A Scientific and Research Review of the Better Quality of Life and its Factors and Phenomena in the Context of Shah Waliullah's Social Thoughts

Introductiondiabetes mellitus is a progressive chronic disease that requires long-term management. This exerts a significant burden on patients, impacting their quality of life (QoL). The study aimed to assess the QoL and its determinants among patients with diabetes mellitus attending a general hospital in Lagos, Nigeria.Methodsa total of 306 patients diagnosed with diabetic mellitus were consecutively recruited from the clinic within the three-month study period. The World Health Organization quality of life (WHOQOL-BREF) tool was used for data collection. Multivariable logistic regression analysis was performed to explore the association between QoL and some clinical variables.Resultsthe majority of the respondents, 79.1% (n=242), were 50 years old and above, with a mean age of 53.7 + 0.6; 62.4% (n=191) females, 82.7% (n=253) married, and 56.2% (n=172) traders. The mean total QoL score was 52.9%. More than half, 55% (n= 163) of the patients had a good overall QoL score, while 76% (n= 233) perceived they had a good QoL. On multivariate regression analysis, QoL was significantly associated with normal fasting plasma glucose (aOR: 0.383, 95% CI: 0.191-0.768; p= 0.007); and adherence with therapy guidelines (aOR: 4.565, 95% CI: 2.375-8.774; p= 0.000).Conclusionthis study suggests that compliance with therapy guidelines was associated with the greatest odds of having good QoL. With our finding that higher levels of education were significantly associated with good QoL, it is recommended that health literacy become part of the management of patients with diabetes to enhance their QoL. There is a need to specifically target and improve the QoL of underweight patients with diabetes, as they are at a higher risk of having poor QoL, when compared with their overweight and obese counterparts that receive more attention.

Introduction: Every person needs to define their own parameters of values and quality of life as there is a range of life circumstances and objective or subjective factors which force individuals to make decisions and select from available solutions depending on their personalities and other determinants. Currently, these notions have been broadly discussed and the authors of the presented study believe, that in the context of value orientation and life quality, there are new interactions, correlations and new truth to be revealed. Methods: The presented research aimed to find out about the respondents’ perception of their quality of life and value orientation using WHOQOLBREF 1996 questionnaire and Vonkomer’s HO-PO-MO questionnaire and unrevealing the relations between them. The research sample consisted of 300 in their middle-adulthood involved in external university study programs. Results: The results presented in this study indicate that from the aspect of the subjective perception of the quality of life by individuals, external factors such as age or place of residence are not decisive. The most important finding of the research is that, as well as value orientation focusing on the values of knowledge, education and economic aspects leads to a better quality of life; a better quality of life is determined by a value orientation focused on the fields of knowledge, education and economic values. Discussion: The attention of professionals from various fields of science and their research activities is given mostly to the relatively small population of young generation, the process of the creation of their value orientation and thus, their subjective quality of life. The presented study is focused on productive generation of middle-aged adults involved in tertiary education, which has experienced several massive changes in the society and received primary and secondary education in an educational context different from the present situation. Limitations: The conducted research into the respondents’ quality of life is limited by the applied methods as it focuses on four basic areas of quality of life and quantitative methods are used. The advantages of this approach lie in exactly defined fields and quantitative data which enable comparison. One of its shortcomings is that it does not find out anything about the qualitative, dynamic aspects of the respondents’ reflections about their own quality of life. Conclusion: The findings show that quality of mental life correlates with educational value orientation as well as quality of social relationships with social value orientation. It can be stated that, as well as value orientation focusing on the values of knowledge, education and economic aspects leads to a better quality of life; a better quality of life is determined by a value orientation focused on the fields of knowledge, education and economic values.

اهداف: کیفیت زندگی، مفهومی پیچیده و چندبعدی است که تحت تأثیر مولفه هایی چون زمان و مکان، ارزش‌های فردی و اجتماعی از سوی متفکران علوم شهری و سایر اندیشمندان علوم مختلف مطرح و مورد پژوهش قرار گرفته است. تحقیق حاضر با هدف بررسی شاخص‌های کیفیت زندگی و سنجش آن در شهر مرکزی زرین دشت (حاجی‌آباد) بر مبنای 4 گروه شاخص‌های اقتصادی، اجتماعی، خدماتی و کالبدی صورت گرفته است. روش: روش تحقیق، در این مقاله توصیفی- تحلیلی و ابزار آن پرسش‌نامه می‌باشد. روایی پرسش‌نامه با استفاده از نظرات متخصصان و پایایی آن با استفاده از محاسبه آلفای کرونباخ (72%) تعیین شد. جامعۀ آماری در این پژوهش7 محله از شهر حاجی‌آباد (20000نفر) می‌باشد که با استفاده از فرمول کوکران 377 نمونه انتخاب گردید و به‌صورت تصادفی در هر محله پرسش‌نامه توزیع شد. تجزیه و تحلیل پرسش‌نامه با استفاده ازآمار توصیفی، همبستگی و رگرسیون چندگانۀ خطی انجام شد و در نهایت از روش آنتروپی شانون جهت وزن‌دهی شاخص‌ها و تکنیک پرومتی جهت رتبه‌بندی محلات به‌کار گرفته شد. یافته‌ها/نتایج: یافته‌های پژوهش نشان داد که در شهر حاجی‌آباد، محلۀ فرهنگیان بالاترین سطح کیفیت زندگی شهری و محلۀ حسین‌آباد، پایین‌ترین سطح کیفیت را در بین محلات دارد. همچنین در بررسی ابعاد چهارگانۀ شاخص کیفیت زندگی همبستگی مستقیم و معناداری وجود داشته و هر یک از این ابعاد همبستگی معناداری با رضایتمندی نهایی از کیفیت زندگی دارند و از بین شاخص‌های کیفیت زندگی، شاخص اقتصادی بیشترین تأثیر را در کیفیت محلات دارد.

Psychosocial adjustment, psychiatric morbidity and quality of life in adolescents and young adults with congenital heart disease

Background: Patient satisfaction with quality of care is being increasingly recognized and reported as an important outcome measure in oncology. However, it has been argued by some that patients with greater satisfaction with care quality might be the ones with better self-reported quality of life (QoL). In other words, patient satisfaction has been simply purported to be a marker of underlying patient QoL. We asked the question if cancer patients who report higher satisfaction with quality of their care are indeed the ones with better QoL. Methods: 6,914 returning cancer patients treated at four Cancer Treatment Centers of America® hospitals completed a patient satisfaction survey between July 2011 and March 2013. All patients who had not responded to a service quality questionnaire within the preceding 60 days of treatment were eligible. Overall QoL (How would you rate your overall health during the last week?) was measured on a 7-point Likert scale ranging from “very poor” to “excellent”. Overall patient satisfaction (“considering everything, how satisfied are you with your overall experience?”) was also measured on a 7-point Likert scale ranging from “completely dissatisfied” to “completely satisfied”. Spearman correlation was used to investigate the association between patient satisfaction and QoL. Results: A total of 8,642 eligible cancer patients were contacted to participate in the survey. 6,914 patients responded. As a result, the response rate for this study was 80%. The median time duration between the date first seen and the date of first survey was 7.5 months. The mean age at the time of survey was 56.6 years. 4,116 patients were newly diagnosed while 2,798 had been previously treated. 2,778 were males and 4,136 were females. The most common cancer types were breast (27.6%), prostate (13.3%), lung (11.3%), colorectal (8.9%) and pancreas (5.2%). 20%, 28%, 24% and 28% patients had stage I, II, III and IV disease respectively. 1,916 (27.7%) patients reported “excellent” QoL while 5,553 (80.3%) patients were “completely satisfied” with their care. Spearman correlation coefficient between QoL and patient satisfaction for the entire patient population was 0.20 (p<0.001). These correlations in different patient subgroups were as follows: males (0.21), females (0.20), early-stage disease (0.19), late-stage disease (0.22), newly diagnosed (0.19), previously treated (0.20), breast (0.17), colorectal (0.24), lung (0.23), pancreas (0.18), prostate (0.20); with p <0.001 for all. Conclusions: Self-reported QoL has a low correlation with patient satisfaction with care quality. Contrary to what one might expect, higher levels of self-reported QoL do not translate into higher satisfaction with oncology care. This analysis shows that self-reported QoL and satisfaction with care are weakly related dimensions of the larger cancer care quality umbrella. Citation Format: Digant Gupta, James F. Grutsch, Mark Rodeghier, Christopher G. Lis. Do cancer patients with better quality of life report higher satisfaction with the quality of care they receive. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3849. doi:10.1158/1538-7445.AM2014-3849

Background: Growing life expectancy is challenging the quality of healthcare for elderly. Information regarding health-related quality of life (QOL) may help policymakers to design need-based health programs for this population. Objectives: The objective of this study is to estimate health-related QOL of the geriatric population living in rural areas of West Tripura district and to compare it between ethnic and nonethnic populations with respect to important domains. Methodology: This community-based cross-sectional study was conducted between February 1, 2019, and March 31, 2020, among 225 geriatric subjects of rural West Tripura district chosen by multistage sampling. The World Health Organization's QOL–BREF scale was used for data collection. Results: Among the study population, 46.2% had overall good health-related QOL. About 52.9% had good QOL in environment, and 37.3% had good QOL in social relationship domains. Marginally higher proportion of the subjects from ethnic origin had better QOL than the nonethnic, but it was not significant. A higher proportion of the Muslim subjects had better QOL than the rest, but it was also not significant. Bivariate analysis showed significant associations between QOL with age, sex, literacy, financial condition, socioeconomic status, and type of family. Multivariate analysis identified male sex, younger age, and living with spouse as the significant predictors of good QOL. Conclusion: Overall health-related QOL of the geriatric people living in rural areas of West Tripura district is poor, but younger male subjects of ethnic origin and living with spouses may enjoy relatively better QOL.

Background: Growing life expectancy is challenging the quality of health care for elderly. Information regarding health-related quality of life (QOL) may help policy makers to design need-based health programs for this population. Objectives: The objective of the study was to estimate health-related QOL of the geriatric population living in rural areas of West Tripura district and to compare it between ethnic and nonethnic populations in respect to important domains. Materials and Methods: This community-based cross-sectional study was conducted during February 1, 2019–March 31, 2020 among 225 geriatric subjects of rural West Tripura district chosen by multistage sampling. The World Health Organization's QOL–BREF scale was used for data collection. Results: Among the study population, 46.2% had overall good health-related QOL. About 52.9% had good QOL in the environment, and 37.3% had good QOL in social relationship domains. Marginally higher proportion of the subjects from ethnic origin had better QOL than the nonethnic, but it was not significant. A higher proportion of the Muslim subjects had better QOL than the rest, but it was also not significant. Bivariate analysis showed significant associations of QOL with age, sex, literacy, financial condition, socioeconomic status, and type of family. Multivariate analysis identified male sex, younger age, and living with spouse as significant predictors of good QOL. Conclusion: Overall health-related QOL of the geriatric people living in rural areas of West Tripura district is poor, but younger male subjects of ethnic origin and living with spouse may enjoy relatively better QOL.

Quality of life and its determinants among filipino patients living with HIV/AIDS enrolled in treatment hub of a tertiary government hospital

BACKGROUND:Loss of physical function during the process of aging might affect the quality of life. Physical function assessment tests predicts outcomes such as falls, institutionalization, and death. Studies assessing the association of physical function with quality of life and physical activity level of elderly population in India is scarce. Hence we aimed to assess the physical function of community dwelling older adults and to determine its association with physical activity levels and quality of life.MATERIALS AND METHODS:This was a cross-sectional analytical study. 89 community dwelling older adults between 60 and 80 years of age were recruited. Physical function was assessed by standing balance, walking speed, and grip strength. Quality of life was assessed by WHO QOL BREF questionnaire and physical activity level was assessed by International Physical activity Questionnaire.RESULTS:Standing balance was reduced in 24% and walking speed was decreased in 33% of the participants. Males had higher walking speed, and grip strength. Quality of life was better among males. Standing balance, walking speed and grip strength was significantly higher in moderate – heavy activity levels. There was positive correlation between physical function and quality of life. There was also positive correlation between physical activity level and quality of life.CONCLUSION:Physical function, quality of life and physical activity level were decreased. Males had better physical function and quality of life. Physically active individuals had better physical function and quality of life. Early detection of decreased physical function and increase in physical activity level could result in better quality of life among elderly.

Ajustamento psicossocial, morbilidade psiquiátrica e qualidade de vida em adolescentes e jovens adultos com cardiopatias congénitas

BackgroundDementia has become a public health priority along with population aging worldwide. Owing to its chronic progressive nature in the absence of a cure, maintaining the best possible quality of life (QOL) has become the desired outcome for people with dementia (PWD).AimThe current study aimed to determine the factors associated with ‘good QOL’ in people with dementia in the Sri Lankan setting.MethodsAn unmatched case–control study was conducted to identify the factors associated with ‘good QoL. Cases in the study included dementia patients having ‘good’ QOL, whereas controls were those having ‘poor’ or ‘average’ QOL. Both cases and controls were selected from the same patient base at a premier tertiary care state hospital in Colombo District, Sri Lanka. They were identified using the validated DEMQOL (Dementia Specific Quality of Life) tool, adhering to strict eligibility criteria. An interviewer-administered questionnaire was used to assess the associated factors. Bivariate analysis followed by logistic regression modelling determined the associated factors for ‘good QOL’ adjusted for confounders using odds ratio (OR) and 95% confidence interval (CI).ResultsThe study sample consisted of 64 cases and 208 controls. After adjusting for confounders, education up to GCE O/Level and above (OR = 4.02; 95% CI = 2.97, 12.0), ever employed (OR = 3.21; 95% CI = 1.59, 11.06), good social functioning (OR = 4.14; 95% CI = 3.39, 16.46), mild functional impairment (OR = 1.77; 95% CI = 1.13, 9.67), little or no caregiver burden (OR = 2.96; 95% CI = 1.86, 10.94), absence of apathy (OR = 2.22; 95% CI = 1.27, 12.48) and absence of irritability (OR = 2.17; 95% CI = 1.72, 10.34) were found to be significantly associated with ‘good QOL’. 60% of the variance of ‘good’ QOL among PWD was explained by the factors in the final model.Conclusions and recommendationsThe identified determinants of ‘good QOL’ clearly show how the QOL improvement interventions need to be planned. Accordingly, such programmes should be primarily focused on strategies to improve PWDs' ADL (Activities of Daily living), reduce and manage neuropsychiatric symptoms effectively and to promote activities enhancing social functioning, and plan programmes to address caregiver burden.

Growing life expectancy is challenging the quality of health care for elderly. Information regarding health related quality of life (QOL) may help policy makers to design need based health programs for this population. The objectives of this study were to estimate health related QOL of the geriatric population living in rural areas of West Tripura district and to compare it between ethnic and non-ethnic populations in respect to important domains. This community based cross-sectional study was conducted during 1st February 2019 to 31st March 2020 among 225 geriatric subjects of rural West Tripura district chosen by multistage sampling. World Health Organization’s QOL-BREF scale was used for data collection. Among the study population 46.2% had overall good health related QOL. About 52.9% had good QOL in environment and 37.3% had good QOL in social relationship domains. Marginally higher proportion of the subjects from ethnic origin had better QOL than the non-ethnic but it was not significant. Higher proportion of the Muslim subjects had better QOL than the rest, but it was also not significant. Bivariate analysis showed significant associations of QOL with age, sex, literacy, financial condition, socioeconomic status and type of family. Multivariate analysis identified male sex, younger age and living with spouse as significant predictors of good QOL. Overall health related QOL of the geriatric people living in rural areas of West Tripura district is poor but younger male subjects, of ethnic origin and living with spouse may enjoy relatively better QOL.

Background: Young BC survivors are at risk for impaired QOL in part due to issues that are unique to their life stage. We sought to characterize trajectories of QOL in the 5 years following diagnosis among young BC survivors as well as evaluate patient and clinical characteristics associated with poorer or deteriorating QOL trajectories over time. Methods: Women diagnosed with stage I-III BC at age ≤40 enrolled in the Young Women’s BC Study, a prospective cohort in North America, who completed ≥2 study surveys through 5 years of post-diagnosis follow-up. QOL was evaluated with the Cancer Rehabilitation Evaluation System (CARES) physical, psychosocial, and sexual subscale scores. Demographic, treatment, and clinical characteristics were ascertained through surveys and chart review. Longitudinal trajectories for each CARES subscale were defined using group-based trajectory modeling; associations between patient/clinical characteristics and trajectory group membership were estimated for each subscale using multivariable multinomial logistic regression. Results: Among 900 women, median age at diagnosis was 36 (range: 17-40) 89% were white, 2% Black, and 4% Hispanic. At baseline, 73% were partnered, 61% parous and 49% perceived themselves as financially comfortable. Most had hormone-receptor positive (74%), HER2-negative (70%) BC, and most received chemotherapy (82%); 36% underwent mastectomy with radiation. Physical and psychosocial scores each clustered into 4 trajectories, with >75% of participants clustering in groups reflecting excellent or good QOL that was stable over time and few (6% for physical and 4% for psychosocial) clustering into groups that reflected poorer QOL at baseline that did not improve over time. Sexual health trajectories were more variable, clustering into 5 trajectories, with over half of participants clustered into groups reflecting good (35%) or excellent (20%) QOL that remained relatively stable over time, 22% clustered into a trajectory that was poor at baseline but moderately improved over follow-up, 13% in a group that reflected deteriorating from moderate-to-poor QOL and 11% in a group with poor QOL at baseline that did not improve over time. In multivariable regression analyses (Table), factors associated with clustering in a poorer trajectory (vs. clustering in an excellent trajectory), in multiple QOL domains included baseline financial discomfort (associated with poorer QOL across all 3 domains), mastectomy+radiation (vs. lumpectomy, associated with poorer QOL across all 3 domains); chemotherapy receipt (associated with poorer physical and sexual health trajectories); and baseline BMI >25 (vs. 18.5-24.9, associated with poorer physical and poorer/deteriorating sexual health trajectories). Conclusions: Young BC survivors follow distinct QOL trajectories in survivorship. While most will not experience substantial QOL impairment through the first 5 years following diagnosis, a substantial minority report persistently poor or deteriorating QOL. The association between more extensive local therapy and poorer physical/psychosocial/sexual health trajectories underscores the importance of communicating the potential for negative QOL outcomes when women are making surgical decisions. Additionally, the pervasive impact of financial wellbeing on multiple QOL domains supports the potential value of systematic screening for and addressing of financial distress to prevent or mitigate financial toxicity in survivorship Factors associated with clustering in poorer/deteriorating (vs. excellent) QOL trajectories *Reference trajectory=excellent QOL Citation Format: Tal Sella, Zheng Yue, Kathryn Ruddy, Shari Gelber, Rulla Tamimi, Jeffrey Peppercorn, Lidia Schapira, Virginia Borges, Steven Come, Eric Winer, Ann Partridge, Shoshana Rosenberg. Five-year quality of life (QOL) trajectories among young breast cancer (BC) survivors [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-12-01.

Cardiac resynchronization therapy (CRT) for the treatment of heart failure (HF) raises complex problems for informed consent. CRT with and without defibrillator backup has been demonstrated in clinical trials to improve symptoms from HF and decrease mortality.1–4 A CRT pacemaker (CRT-P) may improve symptoms and reduce mortality in selected patients, even without offering the specific protection from malignant arrhythmias afforded by a CRT defibrillator (CRT-D). Further, CRT-P may prevent disease progression even in earlier stages of HF.4,5 Implantable cardioverter-defibrillators (ICDs) alone are effective in preventing sudden cardiac death (SCD) in selected patients.6,7 Although most patients eligible for CRT-P will similarly meet guidelines for an ICD, the decision to include ICD backup with a CRT implant may not be straightforward.8 The decision for CRT-P or CRT-D implantation includes not only the medical facts, but also the important considerations based on values and principles. Patients and physicians may wrestle with fundamental questions about quality and quantity of life and struggle to come together toward a truly informed consent process. There are no formal guidelines or standards that argue for specific content to be included in the informed consent process for CRT. This article examines 4 categories of questions regarding CRT based on an understanding of autonomy and shared decision-making as elements of informed consent: (1) control over the manner of death, (2) quality versus quantity of life, (3) therapeutic flexibility, and (4) clinical uncertainty. This article may help to guide clinicians and patients by clarifying the clinical and moral considerations and the principles behind particular treatment decisions. Autonomy refers to an understanding and knowledge of available options and the ability to choose between them through rational deliberation.9,10 Respect for patient autonomy is the foundation of modern bioethics and, in …

Study designCross-sectional population-based survey for the Australian cohort of the International Spinal Cord Injury (InSCI) Community Survey.ObjectivesTo differentiate subgroups of people with spinal cord injury (SCI) who self-report good and poor overall quality of life (QoL) using domains of the International Classification of Functioning (ICF), and to evaluate how these factors contribute to QoL when considered together, while controlling confounders.SettingAustralian survey data from four state-wide SCI services, one government insurance agency, and three not-for-profit consumer organisations.MethodsExplanatory factors for QoL were compared between participants reporting poor vs. good QoL. Path models estimated total, direct and mediated contributions from each explanatory factor to QoL ratings after accounting for confounders.ResultsMost participants (62%) reported good or very good QoL, 12% reported poor or very poor QoL. When explanatory factors were considered together, the strongest total effects on QoL involved social integration (+0.36 SDs), subjective social position (+0.29), secondary health condition burden (−0.28), activity/participation problem burden (−0.26), day-to-day assistance (−0.26), mental health (+0.18), pain (−0.16), self-efficacy (+0.15), vitality (+0.14) and environmental barriers (−0.11). Effects of social integration, mental health, vitality, self-efficacy, pain and activity/participation problems were partly or wholly direct.ConclusionOpportunities to improve QoL in people with SCI exist at every level of the health system. Virtually all aspects of the ICF framework make a substantive difference to QoL outcomes. Social and psychological factors and ability to complete desired activities have key direct effects and influence effects of secondary health condition burden and environmental barriers.