Life In Chronic Disease Research Articles

Proactive Coping in Early Pregnancy and Adverse Pregnancy Outcomes.

Outside of pregnancy, proactive coping has been associated with both mental and physical well-being and with improved quality of life in chronic disease, but its effects in pregnancy are understudied. Our objective was to evaluate whether early pregnancy proactive coping was associated with adverse perinatal outcomes. This was a planned secondary analysis of nulliparous pregnant people recruited from a tertiary care center. Participants completed a validated assessment of proactive coping (Proactive Coping Scale) at 8-20 weeks and were followed longitudinally through delivery. Detailed pregnancy and delivery data were collected by trained research personnel. The primary outcome was a composite of adverse perinatal outcomes including unplanned cesarean delivery, gestational diabetes, and hypertensive disorders of pregnancy. Secondary analyses included individual perinatal composite components and a neonatal morbidity composite measure. Multivariate regression compared adverse perinatal outcomes by Proactive Coping Scale quartile, controlling for a priori confounders. Of the 281 parturients, the median Proactive Coping Scale score was 45.0 (range 25-55), and 47% experienced an adverse perinatal outcome. After adjusting for confounders, those in the lowest Proactive Coping Scale quartile had 2.2 times higher odds of experiencing an adverse perinatal outcome compared to those in the highest Proactive Coping Scale quartile. There were no differences in odds of the individual composite components or the adverse neonatal outcome. Lower early pregnancy proactive coping scores are associated with significant increase in adverse perinatal outcomes. Interventions that target improving proactive coping may be a novel mechanism for reducing perinatal morbidity.

Assessment of Health Education in The Prevention of Non-Communicable Chronic Disease Complications: Systematic Review

Objective: To evaluate the effectiveness of health education in the prevention of non-communicable chronic diseases. Method: This is a systematic literature review, guided by the question "In patients with non-communicable chronic diseases (NCDs), does health education compared to conventional clinical practice contribute to the prevention of complications?". The selected articles were extracted from the following databases: Biblioteca Virtual em Saúde (BVS), National Library of Medicine (PUBMED), Scientific Electronic Library Online (Scielo), Regional Online Information System for Scientific Journals from Latin America, the Caribbean, Spain, and Portugal (Latindex), and Cochrane Library. Randomized clinical trials in English, Portuguese, and Spanish from the last 10 years with full-text availability were chosen as eligibility criteria, resulting in a final sample of 10 articles. Results: Positive findings were observed regarding the complications of non-communicable diseases, such as: improvement in quality of life and cardiac anxiety scores; reduction in anxiety and depression; increased therapeutic adherence, diabetic foot care, physical activity stimulation, adoption of healthy eating habits, blood glucose self-monitoring and health literacy improvement; reduction in systolic and diastolic blood pressure; improvement in self-management of Type 2 Diabetes Mellitus; overall prevention of NCDs; promotion of motivation for behavioral change in smoking patients, and improvement in renal function with a considerable decrease in serum creatinine and a stable glomerular filtration rate. Implementing educational programs can be helpful in enhancing the quality of life in chronic diseases. Conclusion: Despite the limitation resulting from the diversity of interventions, the consistency in results highlights the beneficial impact of educational approaches, calling for attention from healthcare professionals and public policymakers to expand the use of these strategies in the management of NCDs.

Effects of medical interventions on health-related quality of life in chronic disease - systematic review and meta-analysis of the 19 most common diagnoses.

The demographic shift leads to a tremendous increase in age-related diseases, which are often chronic. Therefore, a focus of chronic disease management should be set on the maintenance or even improvement of the patients' quality of life (QoL). One indicator to objectively measure QoL is the EQ-5D questionnaire, which was validated in a disease- and world region-specific manner. The aim of this study was to conduct a systematic literature review and meta-analysis on the QoL across the most frequent chronic diseases that utilized the EQ-5D and performed a disease-specific meta-analysis for treatment-dependent QoL improvement. The most common chronic disease in Germany were identified by their ICD-10 codes, followed by a systematic literature review of these ICD-10 codes and the EQ-5D index values. Finally, out of 10,016 independently -screened studies by two persons, 538 studies were included in the systematic review and 216 studies in the meta-analysis, respectively. We found significant medium to large effect sizes of treatment effects, i.e., effect size >0.5, in musculoskeletal conditions with the exception of fractures, for chronic depression and for stroke. The effect size did not differ significantly from zero for breast and lung cancer and were significantly negative for fractures. Our analysis showed a large variation between baseline and post-treatment scores on the EQ-5D health index, depending on the health condition. We found large gains in health-related quality of life mainly for interventions for musculoskeletal disease. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020150936, PROSPERO identifier CRD42020150936.

Quality of Life in Chronic Diseases

Over the past few decades, there has been a increasing prevalence of chronic diseases, live with a large number of people chronic diseases that may adversely affect them quality of life. The goal of the current work is to To investigate quality of life, particularly health-related quality of life (HRQoL) in patients with chronic diseases. HRQOL is a multidimensional structure It consists of at least three large domains − physical, mental and social functioning − affected by disease and/or treat. HRQoL usually starts with chronically ill and often impaired most. In addition, the following factors Also correlated with good and bad HRQoL Discussed as HRQoL assessment. That Estimating the relative impact of chronic diseases Necessary for HRQoL disease Better plan and allocate healthcare Resources to Improve HRQoLOver the past few decades, there has been a increasing prevalence of chronic diseases, live with a large number of people chronic diseases that may adversely affect them quality of life. The goal of the current work is to To investigate quality of life, particularly health-related quality of life (HRQoL) in patients with chronic diseases. HRQOL is a multidimensional structure It consists of at least three large domains − physical, mental and social functioning − affected by disease and/or treat. HRQoL usually starts with chronically ill and often impaired most. In addition, the following factors Also correlated with good and bad HRQoL Discussed as HRQoL assessment. That Estimating the relative impact of chronic diseases Necessary for HRQoL disease Better plan and allocate healthcare Resources to Improve HRQoL

Quality of Life in Chronic Diseases

Over the past few decades, there has been a increasing prevalence of chronic diseases, live with a large number of people chronic diseases that may adversely affect them quality of life. The goal of the current work is to To investigate quality of life, particularly health-related quality of life (HRQoL) in patients with chronic diseases. HRQOL is a multidimensional structure It consists of at least three large domains − physical, mental and social functioning − affected by disease and/or treat. HRQoL usually starts with chronically ill and often impaired most. In addition, the following factors Also correlated with good and bad HRQoL Discussed as HRQoL assessment. That Estimating the relative impact of chronic diseases Necessary for HRQoL disease Better plan and allocate healthcare Resources to Improve HRQoLOver the past few decades, there has been a increasing prevalence of chronic diseases, live with a large number of people chronic diseases that may adversely affect them quality of life. The goal of the current work is to To investigate quality of life, particularly health-related quality of life (HRQoL) in patients with chronic diseases. HRQOL is a multidimensional structure It consists of at least three large domains − physical, mental and social functioning − affected by disease and/or treat. HRQoL usually starts with chronically ill and often impaired most. In addition, the following factors Also correlated with good and bad HRQoL Discussed as HRQoL assessment. That Estimating the relative impact of chronic diseases Necessary for HRQoL disease Better plan and allocate healthcare Resources to Improve HRQoL

Beliefs about the Benefits and Barriers to Physical Activity Promotion for Cancer Patients among Nurses in Malaysia

Introduction: Physical activity (PA) can improve survival and quality of life in chronic diseases including cancer. Given the scarcity of research on nurses’ beliefs that used a psychology perspective, the purpose of this study was to determine nurses’ beliefs about the benefits and barriers to physical activity promotion for cancer patients at a tertiary teaching hospital in Malaysia. Methods: A cross-sectional study was performed on nurses (n=104) at one Malaysian tertiary teaching hospital, using a simple random sampling method. A self-administered online questionnaire was surveyed from January until March 2021. The data was analysed using Pearson correlation analysis and an independent T-test with a significant level of p ≤.0.05. Results: 80.8% of nurses perceived the benefits of physical activity promotion for improving mental health in cancer patients. Lack of time (30.8%), patients appearing tired or unwilling to cooperate (20.2%), and a lack of knowledge (16.3%) were the barriers to physical activity. There was no correlation between beliefs about the benefits of physical activity promotion and age (p=0.908), working experience (p=0.982), ward type (p=0.666) or the average number of cancer patients cared (p=0.144). Conclusion: Nurses’ perspectives on the benefits of physical activity promotion for cancer patients support the use of planned behaviour theory for evidence-based nursing practice. There were, however, barriers to encouraging cancer patients to engage in physical activity. As a result, as a setting for health promotion, the tertiary teaching hospital must raise awareness, facilitate, and encourage nurses to engage in physical activity promotion behaviours.

Quality of Life and Its Relevant Factors in Menopausal Women

Introduction: Menopause is an essential part of human life that affects women's quality of life (QOL). Objective: This study investigated the quality of life and some relevant factors in menopausal women. Materials and Methods: This cross-sectional study was conducted on 45-60 years old menopausal women in 3 areas of Kashan city, Iran in 2018. By cluster sampling method, 236 participants were included in the study. The study questionnaires consist of demographic and obstetric information and menopausal quality of life (MENQOL). The Kolmogorov-Smirnov test, t test, the Pearson and Spearman correlation tests, as well as linear regression analysis, were used for data analysis. Results: The mean ±SD age of the women was 52.65 ±3.67 years. Also, their mean±SD years lapsed menopause was 2.89 ±1.53, and the mean ±SD for QOL was 31.24 ±11.47. There were no significant correlations between QOL and women's age, menopausal age, and elapsed years since menopause. Based on linear regression analysis, the variables of age (B= 2.61, 95%CI; 0.46-4.77, P=0.02), menopausal age (B= -2.19, 95%CI; -4.39 - -0.01, P=0.049), and satisfaction of spouse ((B= -4.90, 95%CI; -8.45- -0.35, P=0.007) remained in the model as relegated variables to quality of life (R2 = 11.8%). Conclusion: Since most women had moderate menopausal QOL score, intervention programs to improve the QOL for postmenopausal women is recommended in health centers. Further studies are suggested to evaluate the quality of life in chronic diseases of postmenopausal women.

Naturalizing digital and quality of life in chronic diseases: Systematic review to research perspective into technological advancing and personalized medicine.

The increasing of chronic diseases and related health management are the main clinical and public health challenges. The long-term nature and the need for continuous monitoring in chronic disease management gave rise to early technological innovations (mobile Health) to improve care management plans, therapeutic adherence, and psychological support to the patient. This review aimed to map the literature on the impact of the use of wearable device on quality of life in patients with chronic diseases. We performed a systematic search of MEDLINE through PubMed, Web of Science, and Scopus of all scientific literature published until January 2022. Based on inclusion and exclusion criteria, a total of 10 papers were included. This review pointed out the relevant focus on the use of wearable device in chronic disease patients highlighting the wearable device impact on several domains including quality of life, Self-Efficacy, Self-Management, and feelings on patients with chronic diseases. The available scientific literature related to the impact of the use of wearable device on quality of life and psychological features in patients with chronic diseases, general underline a need to develop professional healthcare guidelines and tailored intervention on patients with a chronic condition, using mobile Health solutions and trying to fill the lack of knowledge about the topic.

The efficacy of homoeopathy on enhancement in quality of life in children with epilepsy

Objectives: To study the improvement in the Quality of Life in Epilepsy affected Children’s with Homoeopathic medicines. To find the Homoeopathic remedies in the treatment of Epilepsy from complete repertory.Background: Children with epilepsy particularly suffer from the Problems with Chronic antiepileptic medication use which is associated with possible side effects and have an influence on a child´s overall health and quality of life. Homeopathy system of medicine which not only relieves the symptom of the disease but also improve the quality of life in chronic diseases, as the medicine selection is based on the individuality of the patient. Materials and Methods: Random selection of 15 cases presenting with similar symptoms of Epilepsy from the OPD, and peripheral centres of Sarada Krishna Homoeopathic Medical College are taken. Pre and post treatment analysis was done using Quality of Life in Childhood Epilepsy scale score (QOLCE-55).Remedies prescribed based on the rubrics selected from the complete repertory.Result and Conclusion: Comparing the before and after scores based on Quality of life scale 55 for epilepsy of all the 15 cases taken for this study, 7 cases showed marked improvement, 5 cases showed moderate improvement, 1 case showed mild improvement and 2 case did not show any improvement. The study concludes that individualistic approach of Homoeopathy on epilepsy affected children’s found effective in the management of epilepsy as well as improvement in the quality of life.

Acceptance of illness and quality of life in patients with type 2 diabetes

Background: results of studies concerning the quality of life in chronic diseases and the predictors thereof are a source of valuable information making it possible to take the right actions, both educational, at every stage, and therapeutic. The assessment acceptance of illness and the quality of life enables the identification of patients' actual problems and objections as well as the recognition of their needs for the purpose of treatment optimization.Objective: The aim of the study was to evaluate the acceptance of the disease and the quality of life of patients with type 2 diabetes.Materials and methods: The study assessed disease acceptance and the quality of life in 194 people living with type 2 diabetes for over 10 years. The AIS (Acceptance of Illness) and WHOQoL –BREF questionnaires were used.Results: Acceptance of illness in the study group was average 24.21 points (SD=8.61).Patients are not satisfied with the quality of their life and their own health. According to the assessment of patients, the quality of their life is the highest in the social domain (mean13.72±2.18), slightly worse in the environmental domain (mean 13.31±2.1) and it is the worst in the mental (mean12.82±2.78) and physical (mean 12.02±3.24) domain. The AIS result significantly and positively correlated with each domain of life (all of them p<0.05), therefore, the higher the AIS result (better acceptance of illness).Conclusion: Acceptance of illness is an independent predictor of the quality of life in terms of the perception of own health and the perception of the quality of life in general. It also affects all domains of life. The greater the acceptance of illness, the higher the quality of life in all domains.

Overview of Systematic Reviews with Meta-Analysis Based on Randomized Controlled Trials of Balneotherapy and Spa Therapy from 2000 to 2019.

BackgroundThe objectives of this review were to summarize systematic reviews with meta-analysis of balneotherapy (BT) and spa therapy (ST) based on randomized controlled trials, and to provide a perspective for future research.MethodsEligible studies were systematic reviews based on randomized controlled trials with meta-analysis that included at least one group treated with BT or ST. We searched the following databases for articles published in English from the year 2000 to 20 November 2019: Cochrane Database Systematic Review, MEDLINE, CINAHL, Web of Science, and Ichushi-Web.ResultsEighteen studies met all inclusion criteria. Based on the International Classification of Diseases (ICD)-11, among these 18 studies, 8 (44%) were about “#15 Diseases of the musculoskeletal system or connective tissue”, 5 (28%) were about “#21 Symptoms, signs or clinical findings, not elsewhere classified”, 4 (22%) were about “#11 Diseases of the circulatory system”, and 1 study (6%) was about “#8 Diseases of the nervous system”. Both BT and ST provided significant pain relief and improved quality of life in chronic diseases of the musculoskeletal system and connective tissues. Additionally, BT and ST with exercise under water improved physical fitness and function in patients across diseases.ConclusionResearchers need to conduct studies on the treatment of many kinds of potential diseases using the keywords of pain relief and QoL. In addition, depending on patients’ symptoms, physical fitness, and disabilities, performing exercise under water may improve treatment effects on physical function and fitness.

Associations of sense of coherence and self-efficacy with health status and disease severity in COPD

Sense of coherence and self-efficacy has been found to affect health-related quality of life in chronic diseases. However, research on respiratory diseases is limited. Here we report findings on quality of life (QoL) of COPD patients and the associations with coherence and self-efficacy. This study consists of the Greek national branch of the UNLOCK study, with a sample of 257 COPD patients. Coherence and self-efficacy are positively inter-correlated (Pearson rho = 0.590, p < 0.001). They are negatively correlated with the quality of life (CAT) [Pearson rho: coherence = −0.29, p < 0.001; self-efficacy = −0.29, p < 0.001) and mMRC (coherence = −0.37, p < 0.001; self-efficacy rho = −0.32, p < 0.001)]. Coherence is inversely associated with (Global Initiative for Chronic Obstructive Lung Disease) GOLD 2018—CAT and GOLD 2018—mMRC classification and “having at least one exacerbation in the past year”. Findings are stressing the need for their incorporation in primary health care and COPD guidance as it maybe that enhancing coherence and self-efficacy will improve QoL.

The quality of life of the patients with diabetes type 2 using EQ-5D-5\u2009L in Birjand

BackgroundDue to high prevalence of diabetes and its complications, evaluating of the patients’ quality of life is critical. EQ-5D-5 L is a valid tool for assessing the quality of life in chronic diseases including diabetes. The present study conducted to illustrate the quality of life for the patients who referred to the Diabetes clinic and determine its relationship with their demographic and clinical characteristics in Birjand in 2017.MethodsIn this cross-sectional study, 300 patients with type 2 diabetes were selected through a systematic sampling in 2017. Data were collected using a checklist including patients’ demographic, clinical and laboratory information and the EQ-5D-5 L. Data were entered the SPSS (22) software, analyzed by independent sample T-test, ANOVA, Chi-Square and logistic regression tests. Statistical significance was inferred at α = 0.05.ResultsMean age for the participants was 58.1 ± 9.6 years. The mean score for the quality of life based on the EQ-5D-5 L and VAS scale were 0.89 ± 0.13 and 65.22 ± 9.32, respectively. Moderate and severe problems were found in the anxiety/depression dimensions in 12% of the patients, while these numbers for the presence of pain/discomfort and mobility were slightly higher (13.7 and 13.6%, respectively). The mean scores for quality of life and VAS were significantly higher in the men, employed and patients < 50 years age.ConclusionThe quality of life for the type 2 diabetes patients is affected by numerous factors including sex, occupation, duration of the disease and the presence of complications such as neuropathy and nephropathy.

Impact of acute-on-chronic liver failure and decompensated liver cirrhosis on psychosocial burden and quality of life of patients and their close relatives

BackgroundPatients with liver cirrhosis often suffer from complications such as ascites, gastrointestinal bleeding, and infections, resulting in impaired quality of life. Frequently, the close relatives of patients also suffer from a lower quality of life in chronic diseases. In recent years, acute-to-chronic liver failure has been defined as a separate entity with high mortality. Often several organs are affected which makes intensive care therapy necessary. Little is known about the influence of acute-on-chronic-liver failure (ACLF) on the quality of life of patients and the psychosocial burden on close relatives.AimThe purpose of this prospective study is to investigate the influence of decompensated liver cirrhosis and the onset of ACLF of the patient’s’ quality of life and the psychosocial burden of close relatives.MethodIn this non – randomized prospective cohort study a total of 63 patients with acute decompensation of liver cirrhosis and hospital admission were enrolled in the study. To assess the quality of life of patients, the disease specific CLDQ questionnaire was assessed. In addition. Quality of life and psychosocial burden of first degree relatives was measured using the generic SF-36 questionnaire as well as the Zarit Burden Score.Results21 of the 63 patients suffered from ACLF. Patients with ACLF showed a lower quality of life in terms of worries compared to patients with only decompensated liver cirrhosis (3,57 ± 1,17 vs. 4,48 ± 1,27; p value: 0,008) and increased systemic symptoms (3,29 ± 1,19 vs. 4,48 ± 1,58; p value: 0,004). The univariate analysis confirmed the link between the existence of an ACLF and the concerns of patients. (p value: 0,001). The organ failure score was significantly associated with overall CLDQ scores, especially with worries and systemic symptoms of patients. Interestingly the psychosocial burden and quality of life of close relative correlates with patient’s quality of life and was influenced by the onset of an acute-on-chronic liver failure.ConclusionPatients with decompensated liver cirrhosis suffer from impaired quality of life. In particular, patients with ACLF have a significantly reduced quality of life. The extent of the psychosocial burden on close relative correlates with poor quality of life in patients with decompensated liver disease and is influenced by the existence of ACLF.

Quality of life in chronic diseases, the role of the family

Introduction. Everyone, especially the sick, wants closeness and understanding. He seeks contact with his nearest and dearest, with his family. The family becomes a support for the sick person. A sick person usually expects a balanced interest and willingness to help when he or she requests it. At the same time, especially a chronically ill person needs respect, acceptance of limited physical abilities, various forms of disability often resulting from the progress of the illness, acceptance of a long stay in bed, sometimes its emotional lability.Aim of the study. The aim of the work was to briefly discuss the importance of quality of life, with particular emphasis on the quality of life in a chronic disease, on characterising the contem-porary significance of the family and its role in the life of a chronically ill person.Selection of materials. The search was conducted in the Scopus database for the period 2003-2019, using the terms chronic dis-ease, quality of life in chronic disease, the family, its role in the life of a chronic patient. From the literature found in the Google Scholar database, studies were selected which, in the opinion of the authors, would be most useful in the preparation of this study.Conclusions. The family should be a sensitive observer of the patient's condition. This applies especially to sick children. Par-ents must not allow the child's confidence to be reduced. They must be a reliable partner in discussions with the sick child. They must know the child's needs and expectations skilfully. This will in many situations increase proximity and understanding.

Two-month breathing-based walking improves anxiety, depression, dyspnoea and quality of life in chronic obstructive pulmonary disease: A randomised controlled study.

To examine the effects of the two-month breathing-based walking intervention and its follow-up on anxiety, depression, dyspnoea and quality of life in patients with chronic obstructive pulmonary disease. Mind-body-related exercises improve bio-psychological symptoms and quality of life in chronic diseases, but these improvements are not proven for chronic obstructive pulmonary disease. This was a randomised controlled study and applied the Consolidated Standards of Reporting Trials (CONSORT) statement. Outpatients diagnosed with chronic obstructive pulmonary disease were recruited from a medical centre in Taiwan and randomly assigned to two groups. The walking group (n=42) received breathing, meditation and walking for two months, and the control group (n=42) did not. Data from the outcomes of anxiety, depression, dyspnoea and quality of life were collected at baseline and in Month 1, Month 2 and Month 3. Clinical trial registration was done (ClinicalTrials.gov.: NCT03388489). The results showed significant changes in anxiety, depression, dyspnoea and quality of life in the walking group across three months, compared to those in the control group and at baseline. This breathing-based walking intervention is promising to achieve bio-psychological well-being for patients with chronic obstructive pulmonary disease. This breathing-based walking, as a mind-body exercise, could serve as an evidence-based nursing care that contributes to improving anxiety, depression, dyspnoea and quality of life in stable chronic obstructive pulmonary disease outpatients. The feasibility and acceptability of the breathing-based walking were met the requirement of the chronic obstructive pulmonary disease outpatients, which could be considered as home-based exercise.

Ingestible Contrast Agents for Gastrointestinal Imaging.

Gastrointestinal (GI) ailments cover a wide variety of diseases involving the esophagus, stomach, small intestine, large intestine, and rectum. They bring about many inconveniences in daily life in chronic diseases and can even be life threatening in acute cases. Rapid and safe detection approaches are essential for early diagnosis and timely management. Contrast agents for GI imaging can enhance contrast to distinguish abnormal lesions from normal structures. Computed tomography and magnetic resonance imaging are two important diagnostic tools for the evaluation of GI conditions. This review mainly involves several common GI diseases, including inflammatory diseases, intestinal tumors, diarrhea, constipation, and gastroesophageal reflux diseases. Selected contrast agents, such as barium sulfate, iodine-based agents, gadolinium-based agents, and others, are summarized. Going forward, continued endeavors are being made to develop more emerging contrast agents for other imaging modalities.

Improving the assessment of medication adherence: Challenges and considerations with a focus on low-resource settings.

Improving patient survival and quality of life in chronic diseases requires prolonged and often lifelong medication intake. Less than half of patients with chronic diseases globally are adherent to their prescribed medications which preclude the full benefit of treatment, worsens therapeutic outcomes, accelerates disease progression, and causes enormous economic losses. The accurate assessment of medication adherence is pivotal for both researchers and clinicians. Medication adherence can be assessed through both direct and indirect measures. Indirect measures include both subjective (self-report measures such as questionnaire and interview) and objective (pill count and secondary database analysis) measures and constitute the mainstay of assessing medication adherence. However, the lack of an inexpensive, ubiquitous, universal gold standard for assessment of medication adherence emphasizes the need to utilize a combination of measures to differentiate adherent and nonadherent patients. The global heterogeneity in health systems precludes the development of a universal guideline for evaluating medication adherence. Methods based on the secondary database analysis are mostly ineffectual in low-resource settings lacking electronic pharmacy and insurance databases and allowing refills without updated, valid prescriptions from private pharmacies. This significantly restricts the choices for assessing adherence until digitization of medical data takes root in much of the developing world. Nevertheless, there is ample scope for improving self-report measures of adherence. Effective interview techniques, especially accounting for suboptimal patient health literacy, validation of adherence questionnaires, and avoiding conceptual fallacies in reporting adherence can improve the assessment of medication adherence and promote understanding of its causal factors.

Therapeutic Relationship and Quality of Life in Chronic Diseases

The relationship between healthcare professionals and patients is a special form of human relationship. The interpersonal relationship developed among the patient and the caregiver involves not only communication and active listening, but also emotions from both sides. The establishment of a therapeutic relationship and the roles within it are largely determined by the behavior of those involved. A therapeutic relationship requires effective communication and empathy of the nurse practitioner, as well as the patient’s active participation in the process. The quality of the relationship between two people is the most important element in determining the effectiveness of the care delivered.

Optimism on quality of life in Portuguese chronic patients: moderator/mediator?

optimism is an important variable that has consistently been shown to affect adjustment to quality of life in chronic diseases. This study aims to clarify if dispositional optimism exerts a moderating or a mediating influence on the personality traits-quality of life association, in Portuguese chronic patients. multiple regression models were used to test the moderation and mediation effects of dispositional optimism in quality of life. A sample of 729 patients was recruited in Portugal's main hospitals and completed self-reported questionnaires assessing socio-demographic and clinical variables, personality, dispositional optimism, quality of life (QoL) and subjective well-being (SWB). the results of the regression models showed that dispositional optimism did not moderate the relationships between personality traits and quality of life. After controlling for gender, age, education level and severity of disease perception, the effects of personality traits on QoL and in SWB were mediated by dispositional optimism (partially and completely), except for the links between neuroticism/openness to experience and physical health. dispositional optimism is more likely to play a mediating, rather than a moderating role in personality traits-quality of life pathway in Portuguese chronic patients, suggesting that "the expectation that good things will happen" contributes to a better quality of life and subjective well-being.