Quality Of Life Model Research Articles

Quality of Life in Saskatoon 1991 and 1996: A Geographical Perspective

Interest in the concept of "quality of life" (QOL) has increased exponentially in many areas of public policy. A constant theme in QOL research in the last 30 years has been a focus on the measurement and the types of indicators utilized. The objective of this paper is to identify the structure, spatial variation, and change in quality of life from 1991 to 1996 within Saskatoon, Saskatchewan by using a range of indicators relating to the social and physical environment, modified by perception. The QOL model u ed was developed by combining aspects of Cutter's (1985) geographical model of quality of life and Myers' (1987) community of quality of life model to assess QOL over time from a geographical perspective. The integration of objective, subjective and perceptual indicators, using a survey of Saskatoon residents, allowed for a broader interpretation of quality of life than is normally the case. The structure of QOL identified from the results of a series of principal component analyses consistently identified two important structures, structures of general affluence and general disadvantage. Results showed that the most disadvantaged residents in 1991 and 1996 were living to the west of the Central Business District, clustered in several neighborhoods, while residents enjoying a higher QOL tended to live in the suburbs toward the periphery of Saskatoon.

Predictors of Quality of Life of Breast Cancer Patients

Research has indicated that several demographic and clinical factors may affect the quality of life of breast cancer patients. Few studies, however, have sufficient sample sizes for multivariate analyses to be tested. Furthermore, several important factors, such as arm morbidity, communication and comorbid illness, have not been included in quality of life models. The aim of this study was to predict the simultaneous effect of these factors on long-term quality of life. Breast cancer patients (n=990) completed a quality of life survey, including the EORTC QLQ-C30, over five years. Clinical details were registered in the Munich Cancer Registry. Eleven predictors across eight quality of life domains were analyzed over a period of five years using a logistic regression model. Arm problems, communication, comorbidity, age, surgery, and, to a lesser extent, marital, educational and employment status were significantly associated with quality of life. Adjuvant therapy, medical insurance and pT category were not significant predictors. This study is the first to demonstrate the consistency and strength of arm dysfunction and doctor–patient communication on breast cancer patients’ quality of life. These important factors in breast cancer care can be improved and should be regarded as a priority.

Quality of life of patients who have undergone the Nuss procedure for pectus excavatum: Preliminary findings

Background/Purpose: The current project is a preliminary qualitative exploration of changes in quality of life of patients who have undergone the Nuss Procedure. The current study explores quality of life after surgical repair from the perspectives of both the patients and the parent(s) of the younger participants. Methods: This research constitutes the first segment in a mixed-method longitudinal design. The author conducted semistructured interviews based on the Keith and Schalock's quality of life model. Five youth who have undergone the Nuss Procedure and the parent(s) of the 4 younger participants were included in the study for a total of 10 participants. Textual analysis has been carried out using Atlas.ti, a qualitative data analysis program that facilitates such activities as selecting, coding, and comparing textual segments. Results: Results based on these preliminary data indicate that the patients interviewed had significant improvement in overall quality of life, which they attributed to the surgery. Specific examples of patients' expressions of improved self-confidence and renewed interest in physical activity are given. Conclusions: The Nuss Procedure is a minimally invasive surgical option for correcting pectus excavatum deformities that may make important contributions to patients' self-perceptions and quality of life. The participants in the current study expressed satisfaction with both the physical results of the surgery and with how it improved their overall quality of life. The authors recommend further prospective longitudinal research that assesses pre- and postsurgery psychosocial status and the maintenance of perceived quality of life changes. J Pediatr Surg 38:779-783. © 2003 Elsevier Inc. All rights reserved.

Social Workers Custody Recommendations

This study of the custody recommendations of 130 social workers in Israel shows that they generally recommended custody with the parent with whom the child was expected to have the higher quality of life (as assessed by Shye's Systemic Quality of Life Model), whose economic status was better, who had fewer emotional, physical, and cognitive problems, and who were not engaged in criminal activity. The findings also show, however, that the disparities in the child's expected QOL with each of his/her parents had significantly greater explanatory power than that of these parental features and, moreover, that the parental features added little to its explanatory power. These findings highlight the importance of expected quality of life in custody decisions as well as the utility of the Systemic Quality of Life Model for examining and explaining custody decisions. In addition, the findings show that mothers who were poor or who had cognitive or psychological problems were around three times more likely to be awarded custody than fathers in the same situation. This difference suggests that the social workers weighed the father's problems against him more heavily than they weighed the mother's problems against her and provides yet further evidence of gender bias in professionals' custody recommendations.

Latent Mean Structure Analysis: A Technique to Compare Group Differences in a Second-Order Quality of Life Model

Latent Mean Structure Analysis: A Technique to Compare Group Differences in a Second-Order Quality of Life Model

Challenges for Inclusion within a Quality of Life Model for the 21st Century

Quality of life is now well developed in the disability literature yet there are few studies that relate to children. In this paper the implications of quality of life models for the field of inclusion are discussed. Quality of life is seen as an attribute of well being and the principles relevant to this are outlined. Inclusion is not seen simply as an educational process, for the authors argue that educational inclusion can only be effective when it is set within proactive community and family behaviour which is also inclusive. Together these concepts give rise to broad educational criteria and it is the discussion of these which forms the central focus of this paper. Implications for family and community as well as the education system including professional education are also discussed.

Contribution of self-help to the quality of life of laryngectomees in Hong Kong

The contribution of self-help activities in enhancing the quality of life of laryngectomees in Hong Kong was examined. Forty-six senior members of a laryngectomees' self-help organization – the New Voice Club – were selected to participate in a survey study. The questionnaire used in the present study provided information on the degree of participants' involvement in the self-help group and their perception of quality of life after laryngectomy. The five components of quality of life including (1) physical health condition; (2) psychosocial condition; (3) speech/communication ability; (4) vocational aspect; and (5) the interaction with the environment were studied, according to a hybrid model of quality of life in the laryngectomy population. The results revealed that the degree of self-help involvement is a positive predictor of the psychosocial domain of the quality of life model. The function of a self-help organization can be perceived as an informal mode of health service that can serve to close the service gap in health care delivery and form a seamless health care delivery mechanism for laryngectomees.

Influence of culture on cancer pain management in Hispanic patients.

The purpose of this pilot study was to describe the influence of culture on cancer pain management in Hispanic (Mexican and Central American) patients. This qualitative study is guided by the conceptual framework of the Pain and Quality of Life model and the Biocultural Model of Pain. It was developed as a companion study to a National Cancer Institute (NCI)-funded project to disseminate a pain education program for adult patients with cancer and their family care givers in community home-care agencies. After completing the NCI study, Hispanic subjects were invited to participate in the qualitative companion study. A total of 17 subjects, the majority of whom were women, were interviewed. The Hispanic Pain Experience Questionnaire (HPEQ) was used to elicit answers to open-ended questions regarding the perception and management of cancer pain. Themes that emerged from the questionnaire were Influence of Culture, Expressions of Pain, Managing Pain/Medications, and Use of Nondrug Interventions. Responses suggest that culture, family beliefs, and religion contribute significantly to management and expression of pain by the patient and care giver. In addition, this group showed that pain may be approached with stoicism; therefore, lack of verbal or behavioral expression of pain does not indicate a lack of pain itself. These patients also demonstrated a reliance on folk beliefs and nondrug interventions. The most common reason cited for noncompliance with pharmacologic treatment was an inability to understand instructions. When providing care to Hispanic patients, it is imperative to be nonjudgmental, sensitive, and respectful. To improve compliance, the multidisciplinary cancer team should 1) incorporate the patients' folk healthcare practices and beliefs into the plan of care when possible; 2) involve family members and friends in the patient's care, identifying one key family contact; and 3) ensure that instructions for medications are available in Spanish and understood by the patient and care giver. When patients' overall beliefs and values are respected, compliance with pharmacological and other interventions may increase accordingly.

Investigating Patient Satisfaction as an Outcome for Ultrasound-Guided Breast Procedures

An investigation of patient satisfaction with ultrasound-guided breast procedures (fine needle biopsy and cyst aspiration) was performed. The research was designed around a proposed imaging loop added to the Health Related Quality of Life model. A patient questionnaire, devised to assess three areas of the imaging loop—preanalytical, postanalytical, and overall satisfaction with the procedure—was administered. Results show a population of patients satisfied with these invasive procedures. Study patients' satisfaction levels were comparable with those of control subjects. Procedure anxiety was identified as a patient perception, but did not hamper level of satisfaction. Study patients also reported that ultrasound-guided breast procedures contributed to a perception of favorable overall health and gave a high level of patient satisfaction.

Quality of life indicators and health: Current status and emerging conceptions

Quality of life is an increasingly common theme in the health status and health promotion literatures. Six approaches that consider quality of life and health are reviewed. These are (a) health-related quality of life; (b) quality of life as social diagnosis in health promotion; (c) quality of life among persons with developmental disabilities; (d) quality of life as social indicators; (e) the Centre for Health Promotion (University of Toronto) model, and (f) Lindstrom's quality of life model. Each approach is considered as to its emphasis on objective or subjective indicators, individual or system-level measurement, value-laden or value-neutral assumptions, and potential relationship to social policy and social change goals. The links among the social indicators, quality of life, and health promotions areas are examined.

The complementarity of qualitative and quantitative methods in the evaluation of institutional environments

Understanding the impact of service environ­ ments, and especially residential environments, and exploring their meaning for elderly people became an important research issue in ecological gerontology during the last two decades. One of the major poli­ cy questions is, thus, how to improve quality of care and quality of life in the various service envi­ ronments to the elderly? In 1994, 220 long-term-care facilities were op­ erating in Israel with a supply of 18 000 beds. The rate of institutionalization in Israel is relatively low: 4 .4% (44.3 beds per 1000 Jewish elderly in the pop­ ulation) as compared to 8-11% in Holland, Sweden, Canada and Switzerland. This, even though the overall rate of disability in activities of daily living (ADL) among the elderly is very similar to that of the United States and other European countries. The rel­ atively lower rate may be related to the existence of a strong family-oriented informal support system , as well as a growing network of community and home­ based services (1). Israel is "somewhere in the hap­ py medium" between some European countries and America in the rate of community us institutional ser­ vices. It should be noted , however, that historically in­ stitutional care was the first type of services for the elderly developed in Israel , preceding community services by some 50 years (2). In Israel, the licensing and supervisory mandate for residential care is divided between two ministries: the Ministry of Labor and Social Affairs is in charge of institutions for the well aged and the semi-frail el­ derly, while the Ministry of Health is responsible for the mentally infirm elderly and their nursing. This di­ vision contributes to fragmentation , and impacts on quality of care. In order to overcome some of the shortcomings inherent in such a division, and to meet the growing needs for services for the aged, ES­ HEL, the Association for the Planning and Devel­ opment of Services for the Aged in Israel, was es­ tablished 25 years ago. ESHEL's major goals are to expand existing services, to develop new and inno­ vative services, and to improve the quality of the services. During the last five years , ESHEL placed priority on improving the quality of institutional services in or­ der to improve residents' quality of life. Four major demonstration projects were introduced: a nutri­ tion program within the framework of health pro­ motion; residents ' participation program; quality of care for the mentally infirm; and quality of life and personal space project. The study reported here is part of this fourth project that introduced professional and organiza­ tional changes into residential settings , and included an evaluation research based on the models of per­ son-environment fit (3-6), using parts of the Glass (7) quality of life model. The aim was to study the relations between per­ ceived environmental impact, and residents' quality of life and well-being. Specifically, the goals were : 1) to measure and evaluate environmental aspects which im­ pact on residents' quality of life ; 2) to use various eval­ uation tools, quantitative and qualitative, to capture the objective and subjective dimensions of quality of life; and 3) to introduce organizational changes, based on the findings, through "planned intervention" fo­ cusing on the "whole " institution. The study was conducted in 3 non-profit medium sized (200 and 100 beds) facilities in Haifa, Israel, which include all levels of care. In each home , a 30 % sample of residents (N=120) and 40 staff members were interviewed. Close to 85% of the residents were

Quality of Life for People with Learning Difficulties: The Challenge for Behavioural And Emotional Disturbance

The concept of quality of life is examined in terms of its relevance to the field of learning difficulties with particular reference to those who also show symptoms of behavioural and emotional disturbance. It is argued that quality of life encourages a re-examination of our understanding of the field of learning difficulties and underlines the need to recognize the role of choice in the development of normalizing services. The implications of this for assessment, programming and service delivery are explored. It is argued that the use of natural environments and the development of support of family members is critical within a quality of life model. Such views have relevance to the way professional practitioners are trained, enabling them to perform effectively away from traditional centres, and in the more natural environments associated with their clients. Finally, it is argued that the notion of quality of life underscores the importance of moving away from traditional, and linear models of labelling ...

A canonical quality of life model.

A five equation model was developed which related measurements of quality of life (QOL) to policy variables and to economic and social characteristics. The model was used to i) determine the jointness, or interdependency, of components of QOL, ii) demonstrate the usefulness of canonical correlation for measuring the marginal products of determinants of QOL, and iii) construct QOL indexes of social indicators. The model's parameters were estimated from state data for the U.S.A. Among the determinants of QOL educational attainment, investments in transportation facilities, region size and urbanization were most important. Expenditures on higher education, health care, and law enforcement had very little effect on socio-economic well being. Most of the differences in QOL between states were due to economic factors.

Preface to Management Science, Ecology and the Quality of Life

Most of the articles that follow are the papers that formed the Distinguished Lecturer Series—i.e., the invited, thematic series—at the XIX International Meetings of The Institute of Management Sciences in Houston, Texas, on April 4–8,1972. There are two exceptions: (1) “The ORSA New Orleans Address on ‘Compact City’” by G. B. Dantzig and (2) “A Model to Study Revenue Sharing and Account for Regionalized Economic Activity and Social Goals” by A. Charnes, C. Colantoni, W. W. Cooper and K. O. Kortanek. The former, as its title suggests, was the basis of Dr. Dantzig's plenary lecture on April 27, 1972, to the 41st National Meeting of the Operations Research Society of America in New Orleans—to which he has added “An Agenda for Research on Urban Development”. The latter paper is intended to complement “Measuring, Monitoring and Modeling Quality of Life” which was presented by A. Charnes, W. W. Cooper and G. Kozmetsky, as the final Distinguished Lecture in the TIMS series at Houston.

Measuring, Monitoring and Modeling Quality of Life

Issues addressed include use of multi-dimensional vs. single scalar approaches to measuring quality of life. The former seems preferable to the latter. This is illustrated by reference to examples from the national accounts systems approach, using objective data only, as proposed by Nestor Terleckyj, and the local use of questionnaires and interviews to deal with subjective feelings and reactions as reported in the citizen-type panel arrangements suggested by Norman Johnson and Edward Ward. Ways of allowing for trends and dynamic changes are examined and, inter alia, audits and other devices are suggested for detecting emerging needs for new roles and social-institutional arrangements. Areas that may lie beyond any such measurement and detection systems are also examined.