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Lower QoL (lower + qol)
Selected AbstractsThe Costs and Quality-of-Life Outcomes of Drug-Eluting Coronary Stents: A Systematic ReviewJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 1 2007M.S., PETER W. GROENEVELD M.D. Objectives: While the efficacy of drug-eluting coronary stents (DES) has been demonstrated by several clinical trials, the impact of DES on health-care costs and recipient quality of life (QOL) is controversial. We performed a systematic review of the published literature on DES costs and the QOL effects of restenosis and target vessel revascularization (TVR). Methods: Among 536 potential articles initially identified by a broad search, 12 publications ultimately met inclusion criteria. Data were independently abstracted, evaluated for quality and relevance, and summarized by two reviewers. Excessive heterogeneity among these studies prevented formal meta-analysis, thus a narrative synthesis of the literature was performed. Results: In four economic studies, DES recipients had $1,600,$3,200 higher up-front costs than recipients of bare metal stents, but the differences in total costs after 1 year were less pronounced ($200,$1,200), and estimates of the average cost of an avoided revascularization ranged widely ($1,800,$36,900). All eight QOL studies indicated that restenosis was associated with lower QOL, but only two studies quantified this in terms of quality-adjusted life years (QALYs), with estimates ranging from 0.06 to 0.08. An additional study estimated that the median willingness to pay to prevent restenosis was $2,400,$3,600. Conclusions: There is a lack of convergence in the literature on the cost of DES in avoiding TVR. There is more agreement that the average QALY benefit of an avoided revascularization is 0.04,0.08. This implies that use of DES in patients where the average cost per avoided revascularization exceeds $8,000 may be less likely to be cost-effective. [source] Parenting the premature infant: balancing vulnerability and quality of lifeTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 11 2005C. Eiser Background:, Relationships between child quality of life (QOL), maternal well-being and parenting were explored in a questionnaire study. Method:, Mothers of 126 full-term (FT) and 91 pre-term (PT) infants during the child's second year of life completed measures of their own and the child's quality of life and behavioural difficulties. We developed a measure of parenting style derived from Regulatory Focus Theory (RFT), to distinguish greater reported use of promotion as opposed to prevention strategies (emphasising gains rather than losses, and encouraging pursuit of goals rather than prevention of harm). Results:, The two groups of mothers showed no differences on the parenting measure, but those in the PT compared with the FT group described their infant as having lower QOL and more behavioural and mood problems, and rated their own well-being as less satisfactory. Greater use of promotion was associated with reports of fewer difficulties (better QOL) for the child and better mothers' well-being. Differences in mothers' well-being as a function of group (FT vs. PT) and promotion were strongly mediated by mothers' perceptions of their child's difficulties. At the same time, associations with child difficulties were partly mediated by mothers' well-being, suggesting that maternal distress may have partly contributed to higher perceptions of such difficulties. Among PT infants, the degree of prematurity predicted child difficulties, but was not consistently related to mothers' well-being. Discussion:, Mothers of PT infants report more physical health and behavioural difficulties than mothers of FT infants, but specific parenting styles can contribute to child difficulties and QOL in both infants and their mothers. Conclusion:, We conclude that RFT has potential for understanding the conflicts experienced by parents caring for vulnerable children. [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] Quality of life in Jordanian children with asthmaINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 6 2008Nemeh Al-Akour RN MSN DNSc The purpose of this study was to describe how Jordanian children with asthma experience their quality of life (QoL). Two hundred children with asthma (34% girls and 66% boys) participated in the study. The Paediatric Asthma Quality of Life Questionnaire was used to measure how children with asthma disease impaired their daily life during the previous week on three domains: ,activity limitations', ,symptoms' and ,emotional function'. The main finding of this study was that children with asthma scored their QoL towards the negative end of the scale, but they scored more limitations in the domain of activities than in emotions and symptoms. Children reported that the most restricted activity was their ability to run. Younger children, being a girl and living in the rural areas, were associated with lower QoL. The children in the present study might not comply with their health regimen, and this might gave a darker view of the daily life of children with asthma. Further studies of Jordanian children and their QoL were suggested to identify and support the factors which influence QoL of children with asthma and other chronic diseases in Jordan. [source] Cognitive abilities, behaviour and quality of life in children after liver transplantationPEDIATRIC TRANSPLANTATION, Issue 4 2010T. Kaller Kaller T, Boeck A, Sander K, Richterich A, Burdelski M, Ganschow R, Schulz KH. Cognitive abilities, behaviour and quality of life in children after liver transplantation. Pediatr Transplantation 2010: 14:496,503. © 2010 John Wiley & Sons A/S. Abstract:, Aims:, We investigated interrelations between cognitive abilities, behavioural problems, quality of life and disease-related variables of children after LTX. Methods:, Our sample consisted of 25 children. They were 8.5/2.8 (M/SD) years old and had received the transplant 5.5/3.1 years previously. For assessment we used well-established instruments. Results:, Liver transplanted children scored below the population mean on the cognitive as well as on the behavioural instrument and showed scores below average in the scales Self-esteem, Friends and Total Score regarding QoL. Behavioural problems were associated with poorer cognitive performance (r=,0.38 to ,0.63). QoL regarding physical well-being was correlated with sequential processing (r=0.41). Lower sequential processing scores were associated with lower QoL. Also between behavioural parameters and QoL correlations could be determined. Children with more behavioural problems experienced lower QoL (r=,0.40 to r=,0.76). Age at onset of disease showed correlations with behavioural and QoL parameters (r=,0.49 resp. r=0.44). Cognitive functioning was associated with medical complications (r=,0.44). Conclusions:, High interrelations between cognitive functioning, behavioural deficits and QoL were obtained. Especially noticeable are correlations between sequential processing and internalized behavioural functions as both are associated with left lateralized brain functioning. This relationship could indicate differential effects on brain development during the preoperative phase. [source] Development of a client-generated health outcome measure for community nursingAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 5 2000Rhonda Griffiths Objective:To develop a client-generated outcome measure for use in community nursing. Method:Participants for the study were identified from the case load of community health nurses, from a nursing home service and from residents of a retirement village. All participants had a diagnosis of venous leg ulcer (VLU) and/or type 2 diabetes. Preliminary development of the measure involved focus groups of community clients and health professionals, and pilot testing of an existing quality of life (QoL) measure, the Patient-Generated Index. The resulting Client-Generated Index was tested for reliability and validity. Results:The Pearson's correlation coefficient between administration of the CGI at T1 and T2 was 0.526 (n=51; p=0.0001). The CGI correlated significantly with four of eight dimensions of the SF-36, and with pain as a clinical marker for VLU r=0.54 (p=0.001). Overall, participants with VLU reported a lower QoL (mean CGI score 2.8) compared to those with diabetes (mean CGI score 4.1). Conclusions:The CGI was developed to measure outcomes in community health settings. Some measures of its reliability and validity are demonstrated and further research is needed to validate the instrument using other client groups. Implications:If routine assessment and evaluation is to contribute to measures of outcome, the instruments need to be concise and acceptable to health care providers. The CGI has all these properties. [source] The impact of lower urinary tract symptoms and comorbidities on quality of life: the BACH and UREPIK studiesBJU INTERNATIONAL, Issue 2 2007Chris Robertson In a large epidemiological study, authors investigated the effect of LUTS on quality of life among various cultures. They showed a close association between the two, and that the effect of having moderate symptoms has a similar effect on quality of life as diabetes, hypertension or cancer, and that having severe symptoms had a similar effect as a heart attack or stroke. OBJECTIVES To investigate the effect of lower urinary tract symptoms (LUTS) on quality of life (QoL) and to determine its extent across a variety of cultures, and the confounding effects of self-reported comorbidities and demographics. SUBJECTS AND METHODS Data were obtained from two population-based studies in five cities: UREPIK (Boxmeer, the Netherlands; Auxerre, France; Birmingham, UK; and Seoul, Korea) and the Boston Area Community Health (BACH) study (Boston, USA). UREPIK used stratified random samples of men aged 40,79 years. BACH used a multistage stratified cluster sample to randomly select adults aged 40,79 years. QoL was assessed using a standard Medical Outcomes Study,Short Form 12 (SF-12, mental and physical health component scores); LUTS was assessed using the International Prostate Symptom Score (IPSS). The association between QoL and IPSS, associated illnesses, and lifestyle factors was investigated using weighted regression. RESULTS The UREPIK studied 4800 men aged 40,79 years; BACH recruited 1686 men aged 40,79 years. The prevalence of LUTS, defined as an IPSS of ,8, varied by city (P < 0.001), with Auxerre reporting a prevalence (se) of 18.1 (1.2)%, Birmingham 25.6 (1.5)%, Boston 25.1 (1.6)%, Boxmeer 21.2 (1.3)%, and Seoul 19.0 (1.2)%. Overall, this was similar to the reported rate of high blood pressure. Severe LUTS, defined as an IPSS of ,20, affected , 3.3% of the age group; this was roughly similar to stroke (2.2%), cancer (4.5%), or heart attack (4.5%) and less than half as much as diabetes (8.6%). A 10-point increase in IPSS was associated with a 3.3 (0.3)-point reduction in SF-12 physical health component score, with the same effect in all cities (P = 0.682 for the interaction test). This was more than the physical health component score reduction caused by cancer, diabetes, or high blood pressure (2 points each), but less than stroke or heart attack (6 points). The comorbidities had no significant impact on SF-12 mental health component score (other than a heart attack, that had a 1.8-point reduction). A 10-point increase in IPSS was associated with a 3.4 (0.6)-point reduction of the mental health component score in the four western cities and a 1.4 (0.3)-point reduction in Seoul. CONCLUSIONS Increasingly severe LUTS is associated with a lower QoL. The effect of moderate LUTS on QoL physical health component score is similar to that of having diabetes, high blood pressure or cancer, while the effect of severe LUTS is similar to a heart attack or stroke. These changes were consistent across cultures. This analysis shows the magnitude and consistency of the effects of LUTS on QoL. While these patients might be seen by several types of practitioners, it is likely that urologists will be in the best position to recognize the true impact of LUTS on a patient's QoL, to be aware of the effects of therapies for LUTS on QoL, and to ensure that colleagues in other disciplines recognize the importance of these symptoms and their treatment. [source] Section Editor: Aad Tibben, email: Tibben@lumc.nl: Quality of life and psychological distress in patients with Peutz,Jeghers syndromeCLINICAL GENETICS, Issue 3 2010MGF Van Lier van Lier MGF, Mathus-Vliegen EMH, van Leerdam ME, Kuipers EJ, Looman CWN, Wagner A, Vanheusden K. Quality of life and psychological distress in patients with Peutz,Jeghers syndrome. Little is known about psychological distress and quality of life (QoL) in patients with Peutz,Jeghers syndrome (PJS), a rare hereditary disorder. We aimed to assess QoL and psychological distress in PJS patients compared to the general population, and to evaluate determinants of QoL and psychological distress in a cross-sectional study. PJS patients completed a questionnaire on QoL, psychological distress, and illness perceptions. The questionnaire was returned by 52 patients (85% response rate, 56% females, median age 44.5 years). PJS patients reported similar anxiety (p = 0.57) and depression (p = 0.61) scores as the general population. They reported a lower general health perception (p = 0.003), more limitations due to emotional problems (p = 0.045) and a lower mental well-being (p = 0.036). Strong beliefs in negative consequences of PJS on daily life, a relapsing course of the disease, strong emotional reactions to PJS, and female gender were major determinants for a lower QoL. PJS patients experience a similar level of psychological distress as the general population, but a poorer general health perception, more limitations due to emotional problems, and a poorer mental QoL. Illness perceptions and female gender were major predictors for this lower QoL. These results may help to recognize PJS patients who might benefit from psychological support. [source] | ||||||||||