Positive functioning as an outcome in its own right.
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4001 to 4025 of 6,178Determinants associated with the utilization of primary and specialized mental health services.
The study aims to compare variables associated with the exclusive and joint use of primary and specialized care for mental health reasons by individuals diagnosed with a mental disorder in a Montreal/Canadian catchment area. Data were collected from a random sample (2,443 individuals). Among 406 people, diagnosed with a mental disorder 12 months pre-interview, 212 (52%) reported having used healthcare services. Compared to users of primary care only, people who sought both primary and specialized care presented more mental disorders and lower quality of life. People using only specialized healthcare received significantly less social support than persons using primary care exclusively and lived in neighborhoods with a high proportion of rental housing. Healthcare service provision should favor social networking and enable social cohesion and integration, particularly in neighborhoods wit…
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Grief, depressive symptoms, and physical health among recently bereaved spouses.
Purpose: Widowhood is among the most distressing of all life events, resulting in both mental and physical health declines. This paper explores the dynamic relationship between physical health and psychological well-being among recently bereaved spouses.
Design and methods: Using a sample of 328 bereaved persons who participated in the "Living After Loss" study, we modeled trends in physical health, somatic symptoms, and psychological well-being over the first year and a half of widowhood. The primary focus is whether physical health at the time of widowhood modifies psychological well-being over time.
Results: There were considerable somatic symptoms during the earliest months of bereavement but no major health declines over the first year and half of bereavement. Those in poor health had initially higher levels of grief and depressive symptoms, but the trajectories or changes over time…
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Klassen AF, Gulati S, Granek L, Rosenberg-Yunger ZR, Watt L, Sung L, Klaassen R, Dix D, Shaw NT (2012)MEDLINE-indexed journal, not yet read by usQuality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation32 citations Understanding the health impact of caregiving: a qualitative study of immigrant parents and single parents of children with cancer.
Purpose: Research looking at the health of parents of children with cancer typically uses outcome measures focused on symptoms of anxiety, depression, or post-traumatic stress. Our team builds on this literature to provide a more comprehensive understanding of the health impact of caregiving.
Methods: Interviews were conducted with 79 Canadian parents of children with cancer at least 6 months post-diagnosis. Line-by-line coding was used to establish categories and themes. Constant comparison was used to examine relationships within and across codes and categories. Interviewing continued until no new themes emerged.
Results: Parents described health concerns as including sleep disturbance, daytime fatigue, anxiety, depression, social isolation, and changes in social roles. Parents described the positive impacts of caregiving as including gaining a greater appreciation for child and family…
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Gershon RC, Lai JS, Bode R, Choi S, Moy C, Bleck T, Miller D, Peterman A, Cella D (2012)MEDLINE-indexed journal, not yet read by usQuality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation293 citations Neuro-QOL: quality of life item banks for adults with neurological disorders: item development and calibrations based upon clinical and general population testing.
Purpose: Neuro-QOL provides a clinically relevant and psychometrically robust health-related quality of life (HRQL) assessment tool for both adults and children with common neurological disorders. We now report the psychometric results for the adult tools.
Methods: An extensive research, survey and consensus process was used to produce a list of 5 priority adult neurological conditions (stroke, multiple sclerosis, Parkinson's disease, epilepsy and ALS). We identified relevant health related quality of life (HRQL) domains through multiple methods and data sources including a comprehensive review of the literature and literature search, expert interviews and surveys and patient and caregiver focus groups. The final domain framework consisted of 17 domains of Physical, Mental and Social health. There were five phases of item development: (1) identification of 3,482 extant items, (2) item cl…
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The lifetime impact of attention deficit hyperactivity disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC).
Background: The aim of the study was to present nationally representative data on the lifetime independent association between attention deficit hyperactivity disorder (ADHD) and psychiatric co-morbidity, correlates, quality of life and treatment seeking in the USA.
Method: Data were derived from a large national sample of the US population. Face-to-face surveys of more than 34 000 adults aged 18 years and older residing in households were conducted during the 2004-2005 period. Diagnoses of ADHD, Axis I and II disorders were based on the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV version.
Results: ADHD was associated independently of the effects of other psychiatric co-morbidity with increased risk of bipolar disorder, generalized anxiety disorder, post-traumatic stress disorder, specific phobia, and narcissistic, histrionic, borderline, antisocial and sch…
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Patients with psoriasis feel stigmatized.
Stigmatization is defined as having a discrediting mark that leads to social discrimination and alienation. The aim of this study was to estimate the level of stigmatization experienced by patients with psoriasis. A total of 102 individuals with psoriasis were recruited and was assessed using the 6-item Stigmatization Scale and the 33-item Feelings of Stigmatization Questionnaire. In addition, quality of life, stress and depression were evaluated. The majority of patients felt that they were stigmatized by psoriasis. The most bothersome aspect was that other people stared at their skin changes. According to the 33-item questionnaire, anticipation of rejection and feelings of guilt and shame were the major aspects of stigmatization, the level of which correlated significantly with pruritus intensity, stress prior to exacerbation, depressive symptoms and quality of life. In order to decrea…
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Chemotherapy and information-seeking behaviour: characteristics of patients using mass-media information sources.
Objective: Fulfilling patients' information needs can help them cope with illness and improve their well-being. Little research has been conducted on the characteristics of patients using different information sources. This study aims to get insight into which information sources patients receiving chemotherapy for the first time use and which factors (background characteristics, psychological factors, information needs and source reliability) explain the use of different mass-media information sources.
Methods: Three hundred forty-five patients receiving chemotherapy in ten hospitals in the Netherlands completed a questionnaire. Use of 16 sources (mass-media and interpersonal) was measured with a five-point Likert scale. Regression analyses were conducted to test whether use of the three most frequently used mass-media sources could be explained by socio-demographic, medical and psychol…
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New mothers and media use: associations between blogging, social networking, and maternal well-being.
Drawing on Bronfenbrenner's ecological theory and prior empirical research, the current study examines the way that blogging and social networking may impact feelings of connection and social support, which in turn could impact maternal well-being (e.g., marital functioning, parenting stress, and depression). One hundred and fifty-seven new mothers reported on their media use and various well-being variables. On average, mothers were 27 years old (SD = 5.15) and infants were 7.90 months old (SD = 5.21). All mothers had access to the Internet in their home. New mothers spent approximately 3 hours on the computer each day, with most of this time spent on the Internet. Findings suggested that frequency of blogging predicted feelings of connection to extended family and friends which then predicted perceptions of social support. This in turn predicted maternal well-being, as measured by mari…
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Determination of minimum clinically important difference in pain, disability, and quality of life after extension of fusion for adjacent-segment disease.
Object: Spinal surgical outcome studies rely on patient-reported outcome (PRO) measurements to assess treatment effect. A shortcoming of these questionnaires is that the extent of improvement in their numerical scores lack a direct clinical meaning. As a result, the concept of minimum clinical important difference (MCID) has been used to measure the critical threshold needed to achieve clinically relevant treatment effectiveness. As utilization of spinal fusion has increased over the past decade, so has the incidence of adjacent-segment degeneration following index lumbar fusion, which commonly requires revision laminectomy and extension of fusion. The MCID remains uninvestigated for any PROs in the setting of revision lumbar surgery for adjacent-segment disease (ASD).
Methods: In 50 consecutive patients undergoing revision surgery for ASD-associated back and leg pain, PRO measures of ba…
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Are only Emotional Strengths Emotional? Character Strengths and Disposition to Positive Emotions.
This study aimed to examine the relations between character strengths and dispositional positive emotions (i.e. joy, contentment, pride, love, compassion, amusement, and awe). A sample of 574 German-speaking adults filled in the Dispositional Positive Emotion Scales (DPES; Shiota, Keltner, & John, 2006), and the Values in Action Inventory of Strengths (VIA-IS; Peterson, Park, & Seligman, 2005). The factorial structure of the DPES was examined on item level. Joy and contentment could not be clearly separated; the items of the other five emotions loaded on separate factors. A confirmatory factor analysis assuming two latent factors (self-oriented and object/situation specific) was computed on scale level. Results confirmed the existence of these factors, but also indicated that the seven emotions did not split up into two clearly separable families. Correlations between dispositional posit…
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Family members of cancer patients: Needs, quality of life and symptoms of anxiety and depression.
Background: Family members of cancer patient's have multiple needs, many of which are not adequately met. Unmet needs may affect psychological distress and quality of life (QOL). The purpose of this study was to assess needs and unmet needs, QOL, symptoms of anxiety and depression, and the relationship between those variables in a large sample of family members of cancer patients in different phases of illness.
Material and methods: Of 332 family members invited to participate, 330 accepted and 223 (67%) completed a cross-sectional, descriptive study. Data was collected with the Family Inventory of Needs (FIN), Quality of Life Scale (QOLS) and the Hospital Anxiety and Depression Scale (HADS).
Results: Of 20 needs assessed the mean (SD) number of important needs and unmet needs was 16.4 ± 4.3 and 6.2 ± 5.6, respectively. Twelve important needs were unmet in 40-56% of the sample. The mean …
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Assessment of health-related quality of life among primary caregivers of children with autism spectrum disorders.
The impact of caring for a child with autism on caregivers' health-related quality of life (HRQOL) is not fully understood. The objective of this study was to compare the HRQOL scores of caregivers of children with autism to those of the general US population and to identify the factors that influence HRQOL. Caregivers of children with autism had lower HRQOL scores than the general population. Care recipient level of functional impairment, social support, use of maladaptive coping, and burden influenced caregiver mental HRQOL. Care recipient extent of behavioral problems and social support influenced caregiver physical HRQOL. Findings emphasize the use of multi-pronged intervention approach that incorporates components aimed at improving family functioning, increasing support services, and assisting caregivers in developing healthy coping skills.
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Social network type and subjective well-being in a national sample of older Americans.
Purpose: The study considers the social networks of older Americans, a population for whom there have been few studies of social network type. It also examines associations between network types and well-being indicators: loneliness, anxiety, and happiness.
Design and methods: A subsample of persons aged 65 years and older from the first wave of the National Social Life, Health, and Aging Project was employed (N = 1,462). We applied K-means cluster analysis to derive social network types using 7 criterion variables. In the multivariate stage, the well-being outcomes were regressed on the network type construct and on background and health characteristics by means of logistic regression.
Results: Five social network types were derived: "diverse," "friend," "congregant," "family," and "restricted." Social network type was found to be associated with each of the well-being indicators after …
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Quality of life measures in Islamic rectal carcinoma patients receiving counselling.
Aim: This prospective study was conducted to compare changes in the health-related quality of life (HRQoL) and religious practices of patients who underwent surgery for rectal cancer.
Method: We prospectively followed 93 Muslim patients after surgery for colorectal carcinoma: abdominoperineal excision (APE, n = 50), sphincter-saving resection (LAR, n = 22) or anterior resection including sigmoid colectomy (AR, n = 1). The HRQoL was measured pre- and postoperatively at 15-18 months with the Medical Outcomes Study Short Form 36 Health Survey (SF-36) and a modified version of the American Society of Colorectal Surgeons (ASCRS) Fecal Incontinence questionnaire. Life standards, including religious practice, were measured using the Ankara University Life Standard Questionnaire.
Results: No difference was detected in any SF-36 Health Survey HRQoL domain among the groups, although there were dif…
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Benefit finding and post-traumatic growth in long-term colorectal cancer survivors: prevalence, determinants, and associations with quality of life.
Background: As research on quality of life of colorectal cancer (CRC) survivors has mainly focused on downsides of cancer survivorship, the aim of this study is to investigate benefit finding (BF) and post-traumatic growth (PTG) in long-term CRC survivors.
Methods: Benefit finding, PTG, and quality of life were assessed 5 years after diagnosis in a population-based cohort of 483 CRC patients using the benefit finding scale, the post-traumatic growth inventory, and the EORTC QLQ-C30. Prevalence of BF and PTG, determinants of moderate-to-high BF and PTG, and the association between BF, PTG, and quality of life were investigated.
Results: Moderate to high levels of BF and PTG were experienced by 64% and 46% of the survivors, respectively. Survivors with the highest level of education and with higher depression scores reported less BF and PTG. The PTG increased with increasing stage and self…
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Spirituality, religiosity, and spiritual pain in advanced cancer patients.
Context: Spirituality, religiosity, and spiritual pain may affect advanced cancer patients' symptom expression, coping strategies, and quality of life.
Objectives: To examine the prevalence and intensity of spirituality, religiosity, and spiritual pain, and how spiritual pain was associated with symptom expression, coping, and spiritual quality of life.
Methods: We interviewed 100 advanced cancer patients at the M.D. Anderson palliative care outpatient clinic in Houston, TX. Self-rated spirituality, religiosity, and spiritual pain were assessed using numeric rating scales (0=lowest, 10=highest). Patients also completed validated questionnaires assessing symptoms (Edmonton Symptom Assessment Scale [ESAS] and Hospital Anxiety and Depression Scale), coping (Brief COPE and Brief R-COPE), the value attributed by the patient to spirituality/religiosity in coping with cancer (Systems of Belief …
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Getting precise and pragmatic about the assessment of bullying: the development of the California Bullying Victimization Scale.
Accurate assessment of bullying is essential to intervention planning and evaluation. Limitations to many currently available self-report measures of bullying victimization include a lack of psychometric information, use of the emotionally laden term "bullying" in definition-first approaches to self-report surveys, and not assessing all components of the definition of bullying (chronicity, intentionality, and imbalance of power) in behavioral-based self-report methods. To address these limitations, we developed the California Bullying Victimization Scale (CBVS), which is a self-report scale that measures the three-part definition of bullying without the use of the term bully. We examined test-retest reliability and the concurrent and predictive validity of the CBVS across students in Grades 5-12 in four central California schools. Concurrent validity was assessed by comparing the CBVS wi…
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Awareness of social and emotional functioning in people with early-stage dementia and implications for carers.
Objectives: This study explores the extent to which awareness of social and emotional function is reduced in early-stage dementia and whether this relates to the quality of life of the person with dementia (PwD), the quality of the relationship between the PwD and carer and carer stress.
Method: Ninety-seven participants with a diagnosis of Alzheimer's, vascular or mixed dementia rated their social functioning using the Socio-Emotional Questionnaire (SEQ). Carers provided parallel ratings, allowing calculation of discrepancy scores used to index awareness. Neuropsychiatric symptoms, PwD quality of life, the perceived quality of the relationship for both partners and carer stress were also measured.
Results: Factor analysis of the SEQ indicated three domains of social functioning: emotional recognition and empathy (ERE), social relationships (SR) and prosocial behaviour (PB). For PwD unaw…
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The relation between objective and subjective domains of recovery among persons with schizophrenia-related disorders.
In recent years, growing emphasis has been placed on the vision of recovery, which is broadly organized into two types: clinical objective versus personal subjective. The purpose of the present study was to investigate the relation between objective clinical recovery as defined by symptom severity and level of functioning, and subjective personal recovery as defined by quality of life, domains of personal confidence and hope, willingness to ask for help, reliance on others and no domination by symptoms. One hundred and fifty-nine persons diagnosed with schizophrenia or schizoaffective disorder completed measures of recovery, quality of life, perceived social support and emotional loneliness. Clinicians used the Modified Brief Psychiatric Rating Scale and the Global Assessment Functioning Scale to assess the severity of symptoms and level of functioning. Results revealed no direct correla…
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Vitamin D deficiency, self-reported physical activity and health-related quality of life: the Comprehensive Dialysis Study.
Background: As research has identified a wide array of biological functions of vitamin D, the consequences of vitamin D deficiency in persons with chronic kidney disease has attracted increased attention. The objective of this study was to determine the extent of 25-hydroxyvitamin D (25-OH vitamin D) deficiency and its associations with self-reported physical activity and health-related quality of life (HRQoL) among participants of the Comprehensive Dialysis Study (CDS).
Methods: The nutrition substudy of the CDS enrolled patients new to dialysis from 68 dialysis units throughout the USA. Baseline 25-OH vitamin D concentration was measured using the Direct Enzyme Immunoassay (Immunodiagnostic Systems Inc.). Physical activity was measured with the Human Activity Profile (HAP); the Medical Outcomes Study Short Form-12 (SF-12) was employed to measure HRQoL.
Results: Mean age of the particip…
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The impact of the social network, stigma and empowerment on the quality of life in patients with schizophrenia.
Objective: The quality of life (QOL) of patients with schizophrenia has been found to be positively correlated with the social network and empowerment, and negatively correlated with stigma and depression. However, little is known about the way these variables impact on the QOL. The study aims to test the hypothesis that the social network, stigma and empowerment directly and indirectly by contributing to depression influence the QOL in patients with schizophrenia and schizoaffective disorders.
Method: Data were collected on demographic and clinical variables, internalized stigma, perceived devaluation and discrimination, empowerment, control convictions, depression and QOL. Structural equation modelling (SEM) was applied to examine the impact of the above-mentioned constructs on QOL.
Results: The influences of the social network, stigma, empowerment and depression on QOL were supported …
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Resilience in infertile couples acts as a protective factor against infertility-specific distress and impaired quality of life.
Objective: Our hypothesis was that resilience (=psychosocial stress-resistance) reduces infertility-specific distress and maintains quality of life of infertile couples.
Methods: Questionnaire data of WHO Quality of Life assessment (WHOQOL; domains: 'physical', 'psychological', 'social relationships' and 'environment'), Fertility Problem Inventory (FPI; scales: 'social concern', 'sexual concern', 'relationship concern', 'rejection of childfree lifestyle' and 'need for parenthood'), Resilience Scale (RS), as well as sociographic and medical data were available for 199 infertile couples.
Results: Age, medical diagnosis and 'intensity of desire for a child' had no influence on quality of life. High scores on 'suffering from childlessness' went along with less satisfaction on 'physical' and 'psychological' domains for the women only. For both partners, high scores on 'suffering from childles…
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Hoertnagl CM, Muehlbacher M, Biedermann F, Yalcin N, Baumgartner S, Schwitzer G, Deisenhammer EA, Hausmann A, Kemmler G, Benecke C, Hofer A (2011)MEDLINE-indexed journal, not yet read by usBipolar disorders56 citations Facial emotion recognition and its relationship to subjective and functional outcomes in remitted patients with bipolar I disorder.
Objectives: Outcome in bipolar disorder (BD) is multidimensional and consists of clinical and psychosocial domains. Difficulties in affect recognition and in emotional experience are a hallmark of BD, but there is little research investigating the consequences of this deficit on the psychosocial status of patients who are in remission.
Methods: This cross-sectional study examined the relationship of facial affect recognition and treatment outcomes in terms of psychopathology, quality of life, and psychosocial functioning in remitted BD patients compared to healthy volunteers.
Results: Altogether, 47 outpatients meeting diagnostic criteria for bipolar I disorder according to DSM-IV and 45 healthy control subjects were included in the study. Patients were particularly impaired in the recognition of facial expressions depicting disgust and happiness. For patients, the most frequently observ…
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Breathing retraining - a five-year follow-up of patients with dysfunctional breathing.
Introduction: The term dysfunctional breathing (DB) has been introduced to describe patients who display divergent breathing patterns and have breathing problems that cannot be attributed to a specific medical diagnosis. Patients with DB are often misdiagnosed as having asthma.
Objectives: To describe patients with DB, five years after a breathing retraining intervention.
Methods: Out of initially 25 patients with DB and 25 age and sex-matched patients with asthma, 22 patients with DB and 23 patients with asthma (ages 25-78 years) were followed up after five years. Data were collected from posted self-report questionnaires. Only patients with DB had received breathing retraining, consisting of information, advice and diaphragmatic breathing. Patients were evaluated regarding quality of life (SF-36), anxiety, depression, sense of coherence, hyperventilation, influence on daily life, emerg…
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Yang YM, Wang HH (2011)MEDLINE-indexed journal, not yet read by usJournal of transcultural nursing : official journal of the Transcultural Nursing Society19 citations Acculturation and health-related quality of life among Vietnamese immigrant women in transnational marriages in Taiwan.
Purpose: To examine associations between demographic variables, acculturation, and health-related quality of life among Vietnamese immigrant women in transnational marriages in Taiwan.
Design: A cross-sectional survey of 203 participants in southern Taiwan. Instruments included a demographic inventory, the Suinn-Lew Asian Self-Identity Acculturation Scale, and the Short Form Health Survey-Version 2.
Findings: Most participants had low acculturation levels. Length of residency, number of children, marital status, level of education, religion of spouse, and employment status of spouse significantly correlated with level of acculturation, as did mental health, bodily pain, vitality, and social functioning.
Discussion and conclusion: Programs are needed to encourage social assimilation for Vietnamese immigrant women in Taiwan. Culturally sensitive medical evaluations will ensure early treatm…
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