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Health Domain (health + domain)

Distribution by Scientific Domains
Medical Sciences83%

Kinds of Health Domain

  • general health domain
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    Selected Abstracts

    Insurance and quality of life in men with prostate cancer: data from the Cancer of the Prostate Strategic Urological Research Endeavor

    BJU INTERNATIONAL, Issue 6 2008
    Natalia Sadetsky
    OBJECTIVE To evaluate the effect of medical insurance coverage on health-related quality of life (HRQoL) outcomes in men newly diagnosed with prostate cancer, as insurance status has been shown to be related to clinical presentation, and types of treatments received for localized prostate cancer, but the relationship of insurance and QoL has not been explored sufficiently. PATIENTS AND METHODS Data from the Cancer of the Prostate Strategic Urological Research Endeavor (CaPSURE), a national longitudinal database registry of men with prostate cancer, were used for this study. Men who were newly diagnosed at entry to CaPSURE and completed one questionnaire before treatment, and one or more afterwards, were included. Insurance groups specific to age distribution of the study population were assessed, i.e. Medicare, preferred provider organizations (PPOs), health maintenance organizations (HMOs), fee for service (FFS), and the Veterans Administration (VA) for the younger group, and Medicare only, Medicare plus supplement (+S), and HMO/PPO for the older group. Associations between patients' clinical and sociodemographic characteristics and insurance status were evaluated by chi-square and analysis of variance. Relationships between insurance status and HRQoL outcomes over time were evaluated by multivariate mixed model. RESULTS Of 2258 men who met the study criteria, 1259 were younger and 999 were older than 65 years. More than half of the younger patients belonged to an HMO or PPO (42.2% and 32.5%, respectively), with the remainder distributed between Medicare, FFS and VA. In the older group most men belonged to Medicare only and the Medicare +S groups (22.4% and 58.8%, respectively). There was greater variation in clinical risk categories at presentation by insurance groups in the younger group. In the multivariate analysis, insurance status was significantly associated with changes in most HRQoL outcomes over time in the younger group, while in the older patients the effect of insurance diminished. Men in the VA and Medicare systems had lower scores at baseline and a steeper decline in Physical Function, Role Physical, Role Emotional, Social Function, Bodily Pain, Vitality, and General Health domains over time, controlling for type of initial treatment received, timing of HRQoL assessment, number of comorbidities, clinical risk at presentation, and income. CONCLUSION Insurance was independently related to changes in a wide range of HRQoL outcomes in men aged <65 years treated for prostate cancer. With the latest advances in early diagnosis and treatment of prostate cancer, clinicians and researchers should be aware of the specific groups of patients who are more vulnerable to the adverse effects of treatment and subsequent decline in functioning. The present findings could provide important tools for understanding the process of recovery after treatment for prostate cancer, and identifying needs for specific services. [source]

    The politics of risk and trust in mental health

    CRITICAL QUARTERLY, Issue 3 2004
    John Wilkinson
    This essay provides a critical account of Risk Society theory through analysis of an article by ,I,ek on human genetics research, using this as a basis for distinguishing a range of meanings of 'risk' and describing their interplay within the mental health domain. The paper argues that mental health policy in the UK has been distorted through a preoccupation with a supposedly scientific practice of risk assessment which uncannily reflects popular and tabloid prejudice. It is argued that Risk Society theory does not, as its proponents claim, supersede the politics of inclusion and exclusion, so much as overlay and disguise them. The importance of Risk Society theory in the development of Third Way politics would invite a similarly critical view of a range of contemporary British social policy. [source]

    The art of public health nursing: using confession technč in the sexual health domain

    JOURNAL OF ADVANCED NURSING, Issue 4 2006
    Dave Holmes PhD RN
    Aim., This paper explores the sexual health interview from a critical perspective, and to demonstrate how the confession ritual involved in this interview is implicated in the construction of subjectivities (meaning identities) as well as in fostering self-surveillance (self-regulation). Background., The concept of public health depends primarily on several surveillance tools that monitor both the incidence and prevalence rates of certain diseases. Within the subgroup of infectious diseases, sexually transmitted infections comprise a group that is closely monitored. As a result, surveillance techniques, including policing sexual practices, are part of the public health worker's mandate. Method., Using a Foucauldian perspective, we demonstrate that confession is a political technology in the sexual health domain. Findings., As one group of frontline workers in the field of sexual health, nurses are responsible for data collection through methods such as interviewing clients. Nurses play an integral role in the sexual health experience of clients as well as in the construction of the client's subjectivity. We strongly believe that a Foucauldian perspective could be useful in explaining certain current client behavioural trends (for example, an avoidance by at-risk groups of interactions with nurses in sexual health clinics) being observed in sexual health clinics across the Western hemisphere. Conclusion., Clinicians need to be aware of the confessional nature of their questions and provide requested services rather than impose services that they determine to be important and relevant. By appreciating that the sexual health interview is an invasive and embarrassing sexual confession, healthcare providers and policy-makers may be better able to design and implement more user-oriented, population-sensitive sexual health services. [source]

    Health-related quality of life among persons with irritable bowel syndrome: a systematic review

    ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 6 2002
    H. B. El-Serag
    Summary Aim : To perform a systematic review of the literature with three objectives: (1) to compare the health related quality of life (HRQoL) of patients with irritable bowel syndrome with that of healthy controls; (2) to compare the HRQoL of irritable bowel syndrome patients to those with other diseases; and (3) to examine therapy-associated changes in HRQoL of irritable bowel syndrome patients. Methods : Searches of all English and non-English articles from 1980 to 2001 were performed in Medline and Embase, and two investigators performed independent data abstraction. Results : Seventeen articles met our selection criteria. 13 studies addressed objective no. 1; 11 showed a significant reduction in HRQoL among irritable bowel syndrome patients. Of these, only one study was considered of high quality. Four studies addressed objective no. 2, none of which was considered to be high quality in addressing this objective. Four trials (three of high quality) addressed objective no. 3. One showed that symptomatic improvement with Leupron compared to placebo was accompanied an improvement only in the comparative health domain of the HRQoL. The second study reported significant positive changes in HRQoL after 12 weeks of cognitive behavioural therapy. The third report of two placebo-controlled studies indicated significant improvement with alosetron on most domains of Irritable Bowel Syndrome Quality of Life Questionnaire. Conclusions : (i) There is reasonable evidence for a decrease in HRQoL in patients with moderate to severe irritable bowel syndrome; however, the data are conflicting regarding the impact of irritable bowel syndrome on HRQoL in population-based studies of nonconsulters. (ii) HRQoL in irritable bowel syndrome patients is impaired to a degree comparable to other chronic disorders such as GERD and depression. (iii) A therapeutic response in irritable bowel syndrome-related pain has a corresponding improvement in HRQoL. (iv) Limitations of the literature include focusing on moderate-severe irritable bowel syndrome in referral centres, and lack of appropriate controls [source]

    A randomized comparison of post-operative pain, quality of life, and physical performance during the first 6 weeks after abdominal or vaginal surgical correction of descensus uteri

    NEUROUROLOGY AND URODYNAMICS, Issue 4 2005
    J.P.W.R. Roovers
    Abstract Aims With respect to urogenital function, vaginal hysterectomy combined with anterior and/or posterior colporraphy has been shown to be superior to abdominal sacrocolpopexy with preservation of the uterus. We performed a randomized trial to compare the effects of both procedures on pain, quality of life and physical performance during the first six weeks after surgery. Methods Eighty-two patients were randomized to have surgery either by vaginal or abdominal approach. All patients were asked to complete the RAND-36 before surgery and 6 weeks after surgery and to keep a diary for the first 6 weeks after surgery. This diary assessed the pain perception and use of pain medication, bother of limitations due to the surgery and performance of daily activities after surgery. These outcomes were compared. Results All patients completed the RAND-36 and 68 patients completed the diary. Patients who had undergone abdominal surgery had a statistically lower score on the health change domain (56 vs 68), bodily pain domain (63 vs 80) and mental health domain (74 vs 81) of the RAND-36, as compared to patients who had undergone vaginal prolapse surgery. During hospital stay, the abdominal group experienced on average more days of pain (4.5 vs 3.0) and impaired mobility (3.7 vs 2.9) as compared to the vaginal group. Patients received more pain medication following abdominal surgery as compared to vaginal surgery. Conclusions The vaginal operation to correct a descensus uteri is associated with less pain, better quality of life and better mobility during the first 6 weeks of the recovery period as compared to the abdominal approach. Neurourol. Urodynam. © 2005 Wiley-Liss, Inc. [source]

    Measuring Quality of Life in Stroke Subjects Receiving an Implanted Neural Prosthesis for Drop Foot

    ARTIFICIAL ORGANS, Issue 5 2010
    Anke I. Kottink
    Abstract The aim was to determine if the treatment of a drop foot by means of an implantable two-channel peroneal nerve stimulator improves health-related quality of life (HRQoL). All subjects were measured at baseline and after a follow-up period of 12 and 26 weeks. Twenty-nine stroke survivors with chronic hemiplegia with drop foot who fulfilled the predefined inclusion and exclusion criteria were included in the present randomized controlled trial. The intervention group received an implantable two-channel peroneal nerve stimulator for correction of their drop foot. The control group continued using their conventional walking device, consisting of an ankle-foot orthosis, orthopedic shoes, or no device. HRQoL was assessed in two different ways: (i) by taking descriptive measures, that is, the Short Form-36 (SF-36; generic measure) and the Disability Impact Profile (DIP; specific measure); and (ii) by obtaining preference-based utilities both measured with the time trade-off (direct way) and by calculating them from the EuroQol (EQ-5D) and SF-36. A significant positive effect of the implantable device was found on the physical functioning domain, the general health domain, and the physical component summary score of the SF-36. For the DIP, a significant improvement was found on the domains mobility, self-care, and psychological status in the intervention group. Regarding the preference-based utility measures, a significant effect was found for the utility index calculated from the EQ-5D. The implantable two-channel peroneal nerve stimulator seems to be efficient to improve HRQoL, mainly the domains related to physical functioning. A relation was present between the utility indexes calculated from the EQ-5D and SF-36. [source]

    University faculty perceptions of the health risks related to cigarettes and smokeless tobacco

    DRUG AND ALCOHOL REVIEW, Issue 2 2010
    NICHOLAS PEIPER
    Abstract Introduction and Aims. It is now widely understood by tobacco research and policy experts that smokeless tobacco (ST) use confers significantly less risk than smoking, but no studies have assessed tobacco risk perceptions in highly educated populations. The purpose of this study was to explore the perception of risks related to smoking and ST use among full-time faculty on two campuses at the University of Louisville. Design and Methods. In October 2007, a survey that quantified risk perceptions of cigarette smoking and ST use with respect to four health domains (general health, heart attack/stroke, all cancer, oral cancer) was sent to 1610 full-time faculty at the Belknap and the Health Sciences Center (HSC) campuses of the University of Louisville, and 597 (37%) returned a completed survey. Results. Overall, cigarettes were considered as high risk for all health domains by large majorities (75,97%). Except for heart attack/stroke, ST was also considered as high risk by the majority of faculty (69,87%), and at least half perceived cigarettes and ST to be equally harmful across all domains. HSC faculty had somewhat more accurate risk perceptions than Belknap faculty for ST, but both groups overestimated the risks, especially for oral cancer. Discussion and Conclusions. This study found that the risks of ST use are overestimated and conflated to that of cigarettes among highly educated professionals, demonstrating the need for better education about the risks of tobacco use and for communication of accurate information by health organisations and agencies.[Peiper N, Stone R, Van Zyl R & Rodu B. University faculty perceptions of the health risks related to cigarettes and smokeless tobacco. Drug Alcohol Rev 2010] [source]

    Does condition-specific quality of life correlate with generic health-related quality of life and objective incontinence severity in women with stress urinary incontinence?

    NEUROUROLOGY AND URODYNAMICS, Issue 4 2006
    Seung-June Oh
    Abstract Aims We examined the impact of stress urinary incontinence (SUI) on health-related quality of life (QOL) and evaluated the relationships between incontinence-specific QOL and objective disease severity. Methods A total of 158 women (mean age 49.9) suffering from SUI were included in the study. The Medical Outcomes Study Short Form-36 (SF-36) and the King's Health Questionnaire (KHQ) were used to assess QOL in the patient and control groups. Results The SF-36 scores did not show any significant differences between the two groups except for one domain (physical functioning, P,=,0.005). The patient KHQ scores were significantly lower than those of the controls (P,<,0.001 for all domains). The scores of the KHQ domains correlated with those of the SF-36 domains, but the relationship was low to moderate, ranging from ,0.033 to ,0.686. However, they did not correlate with Valsalva leak point pressure (VLPP). When patients were divided into the low VLPP group (n,=,60) and the higher VLPP group (n,=,98), statistically significant differences were found between the groups for general health domains of the SF-36 (P,=,0.010) and of the KHQ (P,=,0.027). No statistically significant differences were found in other domains of both questionnaires. Conclusions The generic QOL instrument is not a sensitive tool for measuring QOL in women with SUI. In addition, our findings suggest that objective disease severity is not associated with generic or incontinence-specific QOL. Neurourol. Urodynam. © 2006 Wiley-Liss, Inc. [source]

    Impact of faecal incontinence severity on health domains

    COLORECTAL DISEASE, Issue 3 2005
    M. Deutekom
    Abstract Objective Faecal incontinence is a problem that can have a major impact on the quality of life of those affected. Our aim was to relate the severity of faecal incontinence to the impact on several general health domains. Methods Patients from a prospective diagnostic cohort study, performed in 16 medical centres in the Netherlands, were invited to the study. The severity of incontinence was determined with the Vaizey score, which ranges from 0 (continent) to 24 (totally incontinent). Based on their Vaizey score, patients were assigned to one of five severity categories. All patients completed the EuroQol-5D instrument, which evaluates the existence of problems on five health domains: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Results Data from 259 consecutive patients (25 male) could be analysed. Their mean age was 59 years (SD ± 12). The mean duration of faecal incontinence was 8.1 years (SD ± 8). The proportion of patients reporting problems rose significantly with increasing severity of faecal incontinence in the domains of usual activities (ranging from 36% in the least severe group to 71% in the most severe group (P < 0.001)), pain/discomfort (ranging from 35% to 60%; P = 0.025), and anxiety/depression (ranging from 23% to 49%; P = 0.037). No significant trends could be observed in the domains of mobility and self-care. Conclusion There exists a significant relation between severity of incontinence and frequency of reported problems in the domains of usual activities, pain/discomfort and anxiety/depression. [source]