Quality Of Life Model Research Articles

Quality of Life: Review on an Approach Integrating Maqasid al-Shariah

Quality of life is one of the indicators to measure a nation’s development status, economic growth and political stability. Previous studies suggested that modernisation and globalisation has influenced the development of various techniques or parameters to measure the quality of life of the people. The social, economic, quantitative, qualitative or subjective well-being indicators have been developed to define and measure quality of life including through assessing people’s reactions to their lives and societies. However, there is also a holistic approach to measure quality of life form religious perspectives. A more holistic and inclusive concept to represent the new quality of life model that integrates the physical/material, intellectual and spiritual dimensions of human beings need to be formulated or studied in order to make the study on quality of life more comprehensive. This paper attempts to review the literature of quality of life in relation to the Islamic principle of. The study on Maqasid al- Shariah in relation to conventional theory of quality of life is essential to Malaysian as majority of the population (60% of the population) is Muslim. Finding from the study is hoped to be beneficial to the stakeholders and policy makers in developing policies and strategies that able to enhance the quality of life of Malaysian.

Abstract C24: An integrative review of psychosocial concerns among young African American breast cancer survivors

Abstract Background: African American women are more likely to be diagnosed with breast cancer at an early age, more likely to experience morbidity after treatment, and disparities in survivorship. While psychosocial well-being is well known among breast cancer survivors, data are few regarding minorities such as African Americans, particularly those who are young. Objective: This integrative review examines psychosocial concerns in survivorship among young African American breast cancer survivors (YAABCS) using a holistic quality of life framework. Methods: Pubmed, CINHAL, and Scopus were searched for articles exploring psychological or social well-being in YAABCS. Results: The search yielded 264 articles. Thirty-six articles were retrieved and reviewed for relevance. Of these, 14 articles were selected based on inclusion/exclusion criteria. Themes of YAABCS psychosocial concerns were sexuality, mood, social support, and spirituality. Conclusions: The review demonstrated need for further research in YAABCS quality of life to adapt a more fitting quality of life model and to develop culturally-appropriate survivorship interventions. Implications for Practice: Clinicians, researchers, and YAABCS must partner to increase knowledge of the multidimensional survivorship of YAABCS. With knowledge, we may be able to decrease health disparities among YAABCS. The project was funded by an American Cancer Society Doctoral Degree in Nursing Scholarship, Jonas Nurse Leadership Scholarship, and Gladys F. Colvin Doctoral fellowship. Additional support received from a Komen Graduate Training in Disparities Research Award. Citation Format: Timiya S. Nolan, Jennifer Frank, Silvia Gisiger-Camata, Karen Meneses. An integrative review of psychosocial concerns among young African American breast cancer survivors. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr C24.

An Exploratory Study to Determine the Quality of Life (QoL) and Factors Leading to Imprisonment among Women Prisoners in a Selected Women Prison

The research study titled “An exploratory study to determine the quality of life (QoL) and factors leading to imprisonment among women prisoners in a selected women prison” was based on the objectives; to determine the quality of life of women prisoners, to explore the factors leading to imprisonment, to find the association between the QoL of women prisoners and selected socio demographic and clinical variables, to find the association between the QoL and domains of quality of life of women prisoners and to find the association between the QoL of women prisoners and factors leading to imprisonment. Survey approach with an exploratory design was adopted and was conducted in a selected women prison. The conceptual framework was based on the Quality of Life model at the Centre for Health Promotion, University of Toronto. The study had primary outcome variables as quality of life and factors leading to imprisonment among women prisoners. Seventy samples were selected by purposive sampling technique. The tools used for the study were validated, pretested and the reliability also was established. The major findings of the study revealed that 43 (61.4%) participants have good quality of life. Among seventy participants 21 (30%) of them had poor QoL in psychological domain. Thirty seven (52.9%) of the participants had good QoL score in physical domain and 36 (51.4%) of them had medium QoL score in psychological domain. Majority 51 (72.9%) of the samples had good QoL score in social domain and 46 (65.7%) of them had good QoL score in environmental domain. Majority i.e. 61 (87.1%) of them had good QoL score in spiritual domain. Among the 70 participants, 10 (14.3%) of the participants had poverty as the leading reason for committing crime, followed by 8 (11.4%) having physical abuse and another 8 (11.4%) having family breakdown as the factor leading to imprisonment. Among the socio demographic variables; age of women prisoners has statistically significant association with the QoL of women prisoners (p<0.05). Among the clinical variables; Blood pressure and Lipid profile (Total serum cholesterol) have statistically significant association with quality of life (p=0.048). Physical, psychological and social domains have statistically significant association with the QoL of women prisoners (p<0.05). Factors leading to imprisonment has statistically significant association with the QoL of women prisoners (p <0.05).

Quality of Life Model in Multiple Sclerosis: Personality, Mood Disturbance, Catastrophizing and Disease Severity

Objective: The aim of current study was to investigate the interaction between factors such as personality, catastrophizing, mood disturbance and disease severity, which may affect the quality of life in patients with multiple sclerosis. The result of this study can identify the factors that have an impact on quality of life among these patients and hopefully it may lead to improve the services provided for these patients. Design: One hundred and thirteen participants with multiple sclerosis completed the following questionnaires: Type D Personality (DS-14), Hospital Anxiety and Depression (HADS), Illness Perception (Brief-IPQ) and Quality of Life (SF-36). The Expanded Disability Statue Scale (EDSS) assessed disease severity. Main Outcome Measures: Data was analyzed in structural equation modeling. Results: Type D personality was associated with quality of life and the relationship was mediated by disease severity, catastrophizing and mood status. Conclusion: Results showed a significant relationship between Type D personality and QOL. However, when the variables were added to the model, the relationship ceased to exist. These results suggest that personality traits are indirectly associated with QOL, mediated by another variable.

Dietary Flavonoid Intake and Incident Coronary Heart Disease in the Reasons for Geographic and Racial Differences in Stroke Study (REGARDS)

Dietary Flavonoid Intake and Incident Coronary Heart Disease in the Reasons for Geographic and Racial Differences in Stroke Study (REGARDS)

Stabilisation of health as the centre point of a health psychology of ageing

Current health psychological theories and research mainly cover improvement of health, recovery from illness or maintenance of health. With this theoretical manuscript, we argue that in ageing societies in which chronic illness and multimorbidity become the norm rather than the exception, this focus of health psychology is no longer sufficient. Instead, in line with a recent conceptualisation of health as “the ability to adapt and to self-manage”, we suggest that the centre point of a health psychology of ageing needs to be the stabilisation of health. Current theories of lifespan development, such as the model of selection, optimisation and compensation, the motivational theory of life span development, the two-process model of assimilative and accommodative coping and the recently introduced functional quality of life model are described with regard to their assumptions and related research focussing on stabilisation. All of these models explicitly comprise stabilisation as an important process of successful, healthy ageing. So far, however, the empirical research examining these models does not take stabilisation into account. Implications for research methods and practise of health stabilisation are discussed.

Assessing a conceptual model of over-the-counter medication misuse, adverse drug events and health-related quality of life in an elderly population.

The objectives of the present study were to test Spilker's quality of life model in the elderly population consuming over-the-counter (OTC) medications. It was hypothesized that OTC medication misuse increases adverse drug events (ADEs), ADEs as a result of OTC medication misuse decrease health-related quality of life (HRQoL) and the impact of OTC medication misuse on patients' HRQoL is fully medicated by ADEs associated with OTC medications. Data were used from a previously carried out cross-sectional study using survey instruments with elderly patients consuming OTC medications in Houston, Texas, USA. The presence/absence of OTC misuse was assessed by an expert panel based on patient reported information on drug use characteristics; ADE was self-reported and HRQoL was measured using the Short Form-12v2, which contains a physical component summary score (PCS) and a mental component summary score (MCS). Of the 154 respondents, 18.2% misused OTC medications and 22.1% reported ADE as a result of OTC medications. The mean ± SD score of PCS and MCS was 40.6 ± 6.8 and 46.4 ± 7, respectively. The hypothesized framework provided a well-fitted solution to the data (χ(2) = 1.387, d.f. = 2, P = 0.49; weighted root mean square residual = 0.317). Misuse of OTC medications significantly increased ADEs associated with OTC medications (β = 0.298) and increased ADEs significantly decreased patient reported PCS (β = -0.312), but not MCS (β = -0.213). OTC medication misuse indirectly decreased PCS and MCS by mediating the effect of an increase in ADE; however, the association was not statistically significant. Misuse of OTC medications is highly associated with ADEs. ADEs are capable of decreasing the physical health of elderly patients.

Challenging lives: an exploratory qualitative study of quality of life in young adults living with a chronic neurological condition

Objectives:The transition from adolescence to young adulthood is traditionally a time of self-discovery, career establishment, and the development of relationships. However, for young adults with a chronic illness this time in life can be very challenging, and the management of the transition is crucial for these young adults to reach their potential. The purpose of this study was to explore the lived experiences, perceptions, and challenges of young adults with a chronic neurological condition undergoing the transition from adolescence to adulthood. The Quality of Life model was used to inform the interview schedule and explored two specific areas: identity and condition.Methods:Six participants with chronic neurological conditions (age 18–25 years) took part in the study. Audio-recorded semi-structured interviews were transcribed verbatim and analyzed using Interpretive Phenomenological Analysis.Results:The findings revealed a number of interlinking superordinate themes across the participants: ‘condition’, ‘support’, ‘strive for independence’, and ‘transition’.Conclusions:The findings of this exploratory study provide a visible indication of the specific needs of the participant group, including informational and social support needs, and removal of barriers for successful participation. They also highlight holistic service requirements and the interlinking relationships of the direction of support which could be provided to meet these needs.

Bespoke Program Design for School-Aged Therapy Disability Service Delivery

This article uses the evaluation of a school-aged therapy service for children with disabilities in Western Australia to investigate models of service delivery. The current literature on family-centered practice, multidisciplinary and transdisciplinary approaches, and 4 models of service are reviewed. The models include the life needs model, the relational goal-orientated model of optimal service delivery to children and families, the quality of life model, and the collaborative model of service delivery. Analysis of the data is presented together with a bespoke model of service delivery for children with disabilities, arguing that local contexts benefit from custom-made service design.

Educating Health Care Professionals to Provide Institutional Changes in Cancer Survivorship Care

The Institute of Medicine (IOM) 2006 report, From Cancer Patient to Cancer Survivor: Lost in Transition (In M. Hewitt, S. Greenfield and E. Stovall (Eds.), (pp. 9-186). Washington DC: The National Academies Press, 2006) identifies the key components of care that contribute to quality of life for the cancer survivor. As cancer survivorship care becomes an important part of quality cancer care oncology professionals need education to prepare themselves to provide this care. Survivorship care requires a varied approach depending on the survivor population, treatment regimens and care settings. The goal of this program was to encourage institutional changes that would integrate survivorship care into participating centers. An NCI-funded educational program: Survivorship Education for Quality Cancer Care provided multidiscipline two-person teams an opportunity to gain this important knowledge using a goal-directed, team approach. Educational programs were funded for yearly courses from 2006 to 2009. Survivorship care curriculum was developed using the Quality of Life Model as the core around the IOM recommendations. Baseline data was collected for all participants. Teams were followed-up at 6, 12 and 18 months postcourse for goal achievement and institutional evaluations. Comparison data from baseline to 18 months provided information on the 204 multidiscipline teams that participated over 4 years. Teams attended including administrators, social workers, nurse practitioners, registered nurses, physicians and others. Participating centers included primarily community cancer centers and academic centers followed by pediatric centers, ambulatory/physician offices and free standing cancer centers. Statistically significant changes at p = <0.05 levels were seen by 12 months postcourse related to the effectiveness, receptiveness and comfort of survivorship care in participant settings. Institutional assessments found improvement in seven domains of care that related to institutional change. This course provided education to participants that led to significant changes in survivorship care in their settings.

Quality of Life and Perceived Educational Needs among Older Cancer Survivors

The purpose of this study was to evaluate perceived educational needs regarding nutrition and exercise in older cancer survivors. One hundred ninety survivors, age 70.7 (7.5), completed a Survey of Needs developed from the City of Hope Quality of Life model. Fifty percent reported distress related to poor appetite, 60% reported distress related to weight change, 64% reported distress related to balance/walking/mobility difficulty, and 79% reported distress related to fatigue. Weight change, poor appetite, balance/walking/mobility difficulty, and fatigue were significantly associated with distress related to (a) managing household activities, (b) caring for family, (c) maintaining a sense of well-being, (d) coping with grief and loss, and (e) managing stress. Despite distress associated with weight change, poor appetite, mobility difficulty, and fatigue, respondents did not recognize a need for education regarding nutrition and exercise. Findings suggest that evaluating older survivors' perceptions of needs may be necessary prior to designing interventions for care.

Oncologic Emergencies

The picture of oncologic emergencies in the intensive care unit has changed over the past decade. The classic emergencies, that is, superior vena cava syndrome, spinal cord compression, tumor lysis syndrome and life-threatening hypercalcemia, are now routinely managed on the general oncology unit or in an outpatient setting. Vigilant monitoring for early signs of complications, proactive interventions to prevent complications, and aggressive management account for this change. Currently, emergent conditions that necessitate intensive care unit admission or transfer in the patient with cancer include respiratory failure, cardiac emergencies, hemorrhagic events and coagulopathies, sepsis, and hemodynamic instability. This article will present the current evidence-based management of these conditions, a brief summary of classic oncologic emergencies, and the role of the critical care nurse in meeting the multidimensional needs of the patient and family during the life-threatening episode, based on Ferrell’s quality of life model.

Psychosocial Care for Adolescent and Young Adult Hematopoietic Cell Transplant Patients

Psychological issues following hematopoietic cell transplantation (HCT) are unfortunately common. Literature specific to the transplant experience for the needs of adolescents and young adults (AYA) is lacking. The purpose of this article is to (1) describe the allogeneic transplant experience for AYA transplant patients during the first year following transplantation including demographic and treatment characteristics, (2) present AYA data obtained during and following a six-part posttransplant discharge study, (3) illustrate typical AYA experiences using case studies, and (4) propose AYA intervention strategies within Erickson's stages of psychosocial development. A quality of life model provided the research conceptual framework, and the content analysis framework for the qualitative research. Themes that emerged within each domain were the following: sexuality/fertility, fatigue, depression/poor coping/habits, adherence issues, use of technology, dependency issues, changes in roles/relationships, issues with school/education, financial issues, family problems/issues, miscellaneous, religion/spirituality, fear of future, uncertainty, life, death, more life appreciation. These data guide us for providing targeted interventions for the needs of this AYA population. This paper has presented literature and developmental theory, qualitative and qualitative data from an intervention study, and clinical cases in order to propose a developmental treatment model for AYA transplant patients. A coordinated and multidisciplinary approach is needed for the HCT patient who is an AYA.

Oncologic Emergencies

The picture of oncologic emergencies in the intensive care unit has changed over the past decade. The classic emergencies, that is, superior vena cava syndrome, spinal cord compression, tumor lysis syndrome and life-threatening hypercalcemia, are now routinely managed on the general oncology unit or in an outpatient setting. Vigilant monitoring for early signs of complications, proactive interventions to prevent complications, and aggressive management account for this change. Currently, emergent conditions that necessitate intensive care unit admission or transfer in the patient with cancer include respiratory failure, cardiac emergencies, hemorrhagic events and coagulopathies, sepsis, and hemodynamic instability. This article will present the current evidence-based management of these conditions, a brief summary of classic oncologic emergencies, and the role of the critical care nurse in meeting the multidimensional needs of the patient and family during the life-threatening episode, based on Ferrell's quality of life model.

Quality of Life Model: Predictors of Quality of Life Among Sick Older Adults

The aim of this study was to explore how depressive symptoms, physical function, health satisfaction, age, and environmental conditions predict quality of life (QoL) in a conceptual model based on the Wilson and Cleary's Model (WCM). A stratified sample by age, gender, and living area was drawn from the Norwegian population of older adults receiving community health care (mean age of 78.6 years, 94.4% living at home, 5.6% living in nursing homes). The study is part of a larger international study. Face-to-face interviews were conducted using the WHOQoL-Old, the WHOQoL-Bref Environment domain, the Geriatric Depression Scale, the Short Form SF-12, and sociodemographic and health questions. A path analysis (structural equation modeling) showed that the overall model provided empirical evidence for linkages in the WCM. QoL was manifested by significant direct effects of environmental conditions and health satisfaction. In addition, environmental conditions had indirect effects on QoL, in particular via depressive symptoms and health satisfaction. This model may help nurses in community health care to collect and assess information, to suggest suitable interventions, and to guide decision making.

Supported Accommodation for People With Intellectual Disabilities and Quality of Life: An Overview

This article presents the findings of a review of evidence related to quality of life in models of supported accommodation for adults with intellectual disabilities identified in English-speaking nation deinstitutionalization and postdeinstitutionalization studies. An international literature-based investigation of research published between 1995 and 2005 in English-language peer-reviewed academic journals was conducted to: (1) review the outcome of deinstitutionalization and postinstitutionalization studies; (2) examine instruments used to measure outcomes for individuals; and (3) compare costs and benefits associated with different models of supported accommodation. In the deinstitutionalization studies, there was consistent evidence of greater choice and self-determination, participation in social networks or relationships and community-based activities, and personal satisfaction in community-based settings. Postdeinstitutionalization studies provided consistent evidence for greater choice, self-determination, and participation in community-based activities in smaller settings, but no evidence for greater physical health or material well-being, and little evidence for a relationship between type of setting and employment. Future research is needed to meet methodological challenges identified here, to investigate the apparent failure of smaller residences to improve residents’ well-being and to study systematically factors not directly addressed in the studies under review: poverty and income, organizational culture, and geographical variation.

Predicting quality of life for people living with HIV: international evidence from seven cultures

The need for a validated quality of life (QOL) model focussing on people living with HIV/AIDS has led to an international re-evaluation and extension of the Chronic Illness Quality of Life model using complex latent modelling techniques. After reoperationalising six model variables and including independence and sex-life, the WHOQOL-HIV was administered to 1281 people with asymptomatic-HIV (42%), symptomatic-HIV (40%) or AIDS (18%; 34 years; 62% male) living in Australia, Brazil, India (north & south), Italy, Thailand and Ukraine. The overall model fit was acceptable. Social inclusion did not directly improve QOL, but increased positive feelings, social support and perceived improvements of access to health and social care; all three improved QOL. Social inclusion increased perceived physical health indirectly through positive feelings. Better physical health improved sex-life and gave greater independence; both improved QOL. Gender and disease stage models were acceptable, fitting best for men and asymptomatic-HIV. Similar aspects of QOL were depleted for women and some disease stages. Increased social support did not consistently improve independence or positive feelings. Positive feelings improved the sex-life of men and those with asymptomatic-HIV. This cross-cultural approach combining assessment with theory, could guide future international interventions and practice.

Enteral Nutrition Enriched With Eicosapentaenoic Acid (EPA) Preserves Lean Body Mass Following Esophageal Cancer Surgery: Results of a Double-Blinded Randomized Controlled Trial

Esophagectomy represents an exemplar of controlled major trauma, with marked metabolic, immunologic, and physiologic changes as well as an associated high incidence of complications. Eicosapentaenoic acid (EPA) enriched enteral nutrition (EN) modulates immune function and limits catabolism in patients with advanced cancer, but its impact in the peri-operative period is unclear. To examine the effects of perioperative EPA enriched EN on the metabolic, nutritional, and immuno-inflammatory response to esophagectomy, and on postoperative complications. In a double-blind design, patients were randomized to a standard EN formula or a formula enriched with 2.2 g EPA/d for 5 days preoperatively (orally) and 21 days postoperatively (jejunostomy). Segmental bioelectrical impedance analysis was performed preoperatively and on POD 21. Postoperative complications were monitored, as well as the acute phase response, coagulation markers, and serum cytokines. Fifty-three patients (28 EPA, 25 standard) completed the study, and both groups were well matched. Serum and peripheral blood mononuclear cell (PBMC) membrane EPA levels were significantly increased in the EPA group. There was no difference in the incidence of major complications. The EPA group maintained all aspects of body composition postoperatively, whereas patients in the standard EN group lost significant amounts of fat-free mass (1.9 kg, P = 0.030) compared with the EPA group [leg (0.3 kg, P = 0.05), arm (0.17 kg, P = 0.01), and trunk (1.44 kg, P = 0.03)]. The EPA group had a significantly (P < 0.05) attenuated stress response for TNFalpha, IL-10, and IL-8 compared with the standard group. EPA supplemented early EN is associated with preservation of lean body mass post esophagectomy compared with a standard EN. These properties may merit longer-term study to address its impact on recovery of function and quality of life in models of complex surgery or multimodal cancer treatment regimens.

Coping mechanisms and support groups: women with cervical cancer

A diagnosis of cervical cancer creates such great stress for a woman that she may not be able to cope well with the symptoms of the disease. Social support groups have been extensively documented to be effective in improving coping and quality of life of persons with cancer or other illnesses. The main objective of this study was to determine the effectiveness of social support groups on women newly diagnosed with cervical cancer in Tanzania and their ways of coping. The hypotheses of this study were: (1) Women receiving formal social support would use adaptive coping strategies more than women not receiving formal social support. (2) Women receiving formal social support would use maladaptive coping strategies less than women not receiving formal social support. The illness-coping and quality of life model guided the study. A six-point control group time series design was used to investigate the effectiveness of formal social support on ways of coping of women newly diagnosed with cervical cancer, utilizing a validated tool. Formal social support groups were administered for a period of six months. This study revealed that before the intervention (provision of formal social support) there were no significant differences in the women's ways of coping with the disease. However, after the intervention there were significant differences found in the ways the subjects coped. Significant differences were found in the use of seven out of eight coping strategies between the experimental and control groups. These findings contribute to knowledge and understanding of complex coping mechanisms of women with cervical cancer, especially Tanzanians. The findings should enable health professionals, including nurses, to carry on with the facilitation of already established social support groups, and even multiply the groups within the country in order to improve the wellbeing of women with cervical cancer.

Latent Mean Structure Analysis: A Technique to Compare Group Differences in a Second-Order Quality of Life Model

The challenge in using conceptual models to measure multidimensional outcome concepts has been the inability to statistically compare group differences. An illustration of latent mean structure analysis using a second-order factor model representing quality of life is presented. Tests for the structure of the second-order factor model representing quality of life, and for its invariance across the 2 groups were based on the analysis of latent mean structures. Group means on the first-order factors could be compared and there were significant differences. Nursing researchers are often interested in studying theoretical constructs that cannot be measured directly. This analysis demonstrated a process by which means of a quality of life conceptual model could be compared between groups.