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Quality-of-life Measures (quality-of-life + measure)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Hub-and-spoke model for a 5-day structured patient education programme for people with Type 1 diabetes

DIABETIC MEDICINE, Issue 9 2009
H. Rogers
Abstract Aims, Structured education programmes for people with Type 1 diabetes can deliver improved diabetes control (including reduced severe hypoglycaemia) and quality of life. They can be cost-effective but are resource intensive. We tested the ability to deliver an evidence-based 5-day programme in diabetes centres too small to deliver the courses. Methods, Specialist medical and nursing staff from three district general hospital diabetes services (the ,spokes') were trained in all aspects of the education programme, except those directly related to course delivery, by a larger centre (the ,hub'). The hub staff delivered the 5-day patient education courses, but all other patient education and management was managed locally. Diabetes control and quality of life were assessed at 1 year post-course. Results, In 63 patients with follow-up data, glycated haemoglobin (HbA1c) fell by 0.42 ± 1.0% (P = 0.001), with a greater fall in those with high HbA1c at baseline, and no mean weight gain. Emergency call-out for severe hypoglycaemia fell from 10 episodes in seven patients the year before to one episode in one patient (P = 0.03). Quality-of-life measures improved, with reduced negative impact of diabetes on diabetes-related quality of life (P < 0.00004) and ,present quality of life' improving (P < 0.001). Conclusions, The benefits of a 5-day structured education programme can be provided to patients with Type 1 diabetes attending centres without the resources to provide the teaching course itself, by a ,hub-and-spoke' methodology. [source]

Self-report quality of life as a predictor of hospitalization for patients with LV dysfunction: A life course approach,

RESEARCH IN NURSING & HEALTH, Issue 6 2001
Donald E. Stull
Abstract For this secondary data analysis of a large clinical drug study, researchers investigated the independent prognostic utility of self-report quality-of-life measures versus clinical measures for assessing patient risk for heart-failure-related hospitalization. The experience of heart failure varies over the life course; hence, four age groups were investigated. Quality-of-life measures, specifically health-related quality-of-life and psychosocial quality-of-life measures, were found to be independent and significant predictors of heart-failure-related hospitalizations, as compared to traditional clinical indicators. In addition, the psychosocial quality-of-life measure varied by age group in its importance as a predictor of hospitalization, suggesting differential relevance over the life course. Specifically, psychosocial quality of life was most strongly predictive of hospitalization for those ages 21,44, was less predictive for those ages 45,54, and was nonsignificant for those 55,64 years of age and those 65 and over. Including self-report quality-of-life measures provides a more complete picture of the factors associated with risk of hospitalization at different points in the life course for individuals with heart failure. These findings suggest that researchers and practitioners could use self-report quality-of-life measures as additional prognostic indicators of a patient's condition and risk for heart-failure-related hospitalization, especially for younger patients. © 2001 John Wiley & Sons, Inc. Res Nurs Health 24:460,469, 2001 [source]

Translation and validation of the standard Chinese version of PDQ-39: A quality-of-life measure for patients with Parkinson's disease

MOVEMENT DISORDERS, Issue 5 2002
Kin-Lun Tsang MBBS
Abstract PDQ-39 has been widely used in the research and clinical management of Parkinson's disease. It has been translated into and validated in various non-English languages. We report here on the validity and reliability results for the translated standard Chinese PDQ-39 questionnaire. Fifty-four patients were recruited from a movement disorder clinic and two regional patient groups, and data were collected by direct interview. Nineteen patients had the tests repeated 4 weeks later to assess the test,retest and interrater reliability. The standard Chinese version of PDQ-39 demonstrated acceptable internal consistency (Cronbach's , = 0.54,0.90) and was comparable to versions in other languages. Further analysis showed good construct validity and test,retest reliability. Implications and limitations of the study are discussed. © 2002 Movement Disorder Society [source]

Self-report quality of life as a predictor of hospitalization for patients with LV dysfunction: A life course approach,

Why are we ,weighting'?

COMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 1 2004
An assessment of a self-weighting approach to measuring oral health-related quality of life
Abstract ,,, Objective: To determine whether or not self-weighting at an item level contributes to the performance of an oral health-related quality-of-life measure. Design: Data were collected in two national surveys conducted a month apart, one using the ,weighted' measure and the other an ,unweighted' version of the UK oral health-related quality-of-life measure. In addition, sociodemographic and self-reported oral health status were recorded. Results: The UK oral health-related quality-of-life measure discriminated between groups based on age group (<65, 65 and older) and social class (higher and lower) irrespective of the version of the questionnaire used. Both versions also showed significant associations with self-reported oral health: denture status (P < 0.01) and number of teeth possessed (P < 0.01). In addition, both versions demonstrated predictive ability in identifying those in prosthetic need (<20 teeth and without recourse to a denture, P < 0.01). Conclusion: Weighting the UK oral health-related quality-of-life instrument does not improve the psychometric properties of the instrument and thus raises questions about the value of self-weighting at an item level. [source]

Culturally appropriate health education for Type 2 diabetes in ethnic minority groups: a systematic and narrative review of randomized controlled trials

DIABETIC MEDICINE, Issue 6 2010
K. Hawthorne
Diabet. Med. 27, 613,623 (2010) Abstract To determine if culturally appropriate health education is more effective than ,usual' health education for people with diabetes from ethnic minority groups living in high- and upper-middle-income countries. A systematic review with meta-analysis, following the methodology of the Cochrane Collaboration. Electronic literature searches of nine databases were made, with hand searching of three journals and 16 author contacts. The criteria for inclusion into the analysis were randomized controlled trials of a specified diabetes health education intervention, and a named ethnic minority group with Type 2 diabetes. Data were collected on HbA1c, blood pressure, and quality-of-life measures. A narrative review was also performed. Few studies fitted the selection criteria, and were heterogeneous in methodologies and outcome measures, making meta-analysis difficult. HbA1c showed an improvement at 3 months [weighted mean difference (WMD) ,0.32%, 95% confidence interval (CI) ,0.63, ,0.01] and 6 months post intervention (WMD ,0.60%, 95% CI ,0.85, ,0.35). Knowledge scores also improved in the intervention groups at 6 months (standardized mean difference 0.46, 95% CI 0.27, 0.65). There was only one longer-term follow-up study, and one formal cost-effectiveness analysis. Culturally appropriate health education was more effective than ,usual' health education in improving HbA1c and knowledge in the short to medium term. Due to poor standardization between studies, the data did not allow determination of the key elements of interventions across countries, ethnic groups and health systems, or a broad view of their cost-effectiveness. The narrative review identifies learning points to direct future research. [source]

Titration with Oxymorphone Extended Release to Achieve Effective Long-Term Pain Relief and Improve Tolerability in Opioid-Naive Patients with Moderate to Severe Pain

PAIN MEDICINE, Issue 7 2008
Richard Rauck MD
ABSTRACT Objective., Assess the effectiveness and tolerability of a program of gradual dose titration with oxymorphone extended release (ER) for treatment of moderate to severe chronic pain in opioid-naive patients. Design., Open-label, nonrandomized 6-month study with a titration/stabilization period of ,1 month followed by a 5-month maintenance period. Setting., Multidisciplinary pain centers in the United States. Patients., Adult opioid-naive patients with moderate to severe chronic pain. Interventions., Patients were gradually titrated from a 5-mg dose of oxymorphone ER (taken every 12 hours) to a stabilized dose that provided effective pain relief and was well tolerated. Outcome Measures., Brief Pain Inventory Short Form questions 5 and 9, patient and physician global assessments of pain relief, adverse events (AEs), and discontinuations. Results., The majority (94/126; 75%) of patients were stabilized on a dose of oxymorphone ER that provided effective pain relief with tolerable AEs. Most (81/94; 86%) required <24 days to reach a stable dose. Sixteen percent of patients in the titration period and 17% of patients in the maintenance period discontinued because of AEs possibly or probably related to oxymorphone ER. Patients completing the entire 5-month maintenance period experienced effective pain relief with significant (>50%) reductions of pain interference with quality-of-life measures. There was minimal dose escalation over the 5 months and low use of rescue medication. Conclusions., Oxymorphone ER provided effective pain relief from moderate to severe chronic pain in opioid-naive patients. Gradual titration was well tolerated, with a low rate of discontinuations caused by AEs. [source]

Self-report quality of life as a predictor of hospitalization for patients with LV dysfunction: A life course approach,

Sodium oxybate relieves pain and improves function in fibromyalgia syndrome: A randomized, double-blind, placebo-controlled, multicenter clinical trial,

ARTHRITIS & RHEUMATISM, Issue 1 2009
I. Jon Russell
Objective To evaluate the safety and efficacy of sodium oxybate for management of the symptoms of fibromyalgia syndrome (FMS). Methods Patients with FMS (according to the American College of Rheumatology 1990 criteria) were randomized, after discontinuing their prestudy medications for FMS, to receive 4.5 gm or 6 gm of sodium oxybate or matching placebo once per night for 8 weeks. The primary outcome variable (POV) was a composite score for changes from baseline in 3 coprimary self-report measures: patient's pain rating (in daily electronic diaries) on a visual analog scale (PVAS), the Fibromyalgia Impact Questionnaire (FIQ) score, and the Patient Global Impression of Change (PGI-C). A beneficial response rate for the POV composite score was defined as ,20% improvement in the PVAS and FIQ scores plus a rating of "much better" or "very much better" on the PGI-C. Secondary measures included subjective sleep outcomes (on the Jenkins Scale for Sleep) and quality-of-life measures. The analyses were based on an intent-to-treat (ITT) population. Results The ITT population included 188 patients with FMS, 78% of whom completed the trial. Significant benefit was observed with both dosages of sodium oxybate, according to changes in the POV and subjective sleep quality. Improvements in the PVAS score were significantly correlated with sleep outcomes. Sodium oxybate was well tolerated overall; dose-related nausea (,28% of patients) and dizziness (,18% of patients) tended to resolve with continued therapy. Conclusion Sodium oxybate therapy was well tolerated and significantly improved the symptoms of FMS. Further study of sodium oxybate as a novel therapeutic option for FMS is warranted. [source]

PC-SPES, a dietary supplement for the treatment of hormone-refractory prostate cancer

BJU INTERNATIONAL, Issue 4 2000
B.L. Pfeifer
Objective To assess the effectiveness of PC-SPES, a dietary supplement containing eight herbal extracts, which is a popular alternative therapy among patients with hormone-refractory prostate cancer; anecdotal reports claim that this agent provides relief of metastatic pain, improvements in quality of life and reduction of prostatic specific antigen (PSA) level. Patients and methods Sixteen men treated for advanced metastatic prostate cancer (stage D3) with either orchidectomy or a luteinizing-hormone releasing hormone agonist, with or without anti-androgen, were enrolled into a prospective clinical trial to evaluate the possible toxic and beneficial effects of PC-SPES. After hormone-ablative therapy had failed, and with established disease progression, all patients received supplemental treatment with PC-SPES (2.88 g daily) for 5 months. Hormonal therapy was continued throughout the trial to avoid the known withdrawal effect of anti-androgen on PSA levels. Results The supplemental intake of PC-SPES was associated with significant (P < 0.05,0.01) improvements in quality-of-life measures, reductions in patient's pain ratings (P < 0.05,0.01), and a decline in PSA levels (P < 0.01), with no major side-effects. Conclusions These results support the anecdotal reports of the beneficial effects of PC-SPES as a comparable alternative to current management regimens in hormone-refractory prostate cancer. However, no conclusions can be drawn about the long-term effects of this new herbal therapy. [source]