Objective Quality Of Life Measures Research Articles

EQ-5D-3L Population Norms for Trinidad and Tobago

ABSTRACT Objective Quality of life measures are increasingly being used in clinical practice and in research. Internationally EQ-5D is the most commonly used generic health related quality of life instrument. The EQ-5D system comprises five dimensions: mobility, self-care, ability to conduct usual activities, pain/discomfort and anxiety/depression. This study sought to provide a set of population norms for Trinidad and Tobago to facilitate clinical and other researchers who wish to use the EQ-5D-3L value set that was recently created for Trinidad and Tobago. Population norms are baseline values against which the EQ-5D health status of patients or patient groups can be compared. Methods Self-reported health data using the EQ-5D-3L questionnaire were taken from two previously undertaken surveys of representative samples of the Trinidad and Tobago population. EQ-5D-3L health states, mean EQ VAS (visual analogue scale) scores and mean EQ-5D-3L index values were obtained for demographic groups. Results Data were obtained for 590 respondents. The mean EQ VAS value was 82.3 and the mean EQ-5D-3L index value was 0.931. The EQ-5D dimensions with the highest rates of reported problems were pain/discomfort (29%) and anxiety/depression (14%). Self-reported health was observed to decline as age progresses and men reported higher levels of health than women. Conclusion The population norms in this study can be used as base-line values for key demographic groups in clinical practice and in clinico-economic research using EQ-5D-3L.

Systematic review of global functioning and quality of life in people with psychotic disorders.

In May 2016, ten electronic databases were searched using a two-phase process to identify articles in which associations between global functioning and QoL were assessed. Basic descriptive data and correlation coefficients between global functioning and QoL instruments were extracted, with the strength of the correlation assessed according to the specifications of Cohen 1988. Results were reported with reference to the Meta-analysis of Observational Studies in Epidemiology guidelines and PRISMA standards. A narrative synthesis was performed due to heterogeneity in methodological approaches. Of an initial 15 183 non-duplicate articles identified, 756 were deemed potentially relevant, with 40 studies encompassing 42 articles included. Fourteen instruments for measuring global functioning and 22 instruments for measuring QoL were used. Twenty-nine articles reported linear associations while 19 assessed QoL predictors. Correlations between overall scores varied in strength, primarily dependent on the QoL instrument employed, and whether QoL was objectively or subjectively assessed. Correlations observed for objective QoL measures were consistently larger than those observed for subjective measures, as were correlations for an interviewer than self-assessed QoL. When correlations were assessed by domains of QoL, the highest correlations were found for social domains of QoL, for which most correlations were moderate or higher. Global functioning consistently predicted overall QoL as did depressive and negative symptoms. This review is the first to explore the extent of associations between global functioning and QoL in people with psychotic disorders. We consistently found a positive association between global functioning and QoL. The strength of the association was dependent on the QoL instrument employed. QoL domains strongly associated with global functioning were highlighted. The review illustrates the extensive array of instruments used for the assessment of QoL and to a lesser extent global functioning in people with psychotic disorders and provides a framework to understand the different findings reported in the literature. The findings can also inform the future choice of instruments by researchers and/or clinicians. The observed associations reassure that interventions for improving global functioning will have a positive impact on the QoL of people living with a psychotic disorder.

Subjective and objective quality of life at first presentation with psychosis.

Quality of life (QOL) in first-episode psychosis (FEP) is impaired when compared to non-clinical controls and several clinical factors including symptoms and untreated psychosis have been linked with poorer QOL. Measurement methods are varied, however, resulting in inconsistent findings and there is a need to simultaneously combine subjective and objective measures of QOL. We examined both subjective (n = 128) and objective QOL (n = 178) in a catchment area cohort of individuals with FEP (n = 222) to determine correspondence between patient satisfaction and clinician-rated functional domains. We also examined the contribution of sociodemographic and clinical characteristics to both subjective and objective QOL. There were complex relationships between subjective and objective QOL domains in that patient's assessments of health status (psychological well-being, symptoms/outlook, physical health) were not correlated with clinicians but there were strong correlations between social functioning domains (occupation, social relations, financial status and activities of daily living) assessed by patients and clinicians. Longer duration of untreated psychosis, being treated as an inpatient, higher positive symptoms and poorer social functioning in client-rated QOL domains predicted poorer objective QOL. We found that both subjective and objective assessments of QOL displayed a degree of clinical utility demonstrated by relationships between clinical factors and both QOL perspectives. Moreover, the lack of association between patient characteristics and QOL shows some potential malleability of QOL outcomes through intervention as there were several clinical factors linked with both subjective and objective QOL.

Quality of life and its predictors in people with schizophrenia

The author reviewed measurement of quality of life (QOL) of schizophrenia patients and the clinical factors related to their QOL. As schizophrenia patients were thought to be unable to assess their own QOL because of their cognitive impairment, objective QOL measures had been frequently used. However, nowadays, there is general agreement that symptomatically stabilized patients could assess their QOL by themselves. Therefore, researchers gradually have become interested in subjective QOL measure. Although most researchers often evaluate schizophrenia patients' QOL using only subjective or objective QOL measure, considering the fact that there is a discrepancy between the two types of measures, it is recommended to use both of them as complementary measures. As for clinical factors related to lowered QOL, several studies reported that depressive symptom was most associated with lowered subjective QOL, negative symptom was strongly related to lowered objective one and poor life skill was associated with both. Moreover, several studies found that cognitive dysfunctions in some cognitive domains were related to lowered objective QOL but the effects of them were much smaller than those of negative symptoms. It is suggested that improving depressive and negative symptoms and life skills may contribute to enhancement of QOL of schizophrenia patients.

A Comparison of Quality of Life Outcomes for People with Intellectual Disabilities in Supported Employment, Day Services and Employment Enterprises

Background Policy objectives for people with intellectual disabilities include day service modernization and the promotion of paid employment and quality of life. Quality of life is under represented as an outcome measure in vocational research. This research compares subjective and objective quality of life, and quality of work environment for adults with intellectual disabilities in supported employment, employment enterprises and day services with non‐disabled workers in community employment.Methods Comprehensive Quality of Life Scale, and Work Environment Scale were collected for people with intellectual disabilities: 17 supported employees; 10 employment enterprise workers; 10 day service attendees; and 17 non‐disabled work colleagues of supported employees.Results Supported employees reported higher objective quality of life than employment enterprise workers and day service attendees. Non‐disabled co‐workers reported higher objective quality of life and autonomy at work than the three groups of people with intellectual disabilities. Supported employees reported higher subjective quality of life than non‐disabled co‐workers.Conclusions The findings support the utility of supported employment as a means to provide constructive occupation and enhanced quality of life to people with intellectual disabilities. However, closing the gap with respect to non‐disabled co‐workers on objective quality of life measures represents a challenge and will require improving the quality of job finding and workplace support and the training provided.

Quality of Life and Resilience in Adolescents with a Mobility Disability

To examine the influences from life stress and the hypothesized protective variables of social competence, family functioning, and peer social engagement on quality of life (QL) in adolescents with mobility disabilities within a stress-resilience model. Variables were assessed with questionnaires completed by 159 adolescents with a mobility disability (aged 11-18 years) and their parents. Both more subjective and objective QL measures were completed using both adolescent and parent reports. Increased life stress was associated with worse QL. Hypothesized protective variables were used to explain significant variance in more subjective, but not objective, measures of QL beyond covariates and life stress. The hypothesized protective variables, however, did not moderate the effects of life stress on QL. There was a cumulative effect from the hypothesized protective variables such that adolescents with more of these factors had more subjective QL than those with just one factor, regardless of the specific factor. Consistent with the tested model, interventions to improve QL in adolescents with a mobility disability may focus on reducing life stress and developing resilience by enhancing a variety of personal and social resources.

Were People in the Past Poor and Miserable?

SUMMARYStandard economic theory would suggest close linkages between income, broader measures of the quality of life and ‘utility’. To some extent it is hard to test the link between income and utility given the way that utility is proxied by economists, but we do have measures of objective and subjective wellbeing as a potential guide. When we look at broader measures of objective and subjective wellbeing in both rich and poor countries today, the relationship to absolute income is perhaps surprisingly weak. Turning to the past, we know that most people were in an absolute income sense very poor, and faced a considerably lower broad quality of life using objective measures. However, the link between these two factors is not as straightforward as sometimes assumed. At the same time, from the preoccupations of political thinkers and others, it does appear that relative (rather than absolute) income has long been a concern, and that concerns with absolute income at the national level appear to center around avoiding absolute deprivation rather than the advantage of ever more consumption goods. In short, there is plentiful evidence that people in the past were nearly all absolutely poor and broadly worse off according to other objective quality of life measures, less evidence that these two were intimately linked, even less that everyone was miserable, and less again that those who did feel miserable felt so because they were absolutely poor.

The Relationship Between the Level of Personal Empowerment and Quality of Life Among Psychosocial Clubhouse Members and Consumer-Operated Drop-In Center Participants

This cross-sectional, correlational study examined the relationship between personal empowerment and quality of life among 151 mental health consumers (77 psychosocial clubhouse members and 74 consumer-operated drop-in center participants). This study also evaluated the group differences between empowerment and quality of life. Data collected from face-to-face interviews indicate a positive relationship between personal empowerment and quality of life, with drop-in center participants reporting slightly higher levels of personal empowerment than clubhouse members. Mixed results were found between the two groups with respect to subjective and objective quality of life measures. The results of this study suggest an important association between the ability to make life choices and a mental health consumer's quality of life, especially when high levels of social contact are a part of everyday life.

Radiosurgical treatment of trigeminal neuralgia: evaluating quality of life and treatment outcomes

Purpose To assess the safety, efficacy, and quality of life (QOL) associated with radiosurgical treatment for trigeminal neuralgia (TN). Methods and materials Between June 1996 and June 2001, 112 patients with TN refractory to medical or surgical management were treated with gamma knife radiosurgery (GKRS) at the University of Maryland Medical Center. A median prescription dose of 75 Gy (range: 70–80 Gy) was delivered to the involved trigeminal nerve root entry zone. Treatment outcomes were assessed through patient self-reports of pain control and medication usage during follow-up visits. In addition, patients responded to a standard questionnaire containing the Barrow Neurologic Institute Pain Scale (BNI) and selected sections of the McGill Pain Scale. Treatment outcomes and objective quality of life measures were also addressed. Results Ninety-six patients (86%) completed questionnaires for a median follow-up of 30 months (range: 8–66 months). Seventy-four patients (77%) reported pain relief occurring after a median of 3 weeks (range: 0–24 weeks) after GKRS. A decrease in medication usage was noted in 66% of patients. Actuarial analysis demonstrated 1-year, 2-year, and 3-year recurrence rates of 23%, 33%, and 39%, respectively. Response to treatment was associated with lack of prior surgical treatment ( p = 0.03) and less than 50 months’ pain duration before GKRS ( p = 0.04). Patients who described their TN pain as more severe than their worst non-TN headache pain (McGill Pain Scale IV–V vs. I–III) were also more likely to respond to treatment ( p < 0.001). Seven (7.3%) patients reported new or increased trigeminal dysfunction; however, only 3.1% reported these symptoms as bothersome (BNI III–IV). Patients with sustained pain relief reported an average of 100% improvement in their QOL as a direct result of pain relief after GKRS, and 100% believed that the procedure was successful. Furthermore, among those patients with temporary pain relief and subsequent recurrence, 65% felt their treatment was a success with an average of 80% improvement in their QOL. Conclusions GKRS provides significant pain relief and improves QOL in the majority of patients treated for TN, with few bothersome side effects. Patients with both temporary and sustained responses to treatment realized significant improvements in QOL after GKRS, and considered their treatment successful. Longer follow-up of these patients may reveal additional recurrences highlighting the importance of studies evaluating repeat GKRS and optimization of current treatment techniques and patient selection.

Inflammatory bowel disease in children and adolescents: Working Group Report of the First World Congress of Pediatric Gastroenterology, Hepatology, and Nutrition.

Inflammatory bowel disease in children and adolescents: Working Group Report of the First World Congress of Pediatric Gastroenterology, Hepatology, and Nutrition.

The Effects of Quality of Life on National Elections: A Multi-Country Analysis

This paper studies the effects of several Quality ofLife (QOL) indicators on the outcomes of nationalelections. We test the hypothesis that declines innational QOL will have a negative effect on the votingsupport for the governing party in the next election. For each election since 1960 in thirteen countries, weuse objective measures of QOL for the previous year toestimate the voting function by using astate-of-the-art technique called Sliced InverseRegression (Li, 1991). These objective measuresinclude GDP per capita, food availability, inflation,crime rates, divorce rate, and percent of females inthe labor force, among others. The estimated “votingfunction” is the best predictor of voters' behavior asa function of the changes in QOL. The results show that changes in economic variablesand food availability significantly affect electionoutcomes. In addition, changes in crime rates werefound to be nearly as important as economic variablesin influencing the election outcomes. This marks thefirst time that a non-economic indicator has beenshown to affect elections. In contrast, measures ofsatisfaction with family life, such as divorce, infantmortality, and percent females in the workforce, showno effect on voting behavior, probably because votersdo not hold their governments responsible for familyaffairs.

Homeless mentally ill clients and the quality of life

Using a sample of homeless mentally ill clients, this study examined the reliability and validity of the Satisfaction with Life Domains Scale (SLDS), a measure of subjective quality of life (QOL). The SLDS exhibited good internal consistency and test-retest reliability. The SLDS was also correlated with psychopathology and self-esteem, providing some evidence for the concurrent validity of the SLDS. However, subjective QOL, as measured by the SLDS, did not correlate with comparable objective QOL measures (e.g. days stably housed, income, total service utilization), raising doubts about the validity of the SLDS and other subjective QOL measures for this population.