Home About us Contact
|
Home About us Contact | ||
|
|
||
QOL Domains (qol + domain)
Selected AbstractsClinical trial: chest pain caused by presumed gastro-oesophageal reflux in coronary artery disease , controlled study of lansoprazole vs. placeboALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2 2010V. Talwar Aliment Pharmacol Ther 2010; 32: 191,199 Summary Background, Gastro-oesophageal reflux (GER) and coronary artery disease commonly co-exist. Coronary artery disease patients may mistake GER-induced pain for cardiac pain or GER might provoke angina. Aim, To investigate if GER might contribute to nocturnal/rest chest pain among coronary artery disease patients. Methods, Double-blind placebo-controlled crossover study investigating effect of lansoprazole on chest pain; 125 patients with angiographically proven coronary artery disease enrolled with at least one weekly episode of nocturnal/rest pain, randomized to lansoprazole 30 mg daily or placebo with crossover after 4 weeks. Symptoms recorded and QOL assessed by Nottingham Health Profile Questionnaire; ST segment depression episodes counted from 24 h electrocardiographic monitoring in final week of both periods. Statistical analysis: ANCOVA with period and carryover analysis. Results, In all, 108 patients completed the study. There was a modest increase in pain-free days on lansoprazole vs. placebo (P < 0.02), with fewer days with pain at rest (P < 0.05) and at night (P < 0.009) on lansoprazole vs. placebo, but no significant differences in ST segment depression episodes (P = 0.64). There was a trend for reduction in the ,physical pain' QOL domain. Conclusions, Among coronary artery disease patients, lansoprazole modestly increases pain-free days and reduces rest/nocturnal pain. As lansoprazole did not affect ST segments, this may be by suppression of GER-provoked pain misinterpreted as angina, rather than acid-provoked ischaemia. [source] Subjective quality of life aspects predict depressive symptoms over time: results from a three-wave longitudinal studyACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2009C. Kuehner Objective:, Little is known about predictive effects of quality of life aspects on the course of depressive symptoms in clinical and non-clinical settings. This study examines longitudinal associations between depressive symptoms and subjective quality of life (QOL) dimensions using a parallel sample of depressed patients and community controls. Method:, Eighty-two depressed patients were investigated 1, 6, and 42 months after hospital discharge together with 76 community controls regarding depressive symptoms measured by Montgomery Asberg Depression Rating Scale (MADRS) and QOL (WHOQOL-BREF). Data analysis included time-lagged linear models. Results:, Physical, psychological, environmental and overall QOL, controlled for depressive symptoms, predicted future depression levels. Group status did not moderate these associations. Depressive symptoms predicted future QOL levels only regarding social relations. Conclusion:, Our study suggests that subjective QOL domains have prognostic value for the course of depressive symptoms over time, both in patient and community samples. Respective self-perceptions should therefore be directly addressed by therapeutic and preventive interventions. [source] Quality 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] Epoetin alfa corrects anemia and improves quality of life in patients with hematologic malignancies receiving non-platinum chemotherapyHEMATOLOGICAL ONCOLOGY, Issue 4 2003Timothy J. Littlewood Abstract Anemia, a commonly occurring morbidity in patients with cancer, often leads to diminished quality of life (QOL). Numerous clinical trials have shown that epoetin alfa treatment improves hematologic and QOL variables in cancer patients. The clinical trial analysis reported here was performed to assess response to epoetin alfa in patients with hematologic malignancies. Cancer patients with anemia undergoing non-platinum-based chemotherapy who were enrolled in a multinational, randomized (2:1), double-blind, placebo-controlled trial were prospectively stratified by tumor type (hematologic, solid). Efficacy endpoints included proportion of patients transfused after day 28; change in hemoglobin (Hb) level from baseline to last assessment; proportion of treatment responders (increase in Hb ,2,g/dl unrelated to transfusion) and correctors (patients whose Hb levels reached ,12,g/dl during the study); and QOL. The protocol was amended before unblinding to prospectively collect and assess survival data 12 months after the last patient completed the study, and survival for the full study cohort was estimated using Kaplan,Meier techniques. Efficacy analyses of hematologic and QOL variables, as well as Kaplan,Meier estimates of survival, were performed post hoc for the hematologic tumor stratum. Among patients with hematologic malignancies, the mean increase in Hb levels was greater with epoetin alfa than with placebo treatment (2.2 vs. 0.3,g/dl). Transfusion requirements were lower in patients who received epoetin alfa versus placebo (25.2 vs. 43.1%), and the proportion of responders and correctors was higher with epoetin alfa than with placebo (75.2 vs. 16.7% and 72.6 vs. 14.8%, respectively). Patients who received epoetin alfa had improved QOL while patients who received placebo had decreased QOL. These results are similar to those seen in the full study cohort, where differences between epoetin alfa and placebo were significant (P<0.05) for all five primary cancer- and anemia-specific QOL domains evaluated. Although the study was not powered for survival, Kaplan,Meier estimates showed a trend in overall survival favoring epoetin alfa in both the full study cohort and the hematologic subgroup. Epoetin alfa treatment was well tolerated. Epoetin alfa therapy increased Hb levels, reduced transfusion requirements, and improved QOL in patients with anemia undergoing non-platinum chemotherapy for hematologic malignancies. Copyright © 2004 John Wiley & Sons, Ltd. [source] Effect of Extended-Release Naltrexone (XR-NTX) on Quality of Life in Alcohol-Dependent PatientsALCOHOLISM, Issue 2 2009Helen M. Pettinati Background:, Extended-release naltrexone (XR-NTX) is a once-a-month injectable formulation for the treatment of alcohol dependence previously shown to reduce drinking and heavy drinking relative to placebo (Garbutt et al., 2005). A 24-week, randomized, double-blind, placebo-controlled study established the efficacy and safety of XR-NTX in this patient population. In this report, the effect of XR-NTX on quality of life (QOL) was examined. Methods:, Alcohol-dependent patients were randomly assigned to receive XR-NTX 380 mg (N = 205), XR-NTX 190 mg (N = 210), or placebo (N = 209), combined with a standardized psychosocial intervention. QOL was assessed using the Medical Outcomes Study 36-item short-form health survey, administered at baseline and at 4-week intervals during 24 weeks of treatment. Results:, Compared with U.S. population norms, patients showed initial impairment in the health-related QOL domains of mental health, social functioning, and problems with work or other daily activities due to emotional problems. Adherence to all 6 injections was 65% for XR-NTX 190 mg, 63% for XR-NTX 380 mg, and 64% for placebo. Generalized estimating equations analyses using an intention-to-treat sample revealed that XR-NTX 380 mg was associated with significantly greater improvements from baseline in mental health (p = 0.0496), social functioning (p = 0.010), general health (p = 0.048), and physical functioning (p = 0.028), compared with placebo. Linear regression analyses revealed that reductions from baseline in drinking (percentage of drinking days and percentage of heavy drinking days in the last 30 days) were significantly (p < 0.05) correlated with improvements in quality of life. Conclusion:, Extended-release naltrexone 380 mg in combination with psychosocial intervention was associated with improvements in QOL, specifically in the domains of mental health, social functioning, general health, and physical functioning. [source] Antecedents of domain-specific quality of life after colorectal cancerPSYCHO-ONCOLOGY, Issue 2 2009Suzanne K. Steginga Abstract Objective: The present study prospectively assessed the influence of medical, socio-demographic, psychological, and lifestyle variables on physical, social/family, emotional, functional well-being and colorectal cancer-specific concerns in a population-based sample of colorectal cancer survivors. Methods: Participants (n=1822) were assessed at 6 and 24 months post-diagnosis. Predictor variables assessed at 6 months included socio-demographic and medical variables, symptoms/side-effects, body mass index, physical activity, optimism, social support, and cancer threat appraisal. Quality of life (QOL) was assessed at 6 and 24 months post-diagnosis using the Functional Assessment of Cancer Therapy - Colorectal (FACT-C). Results: For each QOL subscale and for the overall FACT-C scale, 6 month scores were the strongest predictor of QOL scores at 24 months post-diagnosis (e.g. ,=0.447, p < 0.001 for overall QOL). Socio-demographic, medical, and psychosocial variables, but not lifestyle variables, differentially predicted domain specific QOL. Only cancer threat appraisal was associated with all five QOL domains. Conclusion: Cancer threat appraisal presents as a potentially modifiable variable for interventions seeking to improve QOL. Symptom management and lifestyle strategies to ameliorate the effects of co-morbidities, disease stage and troublesome symptoms such as faecal incontinence on QOL should also be included. Copyright © 2008 John Wiley & Sons, Ltd. [source] Quality of life in multiple sclerosis: a Kuwaiti MSQOL-54 experienceACTA NEUROLOGICA SCANDINAVICA, Issue 6 2008A. F. Alshubaili Objectives,,, We compared the quality of life (QOL) self-ratings of relapsing,remitting multiple sclerosis (RRMS) and progressive multiple sclerosis (PMS) patients with those of the general population; and assessed the association of demographic, clinical, and caregiver variables with patients' QOL. Methods,,, Consecutive clinic attendees were assessed with MSQOL-54, Beck's Depression Inventory, and Expanded Disability Status Scale. Caregivers rated their impression of patients' QOL and attitudes to patients' illness. Results,,, Of 170 patients (35.5% M, 64.5% F), 85.3% had RRMS and 14.7% PMS. RRMS had higher QOL domain scores (P < 0.001). Patients had lower QOL than controls (P < 0.001). Depression was the commonest significant covariate of QOL domains. After controlling for depression and disability, differences between the MS groups were less significant. Predictors of overall QOL were caregiver impression of patient's QOL, depression, and treatment side effects. Conclusion,,, Programs that address depression, disability, the impact of treatment side effects, caregiver attitudes and education should enhance QOL outcomes. [source] Agreement between parent and child report of quality of life in children with attention-deficit/hyperactivity disorderCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 4 2006A. F. Klassen Abstract Background There is little information in the research literature of agreement between parent and child in reports of child quality of life (QOL) for a sample of children diagnosed with attention-deficit/hyperactivity disorder (ADHD). The aim of our study was to determine whether parent and child concordance is greater for physical domains of QOL than for psychosocial domains; whether parents rate their child's QOL better or poorer than their child's ratings; and whether concordance is related to demographic, socioeconomic or clinical factors. Methods The study was a questionnaire survey of children aged 10,17 referred to the ADHD clinic and diagnosed with ADHD in the province of British Columbia (Canada) between November 2001 and October 2002 and their parent. Results Fifty-eight children diagnosed with ADHD and their parents completed our study questionnaire. The main outcome measure was the Child Health Questionnaire, which permitted comparisons on eight QOL domains and one single item. Intraclass correlation coefficients were moderate for five domains (range from 0.40 to 0.51), and good for three domains (range from 0.60 to 0.75). Children rated their QOL significantly better than their parents in four areas and poorer in one. Standardized Response Means indicated clinically important differences in mean scores for Behaviour and Self-esteem. Compared with population norms, across most domains, children with ADHD reported comparable health. Discrepancies between parent,child ratings were related to the presence of a comorbid oppositional/defiant disorder, a psychosocial stressor and increased ADHD symptoms. Conclusions Although self-report is an important means of eliciting QOL data, in children with ADHD, given the discrepancies in this study between parent and child report, measuring both perspectives seems appropriate. [source] Quality of life in chronic disease: a comparison between patients with heart failure and patients with aphasia after strokeJOURNAL OF CLINICAL NURSING, Issue 13-14 2010Ĺsa Franzén-Dahlin Objectives., This study aimed to describe the impact of heart failure and of stroke with aphasia on quality of life (QoL) and to compare the different domains of QoL in these groups. Background., The prevalence of chronic conditions has increased during the last decades, and chronic diseases such as stroke and heart failure may have a great impact on QoL. Design., Comparative study of patients from two randomised controlled studies. Method., Seventy-nine patients with heart failure and 70 patients with aphasia after stroke were evaluated concerning the severity of their disease and by QoL, as measured with the Nottingham Health Profile, in the acute phase and after six months. Results., The severity of the disease improved between baseline and six month for both groups. Correlations between New York Heart Association (NYHA) class and all QoL domains were seen in patients with heart failure after six months. The degree of aphasia correlated to mobility, social, emotional and total score after six month. QoL in patients with heart failure was more affected in the domains of sleep and energy in the acute phase and in the energy domain at six months. Conclusion., Although low energy is more frequent among patients with heart failure, both groups report poor QoL. Improvement in severity of the disease is not necessarily accompanied by improvement in QoL. Relevance to clinical practice., Nottingham Health Profile can easily be used as a screening instrument, aiming to identify patients at risk for adverse effects on QoL. A better understanding of the subjective QoL of patients with chronic disease is fundamental for health care professionals to be able to identify and support vulnerable patients. [source] Quality of Life,Towards an understanding of individuals with psychopathic tendenciesPERSONALITY AND MENTAL HEALTH, Issue 3 2009Marie Väfors Fritz The objectives are to explore: (1) the association between psychopathy and self-rated quality of life; and (2) the possible role of childhood hyperactivity on the relationships between Psychopathy Checklist (PCL) scores and self-rated domains of Quality of Life (QoL). Male subjects with a history of criminality at age 11,14 years (n = 108) and matched controls (n = 59) from a Swedish longitudinal project were studied. Self-rated QoL domains of psychological health, family relationships and work satisfaction were dichotomized and used as dependent variables in calculations of odds ratios (ORs) with dichotomized PCL scores as the independent variable, as assessed at age 38,41. The results showed that for each of the three QoL domains, the proportion of individuals that reported dissatisfaction was significantly higher in both criminals and controls characterized by psychopathic tendencies (PT) compared with the groups with no psychopathic tendencies. Furthermore, the results revealed higher strata-specific risk of dissatisfaction among the PT individuals for two of the domains: psychological health (OR = 6.58) and work satisfaction (OR = 7.98). Childhood hyperactivity individuals were overrepresented in the PT group. However, hyperactivity did not confound the association between PCL and QoL. The results are discussed in the light of possible treatment implications. Copyright © 2009 John Wiley & Sons, Ltd. [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] Allergic rhinitis and quality of life: where are we?CLINICAL & EXPERIMENTAL ALLERGY REVIEWS, Issue 3 2003G. Majani Summary Health-Related Quality of Life (QoL) considers the impact of both illness and treatment on a patient's life as perceived by the patient himself. As well as providing information on how a disease affects a patient's life, QoL instruments could provide important information concerning the treatment outcomes. The SF-36 enlighted a significant impairment in eight of the nine QoL domains in patients with persistent allergic rhinitis, compared to healthy subjects. In seasonal rhinitis a patient's satisfaction profile does not show consistent changes before and after the pollen season. Adherence to treatment and caregivers' and relatives' QoL assessment still deserve more attention. In conclusion there is still a long way to go towards a full knowledge of QoL in allergic rhinitis. [source] | ||||||||||