Different Aspects Of Quality Of Life Research Articles

IMPACT OF DIGITAL AND SOCIAL ENGAGEMENT ON QUALITY OF LIFE AMONG RURAL OLDER ADULTS

Abstract Objectives In the current digitalized society, digital and social engagement are important elements in the well-being of older adults. This study examines how different types of digital and social engagement are associated with different aspects of quality of life among rural healthy older adults. Methods Older adults without cognitive impairments, residing in the community in Southeast Idaho (n=154) participated in the ‘Aging in Idaho study’ in 2018. Internet use for communication, instrumental purposes, and health information searches were measured. Informal and formal social participation were measured. Five aspects of quality of life (QOL) were measured using the WHOQOL-BREF. Multiple regression analyses were performed. Results Well-educated (M=16 years) rural older adults used the Internet for various purposes, actively engaged in social activities, and reported higher level of QOL for overall and life environment (e.g., M=4.6, Range=1-5). Internet use for communication was positively associated with QOL general health (β=.20, P <.05). Online health information search was negatively associated with QOL general health (β= -.42, P <.05). Informal social participation was positively associated with QOL overall (β=.17, P <.05), psychological health (β=.13, P <.05), and life environment (β=.20, P <.05). Formal social participation was positively associated with QOL social relationships (β=.16, P <.05). Discussion Digital and social engagement relate in distinct ways with different aspects of QOL. Older adults perceived QOL to be better when they actively adopted digital technology whereas maintaining social engagement well in the community. Promoting digital engagement which enables to facilitate social engagement in later life will be discussed.

Threshold effect of unmet walking needs on quality of life for seniors

Walking is positively related to seniors’ Quality of Life (QoL). However, existing studies neglected the role of unmet walking needs. To address this gap, this study evaluates if and to what extent unmet walking needs affect different aspects of QoL. Ordered logistic models were applied to analyze survey data of 533 seniors from China, results suggest that unmet walking needs have overall negative correlations with all four dimensions of QoL including overall QoL, Physical Health (PhyH), Psychological Health (PsyH), and Social Health (SH). Results also support the assumption that tolerance thresholds exist when detecting correlations between unmet walking frequencies and different aspects of QoL. PsyH has the smallest tolerance threshold, followed by overall QoL and PhyH, and SH has the largest tolerance threshold. These findings provide evidence for policymakers to establish effective strategies on how to reduce unmet walking frequencies and minimize its negative effects on QoL of seniors.

Quality of life associated with immunosuppressant treatment adherence in liver transplant recipients: A cross-sectional study.

Purpose: Transplanted organ survival after solid organ transplantation highly correlates with the adherence levels of the patients to their immunosuppressive drugs. On the other hand, one of the main goals of liver transplantation is to increase the overall quality of life (QOL) for the patient. This study is aimed to analyze the relationship between adherence and QOL in adult liver transplant recipients of the biggest liver transplant center in Asia. Methods: All of the included patients were older than 18 years and at least 6 months had passed from their liver transplantation. The adherence level was measured with BAASIS method and the QOL was assessed by SF-36 questionnaire in real-time interviews. The relationship between adherence and different aspects of QOL in addition to qualitative and quantitative influential factors on these two outcomes was calculated with statistical analysis. Results: Among the 122 included patients, 41% of the were categorized in the non-adherent group. The most important reasons for non-adherence in these patients included forgetfulness (62%), lack of medication (12%), financial problems for drug supply (9%), and side effects (2%). According to the results of the multivariate linear regression model, rejection was the only influential factor in the occurrence of non-adherence among patients (OR = 8.226 CI (1.404-48.196)). The overall mean QOL score of patients was reported 51.09 ± 21.86. The lowest is given to social functioning, while mental health has achieved the highest score. The mean QOL scores in different dimensions in patients with adherence were higher than non-adherents, which was only significant in mental health (p-value = 0.01). Additionally, in total scores related to Physical Composite Score (PSC) and Mental Composite Score (MCS), the mean MSC scores in adherent patients were significantly higher than non-adherent patients (p-value: 0.02). Although adherent patients have an overall greater QOL, the only meaningful effect on QOL total score was from income level. Conclusion: The overall QoL score has been in all parameters higher in the adherent group compared with non-adherent patients. The difference in QoL was most meaningfully significant in mental composite score among other parameters of QoL.

Assessment of Quality of Life in Patients with Stroke Using Stroke Specific Quality of Life Scale

Background: Quality of life (QOL) is the degree to which an individual is healthy, comfortable, and able to participate in or enjoy life events. It is necessary to understand how the duration and age of patients affects different aspects of QOL so that it will help to frame appropriate guidelines about management of stroke related impairments and participation restriction. Methodology: It was an observational study conducted in physiotherapy OPD of a tertiary care hospital from January to October 2021. After the approval from Institutional Ethics committee, 100 patients with stroke were included in the study. Stroke Specific Quality of life questionnaire was administered on them in local language. Results: As the duration of stroke increases, scores on SSQOL scale increases indicating better functioning with scores of 112.9 for the duration of 6-16 months, 117.94 for 17-27 months and 130.5 for 28-38 months. As per the age analysis, age group of 45-65yrs shows better quality of life with score of 123.18 as compared to score of 99.58 for 66-86yrs and score of 110.16 for 24-44yrs. Conclusion: Patients with duration of stroke of 28-38 months showed better quality of life as compared to 6-16 months and 17-27 months. Similarly, patients in the age range of 45-65 years showed better quality of life as compared to lower and upper age groups. However, Social Roles scored the same across all duration of condition indicating the need for remedial measures to be taken to improve the same. Keywords: Quality of life, stroke, Stroke Specific Quality of Life Scale

Associations between depressive symptoms and quality of life among residents of Wuhan, China during the later stage of the COVID-19 pandemic: A network analysis

BackgroundVarious populations have experienced significant increases in depression and decreased quality of life (QOL) during the coronavirus disease 2019 (COVID-19) pandemic. This network analysis study was designed to elucidate interconnections between particular depressive symptoms and different aspects of QOL and identify the most clinically important symptoms in this network among adults in Wuhan China, the initial epicenter of the COVID-19 pandemic. MethodsThis cross-sectional, convenience-sampling study (N = 2459) was conducted between May 25 to June 18, 2020, after the lockdown policy had been lifted in Wuhan. Depressive symptoms and QOL were measured with the Patient Health Questionnaire-9 (PHQ-9) and first two items of the World Health Organization Quality of Life Questionnaire - brief version (WHOQOL-BREF), respectively. A network structure was constructed from the extended Bayesian Information Criterion (EBIC) model. Network centrality strength and bridge strength were evaluated along with the stability of the derived network model. ResultsLoss of energy (DEP-4) and Guilt feelings (DEP-6) were the two central symptoms with the highest strength as well as the two most prominent bridge symptoms connecting the clusters of depression and quality of life (QOL) in tandem with the two nodes from the QOL cluster. Network structure and bridge strengths remained stable after randomly dropping 75 % of the sample. ConclusionInterventions targeting “Loss of energy” and “Guilt feelings” should be evaluated as strategies for reducing depressive symptoms and promoting improved QOL in COVID-19-affected populations.

Quality of life in terminally ill cancer patients: what is the role of using complementary and alternative medicines?

Background and purposeCancer is the world’s second greatest cause of mortality and a leading cause of death in both developed and developing countries. Patients employ a number of complementary and alternative medicine (CAM) methods to deal with the problems and difficulties of cancer, which can have an impact on their quality of life (QOL). The aim of the present study was to assess the correlation between QOL and the use of different CAM methods in terminally ill cancer patients.MethodsThis was a cross-sectional study. In southern Iran, 238 individuals with advanced cancer were studied in oncology centers and doctors’ offices. During the months of January to August 2021, patients were selected using convenience sampling. A demographic information questionnaire, the EORTC core quality of life questionnaire, and the CAM questionnaire were used to collect data.ResultsThe results showed that terminally ill cancer patients had a good quality of life. Last year, 85.7% of participants used at least one kind of CAM. Furthermore, 45.4% of participants used only one form of CAM, 30.3% used two types of CAM, 6.7% used three types of CAM, and 3.4% used four to five types of CAM. When all CAM users were compared to non-CAM users, CAM users had significantly higher social QOL and overall quality of life. Two subscales of QOL symptoms and function were correlated with cancer history, income, and use of CAMs, and the scores of QOL symptoms and function were greater in CAM users compared to non-CAM users. Among all the study variables, only the usage of CAM was correlated to overall QOL among terminally ill cancer patients.ConclusionThe current study found that using CAM could affect different aspects of QOL in terminally ill cancer patients. As a result, it is feasible that using CAM could help these people enhance their health and QOL.

Obsessive-compulsive symptoms moderates the effects of cognitive functioning on quality of life in clozapine-treated schizophrenia

Obsessive-compulsive symptoms (OCS) are frequently reported in clozapine-treated schizophrenia. Studies on the effects of OCS on cognitive abilities and quality of life (QoL) yielded contrasting results, ranging from benefits to adverse effects. We investigated the interactive effects of OCS and cognitive functioning on different aspects of QoL in clozapine-treated patients. 54 patients with schizophrenia underwent a neurocognitive, functional and psychopathological battery. Using moderation models, we examined the interplay between OCS and cognitive abilities on different QoL domains. We found several main effects and interactions between I.Q. and OCS on global QoL, as well as specific effects on psychological and environmental domains. Mild OCS have beneficial effects on QoL, but, as OCS become more severe in patients with more preserved cognitive abilities, the QoL drops steeply. Findings highlight the complex interplay between OCS and cognitive functioning, whose effects on QoL appear to depend on patients’ OCS severity and cognitive profile, as well as on the functional domain addressed. Our data may help to reconcile the seemingly contrasting results from previous studies, and shed a new light on the importance of evaluating OCS in schizophrenia, thus establishing specific interventions that can lead to consequent effects on social well-being and QoL. • Some OCS (e.g., checking) are more frequent in patients treated with clozapine. • Mild OCS act as a “protective” organizing factor on quality of life. • Severe OCS and cognitive abilities interplay negatively affects quality of life. • Effects on quality of life depends on the functional domain addressed.

Longitudinal analysis of quality of life of patients on home parenteral nutrition at a regional centre

Home parenteral nutrition (HPN) is the primary treatment for patients with intestinal failure (IF). Quality of life (QOL) of patients receiving home parenteral nutrition is well documented by Baxter et al.1 A QOL assessment tool (HPN-QOL©) has been developed and validated specifically for this patient population. We assessed the QOL in our HPN cohort in 2016 and throughout 2019-2020. This study assesses the impact of HPN on QOL over time in this cohort. We aimed to determine if there was a significant change in relation to different aspects of QOL.

How Owners of Epileptic Dogs Living in Italy Evaluate Their Quality of Life and That of Their Pet: A Survey Study.

Epilepsy is the most common chronic neurological disorder of dogs and requires a substantial commitment by the pet owner. The aim of this study was to evaluate how Italian owners of epileptic dogs receiving long-term treatment perceived their own quality of life (QoL) and that of their pet, using a list of key questions. A questionnaire was sent to owners of dogs affected by recurrent seizures and treated with antiepileptic drugs for at least three months. The questions included signalment, medical history and physical, social and psychological aspects associated with managing an epileptic dog. Eighty complete questionnaires were obtained. Most owners surveyed had a positive opinion on their dog’s QoL and they did not believe that commitment to managing their animals was a limitation of QoL. Dog QoL, seizure, frequency and severity were considered the most important factors in evaluating the efficacy of the antiepileptic treatment. The evaluation of the different aspects of QoL can help veterinary professionals understand the need for correct and exhaustive information provided to owners and the development of therapeutic plans and follow up, corresponding to the needs of dogs and owners.

The Quality of Life of Thalassemic Patients: The Role of Endocrine Defect Compensation.

The improvement of beta thalassaemia treatments has led to an increase in life expectancy. This implies the emergence of new comorbidities. Amongst others, endocrine glands are extremely sensitive to iron overload. We aimed to understand the impact of the endocrine conditions on the patient's quality of life (QOL). Hypogonadism may present with lack or delay of pubertal development, sexual dysfunctions and impaired fertility, which impact QOL in both sexes. Early recognition and treatment, as well as choosing the most appropriate therapy, according to patient's needs (fertility, pubertal development, psychological concerns, comorbidities), are advisable. Osteoporosis affects QOL irrespective of symptoms. Growth hormone deficiency may occur both in childhood and in adulthood, and it affects different aspects of QOL. In adults, it could be difficult to examine if the symptoms are due to GHD, and a trial of GH replacement could be useful to identify benefits and needs. Glucose metabolism impairment is common in thalassaemic patients and early recognition is mandatory because long-term complications can have a detrimental impact on QOL (as blindness or dialysis). Although the incidence of adrenal insufficiency seems to be rare in thalassaemic patients, when it occurs, it has a severe impact on QOL. Limited data is available on QOL in thalassaemic patients, and is even less related to endocrinopathies. We can speculate that endocrinopathies have an impact on everyday life. More studies are needed to allow our patients to achieve not just a longer life but also a better quality of life.

Breast Cancer Patients’ Perceptions of Their Experience With Chemotherapy-Induced Nausea and Vomiting and Its Impact on Quality of Life in Jeddah, Saudi Arabia

BackgroundBreast cancer accounts for 11.6% of all neoplasms worldwide and is the commonest cancer among Saudi females (29.7%). Chemotherapy-induced nausea and vomiting (CINV) is a very common side effect of chemotherapy that has a great impact on the quality of life (QoL) of patients. Literature is still scarce about this effect on the Saudi population. This study aims to explore breast cancer patients’ perception of their experience with CINV and its impact on QoL.MethodsThis is a cross-sectional retrospective study conducted on Saudi adult female breast cancer patients who underwent chemotherapy at King Abdulaziz Medical City, Jeddah, Saudi Arabia. Data collected through patients’ records review, face-to-face and telephone structured interviews using a questionnaire composed of four parts: sociodemographic characteristics, nature of acute CINV (within 24 hours) and delayed CINV (after 24 hours), impact on QoL, and general information on their experience.ResultsOut of a total population of 173, 98 (56.65%) patients participated in the study. The main findings show that 78.6% experienced nausea, whereas 35.7% experienced vomiting. Most participants had a moderate-to-extreme impact on their QoL due to nausea (74.0%) and vomiting (62.9%). Overall, 57.5% rated anti-emetics as excellent for controlling CINV, whereas 22.9% rated them as moderate to good; 83.5% were completely compliant on anti-emetics and 71.1% reported that they received completely comprehensive education about CINV. Religious practices (74.4%), diet (57.7%), and relaxation techniques (44.9%) were found to be the most common non-pharmacological methods used to control CINV. No significant correlation was found between the effect of CINV on QoL and sociodemographic characteristics (p > 0.05).ConclusionsCINV is very common among Saudi adult female breast cancer patients; despite being completely compliant and receiving comprehensive education and effective anti-emetics; CINV still had a high impact on different aspects of QoL. Health care professionals should consider CINV as an issue and should find effective strategies for alleviating patients’ suffering.

Measuring Quality of Life in Stroke Survivors

Introduction: The number of patients living with the consequences of stroke is increasing worldwide due to the improving stroke care and the modern differentiated treatment options for ischemic stroke – thrombolysis and thrombectomy. Hence, a significant interest has arisen in quality of life (QOL) measurement in post-stroke patients. Objectives. Measuring QOL in stroke survivors can be achieved by using various generic and stroke specific questionnaires. All tools should assess different domains of health such as physical acting, communication, daily activities and others. This article describes the most commonly used scales for measuring post-stroke QOL. Methods. We searched the PubMed electronic databases with the keywords — Quality of life, Stroke, Measuring for the period from January 2000 to May 2020. Results. Various generic and specific scales for quality of life measuring are available. The advantages of the specific scales include high accuracy and detailed information for the assessed domains. The limitations are due to numerous items, long evaluation time and high dependency on patient’s compliance. The generic scales give the ability to compare the QOL in patients with different diseases. The disadvantage is lack of detailed information for the health status in certain disease or condition. Conclusion. Measuring the different aspects of QOL in post-stroke patients is powerful tool in order to focus the further efforts to the most affected domains. A combination between generic and stroke-specific measure might be considered in order to overcome the limitations. The choice of measuring scales must be balanced in the terms of lengthy and repetitive surveys.

Quality of Life in Children with Migraine: A Case–Control Study

AbstractIn this article, we conducted a case–control study to determine the effects of migraine on quality of life (QOL) in children. Participants, aged between 6 and 18 years, were assigned to migraine (n = 70) and control (n = 70) groups. We used a translated version of Pediatric Quality of Life Inventory 4.0 questionnaire. From the children's perspective, the overall QOL scores in all domains were lower in children with migraine. Children in the migraine group had significant lower scores in the social, emotional, and physical functioning (p-value < 0.05) than control group. Interestingly, a significant difference in the educational performance was not seen (p-value = 0.101). Relative to the parents' responses and children, the overall scores in all domains were lower in children with migraine. Statistically significant lower scores were found only in emotional and physical domains (p-value < 0.05). The results of this study indicated that migraine imposes a substantial negative impact on the different aspects of QOL in children.

Functional and Quality of Life Outcomes of Surgery for Degenerative Cervical Myelopathy: a Quality Improvement Study

Background: This study aimed to determine the outcome of surgical treatments in patients with degenerative cervical myelopathy (DCM). During one-year follow-up period, we evaluated patient-reported functional and quality of life (QOL) measures.
 
 Methods: In a retrospective single-center study, we collected data of patients with DCM who underwent cervical fusion surgeries in Imam Khomeini Hospital, Tehran, Iran, from 2011 to 2015. Patients underwent single or multi-level anterior cervical discectomy and fusion (ACDF), anterior cervical corpectomy and fusion (ACCF), or posterior laminectomy and fusion. We utilized patient-reported assessments including Short Form 36 (SF-36), Visual Analogue Scale (VAS), Neck Disability Index (NDI), and Nurick grade. Follow-up was performed at 6 weeks, 3 months, 6 months, and 12 months post-operatively to assess the outcome of surgery.
 
 Results: Ninety patients (56 men, 34 women) with a mean age of 54.1 (27-87) years were included. Comparison of pre- and post-operative scores showed significant improvement in SF-36 parameters, VAS, NDI, and Nurick grade (P < 0.001). Also, women’s VAS scores improved more than men's VAS scores during the follow-up period (P < 0.050). Age and type of surgery did not significantly affect the SF-36 parameters, VAS, NDI, and Nurick grade (P > 0.05).
 
 Conclusions: Cervical surgeries in patients with different severity of DCM can improve different aspects of QOL during one-year after surgery

Quality of life in long term ventilated adult patients with Duchenne muscular dystrophy

The aim of this study was to evaluate quality of life (QoL) and its possible determinants in patients affected by Duchenne muscular dystrophy (DMD) in late stages of their disease, when non-invasive ventilation (NIV) is already established. Forty-eight DMD patients who were treated by NIV were enrolled. QoL was assessed by the Individualized Neuromuscular Quality of Life (INQoL) questionnaire. By this questionnaire, different aspects of QoL were assessed on a scale from 0 (best) to 100 (worst). In addition, motor and respiratory function tests were performed. Dysautonomia symptoms, sleep quality, sleepiness, anxiety, and depression were evaluated by validated questionnaires. The global INQoL score was 42.8 ± 19, reflecting a moderately altered QoL. The physical health domain was heavily impaired while the psychosocial domain was only mildly affected. Independence had the highest scores (81.1 ± 21.2), proving to be the most affected item. On multivariate analysis, maximal inspiratory pressure and Pittsburgh Sleep Quality Index, but not daily duration of NIV therapy, predicted global INQoL score. Respiratory impairment and sleep quality were independent predictors of poor QoL in DMD patients under NIV. Sleep quality in DMD is often disregarded, while it should be carefully addressed to ensure a better QoL.

Investigating the relative value of health and social care related quality of life using a discrete choice experiment

A key outcome in the evaluation of health technologies is the quality adjusted life year (QALY) which is often estimated using health measures such as the EuroQol instruments (EQ-5D-3L and EQ-5D-5L). The impacts of many interventions extend beyond a narrow definition of health to include non-health impacts such as social care related dimensions of quality of life (QoL). This means that there are circumstances where the QALY does not capture the full value of an intervention. In response to this, instruments with a wider measurement framework, such as the Adult Social Care Outcomes Toolkit (ASCOT), which measures social care related QoL, have been developed. Given the range of instruments available, it is important that decision-makers have tools to assess value for money comprehensively and consistently. To date, preference elicitation of different aspects of QoL combined within the same valuation procedure has not been tested. We investigate the relationship between health and social care aspects of QoL when assessed jointly by combining EQ-5D-5L and ASCOT in an online discrete choice experiment (DCE). In July 2016, 975 respondents recruited from internet panels completed 15 choice sets from an underlying design of 300. Conditional logit regression was used to estimate coefficient decrements for each attribute and examine their relative magnitude. Latent class and mixed logit modelling were used to understand preference heterogeneity. The results suggest trading across health and social care aspects indicated by coefficient estimates of differing magnitude. Dimensions with the largest disutility include four from EQ-5D-5L and one from ASCOT. There is evidence of preference heterogeneity at more severe dimension levels. We have used an established method to test the joint valuation of concepts measuring different aspects of QoL. The results have implications for the aspects of QoL that are included in QALY estimation and used in resource allocation decision-making.

Quality-of-Life Research in Acne Vulgaris: Current Status and Future Directions.

Acne patients may have significant quality-of-life (QoL) impairment, therefore assessment of health-related QoL (HRQoL) in acne patients is recommended by several national and international guidelines as an integral part of acne management. The inclusion of QoL assessment in core outcome sets is now a popular idea. Several acne-specific QoL questionnaires are available but none cover all topics presented in other instruments. The impact of acne on different aspects of QoL may vary between patients from different age groups. The European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes has initiated a study on the relevance of the different QoL topics in acne patients. Detailed recommendations on treatment goals and changes of treatment approaches based on a validated banding system and a minimal clinically important difference in HRQoL questionnaires (such as the Dermatology Life Quality Index) may be an important and promising approach.

Quality of life assessment of breast cancer patients in Saudi Arabia.

BACKGROUND:To assess the quality of life (QOL) of females with breast cancer in Saudi Arabia and its association with patients' demographic, social, and clinical data.MATERIALS AND METHODS:This analytical cross-sectional study was conducted among breast cancer patients attending King Abdullah Medical City, Makkah. Participants were asked to complete a self-administered structured questionnaire. We utilized the validated Arabic version of the European Organization for Research and Treatment of Cancer QOL-C30 (EORTC-QOL-C30) and breast cancer module QLQ-BR23 (EORTC-QOL-BR-23). Data were analysed using SPSS; mean and standard deviation computed for continuous variables, and percentages for categorical variables. Student's t-test performed to compare mean scores for various groups.RESULTS:Eighty-eight women participated in the study. The participants had a mean global health score of 64.0, standard deviation (SD) = 27.7. Of the functional scales, role functioning scored the highest (mean 71.2, SD = 31), while social and emotional functioning scored the lowest, (mean 57 SD = 35.8) and (mean 59.5 SD = 32), respectively. On the symptom scales, the most troubling symptoms were fatigue and insomnia, (mean 48.86 SD = 29.4) and (mean = 48, SD = 35), respectively. On the disease-specific tool (QLQ-BR23), body image and future perspective scored the lowest with a mean of 60.2 SD = 35 and 42.0 SD = 39.6, respectively. The most distressing symptom was hair loss (mean 61.56 SD = 41).CONCLUSIONS:Our population showed an acceptable overall global health score. However, they scored low on the important functional and symptoms domains. This study implies that patient age, social, and physical factors were possible determinants of global health and QOL scores. The healthcare system of Saudi Arabia should, therefore, address all these different aspects of QOL of breast cancer survivors.

Attention-Deficit/Hyperactivity Disorder Symptoms, Depression Risk, and Quality of Life in Black Pregnant Women.

Experiencing mental health difficulties during pregnancy predicts a variety of quality-of-life (QoL) outcomes for Black women. However, one area of prenatal mental health remains underresearched: attention-deficit/hyperactivity disorder (ADHD). Given the impairments reported by adults with significant symptoms of ADHD and the linkages between depression and ADHD in nonpregnant samples, the current study aimed to examine the relationships among ADHD symptoms, depression, and QoL in Black pregnant women. Participants for this study were 116 pregnant Black women aged 18-43 years (mean age = 27.14, standard deviation = 5.67) presenting to an urban women's health clinic. We investigated associations among maternal ADHD symptoms, risk of maternal depression, and different aspects of QoL, including relationships, life outlook, and life productivity. Linear hierarchical regressions were performed to investigate the ability of maternal depression risk to mediate the relationship between maternal ADHD symptoms and QoL. Moderate to large negative correlations were found between maternal ADHD symptoms, depression risk, and quality of life (p's ≤ 0.001). Furthermore, maternal depression risk either partially or fully explained the relationship between ADHD symptoms and the different QoL variables. This study illustrates that symptoms of both ADHD and depression are important clinical considerations for Black women during pregnancy. As significant ADHD symptoms can lead to the development of depression, future research should investigate the temporal relationship between depression and QoL in pregnant women diagnosed with ADHD, as well as study whether ADHD treatment results in improvements in depressive symptoms.

Socioeconomic status and quality of life among Chinese American breast cancer survivors: The mediating roles of social support and social constraints.

Literature has well noted ethnic/racial disparities in cancer survival and cancer care. However, socioeconomic disparities in psychosocial adjustment to breast cancer have garnered little attention. This study addresses the research gap by investigating the associations between socioeconomic indicators (ie, education, annual personal, and household income) and quality of life (QOL) and the mediating roles of social support and social constraints (objective and subjective conditions that constrain individuals from disclosing cancer concerns) in these associations among Chinese American breast cancer survivors (CABCS). Ninety-six CABCS completed questionnaires assessing these variables. After controlling for stage of cancer, annual personal and household income had indirect effects on QOL through social support, and education showed indirect effect on QOL through social support and social constraints. Subscale analyses indicated that controlling for years of immigration, annual personal and household income showed indirect effect on functional well-being through social support. When controlling for stage of cancer and income, education showed indirect effects on physical well-being through social support and social constraints and showed both direct and indirect effects on breast cancer concerns through social constraints. This study suggested that socioeconomic indicators, education, and income could be associated with different aspects of QOL through unique interpersonal mechanisms among CABCS. Our findings implied that increasing social support and reducing social constraints when implementing psychosocial interventions for CABCS may help to address the SES-related health disparities.