Proportion Of Variance In Quality Research Articles

The relationship between context, structure, and processes with outcomes of 6 regional diabetes networks in Europe.

BackgroundWhile health service provisioning for the chronic condition Type 2 Diabetes (T2D) often involves a network of organisations and professionals, most evidence on the relationships between the structures and processes of service provisioning and the outcomes considers single organisations or solo practitioners. Extending Donabedian’s Structure-Process-Outcome (SPO) model, we investigate how differences in quality of life, effective coverage of diabetes, and service satisfaction are associated with differences in the structures, processes, and context of T2D services in six regions in Finland, Germany, Greece, Netherlands, Spain, and UK.MethodsData collection consisted of: a) systematic modelling of provider network’s structures and processes, and b) a cross-sectional survey of patient reported outcomes and other information. The survey resulted in data from 1459 T2D patients, during 2011–2012. Stepwise linear regression models were used to identify how independent cumulative proportion of variance in quality of life and service satisfaction are related to differences in context, structure and process. The selected context, structure and process variables are based on Donabedian’s SPO model, a service quality research instrument (SERVQUAL), and previous organization and professional level evidence. Additional analysis deepens the possible bidirectional relation between outcomes and processes.ResultsThe regression models explain 44% of variance in service satisfaction, mostly by structure and process variables (such as human resource use and the SERVQUAL dimensions). The models explained 23% of variance in quality of life between the networks, much of which is related to contextual variables. Our results suggest that effectiveness of A1c control is negatively correlated with process variables such as total hours of care provided per year and cost of services per year.ConclusionsWhile the selected structure and process variables explain much of the variance in service satisfaction, this is less the case for quality of life. Moreover, it appears that the effect of the clinical outcome A1c control on processes is stronger than the other way around, as poorer control seems to relate to more service use, and higher cost. The standardized operational models used in this research prove to form a basis for expanding the network level evidence base for effective T2D service provisioning.

The Influence of Consent on College Students’ Perceptions of the Quality of Sexual Intercourse at Last Event

ABSTRACT. The current study assessed consent's relation to quality of sexual intercourse. College students (n = 640) participated in a survey assessing their most recent intercourse. Hierarchical regression was conducted: alcohol consumption, relationship status, and age were entered in Step 1; the Internal and External Consent Scale factors were entered in Step 2. For women, three internal consent factors explained a significant proportion of variance in quality of intercourse beyond Step 1 (ΔR2 = .17, p < .001). For men, one internal and two external consent factors were significant predictors beyond Step 1 (ΔR2 = .24, p < .001). Preliminary findings suggest consent is associated with quality of intercourse.

Cystic Fibrosis: Lichaamsbeeld, Zelfwaardering en Kwaliteit van Leven

Cystic Fibrosis: Body image, self-esteem and quality of life In this study, body image was examined as a possible predictor of quality of life in adolescents with Cystic Fibrosis (CF). Furthermore, it was investigated whether self-esteem mediates the relationship between body image and quality of life. CF-patients between 14 en 23 years old (N = 44) were interviewed using structured questionnaires. As expected, body image proved to be a strong predictor of quality of life. By adding domains of self-esteem in the multiple regression analyses, a significant extra proportion of variance was accounted for. Especially perceived athletic competence, social acceptance and stable friendships were important additional predictors of scores on several domains of quality of life. The fact that domains of self-esteem, instead of global selfesteem, were contributing to incremental validity, indicates the importance of a differentiated approach towards this concept. Selfesteem was not a mediator in the relation between body image and quality of life. Thus, by taking into account not only body image, but also domains of self-esteem, a larger of proportion of variance in quality of life could be explained. The practical implications of these outcomes are discussed.

Anxiety symptoms and quality of life in middle-aged and older outpatients with schizophrenia and schizoaffective disorder.

This study examined whether anxiety symptoms make an independent contribution to poorer quality of life among middle-aged and older outpatients with schizophrenia or schizoaffective disorder. We evaluated data from an ongoing study of 163 older patients with DSM-III-R or DSM-IV schizophrenia or schizoaffective disorder who were enrolled in research at the University of California, San Diego, Advanced Center for Interventions and Services Research from October 1992 to April 1998. Measures used were the anxiety, somatization, obsessive-compulsive, and phobic anxiety subscales of the Brief Symptom Inventory. We performed hierarchical multiple regressions with forced entry of variables to determine whether anxiety symptoms significantly predicted poorer health-related quality of life (measured by 2 scales) after controlling for demographic variables, akathisia, cognitive impairment, depressive symptoms, and overall psychopathology. Anxiety symptoms were associated with poorer outcomes on overall quality of well-being and subscales representing vitality, social functioning, and role functioning limitations due to physical problems. In most cases, the proportion of variance in quality of life accounted for by anxiety symptoms was greater than that accounted for by depressive symptoms. Results suggest that anxiety symptoms have a significant negative impact on the quality of life of middle-aged and older patients with schizophrenia and schizoaffective disorder.

Association between perceived social support and strain, and positive and negative outcome for adults with mild intellectual disability.

Social strain has been identified as a trigger for both depression and physical health problems, but has not been well researched in people with intellectual disability (ID). The present study contrasted the effects of social support with social strain on depressive symptoms, somatic complaints and quality of life over time in adults with mild ID. The level of social support explained a significant proportion of variance in quality of life 6 months later, but not depressive symptoms or somatic complaints. In contrast, the level of social strain accounted for a significant proportion of variance in depressive symptoms and somatic complaints 6 months later, but not quality of life. The results suggest that interpersonal relationships can be both positively and negatively associated with physical and mental health for people with ID.