quality of life. We sought to explore the experiences of participants with respect to feasibility, acceptability and impact of Beating Bipolar.
Methods: Participants were invited to take part in a semi-structured interview. Thematic analysis techniques were employed; to explore and describe participants' experiences, the data were analysed for emerging themes which were identified and coded.
Results: The programme was feasible to deliver and acceptable to participants where they felt comfortable using a computer. It was found to impact upon insight into illness, health behaviour, personal routines and positive attitudes towards medication. Many participants regard…
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