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Well-being Scale (well-being + scale)
Selected AbstractsMaintenance Treatment for Old-Age Depression Preserves Health-Related Quality of Life: A Randomized, Controlled Trial of Paroxetine and Interpersonal PsychotherapyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2007Alexandre Y. Dombrovski MD OBJECTIVES: To determine whether maintenance antidepressant pharmacotherapy and interpersonal psychotherapy sustain gains in health-related quality of life (HR-QOL) achieved during short-term treatment in older patients with depression. DESIGN: After open combined treatment with paroxetine and interpersonal psychotherapy, responders were randomly assigned to a two (paroxetine vs placebo) by two (monthly interpersonal psychotherapy vs clinical management) double-blind, placebo-controlled maintenance trial. HR-QOL outcomes were assessed over 1 year. SETTING: University-based clinic. PATIENTS: Of the referred sample of 363 persons aged 70 and older with major depression, 210 gave consent, and 195 started acute treatment; 116 met criteria for recovery, entered maintenance treatment, and were included in this analysis. INTERVENTIONS: Paroxetine; monthly manual-based interpersonal psychotherapy. MEASUREMENTS: Overall HR-QOL as measured using the Quality of Well-Being Scale (QWB) and six specific HR-QOL domains derived from the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) subscales. RESULTS: All domains of HR-QOL except physical functioning improved with successful acute and continuation treatment. After controlling for any effects of psychotherapy, pharmacotherapy was superior to placebo in preserving overall well-being (P=.04, effect size (r)=0.23), social functioning (P=.02, r=0.27), and role limitations due to emotional problems (P=.007, r=0.30). Interpersonal psychotherapy (controlling for the effects of pharmacotherapy) did not preserve HR-QOL better than supportive clinical management. CONCLUSION: Maintenance antidepressant pharmacotherapy is superior to placebo in preserving improvements in overall well-being achieved with treatment response in late-life depression. No such benefit was seen with interpersonal psychotherapy. [source] Deficits in Psychological Well-Being and Quality-of-Life in Minor Depression: Implications for DSM-VCNS: NEUROSCIENCE AND THERAPEUTICS, Issue 4 2010Andrew A. Nierenberg Objective: To examine deficits in psychological well-being (PWB) and quality-of-life (QOL) in minor depressive disorder (Min D). Method: Ninety-three subjects entering a treatment study for Min D were assessed using the QOL, Enjoyment and satisfaction questionnaire (Q-LES-Q), and the Psychological Well-Being Scale (PWBS). Scores were compared with major depressive disorder (MDD) and normative community samples. Results: Even though subjects had mild depressive severity, Q-LES-Q total scores for the Min D sample averaged nearly two standard deviations below the community norm. Almost 40% of Min D cases had Q-LES-Q scores in the lowest 1% of the population. Responses to most Q-LES-Q items were closer to subjects with MDD than to community norms. Mean standardized PWB scores were extremely low for subscales of Environmental Mastery and Self-Acceptance, low for Purpose in Life and Positive Relations with others, but within the normal range for Personal Growth and Autonomy. QOL and PWB measures had low correlations with depressive symptom severity, and scores were similar in the presence or absence of a prior history of MDD. Conclusions: Mild depressive symptoms with Min D are associated with major deficits in QOL and PWB measures of environmental mastery and poor self-acceptance. Our findings suggest that diminished QOL and PWB may be intrinsic cognitive aspects of Min D with or without a history of MDD. It may be unnecessary in the DSM IV-TR to exclude the diagnosis of Min D if a subject has had a past episode of MDD. ,,Minor depression exists along a continuum of depression. ,,Deficits in psychological well-being and quality-of-life in minor depression are severe. ,,No difference in these measures if minor depression existed with or without a history of major depression. [source] Older people specific health status and quality of life: a structured review of self-assessed instrumentsJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 4 2005Kirstie L. Haywood DPhil Abstract Objectives, To review evidence relating to the measurement properties of older people specific self-assessed, multi-dimensional measures of health status. Design, Systematic literature searches to identify instruments. Pre-defined criteria relating to reliability, validity, responsiveness, precision and acceptability. Results, A total of 46 articles relating to 18 instruments met the inclusion criteria. Most evidence was found for the OARS Multidimensional Functional Assessment Questionnaire (OMFAQ), CARE, Functional Assessment Inventory (FAI) and Quality of Life Profile , Seniors Version (QOLPSV). Most instruments have been evaluated in single studies. Four instruments have evidence of internal consistency and test,retest reliability , LEIPAD, Philadelphia Geriatrics Centre Multilevel Assessment Inventory, Perceived Well-being Scale, Wellness Index (WI). Two instruments lack evidence of reliability , Brief Screening Questionnaire, Geriatric Quality of Life Questionnaire (GQLQ). Older people contributed to the content of the GQLQ, QOLPSV and WI. Most instruments were assessed for validity through comparisons with other instruments, global judgements of health, or clinical and socio-demographic variables. Limited evidence of responsiveness was found for five instruments , GQLQ, OMFAQ, PGCMAI, QOLPSV, Self-Evaluation of Life Scale (SELF). Conclusion, Although most evidence was found for the OMFAQ this was largely for the ADL domain; evidence for reliability and responsiveness is limited. Limited evidence of reliability, validity and responsiveness was found for the PGCMAI, QOLPSV and SELF. The lack of evidence for measurement properties restricts instrument recommendation. Instrument content should be assessed for relevance before application and the concurrent evaluation of specific and widely used generic instruments is recommended. Several instruments, including the BSQ and EASY-Care, were developed recently and further evidence of instrument performance is required. [source] Measuring well-being rather than the absence of distress symptoms: a comparison of the SF-36 Mental Health subscale and the WHO-Five well-being scaleINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 2 2003Per Bech Abstract The health status questionnaire Short-Form 36 (SF-36) includes subscales measuring both physical health and mental health. Psychometrically, the mental health subscale contains a mixture of mental symptoms and psychological well-being items, among other things, to prevent a ceiling effect when used in general population studies. Three of the mental health well-being items are also included in the WHO-Five well-being scale. In a Danish general population study, the mental health subscale was compared psychometrically with the WHO-Five in order to evaluate the ceiling effect. Tests for unidimensionality were used in the psychometric analyses, and the sensitivity of the scales in differentiating between changes in self-reported health over the past year has been tested. The results of the study on 9,542 respondents showed that, although the WHO-Five and the mental health subscale were found to be unidimensional, the WHO-Five had a significantly lower ceiling effect than the mental health subscale. The analysis identified the three depression symptoms in the mental health subscale as responsible for the ceiling effect. The WHO-Five was also found to be significantly superior to the mental health subscale in terms of its sensitivity in differentiating between those persons whose health had deteriorated over the past year and those whose health had not. In conclusion, the WHO-Five, which measures psychological well-being, reflects aspects other than just the absence of depressive symptoms. Copyright © 2003 Whurr Publishers Ltd. [source] Development and psychometric testing of a new geriatric spiritual well-being scaleINTERNATIONAL JOURNAL OF OLDER PEOPLE NURSING, Issue 3 2008Karen S. Dunn PhD Aims and objectives., Assess the psychometric properties of a new geriatric spiritual well-being scale (GSWS), specifically designed for older adults. Background., Religiosity and spiritual wellness must be measured as two distinct concepts to prevent confounding them as synonymous among atheist and agnostic population. Design., A test,retest survey design was used to estimate the psychometric properties. Methods., A convenience sample of 138 community-dwelling older adults was drawn from the inner city of Detroit. Data were collected using telephone survey interviews. Data analyses included descriptive statistics, structural equation modelling, reliability analyses, and point-biserial correlations. Results., The factorial validity of the proposed model was not supported by the data. Fit indices were ,2 = 185.98, d.f. = 98, P < 0.00, goodness-of-fit index of 0.85, comparative fit index of 0.87 and root mean error of approximation of 0.08, indicating a mediocre fit. Reliability statistics for the subscales ranged from being poor (0.36) to good (0.84) with an acceptable overall scale alpha of 0.76. Participants' performance stability and criterion-related validity were also supported. Conclusions., The GSWS is an age-specific assessment tool that was developed specifically to address a population's cultural diversity. Future research endeavors will be to test the psychometric properties of this scale in culturally diverse older adult populations for further instrument development. Relevance to clinical practice., Nurses need to recognize that agnostics/atheists have spiritual needs that do not include religious beliefs or practices. Thus, assessing patients' religious beliefs and practices prior to assessing spiritual well-being is essential to prevent bias. 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