Affect Health Related Quality Of Life Research Articles

Does gender affect health-related quality of life in patients with type 2 diabetes (ADDQoL) in Central European countries?

The aim of this study was to compare the impact of type 2 diabetes on quality of life (QoL), taking into account gender differences in relation to individual domains of Diabetes-Related Quality of Life Audit (ADDQoL) in adult men and women in Poland, the Czech Republic and Republic of Slovakia. The participants were 608 patients from the three countries, of whom 278 were women and 330 men with type 2 diabetes mellitus. The tool used was the Audit of Diabetes-Dependent Quality of Life (ADDQoL). The overall average QoL was slightly higher in men than in women. In ADDQoL scores, mean weighted impact scores were negative for all domains. The domain which was the most affected by type 2 diabetes in both men and women from all three countries was the 'freedom to eat', while the 'living conditions' domain was the least affected. Diabetes had a slightly negative average weighted impact on most men and women - AWI<-3.0. Except for the different AWI scores in men with type 2 diabetes depending on their education, neither men nor women revealed any significant changes in terms of the impact of education, residence, marital status, smoking, hypertension, or taking anti-hypertensive drugs. Type 2 diabetes mellitus negatively affects all the domains of life, in both men and women in all three countries; however, this impact is insignificant. The participants assessed their quality of life as good and very good.

The psychological impact of Behçet's disease.

Bechet's disease (BD), a chronic multiorgan involving disease, has a significant impact on quality of life in spite of effective treatment modalities. Disease manifestations such as arthritis, orogenital ulcerations, rashes, angiitis, and neurological involvement affect health-related quality of life (HRQoL) through its impact on depression, anxiety, and fatigue. We aimed explore the psychological impact of BD, taking into consideration the effect on the HRQoL, as well as the association with depression, anxiety, wellbeing, and fatigue. This is a narrative review of the literature that looks into the association of BD on the HRQoL including all studies that have assessed such as association. Depression and anxiety are prevalent among patients with BD, and contribute significantly to fatigue, a common symptom among BD patients. In addition, the psychological wellbeing is affected by the disease, however, more studies are needed to assess this relationship. Depression and anxiety are strongly associated with BD, and contribute significantly to fatigue, a common symptom among BD patients. In addition, the psychological wellbeing is affected by the disease, however, more studies are needed to assess this relationship. Besides, the controlling factors of the psychological impact are still to be deciphered.

Barriers to Healthcare Access and to Improvements in Health-Related Quality of Life After an Acute Coronary Syndrome (From TRACE-CORE)

Little is known about how barriers to healthcare access affect health-related quality of life (HRQOL) after an acute coronary syndrome (ACS). In a large cohort of ACS survivors from 6 medical centers in Massachusetts and Georgia enrolled from 2011 to 2013, patients were classified as having any financial barriers, no usual source of care (USOC), or transportation barriers to healthcare based on their questionnaire survey responses. The principal study outcomes included clinically meaningful declines in generic physical and mental HRQOL and in disease-specific HRQOL from 1 to 6 months posthospital discharge. Adjusted relative risks (aRRs) for declines in HRQOL were calculated using Poisson regression models, controlling for several sociodemographic and clinical factors of prognostic importance. In 1,053 ACS survivors, 29.0% had a financial barrier, 14.2% had no USOC, and 8.7% had a transportation barrier. Patients with a financial barrier had greater risks of experiencing a decline in generic physical (aRR 1.48, 95% confidence interval [CI] 1.17, 1.86) and mental (aRR 1.36, 95% CI 1.07, 1.75) HRQOL at 6 months. Patients with 2 or more access barriers had greater risks of decline in generic physical (aRR 1.53, 95% CI 1.20, 1.93) and mental (aRR 1.50, 95% CI 1.17, 1.93) HRQOL compared with those without any healthcare barriers. There was a modest association between lacking a USOC and experiencing a decline in disease-specific HRQOL (aRR 1.46, 95% CI 0.96, 2.22). Financial and other barriers to healthcare access may be associated with clinically meaningful declines in HRQOL after hospital discharge for an ACS.

Does personality affect health-related quality of life? A systematic review.

BackgroundHealth-related quality of life (HRQOL) is increasingly measured as an outcome for clinical and health services research. However, relatively little is known about how non-health factors affect HRQOL. Personality is a potentially important factor, yet evidence regarding the effects of personality on HRQOL measures is unclear.MethodsThis systematic review examined the relationships among aspects of personality and HRQOL. Eligible studies were identified from Medline and PsycINFO. The review included 76 English-language studies with HRQOL as a primary outcome and that assessed personality from the psychological perspective. Individuals with various health states, including ill (e.g., cancer, cardiovascular disorders), aging, and healthy, were included in this review study.ResultsSome personality characteristics were consistently related to psychosocial aspects more often than physical aspects of HRQOL. Personality characteristics, especially neuroticism, mastery, optimism, and sense of coherence were most likely to be associated with psychosocial HRQOL. Personality explained varying proportions of variance in different domains of HRQOL. The range of variance explained in psychosocial HRQOL was 0 to 45% and the range of explained variance in physical HRQOL was 0 to 39%.ConclusionsPersonality characteristics are related to HRQOL. Systematic collection and analysis of personality data alongside HRQOL measures may be helpful in medical research, clinical practice, and health policy evaluation.

Impact of Symptoms of Maternal Anxiety and Depression on Quality of Life of Children with Cerebral Palsy.

Cerebral palsy (CP) interferes with the quality of life (QOL) of children with CP, and given that parents report having to often guide their children's decision making, it is important to understand the psychosocial factors that have a potential influence on parent-proxy reports. The purpose of this study was to investigate the impact of maternal anxiety and depression symptoms on parent proxy-reported health-related QOL (HRQOL) for children with CP, while controlling other clinical and demographical variables that may have affect HRQOL. The HRQOL scores of 97 outpatients with CP, aged 7-18 years, were assessed using the Pediatric QOL Inventory, Parent version (PedsQL-P). Each patient's type of CP, gross and fine motor function levels, severity of intellectual disability (ID), and other clinical variables were recorded. The levels of depression symptoms in each mother were assessed using the Beck Depression Inventory (BDI), and the levels of anxiety symptoms were assessed with the Beck Anxiety Inventory (BAI). According to regression analyses, male gender, severity of ID, and higher mothers' BAI scores had negative effects on the PedsQL-P physical scores, and severity of ID and higher mothers' BDI scores had negative effects on the PedsQL-P psychosocial scores. Regarding the determinants of total HRQOL, severity of ID, GMFCS score, and higher mothers' BDI scores negatively impacted the PedsQL-P total scores. Our findings show significant predictor effects of the mothers' anxiety and depressive symptoms, independent from other clinical variables, on the mother-rated HRQOL scores in children with CP.

Health related quality of life in colorectal cancer patients: state of the art

BackgroundColorectal cancer (CRC) is the third most commonly diagnosed cancer in males and the second in females with a progressive increase in prevalence in industrialized countries. The loss of health due to the cancer and/or the consequence of the treatment may result in psychophysical, functional and social impairment; all of these affect health-related quality of life (QoL).DescriptionThe most frequently CRC-specific QoL questionnaires is the FACT-C. QoL is not only important for the well-being of cancer patient but it also influences survival and response to therapy. Many studies investigated various determinants involved in the assessment of QoL in CRC, suggesting that symptoms, surgical procedures and the number of comorbidity significantly affected QoL.ConclusionDespite that CRC patients have a relatively good QoL compared with the general population, a wide range of intervention could be undertaken to improve their QoL. The finding of this review may be useful for cancer clinicians in taking therapy and surveillance-related decisions. However, future research should be directed to large-scale prospective studies using well validated QoL instruments to facilitate comparison of results.

Health information needs and health-related quality of life in a diverse population of long-term cancer survivors

ObjectiveTo investigate health information needs and their association with health-related quality of life (HRQOL) in a diverse, population-based sample of long-term cancer survivors. MethodsWe analyzed health information needs from 1197 cancer survivors 4–14 years post-diagnosis drawn from two cancer registries in California. Multivariable regression models were used to identify factors associated with endorsement of total number and different categories of needs. The relationship between number of needs and HRQOL and effect modification by confidence for obtaining information was examined. ResultsSurvivors reported a high prevalence of unmet information needs in the following categories: side effects & symptoms: 75.8%; tests & treatment: 71.5%; health promotion: 64.5%; interpersonal & emotional: 60.2%; insurance: 39.0%; and sexual functioning & fertility: 34.6%. Survivors who were younger, non-White, and did not receive but wanted a written treatment summary reported a higher number of needs. Number of information needs was inversely related to mental well-being, particularly for those with low confidence for obtaining information (P<0.05). ConclusionThese patterns suggest disparities in access to important health information in long-term survivors and that affect HRQOL. Practice ImplicationsFindings suggest a need for tailored interventions to equip survivors with comprehensive health information and to bolster skills for obtaining information.

Sexual function in adult spina bifida patients

Purpose To evaluate the sexual function (SF) in adult spina bifida patients and its impact on quality of life (QOL). Material and methods Between March 2005 and May 2006, 76 adult patients with spina bifida (34 women, 42 men), mean age 24.4 years (range 18-37), were seen in our institution. Following IRB approval, data were collected from medical records and validated questionnaires (Watts sexual function questionnaire [WSFQ] to assess SF and Medical Outcomes Study 36-item Short-Form [SF36] to assess QOL) were completed. Results 18 of 76 patients (24%, 9 women, 9 men) have had sexual intercourse at least once within the last two months. There was no difference regarding age and gender distribution in sexually active (SA) versus not sexually active (NSA) patients (25.8±4.2 vs. 24±4.5 years, p = 0.13). All levels (thoracic [T] to sacral [S]) of myelomeningoceles (MMC) were seen in both groups with a significant tendency to more caudal levels of neurological impairment in SA patients (T: 22%, S: 22%) compared to the NSA group (T: 42%, S: 3%; p Conclusions In our cohort, 24% of adult spina bifida patients are sexually active. Sexual activity is not related to gender, urinary incontinence or physical disability, but is more likely in patients with more caudal levels of neurological impairment. No difference in WSFQ scores in SA patients is observed between men and women. Sexual function seems not to affect health related QOL in these patients.

Does the menopausal transition affect health-related quality of life?

We address whether the menopausal transition affects health-related quality of life (HRQOL). To do this, we review how HRQOL is defined and measured, present HRQOL findings from the large, population-based studies of menopause, and identify key gaps in knowledge. HRQOL is defined as the value assigned to duration of life as modified by impairments, functional states, perceptions, and social opportunities that are influenced by disease, injury, treatment, or policy. The specific domains of HRQOL include resilience or the capacity to respond to stress, health perceptions, physical functioning, and symptoms. The majority of menopause studies have operationalized HRQOL as frequency and severity of symptoms. Taken together, the findings from 12 cross-sectional reports and 3 longitudinal studies suggest that the perimenopause is associated with higher levels of somatic symptoms. It is unclear whether the perimenopause is related to other domains of HRQOL. Only 1 longitudinal study reported an association between reduced physical functioning and perimenopause. Studies typically compare premenopausal women with women of other menopausal transition status separately, thereby not addressing the question of further change in HRQOL after the cessation of menses. There is a clear need for understanding the effects of the menopause beyond the domain of symptoms and to consider whether some domains of HRQOL may improve.

Does the menopausal transition affect health-related quality of life?

Does the menopausal transition affect health-related quality of life?

The benefit of negative tests in non-ulcer dyspepsia.

Negative diagnostic tests are usually evaluated by their ability to advance a diagnostic search, or they are considered redundant expenditures in establishing a definitive diagnosis. It has remained difficult to assess their benefit in terms of their own merit and the reassurance that they provide to a patient. The aim of the present study is to develop a mathematical model for quantifying the impact of diagnostic tests on a patient's health-related quality of life (HRQL). An influence diagram is used to model how non-ulcer dyspepsia (NUD) and its medical care affect HRQL. Diagnostic tests and medical therapy benefit HRQL by alleviating fear of disease and NUD symptoms. Medical care can also adversely affect HRQL, lead to expenses in time and money, and compromise a patient's sense of autonomy. HRQL is modeled as the focal point of multiple influences detracting from its value. Negative diagnostic tests can improve HRQL in NUD. The improvement of HRQL by diagnostic tests depends on a multitude of individual influences and the interactions between them, such as the severity of NUD symptoms andfear of disease, as well as the impact of medical care itself on HRQL. If a patient harbors a strong fear of serious disease or cancer, more extensive testing is likely to improve the patient's well-being and appears a worthwhile endeavor. Other patients, however, would be served perfectly well by empirical therapy only. For the vast majority of subjects with NUD who never seek medical advice, the unpleasantness of the disease itself does not outweigh the anticipated downside of obtaining medical care. The analysis illustrates the applicability of the influence diagram in modeling disease behavior. This method helps to assess the benefit of negative tests beyond their means of generating information.

The Benefit of Negative Tests in Non-Ulcer Dyspepsia

Objectives. Negative diagnostic tests are usually evaluated by their ability to advance a diagnostic search, or they are considered redundant expenditures in establishing a definitive diagnosis. It has remained difficult to assess their benefit in terms of their own merit and the reassurance that they provide to a patient. The aim of the present study is to develop a mathematical model for quantifying the impact of diagnostic tests on a patient’s health-related quality of life (HRQL).Methods. An influence diagram is used to model how non-ulcer dyspepsia (NUD) and its medical care affect HRQL. Diagnostic tests and medical therapy benefit HRQL by alleviating fear of disease and NUD symptoms. Medical care can also adversely affect HRQL, lead to expenses in time and money, and compromise a patient’s sense of autonomy. HRQL is modeled as the focal point of multiple influences detracting from its value.Results. Negative diagnostic tests can improve HRQL in NUD. The improvement of HRQL by diagnostic tests depends on a multitude of individual influences and the interactions between them, such as the severity of NUD symptoms and fear of disease, as well as the impact of medical care itself on HRQL. If a patient harbors a strong fear of serious disease or cancer, more extensive testing is likely to improve the patient’s well-being and appears a worthwhile endeavor. Other patients, however, would be served perfectly well by empirical therapy only. For the vast majority of subjects with NUD who never seek medical advice, the unpleasantness of the disease itself does not outweigh the anticipated downside of obtaining medical care.Conclusion. The analysis illustrates the applicability of the influence diagram in modeling disease behavior. This method helps to assess the benefit of negative tests beyond their means of generating information.