Different Domains Of Quality Research Articles

Evaluación de la calidad de vida de adultos con discapacidad intelectual institucionalizados en Chile

This study analyzes the quality of life for a sample of 285 institutionalized adults with intellectual disabilities. Quality of life, as assessed by professionals, is conceptualized according to the eight domains model from Schalock and Verdugo. The study also offers evidence of the adequacy (reliability and validity) of the Cross-cultural Measure of Quality of Life Indicators for use with this population. The results revealed significant differences in importance and use of the different dimensions of quality of life, and evaluation ratings of quality of life, based on the degree of disability of the participants. Length of institutionalization significantly impacted on ratings of importance of the different domains of quality of life. Discussion on further research on perceptions of service providers concerning the quality of life of its users and the impact of institutionalization is included.

English

All the aspects of status, style, satisfaction, mental state or well- being together reflect the multi-dimensional nature of 'Quality of Life' in an individual. Geriatric health problems relating to the quality of life often remains neglected. They demonstrate higher rates of morbidity, mortality, hospitalizations and experience a poorer quality of life. Hence, this study was conducted to explore the different domains of Quality of Life affected by socio demographic factors and to assess the status of morbidity in the elderly. A cross-sectional qualitative study was conducted on all the elderly who visited the PHC (Mundakur), field practice area of K.S. Hegde Medical Academy. All the elderly above the age of 60 years irrespective of sex were included and WHO BREF on Quality of life was administered to them by the first author in person. The basic demographic data along with their morbid and co-morbid conditions were asked for and the details were collected after obtaining informed consent. The data was tabulated and analysed using the statistical package of SPSS 17.0 version. Independent t-test was applied to compare the mean scores of different variables and the domains. The distribution of participants in this study were as follows: 55% were males while 45% were females.75% of the participants belonged to the age group of 60-69 years, 25% of the participants were 70 years and above. 66.66% of the individuals were married and 33.34% were either unmarried or widowed. Illiterates were 21.6%, literates were 78.4%.Males & literates had a slightly better quality of life than females and illiterates. With increasing age, the quality of life decreases. Married people had a slightly better quality life than those who were widowed / single. The most common morbidities were found to be vision impairment, hypertension &arthritis.

AB0315 Effect of prednisone on quality of life domains in early rheumatoid arthritis - additional analyses of the camera-ii-trial -

BackgroundIn the Computer Assisted Management in Early RA trial-II (CAMERA II), addition of 10 mg prednisone (versus placebo) to an MTX-based tight control treatment strategy resulted in lower disease activity...

An assessment of the quality of information on stroke and speech and language difficulty web sites

Online healthcare information is used by patients, their carers and families (PCF) experiencing speech and language difficulties (SLD) after a stroke. This information may be of variable quality. Tools have been designed to assess the risk of poor information quality, evaluating both generic and specific concepts, yet none focuses on stroke. The readability of information is also an issue when communication disorders are under consideration. The study investigated the quality and readability of information on 51 web sites pertaining to SLD following a stroke. These were assessed using two generic evaluation tools (DISCERN and the HON Code), readability tests (Flesch Reading Ease and Flesch-Kincaid Grade Level) and a specifically designed Stroke Tool based on the reported information needs of stroke PCF experiencing SLD. The tools themselves were then evaluated for their feasibility, reliability and validity. In common with previous studies, the information quality of the selected web sites was found to be extremely variable with only 59% achieving a score of 50% or more using HON, only 37% using DISCERN, and 49% using the Stroke Tool. Readability is generally very poor with only 6% of web sites scoring below the recommended grade 7. The tools did not correlate well, suggesting that they measure different domains of quality. The Internet may be a valuable resource for stroke PCF; however, the variable quality of information means that cautious use is recommended. The readability of information is a more serious issue that needs addressing by web site developers.

Dry Mouth and Sticky Saliva -- Quality of Life Domains Most Affected in the Acute Toxicity Phase of Radiation Therapy

The objective of this study was to evaluate the effect of curative radiation therapy (RT) on different domains of quality of life (QOL) in head and neck cancer patients depending on surgery prior to RT and concurrent chemotherapy (CRT).

Quality of life of residents with dementia in traditional versus small-scale long-term care settings: A quasi-experimental study

BackgroundThe number of people living with dementia worldwide is increasing, resulting in a need for more residential care. In response to criticism of the traditional medical approach to residential dementia care, many large nursing homes are transforming their traditional care facilities into more home-like small-scale living facilities. ObjectivesThis study examined the assumed benefits of small-scale living for residents with dementia, compared to traditional long-term care in the Netherlands and Belgium. The primary outcome was quality of life, divided into nine different domains. DesignThe study had a longitudinal design within a one-year time interval. SettingsFive long-term care settings in the Netherlands and Belgium containing four traditional and twelve small-scale living units participated in the study. ParticipantsData were obtained from 179 residents with dementia (age>65 years) (Dutch small-scale N=51, traditional N=51, Belgian small-scale N=47, traditional N=30). MethodsNurses and nursing assistants were trained to fill in the questionnaires. ResultsIn the Dutch sample, residents in small-scale settings had higher mean scores on ‘social relations’, ‘positive affect’, and ‘having something to do’ than residents in traditional settings. Moreover, mean scores on ‘caregiver relation’ and ‘negative affect’ remained stable over time among residents in small-scale settings, but decreased in traditional settings. These differences could not be explained by differences in behavioural characteristics, behavioural interventions, or social interaction. In the Belgian sample, fewer differences were found between traditional and small-scale settings. Nevertheless, residents in small-scale settings were reported to experience less ‘negative affect’ than those in traditional settings, which could be explained by differences in depression. Over time, however, residents ‘felt more at home’ in traditional settings, whereas no such increase was found for small-scale settings. Moreover, the mean quality of life scores on ‘restless behaviour’, ‘having something to do’ and ‘social relations’ decreased in small-scale settings, but remained stable in traditional settings. ConclusionsBoth small-scale and traditional settings appear to have beneficial effects on different domains of quality of life of residents with dementia. Future research should focus more on the quality and content of the care provided, than on the effects of the scale and design of the environment in long-term care settings.

Cross-cultural Adaptation of a Questionnaire on Self-perceived Level of Skills, Abilities and Competencies of Family Physicians in Albania.

Objective:Our aim was to validate an international instrument measuring self-perceived competency level of family physicians in Albania.Methods:A representative sample of 57 family physicians operating in primary health care services was interviewed twice in March-April 2012 in Tirana (26 men and 31 women; median age: 46 years, inter-quartile range: 38-56 years). A structured questionnaire was administered [and subsequently re-administered after two weeks (test-retest)] to all family physicians aiming to self-assess physicians’ level of abilities, skills and competencies regarding different domains of quality of health care. The questionnaire included 37 items organized into 6 subscales/domains. Answers for each item of the tool ranged from 1 (“novice” physicians) to 5 (“expert” physicians). An overall summary score (range: 37-185) and a subscale summary score for each domain were calculated for the test and retest procedures. Cronbach’s alpha was used to assess the internal consistency for both the test and the retest procedures, whereas Spearman’s rho was employed to assess the stability over time (test-retest reliability) of the instrument.Results:Cronbach’s alpha was 0.87 for the test and 0.86 for the retest procedure. Overall, Spearman’s rho was 0.84 (P<0.001). The overall summary score for the 37 items of the instrument was 96.3±10.0 for the test and 97.3±10.1 for the retest. All the subscale summary scores were very similar for the test and the retest procedure.Conclusion:This study provides evidence on cross-cultural adaptation of an international instrument taping self-perceived level of competencies of family physicians in Albania. The questionnaire displayed a satisfactory internal consistency for both test and retest procedures in this sample of family physicians in Albania. Furthermore, the high test-retest reliability (stability over time) of the instrument suggests a good potential for wide scale application to nationally representative samples of family physicians in Albanian populations.

Combining Both Generic and Disease-Specific Properties: Development of the McGill COPD Quality of Life Questionnaire

Presently, a generic and a disease-specific questionnaire are often co-administered to capture the different domains of quality of life in chronic obstructive pulmonary disease (COPD) subjects. A health-related-quality of life (HRQL) questionnaire in COPD combining both generic and disease-specific properties is needed. Objective: To develop a new, hybrid-HRQL questionnaire, the McGill-COPD-questionnaire, with qualities of both generic and disease-specific instruments. Using pre-defined criteria, we selected items from the SF-36 to complement the items from a COPD-specific-module to create the new hybrid-HRQL-questionnaire. Domains were identified via confirmatory factor analysis. The McGill COPD questionnaire is available in English and French; it assesses three domains: symptoms, physical-function and feelings, has 29 items: 17 from the COPD-specific-module and 12 from the SF-36. The symptom sub-scale has 6 items, all from the COPD-specific-module; the feelings sub-scale has 10 items, 5 each from COPD-specific-module and SF-36 and the physical-function sub-scale has 13 items, 6 from COPD-specific-module and 7 from SF-36. The McGill COPD questionnaire was developed using a novel method of combining items from the SF-36 and a COPD-specific-module. Thus, this new questionnaire has items from a generic-questionnaire and a disease-specific-module and, hence, is promising to be a stand alone quality-of-life questionnaire for COPD subjects.

Association between drug prescribing and quality of life in primary care

To evaluate quality of life among patients of Family Health Strategy Units and how it relates to the prescribing complexity and to the number of psychotropic medications prescribed, including adjustments for sociodemographic characteristics. Family Health Strategy Units in a municipality in the Brazilian state of Rio Grande do Sul. Cross-sectional study using face-to-face interviews and prescribing analysis among users of Family Health Strategy Units. Patients were recruited by consecutive sampling. Multiple linear regression models were fitted to the different domains of quality of life in the WHOQOL-Bref questionnaire. The response rate for the patients who completed the interview was 97%. The prescribed medication data and sociodemographic characteristics of the sample were included as covariates. Prescribing complexity was analyzed by means of the Medication Regimen Complexity Index. The assumptions in the estimated models were tested and the models were validated. Quality of life among patients of Family Health Strategy Units. At total, 336 patients answered the questionnaire. Through multiple linear regression, it was observed that higher prescribing complexity was associated with significantly low scores in the physical (-2.01, 95% CI = -2.89 to -1.35) and overall (-1.93, 95% CI = -2.81 to -0.99) quality of life domains. Greater amounts of psychotropic medications prescribed were associated with significantly low scores in the physical (-1.02, 95% CI = -1.29 to -0.56), psychological (-2.52, 95% CI = -3.15 to -1.65) and overall (-0.97, 95% CI = -2.06 to -0.33) domains of the interviewees' quality of life. The estimated models were adjusted for the sociodemographic characteristics of the sample and presented good predictive capacity. The evaluated aspects of the prescribed medication (complexity and presence of psychotropic medications) were associated with low scores in the physical, psychological and overall quality of life domains. This may be an intrinsic characteristic of the interviewed patients, like having the quality of life at such a low level before starting the treatment, that the medication could not improve it to normal levels. Also, it can be a demonstration of the ineffectiveness of these treatments within primary health care.

Impact of disability on different domains of health-related quality of life in the noninstitutionalized general population

The relationship between disability and health related quality of life (HRQL) is complex because of the role that function plays in the measurement, and certain points need to be dealt with in greater detail when the analysis is applied to the different dimensions of HRQL. The purpose of this study was to assess the impact of disability on different domains of quality of life. Variables were drawn from the 2002 Basque Country Health Survey. Logistic regression models were constructed to measure the adjusted effect of disability on quality of life as determined by the SF-36 questionnaire. The models were adjusted for sociodemographic variables and the presence of comorbidity. The greatest difference between disabled and nondisabled subjects was found in the physical components of the questionnaire. Odds Ratios (ORs) for a suboptimal level of quality of life as determined by functional status were much higher for the physical than for the mental dimensions. Adjustment for different variables showed a decrease in ORs in the physical, mental, and social dimensions. This study establishes a significant relationship between disability and the loss of quality of life in both physical and mental dimensions of SF-36, irrespective of the associated disease.

Disability and Health-Related Quality of Life after Breast Cancer Surgery: Relation to Impairments

The aim of this study was to determine the prevalence of impairments relevant to upper extremity following breast cancer surgery and its impact on disability and health-related quality of life. Sixty-seven female patients being treated with modified radical mastectomy or breast conserving surgery were included. They were evaluated for impairments (arm edema, loss of handgrip strength, limited shoulder joint range of motion, and pain), physical disability using the disabilities of the arm, shoulder, and hand (DASH) questionnaire, and for health related quality of life by means of the functional assessment of cancer therapy-breast+4 (FACT-B+4). The most common impairment observed was arm pain on motion; the cause of 20% variance in disability score (r = 0.203, P = 0.000). Arm pain on motion, anterior chest wall pain, loss of grip strength, and shoulder flexion were significant factors in different domains of quality of life according to the FACT-B+4 questionnaire. Pain relief should be the priority of treatment along with the prevention of joint movement restriction to ensure a sufficient quality of life for surgically treated breast cancer patients.

Quality of Life in Opium-Addicted Patients With Coronary Artery Disease as Measured With WHOQOL-BREF

Several factors can influence the quality of life in patients with coronary artery disease (CAD). The goal of this research was to measure quality of life in opium-addicted patients with CAD in order to assess the effect of CAD risk factors on their quality of life. The WHOQOL-BREF questionnaire was completed through interviews with 275 patients who underwent isolated coronary artery bypass surgery in Tehran Heart Centre between May and September 2006. No significant differences were found in the mean scores of the four domains of quality of life between the addicted and non-addicted patients. Furthermore, the evaluation of QOL in the groups with CAD risk factors showed that the mean QOL domains were statistically similar between opium addicted and non-opium addicted patients. In the addicted group, men had a higher psychological health score than women. A previous history of myocardial infarction reduced the psychological score in this group. Also, in the addicted patients with a history of diabetes mellitus, social functioning was better than that of the non-diabetics. The different domains of quality of life in our opium-addicted and non-addicted patients with CAD were similar; and among all the major risk factors for coronary artery disease, only female gender and a previous history of myocardial infarction could influence quality of life in the opium-addicted patients.

Association between quality of life and self-stigma, insight, and adverse effects of medication in patients with depressive disorders

The aims of this study were to examine whether different domains of quality of life (QOL) are differently affected by depressive disorders by comparing QOL of subjects with and without depressive disorders, and to examine the association of QOL with self-stigma, insight and adverse effects of medication among subjects with depressive disorders. The QOL on the four domains of the WHOQOL-BREF Taiwan version were compared between the 229 subjects with depressive disorders and 106 control subjects. Among the depressive subjects, the association between the four QOL domains and subjects' self-stigma, insight, and adverse effects of medication were examined using multiple regression analyses by controlling for the influence of depression, socio-demographic and clinical characteristics and family function. Depressive subjects had poorer QOL on the physical, psychological and social relationship domains than the non-depressive control group. The depressive subjects who had more severe self-stigma had poorer QOL on all four domains. The depressive subjects who perceived more severe adverse effects from medication had poorer QOL on the physical, psychological and environmental domains. However, insight was not associated with any domain of QOL in patients with depressive disorders. The results of this study demonstrate that different domains of QOL are differently affected by depressive disorders, and that clinicians must consider the negative influences of self-stigma and adverse effects from medication on QOL of subjects with depressive disorders.

Coping and quality of life after tumor surgery: Personal and social resources promote different domains of quality of life

Personal and social resources facilitate the adaptation to critical life events. The present study investigates whether general self-efficacy beliefs and received social support elevate cancer patients’ physical, emotional, and social well-being directly, or whether these effects are rather mediated by active or meaning-focused coping. Gastrointestinal, colorectal, and lung cancer patients were approached at 1 month and at 6 months after surgery (N=175). Structural equation models indicate that self-efficacy at 1 month after surgery exerted a positive direct effect on all three domains of health-related quality of life at 6 months after surgery, but indirect effects through active and meaning-focused coping were also observed. Initial received support elevated later emotional well-being, but not the other two quality of life domains. This effect was not mediated by coping. Results suggest the development of interventions to increase optimistic self-beliefs and coping skills in tumor-surgery patients.

Association between quality of life and self-stigma, insight, and adverse effects of medication in patients with depressive disorders

Background: The aims of this study were to examine whether different domains of quality of life (QOL) are differently affected by depressive disorders by comparing QOL of subjects with and without depressive disorders, and to examine the association of QOL with self-stigma, insight and adverse effects of medication among subjects with depressive disorders. Method: The QOL on the four domains of the WHOQOL-BREF Taiwan version were compared between the 229 subjects with depressive disorders and 106 control subjects. Among the depressive subjects, the association between the four QOL domains and subjects' self-stigma, insight, and adverse effects of medication were examined using multiple regression analyses by controlling for the influence of depression, socio-demographic and clinical characteristics and family function. Results: Depressive subjects had poorer QOL on the physical, psychological and social relationship domains than the non-depressive control group. The depressive subjects who had more severe self-stigma had poorer QOL on all four domains. The depressive subjects who perceived more severe adverse effects from medication had poorer QOL on the physical, psychological and environmental domains. However, insight was not associated with any domain of QOL in patients with depressive disorders. Conclusions: The results of this study demonstrate that different domains of QOL are differently affected by depressive disorders, and that clinicians must consider the negative influences of self-stigma and adverse effects from medication on QOL of subjects with depressive disorders. Depression and Anxiety 26:1033–1039, 2009. © 2009 Wiley-Liss, Inc.

A cross-sectional study on quality of life in geriatric population

Correspondence to: Dr. Ankur Barua, Department of Community Medicine, Sikkim-Manipal Institute of Medical Sciences (SMIMS), 5th Mile Tadong, Gangtok 737 102, Sikkim, India. E-mail: ankurbarua26@yahoo.com Received: 17.05.04 All the aspects of “health status”, “life style”, “life satisfaction”, “mental state” or “well-being” together reflect the multi-daimensional nature of Quality of Life in an individual.(1,2) Geriatric mental health problems with respect to the quality of life often remains neglected.(3-5) Hence, this mental health study was conducted to explore the different domains of quality of Life affected by sociodemographic factors in elderly population.

Personal and Interpersonal Perceived Control and the Quality of Life of Persons With Severe Mental Illness

Studies have been carried out to explore the impact of sense of control on the outcome of persons with severe mental illness (SMI). However, few studies have compared the differential effects of perceived personal control (control of the self) and perceived interpersonal control (the control of significant others). In the present study, we investigated the relations between perceived personal and perceived interpersonal control and different domains of quality of life (QOL) of persons with SMI. Measures of perceived personal and interpersonal control and QOL were administered to 145 participants with a diagnosis of SMI (schizophrenia, affective disorders, anxiety disorders, personality disorders). The results showed personal control to be positively related to various domains of QOL (beta = .28-.31, p < 0.001-0.01) while interpersonal control was negatively related to the physical domain of QOL (beta= -.20, p < 0.05). Theoretical, empirical, and clinical implications of the distinction between personal and interpersonal control for persons with SMI are discussed.

Impact of an exercise program on physical, emotional, and social aspects of quality of life of individuals with Parkinson's disease

We evaluated changes in different domains of quality of life (QL) for persons with Parkinson's disease after a program of physical activity. Twenty subjects with a diagnosis of Parkinson's disease classified as Stages 1 to 3 on the Hoehn and Yahr scale and with a mean age of 61.5 +/- 9.8 years participated in 36 group sessions of a combined group program of aerobic conditioning and muscular strengthening. QL was investigated by the Nottingham Health Profile, a generic questionnaire composed of six domains. Student's paired t tests indicated significant gains associated with the program (P < 0.05) on the total score and those related to emotional reactions (ER), social interactions (SI), and physical ability (PA). SI was the domain that showed the greatest program gains (41.4%). The program of physical activity performed with persons with Parkinson's disease at light to moderate stages resulted in improvements in their perception of QL, mainly in the domains of ER, SI, and PA.

Assessment of the domains of quality of life in the geriatric population.

Background:The number of studies from India on geriatric health problems, particularly mental health disorders and quality of life, is limited.Aim:This cross-sectional study was carried out in the geriatric population visiting the Dr T.M.A. Pai Rotary Hospital, Karkala, Karnataka. It examined the different domains of quality of life according to sociodemographic variables.Methods:We studied 70 individuals in the geriatric age group (≥60 years) who visited the hospital over a period of two months from March 2003 to April 2003. The results were expressed in terms of mean and SE of mean. Z-test and one-way ANOVA test were applied to compare the mean scores of different variables under the four domains. A p value <0.05 was considered significant.Results:The total mean score, as well as the mean scores in each of the four domains studied were similar in men and women as well as literates and illiterates. The mean scores of subjects in various age groups differed significantly in the domains of physical, psychological and social relations, while single and married subjects differed significantly in the domains of environmental and social relations. Overall well-being was significantly affected in those who were single (unmarried/widowed) or in the age group of 60–69 years.

Quality of life and tinnitus

Tinnitus is a common finding which can adversely affect the quality of life in a relatively small proportion of individuals. The aspects of quality of life affected may differ between individuals but the commonest are psychological or emotional effects, impact on lifestyle, sleep disturbance, auditory and health effects. There is a number of types of measures used to assess the quality of life effects of tinnitus. Generic measures may be used to compare the effects of tinnitus with other conditions before and after intervention and may have a useful application in resource allocation. Tinnitus‐specific measures can be helpful in identifying the specifically troublesome effects of tinnitus and the impact of tinnitus on different domains of quality of life. These can be useful in planning rehabilitative strategies and assessing outcome measures of different interventions. Both generic and tinnitus‐specific measures use a variety of approaches, and the uses and limitations of each approach and type of measur...