QoL Measurement Research Articles

Measurement of QOL of 1,202 New Japanese Outpatients Using the Japanese Version of Skindex16

Measurement of QOL of 1,202 New Japanese Outpatients Using the Japanese Version of Skindex16

P03-255 Quality of life among the navies at six months after the tsunami in phang-NGA naval base, phang-NGA province, Thailand

Objective:This study aimed to identify the health-related quality of life (HRQOL) among the navies or their spouses at 6 months after the tsunami disaster, to compare HRQOL with the 2006 Thailand normative data for Short Form - 36 (Bangkok)4.Method:A structured questionnaire modified from the 36-item Medical Outcome Study Short-Form Health Survey (MOS SF - 36), including demographic data, characteristics and amount of loss, social support, health information, and type of Tsunami exposure were recorded.Result:A total of 434 subjects participated in this study. Male was 77%. Married was 67%. Mean age was 33.56 ± 9.26 years old. The QOL scores among members of the Navy or their spouses were lower than the 2006 Thailand normative data (Bangkok) in almost all subscales except physical functioning, bodily pain, and social functioning. The major consequence of the Tsunami was mental health problems. A majority of the survivors who seriously experienced mental problems were female, low education, decreased income, loss of one's family members/loved ones, or property. Bodily pain was the only indicator subscale of QOL which was significant statistically associated with Tsunami exposure.Conclusion:The QOL measurement provided essential information that helped healthcare providers to identify survivors’ needs and outcomes. In addition, the changes in QOL over time after Tsunami disaster might be an effective guideline for health resources allocation. To improve their quality of life, these people required appropriate social support as well as physical and mental health care.

Quality of Life in Cities: Setting up Criteria for Amman-Jordan

In recent years, the interest grew in research on measuring the “quality of life” (QOL) in cities. This interest comes from the success QOL measurement achieved in understanding communities’ needs, tracking changes in different aspects of life and assessing the most desired types of future development among citizens. This research highlights the importance of measuring QOL in Jordan. It examines the opportunity and applicability of carrying out QOL measurement studies in Amman, the capital city. It outlines different scopes, visions and approaches that can be used to study and measure QOL and the most suitable mechanism that can work firmly. A professional top–bottom approach was used for that. Thirty-three experts with different backgrounds were interviewed in order to determine the appropriate scopes and visions for studying QOL, define the most significant aspects affecting QOL in Amman, and define the appropriate domains to be studied. Results were analyzed, limitations were defined and the final set of representative domains was stated. Domains were ranked according to their relevance and the important -underneath- aspects were defined in the form of models, each representing a certain domain. The paper attempts by the end to set the stage for setting up criteria for measuring QOL in Amman and to open the way for future QOL research to take place in Jordan.

Quality of life in migraine

AbstractMigraine headaches vary in severity from moderate pain with no activity limitations to severe pain and prolonged incapacitation undermining severely the quality of life. The physical, emotional, social, and economic burdens of headache are poorly acknowledged in general practice. Both moderate and severe disabling migraines have a profound impact on HRQoL. In addition to disease‐specific measures, enhancing daily functioning and well‐being are increasingly advocated goals. The evolution of the measurement of QoL in migraine has followed a progression from being discriminative, to evaluative, to predictive. HRQoL measures have not only added another dimension to migraine clinical trials endpoints but have also led to research predicting response to therapy. To measure the effect of headache and the effectiveness of therapy, instruments (generic and disease specific) have been developed that assess headache patients' perceptions of personal functioning and well‐being during or between attacks. Disease specific instruments are more sensitive in evaluating variations in patient perceptions of HRQoL during the course of disease. Most HRQoL research in migraine has been conducted in subspecialty clinics or patients participating in clinical trials which are more likely to be refractory to treatment than subjects with migraine in the community, thus not representative of patients with migraine in the community. Population‐based studies have the strength of identifying and inclusion of cases that otherwise do not come to the attention of the health care system. Migraine and depression exert a significant and independent influence on HRQoL. The qualitative studies further help to gain insight into the management of migraine from the patients' perspective, as the patients' perceptions of migraine and expectations from treatment are sometimes conflicting and thus influencing the patients' behavior. The incorporation of HRQoL measures in the treatment of patients with migraine is an increasing and valued practice by its specialists. The research on newer pharmaceuticals should focus on impact of headache on QoL, and outcomes. Such data is needed to compare prophylactic with abortive therapies or to compare outcomes among different therapeutic agents. Drug Dev Res 68:403–411, 2007. © 2008 Wiley‐Liss, Inc.

Cultural Participation and Individual Quality of Life: A Review of Research Findings

ObjectivesTo examine the research evidence for the contribution of cultural participation to individual quality of life; to discuss the utility of different types of QOL conceptualisation and measurement for cultural policy making.Materials and MethodsA literature review of English language publications over the decade from 1995.ResultsThere are few extant QOL studies, and very little empirical evidence to support the claims made by policymakers about culture and individual QOL.ConclusionsThe article suggests that a multi-dimensional, rather than a global, conceptualisation of QOL is best suited to the cultural policymaking context. Securing findings generalisable across all cultural forms, project types and all individuals or populations is not an achievable goal. Methodologies need to be developed and tested to understand how and why cultural participation affects individual QOL domains and these need to take into account differences in types of cultural participation, the quality of the experience, and between individuals in different social circumstances and in different life stages.

Can we really measure animal quality of life? Methodologies for measuring quality of life in people and other animals

AbstractQuality of life (QoL) is an abstract construct that has been formally recognised and widely used in human medicine. In recent years, QoL has received increasing attention in animal and veterinary sciences, and the measurement of QoL has been a focus of research in both the human and animal fields. Lord Kelvin said “When you cannot measure it, when you cannot express it in numbers — you have scarcely in your thoughts, advanced to a stage of science, whatever the matter may be” (Lord Kelvin 1893). So are we able to measure animal QoL? The psychometric measurement principles for abstract constructs such as human intelligence have been well rehearsed and researched. Application of traditional and newer psychometric approaches is becoming more widespread as a result of increasing human and animal welfare expectations which have brought a greater emphasis on the individual. In recent decades the field of human medicine has developed valid measures of experienced pain and QoL of individuals, including those who are not capable of self-report. More recently, researchers who are interested in the measurement of animal pain and QoL have begun to use similar methodologies. In this paper, we will consider these methodologies and the opportunities and difficulties they present.

NORMAL RESPONSE DATA FOR THE PANCREATIC CANCER QUALITY OF LIFE (QoL) ASSESSMENT QUESTIONNAIRE EORTC QLQ-PAN26

Introduction: The QLQ-PAN26 is validated for measurement of health related QoL in pancreatic cancer (Fitzsimmons 1999). It can also be used, with additional questions, to assess QoL in chronic pancreatitis (Fitzsimmons 2005). This study reports reference data for responses from normal individuals. Methods: We collected responses to the PAN26 from randomly selected normal people. Every tenth name was extracted from family doctor registers in three areas (inner city, suburb and rural town). Any person known to be suffering from cancer was excluded. A single mailing asked 300 individuals to complete and return the combined EORTC QLQ-C30 and QLQ-PAN26 questionnaires. Results: Responses were received from 101 (33%) people, median age 39.5 (range 20-84) years, interquartile range 23-55 years. Responses to the QLQ-C30 were similar to previously published normative data (EORTC). As expected, the responses to symptom-based questions showed a skewed distribution, with most replies indicating absent or very low scores: 83% had no or little abdominal discomfort or bloating; 91% had no, or little worries about future health; worry about low weight was absent, weakness was reported by only 3%, "yellowness" by 2%. Frequency of bowels affected QoL "quite a bit" for 18% and "a lot" for 9% of normal individuals; 13 had "quite a bit" and 3 "a lot" of back pain. Overall health and QoL responses showed 88% and 84% better than the mid point of the scale, median 6, normalised mean score 80.7%. Conclusions: This is the first report of norm reference data for the QLQ-PAN26. More responses are needed from individuals aged over 60, to provide a relevant comparison for pancreatic cancer patients. Normal individuals have better QoL than published findings in pancreatic cancer and chronic pancreatitis.

Necessity for including quality of life diagnostics and therapy in routine oncological care: Evaluation by methods of clinical guideline implementation

18594 Background: Application of quality of life assessment has become an important topic in oncology. Current approaches, however, have focused on technical issues within single center settings overlooking the requirements of routine care. We report on implementing of structural elements of a quality of life diagnostics and therapy system (QoL system). It was designed as integral part of the health care program for breast cancer patients in a regional tumor center. Methods: The QoL system was implemented by a systematic approach (Med. Care, 39, Suppl.2, 2(2001). Its elements comprised (a) coordinating practitioners (CPs) who functioned as gate keepers for QoL related therapies, (b) experts in the QoL unit who provided QoL reports and specific therapeutic recommendations based on patients’ responses to the EORTC questionnaire, (c) professional health care providers in psychotherapy, pain therapy, social support, physiotherapy/lymph drainage, and fitness (nutrition, sports), (d) clinicians (gynecologists) for patient recruitment and (e) opinion leaders for educational influence on the CPs to keep the QoL system in daily practice. Success of implementation (as indicated by CPs’ QoL-related changes in knowledge, attitude and behavior) was evaluated in a prospective study with breast cancer patients. Results: The QoL system was applicable in all of 170 patients recruited between Dec. 2002-June 2004 (age 34–86yrs, UICC 0–4, breast conserving surgery 67%). From 75 CPs (mostly gynecologists) in the area only 39 fulfilled criteria for the QoL system, 1 refused to participate. 38 CPs showed knowledge about QoL following educational outreach visits. Concerning attitudes and behavior, 64% of CPs found the experts’ reports comprehensible, 56% followed their recommendations, 20% made additional actions. Follow-up 4 months after first QoL measurement revealed improvements in pain, body image and social life (p < .05). Conclusion: The study—in combining doctor’s approach and patient’s demands—showed success using methods of guideline implementation by improving QoL deficits within a routine oncological care. Effectiveness will be analyzed in an ongoing randomized trial. No significant financial relationships to disclose.

Acupuncture Treatment Effects in IBS Are Predominantly Placebo Effects

Purpose: Despite occasional positive reports on the efficacy of acupuncture on functions of the gastrointestinal tract, published data not provide conclusive evidence that acupuncture (AC) is effective in the treatment of the irritable bowel syndrome (IBS). Methods: Forty-three patients with the diagnosis of IBS according to Rome II criteria were randomly assigned to receive either acupuncture (n = 22) or sham acupuncture (n = 21) (SAC) using the so-called “Streitberger needle”, and a standardized acupuncture treatment according to Traditional Chinese Medicine (TCM). Treatment duration was 10 sessions with an average 2 acupuncture sessions per week, and primary endpoint was improvement of quality of life (QOL) using the FDDQOL and the SF36, compared to baseline assessment at the end of treatment. QoL measurement was repeated three months after treatment. Results: Both the AC as well as the SAC group improved significantly in global QOL by the FDDQOL at the end of treatment (p = .022), with no differences between both groups; the SF36 was insensitive to these changes. This effect was partially reversed three months later. Based on the the small differences found between AC and SAC, a study including 570 patients would be neccessary to prove efficacy of AC over SAC. Post-hoc comparison of responders and non-responders in both groups combined revealed a significant prediction of the placebo response by two subscales of the FDDQOL (sleep, coping) (F = 6.746, p = .003) in a stepwise regression model. Conclusions: Acupuncture efficacy in IBS is primarily a placebo response that may in part be predicted by high coping capacity and low sleep quality in individual patients. (Supported by the German Medical Acupuncture Association, DÄGfA)

Measurement of Health-Related QOL in Diabetes Mellitus

A number of health-related QOL (HR-QOL) measures specifically designed for people with diabetes mellitus have appeared in the literature. This article provides a selective review of 12 measures that address this important construct. For each included study, a description of the measure and its development phase is provided, followed by discussion of sampling, reliability, validity and appropriateness for selected populations. Measures designed to investigate broad and specific conceptualisations of diabetes-specific QOL are included. For research in which a broad conceptualisation of diabetes-specific QOL is appropriate, the following measures are recommended: Diabetes-39, Diabetes Care Profile (DCP), Diabetes Impact Management Scales (DIMS), Diabetes Quality of Life (DQOL) and the Diabetes-Specific Quality of Life Scale (DSQOLS). For investigation of one or more specific aspects of diabetes-specific QOL, other measures may also be appropriate: single-scale questionnaires such as the Appraisal of Diabetes Scale (ADS) [stressful impact], Audit of Diabetes-Dependent Quality of Life (ADDQoL) [life without diabetes] and the Problem Areas in Diabetes scale (PAID) [diabetes-related distress]; the Diabetes Health Profile (DHP) which focuses on diabetes-related distress, activity and eating behaviour; the Questionnaire on Stress in Patients with Diabetes-Revised (QSD-R) which has a primary focus on diabetes-related distress; and the Well-Being Enquiry for Diabetics (WED) which is primarily concerned with the perceptions of patients with diabetes in relation to mental health. Researchers selecting a diabetes-specific QOL measure should also carefully consider the conceptual underpinnings of the available instruments, as there is little uniformity in the definition and conceptualisation of HR-QOL. Based upon participants involved in questionnaire development and validation studies, those questionnaires that appear to be most appropriate for use with a variety of patient populations include the Diabetes-39, DIMS, Diabetes Quality of Life Clinical Trial Questionnaire-Revised (DQLCTQ-R), PAID and the QSD-R. The DCP and DHP appear to be especially relevant measures of HR-QOL for patients with type 2 diabetes, while the DQOL, DSQOLS and WED have clear emphases on concerns of individuals with type 1 diabetes. The length of the DQLCTQ-R may raise concerns about its use among some populations (e.g. older adults). Recommendations for future research include: (i) increasing the diversity of samples used to develop and evaluate existing and new measures in terms of race/ethnicity, age and gender; (ii) examination of the causal relationship between diabetes self-management and QOL using longitudinal designs; (iii) increasing emphasis on the positive aspects of successful chronic illness self-management; and (iv) use of HR-QOL measures to inform empowering relationships between physicians and patients.

Bronchial Hyperresponsiveness and Quality of Life in Asthmatics

Background: Quality of Life (QoL) measurements are more responsive to clinically significant changes that are not evaluated by conventional clinical measures. Objective: The objective of this study is to examine the relationship between bronchial hyperresponsiveness (BHR) and QoL in asthmatic patients. Patients and Methods: 394 patients underwent clinical follow-up, pulmonary function tests and the methacholine challenge test (MCHt), and completed the Asthma Quality of Life Questionnaire (AQLQ). Results: 200 patients had a positive MCHt and in 194 it was negative. For all 32 items, asthmatic patients had a median value of 4.7 (4.2–5.9) compared to 5.6 (4.7–6.3) in patients with negative MCHt (p < 0.01). For physical activities, patients with positive MCHt showed a median value of 5.0 (4.5–6.0) compared to 5.7 (4.8–6.3) in patients with negative MCHt (p < 0.05). Median scores of 12 items of symptoms and 5 items of emotions were significantly lower in patients with positive MCHt [4.5 (3.7–5.8) and 5.1 (4.2–6.1)] than in patients with negative MCHt [5.5 (4.4–6.1) and 6.3 (5.2–6.9), respectively, (p < 0.01)]. For items of environmental stimuli the median score was 4.7 (3.7–5.9) in patients with positive MCHt, being significantly lower than in patients with negative MCHt [5.4 (4.2–6.4), p < 0.05]. Patients with positive MCHt had lower values of QoL than patients with negative MCHt. Conclusions: QoL changes may be more sensitive than evaluation of BHR. The measurement of Qol may be important because it enables us to characterize patients who could be candidates eventually to a pharmacological treatment for BHR because they have an impaired QoL.

Pharmacoeconomics of cholinesterase inhibitors in the treatment of Alzheimer's disease.

Cholinesterase inhibitors constitute one of few treatment options available for Alzheimer's disease, the most common cause of dementia. The modest effects and relatively high acquisition costs of these drugs make the health economics of dementia an important subject of study. Simulation models can be used to bring together existing data and make predictions of the long-term cost effectiveness of treatment. Most models have been built around cognitive function as a key parameter based on the observed relationship between cognitive function and costs of care. Patients with more severe disease attain higher total costs of care. Also, these patients have a higher share of formal care costs than do patients with mild disease, who are usually looked after by informal caregivers. The valuation of unpaid care is controversial, and the choice of method may affect results considerably. Another important issue is the measurement of health-related QOL in patients with Alzheimer's disease. The few existing studies have used proxy respondents to elicit utility weights in different disease states; however, this methodology has not been validated. It is likely that the increased drug costs incurred by the use of cholinesterase inhibitors will be offset (at least partly) by savings in other healthcare costs. However, these results should be viewed as preliminary, since we are still awaiting data from long-term follow-up studies. Also, the value of treatment for patients and caregivers in terms of QOL improvements has yet to be established.

Quality of Life and Epilepsy Surgery

EpilepsiaVolume 44, Issue s6 p. 61-61 Free Access Quality of Life and Epilepsy Surgery First published: 18 August 2003 https://doi.org/10.1046/j.1528-1157.44.s6.25.xCitations: 1AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat An important implicit aim of the surgical treatment of epilepsy has always been to improve the individual's well-being. Outcome measures, however, until recently have been focused mainly on seizure relief. It is clearly important that evaluation of surgical outcome should include an assessment of the effects of seizure relief or reduced seizure frequency on the individual's psychosocial functioning and well-being, often termed health-related quality of life (HRQOL). PSYCHOSOCIAL FUNCTIONING AND QOL Before the advent of the concept of QOL, postoperative improvement in psychosocial functioning was shown to be associated with freedom from, or substantial reduction in, seizures as well as with the preoperative level of functioning. However, positive changes were seen predominantly in those who already had a relatively high level of psychosocial function preoperatively (1–4). Furthermore, most studies have found that employment rates change only to a limited degree although relief from seizures may lead to improved vocational functioning (1,3–7). In two recent series, however, employment rates increased significantly among patients who became seizure free (8,9). Higher QOL scores have been reported following surgery for epilepsy in people who have achieved total seizure relief than in those who continue to have auras (10,11). In addition, people in whom seizure frequency has been substantially reduced have higher QOL scores than those who still have frequent seizures (9,11). However, even though complete seizure relief is a desired outcome of epilepsy surgery, it is not always achieved. In some people, the aim of surgery is to reduce the severity or frequency of disabling seizures, and for these people, the present measurement of QOL may not be appropriate (12). RECOMMENDATIONS The future use and development of existing epilepsy-specific QOL measures must take account of the wide range of surgical procedures performed in patients with varying disabilities. Individual rehabilitation plans should be based on realistic expectations of the possibilities and limitations of epilepsy surgery, with emphasis on the importance of initiating rehabilitation planning and counselling preoperatively (6). REFERENCES 1 Taylor DC, Falconer MA. Clinical, socioeconomic and psychological changes after temporal lobectomy for epilepsy. Br J Psychol 1968; 114: 1247– 61. 2 Rausch R, Crandall PH. Psychological status related to surgical control of temporal lobe seizure. Epilepsia 1982; 23: 191– 202. 3 Dodrill CB, Batzel LW, Fraser R. Psychosocial changes after surgery for epilepsy. In: HO Lüders, ed. Epilepsy surgery. New York: Raven Press, 1991: 661– 7. 4 Vickrey BG, Hays RD, Hermann BP, et al. Outcomes with respect to quality of life. In: Engel J Jr, ed. Surgical treatment of the epilepsies. New York: Raven Press, 1993:623–35. 5 Guldvog B, Löyning Y, Hauglie-Hanssen E, et al. Surgical versus medical treatment for epilepsy, II: outcome related to social areas. Epilepsia 1991; 32: 477– 86. 6 Fraser RT, Gumnit RJ, Thorbecke R, et al. Psychosocial rehabilitation: a pre- and postoperative perspective. In: J Engel, ed. Surgical treatment of the epilepsies. New York: Raven Press, 1993: 669– 77. 7 Lendt M, Helmstaedter C, Elger CE. Pre- and postoperative socioeconomic development of 151 patients with focal epilepsies. Epilepsia 1997; 38: 1330– 7. 8 Sperling MR, O'Connor MJ, Saykin AJ, et al. Temporal lobectomy for refractory epilepsy. JAMA 1996; 276: 470– 5. 9 Kellett MW, Smith DF, Baker GA, et al. Quality of life after epilepsy surgery. J Neurol Neurosurg Psychiatry 1997; 63: 52– 8. 10 Vickrey BG, Hays RD, Graber J, et al. A health-related quality of life instrument for patients evaluated for epilepsy surgery. Med Care 1992; 30: 299– 319. 11 Malmgren K, Sullivan M, Ekstedt G, et al. Health related quality of life after epilepsy surgery: a Swedish multicentre study. Epilepsia 1997; 38: 830– 8. 12 Taylor DC. New measures of outcome needed for the surgical treatment of epilepsy. Epilepsia 1997; 38: 625– 30. Citing Literature Volume44, Issues6September 2003Pages 61-61 ReferencesRelatedInformation

Exercise testing no substitute for QOL measurement in CAD

Exercise testing no substitute for QOL measurement in CAD

Combination or mild single agent chemotherapy for advanced breast cancer? CMF vs epirubicin measuring quality of life

Forty patients with advanced breast cancer, randomised to receive CMF or weekly low dose Epirubicin, were evaluated by UICC criteria of response and WHO toxicity criteria, in addition to three QoL instruments: the 'Qualitator' daily diary card, 4 weekly Nottingham Health Profile (NHP) and Linear Analogue Self-Assessment (LASA). Response rates were 58% for CMF and 29% for epirubicin (chi 2 = 3.51, 1 d.f., P > 0.05). Median time to treatment failure was 24 weeks for CMF, 7 weeks for epirubicin (P < 0.05) but survival was similar in both groups. Survival was better for responders than for non-responders (medians 87 and 30 weeks, P = 0.02). CMF caused more objective alopecia (P < 0.001), nausea and vomiting (P < 0.001) and haematological toxicity (P < 0.02). However, QoL measures only recorded a significant difference in energy and pain, influenced primarily by the non-responders in each treatment group but with no difference in overall global scores. Scores for responders, irrespective of treatment, were better to start with (LASA P = 0.001); at 12 weeks, scores had improved (Qualitator P < 0.05; NHP P < 0.05). Scores in non-responders showed no change. In this small study aggressive chemotherapy gave better response and similar survival without impairing Quality of life overall. Detailed QoL measurement should be integral to all cancer chemotherapy trials.

Measuring housing and environmental quality as indicator of quality of urban life: A case of traditional city of Benin, Nigeria

Using objectively derived criteria from Nigerian 1959 Town Planning Act, the National Council on Housing definition of standard housing and Oredo Local Authority Building and Adoptive Bye-Laws, this study measured the quality of housing in the three major areas of structural materials, internal unit facilities provided and environmental or neighbourhood amenities/facilities. The computations showed that deficiencies were greatest in the neighbourhood, internal facilities and structural materials in that order. Quality showed a lapse rate from the core to the periphery and from high to low income areas. The QOL measurement showed that to the respondents the quality of the city housing detracts from their quality of living. Policy and planning implications of the findings were discussed.

Analytical problems in the measurement of the quality of life

The absence of an explicit theoretical framework seems to have led to a number of objectionable features — empirical as well as conceptual — in previous attempts to construct and apply QOL measures. This paper presents a theoretical framework for QOL measurement based on individual utility maximization. Without severe restrictions on the form of the utility function, however, this framework does not lead to meaningful average or aggregate QOL measures. Furthermore, our empirical analysis indicates that attempts to use currently available QOL measures — despite their conceptual inadequacy — in the analysis of migration have been ill conceived.