Perception Of Health-related Quality Research Articles

Prevention of Type 1 Diabetes: Current Perspective.

People living with type 1 Diabetes (T1D) and their families have poor perception of health related quality of life. Therapies for T1D are becoming better with time, but they still involve a lot of effort. Prevention of T1D, if successful, has potential to change lives of millions of families across the globe. Type 1 diabetes is an autoimmune disease with underlying genetic predisposition for autoimmunity against beta cell antigens upon exposure to an environmental trigger. Identifying underlying primary antigen responsible for initiating autoimmune cascade, avoiding environmental trigger and modifying immunity has all been used as strategies for preventing or delaying onset of type 1 diabetes. Primary prevention for type 1 diabetes is hindered by difficulty in identifying at-risk population and also due to lack of effective preventive strategy. Secondary prevention, in children with presence of autoimmunity, has recently received a boost with approval of Teplizumab, an immunity modifying drug by its Anti-CD3 action. Application of preventive strategies would also change based on country specific incidence, prevalence and availability of health resources. In current review, an update on preventive strategies for type 1 diabetes is being discussed as well as their applicability in Indian context.

Health-related quality of life, Mediterranean diet, physical activity and socioeconomic factors of Greek adolescents during COVID-19: A cross sectional study

BACKGROUND: Health related quality of life of the adolescents during quarantine and social isolation potentially decreases, with significant alteration on physical activities and nutrition behaviour. OBJECTIVE: The present study investigates the relationship between Greek adolescents’ health related quality of life and socioeconomic factors, lifestyle and dietary characteristics, along with their adherence to the Mediterranean Diet immediately after the lockdown period in Greece. METHODS: A total sample of 459 students aged 12–16 years old were recruited from secondary schools in the area of Athens. The KIDSCREEN-27 questionnaire for children and adolescents, the KIDMED test, the Godin and Shephard Leisure Time Physical Activity Questionnaire and the Family Affluence Scale III, were used for the statistical analysis. T-tests, Kruskal Wallis, Chi-square, Anova tests and multiple regression analyses were employed. RESULTS: Econometric analysis reveals that adolescents’ health related quality of life is higher among boys, adolescents who live with both parents, tend to sleep more during night and do not spend many hours on screen viewing. Also, adolescents with higher family affluence level, being physically active and with a high adherence to the Mediterranean Diet have higher health related quality of life. CONCLUSIONS: Adolescents’ adherence to the Mediterranean Diet, physical activity, socioeconomic characteristics and life style behaviors are highly correlated with perceived health related quality of life during COVID-19 period.

The Perception of Religious Coping and Health Related Quality of Life in The Case of an ALS Caregiver During COVID-19

Research ObjectivesTo investigate the degree to which the progression of disease and loss of swallowing and communication in amyotrophic lateral sclerosis (ALS) patients affect the quality of life and religious coping of a caregiver over time. To investigate the perceptions of the impact of the coronavirus on caregiving.DesignMixed method longitudinal time 1 (T-1) and time 2 (T-2) case study design for a duration of 24 weeks from September 2020 to February 2021.SettingPhone interviews, per Centers for Disease Control and Prevention (CDC) social distancing guidelines, were held in the general community.ParticipantsA single informal (non-compensated) family caregiver of a spouse with ALS. Convenience sample: The participant was referred by a hospital-based speech language pathologist.InterventionsNot applicable.Main Outcome Measures1) Qualitative interviews, 2) the Brief RCOPE (a 14-item measure of positive and negative religious coping with major life stressors), and 3) a health-related quality of life survey instrument (SF12v2).ResultsLongitudinal case study findings revealed changes from T-1 to T-2 for all measures. Negative religious coping was essentially unchanged, with two notable exceptions. At T-2, she no longer felt punished by God, nor questioned God's love for her. She also “somewhat wondered” whether her church had abandoned them. Positive religious coping which measures a sense of connection to God decreased. The health related quality of life measure indicated a decline in energy, physical health, and level of task accomplishment. Perceptions of the impact of the coronavirus were mixed. At T-1, she reported decreased pressure for managing appointments and visitors. By T-2, her feelings of isolation and loneliness increased.ConclusionsIn this case study, the ALS caregiver's perceptions of health related quality of life and religious coping appeared declined in the face of losses due to major life stressors; communication and swallowing abilities. This was evidenced by reporting feeling less connected to God, less productive during completion of tasks, and reduced energy. The duration of coronavirus precautions resulted in perceived increase in isolation and loneliness.Author(s) DisclosuresNo conflicts for any authors.

Oncological Children and Well-Being: Occupational Performance and HRQOL Change after Fine Motor Skills Stimulation Activities.

Cancer children experience long periods of hospitalization, which are associated with limited performance in several developmental domains and participation restrictions in age appropriate occupations. Fine motor abilities represent building blocks in performing daily life skills and have been found to be closely connected with later academic success. Moreover, medical and psychological sequelae for cancer inpatients may result in diminished daily activities functioning, poor perceived health related quality of life (HRQOL), and increase the likelihood of long-term impairments. This study examines the variations in the occupational performance of children hospitalized for acute lymphoblastic leukemia (ALL) after their participation to a stimulation program designed to enhance fine motor skills. Parents reported significant gains in children’s motor functioning, a slight improvement in overall occupational performance related to an increase in the area of productivity and self-care, and a better quality of life perception following the stimulation activities. Feasibility of the stimulation program in a health care setting are discussed evaluating its benefits for cancer children and their families.

AUTHOR REPLY

The preceding editorial offers insightful commentary and discussion points which is appreciated. Intraoperative and post-operative complications certainly impact patient recovery and influence perceived health related quality of life (HRQOL). The degree and duration of surgical complications vary considerably in this patient population. While we present the largest cohort of patients who received ileal conduits, neobladders, or Indiana pouches, it was not possible to perform a subset analysis of the various complications with respect to each urinary diversion as the small subsets made a statistical analysis prohibitive.

Psychophysical health and perception of well-being between master badminton athletes and the adult Italian population.

Background and aim of the work:Sport participation, regular exercise and physical activity in general exert many benefits on wellness, perceived health related quality of life and social satisfaction. As the people age, physical and mental deterioration occur. Master athletes are older adults that practice different sports, such as running, swimming and badminton. This is a widespread sport practiced by over 200 million people and is one of the most exerted sport in the world. In our study we compared the health perception of Italian Badminton Master athletes and normal Italian population of same age.Methods:Thirty (22 males, 8 females) Master badminton athletes between 18 and 69 years old participating to 2018 edition of the Italian Master Badminton Championship were enrolled for the study. All athletes compiled a six questions questionnaire, about perceived quality of life, included in the 2014-2017 Italian surveillance database “PASSI” questionnaire and answers were compared to 18-69 y/o Italian population results included in the public database.Results:Statistically significative differences were not detected between genders of master athletes. There was only a significative better psychological perception of quality of life in younger class of master athletes (p<0.05). A significative better perception was detected in Master athletes compared to normal Italian population.Conclusions:Aerobic sports, such as badminton, represent positive factors for improving health, psychological wellness and social engagement. Sport has a crucial role for the positive influence on growth in youngers and on the preventive role on typical diseases of older age, such as diabetes, ischemic cardiomyopathy and mental illness. (www.actabiomedica.it)

Health-related quality of life of teen/adult patients with cystic fibrosis in the Republic of North Macedonia

The present study investigates the Health-related quality of life of teen/adults patients with cystic fibrosis in the Republic of N. Macedonia for the first time. The main objective was to describe the health-related quality of life status of these patients with cystic fibrosis and the second objective was to investigate the connection of the current medical treatment with the analysed parameters. The survey was conducted on 31 patients by using the Cystic Fibrosis Questionnaire Revised for Health-related quality of live measurement and questions for current medical treatment. All patients scored their digestive condition with the highest score, while the lower score was reported for social activity. The gender, the nationality and the educational level of the patients with Cystic Fibrosis had no significant impact on their perception of Health-Related Quality of Live. The highest score for digestive condition was in positive correlation with the fact that all patients continuously used enzyme therapy. Patients who practiced physical therapy and physical activities reported high scores for physical conditions and body images. This finding point out that patient with Cystic Fibrosis should be encouraged to practice physical activity more often. The lowest scores for life activities and treatment burden shows that this medical condition has a negative impact on the patients’ self-perception and in the execution of their daily activities. Keywords: cystic fibrosis, Health-Related Quality of Live, digest, daily activities

A physical activity program versus usual care in the management of quality of life for pre-frail older adults with chronic pain: randomized controlled trial

BackgroundExercise has shown being effective for managing chronic pain and preventing frailty status in older adults but the effect of an exercise program in the quality of life of pre-frail older adults with chronic pain remains unclear. Our objective was to evaluate the effectiveness of multicomponent structured physical exercise program for pre-frail adults aged 65 years or more with chronic pain to improve their perceived health related quality of life, compared with usual care.MethodsOpen label randomized controlled trial. Participants were community-dwelling pre-frail older adults aged 65 years or older with chronic pain and non-dependent for basic activities of daily living attending a Primary Healthcare Centre. Forty-four participants were randomly allocated to a control group (n = 20) that received usual care or an intervention group (n = 24) that received an 8-week physical activity and education program. Frailty status (SHARE Frailty Index), quality of life (EuroQol-5D-5L), pain intensity (Visual Analogue Scale), physical performance (Short Physical Performance Battery) and depression (Yessavage) were assessed at baseline, after the intervention and after 3 months follow-up. The effect of the intervention was analysed by mean differences between the intervention and control groups.ResultsThe follow-up period (3 months) was completed by 32 patients (73%), 17 in the control group and 15 in the intervention group. Most participants were women (78.1%) with a mean age (standard deviation) of 77.2 (5.9) years and a mean pain intensity of 48.1 (24.4) mm. No relevant differences were found between groups at baseline. After the intervention, mean differences in the EuroQol Index Value between control and intervention groups were significant (− 0.19 95% CI(− 0.33- -0.04)) and remained after 3 months follow-up (− 0.21 95% CI(− 0.37- -0.05)). Participants in the exercise group showed better results in pain intensity and frailty after the intervention, and an improvement in physical performance after the intervention and after 3 months.ConclusionsAn eight-week physical activity and education program for pre-frail older adults with chronic pain, compared with usual care, could be effective to improve quality of life after the intervention and after three-months follow-up.Study registration detailsThis study was retrospectively registered in ClinicalTrials.gov with the identifier NCT04045535.

Health-related quality of life using specific and generic questionnaires in Spanish coeliac children

BackgroundWe aimed to compare the perception of health-related quality of life (HRQOL) and related factors in Spanish coeliac children and their parents, using two questionnaires, the generic KIDSCREEN-52 and the specific the Celiac Disease DUX (CDDUX), and to assess the correlation between them.MethodsCoeliac children, aged 8-18, who are members of the Madrid Coeliac Association (MCA) and their parents, answered the Spanish version of the CDDUX and KIDSCREEN-52 questionnaires via e-mail. CDDUX was answered by 266 children and 428 parents and KIDSCREEN-52 by 255 children and 387 parents. Linear regression models were fitted to evaluate the association of demographic and clinical factors with HRQOL scores. CDDUX scores were compared with the subjective perception of health status assessed by the first question of KIDSCREEN-52. The correlation between the questionnaires was analysed.ResultsWe found that the main factors that negatively affected HRQOL were having social or economic difficulties associated with following the diet and having transgression-related symptoms. The maximum correlation between the questionnaires was 0.309 and − 0.254 in parents and children respectively.ConclusionsAlthough there is a poor correlation between the two questionnaires, both agreed that the main concerns of the respondents were related to the social and economic difficulties of following the diet. It would be interesting to use both types of questionnaires in order to perform a more complete assessment of HRQOL in coeliac children.Trial registrationNot applicable.

Association between eating habits and health related quality of life among school age adolescents

Adolescence is considered a nutritionally vulnerable period of life, since their eating habits are influenced by factors that can promote the consumption of non-nutritious food. To analyze the relation between eating habits, obesity, and the perception of Health-Related Quality of Life in school-aged adolescents. A cross-sectional study of 550 adolescents aged 16 ± 1 years (60% women) attending a public education institution in Valparaíso, Chile. The Global School-based Student Health Survey (GSHS) for eating habits and the KIDSCREEN-27 survey for health-related quality of life were self-administered online. The answers were anonymous. A logistic regression analysis was conducted to evaluate the relationship between the variables, which was adjusted for age and sex. Ten percent of men and 6% of women were obese. Those with an inadequate consumption of fruits had a worst perception of their physical well-being, autonomy and relationship with their parents. Psychological well-being and school environment were perceived worst among those that did not consume breakfast. Obese respondents also reported a poorest physical health. Inadequate eating habits and obesity have a negative effect of health-related quality of life among adolescents.

Smoking and Quality of Life - Is there really an association? Evidence from a Nepalese sample.

Tobacco smoking has a negative impact on human health. Thus, it seems plausible for it to affect perceived quality of life as well. Information in this regard is lacking in Nepalese context. Thus, a comparative study was designed to assess association of cigarette smoking with Health Related Quality of Life (HRQoL). This study was conducted among 125 current and never cigarette smokers who attended a teaching hospital in peri-urban area of Capital city of Nepal from December 2015 to June 2016. The data regarding their socio-demographic characteristic, tobacco history and HRQoL was collected using a self administered questionnaire. QoL assessment was made with the help of valid, translated version of WHO QOL-BREF. Results showed current smokers on an average used 4 sticks of cigarettes per day. Significant proportions of current smokers also consumed alcohol compared to never smokers (p <0.05). Mean difference of both overall QoL score and domain scores among both study groups were relatively small and thus, failed to reach statistical significance. On the other hand, the socio-demographic characteristics like male gender, currently earning and attaining more than higher secondary education were predictors of better HRQoL scores. According to study results, relationship between smoking status and self reported QoL is unclear. Thus, the policy makers should also focus on wider determinants of ill health and well being and not just smoking status. Further research is still needed to understand the effect of tobacco on self perceived health related quality of life.

A pilot test of the Adult Sickle Cell Quality of Life Measurement Information System (ASCQ-Me) and the Jenerette Self-Care Assessment (J-SAT) Tools in adults with sickle cell disease

BackgroundThe purpose of this study was to pilot test two sickle cell-specific instruments, the Adult Sickle Cell Quality of Life Measurement Information System (ASCQ-Me) and Jenerette Self-Care Assessment Tool (J-SAT), to determine recruitment rate, percent completion of the instrument battery, and patient perceptions of health-related quality of life outcomes and self-care activities in a convenience sample of adults with sickle cell disease (SCD).MethodsA cross-sectional pilot study was conducted. Participants were recruited from a sickle cell clinic and conference on SCD. Subjects completed self-administered assessments including demographic and clinical characteristics, ASCQ-Me, and the J-SAT.ResultsTwenty of 22 participants completed the instruments (2 refusals) and most instruments had 100% completion rates. Participants reported average to healthier status on ASCQ-Me measures than a normative referent population of 556 individuals with SCD. Participants also reported high disease severity and high J-SAT scores (mean = 30.2), indicating frequent participation in self-care activities.ConclusionsThere was good participation, low refusal rates, and subjects completed the instruments and items without difficulty. Based on this work, a multi-method, multi-site study in Jamaica and the USA will be conducted to understand the relationships between health-related quality of life, stigma, and self-management in adults with SCD.

Degree of Functionality and Perception of Health-Related Quality of Life in People with Moderate Stroke: Differences between Ischemic and Hemorrhagic Typology.

Objectives The objectives of this pilot study were to analyze the functional differences and the differences regarding the perception of health-related quality of life between people affected by ischemic and hemorrhagic stroke, respectively, and between these and their normative groups. Methods A pre-post design study was conducted with 30 patients aged 65 ± 15 during eight weeks. It assessed disability, mobility, and health-related quality of life. Exact nonparametric tests were used to compare both types of stroke, and t-tests and effect size estimates were employed to compare the stroke group and the normative group. Results At baseline, there were differences in disability (“getting along” domain), where a poorer result was obtained by the hemorrhagic stroke group, and in the “vitality” and “mental health” domains of the health-related quality of life test, where the ischemic group obtained poorer results. Both groups made significant progress in their health assessments and functionality after eight weeks, and no significant differences were found between them at that time. The scores obtained in both groups differed statistically from the normative values, both at baseline and at posttest. Conclusions Regardless of the stroke type, divergent results were only found in two domains, “vitality” and “mental health.” There was an improvement over time, but the scores obtained were still lower than those observed in the normative group, which indicated that the participants' health was highly compromised. This study provides more information for faster rehabilitation after stroke; even so, more studies are needed.

The role of pain in chronic pain patients' perception of health-related quality of life: a cross-sectional SQRP study of 40,000 patients.

Background and aims Health-related quality of life (Hr-QoL) reflects the burden of a condition on an overarching level. Pain intensity, disability and other factors influence how patients with chronic pain perceive their condition, e.g. Hr-QoL. However, the relative importance of these factors is unclear and there is an ongoing debate as to what importance pain measures have in this group. We investigated the importance of current pain level and mood on aspects of Hr-QoL in patients with chronic pain and investigated whether such relationships are influenced by demographics. Methods Data was obtained from the Swedish Quality Registry for Pain Rehabilitation (SQRP), between 2008 and 2016 on patients ≥18 years old who suffered from chronic pain and were referred to participating specialist clinics. Dependent variables were general Hr-QoL [using two scales from European Quality of Life instrument: EQ5D Index and the European Quality of Life instrument health scale (EQ thermometer)] and specific Hr-QoL [from the Short Form Health Survey (SF36) the physical component summary (SF36-PCS) and the mental (psychological) component summary (SF36-MCS)]. Independent variables were sociodemographic variables, pain variables, psychological distress and pain attitudes. Principal component analysis (PCA) was used for multivariate correlation analyses of all investigated variables and Orthogonal Partial Least Square Regression (OPLS) for multivariate regressions on health aspects. Results There was 40,518 patients (72% women). Pain intensity and interference showed the strongest multivariate correlations with EQ5D Index, EQ thermometer and SF36-PCS. Psychological distress variables displayed the strongest multivariate correlations with SF36-MCS. Demographic properties did not significantly influence variations in the investigated Hr-QoL variables. Conclusions Pain, mood and pain attitudes were significantly correlated with Hr-QoL variables, but these variables cannot explain most of variations in Hr-QoL variables. The results pinpoint that broad assessments (including pain intensity aspects) are needed to capture the clinical presentation of patients with complex chronic pain conditions.

Anxiety and Coping Based on Emotions may contribute to Reduced Quality of Life in Patients with Mild Systolic Heart Failure

Aims and Scope: Perception of health related quality of life (QoL) may result from the complex interplay between the severity of the disease and the patient’s psyche. It the present study we assumed that anxiety and coping based on emotions may contribute to reduced QoL in patients with mild systolic heart failure (HF). Methods: We examined mainly males with systolic HF (almost all with ischemic etiology of HF, all classified in the NYHA class II, receiving standard pharmacological treatment). Each patient underwent a physical examination, routine laboratory tests and standard transthoracic echocardiography and completed psychological questionnaires assessing: coping styles, sense of self efficacy, acceptance of illness, optimism and the level of anxiety and QoL (by Minnesota Living with Heart Failure Questionnaire). Results: Emotion-oriented coping was strongly positively related to an overall score reflecting QoL (r=0.37) as well as to both dimensions of QoL, with exceptionally high correlation with the emotional dimension (r=0.24 and r=0.62, respectively, all p&lt;0.05). More reduced QoL (overall score as well as scores in both analysed dimensions) was significantly (all p&lt;0.05) but weakly (r=-0.21, r=-0.20 and r=-0.26, respectively) related to lower acceptance of the illness. Higher level of anxiety was related to more reduced QoL (all p&lt;0.05). Reduced QoL in emotional dimension was related to the tendency to avoidance-oriented coping (r=0.26, including also a sub style based on distraction, r=0.34) as well as to lower sense of self-efficacy (r=-0.20) and lower level of optimism (r=-0.20, all p&lt;0.05). Conclusion: The results indicate that HF patients are psychologically diverse, which is not related to disease severity. However, QoL was related to emotion-oriented coping and anxiety. Psychological support for patients with HF should be focused on teaching adequate methods of coping and reducing anxiety.

Health-related quality of life of adolescent students.

This study aimed to evaluate the perception of health related quality of life (HRQoL) of adolescent students. This is a cross-sectional study with 807 adolescents aged 10 to 17 years from two public schools of Niteroi and four private schools of Rio de Janeiro and São Gonçalo. Information on HRQoL was obtained by a reduced version of the Kidscreen questionnaire with 27 items. Student t tests were used to assess the perception of HRQoL stratified by type of school, gender, age and ownership of assets. We used linear regression models to evaluate HRQoL settings. In general, the evaluated adolescents evidenced a good HRQoL. However, results show significant differences in the perception of each HRQoL realm between subgroups. Private school adolescents had better HRQoL compared to public schools in all Kidscreen-27 realms. Older adolescents, those from public school and those with lower ownership of assets had lower HRQoL values in most realms, particularly in the 'Autonomy and Relationship with Parents' realm. Disclosure of the differentiated profile of HRQoL among adolescents is the first step towards developing action strategies in the school environment that prioritize the most vulnerable groups.

Modification of the Coping and the Emotional Comorbidity in Patients Candidates to Cardiac Surgery

Objective: To evaluate the effectiveness of a program of psychological preparation for invasive procedures in patients with heart disease, candidates for cardiac surgery, to reduce emotional morbidity and improve perception of health related quality of life. Methods: A Quasi-experimental design was used. The study included a non-probabilistic randomized sample of 110 patients treated in the Division of Cardiac Surgery Centro Medico Nacional Siglo XXI Instituto Mexicano del Seguro Social IMSS. They were divided in two groups: Experimental group (n = 44) and Control group (n = 66). Instruments: CHIP Coping Questionnaire, HADS Anxiety and Depression Hospital Scale, Health Related Quality of Life Questionnaire and a Visual Analogue Scale (VAS) to measure postoperative pain. Results: The experimental group showed an increase in instrumental coping style compared to pre (M = 24.55) and post evaluation (M = 25.93); statistically significant differences were found in the variables of stress (p = 0.042), anxiety (p = 0.001), depression (p = 0.056) and health related quality of life (p = 0.000); while in the control group, the distraction coping style (pre M = 25.80, post M = 26.73) is the one that increased; there were no statistically significant differences in the variables stress (p = 0.274), anxiety (p = 0.671) and depression (p = 0.850), except for the health related quality of life (p = 0.000). This study is the first in Mexico to manage emotional comorbidity in this type of population.

Do Clinical And Psychosocial Factors Affect Health-Related Quality of Life in Adolescents with Chronic Diseases?

Living with a chronic disease in adolescence can have an impact on the perception of Health-related Quality of Life (HRQoL). Facing the increasing relevance of psychosocial dimensions and also considering the interaction with clinical variables, this study aimed to measure the impact of clinical and psychosocial factors (separated and combined) on adolescent’s reported HRQoL.A cross-sectional study was conducted in a clinical population of 135 adolescents with chronic diseases (n=70 boys), average age: 14±1.5 years old. Through a self-reported questionnaire, HRQoL (KIDSCREEN-10), socio-demographic, clinical variables (diagnostic; time of diagnosis; self-perceived pain; disease severity proxy; disease-related medication intake/use of special equipment), and psychosocial variables (psychosomatic health; resilience; self-regulation; social support) were assessed.Separately, clinical and psychosocial variables showed a significant impact in HRQoL, 27.9% and 62.4%, respectively. Once combined, the previously identified variables had a significant impact (64.2%), but a different contribution from clinical and psychosocial variables was revealed: when first entering the clinical variables (model 1) the variance only reaches 30%, and much more from psychosocial variables seems to explain the total (64.2%); inversely, when first integrating psychosocial variables (model 2), the clinical ones added a small significance to the model (0.6%).The present study underlined the association of clinical (“disease-related”) and psychosocial (“non-disease-related”) factors on HRQoL. Furthermore, it reinforced the need to focus more on psychosocial dimensions, highlighted the potential role of psychosomatic health, resilience, self-regulation and social support. It can be suggested that the identification of impaired psychosocial domains may help professionals to better plan, and achieve effective interventions of psychosocial care.

Health-related quality of life in the Brazilian Amazon: a population-based cross-sectional study

BackgroundTo analyze perceptions of health-related quality of life and associated factors in populations from the Manaus Metropolitan Region.MethodsWe conducted a population-based cross-sectional study from May to August 2015. Adults aged 18 years and older were selected using probabilistic three-phase cluster sampling and stratified by sex and age, based on official estimates. Quality of life data were collected using the European Quality of Life 5-Dimensions 3-Levels (EQ-5D-3L) along with socioeconomic, demographic, and health perception data. Utility scores were calculated using the Brazilian version of the EQ-5D-3L. Descriptive statistics were derived, and a multivariate Tobit regression model with correction for complex sampling was performed to identify the variables that influence utility levels.ResultsA total of 4001 participants were included. The average utility score was 0.886 (95% confidence interval [CI]: 0.881–0.890) with significant differences according to living area (the capital (0.882 ± 0.144) or inner cities (0.908 ± 0.122; p < 0.001)). The dimension for which the highest proportion of people reported moderate to severe problems was pain/discomfort (39%), followed by anxiety/depression (18%). Men had a higher quality of life than women (β = 0.041, p < 0.001). Not working was a factor that increased quality of life compared with being formally employed (β = 0.031, p = 0.037). The poorest people had a lower quality of life than the richest people (β = −0.118, p < 0.001). Better health perceptions increased utility scores (p < 0.001), while being separated decreased the scores (β = −0.052, p = 0.001).ConclusionHealth-related quality of life in the Manaus Metropolitan Region was high, as expected for the general population, and was higher among individuals who lived in the inner cities, men and those in higher social classes. Gender discrepancies and differences in quality of life between the capital and inner cities should be further investigated.

Life-orientation, Subjective Well-being and Social Support as Predictors of Quality of Life in Patients with End Stage Renal Disease

Background: Psychosocial experiences such as life-orientation, subjective well-being and social support are punitive in determining the health related quality of life of patients in end stage of Chronic Renal Disease; also termed as End Stage Renal Disease (ESRD).Objectives: to investigate the phenomenon of life-orientation, subjective well-being, social support and perceived health related quality of life in patients with end stage renal disease. ESRD patients’ life orientation, social support and subjective well-being are significant predictors of their perceived quality of life that further determines their disease management and health status.Materials and Methods: This research has been laid out through cross sectional survey research design. The data was collected between the time span of Jan, 2016 to June, 2016. The sample comprised of 200 respondents from both gender, equally distributed within the age range of 50 to 60 years, going through last stage of ESRD and relying on dialysis from at least past one year or more. Indigenously translated WHO QoL, Subjective Wellbeing Scale, multidimensional Social Support Scale, Life Orientation Scale and a demographic information sheet was used to collect the data.Results: The results revealed that life orientation, social support and subjective well-being significantly and positively predicted the health related quality of life; greater social support and higher levels of subjective wellbeing after controlling for the effects of age, gender, income and education were found when the patients ‘carried optimistic and positive life-orientation.Conclusion: The current research findings therefore incriminate preemptive direction in understanding the phenomenon of life-orientation, social support, subjective wellbeing and health related quality of life in patients with last stage ESRD. This further embarks onto highlighting the insightful guidelines for health and clinical psychologists in devising management interventions, targeting the increased subjective well-being, and promotion of optimistic life-orientation in order to facilitate health related quality of life in the patients with end stage renal disease.Bangladesh Journal of Medical Science Vol.16(3) 2017 p.346-353