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Disease Impact (disease + impact)
Selected AbstractsValidity of an instrument to measure the impact of valve heart disease on the patient's daily lifeJOURNAL OF CLINICAL NURSING, Issue 7 2007Kátia Melissa Padilha RN Aim., This study was to verify the psychometric properties of the Heart Valve Disease Impact on daily life, an instrument for measuring the impact of illness in the daily life of the heart valve disease patient, related to its construct validity, criterion-related validity and reliability. Methods., One hundred and twenty heart valve disease outpatients were enrolled. Data were submitted to descriptive analysis, factor analysis, Pearson's correlation coefficient and Cronbach's alpha coefficient. Results., The factor analysis generated four factors that explained 58% of the variance in response to the Heart Valve Disease Impact on daily life. Weak to moderate correlation was measured between the Heart Valve Disease Impact on daily life total score and two of its factors and the General Measure of Impact of illness, indicating criterion-related validity. A Cronbach's alpha of 0·74 was measured. Conclusion., The results of the current study confirm both the construct and criterion validity and the internal consistency of the Heart Valve Disease Impact on daily life. Future studies are necessary to confirm its reliability and provide a better understanding of the meaning of the Heart Valve Disease Impact on daily life dimensions, as well as to evaluate its response to health interventions. Relevance to clinical practice., The Heart Valve Disease Impact on daily life could be a useful instrument to measure the impact of heart valve disease and to evaluate the response to health interventions. [source] Assessment of quality of life in adults receiving long-term growth hormone replacement compared to control subjectsCLINICAL ENDOCRINOLOGY, Issue 1 2003I. A. Malik Summary objective There are few studies of quality of life (QOL) in adults with growth hormone deficiency (GHD) compared to matched control populations without GHD. These have shown impairments in a variety of QOL measures, which improve but do not normalize after short-term replacement with GH. There is little information on QOL in long-term treated GHD patients compared with controls without GHD. patients and methods A total of 120 adults with GHD who had received GH replacement for at least 1 year were identified from the neuroendocrine clinic. Patients were asked to complete eight QOL questionnaires and an Energy Visual Analogue Scale (VAS). Results were compared with 83 control subjects without GHD from the local population who agreed to complete seven of the QOL questionnaires (excluding Disease Impact scale) and the energy VAS. The eight questionnaires were a combination of generic and disease-specific questionnaires used to assess health related QOL, namely: Short Form-36 (SF-36), Nottingham Health Profile (NHP), Disease Impact, Life Fulfilment and Satisfaction scales, Mental Fatigue Questionnaire (MFQ) and Self Esteem scale, Hospital Anxiety Depression (HAD) scale and QOL-AGHDA (assessment of GHD in adults). results Eighty-nine patients returned questionnaires and 85 (71%) had complete data for analysis. The mean (SD) duration of GH replacement was 36·0 ± 26·4 (range 13,159) months. Mean age was 43·9 ± 15·8 years (37 males) in treated GHD patients compared to a mean age 41·7 ± 10·5 years (32 males) in the controls. Mean IGF-1 levels were 22·5 ± 13·6 nmol/l in the GHD patients and the mean dose of GH replacement was 1·2 ± 0·4 IU daily. Analysis of the QOL questionnaires from the GH treated patients revealed highly significant impairments in all measures (most P , 0·0001, except life fulfilment-material, P = 0·33) compared to the control population. conclusions This large population with treated GH deficiency have significant impairments in multiple aspects of QOL despite replacement with GH and other pituitary hormones for at least 1 year (mean 3 years). It is likely therefore that other factors in addition to GH deficiency must influence QOL in these patients. Further strategies to improve QOL in these individuals should therefore be considered, e.g. psychological support and treatments and physical treatments (such as exercise programmes). [source] Preliminary evidence supporting a framework of psychological adjustment to inflammatory bowel disease,INFLAMMATORY BOWEL DISEASES, Issue 10 2010Jennifer L. Kiebles PhD Abstract Background: Adjustment to chronic disease is a multidimensional construct described as successful adaptation to disease-specific demands, preservation of psychological well-being, functional status, and quality of life. Inflammatory bowel disease (IBD) can be particularly challenging due to the unpredictable, relapsing and remitting course of the disease. Methods: All participants were patients being treated in an outpatient gastroenterology clinic at a university medical center. Participants completed a survey of questionnaires assessing illness perceptions, stress, emotional functioning, disease acceptance, coping, disease impact, and disease-specific and health-related quality of life. Adjustment was measured as a composite of perceived disability, psychological functioning, and disease-specific and health-related quality of life. Results: Participants were 38 adults with a diagnosis of either Crohn's disease (45%) or ulcerative colitis (55%). We observed that our defined adjustment variables were strongly correlated with disease characteristics (r = 0.33,0.80, all P < 0.05), an emotional representation of illness (r = 0.44,0.58, P < 0.01), disease acceptance (r = 0.34,0.74, P < 0.05), coping (r = 0.33,0.60, P < 0.05), and frequency of gastroenterologist visits (r = 0.39,0.70, P < 0.05). Better adjustment was associated with greater bowel and systemic health, increased activities engagement and symptom tolerance, less pain, less perceived stress, and fewer gastroenterologist visits. All adjustment variables were highly correlated (r = 0.40,0.84, P < 0.05) and demonstrated a cohesive composite. Conclusions: The framework presented and results of this study underscore the importance of considering complementary pathways of disease management including cognitive, emotional, and behavioral factors beyond the traditional medical and psychological (depression and anxiety) components. (Inflamm Bowel Dis 2010) [source] What people with multiple sclerosis perceive to be important to meeting their needsJOURNAL OF ADVANCED NURSING, Issue 1 2007Angus Forbes Abstract Title. What people with multiple sclerosis perceive to be important to meeting their needs Aim., This paper is a report of the findings of a survey in which people with multiple sclerosis identified what they believed would be helpful in meeting their current needs. Background., People with multiple sclerosis have low levels of satisfaction with the health and social care that they receive, but previous studies suggest that they have a broad range of physical, psychological and social needs. Method., A total of 714 people with different levels of disease impact who were participating in a prospective study evaluating multiple sclerosis specialist nurses were asked, ,What one thing would be most helpful in meeting your current needs?' The question was included in the postal questionnaire used for the study (mailed in 2001 and 2002). The overall response rate for usable returns (at both time points) was 42%. Descriptive statistics on the frequency of codes and categories generated by content analysis were compiled and compared in relation to demographic and disease characteristics. Findings., A total of 445 people responded to the question. Seven categories were identified: medical treatment (29%, n = 126); socio-environmental support and adaptation (19%, n = 81); enhanced care provision (18%, n = 79); information provision (9%, n = 38); rehabilitation therapies (7%, n = 29); non-professional care (6%, n = 28); and psychological support (3%, n = 15). Nine per cent of responses (n = 39) were not coded as their meanings were unclear. Socio-environmental support, rehabilitation and non-professional care were more frequently identified by those with greater disease impact. Information was identified as a stronger need for those in lower disease impact groups. Conclusion., The findings could provide the basis for developing a multiple sclerosis-specific service satisfaction tool. This could be helpful in assessing the quality of provision, given current variations in the coverage and quality of care provided. Nurses could use such a tool to assess the quality of care in a given population, thereby highlighting gaps in service provision. [source] Assessing health-related quality of life in patients with inflammatory bowel disease in Zhejiang, ChinaJOURNAL OF CLINICAL NURSING, Issue 1-2 2010Yunxian Zhou Aims., The aim of this study was to assess health-related quality of life in patients with inflammatory bowel disease in Zhejiang, Mainland China. Background., The incidence of inflammatory bowel disease in China is believed to be low but has been increasing in the past decade. The quality of life of Chinese patients with inflammatory bowel disease is unknown. Design., A cross-sectional study. Methods., The study was conducted in 92 patients with inflammatory bowel disease in Zhejiang, China, 52 with ulcerative colitis and 40 with Crohn's disease. Health-related quality of life was measured by the Chinese version of the Inflammatory Bowel Disease Questionnaire and Short Form-36, respectively. Disease activity was assessed by the Walmsley and Harvey,Bradshaw simple indices for ulcerative colitis and Crohn's disease, respectively. Demographic and clinical variables were also recorded. Short Form-36 data from the study sample were compared with a reference population of 1688 Chinese people residing in Hangzhou, Zhejiang, China. Results., No significant health-related quality of life differences were found between patients with ulcerative colitis and Crohn's disease (p > 0·05). Pooled data showed that inflammatory bowel disease patients with active disease had significantly lower scores for all eight dimensions of Short Form-36 compared to those in remission (p < 0·01); those with active disease scored significantly lower than population norms in all dimensions of Short Form-36 except mental health (p < 0·05); whereas those in remission scored significantly lower than population norms in role physical (p < 0·01) and general health dimensions (p < 0·05). The regression analyses identified only disease activity index and employment status to explain variations in health-related quality of life (p < 0·01). Conclusions., Inflammatory bowel disease similarly impairs health-related quality of life in patients with both ulcerative colitis and Crohn's disease. Relevance to clinical practice., The results suggest that any interventions that produce a stable clinical remission, whether medical or surgical, allowing patients to return to their usual work position can decrease the disease impact on their daily lives. [source] Reliability of self-reported willingness-to-pay and annual income in patients treated for toenail onychomycosisBRITISH JOURNAL OF DERMATOLOGY, Issue 5 2007P.M.H. Cham Summary Background, Willingness-to-pay (WTP) is a health economics measure that has recently been used for skin diseases to evaluate patients' quality of life. However, the reliability of this measure has not been investigated in the dermatology literature and is essential in validating its use in health services research. Objectives, This study evaluated the test-retest reliability of self-reported annual income and WTP, a health economics measure of disease impact, in patients with toenail onychomycosis. Methods, Forty-six patients enrolled in a randomized clinical trial comparing two different dosing regimens of terbinafine completed a self-administered questionnaire at baseline and 1 month later. The questionnaire asked: (i) how much patients would be willing to pay for a theoretical treatment with a cure rate of 85% for their current onychomycosis (10 categories: $0,50, $51,100, to > $800); and (ii) annual income (10 categories: $0,10 000 to > $200 000). Results, Forty-four patients reported WTP at both visits, and 55% reported the same WTP. The quadratic-weighted (Fleiss,Cohen) , statistic indicated moderate agreement (, = 0·50, 95% confidence interval, CI 0·24,0·75, P < 0·01) as did the Spearman rank-order correlation coefficient (rs = 0·57, P < 0·01; median difference = 0, P = 0·50). Strong agreement was shown among the 42 patients who reported income at both visits; 71% reported the same annual income category (, = 0·72, 95% CI 0·47,0·96, P < 0·01; rs = 0·68, P < 0·01; median difference = 0, P = 0·77). Age, disease severity and duration, previous therapy, self-reported annual income, and medication side-effects were not statistically associated with the reliability of WTP. Conclusions, WTP and annual income demonstrated moderate and strong test-retest reliability, respectively. Self-reported WTP can serve as a reliable measure for future health economics research on onychomycosis. [source] | ||||||||||