Missoula-Vitas Quality Of Life Index Research Articles

The effect of exercise on quality of life, fatigue, and pain management in older women: A cross-sectional study in Greece

Background: Frequently, the contribution of exercise to the elderly and the associated benefits of such activities are discussed. Aim: This paper deals with the contribution of exercise to the levels of quality of life, fatigue, and pain management. Method: Then, quantitative and cross-sectional research is carried out to investigate the contribution of physical exercise to the levels of quality of life, fatigue, and pain management in women over 60 years of age. For the data collection, the questionnaire used consisted of the Missoula—VITAS Quality of Life Index (MVQOLI), the Pain Assessment Questionnaire (PSeQ), and the Fatigue Assessment Scale (FAS). Results: From the statistical analysis made between exercise and quality of life, fatigue, and pain management of the women over 60 who participated in the research, it follows that women undergoing exercise show a better quality of life and less fatigue, while no statistically significant difference was detected in terms of pain management. Conclusion: It seems that exercise affects positively quality of life and fatigue. Potential implications must be addressed in order to organize more exercise programs, particularly for older people.

Evaluation of Quality of Life and Fatigue in Dialysis Patients: The Contribution of Social Support and Satisfaction from Nursing Staff

Introduction: Health-related quality of life in patients undergoing dialysis decreases over time, not only due to the treatment of the disease but also due to the reduction of physiological, psychological and social well-being. Aim: The aim of this research is to study social support and nursing care that patients with dialysis receive, their levels of fatigue and their quality of life. In addition, the effect of social support and nursing care on the patients' levels of quality of life is examined. Methodology: A quantitative cross-sectional study was conducted using the questionnaires “Multidimensional Scale of Perceived Social Support”, Fatigue Assessment Scale (FAS), Missoula-VITAS Quality of Life Index and nursing care. The study involved 69 patients on dialysis. Results: Interpersonal relationships were associated with social support (p <0.01). Quality of life was associated with social support (p <0.05). Conclusions: It seems that there is a strong association between social support and quality of life in patients on dialysis.

Κοινωνική Υποστήριξη και Ποιότητα Ζωής Γυναικών με Καρκίνο Μαστού

Introduction: Social support for women with breast cancer is linked to quality of life (QoL) and appears to be vital in treating breast cancer and adapting to the disease. Purpose: The purpose of the present study is the investigation of differences in social support and QoL levels in women with breast cancer (i) during chemotherapy and (ii) two years after chemotherapy. Method: In this cross-sectional study, 74 women with breast cancer participated in two independent groups of patients. Specifically, during chemotherapy (n = 41) and two years after chemotherapy (n = 33). The participants in the study completed the Greek version of the Multidimensional Perceived Social Support Scale (MSPSS) as well as the Greek version of the Missoula-VITAS Quality of Life Index (MVQoLI-15) for measuring social support and quality of life respectively. All statistical analyses were per- formed with the statistical program SPSS 25. Results: The group "two years after chemotherapy" reported better QoL than the group "during chemotherapy". There was no difference in perceived social support between the two groups. The older the patients, the lower the QoL for the chemotherapy group. Conclusions: Research findings indicate that quality of life improves over time.

Supportive Care for Superutilizers of a Managed Care Organization.

Background: Ohana Health Plan, Inc., (OHP) is one of the first managed care organizations offering supportive care services targeted to superutilizers. Bristol Hospice Hawaii, LLC, partnered with OHP to provide interdisciplinary supportive care services to home-bound OHP members.Objectives: The purpose of this study was to measure symptom relief, satisfaction, resource utilization, and cost savings associated with supportive care.Design: Prospective study.Setting: Over 12 months, 27 superutilizer members residing in the community were referred by OHP, 21 members were enrolled into supportive care.Measurements: Data were collected upon admission and repeatedly thereafter using the Edmonton Symptom Assessment Scale (ESAS) and the Missoula–Vitas Quality of Life Index (MVQOLI). The Family Satisfaction with Advanced Cancer Care (FAMCARE) Scale was administered at discharge. Emergency department (ED) visits and hospital utilization were tracked.Results: Median age was 63 years; more than half had cardiac diagnoses. Majority of members were Hawaiian and other Pacific Islander. Median length of stay in supportive care was 90 days. Five (23%) members enrolled in hospice following supportive care. Symptom improvement occurred in pain (p < 0.0001), anxiety (p = 0.0052), and shortness of breath (p = 0.0447). This model has shown a 79.5% reduction of ED visits per thousand members and a 75% reduction of hospitalizations per thousand. Overall net savings was 36%. Discussions and documentation of end-of-life wishes increased from 23% to 85%.Conclusion: Supportive care is highly effective in reducing costs associated with superutilizers. Our experience demonstrates the effectiveness of supportive care approaches in this population through improved care and lower health care costs overall.

Assessing the quality of life and depression among patients with heart failure and heart attack

BackgroundHealth-related quality and of life and depression are major issues among patients with heart diseases. The aim of the current study was to assess the levels of quality of life and depression among patients with heart failure and heart attack as well as the correlation between these domains and the differences in both categories.Participants and procedureIn this cross-sectional study the following tools were used: a) the Missoula-VITAS Quality of Life Index (MVQoLI-15), which examines 5 domains of quality of life, and b) the Center for Epidemiological Studies Depression Scale (CES-D), which measures depression among patients. Finally, a questionnaire about sociodemographic elements was completed by the patients. Data were analyzed through IBM Statistics SPSS 20.0. The statistical level was set at 0.05%.ResultsThe mean value of CES-D Total and MVQoLI-15 were higher for the patients suffering from heart failure than those suffering from a heart attack. However, the dimensions of MVQoLI-15 Interpersonal Relationships, Well-Being and Transcendence were lower for heart failure patients compared to the levels of the patients suffering from a heart attack. According to the Pearson r test, there was a statistically significant negative correlation be-tween the quality of life and depression (p = .001) in the overall sample.ConclusionsPatients with heart failure experience more depression and lower quality of life than heart attack patients.

Social support and quality of life in Greek women with breast cancer during chemotherapy and two years later

BackgroundSocial support in women with breast cancer is associated with quality of life (QoL) and it appears to be vital for treating breast cancer and adaptation to disease. Social support seems to decrease quantitatively and over time while significant improvement in the patients’ long-term emotional and physical function is observed. Therefore, the aim of this study was to investigate the differences in levels of social support and QoL in two independent groups of patients: women with breast cancer (i) during chemotherapy and (ii) two years after the chemotherapy.Participants and procedureIn this cross-sectional study 74 women with breast cancer “during chemotherapy” (n = 41) and “two years after chemotherapy” (n = 33) completed the Greek version of Multi-dimensional Scale of Perceived Social Support (MSPSS) and the Greek version of the Missoula-VITAS Quality of Life Index (MVQoLI-15) to measure social support and QoL respectively. All statistical analyses were performed with SPSS 25 with significance set at p &lt; .05.ResultsThe group “two years after chemotherapy” reported better QoL than the “during chemotherapy” group. There was no difference in perceived social support between the two groups. The higher the patients’ age, the lower the QoL for the “during chemotherapy” group and the higher the social support for the “two years after chemo-therapy” group.ConclusionsQoL improves over time, emphasizing the ability of women to manage difficult situations. Social support re-mains important in both periods.

Health-related quality of life in end-stage renal disease patients, using the Missoula-Vitas quality of life index: a multicenter study.

Background and aimsAssessment of Health-related Quality of Life in chronic hemodialysis patients (CHD) is a predictive indicator of the outcome of the disease, including mortality and hospitalization. Regular surveys of the quality of life (QoL) in CHD patients have been conducted worldwide, using various, internationally validated and standardized tools, including the Missoula-VITAS Quality of Life Index scale (MVQOLI). The aim of this study was to examine the reliability and validity of the Bulgarian version of the Missoula-VITAS Quality of Life Index-15 (B-MVQOLI-15) and QoL in CHD patients using this instrument.MethodsOur study was designed as multi-center cross-sectional. It incorporated 263 end-stage renal disease (ESRD) patients on CHD from across the country and applied the B-MVQOLI-15. Internal consistency and convergent validity of the index were assessed. Non-parametric methods were used to evaluate the impact of demographic factors on the different dimensions scores and on the total score. The relationship between the total QoL score, the total MVQOLI-15 score and dimensions scores were measured based on Spearman’s rho Correlation Coefficient.ResultsThe total MVQOLI-15 score in the study was 16.44, which is slightly above the middle of the index scale. The patients with higher education were less satisfied with the level of their symptom control compared to patients with lower education. However, high education patients seem to manage better with everyday life compared to those with low education. Men seem to feel more satisfied than women when fulfilling their daily activities (P=0.026). Retired patients and unemployed expressed more satisfaction, compared to the employed (P=0.021). Also, patients on dialysis for over 5 years had lower QoL scores (P=0.043).ConclusionsB-MVQOLI-15 is a reliable instrument to measure QoL in Bulgarian patients with CHD. The majority of CHD patients rate their QoL as “Fair”. Four of all five dimensions positively affect the QoL of CHD patients. The most important dimensions positively affecting the QoL of CHD patients were: interpersonal relationships and transcendent factors. Future studies are necessary to assess the adequacy of the delivered dialysis, the level of medico-social care and the needs of ESRD patients treated with CHD in order to improve their QoL.

Quality of life among gynaecological cancer patients receiving palliative care in Kenya: A cross-sectional study

Background/Aims: Cancer and its treatment affects the quality of life in patients. In Africa, there is limited research available on the quality of life among cancer patients. This study describes quality of life in patients with gynaecological cancer attending Kenyatta National Hospital, Kenya. Methods: A descriptive study was conducted among patients with gynaecological cancer attending the palliative care unit. Data were collected using a structured questionnaire adopting the Missoula-VITAS Quality of Life Index, a 25-item quality of life measure containing five subscales. Results: A total of 108 patients were interviewed. The mean total quality of life score was 17.2 (possible range 0 to 30), and the mean global quality of life score was 3.5 (possible range 0 to 5). The following subscale mean scores were recorded: symptom (8.2), transcendent (6.2), function (5.6), interpersonal (5.3) and wellbeing (–2.9) (possible range –30 to 30). Conclusions: The quality of life of patients with gynaecological cancer was moderate, while insufficient attention to patients' psychosocial needs adversely affected patients' perceptions of their quality of life.

THE EFFECT OF PERCEIVED SOCIAL SUPPORT ON HEMODIALYSIS PATIENTS' QUALITY OF LIFE.

Background:Association between perceived social support and quality of life in hemodialysis patients represents a new area of interest.Aim:The aim of this study was to explore the effect of social support on the quality of life of hemodialysis patients.Material and Methods:In this study 258 hemodialysis patients were enrolled. Data was collected using a questionnaire which consisted of three parts: a) the Multidimensional Scale of Perceived Social Support (MSPSS) to assess perceived social support, b) the Missoula-VITAS Quality of Life Index (MVQOLI–15) to assess quality of patients’ life and c) the socio-demographic, clinical and other variables of patients. To test the existence of association between quality of life and social support the correlation coefficient of Spearman was used. Multiple linear regression was performed to estimate the effect of social support on quality of life (dependent variable), adjusted for potential confounders. The analysis was performed on SPSS v20.Results:Patients felt high support from significant others and family and less from friends (median 6, 6 and 4.5 respectively). Patients evaluated their quality of life in its entirety as moderate in the total and “overall quality of life” score (median 17.2 and 3 respectively). Regarding the association between social support and quality of life, results showed that the more support patients had from their significant others, family and friends, the better quality of life they had. (rho =0,395, rho =0,399 and rho=0,359, respectively).Conclusions:Understanding the relation between social support and quality of life should prompt health professionals to provide beneficial care to hemodialysis patients.

The Impact of Anxiety and Depression on the Quality of Life of Hemodialysis Patients.

Material and Methods:The sample studied consisted of 395 hemodialysis patients. Data was collected by the completion of a specially designed questionnaire for the needs of the present study which apart from socio-demographic and clinical, it also included HADS scale to assess the level of anxiety and depression as well as the scale Missoula-VITAS Quality of Life Index (MVQOLI) to assess patients’ quality of life.Results:The results of this study showed that 47.8% had high anxiety levels and 38.2% had high levels of depression. The average total score of quality of life was found to be 17.14. It was also shown that the total score of quality of life presented statistically significant association with family status (p=0.007), educational level (p<0.001), the number of children (p=0.001), patients’ adherence to doctors’ orders (p=0.003) and proposed diet (p=0.002) and the relations of patients with healthcare professionals and the other patients (p<0.001). The multiple linear regression showed that the overall quality of life score was statistically associated with the levels of depression after adjusted for possible confounders. More specifically, it was found that total score of quality of life was 2.5 and 4.4 points lower for patients with moderate and high levels of depression, respectively, compared to patients with low levels of depression (p<0.001).Conclusions:Evaluation of anxiety and depression in conjunction with quality of life in hemodialysis patients should be an integral part of the therapeutic regimen.

The Impact of Kt/V Urea-Based Dialysis Adequacy on Quality of Life and Adherence in Haemodialysis Patients: A Cross-Sectional Study in Greece.

There is clear evidence of a link between dialysis adequacy (as measured by urea kinetic modeling or urea reduction ratio) and such important clinical outcomes as morbidity and mortality. Evidence regarding the relationship between dialysis adequacy and quality of life (QOL) outcomes as well as adherence is less clear. The present paper is a study protocol which is planning to answer the following research question: what is the impact of dialysis adequacy on QOL and adherence in a sample of hemodialysis patients? The final sample size will be around 100 patients undergoing hemodialysis. Each subject’s QOL and adherence will be measured using the following instruments: i) the Missoula-VITAS quality of life index 25; ii) the multidimensional scale of perceived social support and iii) the simplified medication adherence questionnaire. Dialysis adequacy is expected to be related to QOL and adherence scores.

Suitability of quality-of-life outcome measures in palliative care in the South African setting.

Quality of life (QoL) is a multidimensional, subjective, and highly individual phenomenon. The current study speaks to the QoL domains identified by palliative patients living in Africa. The need to identify these domains has been recognized but seemed to still be lacking. This study filled this knowledge gap by providing the domains and by giving directions in terms of the assessment of QoL in palliative patients living in resource-restricted communities in South Africa. We followed a multi-method approach and conducted a literature review to identify and describe the multidimensional QoL instruments used in African palliative care. A secondary analysis design and open-coding method was employed to identify the domains influencing the QoL of palliative patients living in a resource-restricted South African community, after which we compared these domains to the domains assessed by the identified QoL instruments. We found that two multidimensional QoL of life instruments-the Missoula-Vitas Quality of Life Index (MVQoLI) and the Functional Assessments of Chronic Illness Therapy-Palliative Care (FACIT-Pal)-have been used in African palliative care and have identified various domains, grouped as four themes: physical concerns, psychosocial issues, financial restraints, and existential issues. The patient-identified QoL domains were to a great extent not assessed by the MVQoLI and FACIT-Pal. Our study highlights the complexity of QoL and QoL assessment. A more accurate representation of the QoL of palliative patients living in resource-restricted communities might be obtained by using individualized measures or exploring what QoL means to these patients and selecting QoL instruments accordingly.

QUALITY OF LIFE IN HEMODIALYSIS PATIENTS.

Purpose:To explore the quality of life in hemodialysis patients.Material and Methods:The sample studied consisted of 320 patients undergoing hemodialysis in one-day dialysis center. Data were collected by the completion of a specially designed questionnaire which apart from the sociodemographic and clinical variables, it also included the scale Missoula-VITAS Quality of Life Index (MVQOLI) for assessing quality of life.Results:Of the 320 hemodialysis patients, 57,2% were men while 28,1% of the participants were 71-80 years old. The average total score of quality of life was found to be 17.43 (in a range 0-30). The total score of quality of life was found to be higher in participants <60 years (p= 0,009), of higher educational level (p=0.001), being very informed about the health problem (p=0,013), complied with therapeutic recommendations and the proposed diet (p=0,025 & p=0,012, respectively), having very good relations with the medical and nursing staff or other patients (p<0,001), not experiencing difficulties with social or family environment (p=0,001), had help at home (p <0,001) and in those who did not conceal their health problem from the social environment (p<0.001). Furthermore, it was found that the increasing duration of hemodialysis session entailed poorer quality of life (p<0,001). These results were largely confirmed by multiple linear regression.Conclusions:Sociodemographic and clinical characteristics seems to influence the quality of life in hemodialysis patients.

Report on the First Stages in the Translation of Measures of Health-Related Quality of Life at the End of Life

Objectives: To translate and adapt the English version of QUAL-E (Quality of Life at the End of Life Measure) and MVQOLI (Missoula Vitas Quality Of Life Index) into French, taking into account cultural differences. Methods: The selected translation process for linguistic validation included independent translations to the target language (French) performed by translators who were either native English speakers or French native speakers. Then, the translations were confronted to obtain a reconciled version as close as possible to the original text. This involved taking into account specific intercultural validity problems. To evaluate these translations, 30 patients tested and commented on the French adaptations of the quality-of-life (QoL) questionnaires. Results: Some modifications were made following patients’ comments. The QUAL-E and MVQOLI translations were then finalized by the translation team. The prospective study (randomized multicentre cohort study) was then initiated. The validation of psychometric properties in the end-of-life setting is planned. Almost all questions and response options were well understood and accepted, no cultural barrier to the use of the questionnaires in palliative care was detected.

Measuring health: related quality of life in hemodialysis patients. Psychometric properties of the Missoula-VITAS Quality of Life Index (MVQOLI-15) in Greece

Different measuring tools have been used to understand the outcomes of end-stage renal disease (ESRD) therapies. However, survival, cost-effectiveness and quality of life (QOL) are the main parameters to evaluate treatment of ESRD. The current study meant to assess the psychometric properties (reliability and validity) of the Missoula-VITAS Quality of Life Index (MVQOLI-15) translation to Greek in patients undergoing hemodialysis (HD). A total sample of 79 HD patients voluntarily participated in this pilot study. Domain analysis of MVQOLI-15-Greek was conducted based on the collected data at initial assessment. The reliability properties of the instrument were tested using the following measures; internal consistency, repeatability, test-retest reliability and convergent validity. Domain analysis demonstrated that all domains of the questionnaire had good variability. MVQOLI-15-Greek internal consistency was satisfactory with an overall Cronbach&amp;rsquo;s a at 0.74. Pearson&amp;rsquo;s r and intraclass correlation coefficient revealed strong correlations (ranging from 0.91 to 0.98) between initial assessment and reassessment. MVQOLI-15-Greek convergent validity analysis indicated that the domains were strongly related to the same construct. The findings of the study indicate that the Greek version of MVQOLI-15 provided satisfactory psychometric properties supporting its use within pathological populations and in the context of national QOL measurement.

Measuring Health: Related Quality of Life in Hemodialysis Patients. Psychometric Properties of the Missoula-VITAS Quality of Life Index (MVQOLI-15) in Greece.

Different measuring tools have been used to understand the outcomes of end-stage renal disease (ESRD) therapies. However, survival, cost-effectiveness and quality of life (QOL) are the main parameters to evaluate treatment of ESRD. The current study meant to assess the psychometric properties (reliability and validity) of the Missoula-VITAS Quality of Life Index (MVQOLI-15) translation to Greek in patients undergoing hemodialysis (HD). A total sample of 79 HD patients voluntarily participated in this pilot study. Domain analysis of MVQOLI-15-Greek was conducted based on the collected data at initial assessment. The reliability properties of the instrument were tested using the following measures; internal consistency, repeatability, test-retest reliability and convergent validity. Domain analysis demonstrated that all domains of the questionnaire had good variability. MVQOLI-15-Greek internal consistency was satisfactory with an overall Cronbach’s a at 0.74. Pearson’s r and intraclass correlation coefficient revealed strong correlations (ranging from 0.91 to 0.98) between initial assessment and re-assessment. MVQOLI-15-Greek convergent validity analysis indicated that the domains were strongly related to the same construct. The findings of the study indicate that the Greek version of MVQOLI-15 provided satisfactory psychometric properties supporting its use within pathological populations and in the context of national QOL measurement.

Health-related quality of life in cancer patients at the end of life, translation, validation, and longitudinal analysis of specific tools: study protocol for a randomized controlled trial

BackgroundThe end of life for cancer patients is the ultimate stage of the disease, and care in this setting is important as it can improve the wellbeing not only of patients, but also the patients' family and close friends. As it is a matter of profoundly personal concerns, patients' perception of this phase of the disease is difficult to assess and has thus been insufficiently studied. Nonetheless, caregivers are required to provide specific care to help patients and to treat them in order to improve their wellbeing during this period.While tools to assess health-related quality of life (QoL) in cancer patients at the end of life exist in English, to our knowledge, no validated tools are available in French.Methods/designThis randomized multicenter cohort study will be carried out to cross-culturally adapt and validate a French version of the English QUAL-E and the Missoula Vitas Quality Of Life Index (MVQOLI) questionnaires for advanced cancer patients in a palliative setting. A randomized clinical trial component in addition to a cohort study is implemented in order to test psychometric hypotheses: order effect and improvement of sensibility to change.The validation procedure will ensure that the psychometric properties are maintained.The main criterion to assess the reliability of the questionnaires will be reproducibility (test-retest method) using intraclass correlation coefficients. It will be necessary to include 372 patients. The sensitivity to change, discriminant capability as well as convergent validity will be also investigated.DiscussionIf the cross-cultural validation of the MVQOLI and QUAL-E questionnaires for advanced cancer patients in a palliative setting have satisfactory psychometric properties, it will allow us to assess the specific dimensions of QoL at the end of life.Trial registrationCurrent Controlled Trials NCT01545921.

The “Spirit 8” successfully captured spiritual well-being in African palliative care: factor and Rasch analysis

ObjectiveTo describe the dimensionality of a measure of spiritual well-being (SWB) (the “Spirit 8”) in palliative care (PC) patients in South Africa and Uganda, and to determine SWB in this population. Study Design and SettingA cross-sectional survey was conducted using the Missoula Vitas Quality of Life Index (MVQOLI). Translated questionnaires were administered to consecutively recruited patients. Factor analysis and Rasch analysis were used to examine the dimensionality of eight items from the Well-being and Transcendent subscales. The resulting measure (the “Spirit 8”) was used to determine levels of SWB. ResultsTwo hundred eighty-five patients recruited; mean age 40.1; 197 (69.1%) female; primary diagnosis HIV (80.7%), cancer (17.9%). Internal consistency of the eight-item scale was α=0.73; Well-being factor α=0.69, Transcendence factor α=0.68. Rasch analysis suggested unidimensionality. Mean SWB score was 26.01 (standard deviation 5.68). Spiritual distress was present in 21.4–57.9%. Attending the Ugandan service, HIV and younger age were associated with poorer SWB scores. ConclusionThe Spirit 8 is a brief, psychometrically robust, unidimensional measure of SWB for use in South African and Ugandan PC research. Further research testing the Spirit 8 and examining the SWB of PC patients in South Africa and Uganda is needed to improve spiritual care.

Assessing Health - Related Quality of Life using the Missoula - Vitas Quality of Life Index (MVQOLI)

Assessing Health - Related Quality of Life using the Missoula - Vitas Quality of Life Index (MVQOLI)

The MVQOLI successfully captured quality of life in African palliative care: a factor analysis

Objective To examine the factor structure of the Missoula Vitas Quality of Life Index (MVQOLI) in palliative care patients in South Africa and Uganda and to assess the tool’s appropriateness for measuring quality of life (QOL) in this context. Study Design and Setting Cross-sectional survey using the MVQOLI, a 26-item QOL measure containing five subscales ( Function, Symptoms, Interpersonal, Well being, and Transcendent), in five palliative care services in South Africa and Uganda. Results Two hundred eighty-five patients were recruited; mean age was 40.1 years; 197 (69.1%) were female; primary diagnoses were human immunodeficiency virus infection (80.7%) and cancer (17.9%). A five-factor solution, accounting for 55% of variance, presented the best model of fit. The factors corresponded relatively closely to the original subscales, with only 4 of the 20 items not loading on the factor corresponding to the appropriate subscale. Internal consistency was high ( α = 0.83). Conclusion We found evidence of five factors underpinning the MVQOLI in a large sample of South African and Ugandan palliative care patients. The five factors corresponded reasonably well to the original subscales, suggesting that it is a promising measure for use in this population. However, further testing of its psychometric properties, comprehensibility, and scoring require further research in sub-Saharan Africa.