Lower Social Functioning Scores Research Articles

Early Bereavement Psychosocial Outcomes in Parents of Children Who Died of Cancer With a Focus on Social Functioning.

The early grief experience of parents of children who died of cancer remains understudied. Understanding psychosocial symptomology and functioning of parents early in their bereavement is essential to developing supportive interventions aimed at offsetting poor mental and physical outcomes. Parents of children from two centers who died of cancer 6 to 24 months before were mailed a survey that included validated tools and additional Likert scale-based questions. We used correlation and univariate and multiple regression analyses to assess the associations between psychosocial and grief outcomes and parental social functioning. One hundred twenty-five parents representing 88 children completed the survey. Most respondents identified as female (63%), White (84%), and non-Hispanic (91%). The mean time since child's death was 14.7 (range, 8-26) months. Bereaved parents' mean score for social functioning was only slightly below normative values, and most parents indicated post-traumatic growth and adaptive coping. Parents had high symptom levels for depression, anxiety, post-traumatic stress, and prolonged grief, with those identifying as female having significantly higher symptom scores. Using multivariate analysis, parental scores for resilience and continuing bonds were associated with higher social functioning scores and parental scores for depressive symptoms and prolonged grief were associated with lower social functioning scores. Although bereaved parents exhibit resilience and positive coping, they also show high levels of psychosocial distress in the first 2 years after their child's death, which may reflect the typical parental bereavement experience. Screening for low parental social functioning may identify parents who would benefit from additional support early in bereavement.

A-107 Historyt of Remote Mild TBI Predicts Poor Health-Related Quality of Life Outcomes in Military Veterans

Abstract Objective We examined health-related quality of life (QOL) in military Veterans with and without a history of mild traumatic brain injury (mTBI). Additionally, we investigated how mTBI injury characteristics modify health-related QOL. Method Veterans with a history of remote mTBI (n = 81) and military controls (MCs) without a history of mTBI (n = 62) completed self-report questionnaires measuring combat exposure, posttraumatic stress disorder (PTSD) and neurobehavioral symptoms, and health-related QOL. Primary outcomes included the eight subscales of the 36-Item Short-Form Survey (SF-36). Results ANCOVAs adjusting for combat exposure and PTSD symptoms found that the mTBI group demonstrated significantly more health-related QOL symptoms when compared to MCs across the following SF-36 subscales: General Health, Vitality, Bodily Pain, Physical Role Functioning, and Social Functioning (p = .001–.045, ηp2 = 0.03–0.07). Within the mTBI sample, repetitive mTBI, combat exposure, and PTSD and neurobehavioral symptoms collectively significantly predicted all five QOL subscales (all p’s < .001), accounting for roughly 33–53% of the total variance. Greater neurobehavioral symptoms were associated with lower Physical Role Functioning, Vitality, and Social Functioning scores; repetitive TBI was associated with higher Bodily Pain scores; greater PTSD symptoms were associated with lower Social Functioning scores; and greater combat exposure was associated with lower General Health scores. Conclusions Results suggest that, over and above PTSD and combat exposure, mTBI status independently contributes to health-related QOL. Moreover, specific dimensions of health-related QOL are influenced by different factors, with affective and vestibular-related neurobehavioral symptoms showing the strongest negative associations with health-related QOL. Findings highlight the need for comprehensive assessment and multimodal treatment within this vulnerable population.

The impact on quality of life from informing diagnosis in patients with cancer: a systematic review and meta-analysis

BackgroundThe aim of this study was to assess the impact on quality of life from informing patients with cancer of their diagnosis and disease status.MethodWe searched the follow databases, PubMed, CENTRAL (Cochrane Central Register of Controlled Trials), PsycINFO, WEB OF SCIENCE, Embase, CBM (Chinese Biomedical Literature database), WANFANG database (Chinese Medicine Premier), and CNKI (China National Knowledge Infrastructure), using the following terms: neoplasm, cancer, tumor, tumor, carcinoma, disclosure, truth telling, breaking bad news, knowledge, knowing, awareness, quality of life, QOL. Pairs of reviewers independently screened documents and extracted the data, and the meta-analysis was performed using Revman 5.0 software.ResultsEleven thousand seven hundred forty records retrieved from the databases and 23 studies were included in the final analysis. A meta-analysis revealed that there were no differences in either the general quality of life and symptoms of fatigue, pain, dyspnea, insomnia, appetite loss, and diarrhea, between informed and uniformed cancer patients (P > 0.05). There were also no differences found between the patient groups in physical function, role function, cognitive activity, and emotional function (P > 0.05). In terms of vitality, patients who were completely informed about their diagnosis showed higher vitality than uniformed patients. Uninformed patients seemed to have lower social function scores. Between partly informed and uninformed cancer patients, no differences were found in their general quality of life, function domains, and disease-related symptoms (P > 0.05).ConclusionInforming cancer patients of their diagnosis may not have a detrimental effect on their quality of life.Trial registrationCRD42017060073.

The Impact of Air Pollution, Including Asian Sand Dust, on Respiratory Symptoms and Health-related Quality of Life in Outpatients With Chronic Respiratory Disease in Korea: A Panel Study.

ObjectivesAir pollution is a growing concern in Korea because of transboundary air pollution from mainland China. A panel study was conducted to clarify the effects of air pollution on respiratory symptoms and health-related quality of life (HR-QoL) in outpatients with and without chronic obstructive pulmonary disease (COPD) in Korea.MethodsPatients filled out a questionnaire including self-reported HR-QoL in February and were followed up in May and July. The study was conducted from 2013 to 2015, with different participants each year. Air quality parameters were applied in a generalized estimating equation as independent variables to predict factors affecting HR-QoL.ResultsLower physical fitness scores were associated with Asian sand dust events. Daily activity scores were worse when there were high concentrations of particulate matter (PM) less than 10 μm in diameter (PM10). Lower social functioning scores were associated with high PM less than 2.5 μm in diameter and nitrogen dioxide (NO2) concentrations. High NO2 concentrations also showed a significant association with mental health scores. Weather-related cough was prevalent when PM10, NO2, or ozone (O3) concentrations were high, regardless of COPD severity. High PM10 concentrations were associated with worsened wheezing, particularly in COPD patients.ConclusionsThe results suggest that PM, NO2, and O3 cause respiratory symptoms leading to HR-QoL deterioration. While some adverse effects of air pollution appeared to occur regardless of COPD, others occurred more often and more intensely in COPD patients. The public sector, therefore, needs to consider tailoring air pollution countermeasures to people with different conditions to minimize adverse health effects.

Health-related quality of life in paediatric arterial hypertension: a cross-sectional study

BackgroundThe prevalence of paediatric hypertension is increasing worldwide, especially due to the childhood obesity epidemic, and is an important public-health concern. While the Health-Related Quality of Life (HRQoL) was already shown to be impaired in the adult hypertensive population, a scarcity of data still exists on HRQoL in paediatric hypertensive patients. Our purpose was thus to assess the HRQoL of children and adolescents with arterial hypertension, using self- and proxy-reports, and to determine the correlations between child and parent questionnaire scores.MethodsThe Paediatric Quality of Life Inventory™ 4.0 Generic Core Scales were administered via post to children and adolescents, aged 5-18 years, with primary or secondary arterial hypertension and parents as proxy-reports. Patients were recruited from a paediatric nephrology unit in a tertiary hospital, using an out-patient clinic visit registry. Healthy school children and adolescents from a local primary school, aged 6 to 15 years, and their parents formed the control group. HRQoL group comparisons were calculated with independent samples t-test and child-parent correlations with the Pearson’s r correlation coefficient.ResultsIn total we recruited 139 patient and 199 control group participants as self- and proxy-reports. Scores from self- as well as proxy-reports indicated a significantly lower overall HRQoL in the paediatric hypertensive population (95% CI for mean score difference: − 11.02, − 2.86 for self- and − 10.28, − 2.67 for proxy-reports; p = .001). In self-reports, lower physical (95% CI: -13.95, − 4.89; p = <.001), emotional (95% CI: -12.96, − 2.38; p = .005), school (95% CI: -11.30, − 0.42; p = .035), and psychosocial functioning scores were observed (95% CI: -10.34, − 1.89; p = .005). Parent proxy-reports were lower in physical (95% CI: -14.31, − 5.39; p = <.001), emotional (95% CI: -12.39, − 2.60; p = .003) and psychosocial scores (95% CI: -9.36, − 1.34; p = .009). Pearson’s r values ranged between 0.62 to 0.79 in patient and 0.56 to 0.80 in control sample (p < .001). Interestingly, hypertensive children reported lower social functioning scores than hypertensive adolescents (p < .001).ConclusionsThis cross-sectional study gives insight into the detrimental impact of hypertension on children’s and adolescents HRQoL, which may inform public health experts. Furthermore, it shows that clinicians should aim to improve patients’ physical and psychosocial well-being throughout their development.

IMPACT OF SOCIO-DEMOGRAPHIC VARIABLES AND MORBID CONDITIONS ON PERCEIVED MENTAL HEALTH COMPONENTS USING SF-36 QUESTIONNAIRE

Introduction: Perceived Health is a subjective assessment of the physical as well as mental health and includes so many aspects as mentioned in SF-36 form that are difficult to capture clinically such as incipient disease, physiological, psychological reserves and social functions. To assess the impact of Diabetes Mellitus, Hypertension and other socio-demographic factors on the Social Functioning component of mental health of the patients attending a tertiary care hospital in Bareilly. Material and Methods: Perceived health status of the patients was assessed by the Social Functioning dimension of the Mental Component Summary (MCS) using the SF-36 form. Results: The presence of both Diabetes Mellitus and Hypertension was associated with lower Social Functioning scores compared to those with diabetes (p = 0.013) and hypertension alone. Age was negatively related with Social Functioning scores (p less than 0.001) but male gender (p&gt;0.000) and higher income(p less than 0.424) were all associated with higher Social Functioning scores. Rural subjects were found to have better SF score compared to urban. Conclusion: Age, gender and morbidity was found to have profound influence on Social Functioning scoring of the subjects. However, the results should be interpreted in terms of the studys limitations.

Health Related Quality of Life in Children With Autoimmune Liver Disease

BACKGROUND AND AIM: Health-related quality of life (HRQOL), a pivotal outcome indicator of health care interventions, has not been evaluated in children with autoimmune liver disease (AILD). The aim of this study was to determine HRQOL in children with AILD and the factors affecting it. METHODS: The Pediatric Quality Of Life Inventory, generic core scale, was used to collect HRQOL data on children with AILD. Specific liver disease-related questions were added. RESULTS: Survey responses were received from 30 of 40 patients. Patients' mean age at diagnosis was 11.6 ± 4.5 years, with M:F ratio of 1:1.3, and AILD for average of 4.6 ± 4.3 years. Seventy-three percent of patients had advanced liver disease. Mean overall health summary scores for the group per child and parent reports were 71.6 ± 19.0 and 71.3 ± 17.1, respectively, which were lower than healthy controls: 83.9 ± 12.5 and 82.3 ± 15.6 (P = 0.002). Frequent liver-related symptoms were associated with impaired physical and school functioning by child (P = 0.034 and 0.047) and parent reports (P = 0.051 and P = 0.018). Abdominal pain, fatigue, and psychological symptoms were found to adversely affect the HRQOL. Although it was difficult to estimate the effect of individual features of advanced liver disease such as cirrhosis, history of upper gastrointestinal bleed, and portal hypertension on the HRQOL, because of a relatively small sample size, the presence of ascites revealed lower social functioning score per parent report (P = 0.036). In an analysis of patients with any of the above complications versus those without, however, children reported lower social functioning scores (P = 0.018). There were no differences in HRQOL scores in children with autoimmune hepatitis versus primary sclerosing cholangitis versus autoimmune hepatitis/primary sclerosing cholangitis overlap syndrome. CONCLUSIONS: First study to date shows that AILD in children significantly affects HRQOL, especially with frequent liver disease-related symptoms, even in early stages of disease. Findings need to be validated in larger, multicenter studies and will help practitioners understand their patients better and optimize care.

HRQoL in HIV-infected children using PedsQL™ 4.0 and comparison with uninfected children

To assess the reliability and validity of Pediatric Quality of Life Inventory 4.0 (PedsQL(TM) 4.0) in children living with HIV. Also to determine the association of HIV infection, treatment regimens, and type of care received on quality of life (QoL) in pediatric patients. Study was conducted from January to December 2008 at Dr. Ram Manohar Lohia Hospital, New Delhi, India at the HIV pediatric outpatient department (OPD). PedsQL(TM) 4.0 was administered to 100 HIV-infected and 200 uninfected children aged 8-12 years and their primary caregivers. Internal consistency reliability exceeded 0.70 for both proxy-reported and self-reported scales. Intraclass correlation coefficient demonstrated mainly larger values for parent proxy-report (interval of 0.926-0.952 with 95% confidence) than for child self-report (interval of 0.891-0.928 with 95% confidence). Factor analysis was performed and it indicated that five factors were extracted from the PedsQL(TM) 4.0 and these five factors correspond mainly to the five scales. HIV infection was associated with a negative impact on QoL among children with lower scores for physical, school, and emotional functioning and health symptoms. In contrast, uninfected children had lower social functioning scores. Our results showed antiretroviral treatment to be associated with improved QoL among HIV-infected children. We even identified infected children living at home to be at a higher distress of psychosocial functioning and health symptoms when compared with children living in care homes. PedsQL(TM) is an acceptable and valid measure of health-related quality of life (HRQoL) for HIV-infected children and uninfected group. Application of this data will be helpful for program managers to devise care and support programme for both infected and uninfected children.

Quality of life is not related with liver disease severity but with anemia, malnutrition, and depression in HCV‐infected hemodialysis patients

Hepatitis C virus (HCV) infection may deteriorate quality of life. The relationship between HCV infection and quality of life in hemodialysis (HD) patients is unknown. The demographic characteristics, comorbidities, biochemical parameters, and Malnutrition-Inflammation Score (MIS) were recorded. Child-Pugh classification, Beck Depression Inventory, and SF-36 were performed. Liver histopathology was examined. Thirty-two patients (21 Child-Pugh-A, 11 Child-Pugh-B) were included. There was high-grade portal necroinflammatory activity in 14, high-grade lobular necroinflammatory activity in 26, and hepatic fibrosis in 19 patients. Three patients had cirrhosis. Patients with a high stage of liver fibrosis had lower social functioning scores than patient with a low stage of fibrosis (P= 0.011). The only correlation was between aspartate aminotransferase and the physical function subscale (r=-0.395, P= 0.025). None of the SF-36 scores differed between Child-Pugh A and B patients. Instead, most of the SF-36 subscale and summary scores were related with hemoglobin, albumin, MIS and Beck Depression Score. Quality of life in HCV-infected HD patients was independent of liver disease severity anchors, but was correlated with anemia, malnutrition, and depression.

Physical activity and nutritional behaviors of women with physical disabilities: Physical, psychological, social, and environmental influences

We examined predictors of 2 important health behaviors, namely, physical activity and nutritional behaviors, in a sample of community-living women with physical disabilities (N = 386). We conducted a cross-sectional survey with regression analysis. Our regression model accounted for 33.5% of the variance in physical activity. Women with joint problems or multiple sclerosis tended to engage in less physical activity than those with stroke-related disabilities. Those who had lived with their disability longer and those experiencing greater pain tended to report less physical activity. Consistent with the literature, women with greater self-efficacy for physical activity tended to engage in more physical activity. The regression model for nutritional behaviors accounted for 37.9% of the variance. Women with better mobility, greater self-efficacy for nutrition, and more vitality had better nutritional behaviors while those who needed assistance with activities of daily living, had lower social functioning scores, and were engaged in more productive activities reported poorer nutritional behaviors. Our findings highlight the importance of self-efficacy for improving health behaviors. Further research is needed to develop a new paradigm for the measurement of health behaviors, one that focuses on individual improvement rather than comparison to a norm, and health promoting interventions that are responsive to the needs and life circumstances of women with physical disabilities.