Perception Of Overall Quality Research Articles

STUDY OF PATIENTS' QUALITY OF LIFE AS AN ALTERNATIVE TO AN ADDITIONAL DIAGNOSTIC METHOD IN THE EXAMINATION OF PATIENTS WITH DISLOCATED TEMPOROMANDIBULAR JOINT DISKS

"Quality of life is a concept used to assess and measure the level of satisfaction, health, comfort and general well-being of a person or group of people".
 The aim of the study was to investigate the QOL indicators of patients with dislocated TMJ articular discs during examination and treatment.
 The objective of this study is to determine the impact on the QOL of patients' orthopedic treatment of TMJ disc dislocations.
 The number of examined patients was 50, age 25 to 60 years, patients had a dislocated TMJ disk.
 In this study, we compared the QOL indicators in patients with dislocated TMJ discs before and after treatment, using the WHO QOL-100 questionnaire.
 The results of the study showed that the average score of the perception of overall quality of life and health (G) after treatment improved significantly. The study was divided into spheres: "Physical sphere" fatigue has significantly decreased, the feeling of pain and discomfort has disappeared, sleep has normalized, energy and strength have increased; "Psychological sphere" feelings and thinking have become more positive, concentration, self-esteem and appearance have improved, and anxiety has decreased; "Level of independence" increased daily activity and performance; "Social relationships" improved perception of relationships in society; "Environment" normalized general health of patients; in the "Spiritual sphere" patients became more confident.
 Thus, after orthopedic treatment of TMJ articular disc dislocations, QOL of patients improves significantly. The study of QOL in patients in the treatment of TMJ dislocations can be used as a diagnostic criterion for patient recovery.
 Directions for future research: the use of QOL research in assessing the quality of care of orthopedic dentists in the treatment of patients with TMJ dislocations.

Environmental Quality of Life and Psychological Distress of Emerging Adults in Flood-Affected Areas of Assam, India: A Cross-Sectional Study

Abstract Background: Psychological reactions after any catastrophe can vary from person to person and from disaster to disaster depending upon the level of exposure, the extent of loss, coping mechanisms, and social support available at that time. Objective: The objective of this study was to examine mental health-related issues experienced by emerging adults as a result of flooding in various localities of Assam, which are considered to be as worst affected areas. Materials and Methods: It was a cross-sectional research study and was conducted among the emerging adults of flood-affected areas of Assam amid the issues of ongoing floods between June and July 2022. The convenience sampling method was used in the selection of emerging adults in the age group of 18–25 years, residing in Assam during flooding situations. To measure psychological distress, the Depression, Anxiety, and Stress Scale was used. Additionally, to measure an individual’s perception of general health, environmental quality of life, and people’s perception of the overall quality of life, the World Health Organization Quality of Life-BREF Scale was used. Results: The findings show that a significant difference was not found between emerging adults who had flood issues on their property and those who had not gone through in the domain of depression (Mann–Whitney U = 1644.0, p=.85), anxiety (Mann–Whitney U = 1657.0, p=.91), and stress (Mann–Whitney U = 1634.0, p=.81). Significant group difference was seen in the environmental quality of life (Mann–Whitney U = 945.5, p<.001), the individual’s perception of general health (Mann–Whitney U = 1225.0, p=.01), and the individual’s perception of overall quality of life (Mann–Whitney U = 991.5, p<.001). It was found that depression had a significant negative correlation with an individual’s perception of general health (r = −0.172, p=.045). Additionally, anxiety had a significant negative correlation with the individual’s perception of general health (r = −0.193, p=.024). Stress had a significant negative correlation with an individual’s perception of general health (r = −0.169, p=.048). Conclusion: The results in the present study help to comprehend emerging adults’ psychological responses to disasters and have practical insinuations for service planning and delivery. It is very important to strengthen mental health care and psychological consultation facilities, to mitigate, control, and prevent mental health problems.

A STUDY TO ASSESS PATIENT’S SATISFACTION WITH QUALITY OF NURSING CARE

Objectives: Patient satisfaction is a concrete criterion for the assessment of health care and for that reason quality of nursing care. It provides data for healthcare managers by providing significant resources for processes such as those involved in measuring patients’ expectations and satisfaction with nursing care quality, improving nursing service quality through documentation of areas of failure and planning and implementing necessary training. The study was carried on with the aim to assess patient’s satisfaction with quality of nursing care in a tertiary care hospital and to identify the relationship between the satisfaction of patients with selected variables. Methods: This descriptive cross-sectional study was done at a tertiary care hospital of Indian armed forces after taking approval from the ethical committee of the institute. 50 patients from various wards were selected for the study by randomization method. Critical patients, patients in isolation wards/intensive care unit, and patients with mental illness were excluded from the study. All participants were apprised of the study carried out on them and their informed consent was taken. The data were collected from the participants through a validated structured questionnaire to assess the patient’s satisfaction with quality of nursing care. The data were collected and analyzed statistically. Results: Out of all patients, most of the patients (52%) were aged between 36 and 50 years, and many of them, i.e., 82% were married. Analysis of patient’s satisfaction with nursing care quality questionnaire (PSNCQQ) revealed that for item “Ease of getting information: Willingness of nurses to answer your questions” the highest excellent satisfaction response was given by 24% patients. Item under the highest very good satisfaction response was “Information given by nurses: How well nurses communicated with patients, families, and doctors.” The items for which satisfaction levels were lowest were the “The daily routine of the nurses: How well they adjusted their schedules to your needs” and coordination of care after discharge: Nurses’ efforts to provide for your needs after you left the hospital. Overall, patients were satisfied with the quality of nursing care for most of the variables. Analysis of PSNCQQ for perception-related items showed that 24% and 72% of participants’ responses for the “Quality of the care and service provided during your stay at the hospital” were excellent and very good respectively. Analysis of PSNCQQ for perception-related items showed that patients aged between 18 and 35 years were more satisfied with quality of care. In the overall perception about the quality of care, males were more satisfied than females. In overall perception of quality of nursing care married were more satisfied. Educated patients are more satisfied with the quality of nursing care. Conclusion: The results also showed that nurses should provide care in a framework of respect, kindness, and courtesy toward patients by emphasizing the importance of communication. Besides these, the patients were highly satisfied with the overall quality of hospital care, and nursing care and reported that they would recommend this hospital to their families and friends.

A Qualitative Study of the Psychosocial, Physical and Spiritual Benefits and Challenges Experienced by Psychiatric Patients Engaging Community Mental Health Services

Background Mental illness generates feelings of shame, low self-esteem, isolation, and hopelessness which affect wellbeing and quality of life. Mental health care practitioners, therefore, need to support their clients to improve their quality of life. Despite an increasing awareness of the importance of spirituality in mental health contexts, a religiosity gap exists in the difference in the value placed on spirituality and religion. This may be due to a lack of understanding about the complex ways people connect with spirituality within contemporary society and mental health contexts and can result in people's spiritual needs being neglected or dismissed within clinical practice (K. Milner et al., 2020). Additionally, mental illness may cause a variety of psychosocial problems such as decreased quality of life of the patient and their family members as well as increased social distance for the patient and the family caring for the patient. Psychosocial challenges are enhanced by the stigma attached to mental illness, which is a problem affecting not only the patient but also the family. Coping mechanisms for dealing with mentally ill patients differ from one family to another for a variety of reasons (Kakuma R et al., 2010). Objective: The aim of this study was to explore the contribution of community mental healthcare services to the wellbeing of persons with a history of mental illness using the Betty Ferrell’s Quality of Life (QoL) model. Methods A qualitative research approach was adopted, using exploratory descriptive design to describe the experiences of psychiatric patients engaging community mental health services. An in-depth interview was conducted using Betty Ferrell’s Model as a guiding framework. Each interview lasted about an hour. All interviews were audiotaped, transcribed, and the content analyzed thematically. A purposive sampling method was used to select 11 participants who participated in a face-to-face in-depth interview. Responses from the interviews were transcribed verbatim and analysed using the thematic content analysis approach. Results The findings from the study revealed the important and valuable contribution of community mental health nursing services to the quality of life and wellbeing of persons with mental illness in all spheres of their functioning. The main themes and sub-themes on how community mental healthcare services impact the wellbeing of persons with history of mental illness were Spiritual wellbeing (‘hope’, ‘transcendence’, ‘positive changes’), Social wellbeing (‘good social interaction’, ‘good relationship with family’, ‘good relationship with community members’, ‘good relationship with church members’), Psychological wellbeing (‘perception of overall quality of life’, ‘anxiety/depression’, cognition/attention’, assertiveness’), and Physical wellbeing (‘adherence to medication regimen’, overall physical health’, functional ability’, appetite’). Community mental health nurses have also been instrumental in promoting the social wellbeing of people with history of mental illness. Improvement in the spiritual lives and religious activities of the clients through the intervention of the nurses helped them to find some purpose and meaning in life. Counselling, reassurance, encouragement, and education of clients by the nurses provided some relief from their anxieties and depression and promoted client compliance with prescribed treatment regimen. Conclusion Both theoretical and empirical literature reviewed show that social and emotional support for persons living with mental illness, or with a history of mental illness, are important to their quality of life. The support given within the community is invaluable. Thus, community mental health care services span the well-being in the domains of physical, social, spiritual, and psychological functioning.

Perception of Overall Quality of Life Among Occupants of Green and Non-Green Office Buildings in Malaysia

Indoor environmental quality (IEQ) has become an important component of building design because people tend to spend the majority of their time indoors. The main purpose of this study is to investigate the occupants’ overall perceived Quality of Life (QoL) experience in two green and two non-green office buildings. All four buildings are situated in Klang Valley, Malaysia, and they are open-plan office buildings. 162 questionnaires were administered to assess the relationship between individuals' perceived QoL and IEQ factors. The IEQ factors, classified into ambient conditions, designed environment, and behavioural environment, are found to impact QoL. Findings from the case studies reveal that the four buildings varied in the aspect of Behavioural Environment, where some of the IEQ factors in the green buildings were perceived as slightly uncomfortable. It was also found that several IEQ categories interact as a system in which improvement of occupants' QoL experiences cannot be accomplished solely through the instrumental components of IEQ, as the designed and behavioural environments have substantial impacts. Several missing factors linked to the Green Building Index (GBI) criteria were significantly correlated with the QoL experience of occupants.

Long COVID Symptoms in Non-Hospitalised Patients: A Retrospective Study.

The COVID-19 pandemic has presented numerous challenges to healthcare systems. As the number of affected individuals continues to rise, it is crucial to find preventive, diagnostic, and therapeutic approaches. This study aims to describe different COVID-19 sequelae within a Primary Health Care population. A retrospective cohort study was conducted in adults diagnosed with COVID-19 from March 2020 to April 2022, excluding pregnant women, minors, nursing home residents, hospitalizations, and deaths. Data was gathered from surveillance records on the Trace COVID-19® platform, a pre-set original questionnaire (which included the Portuguese version of the World Health Organization's Quality of Life Assessment Instrument), and, if needed, patient electronic health records. Information on sociodemographic and clinical characteristics of acute COVID-19 was collected along with long COVID symptoms. This study included 284 patients, aged 19 to 99 years old. The five most prevalent acute COVID-19 symptoms were fever (50.0%), tiredness (48.2%), myalgias (44.7%), dry cough (37.7%) and odynophagia (36.3%). Symptoms related to the neurological system (23.2%) and tiredness (22.9%) were the most prevalent in long COVID symptoms. Acute tiredness and arthralgia were associated with all long COVID outcomes. The associations between acute COVID-19 symptoms with long COVID outcomes were stronger for anosmia [OR = 5.07, 95% confidence interval (CI) 2.49 - 10.36, p < 0.001] on a neurological chapter, acute tiredness for long lasting tiredness (OR = 4.07, 95% CI 2.07 - 8.02, p = 0.041), fatigue for muscles and/or bones chapter (OR = 7.55, 95% CI 3.06 - 18.66, p < 0.001), tiredness on an endocrine/hormonal chapter (OR = 6.54, 95% CI 2.37 - 18.04, p < 0.001), dyspnea for respiratory symptoms (OR = 5.67, 95% CI 1.92 - 16.74, p = 0.002) and fever for stomach or intestine symptoms (OR = 8.06, 95% CI 2.55 - 25.47, p < 0.001). Almost all quality of life dimensions were negatively associated with the number of long COVID symptoms. A higher number of acute symptoms, as well as the presence of specific COVID-19 symptoms were associated with reported symptoms ≥ 12 weeks after infection. In the studied population, an increased number of symptoms in both acute and long COVID had a significant negative impact on the perception of overall quality of life. The identification of these relationships could provide a new perspective for post-COVID care.

Nursing Students’ Evolving Perceptions of Online Learning: A Hierarchy of Curricula

Many nursing programs had relatively light online learning components before the COVID-19 pandemic. The transition to fully online courses without preliminary planning represented a problematic shock to most nursing students and faculty. To understand students’ perceptions of the critical success of online learning factors, an empirical comparison was conducted of nursing (n = 126) and non-nursing students (n = 1766) with similar demographic characteristics, but in different timeframes. A two-sample t-test was conducted for each question to ascertain significant differences in student perceptions between nursing and non-nursing students. While the ranking of critical success factors was similar for nursing and other students, the perceptions of nursing students were generally far more critical of the capability of online learning due, partially due to the perception that the online medium is less well suited to nursing education, and partially to instructional challenges caused by the rapid transition and chaos caused by the pandemic. The pandemic provided an inferior initial exposure to online nursing education in programs that had not previously prepared for online instruction, but had an abnormally increased demand for more online education. Without aggressive efforts to improve online teaching in programs with similar circumstances, students’ perceptions of overall quality may not improve significantly in the long term.

Evaluating the quality of life among patients undergoing orthognathic surgery using a customized questionnaire: A prospective study

Objectives:A questionnaire, specific to the clinical condition treated is important. The aim of this study was to evaluate the Quality of life (QOL) amongst patients undergoing orthognathic surgery using a customized questionnaire encompassing, patients’ perception of facial form and also patient perception of overall quality of care provided during the entire treatment.Material and Methods:This prospective, qualitative, observational study was carried out on 21 patients, who underwent Ortho-surgical management between Jan 2019 and Mar 2020. The Orthognathic QOL questionnaire was customized, Phase I, immediately prior; and Phase II, 6 months after surgery. Appropriate analysis was done to compare Phase I and Phase II, with the level of significance set to P &lt; 0.05.Results:“Aesthetics” was the most frequent reported reason for seeking treatment. The mean pre-/post-treatment difference for oral function was statistically significant. Majority (87%) of patients reported surgical outcomes met their expectations. Results, post-surgery; good hospital care (33.3%), supportive doctors (28.57%) and regular follow up (9.52%).Conclusion:“Patients’ perspective” of treatment, is often neglected, the immense importance of which has been duly reflected in our study. We recommend the use of our questionnaire in a similar, broad based multicentric study with a larger patient base, will aid in improving overall outcome of ortho-surgical interventions.

Nutrition Habits and Self-Assessment of Health and Quality of Life Among Women from the Kraków Community Participating in the "Healthy Active Senior” Programme

Background: Healthy food choices are among the factors contributing to health, and therefore, a better quality of life at each stage of ontogenesis. The aim of the study was to assess correlations of eating habits with self-rated health and quality of life (QOL) in women participating in the Healthy Active Senior project at the University of Physical Education in Kraków, Poland. Methods: The study was conducted in September 2019 among 201 women aged 60-85 (66 5) using the Questionnaire of Eating Behaviour (QEB) and the WHOQOL-BREF questionnaire. Statistical analysis was performed using Spearman’s rank correlation coefficients (Spearman’s rho), with a significance level set at p&lt;0.05. Results: The study demonstrated that the inclusion of unsweetened foods such as beverages and dairy products as snacks and a preference for baking/roasting as a method of heat treatment of meat led to an increase in self-rated health (p&lt;0.01). On the other hand, overall health assessment decreased (p&lt;0.01) with the consumption of sweetened beverages and sweetened dairy products, and adding salt to ready-made meals or sandwiches. Furthermore, with regular consumption of meals, including unsweetened beverages and dairy products as snacks, and a preference for baking/roasting as a method of heat treatment for meat and consuming wine among alcoholic beverages, the overall perception of quality of life increased (p&lt;0.01). In contrast, choosing sweet snacks and the preference for flavoured water led to a decrease in the overall self-rated QOL (p&lt;0.01). Conclusions: Healthy food choices are associated with an increase in the general perception of health and quality of life while choosing unhealthy foods is related to a decrease in the overall perception of health and QOL in senior women.

Relationship between patient experience and hospital readmission: system-level survey with deterministic data linkage method

BackgroundLinkage of public healthcare data provides powerful resources for studying from a comprehensive view of quality of care than information for a single administrative database. It is believed that positive patient experiences reflect good quality of health care and may reduce patient readmission. This study aimed to determine the relationship between patient experience and hospital readmission at a system level by linking anonymous experience survey data with de-identified longitudinal hospital administrative admissions data.MethodsData were obtained by linking two datasets with anonymised individual-level records from seven largest-scale acute public hospitals over seven geographical clusters in Hong Kong. Selected records in the two datasets involving patient experience survey (PES) (2013 survey dataset) and healthcare utilization (admissions dataset) were used. Following data cleaning and standardization, a deterministic data linkage algorithm was used to identify pairs of records uniquely matched for a list of identifiers (10 selected variables) between two datasets. If patient’s record from the survey dataset matched with the hospitalization records in the admissions dataset, they were included in the subsequent analyses. Bivariate analyses and multivariable logistic regression models were performed to evaluate the associations between hospital readmission in the next calendar month and patient experience.ResultsThe overall matching rate was 62.1% (1746/2811) for PES participants aged 45 or above from the survey dataset. The average score for overall inpatient experience was 8.10 (SD = 1.53). There was no significant difference between matched patients and unmatched patients in terms of their score for the perception of overall quality of care received during hospitalization (X2 = 6.931, p-value = 0.14) and score for overall inpatient experience (X2 = 7.853, p-value = 0.25). In the multivariable model, readmission through the outpatient department (planned admission) in the next calendar month was significantly associated with a higher score given to the overall quality of care received (adjusted OR = 1.54, 95%CI = 1.09–2.17), while such association was absent for readmission through Accident and Emergency department (adjusted OR = 0.75, 95%CI = 0.50–1.12).ConclusionsThis study demonstrated the feasibility of routine record linkage, with the limited intrusion of patients’ confidentiality, for evaluating health care quality. It also highlights the significant association between readmission through planned readmission and a higher score for overall quality of care received. A possible explanation might be the perceived better co-ordination between outpatient departments and inpatient service and the well-informed discharge plan given to this group of patients.

Barriers and enablers to nurses' use of harm prevention strategies for older patients in hospital: A cross-sectional survey.

Preventable harms during hospitalization pose a major challenge for health systems globally. Nurse-led strategies provide comprehensive harm prevention to keep the most vulnerable patients safe in hospital, but gaps in care are common. Nursing roles and activities to prevent harm to patients during acute hospitalization are poorly understood. The aim of this study was to identify nurses' perceived enablers and barriers to the implementation of comprehensive harm prevention for older people admitted to an acute hospital setting. Anonymous, online, cross-sectional survey. The adapted Influences on Patient Safety Behaviours Questionnaire (IPSBQ) was used to collect data from nurses working on five general medicine wards across three hospitals of a single tertiary health service in Australia in 2019. Participants also rated their perceptions of overall quality of care, missed care and awareness of strategies for an eight-factor framework for comprehensive harm prevention. The STROBE reporting checklist was used. Ward response rates between 35% and 58% resulted in 132 complete questionnaires for analyses. High mean scores for behavioural regulation (3.28), beliefs about capabilities (2.96) and environmental context and resources (2.73) indicated these domains were perceived by nurses as enablers. Low mean scores for the domains of intentions (1.65), beliefs about consequences (1.69), optimism (1.72) and professional role and identity (1.85) indicated these were barriers to comprehensive harm prevention by nurses. High perceived quality of care (scored 9-10/10) (p=.024), and awareness of strategies for the eight-factor framework (p=.019) were significant enablers of comprehensive harm prevention. Targeted evidence-based strategies that include education, persuasion, incentivization, coercion and modelling would be most useful for promoting comprehensive harm prevention by nurses. However, to be most effective the harm prevention strategy may need to be tailored for each ward.

The HEALTHQUAL model: Evaluating the Quality of Health Service in the Federal District, Brazil

The objective of this work is to present factors that influence the overall quality of patient care. A total of 173 people participated in the study. The research was explanatory, with a quantitative approach. The data collected was treated by structural equations using SmartPLS software. The proposed structural model was validated by an average composite reliability of 0.826. The model, through its hypotheses, explained the overall quality of health services by 35%. With the analysis of the results, the hypotheses that supported the model were Installation and Infrastructure (29.1%) and Overall Efficiency (4.7%). the core decisive factor for the sampled population is the simple act of "being served". This complex reality is in many daily news reports in the country, where people appear on stretchers in the corridors, lack of equipment and medicines, which demonstrates the lack of structure of hospitals, the disregard for the population, the long time it takes to perform some critical test. Given the model results, it is possible to understand better the critical factors for the success of hospitals in the Federal District, Brazil. Thus, to improve this perception of overall quality of care, it is necessary to guarantee the infrastructure and physical facilities of the health centers for the population through better use of public money and more effective management.

Impact of e-HRM systems on quality of competency assessment in Indian public sector organisations

As public sector organisations are migrating from traditional to web-based competency assessment methods globally, it becomes crucial to know about the perspective of employees towards the quality of competency assessment enhancement after implementation of e-HRM. This research aims to capture the same. The methodology used in the study includes case-based exploration of three large public sector organisations with onward journey transitioning from paper-based competency assessment to e-HRM systems-based competency assessment for enhanced quality. A study is conducted in a group of 506 employees in two different phases' viz. pre-web portal phase and post-web portal phase. The findings indicate that the web-based portal for e-HRM had no significant effect on the employee perceptions of overall quality of competency assessment programs (CAPs) but resulted in improved perceptions of transparency and directness in the sample organisations. The study makes an important contribution towards a shift in the assessment of system-based interventions for performance improvement of public sector employees in India. The paper has significant implications for similar transitions in competency assessments in developing or developed countries' public system management.

Students’ School Satisfaction: The Role of Classroom Climate, Self-efficacy, and Engagement

Students’ satisfaction with school is subjective, cognitive appraisal of overall positivity of school experiences, and precisely because it represents the key aspect of children’s overall perception of quality of life, it is important to find out what influences students’ school satisfaction and to which extent. The goal of this research was to establish whether self-efficacy and engagement function as mediating variables in the relationship between classroom climate and students’ school satisfaction. The research included 597 students from primary schools in Zagreb, Croatia. A structural equation model was designed and tested. The model testing showed that positive classroom climate has statistically significant and positive effects on self-efficacy and engagement. Furthermore, self-efficacy has a significant positive impact on explaining engagement. At the same time, negative classroom climate has a significant positive influence on engagement, which in turn contributes to the final effect on school satisfaction. The model has explained 56% of the school satisfaction variance in total.

Perceptions of water quality, and current and future water consumption of residents in the central business district of Yangon city Myanmar

Abstract Public water supply services in Yangon started in 1842, however the practice of drinking tap water has been uncommon until this moment. Currently, Yangon city development committee is upgrading the tap water system in accordance with the greater Yangon water supply improvement project. It is important to know the perceptual driving factors affecting the decision to drink in order to effectively improve the public acceptance of tap water. In this study, household water management practices and their influencing factors for Yangon city residents are revealed through questionnaires. Residence time in Yangon city is significantly associated with water consumption behaviour. Decisions for drinking come from organoleptic perception rather than important safety considerations. The future consumption of tap water is influenced by income and perception of overall quality. Preferred billing method is associated with education, family size, income and willingness to spend more for better quality water.

HEALTH RELATED QUALITY OF LIFE AMONG HAEMODIALYSIS AND KIDNEY TRANSPLANT RECIPIENTS FROM NEPAL: A CROSS SECTIONAL STUDY USING WHOQOL-BREF

Objective: Very less is known about health-related quality of life (HRQOL) among patients with kidney diseases in Nepal. This study examined HRQOL among haemodialysis and kidney transplant recipients in Nepal. Design and method: The Nepali version of World Health Organization Quality of Life Instruments -(WHOQOL-BREF) questionnaire was administered using face to face interviews among end stage renal disease (ESRD) patients, from two large national referral centers in Nepal. The differences in socio-demographic characteristics among ESRD patients were examined using the Chi-square test. The group differences in quality of life (QOL) were examined using the Mann-Whitney U test and Kruskal-Wallis tests. Results: Of the 161 participants, 92 (57.1%) were renal transplant recipients and 62 (42.9%) patients were on maintenance haemodialysis. Hypertension (70.9%) was the most common co-morbidity among ESRD patients. Haemodialysis patients scored significantly lower than the transplant recipients in all four domains as well as in overall perception of quality of life and general health. Ethnicity (p = 0.020), socio-economic status (p &lt; 0.001), educational status (p &lt; 0.001) and employment status (p = 0.009) were significantly associated with the overall QOL in ESRD patients. Across patient groups, educational status (p = 0.012) was positively associated with QOL in dialysis patients, while urban residence (p = 0.023), higher socio-economic status (p &lt; 0.001), higher educational status (p = 0.004) and diabetes status (p = 0.010) were significantly associated with better QOL in transplant recipients. Conclusions: The overall QOL of the renal transplant recipients was higher than that of the patients on maintenance haemodialysis; this was true in all four domains of the WHOQOL-BREF. ESRD patients with low HRQOL could benefit from targeted risk modification intervention.

Green spaces, quality of life, and citizen perception in European cities

Urban green spaces generate a number of perceived benefits toward human health and well-being, including an overall improvement in the quality of life. To date, processes underlying these benefits are mostly investigated at city level, while very little research has been conducted at a larger scale, such as the European level. Evidence is lacking on the association between green spaces and citizens' perceived benefits based on variations among cities with different socio-economic conditions. This study aims to disentangle the relationship between greenness, citizens' perceived quality of life, the environment, social inclusion and urban management in 51 European cities, as well as the role of per capita income in moderating the effects of greenness on overall perceived quality of life. Through structural equation modeling, the effect of greenness was tested on citizens' perceived overall quality of life (i.e., on the environment, social inclusion, and urban management). The role of metropolitan gross domestic product per capita in moderating the relationship between greenness and citizens' perceptions on overall quality of life was investigated. Our findings confirm the influence of greenness on citizens' quality of life. More importantly, the influence of greenness on the overall perception of quality of life was considerably more marked in lower-income cities. This study represents one of the first attempts at exploring the complex mechanisms underlying the association between green space and citizens' well-being at continent level. Practical implications for European urban planners and policy makers are discussed.

Quality of life among caregivers of children with epilepsy: A cross-sectional study at Eastern Nepal.

ObjectiveTo assess the quality of life among caregivers of children with epilepsy in a tertiary care center of eastern Nepal.MethodsA cross‐sectional study was conducted among primary caregivers of children with epilepsy, who accompanied their child in child neurology clinic. Consecutive sampling was done, and 106 respondents were interviewed. Data were collected using World Health Organization Quality of Life‐BREF (WHOQOL‐BREF) scale and analyzed using Statistical Package for the Social Sciences. Descriptive and Inferential statistics were applied.ResultsMean WHOQOL‐BREF score was 82.25 {standard deviation (SD) ±12. 11}. Transformed scores (0‐100) for each domain were 57.98 ± 14.55 in physical, 55.87 ± 13.16 in psychological, 53.12 ± 13.42 in social, and 52.52 ± 13.04 in environmental domain. Mean score for overall perception of quality of life (QOL) was 2.71 ± 0.79 and was 3.12 ± 0.75 for overall perception of health. Living below poverty line (P = .03) and poor seizure control status of children (P = .46) were significantly associated with lower total QOL score. Living below poverty line was significantly associated with low social relationship (P = .003) and environment domain (<0.001) scores.SignificanceEpilepsy has a multifaceted impact on the lives of affected people. Caring children with epilepsy is associated with enormous psychosocial effects on parents and family members. Caregivers' QOL may affect the treatment and outcome of epilepsy in children. Given the consideration to scarcity of this kind of literature in Nepalese context, this study was conducted.

Biosuggestive therapyin the treatment system of stress-related disorders in internally displaced persons

A comprehensive examination of 86 internally displaced persons from Anti-Terrorist Operation zone with stress-related disorders was conducted. Patients were both sexes, aged 18-55 years. The main group (MG) consisted of 50 patients who in addition to standard treatment according to clinical protocols received a course of biosuggestive therapy, control group (CG) consisted of 36 patients who received standard therapy according to clinical protocols. According to the study data obtained during on the background of therapy in patients of the main group there was a more pronounced decrease in anxiety and depression on the Hospital Anxiety and Depression Scale (HADS) and Hamilton Depression and Anxiety Scales (HDRS, HAM-A). The clinical data were received about reduction of symptoms of anxiety and depression from clinically expressed values to subclinical during use of biosuggestive therapy at patients of the MG, in comparison with scores by the same scales at patients of CG. The use of biosuggestive therapy in the complex treatment of patients with anxiety and mixed anxiety-depressive disorders has a positive effect on the feeling of psychological well-being, strengthening the sense of belonging and personal realization, improving interpersonal relationships, feeling of support from relatives and society, which affects the overall perception of quality of life, and most importantly reduces main symptoms and level of mental stress. Keywords: stress-related disorders, biosuggestive therapy, anxiety, depression.

Health related quality of life among haemodialysis and kidney transplant recipients from Nepal: a cross sectional study using WHOQOL-BREF

BackgroundVery less is known about health-related quality of life (HRQOL) among patients with kidney diseases in Nepal. This study examined HRQOL among haemodialysis and kidney transplant recipients in Nepal.MethodsThe Nepali version of World Health Organization Quality of Life Instruments -(WHOQOL-BREF) questionnaire was administered using face to face interviews among end stage renal disease (ESRD) patients, from two large national referral centers in Nepal. The differences in socio-demographic characteristics among ESRD patients were examined using the Chi-square test. The group differences in quality of life (QOL) were examined using the Mann-Whitney U test and Kruskal-Wallis tests.ResultsOf the 161 participants, 92 (57.1%) were renal transplant recipients and 69 (42.9%) patients were on maintenance haemodialysis. Hypertension (70.9%) was the most common co-morbidity among ESRD patients. Haemodialysis patients scored significantly lower than the transplant recipients in all four domains as well as in overall perception of quality of life and general health. Ethnicity (p = 0.020), socio-economic status (p < 0.001), educational status (p < 0.001) and employment status (p = 0.009) were significantly associated with the overall QOL in ESRD patients. Across patient groups, educational status (p = 0.012) was positively associated with QOL in dialysis patients, while urban residence (p = 0.023), higher socio-economic status (p < 0.001), higher educational status (p = 0.004) and diabetes status (p = 0.010) were significantly associated with better QOL in transplant recipients.ConclusionThe overall QOL of the renal transplant recipients was higher than that of the patients on maintenance haemodialysis; this was true in all four domains of the WHOQOL-BREF. ESRD patients with low HRQOL could benefit from targeted risk modification intervention.