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Life Issues (life + issues)
Selected AbstractsHealth-Related Quality of Life Issues in Women With Polycystic Ovary SyndromeJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 1 2005Judy Griffin McCook Objective: To evaluate the influence of obesity, fertility status, and androgenism scores on health-related quality of life in women with polycystic ovary syndrome (PCOS). Design: Cross-sectional, correlational. Setting: Private reproductive endocrinology practice in two southeast U.S. cities. Participants: Convenience sample of 128 women with PCOS, half of whom were attempting to conceive in addition to being treated for PCOS. Most were White (97%), married (78%), with a mean age of 30.4 years (SD ± 5.5). Main Outcome Measures: The Health-Related Quality of Life Questionnaire (PCOSQ) for women with polycystic ovary syndrome. A laboratory panel and clinical measures, including body mass index, waist-to-hip ratio, and degree of hirsutism. Results: The most common health-related quality of life concern reported by women with PCOS was weight, followed in descending order by menstrual problems, infertility, emotions, and body hair. Conclusions: The psychological implications of PCOS are easily underestimated and have been largely ignored. Nursing has a pivotal role in recognizing these concerns and implementing therapy to improve quality of life in women with PCOS. [source] A bird can't fly on one wing: patient views on waiting for hip and knee replacement surgeryHEALTH EXPECTATIONS, Issue 2 2007Barbara L. Conner-Spady PhD Abstract Objectives, To obtain patients' perspectives on acceptable waiting times for hip or knee replacement surgery. Methods, A questionnaire with both open- and close-ended items was mailed to 432 consecutive patients who had hip or knee replacement surgery 3,12 months previously in Saskatchewan, Canada. A content analysis was used to analyse the text data from the open-ended questions. Results, The sample of 303 (response rate 70%) was 59% female with a mean age of 70 years (SD 11). The median waiting time from the decision date to surgery was 17 weeks. Individuals who rated their waiting time very acceptable (48%) had a median waiting time of 13 weeks compared with a median waiting time of 22 weeks for those who rated it unacceptable (23%). The two most common determinants of acceptability were patient expectations and pain and its impact on patient quality of life. The median maximum acceptable waiting time was 13 weeks and median ideal waiting time, 8.6 weeks. Seventy-nine per cent felt that those in greater need (higher severity) should go before them on the waiting list. Patient ratings of maximum acceptable waiting time were based on: pain and loss of mobility, time needed to prepare for surgery, and severity at the time of seeing the surgeon. In consideration of changing their surgeon to one with a shorter waiting list, 68% would not. Conclusions, Patient views on waiting times are not only related to quality of life issues, but also to prior expectations and notions of fairness and priority. Understanding patient views on waiting for surgery has implications for better management of waiting times and experiences for joint replacement. [source] Specialist supportive clinical management for anorexia nervosaINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 8 2006Dip Clin Psyc, Virginia V. W. McIntosh PhD Abstract Objective: This article presents the rationale for, and description of, a nonspecialized therapy for anorexia nervosa, called specialist supportive clinical management (SSCM). Method: Clinical management and supportive psychotherapy models of treatment are outlined. SSCM is described, as it was delivered in a clinical trial of psychotherapies for adult women with anorexia nervosa. Results: The primary focus of SSCM for anorexia nervosa is the resumption of normal eating and the restoration of weight. Therapy aims to maintain a therapeutic relationship that facilitates the return to normal eating, and to enable other life issues that may impact on the eating disorder to be addressed. Conclusion: Possible effective components of SSCM are discussed. © 2006 by Wiley Periodicals, Inc. Int J Eat Disord 2006; 39:625,632 [source] Policies, principles and pragmatism: old age psychiatrists' attitudes and practice regarding influenza immunisation for long stay patientsINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 7 2002Guy Holloway Abstract This study aimed to examine the attitudes and practice of old age psychiatrists with respect to influenza immunisation for their patients in long stay care. A questionnaire was mailed out with a copy of the government immunisation policy. There was considerable disagreement among responders regarding the government policy, quality of life issues and the appropriateness of immunisation. There was a consensus in favour of immunising those who could not consent and for seeking relatives' views in this scenario. Staff immunisation status and patients' prior wishes were highlighted, amongst other factors, as affecting immunisation decisions. The government policy might be more acceptable to psychiatrists if there was more emphasis on the individual nature of clinical decisions and the policy will have to change in the light of new legislation. Copyright © 2002 John Wiley & Sons, Ltd. [source] Peripheral blood vs. bone marrow for molecular monitoring of BCR-ABL1 levels in chronic myelogenous leukemia, a retrospective analysis in allogeneic bone marrow recipientsINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 4 2010A. BALLESTRERO Summary Molecular monitoring of the BCR-ABL1 transcript in chronic myelogenous leukemia (CML) using quantitative real-time PCR (RQ-PCR) can be performed using either bone marrow (BM) or peripheral blood (PB). However, a recent report by Stock et al. [International Journal of Oncology 28 (2006) 1099] questioned the reliability of PB samples for BCR-ABL1 detection as performed by RQ-PCR. We report a study on 114 CML patients who received allogeneic stem cell transplantation (ASCT), and who were monitored by RQ-PCR using paired samples of BM and PB: the total number of determinations was 428, with a median follow-up after transplant of 8 years. BCR-ABL1 transcript was undetectable or <0.1%, in 106 (49.57%) and 62 (29%) paired determinations, respectively. BCR-ABL1 was >0.1% in 36 (16.8%) paired determinations and was discordant in 10 (4.7%). Agreement between PB and BM results was quantified by the kappa test (k = 0.85; 95% CI 0.76,0.94). This study shows that BCR-ABL1 RQ-PCR monitoring of CML patients after ASCT with PB is concordant with BM in 95.3% of cases, and thus may be used to monitor the disease. This may be relevant when discussing both quality of life issues and the need for post-transplant monitoring with the patient. [source] A bladder preservation regimen using intra-arterial chemotherapy and radiotherapy for invasive bladder cancer: A prospective studyINTERNATIONAL JOURNAL OF UROLOGY, Issue 2 2000Naoto Miyanaga Abstract Background: A prospective study was performed to investigate combined treatment with intra-arterial chemotherapy and radiation therapy for bladder preservation in locally invasive bladder cancer. Methods: Patients with invasive bladder cancer, stage T2,3N0M0, were included in the study. Intra-arterial chemotherapy was performed with three injections of methotrexate and cisplatin at 3-week intervals. Simultaneously, the patients underwent X-ray irradiation (40 Gy) of the small pelvic space. Where a post-treatment transurethral resection (TUR) biopsy showed no residual tumor, the tumor site was irradiated by a 30 Gy proton beam and the bladder was preserved. Where tumors remained, radical cystectomy was performed. Results: Between 1990 and 1996, 42 patients were treated according to this protocol. Post-treatment TUR biopsy and urine cytology showed no residual tumors in 39 of 42 cases (93%). The bladder was preserved in accordance with the study protocol in 36 cases. A median follow-up of 38 months showed 3-year non-recurrence in 72% of bladder-preserved patients and the rate of bladder preservation was 84%. The nine recurrences included eight cases of superficial bladder recurrence. One cancer death occurred among the bladder-preservation patients, giving 3-year survival and cause-specific survival rates of 84% and 100%, respectively. Although bladder function decreased slightly in compliance, bladder capacity was retained in almost all cases. Conclusions: This regimen is useful for bladder preservation in T2,3 locally invasive bladder cancer. Information from more cases and the results of more long-term observations are needed, as is an evaluation of appropriate subject selection and factors associated with quality of life issues, particularly regarding bladder function. [source] Impact of Surgical and Orthotic Intervention on the Quality of Life of People with Profound Intellectual and Multiple Disabilities and Their CarersJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 4 2000Aileen Neilson The increasing analysis of quality of life issues for people with disabilities has not been paralleled in relation to people with profound intellectual and multiple disabilities (PIMDs). This is nowhere more the case than with regard to the impact of health status on their quality of life. In addition, people with PIMDs, and the interventions which they require, have not been included within wider considerations of the economics of healthcare and its relation to rational decision-making regarding medical provision. The present exploratory study considered the impact of a wide range of surgical and orthotic interventions on the quality of life of 27 children and adults with PIMDs. These were explored on a pre,post-test basis with respect to: (1) the economic costs associated with surgical and orthotic interventions; (2) clinical assessment of function and behaviour; (3) the participants' and carers' quality of life; and (4) carer satisfaction with the interventions. The results are presented with respect to these individual areas and the extent to which the findings are congruent. The need for the development of these measures to meet the specific requirements of this population and the development of a more formal model integrating these steps are considered. [source] Quality of life of older people in residential care home: a literature reviewJOURNAL OF NURSING AND HEALTHCARE OF CHRONIC ILLNE SS: AN INTERNATIONAL INTERDISCIPLINARY JOURNAL, Issue 2 2009Diana TF Lee MSc, PRD (HCE) Aim., To integrate the research evidence on quality of life of older people living in a residential care home setting. Background. Residential care is provided for older people who are unable to live in their own home due to various health and social reasons. A number of studies have been published that have focused on diverse quality of life issues of residential care home elders. Consolidating the evidence from these studies may provide insights into enhancing quality of life of this particular group of older people. Design. A literature review of research evidence on quality of life issues among residential care home elders. Method. A systematic search of the literature published between 1994,January 2008 was undertaken to identify research evidence on quality of life of older people living in residential care home. Information about the study design, research objectives, study setting, sample characteristics, and key findings were extracted for comparison and integration. Three aspects about quality of life of the residential care home elders were identified: views of residential care home elders on quality of life, factors affecting quality of life of residential care home elders and methods to improve quality of life in residential care home elders. Results. Eighteen publications were identified. Older people perceived their ability to maintain independence, autonomy and individuality as the most important criteria for determining quality of life. Interventions designed to improve quality of life of older people living in residential facilities corresponded to these criteria. A range of interventions including a walking program, mental stimulation and environmental modification were proposed and evaluated to improve quality of life of residential care home elders. Among these interventions, environmental modification that targeted at improving the residential care homes and quality of services appears to be promising. Conclusion. Quality of life in residential care home elders is a complex issue that may be determined by the elders' independence, individuality and autonomy, and influenced by quality of residential care and facilities. Environmental modification appears to be a way to improve the quality of life of residential care home elders. Relevance to clinical practice. The knowledge of understanding quality of life of residential care home elders provides insights into the implementation of appropriate residential care services. Programs that aim to de-institutionalise the residential care home settings are important to the enhancement of residential care services. [source] Ethical issues for parents of extremely premature infantsJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 5 2008Judith Schroeder Abstract: Evidence suggests that NICU (neonatal intensive care unit) parents with an baby born at the threshold of viability do not always receive sufficient counselling during an emergency admission and as a consequence, are not well-informed to accept withdrawal of treatment or quality of life decisions. As prospective parents are not educated earlier in pregnancy about extreme premature delivery, crucial information and counselling explaining neonatal issues is only offered to labouring women during their emergency admission. As a result, most have difficulty understanding the risks and benefits of baby's treatment and therefore rely heavily on the perinatal physician to take responsibility for the initial treatment. However, this lack of understanding often leaves parents disadvantaged, as many are left unprepared to participate objectively in quality of life decisions. According to recent research, morbidity figures remain relatively high with one in five survivors at risk of a long-term disability. This shows that some parents will still be confronted by ethical decision of whether or not to continue treatment, and this may not be apparent until days after treatment has been established. As recent research has shown, parents do, in fact, want increased involvement in the decision-making process regarding their child's treatment. Therefore, it has been argued, that parents should be provided with information earlier in pregnancy to familiarise themselves with quality of life issues which they may encounter as the NICU parents of an extremely premature infant. [source] Clinical review of Crohn's diseaseJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 8 2007APRN-BC, Brenda Ruthruff MSN, CWOCN (Adult Nurse Practitioner, Continence Nurse), Ostomy, Wound Abstract Purpose: This clinical review presents proposed theories regarding the etiology of Crohn's disease (CD), the pathophysiology of the disorder, and current diagnostic methods. Data sources: Pertinent publications in the literature, the Crohn's and Colitis Foundation web page, and relevant texts regarding pathophysiology of the gastrointestinal system. Conclusions: CD can be a devastating disease and difficult to diagnose. The advanced practice nurse (APRN) should be aware of the etiology, pathophysiology, diagnostic methods, and current treatment options of this disorder. Implications for practice: In collaboration with a gastroenterologist, APRNs can provide much needed information to the patient with CD. Practice recommendations include patient education, pain management, and support for quality of life issues. [source] Doctors' reasons for rejecting initial choices of specialties as long-term careersMEDICAL EDUCATION, Issue 4 2003Trevor W Lambert Objectives, To report on rejected choices of specialty as long-term careers and reasons for rejection. Design, Postal questionnaire survey. Setting, United Kingdom. Participants, All graduates of 1996 and 1999 from UK medical schools during their first year after qualification. Main outcome measures, Any career choice which had been seriously considered and rejected and the reason for its rejection. Results, In all, 33·1% (1871) of respondents named a rejected choice and gave reasons for its rejection. Disproportionately high numbers rejected the surgical specialties, paediatrics and obstetrics and gynaecology (O&G), using the specialty distribution of positive choices as the comparator. Relatively few doctors rejected general practice (GP) after giving it serious consideration. Doctors rejecting the hospital medical and surgical specialties or paediatrics were most likely to specify reasons relating to quality of life. Three-quarters of the graduates of 1999 who rejected O&G did so because of poor career prospects. Conclusions, Quality of life issues, and concerns about working relationships, are sufficiently influential to persuade many doctors to abandon an initial choice of medical career. It is unlikely that much of the decline in entry to GP is attributable to rejection of GP by doctors who initially chose it. The decline must therefore represent an increase in the number of doctors who had never seriously considered it as a long-term career choice. [source] Post-stroke fatigue: qualitative study of three focus groupsOCCUPATIONAL THERAPY INTERNATIONAL, Issue 2 2010Nancy A. Flinn Abstract Fatigue affects many persons after cerebrovascular accident, particularly those with mild stroke. A qualitative methodology using focus groups with 19 community-living post-stroke survivors was utilized to explore the occupational impact of fatigue as communicated by the participants. Although self-report of a small sample of the United States' post-stroke population will have limitations in generalizability, this study identifies specific health-related quality of life issues that can occur with post-stroke fatigue. The participants felt unprepared for the fatigue phenomenon and struggled to adapt, with fatigue having a debilitating influence upon daily occupational performance and roles, including social participation, return to work, driving, reading and sleeping. The participants indicated that exercise (such as walking and water aerobics) and use of assistive technology were helpful strategies in reducing fatigue. The occupational performance and role impact identified by participants in this study can inform the design of effective occupational therapy interventions and further quantitative study of persons with post-stroke fatigue. Copyright © 2009 John Wiley & Sons, Ltd. [source] Quality of life issues and second-generation migration: the case of ,Bajan-Brit returnees'POPULATION, SPACE AND PLACE (PREVIOUSLY:-INT JOURNAL OF POPULATION GEOGRAPHY), Issue 3 2009Joan Phillips Abstract This paper forms part of research that is investigating the migration of young Bajan-Brits to Barbados. Specifically, it explores the role of quality of life issues in the decision-making processes of young Bajan-Brits as they negotiate their ,return' to Barbados. The research, based on 51 in-depth qualitative interviews conducted with an under-researched cohort of young Bajan-Brits living in Barbados, argues from a ,lure of home' conceptualisation that the return of young Bajan-Brits to Barbados can best be understood from the context of a search for a better quality of life in the face of social and economic disenfranchisement in the UK context. Subsequently, the paper examines the extent to which the quality of life factors which formed the basis of return to Barbados have in fact been realised on the part of young Bajan-Brits in their adjustment to life in Barbados. The paper ultimately argues that despite problems of adjustment, young Bajan-Brits have generally been successful in actualising a better quality of life in Barbados. Copyright © 2009 John Wiley & Sons, Ltd. [source] Dimensions of quality of life and psychosocial variables most salient to colorectal cancer patientsPSYCHO-ONCOLOGY, Issue 1 2006Jeff Dunn Abstract Colorectal cancer is one of the most common invasive cancers, and is responsible for considerable physical and psychosocial morbidity. Understanding the quality of life experienced by colorectal cancer patients is essential for evaluating the full impact of the disease on individuals, their families and their communities. Patient perspective is essential in establishing a proper understanding of the quality of life of colorectal cancer patients. Despite this, few studies have employed a qualitative methodology to explore quality of life issues for colorectal cancer patients. A review of the literature identified only seven qualitative studies pertaining to quality of life issues for colorectal cancer patients, a surprising finding given the prevalence of this cancer. Accordingly, this study sought to build on the findings of previous qualitative research by providing descriptive data on the quality of life and psychosocial variables most salient to colorectal cancer patients. Six core themes emerged from interview and focus group data: Satisfaction with diagnosis and treatment; support (including information provision); quality of life; benefits of diagnosis; making sense of the cancer experience; and coping strategies. The information derived from this study will help inform the development of supportive care services to address the needs of the increasing number of people diagnosed with colorectal cancer. Copyright © 2005 John Wiley & Sons, Ltd. [source] SEXUAL MEDICINE HISTORY: Satyriasis: The Antiquity Term for Vulvodynia?THE JOURNAL OF SEXUAL MEDICINE, Issue 1 2006Janice McElhiney EdM ABSTRACT From ancient times, through the Middle Ages, and well into the 19th century, physicians concentrated on catastrophic medical conditions and illnesses rather than on quality of life issues. Wars, plagues, and pestilence left little time, energy, or concern for "discomfort" problems. Therefore, it is not surprising that women's conditions that caused distressing symptoms but fell short of major morbidity and mortality were not given a prominent position in medicine until relatively recently. This is especially the case with vulvodynia, a condition that has been reported to affect approximately 15% (and in some studies up to 27%) of the female population at some point in their lives. Despite its high prevalence, this condition was not discussed or reported in traditional medical textbooks until the end of the 1800s. Now, we propose another viewpoint on when the first description of vulvodynia appeared; that is, that vulvodynia was described as far back as the 1st century CE. From our review of the ancient medical literature, we believe that the condition described by Soranus as "satyriasis in females" was actually vulvodynia. McElhiney J, Kelly S, Rosen R, and Bachmann G. Satyriasis: the antiquity term for vulvodynia? J Sex Med 2006;3:161,163. [source] Quality of life issues in nonmetastatic skin cancerBRITISH JOURNAL OF DERMATOLOGY, Issue 1 2010D. Burdon-Jones Summary Background, Current knowledge of quality of life (QOL) issues affecting patients with nonmetastatic skin cancer is unsatisfactory, being based either on the use of QOL questionnaires derived from dermatology patients with predominantly benign lesions or inflammatory skin rashes, or on the use of general health QOL questionnaires. Objectives, We sought to determine the impact of nonmetastatic skin cancer on patients' lives by asking such patients for their written opinions. Methods, An open-ended ,Skin Cancer Quality of Life Question Sheet' was given to 100 consenting patients with nonmetastatic skin cancer [50 with malignant melanoma (MM) and 50 with nonmelanoma skin cancer (NMSC)]. Results, In total, 82 ,Skin Cancer Quality of Life Question Sheets' were returned complete (40 MM and 42 NMSC). There were 44 different patient concerns voiced overall in the responses. The concerns were grouped into 10 main themes. Patients with MM were significantly more likely than those with NMSC to mention ,a sense of relief/gratitude following treatment and/or a commitment to enjoy life here on' (P = 0·001), ,feelings of anxiety/depression/guilt/stress towards oneself or family/friends' (P < 0·001) and ,strengthening of emotional relationships with family and/or friends' (P = 0·02). Patients with NMSC were significantly more likely than those with MM to mention ,concern about the public's lack of understanding and recognition of skin cancer' (P = 0·02). The theme ,realization of one's mortality' was commoner among patients with MM than with NMSC, while the theme ,concern regarding possible scarring/disfigurement or the reaction of others' was commoner among patients with NMSC than with MM, although neither of these two differences was statistically significant (P = 0·07 and P = 0·11, respectively). Conclusions, QOL issues expressed by patients with nonmetastatic skin cancer highlight concerns we must address during their care. A disease-specific QOL measure suitable for both nonmetastatic MM and nonmetastatic NMSC is needed. The psychosocial impact on patients with nonmetastatic MM must not be underestimated. [source] A review of quality of life issues and people with autism spectrum disordersBRITISH JOURNAL OF LEARNING DISABILITIES, Issue 4 2007Lynn A. Plimley Summary This article draws on existing theory and research findings in the field of quality of life (QoL) and those with learning/intellectual disability and extrapolates current thinking in terms of measurable domains of QoL. The condition of autism spectrum disorders (ASD) is becoming increasingly prevalent in the sector of supported living and adult residential care. The author examines the core features of ASD and applies known characteristics to ways in which QoL domains and assessment tools can be adapted to people with ASD. [source] Quality of life issues for South Africans with acne vulgarisCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 1 2005A. Mosam Summary The adverse effects of acne on the psyche have been established in patients from ,first world' countries. There has been no in depth study in predominantly black patients from Africa addressing this issue. This was a prospective cross-sectional study of acne patients attending a dermatology unit in KwaZulu-Natal, South Africa. A questionnaire was completed and acne graded by the Global Acne Grading scale. Psychological morbidity and quality of life (QOL) were assessed by the General Health Questionnaire and Dermatology Specific Quality of Life Questionnaires, respectively. We found that clinical severity was not associated with patient perception or psychological distress. The QOL measures such as feelings, social activities, performance at work or school, activities of daily living and overall mental health were found to be associated with distress with associated P -values of 0.0002, 0.0168, 0.0032, 0.033 and <,0.0001, respectively. The severity of acne was not associated with psychological distress. Painful and bleeding lesions were associated with distress levels; P = 0.042 and P = 0.019, respectively. In conclusion, South African patients with acne vulgaris suffer significant psychological distress, which affects the quality of their lives. [source] Quality of life issues in recurrent respiratory papillomatosisCLINICAL OTOLARYNGOLOGY, Issue 2 2000D.S. Hill Twenty-six adult patients attending the Royal National Throat, Nose, and Ear Hospital with Recurrent Respiratory Papillomatosis completed two postal questionnaires. One was the generic Short Form-36 (SF-36) quality of life instrument. Severely affected patients had lower scores in all dimensions of this instrument, with large differences from normal controls in dimensions of pain, physical limitation, and energy/vitality. The second questionnaire was newly devised, and designed to ask about a wide variety of larynx-specific symptoms. Answers by patients were compared with those of normal controls, and symptoms selected as significantly more likely to be reported by patients were studied further. Correlation was seen with clinical parameters, and questions likely to be responsive to clinical change in disease burden were identified. [source] | ||||||||||||||||||||||