Poorer Physical Quality Of Life Research Articles

The physical and mental aspects of quality of life among patients with eye diseases: a cross-sectional survey study in Afghanistan

BackgroundThe present study examined the quality of life and its relationship with socio-demographic characteristics among eye patients.MethodsA cross-sectional survey was administered from January 2022 to April 2022. Data were collected from participants with eye diseases (N = 617) in the Herat province of Afghanistan.ResultsOf the 617 participants, 63.4% had poor physical quality of life and 14.9% had poor mental quality of life. Multiple regression analysis indicated that poor physical quality of life was significantly associated with being above 54 years old (adjusted odds ratio [AOR] = 1.15, p = .0048), being female (AOR = 3.58. p < 0.01), being illiterate (AOR = 3.31, p = 0.01), being unemployed (AOR = 1.93, p = 0.04), and experiencing a traumatic event during the past month (AOR = 2.06, p = 0.02). Poor mental quality of life was associated with occupational status (being unemployed) (AOR = 3.62, p = 0.05), and experiencing a traumatic event in the past month (AOR = 3.49, p < 0.01).ConclusionThe present study provides a novel contribution to the field eye diseases and quality of life especially in relation to Afghanistan where there has been very little research in this area. The results indicate that public health authorities in Afghanistan should implement policies to improve mental and physical aspects of quality of life of patients with eye diseases as well as formulating strategies to help improve it.

Chronic illness and psychological problems in emerging adults: Moderation by perceived parental distress.

The aim of the current study was to better understand if perceived parental distress moderates the effects of having a chronic illness and poor physical quality of life on psychological problems reported by emerging adults. Participants consisted of 538 college-attending emerging adults (53.5% women; 46.5% men). Participants completed an online study that was composed of questions regarding chronic illness, the World Health Organization Quality of Life - Brief, the Adult Self-Report scale, and the Adult Behavior Checklist. In both emerging adult women and men, endorsing a chronic illness is significantly associated with psychological problems. Psychological problems in both emerging adult women and men were significantly predicted by the three-way interaction between endorsing a chronic illness, physical quality of life, and perceived maternal distress. Specifically, increased perceived maternal distress was associated with higher psychological problems in both emerging adult women and men with chronic illnesses and low physical quality of life. For emerging adult women and men with a chronic illness, higher perceived maternal distress was associated with poorer psychological adjustment, while lower perceived maternal distress was associated with better psychological adjustment.

Living well or not? Quality of life of parental living liver donors: A cross-sectional study.

The aim of this study was to gain comprehensive insight into the quality of life of parental living liver donors after liver donation. Several studies reported good quality of life of living liver donors with the SF-36 scale. Care demand from the recipient and responsibility of being parent might make a difference in parental donors' personal experienced quality of life after transplantation surgery. It is a cross-sectional study. The parental donors' demographics, clinical data and post-donation complications were obtained. Quality of life was assessed using the Medical Outcomes Study SF-36 and the Quality of Life Scale of Living Organ Donors-Common Module. The enrolled participants were contacted by electronic questionnaires and telephonic interview. A total of 345 parental donors were included, with recruited period ranging from 3 to 85 months post-donation. 8.1% of donors had post-operative complications, mostly classified as Clavien grade II. Donors' general quality of life was higher than the Chinese general norm. Issues related to surgical incision, fatigue, worries about income and personal health, effects on work capability, increased medical expenses and difficult reimbursement and suspected donation decision were the prominent problems among donors. Mother-son relationship (OR = 1.87) and equal or less than 2 years after donation (OR = 3.08) were the influencing factors for poor physical quality of life, while unmarried status (e.g. divorced or widowed) was found negatively associated with mental quality of life (adjusted OR = 3.61). General health among parental donors is good but those female, unmarried and near post-donation might in low life quality. Incision, fatigue, finance, reimbursement and donation decision are prominent problems. Post-donation care of living donors should cover social and financial domain besides physical and mental dimension. Providing follow-up care and counselling is necessary to ensure their life quality.

Bonding and Infants' Development and Quality of Life: A Study Among Mothers with Severe Mental Illnesses in Remission.

Maternal mental health has specific implications for bonding and infants' mental health. However, most of the evidence comes from mothers who are either symptomatic or did not have adequate mental health support. In this context, our objective was to explore if symptom status in mothers and bonding share any significant association with the infants' development and quality of life (QOL), in case of mothers with severe mental illnesses in remission. The study included 41 mother-infant dyads from the outpatient perinatal psychiatry services and the mother-baby unit of the current study center. Symptom status, self-reported bonding, mother-infant interactions, and infants' development and QOL were assessed with Clinical Global Impressions, Postpartum Bonding Questionnaire, Pediatric Infant-Parent Exam, Developmental Assessment Scales for Indian Infants, and Pediatric Quality of Life Scale, respectively. Most mothers had a complete recovery or minimal symptoms. Nine (22%) infants had a significant developmental delay. Atypical play-based interactions were observed in nine (22%) mothers. Self-reported bonding and bonding as evinced over play-based interactions did not significantly correlate with the QOL or development of the infants. Mothers who have recovered and are functioning well reported good bonding with their infants, though objective assessment revealed specific difficulties. Symptom severity correlated with poor physical QOL in infants. The association between mothers' bonding and infants' mental health is domain-specific and differential than linear and robust. Infants of mothers with severe mental illnesses postpartum should be routinely monitored for mother-infant bonding, development, and quality of life.

Lifestyles and Quality of Life of People with Mental Illness During the COVID-19 Pandemic

The COVID-19 pandemic has had a significant impact on the quality of life (QoL), daily lifestyle, and mental health of people suffering from a mental disorder. This study aimed to investigate the effects of the prolongation of the COVID-19 emergency on QoL and lifestyles in a sample of 100 outpatients at the Psychiatry Unit in Palermo University Hospital, Italy. QoL was measured through the 12-item Short Form Survey and the COV19-Impact on Quality of Life. Lifestyle changes during the pandemic were measured through the lifestyle change questionnaire. The majority of participants reported a great impact of COVID-19 on the QoL, and almost half reported worsened lifestyles. Worsened lifestyles were predictive of both poor mental and physical health related QoL. These results suggest that people with mental illness need interventions targeting lifestyles, and the mental health service in Italy should adjust to the ongoing pandemic, developing virtual treatments.

Disagreement about perceptions of patient disability between the stroke patient and caregiver: a cross sectional study exploring the association to patient and caregiver quality of life

Objectives This study explored the association of disagreement in the perception of patient disability between patients and family caregivers with physical and psychological quality of life (QOL) in both parties. Methods A cross-sectional analysis of data collected from male stroke patients and family caregivers was conducted. Physical and psychological QOL in patients and caregivers were measured using the WHOQOL BREF. Perceptions of patient disability were measured using the 12-item WHO Disability Assessment Schedule 2.0 (DAS). Using DAS scores reported independently by patients and caregivers, dyads were categorized into one of four groups representing agreement or disagreement about patient disability. Generalized estimating equations were used to examine the associations between WHOQOL scores in patients and caregivers and these four groups. Results Among 56 dyads enrolled, approximately 52% were categorized into ‘agreement’ groups and 48% were categorized into ‘disagreement’ groups. The disagreement in perception about patient disability were significantly associated with poor patient physical QOL. However, the disagreement in perception were not significantly associated with caregiver QOL. Conclusion Findings suggest the association of disagreement with QOL differs between patients and caregivers. Further research is needed to carefully appraise the relationship and interaction between patient and caregiver.

Cardiometabolic factors explaining the association between physical activity and quality of life: U.S. National Health and Nutrition Examination Survey

Background/ObjectiveTo test the Clustered Cardiometabolic Risk (CCMR) factor explaining the relationship between physical activity and physical quality of life (QOL). MethodsUsing the U.S. National Health and Nutrition Examination Survey 2003–2006, 2,445 adults completed the CDC Healthy Days Questionnaire for measuring QOL, wore the accelerometer for assessing physical activity pattern (PAP), and completed triglyceride, glucose, serum insulin, waist circumference, blood pressure, and HDL-cholesterol tests from which the CCMR factor was created. Physical QOL was classified as poor (≥14 days with poor physical health within past 30 days) vs. good (<14 days). We classified PAP by moderate-to-vigorous physical activity (MVPA), light-intensity physical activity (LIPA), and sedentary behavior (SB). We defined MVPA, LIPA, and SB as ≥2020 counts/minute, 100–2019 counts/minute, and ≤99 counts/minute, respectively. We further classified PAP status as unhealthy (MVPA <150 min/week & SB>LIPA) or healthy (MVPA <150 min/week & SB<LIPA, or MVPA ≥150 min/week regardless of SB>LIPA or SB<LIPA). Logistic regressions analyzed the association between unhealthy PAP and poor physical QOL, adjusting for the CCMR factor, age, sex, education, and smoking behavior. ResultsCompared with having healthy PAP, individuals having unhealthy PAP had an elevated risk of poor physical QOL (OR = 1.96; 95% CI = 1.42–2.72). However, this association was explained by higher levels of the CCMR factor (OR = 1.46; 95% CI = 1.07–1.99) through poorer serum insulin (OR = 1.35; 95% CI = 1.04–1.75) and waist circumference (OR = 1.23; 95% CI = 1.02–1.50). ConclusionThe CCMR factor (typically insulin and waist circumference) explained the association between unhealthy physical activity and poor physical QOL.

Change in Asthma Is Associated with Change in PTSD in World Trade Center Health Registrants, 2011 to 2016.

The WTC Health Registry (WTCHR) is a closed, longitudinal cohort of rescue/recovery workers and survivors exposed to the 11 September 2001 disaster. WTCHR enrollees diagnosed with asthma after 11 September 2001 continued to experience poor control despite treatment. Asthma is associated with mental problems, although their bidirectional movement has not been studied. This study tested whether a clinical change in mental problems was associated with a difference in asthma control, and whether a change in asthma control varied with a change in quality of life (QoL). Difference in the Asthma Control Test (ACT) on the WTCHR from 2011–12 to 2015–16 was compared with the change in the Post-traumatic Stress Disorder Checklist (PCL-17), the Patient Health Questionnaire depression scale, self-reported heartburn, and change of physical and mental QoL over this period. In adjusted multinomial multivariable logistic regression, improved PCL-17 was associated with a better ACT score, odds ratio (OR) = 1.42 (95% C.I. 1.01, 1.99), and a worsened PCL-17 score was associated with a worsened ACT score, OR = 1.77 (95% C.I. 1.26, 2.50). Decreased ACT was associated with poor physical QoL, OR = 1.97 (95% C.I. 1.48, 2.62). Change in mental health measures tracked with change in asthma control, which correlated with a change in QoL. Careful follow-up and treatment of all three are indicated to improve these inter-related issues.

Patterns of intrinsic capacity among community-dwelling older adults: Identification by latent class analysis and association with one-year adverse outcomes

ObjectiveTo identify patterns of intrinsic capacity (IC) and determine the association between these patterns with incident one-year outcomes. MethodsA total of 756 older adults aged ≥ 60 years were followed up after 1 year. IC was assessed using the revised integrated care for older people screening tool, and its patterns were examined by the latent class analysis. Logistic regression models were conducted to compare the risk of adverse outcomes. ResultsThree IC patterns were identified. Both “sharp declines in sensory domain” (Class 2) and “sharp declines in locomotion, psychological, cognition and vitality domains” (Class 3) were at greater risk of disabilities and poor physical quality of life than “relatively healthy” (Class 1). The Class 3 was twice as likely to be hospitalized as Class 1. DiscussionAssessment of IC could provide valuable information on stratifying older adults into heterogeneous groups, promoting targeted interventions to delay the adverse outcomes.

Financial distress and its associated burden in couples coping with an advanced cancer.

In efforts to understand financial distress (FD) associated with advanced cancer care from the perspective of both patients with incurable disease and their spousal caregivers, we assessed FD in both members of the couple, identified symptom and quality of life (QOL) correlates, and examined the potential role of illness communication. Patients undergoing treatment for stage III/IV lung cancer or a grade III/IV primary brain tumor and their spousal caregivers (n = 76 dyads) completed measures of somatic and affective symptoms including FD, physical and mental QOL, and ease of engaging in illness communication. Patients and caregivers additionally rated their perception of each other's symptoms, including FD. FD was endorsed by both patients (any FD 62.7%; high FD 24%) and spousal caregivers (any FD 64.7%; high FD 32.3%). Self-reported FD was significantly correlated (partial r = .52, p < .001) within couples. FD was associated with greater symptoms of anxiety (r = .29, p = .01; r = .31, p = .01), depression (r = 29, p = 01; r = .39, p = .001), and poorer physical QOL(r = - .25, p = .03; r = - .25, p = .001) for patients and caregivers, respectively. For patients, FD was additionally associated with poorer mental QOL(r = - .44, p < .001). Caregivers accurately perceived patient FD, yet patients tended to underreport their caregiver's FD by almost an entire point (t = 2.8, p = .007). A 3-way interaction (FD X role X illness communication) revealed (b = .40, p = .041) that illness communication moderated the association between FD and physical QOL for spouses so that spouses who reported less ease of illness communication demonstrated a stronger association between financial distress and physical QOL (b = - 2.08, p < .001) than those reporting greater ease of engaging in illness communication (b = .49, p = .508). In the advanced cancer setting, FD is prevalent in both patients and their spousal caregivers and associated with psychological distress and poor physical QOL. Results suggest that optimal FD assessment should include patients and spouses, and spouse's ease of engaging with illness communication may be a potential target for future intervention studies.

Quality of life of older adults and associated factors in Ghanaian urban slums: a cross-sectional study

ObjectiveThis study provides insight into the quality of life (QoL) of older adults living in urban slums in Ghana.DesignThe study employed a community-based, cross-sectional design to assess QoL among older...

Cardiometabolic health risks, lifestyle behaviours and quality of life in people diagnosed with early psychosis – A cross‐sectional study

WHAT IS KNOWN ON THE SUBJECT?: People diagnosed with schizophrenia have poor cardiometabolic health, with elevated 10-year cardiovascular disease risk (CVD-R) scores and low quality of life (QOL). There is a lack of understanding about CVD-R scores in people diagnosed with early psychosis and no studies have quantified CVD-R using the QRISK® 3calculator in this client group. Establishing potential relationships between modifiable lifestyle behaviours/treatment characteristics with CVD-R or QOL may identify targets for early intervention. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This is the first study to quantify the individual 10-year CVD-R of people diagnosed with early psychosis utilising the QRISK® 3calculator. This is also the first study to investigate relationships between QOL and CVD-R and lifestyle factors in a cohort of Thai people diagnosed with early psychosis. We observed low levels of physical health-related QOL and high levels of CVR-R despite participants reporting relatively positive lifestyle behaviours. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The cardiometabolic health state of this client group warrants as much attention as for those with an enduring severe mental illness; early preventative interventions are warranted. It may be useful to routinely quantify the CVD-R of people diagnosed with early psychosis using the QRISK® 3calculator, even in the absence of immediate concerns about lifestyle behaviours. Mental health nurses should utilise evidence-based approaches such as increasing activity levels, dietary counselling and behaviour change interventions to mitigate poor physical health in this client group. ABSTRACT: Introduction People diagnosed with schizophrenia have poor cardiometabolic health, with elevated 10-year cardiovascular disease risk (CVD-R) scores and poor quality of life (QOL). There is lack of understanding of these issues in early psychosis. Aims To quantify CVD-R in people diagnosed with early psychosis and profile their obesity prevalence, lifestyle behaviours and QOL. Secondary aim was to explore associations between lifestyle behaviours/treatment characteristics and CVD-R/QOL. Method Baseline data from 81 RCT participants were used to profile cardiometabolic health risks (QRISK® 3, BMI and waist circumference). Participants self-reported lifestyle behaviours and QOL. Relationships between modifiable treatment/lifestyle factors and QOL/CVD-R were explored. Results Participants' relative risk for CVD over 10years was 1.93 times higher than healthy counterparts; 39% also had an obese BMI and physical QOL was poor. No significant associations were observed between CVD-R or QOL with treatment characteristics and lifestyle factors. Discussion Despite positive lifestyle behaviours, participants had elevated CVD-R scores and poor physical health-related QOL. Quantifying CVD-R with QRISK® 3may highlight the need for health promotion interventions. Implications for practice Mental health professionals should be aware that elevated CVD-R exists in the context of relatively healthy lifestyle behaviours and utilise evidence-based interventions to address these issues.

Effects of reversible cognitive frailty on disability, quality of life, depression, and hospitalization: a prospective cohort study

Objectives Cognitive frailty, a potentially reversible condition describing the concurrence of physical frailty and mild cognitive impairment (MCI), has been recently proposed to incorporate subjective cognitive decline (SCD), a reversible pre-MCI state with more readily available cognitive reserve, as well as pre-physical frailty. Reversible cognitive frailty has been associated with dementia and mortality. We aimed to examine the association of reversible cognitive frailty with other adverse outcomes including disability, poor quality of life (QOL), depression, and hospitalization. Methods This was a cohort study with 1-year follow-up among 735 Chinese community-dwelling older adults with intact cognition. Reversible cognitive frailty was operationalized with the presence of pre-physical or physical frailty identified by the Frailty Phenotype and SCD identified by the simplified SCD questionnaire including four self-report cognitive domains of memory, naming, orientation, and mathematical reasoning. Adverse outcomes included incident Activities of Daily Living (ADL)-Instrumental ADL (IADL) disability, poor physical, mental and overall QOL, depression, and hospitalization over 1-year follow-up. Results The prevalence of reversible cognitive frailty was 27.8%. Participants with reversible cognitive frailty had higher risk of the incidence of ADL-IADL disability, poor physical QOL, poor mental QOL, poor overall QOL, and depression (Odds Ratios: 1.67–4.38, P < 0.05), but not higher risk of hospitalization over 1-year follow-up. Conclusion Reversible cognitive frailty was not uncommon and associated with incident disability, poor QOL, and depression among community-dwelling older adults. Early identification of reversible cognitive frailty can facilitate targeted interventions and may promote independence in older adults. Supplemental data for this article is available online at http://dx.doi.org/10.1080/13607863.2021.2011835

550-P: Unique Associations of Depressive Symptoms and Diabetes Distress with Quality of Life (QoL) in Youth with Type 1 Diabetes (T1D)

Youth with T1D often experience emotional distress, which can negatively impact QoL. We sought to understand associations of depressive symptoms and diabetes distress with QoL in youth with T1D. Participants (N=420; 50% male; ages 8-17 years; T1D duration 6.4±3.7 (M±SD) years; A1c 8.3±1.0%; 69% pump treated; 70% having parent with college degree) completed the Pediatric Quality of Life Inventory Generic Core Scales (PedsQL)and measures of depressive symptoms (Center for Epidemiologic Studies Depression Scale [CESD]) and diabetes distress (Problem Areas in Diabetes-Pediatric version [PAID-Peds]). Multivariable linear modeling determined independent associations of depressive symptoms and diabetes distress with total, physical, and psychosocial QoL, adjusting for sex, age, T1D duration, A1c, pump therapy, insulin dose, and parent education. Total PedsQL score was 85±13, (physical subscale 89±12, psychosocial subscale 82±15); CESD score was 9±9; PAID-Peds score was 37±24. CESD and PAID-Peds were both correlated with A1c (CESD: p=.01, PAID-Peds: p&amp;lt;.0001); QoL scales were not correlated with A1c. CESD and PAID-Peds were correlated with total, physical and psychosocial QoL (all p&amp;lt;.0001). In multivariable analyses, more depressive symptoms were associated with poorer total (∆R2=.52, p&amp;lt;.0001), physical (∆R2=.35, p&amp;lt;.0001), and psychosocial (∆R2=.51, p&amp;lt;.0001) QoL, adjusting for diabetes distress and sociodemographic/diabetes factors. More diabetes distress was associated with poorer total (∆R2=.05, p&amp;lt;.0001) and psychosocial (∆R2=.06, p&amp;lt; .0001) QoL, adjusting for depressive symptoms and sociodemographic/diabetes factors; more diabetes distress marginally contributed to poorer physical QoL (∆R2=.01, p=.002). Findings suggest unique, negative associations of both depressive symptoms and diabetes distress with QoL. Targeting both depressive symptoms and diabetes distress may help improve QoL in youth with T1D. Disclosure A. Shapira: None. L. K. Volkening: None. L. M. Laffel: Consultant; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Dexcom, Inc., Dompe, Insulogic LLC, Janssen Pharmaceuticals, Inc., Laxmi Therapeutic Devices, LifeScan, Lilly Diabetes, Medtronic, Provention Bio, Inc. Funding National Institutes of Health (R01DK089349, R01DK095273, T32DK007260, P30DK036836); JDRF (2-SRA-2014-253-M-B)

Perceived Injustice Is Associated With Pain-related Function and Mood in Youth With Acute Musculoskeletal Pain.

Perceived injustice (PI), which is one's appraisal of justice or fairness regarding the pain experience, is an emerging area of interest in pediatric pain research. No previous studies have investigated PI in youth with acute pain. To fill this gap, this study examined (1) associations among PI, pain-related function, and psychological function in treatment-seeking youth with acute musculoskeletal (MSK) pain, and (2) the impact of parent-child PI discordance on children's pain and psychosocial function. Participants were youth (aged 11 to 17, 55% male) with acute pain (onset <1 mo) recruited from emergency departments or outpatient clinics and participating parents (102 parent-child dyads). Dyads completed study questionnaires within 1 month of the child's pain onset. Youth-reported PI was significantly correlated with poorer physical and psychosocial quality of life, higher pain catastrophizing, higher fear of pain, increased pain-related disability, and greater depression and anxiety. Furthermore, PI was significantly associated with the physical quality of life, psychosocial quality of life, and pain-related disability. Moreover, discordance in youth and parent ratings of PI was associated with children's psychological and pain-related function. Specifically, compared with Concordant dyads, youth in the Discordant dyads (youth high PI/parent low PI) reported significantly poorer physical quality of life, psychosocial quality of life, higher pain-related disability, depression, anxiety, and pain catastrophizing. These findings reveal that PI in youth with acute MSK pain is associated with quality of life and pain-related disability. Furthermore, results highlight the importance of discordance between youth and parent reports of PI on pain-related functioning.

Influences of religiousness/spirituality on mental and physical health in OEF/OIF/OND military veterans varies by sex and race/ethnicity

BackgroundReligiousness/spirituality (R/S) has been associated with greater mental wellbeing in US military veterans, but this work has been conducted primarily with older veterans, cross-sectionally, using a constrained set of R/S and mental health constructs, and lacking consideration of the influence of sex and race/ethnicity. Further, few studies have focused on associations of R/S with veterans’ physical health. MethodWe investigated the relationship of R/S to mental and physical health in a sample of 410 Operation Iraqi Freedom/Operation Enduring Freedom/Operation New Dawn veterans within five years of military separation and one year later. ResultsIn the full sample, R/S coping, R/S organized practices and private prayer minimally related to mental or physical wellbeing, yet R/S struggle related inversely to concurrent and subsequent mental and physical health. For women only, higher baseline organized R/S was associated with lower subsequent stress, anxiety, and insomnia. For men only, baseline R/S coping predicted subsequent poorer physical quality of life and baseline R/S struggle predicted subsequent increased pain. For minority race but not white veterans, higher baseline private prayer predicted increased current pain level at 12 months; for Latinx ethnicity only, higher baseline R/S coping predicted increased quality of life a year later and higher baseline R/S struggle predicted higher subsequent levels of anxiety. ConclusionsR/S, broadly conceptualized, may relate to wellbeing in military veterans in different ways depending on sex and race/ethnicity, with implications for the role of R/S and R/S struggle in personalizing mental and physical health services.

The Relationship Between Uncertainty in Illness and Quality of Life in Patients With Heart Failure

Background Previous investigators have demonstrated that uncertainty in illness is associated with quality of life (QoL) in patients with chronic illness. However, little is known about the mechanism underlying the relationship in patients with heart failure. Objective The aim of this study was to examine the multiple mediating effects of perceived stress and coping strategies on the relationship between uncertainty in illness and QoL in patients with heart failure. Methods We conducted a cross-sectional study in 302 patients with heart failure recruited at a general hospital in China from October 2016 to September 2017. Uncertainty in illness, perceived stress, coping strategies, and QoL were assessed using self-reported questionnaires. The multiple mediation model was tested using the PROCESS macro for SPSS. Results Of the 302 patients, 51.7% had poor physical QoL and 45.7% had poor mental QoL (physical component summary or mental component summary score of &lt;50 points). Uncertainty in illness had a significantly negative indirect effect on mental QoL through perceived stress and acceptance-resignation (indirect effect, −0.02; 95% confidence interval, −0.04 to −0.01). Uncertainty in illness also had a significantly negative indirect effect on mental QoL via perceived stress only (indirect effect, −0.18; 95% confidence interval, −0.26 to −0.09). Conclusions Poor QoL is prevalent in patients with heart failure. Perceived stress and acceptance-resignation are important mediating factors between uncertainty in illness and mental QoL in patients with heart failure. Interventions aimed at reducing perceived stress and acceptance-resignation coping may be beneficial for improving mental QoL in patients with heart failure.

Health-related quality of life among patients with bipolar disorder in rural southwestern Uganda: a hospital based cross sectional study

BackgroundBipolar disorder is a psychiatric disorder that alters mood and affects over 55 million people globally with an estimated lifetime prevalence of approximately 0.8–1.1%. In Africa, the lifetime prevalence of the bipolar spectrum disorders is slightly lower at 0.1–0.6%. Bipolar disorder is ranked the sixth leading cause of disability with high rates of morbidity and mortality and negatively impacts quality of life of those affected.MethodsThe aim of the study was to determine the health-related quality of life of patients with bipolar disorder attending a mental health clinic in south western Uganda. We enrolled a consecutive sample of 169 participants and evaluated their health-related quality of life using the medical outcomes health survey short form-36 (SF-36) scale. We used bivariate and multivariable logistic regression to determine associations between quality of life, sociodemographic and clinical factors setting the physical and mental component categories of quality life scale as the main outcome variables.ResultsThe mean age of the participants was 37.23 (12.83) and slightly over half (54.4%) were females. More than half (66.86%) of the participants had poor physical component summary (mean = 45.06, SD = 8.44) while 81% of the participants had poor mental component summary (mean = 41.95, SD = 8.45). Poor physical quality of life had a statistically significant association with history of suicidal thoughts (OR = 2.75, 95% CI = 1.14–6.63, P = 0.02), while poor mental quality of life had a statistically significant association with history of suicidal thoughts (OR = 3.94, CI = 1.22–12.71, P = 0.02) and history of psychotic symptoms (OR = 2.46, CI = 1.07–5.64, P = 0.03).ConclusionThe mental and physical quality of life of our participants was poor and history of suicidal thoughts and psychotic symptoms were associated with poor quality of life. There is need to address psychotic symptoms and suicidal thoughts in the management of patients with bipolar disorder to improve health related outcomes and quality of life.

Body mass index (BMI) and quality of life among long-term survivors of childhood acute lymphoblastic leukemia

Background: Adult survivors of childhood cancers such as acute lymphoblastic leukemia (ALL) are at risk of overweight and related chronic morbidities. As childhood cancer survival has been improving, long-term quality of life (QOL) among cancer survivors becomes more important. We examined the association of body mass index with physical and psychosocial QOL among childhood ALL survivors who returned for long-term follow-up after end of therapy. Methods: Using a cross-sectional survey (2006-2012), we assessed the association between body mass index and quality of life in 58 long-term survivors of childhood ALL (ages 9 to 43 at the time of survey/measurement) using age-appropriate QOL instruments (Health-Related Quality of Life Short Form – SF-36 or Child Health Questionnaire-PF-50). Results: Half of the participants were overweight or obese at the time of survey. Mean QOL scores were similar to population norms. Compared to underweight/healthy weight status, being overweight/obese was not significantly associated with poorer physical QOL, but with poorer psychosocial QOL (47.1±13.2 vs. 54.0±6.0, P=0.01, effect size Cohen’s d=0.67), which remained statistically significant after adjusting for age and sex. Conclusions: Weight management should be the target of timely interventions among survivors of childhood ALL.

Life expectancy with poor health-related quality of life among Brazilian older adults

• Life expectancy with poor quality of life differs by sex. • Life expectancy with poor physical quality of life remained stable between years. • Life expectancy with poor mental quality of life increased for women in the period.