Predictors Of QOL Research Articles

An ecological exploration of individual, family, and environmental contributions to parental quality of life in autism

The aim of this study was to assess the respective weight of individual and environmental factors on quality of life (Qol) of parents of children with autism spectrum disorders (ASD). Few studies have investigated both individual and environmental predictors of Qol but to our knowledge, none of them has considered the child's and parents’ characteristics, family context and services available in the same design. Participants were 115 parents (73 mothers and 42 fathers) of children with ASD aged from 3 to 10 years. Hierarchical regression analyses were conducted to investigate predictors of parental Qol among child-related, parent-related and environmental factors. Findings indicate that a higher Qol is associated with a good quality of interaction in marital and parent-grandparents dyads, no family medical history and access to psycho-educational interventions for the child, regardless of child's developmental quotient, comorbidity, parent sex and working time. This final model best fits the data and explains 31.5% of the variance of parents’ Qol. This study highlights that it is crucial to consider both individual and environmental variables as potential protective factors of parental adjustment. An ecological approach seems to be relevant to understand which parenting resources should be targeted in support programs.

Factors influencing quality of life in patients followed in the neurosonology laboratory for carotid stenosis

BackgroundQuality of life (QoL) is one of the main endpoints in stroke prevention or acute stroke treatment studies. The aim of the current study was to identify risk factors affecting the QoL of patients with carotid stenosis in stroke prevention.MethodsSelf-sufficient patients (50–80 years of age) with ≥20% carotid artery stenosis followed in the neurosonology laboratory, and without any severe illnesses within the last 12 months, dementia, or psychiatric disorders were selected for the study after signing informed consent. Patients completed two standardized QoL questionnaires (WHOQoL-BREF and EQ-5D-3 L) and a visual pain scale, provided covariate variables (medication, age, gender, education, and social situation), and the blood pressure and body mass indexes were recorded. Logistic regression (forward stepwise method) was used to identify factors affecting the individual domains of QoL questionnaires.ResultsOf the 584 consecutive patients, 502 met the inclusion criteria and 344 completely filled both QoL questionnaires (164 men; mean age, 69.7 ± 7.8 years). An independent predictor of worse QoL in all domains was pain. Independent factors decreasing the QoL were lower level of education and blood pressure in the physical health domain, female gender in the psychological domain, and male gender in the social relationships domain. Independent factors decreasing satisfaction with health status were female gender and higher blood pressure. Factors negatively influencing the satisfaction with the QoL were living alone, lower level of education, and higher diastolic blood pressure (WHOQoL-BREF). Factors negatively influencing mobility were age, male gender, living alone, lower level of education, and higher body mass index (EQ-5D-3 L; p < 0.05 in all cases).ConclusionsPain, blood pressure, body mass index, education, living alone, gender, and age were associated with the QoL in patients with carotid stenosis.Trial registrationClinicalTrials.gov, NCT02360137. Registered on 26 January 2015.

PD26-04 IS THE ICIQ-SF QUESTIONNAIRE RELIABLE IN PREDICTING QOL OUTCOMES? RESULTS OF A PROSPECTIVE SINGLE-CENTER STUDY

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Male Incontinence: Therapy I1 Apr 2018PD26-04 IS THE ICIQ-SF QUESTIONNAIRE RELIABLE IN PREDICTING QOL OUTCOMES? RESULTS OF A PROSPECTIVE SINGLE-CENTER STUDY Manuela Tutolo, Marco Bianchi, Giulia Castagna, Alberto Briganti, Andrea Salonia, Steven Joniau, Ben Van Cleynenbreugel, Youri Bekhuis, Francesco Montorsi, Wouter Everaerts, and Frank Van der Aa Manuela TutoloManuela Tutolo More articles by this author , Marco BianchiMarco Bianchi More articles by this author , Giulia CastagnaGiulia Castagna More articles by this author , Alberto BrigantiAlberto Briganti More articles by this author , Andrea SaloniaAndrea Salonia More articles by this author , Steven JoniauSteven Joniau More articles by this author , Ben Van CleynenbreugelBen Van Cleynenbreugel More articles by this author , Youri BekhuisYouri Bekhuis More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , Wouter EveraertsWouter Everaerts More articles by this author , and Frank Van der AaFrank Van der Aa More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1343AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To assess the correlation between ICIQ-SF and EORTC QLQ-C30-QoL in a cohort of patients submitted to robot-assisted radical prostatectomy (RARP) at a single center. Likewise, we sought to test the association between ICIQ-SF and satisfactory QoL at different time points METHODS Complete data were available for 392 patients operated between September 2009 and August 2016. Data were prospectively collected in a compulsory regional database (Flemish Cancer Registry). Pre and postoperative ICIQ-SF and EORTC QLQ-C30-QoL questionnaires were available for each patient. Linear regression analyses were used to assess correlation between ICIQ-SF and QoL scores. QoL was defined as satisfactory (>=91), intermediate (81-90) and poor (<=80). Best cut-off methodology and univariable analysis were used to identify two different ICIQ-SF categories associated to satisfactory QoL outcomes. Multivariable analysis (MVA) was used to assess the correlation between ICIQ-SF and QoL, at different time points, after adjusting for clinical and pathological variables (i.e., age at surgery, pathological stage (pT), N stage (N), Gleason Score (GS), Erectile function (EF; defined by IIEF-EF domain score), and biochemical recurrence (BCR) RESULTS Mean follow-up was 13.5 months (median 13, range 12-43). Before surgery, 81% of patients reported an ICIQ-SF score of 0. At baseline, 176 patients had QoL scores of 100 (45%). At 12-mos assessment, 52.6% (n=206) of patients had QoL scores >= 80 and 52% (n=203) had an ICIQ-SF <=2. At linear regression analysis, 12-mos ICIQ-SF scores were significantly associated to 12-mos QoL (p<0.001, β -1,75). At 1-mo assessment, the best ICIQ-SF cut-off associated to 12-mos satisfactory QoL was 2, while the best cut-off value was 5 at 3- and 12-mos (all p <=0.003). At 1 month EF and ICIQ-SF <=2 were associated with satisfactory QoL at 12-mos evaluation (all p=0.001). At 3 months, only ICIQ-SF <=5 was associated to satisfactory QoL scores (p=0.001, OR 5.0, 95%CI: 1,93; 9,71). At 12 months, both ICIQ-SF and EF scores emerged to be predictors of satisfactory QoL (p=0.001, OR 8.2, 95%CI: 2,7; 14,2 and p=0.005, OR 1.07, 95%CI: 1,02; 95%CI: 1,133, respectively). CONCLUSIONS To the best of our knowledge, this is the first prospective, single center study comparing ICIQ-SF findings and the QoL outcomes addressed using the EORTC QLQ-C30, in a cohort of patients submitted to RARP. The ICIQ-SF showed to be highly correlated with satisfactory QoL at 12-mos assessment as from 1 month after surgery. Accordingly, ICIQ-SF assessment can help in patients counseling after surgery © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e553 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Manuela Tutolo More articles by this author Marco Bianchi More articles by this author Giulia Castagna More articles by this author Alberto Briganti More articles by this author Andrea Salonia More articles by this author Steven Joniau More articles by this author Ben Van Cleynenbreugel More articles by this author Youri Bekhuis More articles by this author Francesco Montorsi More articles by this author Wouter Everaerts More articles by this author Frank Van der Aa More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Bridging glycated hemoglobin with quality of life and health state; a randomized case\u2013control study among type 2 diabetes patients

BackgroundThe aim of this study was to explore the predictors of QOL and health state and examine the relationship with glycemic control among type 2 diabetes mellitus (T2DM) patients.MethodsA randomized cross-sectional case–control study was conducted among n = 600 T2DM patients of Malaysia. Study population was distributed into three groups as: controls: patients with HbA1c ≤ 7 (n = 199), cases arm 1: with HbA1c 7–7.9 (n = 204) and cases arm 2 (n = 197): with HbA1c ≥ 8 consecutively last 3 times.ResultsParticipants with diabetes history > 10 years exhibits higher mean QOL score among all the three groups. In contrast mean health status score significantly (p < 0.001) reduced with the exposure duration of diabetes both within and intergroup assessment that participants with poor glycemic control (arm 2) had significantly higher mean QOL score with knowledge and self-care dimensions as compared to others, however mean health state scores were significantly (p < 0.001) lower in all assessment dimensions as compared to controls. The F test of significance showed that demographic and clinical parameters were strong predictors of QOL, whereas self-care activities, comorbidities, ability of positive management and BMI were significant predictors to health state for consistent glycemic control (controls) as compared to poor glycemic control (arm 2) participants.ConclusionThis study suggested that poor glycemic index reported low self-care behavior, increase barriers to daily living activities and poor ability to manage diabetes positively, which cause poor QOL and decrease health state.

Is religious and existential well-being important in quality of life in Hong Kong Chinese?

The present study aims to determine the extent to which general QoL is predicted by religious and existential well-being, taking into consideration the intensity of participants’ religious and personal beliefs. Additionally, we examine the differences between Christians, believers in the Chinese religions, and those who are not religious. The study is based on the secondary analysis of a cross-sectional survey on the Spiritual Well-being scale (SWBS), which encompasses religious (RWB) and existential well-being (EWB). Participants (N=445) were comprised of three religious subsamples for known group comparisons: a Chinese religions group (CRG) (n=133), comprising Buddhism (23.1%), Taoism (5.2%), folk religions and ancestral worship (1.5%); a Christian group (n=144) consisting of Roman Catholics (8.3%) and Protestants (24%); and non-believers (NRel) (n=167). Regardless of their religious affiliations, QoL scores were the same in the overall sample. However, when taking the extent of religious commitment and sense of belonging into consideration, religious believers had higher scores in QoL and SWBS than non-believers (highest in Christians, followed by CRG and NRel). Hierarchical regressions showed that EWB was the only significant predictor of QoL after controlling for gender, age, and the extent of religious belief and commitment. The data indicated positive influences of religious beliefs on QoL and SWBS, although distinct affiliations might have affected these scores to a different extent. Fostering RWB and EWB are vital to promoting QoL.

Modeling of quality of life in older adults with advanced cancer: Data from a URCC NCORP multisite trial.

218 Background: While the importance of symptom assessment is well recognized in Palliative Care (PC), limited evidence is available on the growing population of older adults with advanced cancer. Increasingly geriatric assessment (GA), which incorporates validated tools to assess health status, is advocated as a component of the care for older patients with cancer, but is not routinely incorporated into PC evaluations. We tested the hypothesis that variability in QoL for older adults with advanced cancer would be predicted by both symptoms and GA. Methods: Data from an ongoing cluster RCT conducted at 68 oncology practices were analyzed. Inclusion criteria were: &gt; 70 years old, advanced solid tumor diagnosis, impairment in at least 1 GA domain (e.g., function). Multiple reliable and valid objective assessments and self-report measures for each GA domain were completed. Symptoms were assessed by MD Anderson Symptom Inventory (MDASI). Hierarchical regression modeling was conducted. The dependent variable was FACT score at Time 2 (4-6 weeks). The independent (Time 1) variables were entered in 3 steps: 1) gender, race, educational level( &lt; or &gt; high school), cancer type ( GI / Lung or other), receiving chemotherapy; 2) MDASI, 3) GA measures: Polypharmacy, Blessed Orientation and Memory Concentration Test, % weight loss, Short Physical Performance Battery, Instrumental Activities of Daily Living (IADL), Older Adult Resource Survey (OARS) Comorbidity, OARS Medical Social Support, and Generalized Anxiety Disorder-7. Results: N = 342 at time 1 (Mean age 77 years, 43% female, 90% white, 51% high school graduates, 49% GI or Lung cancer, 68% on chemotherapy). N = 303 at time 2(11% attrition due to death or withdrawal). Overall, 46% of variance in QoL was explained (demographic and disease characteristics: 4% [p = .05], symptoms: 32% [p &lt; .0001], GA measures: 10% [p &lt; .0001]). Significant individual GA predictors of worse QoL were lower social support, higher anxiety, impairment in IADLs, and poorer physical performance. Conclusions: Findings suggest that GA explains variance in quality of life scores for older adults with advanced cancer and reinforce the importance of symptom assessment and management in this population. Clinical trial information: NCT02107443.

Morbidity Profile and Quality of Life (QOL) of the Beneficiaries of Asraya Project: A Study from Kerala

International Journal of Medicine and Public Health,2017,7,3,142-146.DOI:10.5530/ijmedph.2017.3.29Published:Aug 2017Type:Original ArticleMorbidity Profile and Quality of Life (QOL) of the Beneficiaries of Asraya Project: A Study from KeralaSreelakshmi Pallipurathu Raghunathan Nair, Anish Thekkumkara Surendran Nair, Sara Varaghese, Vijayakumar Krishnapillai, Achu Thomas, and Alice Metilda Mendez Sreelakshmi Pallipurathu Raghunathan Nair1, Anish Thekkumkara Surendran Nair2, Sara Varaghese2, Vijayakumar Krishnapillai3, Achu Thomas4, Alice Metilda Mendez5 1Department of Community Medicine, Sree Uthradam Thirunal Academy of Medical Sciences, Vattapara, Thiruvananthapuram, Kerala, INDIA. 2Department of Community Medicine, Govt Medical College, Thiruvananthapuram, Kerala, INDIA. 3Department of Community Medicine, SMCSI Medical College, Karakonam, Thiruvananthapuram, Kerala, INDIA. 4Resident Medical Officer, Govt Thaluk hospital, Kanjirapally, Kottayam, Kerala, INDIA. 5Department of Community Medicine, KMCT Medical College, Kozhikode, Kerala, INDIA. Abstract:Introduction: The State Poverty Eradication Mission of Government of Kerala- ‘Kudumbasree’ launched an innovative programme named Asraya for the destitute individuals. The health conditions and level of living seldom studied among these marginalized individuals. This study aims to assess the morbidity profile and Quality of Life (QOL) of the beneficiaries of the destitute rehabilitation project (Asraya) in Thiruvananthapuram district , Kerala. Methods: This crosssectional study was conducted among 150 beneficiaries of the destitute rehabilitation project in Thiruvananthapuram district, Kerala, India. Sampling technique used was cluster sampling - Probability Proportionate to Size. A pre-tested semi-structured questionnaire was used to collect the baseline information and WHO QOL BREF was used to assess the quality of life.Data was analyzed using SPSS Version 20. Results: Chronic non-communicable diseases topped the list in their morbidity profile. In general, the Quality of Life of these individuals was poor with a mean score of 30 (22.6). Domain wise analysis produced a score of above 40 in two domains namely physical and environmental. Younger age, access to nutrition, free from diseases and supervision by the authorities were important predictors of QoL. Conclusion: This group of individuals suffered from a multitude of diseases. QoL of the destitute was poor in general, with variations with respect to domains. The quality in the physical domain was relatively better than that in psychological domain. Keywords:Asraya project, Health of the Destitute, Marginalized section, Poverty and health, Quality of Life, Standard of livingView:PDF (153.74 KB)

Depression—A Major Contributor to Poor Quality of Life in Patients With Advanced Cancer

ContextQuality of life (QoL) and depression are important patient-reported outcomes in cancer care. However, the relative importance of depression severity in predicting QoL remains unclear because of few methodologically sound studies. ObjectivesTo examine whether depression contributes to impairment of QoL irrespective of prognostic factors and symptom burden. MethodsA total of 563 patients were included from the European Palliative Care Research Collaborative–Computerized Symptom Assessment Study, an international, multi-center, cross-sectional study. The relative importance of prognostic factors (systemic inflammation [modified Glasgow Prognostic Score—mGPS]), co-morbidities and physical performance (Karnofsky Performance Status), symptom burden (loss of appetite, breathlessness, nausea [Edmonton Symptom Assessment Scale], and pain [Brief Pain Inventory]), and depression severity (Patient Health Questionnaire 9) in predicting Global Health/QoL (European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire [EORTC-QLQ-C30]) were assessed using hierarchical multiple regression models. ResultsFifty-five percent were women, median age was 64 years, 87% had metastatic disease, median Karnofsky Performance Status was 70, and mean global QoL was 50.5 (SD = 23.3). Worse QoL was associated with increased systemic inflammation (mGPS = 1 β = −0.12, P = 0.003; mGPS = 2 β = −0.09, P = 0.023), lower physical performance (β = 0.17, P < 0.001), reduced appetite (β = −0.15, P < 0.001), breathlessness (β = −0.11, P = 0.004), pain (β = −0.14, P = 0.002), and higher depression severity (β = −0.27, P < 0.001). The full model accounted for 29% of the observed variance in QoL scores. The strongest predictor was depression severity, accounting for 5.8% of the variance. ConclusionDepression severity was the strongest single predictor of poorer QoL in this sample of patients with advanced cancer, after accounting for a wide range of clinically relevant variables. Future studies should investigate the contribution of psychosocial variables on QoL. Our findings emphasize the importance of managing depression to achieve the best possible QoL for these patients.

Impact of Alzheimer disease patients' sleep disturbances on their caregivers

Sleep disturbance symptoms are common in persons living with Alzheimer disease (AD). However little is known about the impact of sleep disturbance symptoms in patients living with AD on caregiver burden and quality of life (QOL). The aims of this study were to determine the prevalence of symptoms of disturbed sleep in patients with AD, identify the care-recipient sleep disturbance symptoms that predict caregiver burden and QoL, and determine how care-recipient sleep disturbance symptoms compare to other caregiver and patient characteristics when predicting caregiver QoL. Caregiver burden was assessed using the Screen for Caregiver Burden. Sixty percent of the care-recipients had at least one sleep symptom. In 130 caregiver/patient dyads, nocturnal awakenings, nocturnal wandering, and snoring predicted caregiver burden. Multivariate modeling demonstrated that caregiver burden, caregiver physical and mental health, and caregiver depression were predictors of overall caregiver QoL. Treating disturbed sleep in care-recipients and caregiver mental health symptoms could have important public health impact by improving the lives of the caregiving dyad.

Psychosocial Factors Are Associated with Quality of Life After Laparoscopic Antireflux Surgery.

Laparoscopic antireflux surgery (LARS) is the gold standard treatment for refractory gastroesophageal reflux disease (GERD). Traditional surgical outcomes following LARS are well described, but limited data exist regarding patient-reported outcomes. We aimed to identify preoperative characteristics that were independently associated with a high GERD health-related quality of life (GERD-HRQL) following LARS. Clinical data from our single institution foregut surgery database were used to identify all patients with GERD who underwent primary LARS from June 2010 to November 2015. Electronic health record data were reviewed to extract patient characteristics, diagnostic study characteristics, and operative data. Postoperative GERD-HRQL data were obtained through telephone follow-up. Variables hypothesized a priori to be associated with high GERD-HRQL after LARS, which were significant at P ≤ .2 on bivariate analysis, were entered into a multivariable linear regression model with GERD-HRQL as the outcome. The study included 248 patients; 69.0% were female, 56.9% were married, and 58.1% had concurrent atypical symptoms. The most commonly performed fundoplications were Nissen (44.8%), Toupet (41.3%), and Dor (14.1%), respectively. The median follow-up interval was 3.4 years. The telephone response rate was 60.1%. GERD-HRQL scores improved from 24.8 (SD ±11.4) preoperatively to 3.0 (SD ±5.9) postoperatively. 79.9% of patients were satisfied with their condition at follow-up. On multivariable analysis, being married (P = .04) and absence of depression (P = .02) were independently associated with a higher postoperative QoL. Strong social support and psychiatric well-being appear to be important predictors of a higher QoL following LARS. Optimizing social support and treating depression preoperatively and postoperatively may improve QoL outcomes for LARS patients.

Psychometric Properties of the Patient-Reported Outcomes Measure of Pharmaceutical Therapy for Quality of Life (PROMPT-QOL)

ObjectivesTo assess the psychometric properties of a novel instrument for medication management, the Patient-Reported Outcomes Measure of Pharmaceutical Therapy for Quality of Life (PROMPT-QOL), using both conventional psychometrics and Rasch analysis in a large sample. MethodsThis study was conducted with 1156 adult outpatients continuously taking any medicines at least 3 months from three university hospitals in Bangkok, Thailand, between July 2014 and March 2015. The psychometric properties were assessed in five steps: 1) assessment of dimensional structure, 2) item selection, 3) assessment of practicality, 4) assessment of reliability, and 5) assessment of criterion and known-groups validity. ResultsThe PROMPT-QOL contained 43 items including nine domains, and their five-point Likert scale functioning worked well. Most items fulfilled the item selection criteria. The PROMPT-QOL took an average administration time of 13.4 ± 5.8 minutes. Only two items had missing data of 0.1% to 0.2%. All domains provided good to excellent test-retest reliability with intraclass correlation coefficients between 0.67 and 0.83. All domains of the PROMPT-QOL yielded high Cronbach’s α values between 0.77 and 0.89, greater than an acceptable level of 0.70, except for the Availability and Accessibility domain (0.58). A multiple regression showed that the Medication Effectiveness domain was the strongest predictor of the overall QOL of the PROMPT-QOL, followed by the Therapeutic Relationships, Psychological Impacts, Convenience, and Availability and Accessibility domains (adjusted R2 ~ 52%). As expected, patients with higher PROMPT-QOL domain scores were associated with being younger, more educated, having a lower number of medicines, patients’ perceptions of better disease control, having no adverse drug reactions, and medicine preference. ConclusionsThe PROMPT-QOL was practical, reliable, and valid for Thai patients.

Relationships Between Clinical, Self-Reported, and Donation Specific Outcomes: A Prospective Follow-up Study 10 Years After Kidney Donation.

BACKGROUND Long-term consequences of donor nephrectomy might be reduced kidney function, increased risk for cardiovascular disease, impaired quality of life, and fatigue. Few studies have investigated associations between clinical and self-reported outcomes in a long-term perspective. Thus, we aimed to investigate relationships between clinical, self-reported, and donation-specific outcomes in a nationwide cohort. MATERIAL AND METHODS We conducted a prospective follow-up study and assessed pre- and post-donation data from 202 donors who donated in 2001-2004. During 2012-2013, data on donors' self-reported (quality of life and fatigue) and donor-specific outcomes were collected. We performed linear regression for each component score of the generic instrument Short-Form, SF36v2, measuring quality of life, and the 5 domains of fatigue. Clinical parameters tested as independent variables were medical treatment of hyperlipidemia or hypertension, current smoking status, BMI, hemoglobin, and eGFR. Data were adjusted for age and gender. RESULTS Approximately 10 years after donation, 67 donors were hypertensive and 54 donors had eGFR <60 ml/min/1.73 m². Mean increase in plasma creatinine was 16.6 µmol/l (SD=16.3). None of the clinical parameters were significant predictors for QoL. Female gender was significantly associated with general fatigue. There was a significant difference in perception of recognition from health personnel between donors with hypertension and donors without hypertension. CONCLUSIONS Our results show no associations between clinical and self-reported outcomes. However, we found a significant relationship between hypertension and donation-specific outcomes. Hypertension or reduced kidney function was identified in a minority of the donors. The increased risk for fatigue among female donors needs more investigation.

High impact of sleeping problems on quality of life in transgender individuals: A cross-sectional multicenter study.

IntroductionStudies in the general population suggest that determinants of QoL are often sex-dependent. Sex-dependent analyses of QoL in transgender populations have not been performed so far.AimTo identify sex-specific and potentially modifiable determinants of QoL in transgender patientsMethodsIn this cross-sectional multicentre study including 82 transwomen (TW) and 72 transmen (TM) at different treatment stages, we investigated potential determinants for QoL focusing on the impact of mood (BDI, STAI-X), sleep quality (PSQI), chronic pain (GPQ), body image (FBeK) and social support (SSS).Main outcome measureHealth-related quality of life measured with the Short Form (36) Health Survey (SF-36).ResultsThe age-adjusted SF-36 total score and its subscales did not significantly differ between TM and TW. Using a multivariate regression analysis approach, we identified common but also sex-dependent determinants for QoL (Adjusted R2 = 0.228; 0.650 respectively). Accounting for general characteristics such as age, BMI and treatment status, sleep quality according to the PSQI was an independent and strong determinant of QoL in both sexes (β = -0.451, p = 0.003 TM; β = -0.320; p = 0.0029 TW). Chronic pain was a significant independent predictor of QoL in TM (β = -0.298; p = 0.042) but not in TW. In contrast, anxiety (β = -0.451; p< 0.001) being unemployed (β = -0.206; p = 0.020) and insecurity about the own appearance (FBeK) (β = -0.261; p = 0.01) were independent predictors of QoL in TW. The rate of those reporting high sleep disturbances (PSQI ≥5) was high with 79.2% in TW and 81.2% in TM. Accordingly, age-adjusted QoL was also significantly lower in those reporting poor sleep in both sexes.ConclusionsSleep strongly affected QoL in both genders, while other factors, like pain and body image, seem to be gender specific in transgender individuals.

Change of Cancer Symptom, Depression and Quality of Life based on Phases of Chemotherapy in Patients with Colorectal or Stomach Cancer: A Prospective Study

Purpose: The purpose of this study was to identify over time the changes of cancer symptom, depression and quality of life (QOL) among people who had stomach or colorectal cancer. Methods: Of the 74 participants recruited, 67 participated in the study. Participants were asked to complete three instruments at three different time. The instruments were the M. D. Anderson Symptom Inventory-Gastrointestinal Cancer Module, Hospital Anxiety Depression Scale, and the Functional Assessment of Cancer Therapy-General. The questionnaires were administered before chemotherapy, toward the end of chemotherapy, and six months after the completion of adjuvant therapy. Data were analyzed using descriptive statistics and repeated measure ANOVA. Results: At the immediately after chemotherapy point, the most frequent symptom was lack of appetite, followed by fatigue and problem with remembering things. The mean score for depression was 8.27 with a prevalence of 31.3%. The mean score for quality of life was 61.88 out of 135. Repeated measures ANOVA showed a significant increase in cancer symptom (F=23.22, p<.001) and depression (F=35.29, p<.001) after chemotherapy. However, improvement was observed 6 months after the completion of chemotherapy. QOL (F=33.73, p<.001) also showed similar patterns as observed with cancer symptom and depression. Cancer symptom was the strongest predictor of QoL at pre-chemotherapy point. but depression was the strongest predictor at immediately after chemotherapy point. Conclusion: Chemotherapy is highly associated with cancer symptom, depression and QOL in patients with cancer. The nursing intervention is needed to relieve depression as well as cancer symptoms to improve QOL in patients undergoing chemotherapy from baseline to follow-up.

Community integration and health-related quality-of-life following acquired brain injury for persons living at home

Primary objective: To study predictors of community integration (CI) and health-related quality-of-life (HRQoL) in a sample of Canadian adult, urban, multi-ethnic persons with acquired brain injury (ABI) receiving publicly-funded community services. Hypothesis 1 examined the predictive utility of age, ratings of disability, functioning and cognition for CI and HRQoL. Hypothesis 2 examined the correlation between CI and HRQoL.Research design: Cohort study.Methods and procedures: A convenience sample of community-residing clients completed measures with their care co-ordinators: Resident Assessment Instrument-Home Care (RAI-HC), Disability Rating Scale (DRS), Community Integration Questionnaire (CIQ) and the Quality-of-Life after Brain Injury Instrument (QOLIBRI).Results: Regression analysis showed DRS scores explained significant variance in CIQ and QOLIBRI. Correlations also showed that cognitive skill and ADL/IADL functioning are strongly related to CI and the Daily life and autonomy QOLIBRI sub-scale. The CIQ Total was not correlated with QOLIBRI Total, although there were some significant correlations between the CIQ social sub-scale and QOLIBRI.Conclusions: Lesser degree of disability is a key predictor of greater CI and QoL. The present findings suggest that rehabilitation efforts should focus on minimizing disability and promoting social integration and involvement to avoid adverse long-term effects of ABI for community-resident persons.

Personality characteristics in MS patients: The role of avoidant personality

ObjectivesQuality of life (QOL) is markedly affected by multiple sclerosis (MS). Particular personality characteristics (PC) of MS patients can affect their QOL. We designed the present study to determine the role of various PCs on QOL in MS patients accounting for other clinical factors. MethodsQOL, PC, physical disability, and mental status were recorded in 83 MS patients referred to two academic hospitals of Tehran University of Medical Sciences in 2011–2012. ResultsThe mean age of enrolled patients was 31.54±7.38 (range: 14–50) years and 74 (89.2%) were female. Mean disease duration was 4.55±4.70 years. Seventy-seven patients (92.8%) had relapsing–remitting disease, five (6%) had primary progressive, and one showed a secondary progressive course. Correlation between total QOL scores in MS patients and disease duration, cognitive impairment, and physical disability was significant (all p<0.001). Obsessive-compulsive personality was the most frequent PC (43.4%) in our patients. Only avoidant personality had a significant negative correlation with all components of QOL (Beta: 0.33, p<0.00). In addition, avoidant personality, physical disability, and mental status were found to be three predictors of QOL with all its components. ConclusionAvoidant personality appears to be an important predictor of poor QOL in MS patients. In addition, avoidant coping strategies appear to be associated with adverse response to stressful events in these patients. These findings suggest the need for psychological intervention for improving the coping strategies and QOL in MS patients.

Predictors of quality of life in opiate-dependent individuals undergoing methadone maintenance treatment

IntroductionQuality of Life (QoL) is an important outcome variable in Methadone Maintenance Treatment (MMT) for opiate dependence. Previous research has focused on demographic variables, treatment features, drug use and physical and mental health as possible predictors of QoL in this condition but interest in genuinely psychological variables (skills and personal repertoires) has been lacking. Experiential Avoidance (EA), the tendency to behave in order to decrease some kind of internal distress, has a strong relationship to psychological disorders and holds promise as a potential predictor of QoL.ObjectivesTo identify predictors of QoL in clients undergoing MMT, taking into account psychological variables.AimsTo see if EA is related to QoL in clients undergoing MMT.MethodsUsing a cross-sectional design, information was gathered from 48 opiate-dependent individuals undergoing MMT. Variables included were QoL (IDUQOL), severity of drug use, social adjustment and physical and mental health (ASI-6), emotional distress (HAD) and EA (AAQ and its version for substance-abusing individuals, AAQ-SA). Mean-comparison tests and correlation tests were carried out, and several variables were entered into a stepwise multiple regression analysis.ResultsAnxiety and EA were the only variables which made it into the regression model, accounting for 41.9% of variance of QoL.ConclusionsContrary to previous research, the predictors of QoL were psychological. It is the first time that EA is related to QoL in this population. Interventions should explicitly target EA and anxiety. Additional research should make use of longitudinal designs and take into account further psychological variables (emotion regulation, coping).Disclosure of interestThe authors have not supplied their declaration of competing interest.

Suitability of the Patient Concerns Inventory as a holistic screening tool in routine head and neck cancer follow-up clinics

In patients with cancer of the head and neck, efficient screening for problems can improve care and the management of resources. We explored use of the Patient Concerns Inventory (PCI-HN) as a holistic screening tool in the follow up of these patients. Between August 2007 and January 2013, 464 patients completed the PCI-HN and the University of Washington Quality of Life questionnaire version 4 (UWQoL) immediately before their routine follow-up consultations. The median (IQR) number of items selected on the inventory was 3 (1-6). This was associated (p<0.001) with the number of serious problems (dysfunction) in the 12 UWQoL domains (Spearman's correlation, rs=0.51), overall QoL (rs=-0.41), and the 2 UWQoL subscale scores of physical (rs=-0.46) and social-emotional (rs=-0.53) function. Binary regression to predict an overall outcome of “less than good” indicated that use of the PCI could be better than just recording clinical characteristics. Some patients however, chose few PCI items and had numerous problems. The inventory may have a role in the screening of patients with cancer of the head and neck, particularly in relation to social-emotional function and overall QoL, and may have added value when used with the UWQoL-v4. The total number of PCI items selected is a useful predictor of QoL. Further research is required to confirm suitable limits, and to find out whether additional support and repeated use of the inventory over time improve QoL.

Abstract WP140: Infarct Location Predicts Quality of Life Outcomes After Minor Stroke

Introduction: Neuro-QOL was developed to provide researchers with a continuous, validated, patient-reported measurement of quality of life. Previous studies suggest that minor ischemic stroke (MIS) can lead to disability and impaired quality of life in a substantial proportion of patients. We hypothesized that infarct location predicts 3-month QOL in patients with MIS. Methods: We identified MIS (NIHSS ≤ 5) with confirmed acute infarcts on DWI, admitted between August 2012 and July 2013, and who underwent Neuro-QOL outcomes assessments at 3 months. Impaired QOL was defined as T-scores &gt;0.5 SD worse than the general population mean of 50 (SD 10) in any of 5 domains: upper extremity, lower extremity, executive functions, general concerns, and social satisfaction. We analyzed the relationship between acute infarct locations and impaired QOL in univariate and multivariate analysis. We further stratified our analysis by any rehabilitation services (RS) received post-discharge. Results: Among 169 patients (mean age 64.3 years, 54.4% male, 24.9% black, median initial NIHSS score 1, 36.7% received RS post-stroke), impaired QOL was noted in 56 (33.1%) patients at 3 months (56.5% in patient with vs. 19.6% in those without RS, p&lt;0.001). Patients with left hemispheric infarcts (45.8 vs. 20.9%, p=0.001) and thalamic-brainstem infarcts were more likely to have impaired QOL (54.1 vs. 27.3%, p=0.002). In multivariable analysis, left hemispheric (adj. OR 3.45, 95% 1.61-7.41) and thalamic-brainstem infarction (adj. OR 4.59, 95% CI 1.91-11.00) were independent predictors of impaired QOL adjusting for age, NIHSS score, and recurrent stroke. Stratifying by RS, left hemispheric (34.0% vs 8.3% p=0.001) and thalamic-brainstem lesion location (52.6% vs 12.5% p&lt;0.001) was significantly associated with QOL only in those who did not receive RS. Discussion: Left hemispheric and thalamic-brainstems infarcts were independently associated with impaired QOL, especially in MIS patients who did not receive rehabilitation services post-stroke. These data imply that specific acute infarct locations predict patient-reported impairments in QOL and may be useful biomarkers for future studies of targeted rehabilitation services in MIS patients.

Predictors of quality of life in people with intellectual disability in Bosnia and Herzegovina

AbstractQuality of life (QOL) of people with intellectual disability is increasingly becoming the target for intervention and a measure of success of different support programs. Knowing the predictors of QOL might make the support programs more effective. In the present study, QOL of 152 persons with intellectual disability was assessed through the personal outcomes scale (POS)-self report. Total score on the POS was used as a dependent variable and age, sex, level of intellectual disability, employment status and marriage status were assessed as the potential predictors of QOL. The statistically significant predictors of QOL were level of intellectual disability and employment status. These predictors explained 19% of variance in POS scores. The results of this study indicate that the strategies aimed at increasing the QOL of people with disability must focus on finding and expanding the employment opportunities for people with intellectual disability. The role of non-governmental organizations (NGOs) can be very significant in this regard. The article concludes with a discussion of how predictors of QOL outcomes reported by other investigators could be incorporated into the policies and practices of NGOs to enhance person-referenced QOL outcomes.