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HRQOL
Kinds of HRQOL Terms modified by HRQOL Selected AbstractsQuality of life and health-related quality of life of adolescents with cerebral palsyDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 7 2007Peter L Rosenbaum MD FRCP(C) This study assessed quality of life (QOL) and health-related quality of life (HRQOL) of 203 adolescents with cerebral palsy (111 males, 92 females; mean age 16y [SD 1y 9mo]). Participants were classified using the Gross Motor Function Classification System (GMFCS), as Level I (n=60), Level II (n=33), Level III (n=28), Level IV (n=50), or Level V (n=32). QOL was assessed by self (66.5%) or by proxy (33.5%) with the Quality of Life Instrument for People With Developmental Disabilities, which asks about the importance and satisfaction associated with the QOL domains of Being, Belonging, and Becoming; HRQOL was captured through proxy reports with the Health Utilities Index, Mark 3 (HUI3), which characterizes health in terms of eight attributes, each having five or six ordered levels of function. GMFCS level was not a source of variation for QOL domain scores but was significantly associated with the eight HRQOL attributes and overall HUI3 utility scores (p<0.05). Some QOL domain scores varied significantly by type of respondent (self vs proxy; p<0.05). Overall HUI3 utility values were significantly but weakly correlated with QOL Instrument scores for Being (r=0.37), Belonging (r=0.17), Becoming (r=0.20), and Overall QOL (r=0.28), and thus explain up to 14% of the variance (r2). These findings suggest that although QOL and HRQOL are somewhat related conceptually, they are different constructs and need to be considered as separate dimensions of the lives of people with functional limitations. [source] The association between depression and health-related quality of life in people with type 2 diabetes: a systematic literature reviewDIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 2 2010Saima Ali Abstract The relationships between co-morbid depression in people with diabetes and adverse outcomes including poor HbA1c control, adherence to medication and mortality have been examined and confirmed. However, as the awareness of the decrement to health-related quality of life (HRQOL) in people with diabetes and its clinical consequences grows, investigators have become increasingly interested in measuring HRQOL in clinical trials. Given that the psychological factors such as depression may contribute to diminished HRQOL, the present review sought to summarize the association between these variables in people with type 2 diabetes. Articles for a systematic review were obtained via a search performed using MEDLINE, EMBASE and PsycINFO (1980,2007). Fourteen articles fulfilled the inclusion criteria. Studies indicated that self-reported depressive symptoms markedly impaired HRQOL on several domains. However, depression was not related to all sub-domains of HRQOL in all studies, suggesting that the effects of depression on certain aspects of HRQOL may vary between clinical and demographic subgroups. Although a number of shortcomings identified in the current literature should be taken into account for future research, the importance of this review lies in the possibility it raises that the improvements in HRQOL and clinical practice may potentially be achieved by placing greater attention on the identification and management of depression. Copyright © 2010 John Wiley & Sons, Ltd. [source] Health Status among Emergency Department Patients Approximately One Year after Consecutive Disasters in New York CityACADEMIC EMERGENCY MEDICINE, Issue 10 2005William George Fernandez MD Abstract Objectives: Emergency department (ED) patients with disaster-related experiences may present with vague symptoms not clearly linked to the event. In 2001, two disasters in New York City, the World Trade Center disaster (WTCD) and the subsequent American Airlines Flight 587 crash, presented an opportunity to study long-term consequences of cumulative disaster exposure (CDE) on health-related quality of life (HRQOL) among ED patients. Methods: From July 15 to October 30, 2002, a systematic sample of stable, adult patients from two EDs in New York City were enrolled. Participants completed a self-administered questionnaire. The Short Form 36 (SF-36) was used to assess overall health status. Bivariate analyses were conducted to identify individual correlates of worsening health status. Multivariate regression was performed to identify the association between various factors and overall health status, while controlling for relevant sociodemographic variables. Results: Four hundred seventy-one patients (54.6% female) participated. The participation rate was 73.4%. One hundred sixty-one participants (36%) reported direct, indirect, or occupational exposure to the WTCD; 55 (13.3%) had direct, indirect, or occupational exposure to the plane crash; 33 (8.1%) had both exposures. In separate multivariate models, CDE predicted lower SF-36 scores for general health (p < 0.0096), mental health (p < 0.0033), and bodily pain (p < 0.0046). Conclusions: In the year following mass traumatic events, persons with CDE had lower overall health status than those with one or no disaster exposure. Clinicians should consider the impact that traumatic events have on the overall health status of ED patients in the wake of consecutive disasters. [source] Prevalence of Active Epilepsy and Health-Related Quality of Life among Adults with Self-Reported Epilepsy in California: California Health Interview Survey, 2003EPILEPSIA, Issue 10 2007Rosemarie Kobau Summary:,Purpose: To examine the prevalence of self-reported epilepsy and active epilepsy, associated burden of impaired health-related quality of life, risk factors, and access to care in adults with self-reported epilepsy, and those classified as having active epilepsy with and without recent seizures. Methods: We analyzed data from adults aged ,18 years (n = 41,494) who participated in the 2003 California Health Interview Survey (CHIS). Results: In California, 1.2% of adults reported ever being told they had epilepsy or seizure disorder, and 0.7% were classified as having active epilepsy. About three-fourths of adults with active epilepsy with recent seizures reported fair or poor health status. Adults with active epilepsy with recent seizures reported almost two weeks of poor physical or mental health and activity limitation days compared with two to 4 days per month in those without epilepsy. Among adults with active epilepsy and recent seizures, about one-quarter reported not taking any medicine to control their seizure disorder or epilepsy. About one-third reported physical disability/unable to work compared to a small proportion of the general population. The majority of adults with active epilepsy reported having a regular source of medical care. Conclusion: Our findings highlight the burden of epilepsy among adults in California. CHIS serves as a model demonstrating the value of including questions about epilepsy on public health surveillance systems to ascertain the burden of the disorder and to guide intervention research and public policy to improve HRQOL in people with epilepsy. [source] Health-related Quality of Life of People with Epilepsy Compared with a General Reference Population: A Tunisian StudyEPILEPSIA, Issue 7 2004Hela Mrabet Summary:,Purpose: The goal of the study was to assess the health-related quality of life (HRQOL) of persons with epilepsy (PWE) by using the short form survey 36 (SF-36), to compare it with that of a control group and to detect factors influencing it. Methods: We collected clinical and demographic data and information on health status by using the Arabic translation of the SF-36 questionnaire from two groups: (a) 120 PWE consulting our outpatient clinic during a period of 4 months, and (b) 110 Tunisian citizens, representative of the Tunisian general population, as a control group. Results: The mean age of PWE group was 32.74 years, and 45.5% were men. Idiopathic generalized epilepsies were observed in 44.5% of cases, and symptomatic partial epilepsies, in 30%. The most commonly prescribed drug was sodium valproate (VPA). For the SF-36, PWE had lower scores than the control group for only three subscales: general health perception, mental health, and social functioning. Seizure frequency, time since last seizure, and the antiepileptic drug (AED) side effects were the most important variables influencing the HRQOL among PWE. Seizure-free adults have HRQOL levels comparable to those of the control group. Sociodemographic variables had no influence on the SF-36 subscales. Conclusions: HRQOL is impaired in Tunisian PWE. The influencing factors identified in this study differ from the previously published data. Several possible reasons such as family support and cultural and religious beliefs are proposed to explain these cross-cultural differences. A larger study should be conducted to verify such findings. [source] Depression and Altered Quality of Life in Women with Epilepsy of Childbearing AgeEPILEPSIA, Issue 1 2004Ettore Beghi Summary: Purpose: To calculate the prevalence of depression in a referral population of women of childbearing age, to define the factors associated with depression, and to assess health-related quality of life (HRQOL) in the same population. Methods: The 642 consecutive women with epilepsy aged 18,55 years were enrolled by 40 neurologists over an 8-month period and asked to give details on selected demographic and clinical features regarding the disease, any associated clinical condition, and any drug treatment. Depression was diagnosed by using the Hamilton depression scale and HRQOL was measured through the SF-36 form. Demographic, clinical, and therapeutic risk factors for depression were searched for within the study population. Results: Depression (any severity) was present at interview in 242 women, giving a prevalence rate of 37.7%[95% confidence interval (CI), 33.9,41.6]. Mild depression was reported by 18.5% of women, moderate depression by 8.6%, major depression by 10.3%, and severe depression by 0.3%. Factors found to be independently associated with depression (any severity) included treatment of associated conditions [relative risk (RR), 1.5; 95% CI, 1.2,1.8), concurrent disability (RR, 1.3; 95% CI, 1.0,1.6), seizures in the preceding 6 months (RR, 1.4; 95% CI, 1.1,1.7), and being unemployed or a housewife (RR, 1.3; 95% CI, 1.0,1.5). Factors associated with moderate to severe depression included treatment for associated conditions (RR, 2.0; 95% CI, 1.4,2.7), seizures in the preceding 6 months (RR, 1.7; 95% CI, 1.2,2.5), and being unemployed or a housewife (RR, 1.6; 95% CI, 1.1,2.2). Compared with normal women of similar age, patients with epilepsy tended to present lower scores for each HRQOL domain (mostly Role Physical, General Health, Social Functioning, and Role Emotional). However, when the analysis was limited to nondepressed women with epilepsy, any difference disappeared. Conclusions: Women with epilepsy of childbearing age are at high risk of depression. Factors associated with depression include lack of occupation, the presence of an underlying disabling condition (with treatment), and the severity of epilepsy. Compared with the general population, depressed women have greater impairment of HRQOL with epilepsy, which reflects the physical, social, and emotional implications of the disease. [source] Validity of Three Measures of Health-related Quality of Life in Children with Intractable EpilepsyEPILEPSIA, Issue 10 2002Elisabeth M. S. Sherman Summary: ,Purpose: Validity studies on health-related quality of life (HRQOL) scales for pediatric epilepsy are few, and cross-validation with other samples has not been reported. This study was designed to assess the validity of three parent-rated measures of HRQOL in pediatric epilepsy: (a) the Impact of Childhood Illness Scale (ICI), (b) the Impact of Child Neurologic Handicap Scale (ICNH), and (c) the Hague Restrictions in Epilepsy Scale (HARCES). Methods: Retrospective data were examined for 44 children with intractable epilepsy. Validity was assessed by evaluating differences across epilepsy severity groups as well as correlations between HRQOL scales and neurologic variables (seizure severity, epilepsy duration, current/prior antiepileptic medications) and psychosocial measures (emotional functioning, IQ, social skills, adaptive behavior). Scale overlap with a global QOL rating also was assessed. Results: The HRQOL measures were moderately to highly intercorrelated. The scales differed in terms of their associations with criterion measures. The HARCES was related to the highest number of neurologic variables and the ICNH to the fewest. All three scales were related to psychosocial functioning and to global quality of life. Conclusions: The results of this study suggest that the three measures are likely adequate measures of HRQOL for use in intractable childhood epilepsy. The measures were highly intercorrelated, and they were all broadly related to criterion measures reflecting specific domains of HRQOL as well as global QOL. Some differences between scales emerged, however, that suggest care in choosing HRQOL instruments for children with epilepsy. [source] Changes in Quality of Life in Epilepsy: How Large Must They Be to Be Real?EPILEPSIA, Issue 1 2001Samuel Wiebe Summary: ,Purpose: The study goal was to assess the magnitude of change in generic and epilepsy-specific health-related quality-of-life (HRQOL) instruments needed to exclude chance or error at various levels of certainty in patients with medically refractory epilepsy. Methods: Forty patients with temporal lobe epilepsy and clearly defined criteria of clinical stability received HRQOL measurements twice, 3 months apart, using the Quality of Life in Epilepsy Inventory-89 and -31 (QOLIE-89 and QOLIE-31), Liverpool Impact of Epilepsy, adverse drug events, seizure severity scales, and the Generic Health Utilities Index (HUI-III). Standard error of measurement and test-retest reliability were obtained for all scales and for QOLIE-89 subscales. Using the Reliable Change Index described by Jacobson and Truax, we assessed the magnitude of change required by HRQOL instruments to be 90 and 95% certain that real change has occurred, as opposed to change due to chance or measurement error. Results: Clinical features, point estimates and distribution of HRQOL measures, and test-retest reliability (all > 0.70) were similar to those previously reported. Score changes of ±13 points in QOLIE-89, ±15 in QOLIE-31, ±6.3 in Liverpool seizure severity,ictal, ±11 in Liverpool adverse drug events, ±0.25 in HUI-III, and ±9.5 in impact of epilepsy exclude chance or measurement error with 90% certainty. These correspond, respectively, to 13, 15, 17, 18, 25, and 32% of the potential range of change of each instrument. Conclusions: Threshold values for real change varied considerably among HRQOL tools but were relatively small for QOLIE-89, QOLIE-31, Liverpool Seizure Severity, and adverse drug events. In some instruments, even relatively large changes cannot rule out chance or measurement error. The relation between the Reliable Change Index and other measures of change and its distinction from measures of minimum clinically important change are discussed. [source] Health-related quality of life assessment in randomised controlled trials in multiple myeloma: a critical review of methodology and impact on treatment recommendationsEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 4 2009Ann Kristin Kvam Abstract Objectives:, Patients with multiple myeloma (MM) often have pronounced symptoms and substantially reduced quality of life. The aims of treatment are to control disease, maximise quality of life and prolong survival. Hence, health-related quality of life (HRQOL) should be an important end-point in randomised controlled trials (RCTs) in addition to traditional endpoints. We wanted to evaluate whether trials reporting HRQOL outcomes have influenced clinical decision making and whether HRQOL was assessed robustly according to predefined criteria. Methods:, A systematic review identified RCTs in MM with HRQOL assessment as a study end-point. The methodological quality of these studies was assessed according to a checklist developed for evaluating HRQOL outcomes in clinical trials. The impact of the HRQOL results on clinical decision making was assessed, using published clinical guidelines as a reference. Results:, Fifteen publications presenting RCTs with HRQOL as a study end-point were identified. In 13 trials, the author stated that HRQOL results should influence clinical decision making. We found, however, that the HRQOL data only had a limited impact on published treatment guidelines for bisphosphonates, high-dose treatment, interferon, erythropoiesis-stimulating agents and novel agents. Conclusion:, The present review indicates that the there are still few RCTs in MM including HRQOL as a study end-point. Systematic incorporation of HRQOL measures into clinical trials allows for a comparison of treatment arms that includes the patients' perspective. Before the full impact on clinical decisions can be realised, the quality and methodology of collecting HRQOL data must be further improved and the results rendered more comprehensible to clinicians. [source] Relationship between intensity of physical activity and health-related quality of life in Portuguese institutionalized elderlyGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 4 2008Alexandrina Lobo Aims: Health-related quality of life (HRQOL) is considered to be the key goal for health promotion in older people. This study explores the relationship between HRQOL and objectively measured intensity of physical activity (PA) in institutionalized older adults. The analysis of the PA patterns of the subjects in relation to recommended levels of PA was also performed. Methods: One hundred and eighty-five residents of long-term care homes aged 65 years or more, volunteered for this study. The Medical Outcome Study Short Form 36-Item health survey (MOS SF-36) questionnaires and the uni-axial MTI Actigraph were used to assess HRQOL and PA, respectively. Participants were classified as less active, reasonably active and more active by tertile of moderated physical activity (MPA). Results: (i) The men represented a greater number of counts/h and min of MPA in all the tertile groups; (ii) men from the less active group had a significantly higher body mass index; (iii) women came third and exhibited less total activity even though they used this time in more intense activities; (iv) there was a higher significant correlation between MPA, physical function and negative association with body pain in relation to the time of institutionalization in both sexes but was more strongly visible in men; and (v) only men presented a significant positive association with physical health, mental health and vitality. Conclusion: Any intensity of PA seems to be better than no activity for HRQOL, but MPA confers greater benefits for the perception of physical function and body pain in the case of institutionalized elderly persons. [source] Review of quality of life: menorrhagia in women with or without inherited bleeding disordersHAEMOPHILIA, Issue 1 2008M. SHANKAR Summary., The objectives of this study were to identify the impact of menorrhagia on the health-related quality of life (HRQOL) of women in general and those with inherited bleeding disorders and to identify the commonly used tools in assessing quality of life. A review of studies evaluating quality of life in women suffering from menorrhagia was conducted. Data sources used included electronic databases Medline and Embase. Reference lists and bibliographies of the relevant papers and books were hand-searched for additional studies. Eighteen of the 53 studies identified measured quality of life prior to treatment of menorrhagia. Ten of the studies used a validated measure of quality of life. Five studies involving a total of 1171 women with menorrhagia in general and using SF-36 were considered for further review. The mean SF-36 scores in women with menorrhagia were worse in all the eight scales when compared with normative scores from a general population of women. Three studies, involving 187 women, assessed the quality of life in women with menorrhagia and inherited bleeding disorders. None of these studies used a validated HRQOL score making it difficult for comparison. However, all reported poorer scores in study women compared to the controls. In conclusion, HRQOL is adversely affected in women with menorrhagia in general and in those with inherited bleeding disorders. HRQOL evaluation is useful in the management of women with menorrhagia for assessment of treatment efficacy. [source] Health-related quality of life profiles based on survivorship status for head and neck cancer patients,HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 3 2007David P. Goldstein MD Abstract Background. As the methodologies for evaluating health-related quality of life (HRQOL) in head and neck cancer patients have matured over the past 10 years, there has been an increasing focus on reporting longitudinal data. These studies have primarily focused on long-term survivors. This study addresses the HRQOL of both long-term and short-term survivors. Methods. This is a prospective, longitudinal study of 479 head and neck cancer patients followed for at least 3 years after diagnosis. Analysis of longitudinally collected HRQOL scores was based on survivorship status. Results. The HRQOL for 3 survivorship groups: short-term (died <1 year), intermediate-term (died 1-3 years), and long-term survivors (alive >3 years) were different at all time points (pretreatment, 3, 6, and 12 months). Differences were greatest between the short-term and long-term survivors. Long-term survivors demonstrated the best HRQOL and an improving HRQOL trajectory at 12 months. The HRQOL of short-term survivors declined precipitously throughout all available follow-up. Intermediate-term survivors did show some improvement following treatment but had a declining HRQOL trajectory at 12 months. Conclusion. The HRQOL profiles of head and neck cancer patients differed significantly depending on survivorship status. Long-term HRQOL results should be analyzed within the context of the results for all of the patients eligible to have been included in the initial study cohort. © 2006 Wiley Periodicals, Inc. Head Neck, 2007. [source] Longitudinal health-related quality of life after mandibular resection for oral cancer: a comparison between rim and segment,HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 1 2004Simon N. Rogers FDS Abstract Background. Mandibular resection for oral cancer is often necessary to achieve an adequate margin of tumor clearance. Segmental mandibulectomy has been associated with a poor health-related quality of life (HRQOL), particularly before composite free tissue transfer to reconstruct the defect. Little is published in the literature contrasting the subjective deficit of segmental compared with rim resection. The aim of this study was to use a validated head and neck HRQOL questionnaire to compare rim and segmental mandibular resection in patients having primary surgery for oral cancer. Method. There were 224 consecutive patients between 1995 and 1999 who were treated by primary surgery for oral squamous cell carcinoma. One hundred twenty-tree had no mandibular resection, 44 had a rim resection, and 57 had a segmental resection. The University of Washington Quality of life questionnaire (UW-QOL) was adminstered before treatment, at 6 months, 12 months and after 18 months. Results. Preoperatively, patients undergoing segmental resection reported significantly more pain, chewing problems, and a lower composite UW-QOL score. Postperatively, the segment group tended to score worse at all time points, particularly in appearance, swallowing, recreation, and chewing; however, the difference between rim and segment was only seen in smaller resections without adjuvant radiotherapy. Little difference was seen between rim or segment for tumors <4 cm with radiotherapy and between rim and segments for tumors >4cm. Conclusion: After segmental mandibulectomy and reconstruction using composite free tissue transfer, the UW-QOL scores were relatively good. The only 2 difference between rim and segments was noted in the small resections without radiotherapy, and some of this was reflected in differences at baseline. © 2004 Wiley Periodicals, Inc. Head Neck26: 54,62, 2004. [source] Commentary on Jack Dowie, "Decision validity should determine whether a generic or condition-specific HRQOL measure is used in health care decisions"HEALTH ECONOMICS, Issue 1 2002Gordon Guyatt First page of article [source] Commentary on Jack Dowie, "Decision validity should determine whether a generic or condition-specific HRQOL measure is used in health care decisions"HEALTH ECONOMICS, Issue 1 2002David Feeny First page of article [source] Quality of life in chronic hemodialysis patients in RussiaHEMODIALYSIS INTERNATIONAL, Issue 3 2006Irina A. VASILIEVA Abstract The aim of this cross-sectional study was to compare health-related quality of life (HRQOL) of Russian hemodialysis (HD) patients with the general population and international data, and to determine factors influencing HRQOL. One thousand forty-seven HD patients from 6 dialysis centers were studied (576 male, age 43.5±12.5 years, HD duration 55.0±47.2 months). Health-related quality of life was evaluated by SF-36. Self-appraisal Depression Scale (W. Zung), State-Trait Anxiety Inventory, and Level of Neurotic Asthenia Scale were used. Hemodialysis patients scored significantly lower than the general Russian population in the majority of SF-36 scales. The only exception was the Mental Health score, which was even better than the general population. The Mean physical component score (PCS) of HD patients was 36.9±9.7, and the mental component score was (MCS) 44.2±10.5. In multiple linear regression analysis, increasing age, HD duration, depression level and number of days of hospitalization in the past 6 months were significant independent predictors of low PCS along with a low level of serum albumin. Advancing age was also a predictive factor for low MCS along with increase of HD duration, depression level, trait anxiety, and level of asthenia. As far as we know, this is the first study to report on HRQOL of a large sample of Russian HD patients performed using SF-36. Compared with the general population, Russian HD patients had significantly lower scores on the majority of SF-36 scales, especially in the physical domain. The mean PCS and MCS were comparable with European data for HD patients. A number of demographic, clinical, and psychological variables affect HRQOL. [source] Quality of life in patients with primary biliary cirrhosisHEPATOLOGY, Issue 2 2004Renée Eugénie Poupon The impact of primary biliary cirrhosis (PBC) on health-related quality of life (HRQOL) is poorly documented. We assessed quality of life in a group of 276 unselected patients with PBC using the Nottingham Health Profile (NHP). This is a generic scale that assesses six major areas commonly associated with HRQOL. Data were compared with those of a sex- and age-matched control group. The associations between NHP scores and the severity of PBC were tested. Patients (86% women) had a median age of 62 years (range 33,87). Most patients were treated with UDCA. PBC patients showed a strong statistically significant difference in energy compared to controls (respectively, 40.6 vs. 22.9, P < .0001) and had worse scores for emotional reactions (22.2 vs. 16.1, P < .005). No other differences were observed. No associations of the dimension subscores were found with biochemical liver tests, histological stages, or duration of the disease. Among the signs or symptoms, fatigue was the finding most often associated with the dimension subscores. In conclusion, patients with PBC feel that their overall quality of life is worse than that of the control population. This difference is mainly due to the decrease in the subscores of energy and emotional reactions, both associated with fatigue. These effects must be taken into account by clinicians when treating these patients, as they constitute the clinical outcomes that have the most impact on patients' lifestyle and adherence to treatment. (HEPATOLOGY 2004;40:489,494.) [source] Relationship between sick leave, unemployment, disability, and health-related quality of life in patients with inflammatory bowel diseaseINFLAMMATORY BOWEL DISEASES, Issue 5 2006Tomm Bernklev BSc Background: The goal of this study was to determine the rate of work disability, unemployment, and sick leave in an unselected inflammatory bowel disease (IBD) cohort and to measure the effect of working status and disability on the patient's health-related quality of life (HRQOL). Materials and Methods: All eligible patients were clinically examined and interviewed at the 5-year follow-up visit. In addition, they completed the 2 HRQOL questionnaires, the Short Form-36 Health Survey (SF-36) and the Inflammatory Bowel Disease Questionnaire validated for use in Norway (N-IBDQ). Data regarding sick leave, unemployment, and disability pension (DP) also were collected. Results: All together, 495 patients were or had been in the workforce during the 5-year follow-up period since diagnosis. Forty-two patients (8.5%) were on DP compared with 8.8% in the background population. Women with Crohn's disease (CD) had the highest probability of receiving DP (24.6%). A total of 58 patients (11.7%) reported they were unemployed at 5 years. This was equally distributed between men and women but was more frequent in patients with ulcerative colitis. Sick leave for all causes was reported in 47% with ulcerative colitis and 53% with CD, whereas IBD-related sick leave was reported in 18% and 23%, respectively. A majority (75%) had been sick <4 weeks, and a relatively small number of patients (25%) contributed to a large number of the total sick leave days. Both unemployment and DP reduced HRQOL scores, but the most pronounced effect on HRQOL was found in patients reporting IBD-related sick leave, measured with SF-36 and N-IBDQ. The observed differences also were highly clinically significant. Multiple regression analysis confirmed that IBD-related sick leave was the independent variable with the strongest association to the observed reduction in HRQOL scores. Conclusions: Unemployment or sick leave is more common in IBD patients than in the Norwegian background population. The number of patients receiving DP is significantly increased in women with CD but not in the other patient groups. Unemployment, sick leave, and DP are related to the patient's HRQOL in a negative way, but this effect is most pronounced in patients reporting IBD-related sick leave. [source] Impairment of health-related quality of life in patients with inflammatory bowel disease: A Spanish multicenter studyINFLAMMATORY BOWEL DISEASES, Issue 5 2005Dr. F Casellas PhD Abstract Background: Inflammatory bowel disease impairs patients' perception of health and has a negative impact on health-related quality of life (HRQOL). Most studies include patients from a single hospital. This may bias limit results through the use of small patient samples and/or samples within a restricted disease spectrum. Methods: HRQOL was measured in patients with ulcerative colitis (UC) and Crohn's disease (CD) from 9 hospitals located in different geographical areas in Spain using 2 questionnaires: the Spanish version of the Inflammatory Bowel Disease Questionnaire (IBDQ) and the EuroQol. Results are expressed as medians. Results: The study included 1156 patients (528 patients with UC and 628 with CD; median age, 35 yr; slight predominance of women, 617 versus 539). HRQOL worsened in parallel with disease severity to a similar extent in both UC (IBDQ scores of 6.1, 4.7, and 4.0 for the 3 disease severity groups, respectively) and CD (IBDQ scores of 6.1, 5.0, and 4.1, respectively). A similar inverse relation between clinical activity and quality of life was observed when EuroQol preference values were used. All 5 dimensions of the IBDQ showed significantly lower scores in patients with active UC and CD than in patients in remission. The pattern of scores by IBDQ dimensions differed between patients in relapse (who scored worse on the digestive symptoms dimension) and patients in remission. Variables related with disease activity, time of evolution since diagnosis and female sex, were significantly associated with having a worse perception of HRQOL. The type of disease or geographical area of residence did not influence results on the IBDQ. Conclusions: UC and CD impair patients' HRQOL, and the degree of impairment depends on disease activity but is independent of the type of disease and place of residence. [source] Health-related quality of life improves in children and adolescents with inflammatory bowel disease after attending a camp sponsored by the Crohn's and colitis foundation of AmericaINFLAMMATORY BOWEL DISEASES, Issue 2 2005Melissa A. Shepanski MS Abstract Purpose: To describe the reported health-related quality of life (HRQOL) in children and adolescents with inflammatory bowel disease (IBD) after attending an IBD summer camp. Methods: A prospective analysis of quality of life was completed at an overnight camp that was exclusively for patients with IBD, which was sponsored by the Crohn's and Colitis Foundation of America. The IMPACT-II questionnaire (Canada and United States) and the State-Trait Anxiety Inventory for Children were administered to the campers at the beginning and at the end of a 1-week camp to assess HRQOL and anxiety. The IMPACT-II questionnaire consists of 35 questions measuring 6 quality-of-life domains (i.e., bowel domain, systemic symptoms, emotional functioning, social functioning, body image, and treatment/interventions). The State-Trait Anxiety Inventory for Children consists of 2 different 20-item sets of questions. One set assesses state anxiety, and the other, trait anxiety. A repeated-measures multivariate analysis of variance was performed to determine the differences between scores attained before and after camp on the IMPACT-II questionnaire and in each of its domains. Paired sample t tests were performed on state and trait anxiety before and after camp. Results: A total of 125 individuals consented to participate, but 61 patients (50 girls and 11 boys; age range, 9 to 16 y) completed the IMPACT-II questionnaire in full. Of those 61 patients, 47 had Crohn's disease and 14 had ulcerative colitis. There was statistically significant improvement between the mean (±SD) precamp total score (172.95 ± 36.61) and the mean postcamp total score (178.71 ± 40.97; P = 0.035), bowel symptoms scores (P = 0.036), social functioning scores (P = 0.022), and treatment interventions scores (P = 0.012). No difference was found between anxiety scores before and after camp on either the state or trait anxiety inventories (n = 55; P > 0.05). Conclusions: Overall, HRQOL improved in children after attending IBD summer camp. This exploratory study suggests that contributing factors for these improvements may be an increase in social functioning, a better acceptance of IBD symptoms, and less distress regarding treatment interventions, suggesting that a camp that is specifically designed for children with IBD may normalize the chronic illness experience. However, future research using a multimodal measurement approach is warranted to support these conclusions. [source] Health-related quality of life and eating disorders: A review and updateINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 2 2009Scott G. Engel PhD Abstract Objective: The aim of this article is to provide a narrative review of empirical studies related to health-related quality of life (HRQOL) and eating disorders and to report recent changes in the measurement of HRQOL in eating disorders. Method: Twenty-five articles of central importance to the topic were identified in a systematic search of six databases. All articles were selected based on a consensus relevancy rating process. Key themes were extracted from the articles and validated by all authors. Results: We identify six themes in the extant empirical literature. Discussion: We discuss these six themes and review them in light of the fact that they are identified in studies using only generic measures of HRQOL. Four recently developed disease-specific HRQOL measures specific to patients with eating disorder are discussed. © 2008 by Wiley Periodicals, Inc. Int J Eat Disord 2009 [source] Topiramate treatment in bulimia nervosa patients: A randomized, double-blind, placebo-controlled trialINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 4 2005Cerstin Nickel MD Abstract Objective The aim of the current study was to test the influence of topiramate on behavior, body weight, and health-related quality of life (HRQOL) in bulimic patients. Method Thirty patients with bulimia nervosa were treated with topiramate in a 10-week randomized, double-blind, placebo-controlled study. The subjects were randomly assigned to receive topiramate (topiramate group [TG]; n = 30) or a placebo (control group [CG]; n = 30). Primary outcome measures were changes in the frequency of binging/purging, in body weight, and on the SF-36 Health Survey (SF-36) scales. Results In comparison to the CG group (according to the intent-to-treat principle), significant changes in the frequency of binging/purging (a > 50% reduction: TG, n = 11 [36.7%]; CG, n = 1 [3.3%]; p < .001), body weight (difference in weight loss between the two groups: 3.8 kg, 95% confidence interval [CI] = ,5.4 to ,2.1; p < .001), and SF-36 (all ps < .001) could be seen. All patients tolerated topiramate well. Conclusion Topiramate appears to safe and effective in influencing the frequency of binging/purging, body weight, and HRQOL in bulimic patients. © 2005 by Wiley Periodicals, Inc. [source] Cognitive dysfunction and health-related quality of life after a cardiac arrest and therapeutic hypothermiaACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 6 2010J. TORGERSEN Background: Evidence-based treatment protocols including therapeutic hypothermia have increased hospital survival to over 50% in unconscious out-of-hospital cardiac arrest survivors. In this study we estimated the incidence of cognitive dysfunctions in a group of cardiac arrest survivors with a high functional outcome treated with therapeutic hypothermia. Secondarily, we assessed the cardiac arrest group's level of cognitive performance in each tested cognitive domain and investigated the relationship between cognitive function and age, time since cardiac arrest and health-related quality of life (HRQOL). Methods: We included 26 patients 13,28 months after a cardiac arrest. All patients were scored using the Cerebral Performance Category scale (CPC) and Mini-Mental State Examination (MMSE). Twenty-five of the patients were tested for cognitive function using the Cambridge Neuropsychological Test Automated Battery (CANTAB). These patients were tested using four cognitive tests: Motor Screening Test, Delayed Matching to Sample, Stockings of Cambridge and Paired Associate Learning from CANTAB. All patients filled in the Short Form-36 for the assessment of HRQOL. Results: Thirteen of 25 (52%) patients were classified as having a cognitive dysfunction. Compared with the reference population, there was no difference in the performance in motor function and delayed memory but there were significant differences in executive function and episodic memory. We found no associations between cognitive function and age, time since cardiac arrest or HRQOL. Conclusion: Half of the patients had a cognitive dysfunction with reduced performance on executive function and episodic memory, indicating frontal and temporal lobe affection, respectively. Reduced performance did not affect HRQOL. [source] Health-related quality of life among old residents of nursing homes in NorwayINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 5 2009Jorunn Drageset RN PhD This study examined the health-related quality of life (HRQOL) of nursing home residents (, 65 years) using the Short-Form-36 Health Survey subscales and how these subscale scores are related to residents' sociodemographic and medical conditions. Residents 95,102 years old reported higher HRQOL than younger respondents. Those with more education reported higher HRQOL. Residents who reported hobbies or special interests had a higher HRQOL score on vitality and mental health variables. Finally, respondents with no comorbid illness scored highest on all HRQOL dimensions, and this was statistically significant for physical functioning and bodily pain. In conclusion, respondents generally reported highly limited physical functioning and slightly limited social functioning. To improve the situation of residents, more attention should be paid to the environment of nursing homes and residents' hobbies and special interests. [source] Health-related quality of life and sexual function in women with stress urinary incontinence and overactive bladderINTERNATIONAL JOURNAL OF UROLOGY, Issue 1 2008Seung-June Oh Background: We evaluated the impact of stress urinary incontinence (SUI) and overactive bladder (OAB) on health-related quality of life (HRQOL) and sexual function. Methods: A total of 245 women (SUI; n = 123 and OAB; n = 122) from 21 to 79 years old (mean 50.4) were included in the primary analyses. To obtain HRQOL and sexual function assessments, patients were asked to fill in the ,Bristol Female Lower Urinary Tract Symptoms (BFLUTS)' and the ,Medical Outcomes Study Short Form (SF-36)' questionnaires. Results: Of the eight domains in the SF-36 questionnaire, only ,general health' was significantly different between the groups. Patients with SUI had a better general health than those with OAB (P = 0.016). When comparing the BFLUTS scores in the two groups, the score for ,BFLUTS-filling symptoms' was higher in the OAB group (P = 0.002) but that for ,BFLUTS-incontinence symptoms' was higher in the SUI group (P < 0.001). The score for ,BFLUTS-sex' was higher in the SUI group than in the OAB group but this was not statistically significant (P = 0.096). Of the 169 patients who had a sex life, the SUI group had experienced pain (P = 0.033) and leakage (P = 0.056) more frequently during intercourse than the OAB group. Conclusion: Both SUI and OAB have a detrimental impact on patient HRQOL in Korean women. In addition, our findings suggest that women with SUI had more frequently experienced pain during intercourse and coital incontinence than those with OAB. [source] Impact of salvage therapy for biochemical recurrence on health-related quality of life following radical prostatectomyINTERNATIONAL JOURNAL OF UROLOGY, Issue 3 2007Shunichi Namiki Objective: To determine the impact of salvage therapy for prostate-specific antigen (PSA) recurrence on the health-related quality of life (HRQOL) of patients after radical retropubic prostatectomy (RP). Methods: Between January 2000 and December 2003, a total of 249 patients who underwent RP were available for 2-year follow up. Of the respondents, 203 men did not show evidence of recurrence (group A), and 46 men received salvage hormonal therapy and/or radiotherapy after RP because of a rise in PSA (group B). The general and prostate-target HRQOL was assessed with the Medical Outcomes Study 36-Item Short Form and University of California, Los Angeles Prostate Cancer Index, respectively. Patients completed the HRQOL instruments by mail at baseline and at 24 months after RP. Results: All of the patients completed both questionnaires. At baseline no significant differences were found between the two groups in any of the HRQOL domains. There were significant improvements in mental health and social function for the patients without biochemical recurrence postoperatively. Repeated measure anova revealed significantly different patterns of alteration in several general HRQOL domains among the treatment groups. The urinary and bowel domains were equivalent between the two treatment groups at baseline and 24 months after RP. The patients treated with salvage hormonal therapy tended to show delayed recovery of sexual function. Conclusion: Using a self-administered questionnaire, biochemical recurrence following RP was found to impose a substantial burden in patients with localized prostate cancer. [source] Use of the Late-Life Function and Disability Instrument to Assess Disability in Major DepressionJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2009Jordan F. Karp MD OBJECTIVES: To determine whether there was greater disability in subjects with depression than in those without, the correlation between disability and depression severity and quality of life, and whether improvement in disability after antidepressant pharmacotherapy was greater in those who responded to antidepressant treatment. DESIGN: Disability in subjects with and without depression from two different studies was compared for 22 weeks. Correlations were performed for the subjects with depression between disability and depression, anxiety, health-related quality of life (HRQOL), and medical comorbidity. T -tests were used to compare disability between subjects who did and did not respond to antidepressant treatment and change in disability after pharmacotherapy. SETTING: Late-life depression research clinic. PARTICIPANTS: The 313 subjects were recruited from primary care and the community and were aged 60 and older; 244 subjects were participants in a depression treatment protocol, and 69 subjects without depression participated in a separate longitudinal observational study of the mental and cognitive health of depression-free older adults. MEASUREMENTS: The Late-Life Function and Disability Instrument (LL-FDI), a measure of instrumental activity of daily living, personal role, and social role functioning. RESULTS: Subjects with depression scored lower than controls for domains measuring limitation (can do) and frequency (does do) of activities. Both disability domains correlated with depression severity, anxiety, HRQOL, and cognition. Disability improved with antidepressant treatment; for partial responders who continued to receive higher-dose antidepressant treatment out to 22 weeks, there was continued improvement, although not to the level of comparison subjects without depression. CONCLUSION: The LL-FDI appears to discriminate subjects with depression from those without, correlates with depression severity, and demonstrates sensitivity to antidepressant treatment response. We recommend further investigation of the LL-FDI and similar disability instruments for assessing depression-related disability. [source] Chronic pain after cardiac surgery: a prospective studyACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 1 2010K. H. GJEILO Background: Chronic pain is a complication of several surgical procedures. The prevalence of chronic pain reported after cardiac surgery varies from 18% to 61%. However, most studies are retrospective, do not use validated instruments for pain measurement or include only pain at the sternum site. The aim of the present study was to assess chronic pain and health-related quality of life (HRQOL) after cardiac surgery. Methods: In a prospective, population-based study, we included 534 patients (413 males) and assessed chronic pain and HRQOL before, 6 months after, and 12 months after cardiac surgery. Pain was measured by the Brief Pain Inventory, while HRQOL was measured by the Short-Form 36 (SF-36). Results: Five hundred and twenty-one patients were alive 12 months after surgery; 462 (89%) and 465 (89%) responded after 6 and 12 months, respectively. Chronic pain was reported by 11% of the patients at both measurements. Younger age was associated with chronic pain [odds ratio 0.7 (95% confidence interval: 0.5,0.9)] at 12 months. Patients with chronic pain reported lower scores on seven of eight SF-36 subscales. Discussion: In conclusion, we observed a lower prevalence of chronic pain after cardiac surgery than in previous studies. Still, more than one out of 10 patients reported chronic pain after cardiac surgery. Chronic pain appears to affect HRQOL. Thus, given the large number of patients subjected to cardiac surgery, this study confirms that chronic pain after cardiac surgery is an important health care issue. [source] A comparison of pain and health-related quality of life between two groups of cancer patients with differing average levels of painJOURNAL OF CLINICAL NURSING, Issue 5 2003Barbro Boström MNSc Summary ,,A study was performed to describe and compare pain and Health-Related Quality of Life (HRQOL) in two groups of cancer patients in palliative care as well as to describe the correlation between pain and HRQOL. ,,Forty-seven patients with mild average pain [Visual Analogue Scale (VAS) , 3] and 28 patients with moderate to severe average pain (VAS > 3) were included. Medical Outcomes Study Short Form (SF-36) was used to evaluate HRQOL, pain intensity levels were measured with the VAS on Pain-O-Meter. ,,Compared to patients with mild pain, patients with moderate to severe pain had statistically significant, higher pain intensity for the items ,pain at time of interview', ,worst pain in the past 24 hours' and ,pain interrupting sleep.' They also had the lowest scores of the SF-36 dimensions: physical functioning, role-physical, and bodily pain. Patients with moderate to severe pain had statistically significant, fewer months of survival. There were statistically significant positive correlations between pain items and negative correlation between pain and SF-36 dimensions. ,,The conclusion is that pain has a negative impact on HRQOL, especially on physical health and that pain increases towards the final stages of life. Even if patients have to endure symptoms such as fatigue and anxiety during their short survival time, dealing with pain is an unnecessary burden, which can be prevented. [source] Development and evaluation of the quality of life instrument in chronic liver disease patients with minimal hepatic encephalopathyJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 3 2009Ying-qun Zhou Abstract Objectives:, The objective was to develop a valid and reliable health-related quality of life (HRQOL) assessment tool to measure the functional and health status of patients with minimal hepatic encephalopathy (mHE). Methods:, Items potentially affecting the HRQOL of these patients were identified, based on the responses from 53 patients with minimal hepatic encephalopathy, from seven liver experts, four epidemiologists and from a PubMed search of the literature. Results were explored using factor analysis and redundant questions were eliminated. The final stated questionnaire was used in 178 patients with mHE to evaluate its reliability and validity. Results:, Thirty-five items proved to be important for 32 respondents in the item reduction sample. The final instrument included five domains (30 items) which were shown as follows: physical functioning (8 items), psychological well-being (7 items), symptoms/side effects (7 items), social functioning (4 items) and general-health (4 items). An inter-item correlation for each of the five domains ranged from 0.220 to 0.776, with a mean of 0.280. Cronbach's alpha for above five domains was 0.8775, 0.8446, 0.8360, 0.7087 and 0.7016 respectively. The test-retest coefficients for the five domains were 0.94, 0.93, 0.96, 0.82 and 0.83 respectively. Factor analysis showed preservation of five components structure. Cumulative variance of principal components was 63.12%. Patients with more advanced disease seemed to have more impairment of their well-being, especially in the symptoms/side effects domain. Conclusions:, The instrument is short, easy to administer and is of good validity and reliability in patients with mHE. [source] | |||||||||||||||||||||||||||||||||||||||||||