Positive functioning as an outcome in its own right.
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4176 to 4200 of 6,178Barriers to self-management and quality-of-life outcomes in seniors with multimorbidities.
Purpose: Persons with multiple chronic diseases must integrate self-management tasks for potentially interacting conditions to attain desired clinical outcomes. Our goal was to identify barriers to self-management that were associated with lower perceived health status and, secondarily, with lower reported physical functioning for a population of seniors with multimorbidities.
Methods: We conducted a cross-sectional telephone survey of 352 health maintenance organization members aged 65 years or older with, at a minimum, coexisting diagnoses of diabetes, depression, and osteoarthritis. Validated questions were based on previous qualitative interviews that had elicited potential barriers to the self-management process for persons with multimorbidities. We analyzed associations between morbidity burden, potential barriers to self-management, and the 2 outcomes using multivariate linear reg…
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Shilling V, Jenkins V (2007)MEDLINE-indexed journal, not yet read by usEuropean journal of oncology nursing : the official journal of European Oncology Nursing Society139 citations Self-reported cognitive problems in women receiving adjuvant therapy for breast cancer.
Self-reported cognitive problems are common among women receiving adjuvant therapy for breast cancer but are unrelated to actual cognitive impairment. To date, no studies have objectively measured impairment and asked patients to speak about the type and extent of problems they encounter. We report interview data from 142 breast cancer patients receiving adjuvant therapy. We aimed to identify the types of problems and the extent to which they interfered with everyday life. We investigated the relationship between self-reported and objective cognitive impairment, quality of life and psychological distress. The majority of participants reported problems with their memory (71% overall at 6 months, 60% at 18 months) and concentration (64% and 42%, respectively). This was unrelated to objective cognitive decline; rather, it was associated with psychological distress and quality of life. For t…
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Impact of psychosocial factors on quality of life in overweight youth.
Objective: The psychosocial functioning of overweight youth is a growing concern. Research has shown that overweight children report lower quality of life (QOL) than their non-overweight peers. This study sought to extend the literature by examining the association between peer victimization, child depressive symptoms, parent distress, and health-related QOL in overweight youth. Mediator models are used to assess the effect of child depressive symptoms on the relationship between psychosocial variables and QOL.
Research methods and procedures: The sample consisted of 96 overweight and at-risk-for-overweight children (mean age=12.8 years) and their parents who were recruited from a Pediatric Endocrinology Obesity Clinic. Parents completed a demographic questionnaire, the Pediatric Quality of Life Inventory-parent-proxy version, and the Brief Symptom Inventory. Children completed the Child…
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Hypochondriasis and health anxiety in the German population.
Epidemiologic studies on hypochondriasis are very rare and have not been included in large North American community surveys until now. In order to gain information on the prevalence as well as the socio-demographic characteristics of hypochondriasis, the following community study was carried out. Analyses are based on an assessment of 1575 subjects selected by socio-demographic representation criteria for the German community. All subjects completed the Illness Attitude Scales (IAS) and responded to several additional questions on sociodemographics and diagnostic criteria pertaining to Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) hypochondriasis. The IAS is internationally one of the best-established self-rating questionnaires for the assessment of hypochondriasis and health anxiety. Results reveal a 0.4% point prevalence rate of DSM-IV hypochondriasis. …
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Jakobsson U (2007)MEDLINE-indexed journal, not yet read by usAging clinical and experimental research97 citations Using the 12-item Short Form health survey (SF-12) to measure quality of life among older people.
Aims: To present descriptive data, study psychometric abilities, and investigate the characteristics of non-respondents to SF-12.
Method: The study had a randomized sample (n=4278; age: 75-105) stratified in four age groups. Factor analyses were performed to investigate the factor structure of the instrument, and convergent and discriminant validity was assessed by correlation between summary scores and by means of various measures (such as symptoms and ADL). Mean scores and Cronbach's alpha were computed for the total sample and for each stratum. Respondents and non-respondents to SF-12 were compared regarding various measures. A multiple logistic regression analysis was conducted to identify determinants for respondents/non-respondents.
Results: Mean scores in the total sample were 37.5 SD 11.9 for the physical component summary score (PCS) and 50.3 SD 11.5 for the mental component sum…
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Seeking serenity: living with HIV/AIDS in rural Western Canada.
Introduction: The purpose of this naturalistic inquiry was to describe the experience of living with HIV infection in rural Alberta, Canada. Although the urban HIV epidemic has been well researched, the virus continues its spread into more remote populations where there is a need to understand and address its impact. Affected rural residents form a diverse and marginalized group that includes women, Aboriginal peoples, immigrants, injecting drug users, and men who have sex with men, yet there are few data available to inform appropriate health and social services and practice. A number of factors, such as stigma, invisibility, isolation, confidentiality, poverty, and risk behaviours, contribute to the rural experience, but have not been clearly explicated in the literature. This study was conducted in order to better understand the perceptions of health in a rural setting, the processes …
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Perceived helpfulness and impact of social support provided by family, friends, and health care providers to women newly diagnosed with breast cancer.
We evaluated the helpfulness of informational, emotional, and decision-making support received by women newly diagnosed with breast cancer from their family, friends, and health care providers. Data were collected at two time points via patient surveys: baseline on an average 2 months post-diagnosis and follow-up at 5 months post-baseline. In the period closer to diagnosis, majority of the women received helpful informational support from health care providers (84.0%); helpful emotional support from family (85%), friends (80.4%), and providers (67.1%); and helpful decision-making support from providers (75.2%) and family (71.0%). Emotional support at baseline and emotional and informational support at 5-month follow-up were significantly associated with patients' health-related quality of life and self-efficacy outcomes (p<0.01). Perceived helpfulness of informational, emotional, and dec…
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Depression, anxiety, and quality of life in patients with atrial fibrillation.
Objective: To examine the prevalence and persistence of depression and anxiety in patients with atrial fibrillation (AF), and their effect on future quality of life (QoL) status.
Methods: The Beck Depression Inventory and State-Trait Anxiety Inventory were completed by 101 patients with AF (62 men; mean age +/- SD, 66.3 +/- 11.0 years), who were compared to 97 patients with hypertension (as "disease control" subjects) in sinus rhythm (64 men; mean age, 68.0 +/- 7.2 years) at baseline and at 6 months. QoL was ascertained at both time points using Dartmouth Care Cooperative Information Project charts.
Results: At baseline among AF patients, symptoms of depression, state anxiety, and trait anxiety prevailed in 38%, 28%, and 38%, respectively; analogous data for hypertensive patients were 30%, 23%, and 22%. AF patients displayed higher levels of trait anxiety (p < 0.05), with no significant …
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Multimorbidity and quality of life: a closer look.
Background: The presence of multiple chronic conditions is associated with lower health related quality of life (HRQOL). Disease severity also influences HRQOL. To analyse the effects of all possible combinations of single diseases along with their severity on HRQOL seems cumbersome. Grouping diseases and their severity in specific organ domains may facilitate the study of the complex relationship between multiple chronic conditions and HRQOL. The goal of this study was to analyse impaired organ domains that affect the most HRQOL of patients with multiple chronic conditions in primary care and their possible interactions.
Methods: We analysed data from 238 patients recruited from the clientele of 21 family physicians. We classified all chronic conditions along with the measure of their severity into the 14 organ domains of the Cumulative Illness Rating Scale (CIRS). Patients also complet…
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Bejerholm U, Eklund M (2007)MEDLINE-indexed journal, not yet read by usThe American journal of occupational therapy : official publication of the American Occupational Therapy Association66 citations Occupational engagement in persons with schizophrenia: relationships to self-related variables, psychopathology, and quality of life.
Previous research suggests that having schizophrenia involves not being fully equipped to engage in daily occupations. This study was aimed at exploring relationships between occupational engagement and the issues of self-related variables, psychiatric symptoms, and quality of life. Seventy-four outpatients with schizophrenia entered the study. Instruments used in this study were Profile of Occupational Engagement in People with Schizophrenia, Locus of Control, Mastery, Sense of Coherence, Brief Psychiatric Rating Scale, and Lancashire Quality of Life Profile. The results showed that a high level of occupational engagement was related to higher ratings of self-related variables, fewer psychiatric symptoms, and better ratings of quality of life, and vice versa. A significant difference and a linear trend were found among the three subgroups of different levels of occupational engagement a…
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Impact of overactive bladder on women in the United States: results of a national survey.
Background: Overactive bladder (OAB) may affect health-related quality of life. Few data have been gathered on the impact of OAB or on patient satisfaction with therapy. This 2002 survey examined the effects of OAB on participants; treatment-seeking behaviors, patient satisfaction with oral OAB therapies, and desirable characteristics of new treatments were investigated.
Methods: An online questionnaire was administered to 1228 women aged 40-65 years with at least a high school education and minimum annual income of 35,000 dollars. Respondents were categorized as having no OAB symptoms (control group; n = 330) or as having OAB symptoms (n = 898). Those with symptoms were subdivided into treatment groups: current users of prescription OAB medications (n = 309), lapsed prescription medication users (n = 265), and those never treated (n = 324). The significance of between-group differences …
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Insomnia and well-being.
Most Americans have occasional problems with insomnia. The relationship of insomnia to illness is well known. However, insomnia may also relate to lower levels of well-being. Although there are various definitions of well-being, one of the most clearly articulated and comprehensive models identifies 2 overarching constructs, psychological well-being and subjective well-being. The purpose in the present study was to assess the relationship between insomnia symptoms and the dimensions of psychological and subjective well-being, adjusting for the potential confound of comorbid physical and psychological illness. The data for the present study came from the National Survey of Midlife Development in the United States, a survey of community-dwelling adults. After adjustment for demographic characteristics and a wide range of chronic mental and physical health conditions, insomnia symptoms were…
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Attribution of blame, self-forgiving attitude and psychological adjustment in women with breast cancer.
The purpose of this study was to examine relationships among self-blame for developing breast cancer, a self-forgiving attitude, mood, and quality of life among women with breast cancer. In this cross-sectional study, 123 women with Stages 0-III breast cancer completed questionnaires measuring demographic and medical characteristics, self-blame, self-forgiveness, mood, and quality of life. Women who blamed themselves reported more mood disturbance (p <or= .001) and poorer quality of life (p < .001) than those who did not blame themselves. Mediational analyses revealed that self-blame for cancer partially mediated the relationships between a self-forgiving attitude and both mood disturbance and quality of life (Z = -2.72, p = .006 and Z = -2.89, p = .004, respectively). Patients may benefit from a discussion with their oncologists and other healthcare providers about self-forgiveness and …
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Women of the 1950s and the "normative" life course: the implications of childlessness, fertility timing, and marital status for psychological well-being in late midlife.
We explore women's psychological well-being in late midlife in relation to childlessness and timing of entry into motherhood. Using two U.S. surveys, Health and Retirement Study (HRS) (1992) and National Survey of Families and Households (NSFH) (Sweet, Bumpass, & Call, 1988), we assess the well-being of childless women in their 50s compared to mothers with early, delayed, or normatively timed first births. We focus on the cohorts born between 1928 and 1941, who experienced strong normative pressures during the baby boom with regard to marriage and child-bearing. We find few differences among childless women but lower well-being among early mothers, related to singlehood and poorer socioeconomic status. Unmarried mothers are significantly disadvantaged regardless of maternal timing, controlling for socioeconomic status. Current maternal demands are independently related to well-being and …
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The voices acceptance and action scale (VAAS): Pilot data.
Acceptance and mindfulness methods that emphasise the acceptance rather than control of symptoms are becoming more central to behavioural and cognitive therapies. Acceptance and Commitment Therapy (ACT) is the most developed of these methods; recent applications of ACT to psychosis suggest it to be a promising therapeutic approach. However, investigation of the mechanisms of therapy within this domain is difficult because there are no acceptance-based measures available specifically for psychotic symptoms. This paper describes the preliminary evaluation of a self-report instrument designed to assess acceptance-based attitudes and actions in relation to auditory and command hallucinations. Following initial scale development, a 56-item version of the Voices Acceptance and Action Scale (VAAS) was administered to 43 participants with command hallucinations as part of their baseline assessme…
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Quality of life after surgery, external beam irradiation, or brachytherapy for early-stage prostate cancer.
Background: The primary treatments for clinically localized prostate cancer confer equivalent cancer control for most patients but disparate side effects. In the current study, the authors sought to compare health-related quality of life (HRQOL) outcomes after the most commonly used treatments.
Methods: A total of 580 men completed the Medical Outcomes Study Short Form-36, the University of California-Los Angeles (UCLA) Prostate Cancer Index, and the American Urological Association Symptom Index before and through 24 months after treatment with radical prostatectomy (RP), external beam radiation therapy (EBRT), or brachytherapy (BT).
Results: General HRQOL did not appear to be affected by treatment. Obstructive and irritative urinary symptoms were more common after BT (P<.001). Urinary control and sexual function were better after EBRT than BT (P<.001 and P=.02, respectively) and better …
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Influences of hormone-based contraception on depressive symptoms in premenopausal women with major depression.
Objective: Hormone-based contraceptives affect mood in healthy women or in women with premenstrual dysphoric disorder (PMDD). No study has yet examined their association with mood in women with major depressive disorder (MDD). The purpose of this study was to determine whether estrogen-progestin combination or progestin-only contraceptives are associated with depression severity, function and quality of life, or general medical or psychiatric comorbidity in women with MDD.
Methods: This analysis focused on a large population of female outpatients less than 40 years of age with non-psychotic MDD who were treated in 18 primary and 23 psychiatric care settings across the US, using data from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Baseline demographic and clinical information was gathered and compared between three groups based on hormonal use: combination …
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Caregiver burden in multiple sclerosis: the impact of neuropsychiatric symptoms.
Background: We studied the level of distress in caregivers of patients with recently diagnosed multiple sclerosis (MS), and their relation to clinical characteristics.
Methods: Caregivers of patients with MS and Parkinson's disease completed measures of distress and quality of life. MS patients underwent neurological, neuropsychiatric and neuropsychological examinations. Multivariate regression analyses were used to explore the relationship between patient variables and caregiver distress.
Results: Caregivers of patients with MS experienced high levels of distress and reduced quality of life related to caregiving. The level of distress was similar to that reported by elderly spouses of patients with longstanding Parkinson's disease. Psychiatric symptoms and cognitive impairment in patients with MS were associated with caregiver's distress and quality of life, even after controlling for l…
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Locker D, Allen F (2007)MEDLINE-indexed journal, not yet read by usCommunity dentistry and oral epidemiology398 citations What do measures of 'oral health-related quality of life' measure?
The terms 'health-related quality of life' and 'quality of life' are now in common use to describe the outcomes of oral health conditions and therapy for those conditions. In addition, there has been a proliferation of measures designed to quantify those outcomes. These measures, which were initially designated as socio-dental indicators or subjective oral health indicators are now more usually referred to as measures of oral health-related quality of life (OH-QoL). This is based on the assumption that the functional and psychosocial impacts they document must, of necessity, affect the quality of life. While this assumption has been subject to critical scrutiny in medicine, this is not the case with dentistry. Consequently, exactly what is being measured by indexes of OH-QoL is somewhat unclear. Based on the debate between Gill and Feinstein and Guyatt and Cook, we outline a number of cr…
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The stress moderating role of benefit finding on psychological distress and well-being among women living with HIV/AIDS.
This study examines whether the perception of having experienced growth as a result of a stressful event, often termed benefit finding, moderates the effects of stress (both physical symptomatology and social conflict) on psychological distress and well-being. For this cross-sectional study, an ethnically diverse sample (N = 138) of women living with HIV/AIDS completed a series of self-report measures. Hierarchical regression analysis demonstrated that physical symptoms, social conflict, and benefit finding were associated with psychological distress and positive affect, even after controlling for social support, locus of control, and demographic confounds. Significant interactions revealed that among women with a high number of HIV-related physical symptoms, benefit finding moderated the negative effects of physical symptoms on both depressive and anxious symptoms. Benefit finding was n…
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Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study.
Objective: To examine trends and effects of weight loss treatment on health-related quality of life (HRQL) in the severely obese over 10 years.
Design: Swedish obese subjects (SOS) intervention study is a controlled, longitudinal trial of the health effects of weight loss in the severely obese.
Subjects: A total of 655 of 851 surgically treated and 621 of 852 conventionally treated obese men (body mass index, BMI>or=34) and women (BMI>or=38) who completed 10 years of the study.
Measurements: HRQL was assessed before treatment and after 0.5, 1, 2, 3, 4, 6, 8 and 10 years.
Results: HRQL change during the 10-year observation period largely followed phases of weight loss, weight regain and weight stability. Improvements and deteriorations in HRQL were associated with the magnitude of weight loss or regain, except regarding anxiety. Peak improvements in the surgical group were observed during…
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Updated and revised Diabetes Family Conflict Scale.
Objective: The purpose of this study was to update the Diabetes Family Conflict Scale (DFCS) in the era of intensive diabetes management and provide an indication of its psychometric properties.
Research design and methods: The revised DFCS and measures of negative emotions around blood glucose monitoring (BGM), quality of life, and perceived parental burden from diabetes management were completed by 202 children and adolescents with type 1 diabetes and their primary caregivers. Insulin regimen, adherence, and glycemic control were also assessed.
Results: The revised DFCS demonstrated strong psychometric properties. There was acceptable internal consistency for child and caregiver forms of the DFCS. Factor analysis revealed two factors related to direct and indirect management tasks. Both child (r = 0.27, P < 0.01) and caregiver (r = 0.26, P < 0.01) DFCS scores were correlated with A1C v…
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Changes of life satisfaction in the transition to retirement: a latent-class approach.
Contradictory positions have been advanced as to whether retirement has negative, positive, or no effects on subjective well-being. The authors investigated changes in life satisfaction in 1,456 German retirees. Using latent growth mixture modeling, the authors found 3 groups of people who experienced retirement differently. In Group 1, satisfaction declined at retirement but continued on a stable or increasing trajectory thereafter. Group 2 demonstrated a large increase in satisfaction at retirement but overall declining satisfaction. In Group 3, satisfaction showed a temporary very small increase at retirement. Groups differed by retirement age, gender, socioeconomic status, marital status, health, unemployment before retiring, and region. Thus, retirement is not a uniform transition, and resource-rich individuals are less likely to experience retirement-related change in satisfaction.
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Adjusting to life after treatment: distress and quality of life following treatment for breast cancer.
Clinical and anecdotal findings suggest that the completion of cancer treatment may be marked by heightened distress and disrupted adjustment. The present study examined psychological adjustment during the 3 months following treatment among 89 women with stages 0-III breast cancer. Participants completed measures of depression, cancer-related anxiety, cancer concerns, and quality of life at three time points: during treatment, 3 weeks following the end of treatment, and 3 months post-treatment. Post-treatment scores were suggestive of good psychological adjustment among the majority of women. Moreover, distress did not increase following treatment; longitudinal analyses showed no significant changes in depression or recurrence worry, while intrusive thoughts decreased, and quality of life improved. Younger age predicted greater distress across measures. A history of depression or anxiety…
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Anxiety and depression in COPD patients: The roles of gender and disease severity.
Background: The aim of our study was to assess the prevalence of anxiety and depression in the whole chronic obstructive pulmonary disease (COPD) population and in subgroups according to sex and severity classification. A secondary objective was to evaluate the possible differences between patients with and without a significant high level of anxiety, depression, or both, and finally to find out a correlation between psychological aspects, symptoms, functional parameters, and quality of life (QoL).
Methods: Two hundred and two COPD patients were enrolled. Their levels of anxiety, depression, dyspnea, and QoL were assessed using specific questionnaires. One hundred and fourteen sex- and age-matched healthy subjects were used as the control population.
Results: The prevalences of anxiety and depression were high (28.2% and 18.8%) in COPD even when it was of mild degree, compared to the con…
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