Predictors Of Health-related Quality Of Life In Patients Research Articles

Predictors of health-related quality of life after coronary artery bypass graft surgery

Health-related quality of life (HRQOL) is a multifactorial concept in assessing physical and mental health. This study was performed to evaluate the HRQOL of patients undergoing coronary artery bypass graft (CABG) surgery and the predictors of HRQOL in patients until 1 year after surgery. This cross-sectional study included 110 consecutive patients who underwent elective CABG in a medical center in South Korea. The Short-Form Health Survey, cardiac symptom survey, cardiac self-efficacy, and the Interpersonal Support Evaluation List-12 were used to measure the HRQOL, symptom experience, self-efficacy, and social support, respectively. The regression model explained 42% of the variance in the participants' physical HRQOL. The predictors of the physical HRQOL include the presence of a spouse, post-CABG duration, symptom experience, and self-efficacy. The regression model explained 36% of the variance in the participants' mental HRQOL. The predictors of the mental HRQOL included perceived health status, self-efficacy, and social support. The predictive factors for HRQOL after CABG were the presence of a spouse, post-CABG duration, symptom experience, self-efficacy, and social support. Furthermore, a suitable program and nursing interventions could be implemented to improve the HRQOL of post-CABG patients.

Health-related quality of life in patients with non-communicable disease: study protocol of a cross-sectional survey

IntroductionNon-communicable diseases (NCDs) are associated with lower health-related quality of life (HRQoL). However, knowledge about those diseases and predictors with a greater impact on patients’ HRQoL as well as knowledge on the complex relationship between HRQoL and comorbidities is lacking. The aim of this study is to assess the impact of NCDs on patients’ HRQoL, with a focus on multimorbidity and socioeconomic status.Methods and analysisA primary care-based cross-sectional study is conducted in Flanders (Belgium). Study participants (≥18 years) are medically diagnosed with at least one of the following diseases: cardiometabolic disorders, mental disorders and musculoskeletal disorders. A minimum of 50 general practitioners will participate to recruit participants (convenient sample) and a total of 531 patients will be enrolled (voluntary response sample). Each participant will complete a paper-based questionnaire to gather research outcomes. Statistical analyses will be performed using multiple linear regression models with HRQoL as main outcome parameter, adjusted for possible confounders. This study will generate new evidence on the key predictors of HRQoL in patients with NCDs, and particularly provide new insights in multimorbidity to improve the quality of care in primary care, to support patients’ self-management and to allocate resources more effectively.Ethics and disseminationThe study has been approved by the Ethical Committee of Ghent University Hospital, Ghent, Belgium (reference number: B670201939629) prior to the beginning of the recruitment. Study results will be disseminated through peer-reviewed publications and conference presentations.

Quantifying patient centered outcomes associated with the use of bilateral endobronchial coil treatment in patients with severe emphysema

Objective: To determine the impact of endobronchial coils on health-related quality-of-life (HRQoL). This paper utilizes trial data to identify the predictors of HRQoL in patients with severe emphysema, and subsequently estimates the impact of a new treatment on HRQoL (measured by utilities). These utility estimates are used to generate indicative long-term QALY estimates for a range of clinically plausible scenarios as a precursor to cost-effectiveness analyses.Methods: Patient level HRQoL data from RENEW and the National Emphysema Treatment Trial (NETT) were combined and mapped to generic EuroQol 5-dimension health utility questionnaire (EQ-5D) values using a published algorithm. Multilevel statistical models were developed using treatment, time, response, and baseline characteristics (EQ-5D, age, gender, FEV1, lung RV) to predict EQ-5D over time. Lifetime QALY estimates were generated using published survival data from NETT (assuming no impact of treatment on mortality) and four clinically plausible response profiles. Each response profile was combined with assumptions around treatment impact (constant or time varying).Results: After controlling for baseline characteristics, both treatment and response had a statistically significant impact (p < .001) on utility (+0.101 and +0.061, respectively). When combined with selected baseline characteristics and time, Coils and Standard of Care (SoC) generated more QALYs than SoC alone in all scenarios, with incremental lifetime benefit ranging from 0.29–0.55 QALYs.Conclusions: Coils and SoC resulted in statistically significant improvements in HRQoL compared to SoC alone in patients with severe emphysema.

Studying the Relation between Mental Adjustment to Cancer and Health-Related Quality of Life in Breast Cancer Patients

Background: Health-related quality of life in cancer patients has been interested to researchers in the domain of health in recent decades. Mental adjustment to cancer is a concept known as an important indicator of life quality, well-being and health of cancer patients. The aim of this paper is to examine the relation between mental adjustment to cancer and health-related quality of life (HRQoL) among some women with breast cancer. Methods: 100 patients were non-randomly selected from hospitals and oncology clinics in Kermanshah and Shiraz cities, Iran. These patients completed the functional assessment of cancer treatment-breast (FACT-B) in order to measure HRQoL and mini-mental adjustment to cancer questionnaire (Mini-MAC). Data were analyzed by using correlation and regression. Results: The results show that helplessness/hopelessness (58%), fighting spirit (40%), fatalism (33%) and preoccupation anxiety (18%) explain the variance of HRQoL. Conclusions: According to the findings, there is no relation between cognitive avoidance styles and HRQoL, and it can be concluded that coping styles helplessness/hopelessness and fighting spirit are the best predictors of HRQoL in patients with breast cancer. Consequently, the evaluation of the coping styles and emergency interventions in order to enhance coping with illness in cancer patients, decrease the sense of helplessness/hopelessness and anxiety are recommended, which in turn are accompanied by increasing HRQoL.

Predictors of health-related quality of life perceived by end-stage renal disease patients under online hemodiafiltration.

Patients' perception of health-related quality of life (HRQOL) is a consistent and powerful predictor of the outcome of end-stage renal disease (ESRD) patients under dialysis. This study aims to identify factors that could affect the HRQOL of ESRD patients under online hemodiafiltration (OL-HDF). We evaluated 322 ESRD patients under OL-HDF (59.63% males; 64.9 ± 14.3 years old) from five dialysis units in the north of Portugal. Socio-demographic data, comorbidities, hematological data, iron status, dialysis adequacy, nutritional and inflammatory markers were collected from patients records. Patient's reported HRQOL score was assessed by using the Kidney Disease Quality of Life-Short Form (KDQOL-SF). ESRD patients showed a mean (± SD) of 53.17% (± 15.31%) in SF-36 total score, 50.17% (± 9.51%) in the SF-36 mental component summary (MCS) and 49.75% (± 9.44%) in the SF-36 physical component summary (PCS). Red cell distribution width (RDW), feminine gender and diabetes were found as significant predictors of SF-36 total score of HRQOL, which accounts for 12% of the total explained variance. Patient satisfaction, RDW, body mass index and gender were identified as predictors for the PCS, which accounts for 22% of total explained variance. Furthermore, patient satisfaction and dry weight were found as predictors for MCS. These predictors accounted for 28% of the total explained variance. Our results showed that the coexistence of diabetes, gender and erythropoietic disturbances are predictors of HRQOL in patients under OL-HDF and suggest that more attention should be given to woman patients, to the improvement of anemia and to diabetic patients, who are more prone to perceive a worst HRQOL.

Health-Related Quality of Life in Patients with Polycystic Ovary Syndrome (PCOS): A Model-Based Study of Predictive Factors

Understanding the factors that contribute to health-related quality of life (HRQOL) is critical for developing the most appropriate interventions for improving or maintaining the HRQOL in polycystic ovary syndrome (PCOS) patients. This study sought to determine the most significant predictors of the HRQOL in patients with PCOS. This was a cross-sectional study of 300 women with PCOS that was carried out in Kashan, Iran. A sample of women with PCOS was entered into the study and completed the following questionnaires: the Hospital Anxiety and Depression Scale, the Body Image Concern Inventory (BICI), the Rosenberg's Self-Esteem Scale score, the modified polycystic ovary syndrome health-related quality of life questionnaire, the Female Sexual Function Index. Both direct and indirect relationships among clinical severity, psychological status, self-esteem, body image, and sexual function as independent predictors of HRQOL were examined using structural equation modeling (SEM) analysis. By using the SEM, we simultaneously test a number of possible hypotheses concerning the interrelations among the predictors of HRQOL in PCOS patients. In relation with severity of PCOS, reproductive history and menstrual status explained a high proportion of the variance of clinical variables (factor loading 0.37 and 0.34, respectively). The highest effect on HRQL was exerted by indirect effect of clinical factor (β = 0.90), self-esteem (β = 1.12), body image (β = 1.06), and sexual function (β = 0.26) that influenced negatively HRQOL. The infertility and menstrual domains were the most affected areas of HRQOL. In relation with sexual dysfunction, the most affected domains were desire and arousal. The highest effect of PCOS symptoms on HRQOL impairment among patients was exerted by self-esteem, body image, and sexual dysfunction. With regard to HRQOL in clinical routine, we conclude these mediating factors should be taken into consideration and adequately treated if present.

Psychological Factors Are Associated with Changes in the Health-related Quality of Life in Inflammatory Bowel Disease

The effect of different sociodemographic and clinical variables on the health-related quality of life (HRQOL) of patients with inflammatory bowel disease (IBD) is currently known, but the influence of psychological factors has not been sufficiently explored. The objective of this study was to identify psychological predictors of HRQOL in patients with IBD. A cross-sectional prospective study was undertaken including 875 consecutive IBD patients. Independent variables were measured using a sociodemographic and clinical questionnaire, the Hospital Anxiety and Depression Scale (HADS) questionnaire, the Perceived Stress Scale (PSS) questionnaire, and the COPE questionnaire. Dependent variables were measured using the Short Form 36 Health Survey (SF-36) and the Inflammatory Bowel Disease Questionnaire (IBDQ-36). Logistic regression was performed to identify factors associated with HRQOL. The participation rate was 91.3%. Patients with IBD had a poorer HRQOL than the general population except on the Physical Function, Social Function, and Emotional Function Scale. Moreover, high levels of anxiety, depression, and stress were found to be associated with low levels in all quality of life measurements. No significant relationship was found between HRQOL and coping strategies. In patients with IBD, stress, anxiety and depression are important determinants of HRQOL and should therefore be considered in the management of this patient population.

Psychological predictors for health-related quality of life in patients on peritoneal dialysis.

It is currently recognized the impact of different clinical and sociodemographics variables on the health-related quality of life (HRQL) of patients undergoing peritoneal dialysis (DP), albeit the influence of psychological variable has not been thoroughly studied. The objective of this study is to identify the psychological predictors of HRQL in patients under DP. 53 patients on DP participated in the study (49.54 ± 17.03 years, 54.7% women) in whom HRQL was evaluated by the Kidney Disease Quality of Life Short Form and it was obtained information related with psychological variables (depressive and anxious symptoms , alexithymia, health-related locus of control and coping strategies) besides socio-demographical and clinical variables. Patients on DP presented a worse HRQL than general population, particularly in the physical dimension. The comorbility, the number of visits to urgency department, previous hospital admissions, serum albumin and previous treatment with hemodialysis showed a negative impact on several dimensions of HRQL, but depressive symptoms, alexithymia and particularly anxious symptoms were the main determinants of the variability of HRQL in DP patients. We did not obtain a significant relationship between HRQL and the locus of control or the coping strategies. Among patients undergoing DP, anxiety, depression and alexithymia are important determinants of HRQL and they should be considered both in the evaluation and the treatment of this population of patients.

Psychosocial predictors of change in quality of life in patients after coronary interventions

Objective Health-related quality of life (HRQOL) after coronary interventions (coronary artery bypass grafting, percutaneous transluminal coronary angioplasty) usually improves in patients, but not in all patients. Some patients actually show a significant decline in HRQOL. Our aim was to explore the potential of psychologic well-being (anxiety, depression), vital exhaustion, Type D personality, and socioeconomic position as predictors of HRQOL in patients with coronary disease. Methods A total of 106 patients scheduled for coronary angiography were interviewed before (baseline) and 12 to 24 months after coronary angiography. Socioeconomic status was evaluated by education. The General Health Questionnaire 28 was used for measuring psychologic well-being (anxiety, depression), the Maastricht interview was used for measuring vital exhaustion, and the Type D questionnaire was used for measuring personality. HRQOL was assessed using the Short Form-36 (physical and mental components) questionnaire. Functional status was assessed with a combination of New York Heart Association and Canadian Cardiovascular Society classifications. Linear regressions were used to analyze data. Results A change in physical HRQOL was predicted by baseline psychologic well-being (β = −.39; 95% confidence interval [CI], −1.00 to −.16) and baseline HRQOL (β = −.61; 95% CI, −.83 to −.34). A change in mental HRQOL was predicted by (baseline) psychologic well-being (β = −.37; 95% CI, −.99 to −.09), vital exhaustion (β = −.21; 95% CI, −.69 to −.03), and baseline HRQOL (β = −.76; 95% CI, −1.03 to −.44). Ejection fraction did not significantly predict HRQOL. Conclusion Psychosocial factors (psychologic well-being, vital exhaustion) seem to be more important predictors of change in HRQOL compared with some objective medical indicators (ejection fraction) among patients with coronary disease.

Impact of personality and psychological distress on health-related quality of life in kidney transplant recipients

Health-related quality of life (HRQoL) has become an important outcome in the evaluation of kidney transplantation (KT). Although the medical and sociodemographic predictors of HRQoL in patients after KT are well known, there is still a lack of knowledge about the psychological factors involved. This study focuses on the role of personality and actual psychological distress in predicting HRQoL after KT. Sociodemographic (gender, age, education, average income), medical (glomerular filtration, serum albumin, number of co-morbid diseases) and psychological data (neuroticism, extroversion, psychological distress) were collected from 177 (60.5% male subjects; 48 +/- 12.1 years) kidney transplant recipients, and physical and mental HRQoL were measured using the SF-36. A univariate general linear model analysis was performed. Higher physical HRQoL was associated with younger age, higher education and income, a low number of co-morbid diseases, lower neuroticism and distress. Higher mental HRQoL was associated with higher education and income, longer time from KT, higher extroversion, lower neuroticism and distress. In both physical and mental HRQoL, actual distress was the best predictor, even when controlled for neuroticism. These results confirm the importance of psychological distress in patients and its impact on their HRQoL after KT and can be applied in intervention programs focused on increasing HRQoL.

Predictors of health-related quality of life in patients with colorectal cancer

BackgroundMost studies that have identified variables associated with the health-related quality of life (HRQL) of patients with colorectal cancer have been cross-sectional or included patients with other diagnoses. The objectives of this study were to identify predictors of HRQL in patients with colorectal cancer and interpret the clinical importance of the results.MethodsWe conducted a population-based longitudinal study of patients identified through three regions of the California Cancer Registry. Surveys were completed by 568 patients approximately 9 and 19 months post-diagnosis. Three HRQL outcomes from the Functional Assessment of Cancer Therapy – Colorectal (FACT-C) were evaluated: social/family well-being (SWB), emotional well-being (EWB) and the Trial Outcome Index (TOI), which is a colorectal cancer-specific summary measure of physical function and well-being. Sociodemographic, cancer/health, and healthcare variables were assessed in multivariable regression models. We computed the difference in predicted HRQL scores corresponding to a large difference in a predictor variable, defined as a 1 standard deviation difference for interval variables or the difference relative to the reference category for nominal variables. The effect of an explanatory variable on HRQL was considered clinically meaningful if the predicted score difference was at least as large as the minimally important difference.ResultsCommon predictors of better TOI, SWB and EWB were better general health and factors related to better perceived quality of cancer care. Predictor variables in addition to general health and perceived quality of care were identified only for SWB. Being married/living as married was associated with better SWB, whereas being male or of Hispanic ethnicity was associated with worse SWB. Among the sociodemographic, cancer/health, and healthcare variables evaluated, only Hispanic ethnicity had a clinically meaningful effect on an HRQL outcome.ConclusionOur findings, particularly the information on the clinical importance of predictor variables, can help clinicians identify patients who may be at risk for poor future HRQL. Potentially modifiable factors were related to perceived quality of cancer care; thus, future research should evaluate whether improving these factors improves HRQL.

DEPRESSIVE SYMPTOMS AND COGNITIVE STATUS AFFECT HEALTH‐RELATED QUALITY OF LIFE IN OLDER PATIENTS WITH PARKINSON'S DISEASE

DEPRESSIVE SYMPTOMS AND COGNITIVE STATUS AFFECT HEALTH‐RELATED QUALITY OF LIFE IN OLDER PATIENTS WITH PARKINSON'S DISEASE