Predictors Of Health-related Quality Research Articles

Evaluating the impact of depression, anxiety & autonomic function on health related quality of life, vocational functioning and health care utilisation in acute coronary syndrome patients: the ADVENT study protocol

BackgroundDepression and anxiety are highly prevalent and co-morbid in acute coronary syndrome patients. Somatic and cognitive subtypes of depression and anxiety in acute coronary syndrome have been shown to be associated with mortality although their association with patient outcomes is unknown, as are the mechanisms that underpin these associations. We are conducting a prospective cohort study which aims to examine in acute coronary syndrome patients: (1) the role of somatic subtypes of depression and anxiety as predictors of health related quality of life outcomes; (2) how somatic subtypes of depression and anxiety relate to long term vocational functioning and healthcare utilisation; and (3) the role of the autonomic nervous system assessed by heart rate variability as a moderator of these associations.MethodsPatients are being screened after index admission for acute coronary syndrome at a single, high volume centre, MonashHeart, Monash Health, Victoria, Australia. The inclusion criterion is all patients aged > 21 years old and fluent in English admitted to MonashHeart, Monash Health with a diagnosis of acute coronary syndrome. The primary outcome is mean health related quality of life (Short Form-36) Physical and Mental Health Summary scores at 12 and 24 months in subtypes with somatic symptoms of depression and anxiety. Depressive domains are assessed by the Beck Depression Inventory II and the Cardiac Depression Scale. Anxiety is measured using the Speilberger State-Trait Anxiety Inventory and the Crown Crisp Phobic Anxiety questionnaire. Secondary outcomes include clinical variables, healthcare service utilisation and vocational functioning.DiscussionThis manuscript presents the protocol for a prospective cohort study which will investigate the role of somatic subtypes of depression and anxiety as predictors of health related quality of life, long-term vocational functioning and health service use, and the role of the autonomic nervous system in moderating these associations. Findings from the study have the potential to inform more effective pharmacological, psychological and behavioural interventions and better guide health policy on the use of health care resources.

Health-related quality of life in Parkinson's disease patients in northeastern Sicily, Italy: (An ecological perspective).

Parkinson's disease has a negative impact on health-related quality of life in Parkinson's disease patients. Depression, cognitive impairment, coping strategies, dyskinesia, gait disorders and complications of dopaminergic drugs are the variables that most affect health-related quality of life. The ecological model of human development focuses attention on both individual and social environmental factors as targets for health interventions. From this perspective, the aim of this cross-sectional survey was to evaluate the influence of gender, family size and perceived autonomy on health-related quality of life in Parkinson's disease patients in northeastern Sicily, Italy. Ninety Parkinson's disease patients, attending the Movement Disorders Clinic at IRCCS Centro Neurolesi “Bonino-Pulejo” (Messina), were consecutively enrolled. The Unified Parkinson Disease Rating Scale motor subscale (UPDRS-III) scores, the Parkinson Disease Questionnaire-39 Item scores (as a disease-specific measure of health-related quality of life), scores on the Short Form (36) Health Survey Questionnaire (as a generic measure), and answers to a brief checklist were recorded. A total of 85 Parkinson's disease patients (49% males and 51% females; mean age 70.8 ± 8.6 years; mean UPDRS-III 24.15 ± 6.55; mean disease duration 5.52 ± 4.65 years) completed the booklet of questionnaires. In the multivariate regression analysis, we included clinical and social variables as independent predictors of health-related quality of life. Our results suggest a potential compounding effect of ecological intrapersonal and interpersonal levels on health-related quality of life outcomes. Gender, self-evaluated autonomy and family size significantly impacted health-related quality of life. If quality of life is used as an indicator of treatment outcomes, an ecological perspective of the case history will be important to disclose relevant prognostic information and trigger personalized health care interventions.

Is Body Mass Index or Percent Body Fat a Stronger Predictor of Health-Related Quality of Life in Rural Hispanic Youth?

The objective of the present study was to assess whether Body Mass Index or percent body fat was a stronger predictor of health-related quality of life in a community sample of rural Hispanic youth. The sample consisted of 219 Hispanic children and adolescents ages 8–19 years (54.8 % female). Multiple linear regression analysis was conducted with demographics and obesity indicators (BMI, percent body fat) entered as independent variables. Each subscale and summary score of the PedsQL 4.0 Generic Core Scales was a separate dependent variable. Greater percent body fat was associated with lower social functioning in our sample of rural Hispanic youth. BMI percentile was not significantly associated with any of the PedsQL domains. These findings indicate that percent body fat may be more strongly associated with psychosocial functioning than BMI percentile in rural Hispanic youth.

Predictors of Health Related Quality of Life for Adults Ages 40-64

Background: This study focused on access to care for adults 40 to 64 with the purpose of identifying predictors of health-related quality of life (HR-QoL). The literature had inconsistencies and gaps in experimental methoods in determining HR-QoL predictors. Methods: Using Becker’s HBM as its theoretical framework as well as Quality Metric instrument SF 12 vs 2™ for measuring HR-QoL, this explorative correlational study examined under insurance, continued health coverage, and health behavior in relation to HR-QoL while controlling for personal attributes like age, gender, race/ethnicity, and level of income and education. Multivariate regression analyses were conducted with a sample N = 165. Results: The study focused on three research question with three Null and Alternate hypotheses in search of predictors of HR-QoL. Although no significant relations were observed when linking the three predictors to HR-QoL, significant positive association between health seeking behavior and continuity of health coverage was observed. Conclusion: Continuity of health coverage had a significant relation to health seeking behavior with implications for positive social change. An understanding of factors that contribute to health behavior and engaging patients to seek health services are key factors to improving health status.

Frequency of poor quality of life and predictors of health related quality of life in cirrhosis at a tertiary care hospital Pakistan

BackgroundCirrhosis produces variety of symptoms which eventually lead to a negative impact on Health Related Quality of Life (HRQOL). The general aim of this study was to evaluate the magnitude of poor HRQOL and to assess factors related with HRQOL in patients with CLD in Pakistan.FindingsThis was a cross sectional study conducted in gastroenterology outpatient clinics of Aga Khan University Hospital, Karachi on adult patients with cirrhosis. In this study chronic liver disease questionnaire (CLDQ) was used to assess HRQOL of these patients and CLDQ score was used as an outcome measure to determine factors related with HRQOL.273 participants were recruited in the study; 155 (57%) were males. Mean age of participants was 49 ± 11 years. The most common cause for cirrhosis was viral infection 247(91.5%). Mean Model for End Stage Liver Disease (MELD) score was 12.6 ± 6.8 and 2/3 of patients 209 (76.6%) had advanced cirrhosis in Child Turcot Pugh (CTP) B or C stage. Poor HRQOL was seen in 187(69%; 95% C.I.: 63%, 74%) of the participants. Mean CLDQ score was 4.36 ±1.1. Amongst all of the domains, fatigue domain had lower CLDQ score. Hemoglobin (β = 0.09 [SE = 0.04]), Albumin (β = 0.32[SE = 0.09]), Diastolic Blood Pressure (DBP) (β = 0.01[0.005) prior history of decompensation (β = 0.98[SE = 0.39] were significant factors associated with HRQOL in patients with liver cirrhosis.ConclusionFrequency of poor health related quality of life determined by CLDQ score is high in patients with liver cirrhosis. Hemoglobin, serum albumen, prior history of decompensation (like encephalopathy and upper gastro intestinal bleed), are associated with health related quality of life.

Predicting health related quality of life 6 months after stroke: the role of anxiety and upper limb dysfunction

Purpose: This study examined the role of anxiety and upper limb dysfunction, amongst other variables, as predictors of health related quality of life (HRQOL) 6 months after stroke. Method: Participants: Stroke survivors (n = 85) who had previously participated in a randomised controlled trial of a physiotherapy intervention. Dependent variable: HRQOL – Nottingham Health Profile (NHP). Predictor variables: Mood – Hospital Depression and Anxiety Scale; Upper Limb Functioning - Action Research Arm Test; Rivermead Motor Assessment; Activities of Daily Living – Modified Barthel Index; Clinical and demographic factors. Results: Anxiety and depression significantly predicted 49% of variance in overall HRQOL (p < 0.05), but only anxiety significantly predicted NHP pain (13% variance, p < 0.001), emotional reactions (41% variance, p < 0.001), sleep (19% variance, p = 0.02) and social isolation (23% variance, p = 0.02). Depression and anxiety together significantly predicted 30% variance in energy level (p < 0.001). UL motor impairment and activities of daily living predicted 36% of variance in NHP physical activity score (p < 0.001). Conclusions: This study indicates that where anxiety is assessed, it appears more important in determining HRQOL than depression. UL impairment and ADL independence predicted perceived physical activity. Management strategies for anxiety and therapy for UL recovery long after stroke onset are likely to benefit perceived HRQOL.Implications for RehabilitationAnxiety is a major predictor of quality of life six months after stroke.Post-stroke anxiety should be routinely assessed in rehabilitation.Appropriate management strategies for anxiety should occur during rehabilitation with follow-up into the chronic post-stroke period.Upper limb impairment is a stronger predictor of perceptions of physical activity than independence in activities daily living six months after stroke.Rehabilitation of the upper limb should continue into the chronic post-stroke period.

26 Predictors of Health-Related Quality of Life at 6 Months after Left Ventricular Assist Device Implantation: Findings from INTERMACS

and 22 weeks after baseline data. Linear mixed modeling was used to evaluate the trajectory of the conditions of interest. Results: 46 subjects were recruited at a U.S. Midwestern LVAD center. The average caregiver was a 59 y.o. female Caucasian spouse with a high school education living with the LVAD recipient. 52% were employed outside the home. SS scores did not change significantly over time (p .42), with a mean total MOS-SS score of 3.41 1.02. The total score was significantly associated with reduced burden ( 1.7, p .001), although only 1 subscale, tangible support, demonstrated significance with reduced burden ( 1.15, p .04). Reduced burden and increased SS were independently significantly associated with improved QOL ( .75, p .001; 2.7, p .005, respectively). Only the MOS-SS affection subscale approached significance in relation to QOL ( 1.9, p .054). Conclusions: SS is associated with improved LVAD caregiver burden and QOL. LVAD and heart transplant recipients’ caregivers report similar SS, but LVAD caregivers report worse QOL. Program focus on targeted social support can improve caregiver experience.

Predictors of health related quality of life in older people with non-communicable diseases attending three primary care clinics in Malaysia.

To determine the health related quality of life and its predictive factors among older people with non-communicable diseases attending primary care clinics. Cross-sectional study. Three public primary care clinics in a district in Selangor, Malaysia. Registered patients aged 55 years and above. A face-to-face interview was conducted using a validated questionnaire of Medical Outcome Study 36-item short form health survey (SF-36). The outcome measure was the health related quality of life (HRQoL) and other factors measured were socio demography, physical activity, social support (Duke-UNC Functional Social Support Questionnaire), and presence of non-communicable diseases. A total of 347 participants had non-communicable diseases which included hypertension (41.8%), type 2 diabetes (33.7%), asthma (4.8%), hyperlipidaemia (1.7%), coronary heart disease (1.2%), and osteoarthritis (0.2%). Age ≥ 65 years old (OR =2.23; 95%CI=1.42, 3.50), single (OR=1.75; 95%CI=1.06,2.90), presence of co-morbid condition (OR=1.66; 95%CI=1.06, 2.61), and poorer social support (OR=2.11; 95%CI=1.27, 3.51; p=0.002) were significant predictors of poorer physical component of HRQoL . In predicting lower mental health component of HRQoL, the significant predictors were women (OR=2.28; 95%CI=1.44, 3.62), Indian ethnicity (OR=1.86; 95%CI=1.08, 3.21) and poorer social support (OR=2.71; 95%CI=1.63, 4.51). No interactions existed between these predictors. Older people with non-communicable diseases were susceptible to lower health related quality of life. Increasing age, single, presence of co-morbid conditions, and poorer social support were predictors of lower physical health component of HRQoL. While the older women, Indian ethnicity and poorer social support reported lower mental health component of HRQoL.

P02-401 - Dispositional optimism as a predictor of health related quality of life in patients with chronic musculoskeletal disorders

IntroductionPsychological factors are predictive of long term disability for many pain syndromes as well as for pain severity emotional distress and treatment seeking. It is known that fear of pain leads to avoidance of pain-related experiences and contributes to disability.AimsTo determine if there is a significant relationship between optimism/ pessimism, HRQOL and pain in a group of musculoskeletal patients referred to a rehabilitation center, because of chronic pain and mobility difficulties when controlling for fear of pain and pain reduction coping strategies.MethodsThe sample consisted of 96 patients. The questionnaires that were used are the Short Form health questionnaire (12 questions; SF12), the Pain Anxiety Symptoms Scale (PASS), the life orientation test-revised (LOT-R) and a VAS scale for pain measurement. Two separate linear regression analyses were conducted to examine the effects of optimism on each of the two main domains of SF12 with optimism entered in the last step of each model.ResultsAccording to the regression analysis performed, dispositional optimism (β = ,284) is an independent factor affecting the mental composite score in patients with musculoskeletal problems, even after controlling for the effect of pain intensity. Pain -related escape and avoidance is the only factor affecting both physical (β = −,300) and mental health (β = −,192).ConclusionsThe consistent indications that fear is associated with the suffering and disability that often accompany pessimistic patients with chronic musculoskeletal pain, suggests that clinicians working with these individuals should conduct a careful assessment of fear and avoidance, both pain-related and otherwise.

Predictors for Physical and Mental Health 6 Months After Coronary Artery Bypass Grafting A Cohort Study

Knowledge of predictors for health related quality of life (HRQoL) after coronary artery bypass grafting is limited. To identify preoperative and postoperative factors related to physical and mental health status 6 months after surgery. 185 patients completed the Short Form-36 survey preoperatively and 6 months after surgery. Multiple linear regression was used to identify significant independent predictors for both physical and mental health component summary scores 6 months after surgery. Significant predictors for physical health were preoperative physical status (PCS), marital status, hospitalised with acute myocardial infarction and serum creatine kinase-MB (CK-MB) 1st postoperative day. Preoperative mental status (MCS and anxiety and/or depression symptoms) and postoperative pleural drainage were significant predictors of mental health 6 months after surgery. This study identified predictors that have an impact on CABG patients' HRQoL 6 months after surgery. These predictors could cause elevated risk for morbidity and mortality. Clinicians have the opportunity to improve the HRQoL of CABG patients by targeting counselling and/or interventions focusing on the identified predictors.

Predictors of Health-Related Quality of Life in Asthmatic Children

For children with asthma, their perceived health-related quality of life (HRQL) is viewed as a valid outcome measure with which to evaluate care and guide clinical interventions. Numerous clinical variables have been associated with HRQL, but few studies have addressed the role of family functioning in relationship to this outcome. The current study extends the findings of an earlier meta-analysis that indicated that family functioning and illness severity were significant predictors of health-related quality of life in children with asthma. Sixty children and 60 parents or guardians participated in this study of school-age asthmatic children who, over the preceding year, received regular care at a pediatric respiratory clinic for their asthma symptoms. Demographic information was obtained from the adults, who also completed standard measures assessing family stress, adaptation, and cohesion. The children were interviewed by the investigator and completed scales to assess HRQL. The major outcome of interest was the child’s HRQL. The child’s level of control over symptoms and the accumulation of family demands, particularly those related to loss, transition, and illness/family care, negatively affected the child’s quality of life. Multiple regression analysis further revealed that level of control and transitions within the family accounted for 23% of the variance of scores measuring HRQL. Family cohesion emerged as a potential mediating factor that may buffer the negative effects of family stress and the lack of control that an asthmatic child may experience in symptom management. An appreciation of the relationships between family stress, cohesion, and HRQL for children with asthma will directly inform clinical practice. Additional family-centered clinical research that fully incorporates HRQL into a theoretical model of health outcomes will continue to refine effective clinical interventions for asthmatic children.

Health Related Quality of Life for Men Treated for Localized Prostate Cancer With Long-Term Followup

Men who undergo primary treatment for prostate cancer can expect changes in health related quality of life. Long-term changes after treatment are not yet fully understood. We characterized health related quality of life evolution from baseline to 4 years after treatment. We identified 1,269 men in CaPSURE who underwent primary treatment for clinically localized prostate cancer and completed followup health related quality of life questionnaires for at least 4 years. The men underwent radical prostatectomy, external beam radiotherapy, brachytherapy, combined external beam radiotherapy/brachytherapy or androgen deprivation therapy. Health related quality of life was measured using patient reported questionnaires. Effects of select covariates on quality of life were measured with a multivariate mixed model. Age at diagnosis, time from treatment and primary treatment were significant predictors of health related quality of life in all domains (p <0.05) except primary treatment on sexual bother. Men who underwent radical prostatectomy experienced the most pronounced worsening urinary function but also had the greatest recovery. All treatments worsened urinary bother, and sexual function and bother. All forms of radiotherapy moderately worsened bowel function and bother after treatment but eventual recovery to baseline was noted. Age at diagnosis, time from treatment and primary treatment type affect health related quality of life. Treatment has a greater impact on disease specific than general health related quality of life. All treatments adversely affect urinary and sexual function. Most adverse changes develop immediately after treatment. Recovery occurs mostly within 2 years after treatment with little change beyond 3 years.

Dating Relationships in College Students with Childhood-Onset Asthma

Objective. The current study investigated whether differences existed in dating anxiety and fear of intimacy between individuals with childhood-onset asthma and individuals without a chronic illness. Analyses were also conducted to determine if dating anxiety or fear of intimacy were predictors of health-related quality of life in individuals with asthma and healthy controls. Additionally, potential gender differences in dating anxiety and fear of intimacy in individuals with childhood-onset asthma were explored. Methods. College undergraduates at least 17 years of age who self-identified as having childhood asthma were randomly matched by age and gender to healthy control participants. Participants completed a demographic form, the Dating Anxiety Scale for Adolescents, the Fear of Intimacy Scale, and the SF-36 Health Survey, a measure of health-related quality of life. Results. There were no significant differences between self-identified participants with asthma and matched healthy controls on the Dating Anxiety Scale or Fear of Intimacy Scale. However, dating anxiety was a significant predictor of mental health-related quality of life in participants with asthma but not in matched health controls. Fear of intimacy was not a significant predictor of mental or physical health-related quality of life in individuals with asthma. In addition, women with asthma endorsed significantly more dating anxiety and lower physical health-related quality of life than males with asthma. Conclusion. College students with asthma appear to experience similar levels of dating anxiety and fear of intimacy than healthy college students; however, their anxiety about dating may have a larger effect on health-related quality of life than healthy individuals. Additional examination of dating and interpersonal relationships among individuals with asthma appears warranted, particularly as it concerns possible gender differences in individuals with childhood-onset asthma.

Abstract B6: Obesity risk in relation to quality of life: Baseline results from a worksite trial

Abstract Introduction: Obesity, a risk factor for certain cancers, can also be related to reduced health-related quality of life and productivity. We examined eating physical activity behaviors, and body mass index (BMI), as predictors of health-related quality of life and productivity. Methods: MOVE ‘M is a worksite-randomized trial targeting diet and physical activity to reduce weight gain. Secondary outcomes include Obesity and Weight Loss Quality of Life (OWLQOL) and productivity. Baseline data collection occurred from 2006–2008, and data were analyzed in 2009. Results: Baseline data were analyzed for individual-level associations using linear mixed models. Since gender was found to be an effect modifier, data were analyzed separately for men (n=288) and women (n=281). BMI was negatively associated with OWLQOL in both women (p&amp;lt;0.001) and men (p&amp;lt;0.001). The linear effect estimate for OWLQOL score associated with one category increase in BMI was 32% (95% CI: 27%, 37%) for women and 12% (95% CI: 8%, 17%) for men. Physical activity was associated (p=0.007) with OWLQOL only in women. Eating while doing another activity was negatively associated with OWLQOL scores only in men (p=0.0003) and with productivity only in women (p=0.004). Conclusion: Our results suggest obese persons, particularly women, experience diminished OWLQOL. If longitudinal analyses confirm these findings, there may be additional work-related and general health benefits from reducing weight and increasing physical activity. Citation Information: Cancer Prev Res 2010;3(1 Suppl):B6.

Temperament and character as predictor of health related quality of life after metacarpophalangeal joint arthroplasty ——Personality and MCP joint arthroplasty outcome

Purpose: To evaluate personality characteris- tics’ impact upon outcome after silicone-based MP arthroplasty in RA patients. Methods: 40 RA patients who had undergone operations on their MP joints were investigated in a one-year fol- low-up. Objective measurement to assess grip strength and active range of motion—Paper- pencil-tests to assess pain during activity and at rest performance, QoL, and personality. Results: Significant improvement was observed in func- tion and pain related scores except for the pain related VAS and in several QoL facets and do- mains. Patients who experienced improvement reported higher scores on the activities of daily living facet of the WHO QoL questionnaire. Those with lower pain showed more independ- ence. The variance of the QoL domain scores, other than social and physical domains, could substantially and meaningfully be explained by variance of objective measures combined with personality scores. Conclusions: Most RA pa- tients’ QoL can be improved by MP arthroplasty despite remaining substantial level of pain. NS and HA seem to play an important role in the adaptation process during the long term, chronic illness; whereas SD represents a tool of coping with the burden of pain and disability. Personal- ity characteristics are highly predictive for QoL suggesting their important mediating role be- tween experienced pain and disability and HR QoL.

Conversational displays of coping resources in clinical encounters between patients with epilepsy and neurologists: A pilot study

How people with epilepsy (PWE) cope is an important determinant of their resilience to seizures. More adaptive ways of coping are an independent predictor of health-related quality of life. Coping styles have typically been assessed using self-report questionnaires. However, such questionnaires fail to capture the complexity of the phenomenon of coping. This study explores whether close examination of the interactional and linguistic resources used by PWE can be used to enhance our understanding of coping behavior as it naturally emerges in semistructured, first clinical encounters between patients with refractory epilepsy and a neurologist. At a more superficial (topical) level of analysis, our examination of nine interactions reveals that PWE tend to present themselves as resourceful individuals who are in control of their disorder (which thereby becomes less significant). In contrast, the analysis of more subtle linguistic and interactional features indicates that some PWE actually find their disorder quite difficult to deal with.

Determinants of Quality of Life in Patients with Inflammatory Bowel Disease

Purpose: The determinants of health-related quality of life (HRQOL) remain poorly understood in inflammatory bowel disease (IBD). The primary aim of this study is to determine whether depression and disease activity as well as other demographic information are determinants of health-related quality of life in patients with inflammatory bowel disease. Methods: A small exploratory study was conducted at the Yale IBD clinic. Seventy two patients with a known diagnosis of IBD were enrolled in the study. Demographic information-age, gender, diagnosis of ulcerative colitis(UC) or Crohn's disease (CD), disease duration, number of hospitalizations, number of surgeries and use of medications (antidepressants, immunomodulators, biologics, steroids), hematocrit, albumin and C-reactive protein were obtained by chart review. HRQOL was assessed by Short IBD questionnaire (SIBDQ), depression by Beck's Depression Inventory (BDI) and disease activity in CD was assessed by calculating Crohn's Disease activity Index (CDAI) and in UC by calculating Seo Activity Index (SEO). Data obtained was analyzed by fitting a multiple linear regression model. Significant variables were further selected by AIC (Akaike Information Criterion). Power analysis was performed for individual and a combination of the regression coefficients. Results: Seventy two patients were enrolled in the study-38 with CD and 34 with UC. Table 1 shows demographics of the 2 disease groups. After data transformation, fitting a linear regression model and variable selection, the following regression equations are derived: 1. SIBDQ3=5000*(46.368 -✓3.980 BDI - 4.061log (hospitalizations)- 11.489 antidepressant) 2. SIBDQ2 =100*(35.46 - 0.573BDI - 0.0235SEO + 0.359 Disease Duration). Equation 1 shows that HRQOL is inversely related to depression, number of hospitalizations and antidepressant use in CD patients. Equation 2 shows that HRQOL is inversely related to depression and disease severity, but directly related to disease duration in UC. Table 2 shows the P values of significant regression coefficients in multiple regression model from CD patients (Table 2a) and UC patients (Table 2b). The significance of BDI associated with SIDBQ has sufficient power. In CD patients with sample size 38, the power of the regression coefficient for BDI alone is 0.986. In UC patients with sample size 34, the power of the regression coefficient for BDI alone is 0.971.Table 1: DemographicsTable 2: P values of significant regression coefficients in multiple regression modelConclusion: Depression is the most important predictor of health related quality of life in patients with IBD. Other significant predictors in Crohn's disease were number of hospitalizations and antidepressant use and in ulcerative colitis were disease activity and duration.

Predictors of health-related quality of life in the general population

Objective To evaluate health-related quality of life (HRQoL) in the general population in China and research on the predictive factors of HRQoL by using the short form 36 item (SF-36) questionnaire. Methods Using large sample data of health status cross-section survey from general population of nine provinces and municipalities (Jiangsu, Anhui, Gansu, Qinghai, Fujian, Beijing, Jilin, Jiangxi and He'nan) from December 2005 to January 2007,8448 samples in accord with sample data from 1% nationwide population survey in 2005 were randomly selected with sex and age structures, which could representative the general population of China. The relationship between HRQoL score and socio-demographic characteristics,behavior and health-related factors were studied by using variables single factor analysis,and found out the predictive factors of HRQoL by using multiple stepwise regression analysis. Results All sub-scales scores were similar trend of change between Chinese general population and Hong Kong general norm. Single factor analysis showed that the decreasing of HRQoL score was related with sex, age, marital status, education level, occupation, sleep time, exercise habit, body mass index and past history of chronic disease. Multiple stepwise regression analysis showed that there were differences among significant predictive factors of each domain of SF-36;in all eight domains, the first six significant predictive factors have twelve indexes. Among them, the predictive factors of age increase, low-level exercises, past history of chronic disease, farmers, inoccupation people, students,women, less sleep time and low weight leaded to the decrement in HRQoL score, married and higher education were protective factors for HRQoL. Conclusion Age, sex, marital status, education level, occupation, sleep time, exercise habit, body mass index and past history of chronic disease were the predictive factors for HRQoL. Key words: Health-related quality of life; SF-36; Multiple stepwise regression analysis; Predictive factors

Predictors of Health‐Related Quality of Life 3 Months After Traumatic Injury

Examination of predictors of health related quality of life (HRQoL) with a focus on the ability of illness representations to predict HRQoL 3 months after hospital discharge in patients who experienced moderate to severe traumatic injury. A prospective predictive study, using a survey design was undertaken to identify predictors of HRQoL. Telephone interviews were conducted 3 months after patients were discharged from the hospital. Demographic and clinical data and two scales: the Chinese Illness Perception Questionnaire Revised (IPQ-R, Trauma) and the Medical Outcomes Study Short Form 36 (SF-36) were used in this study. Simultaneous multiple regressions were used to identify predictors of HRQoL. A total of 114 participants completed the survey. The most frequently reported symptoms were pain, weight loss, strength loss, and fatigue. The illness representations that scored the highest were Illness coherence, Controllability, and Consequences. The average SF-36 physical summary score was lower than the average mental summary score. Role (physical) had the lowest scores on the physical subscale and vitality had the lowest scores on the mental subscale. Significant predictors of the physical summary score were identity, consequences, timeline (acute/chronic), age, and injury severity score (ISS), and for the mental summary score predictors were identity, emotional representations, and timeline. Illness representations can be used to predict HRQoL 3 months after traumatic injury. These findings can help clinicians to understand illness perceptions of patients with traumatic injury, and help provide a foundation for an interventional program to help patients have better HRQoL following traumatic injury. By understanding patients' illness representations, clinicians could provide information related to postinjury care to facilitate more congruent representations between expectations and real situations. By helping patients understand the important role early interventions might play in their recovery, clinicians might help patients develop more positive cognitive representations.

Predictors of quality of life: A quantitative investigation of the stress-coping model in children with asthma

BackgroundAim of this study is to further explore predictors of health related quality of life in children with asthma using factors derived from to the extended stress-coping model. While the stress-coping model has often been used as a frame of reference in studying health related quality of life in chronic illness, few have actually tested the model in children with asthma.MethodIn this survey study data were obtained by means of self-report questionnaires from seventy-eight children with asthma and their parents. Based on data derived from these questionnaires the constructs of the extended stress-coping model were assessed, using regression analysis and path analysis.ResultsThe results of both regression analysis and path analysis reveal tentative support for the proposed relationships between predictors and health related quality of life in the stress-coping model. Moreover, as indicated in the stress-coping model, HRQoL is only directly predicted by coping. Both coping strategies 'emotional reaction' (significantly) and 'avoidance' are directly related to HRQoL.ConclusionIn children with asthma, the extended stress-coping model appears to be a useful theoretical framework for understanding the impact of the illness on their quality of life. Consequently, the factors suggested by this model should be taken into account when designing optimal psychosocial-care interventions.