Self-rated Quality Research Articles

Higher social distress and lower psycho-social wellbeing: examining the coping capacity and health of people with hearing impairment

Purpose: The objectives of this paper are as follows: (1) propose an explanatory model as to how hearing disability may impact on health and (2) examine the model’s utility. Methods: Data were collected on the psycho-social wellbeing, disability and physical health of farmers (n = 56) participating in an intervention to manage the social impacts of hearing disability. Two models were proposed and examined using multiple hierarchical linear regression. Model 1 used self-rated quality of life and model 2 used capacity to manage hearing and listening impairments, as dependent variables. Results: The analyses found that physical measures of hearing impairment (audiograms) were not correlated with physical or mental health outcomes. However, in model 1, self-confidence and self-rated ability to manage hearing impairment were most closely associated with reduced quality of life (anxiety and diastolic blood pressure were positively associated with quality of life). In model 2, higher anxiety and reduced self-confidence were associated with decreasing ability to successfully manage one’s hearing impairment. Conclusions: The findings support the explanatory model that stress is higher and wellbeing lower when the fit between the person’s coping capacity and environmental demands is poor.Implications for RehabilitationThis paper demonstrates that anxiety is associated with coping with the psycho-social aspects of hearing disability.This finding has important implications for the many hearing services, which only provide assessment and devices.To negate anxiety and its long-term impacts, rehabilitation providers need to ensure people with hearing disability have the capacity to manage the psycho-social aspects of communication breakdown.

Maintenance Cognitive Stimulation Therapy: An Economic Evaluation Within a Randomized Controlled Trial

BackgroundCognitive Stimulation Therapy (CST) is effective and cost-effective for people with mild-to-moderate dementia when delivered biweekly over 7 weeks. AimsTo examine whether longer-term (maintenance) CST is cost-effective when added to usual care. MethodsCost-effectiveness analysis within multicenter, single-blind, pragmatic randomized controlled trial; subgroup analysis for people taking acetylcholinesterase inhibitors (ACHEIs). A total of 236 participants with mild-to-moderate dementia received CST for 7 weeks. They were randomized to either weekly maintenance CST added to usual care or usual care alone for 24 weeks. ResultsAlthough outcome gains were modest over 6 months, maintenance CST appeared cost-effective when looking at self-rated quality of life as primary outcome, and cognition (MMSE) and proxy-rated quality-adjusted life years as secondary outcomes. CST in combination with ACHEIs offered cost-effectiveness gains when outcome was measured as cognition. ConclusionsContinuation of CST is likely to be cost-effective for people with mild-to-moderate dementia.

Quality of education predicts performance on the Wide Range Achievement Test-4th Edition Word Reading subtest.

The current study examined whether self-rated education quality predicts Wide Range Achievement Test-4th Edition (WRAT-4) Word Reading subtest and neurocognitive performance, and aimed to establish this subtest's construct validity as an educational quality measure. In a community-based adult sample (N = 106), we tested whether education quality both increased the prediction of Word Reading scores beyond demographic variables and predicted global neurocognitive functioning after adjusting for WRAT-4. As expected, race/ethnicity and education predicted WRAT-4 reading performance. Hierarchical regression revealed that when including education quality, the amount of WRAT-4's explained variance increased significantly, with race/ethnicity and both education quality and years as significant predictors. Finally, WRAT-4 scores, but not education quality, predicted neurocognitive performance. Results support WRAT-4 Word Reading as a valid proxy measure for education quality and a key predictor of neurocognitive performance. Future research should examine these findings in larger, more diverse samples to determine their robust nature.

Construct Validity of a Single-Item, Self-Rated Question of Diet Quality

ObjectiveTo provide evidence of the construct validity of a single-item overall diet question with a nomological network of self-rated and biometric measures of dietary intake and outcomes. MethodsThe authors conducted a secondary analysis of survey and biometric data from a cross-sectional sample of urban-dwelling adults. In addition to self-rated diet quality, they examined dietary behaviors, biomarkers of intake, and related outcomes. Self-rated diet quality was treated as a continuous variable to calculate P for trend using regression analysis. ResultsSelf-rated diet quality was significantly associated with variation in both subjective and objective measures of dietary intake (fruit and vegetable intake, P < .001; sugar-sweetened beverage intake, P < .001; sodium to potassium ratio, P < .001), behavior (frequency of fast-food dining, P < .001), and related outcomes (systolic blood pressure, P = .010; diastolic blood pressure, P < .001; and body mass index, P < .001). Conclusions and ImplicationsEvidence supports the construct validity of a single-item measure of diet quality. This single-item question may be a useful proxy for more burdensome measures of overall diet quality.

Effect of Cardiac Rehabilitation in Patients with ICD: Are Gender Differences Present? Results from the COPE‐ICD Trial

The COPE-ICD (Copenhagen Outpatient ProgrammE-implantable cardioverter defibrillator) trial studied comprehensive cardiac rehabilitation for patients with ICDs. The purpose of this paper was to explore: (1) gender differences in self-rated health and quality of life (QoL) at hospital discharge after ICD implantation, (2) gender differences in effect of cardiac rehabilitation, and (3) predictors of effect of cardiac rehabilitation. Patients with first-time ICD implantation were randomized to comprehensive cardiac rehabilitation versus usual care. Gender differences in self-rated health and QoL and effect of rehabilitation were tested using t-tests. Predictors of effect of rehabilitation were tested using logistic regression. A total of 196 patients (mean age 58 ± 13 years; 155 men, 41 women) were included. At hospital discharge, significant differences were found in physical component scale, mental component scale, social functioning, physical functioning, bodily pain, vitality, mental health, and QoL with men having higher scores. Among men only, significant differences were found in VO2 (rehabilitation: 20.9 mL/min/kg [standard deviation (SD) 8.1] vs 23.4 mL/min/kg [SD 9.5] and usual care: 22.1 mL/min/kg [SD 8.1] vs 21.8 mL/min/kg [SD 8.3], P = 0.01), total exercise time (rehabilitation: 587.0 seconds [SD 249.6] vs 650.7 seconds [SD 279.8] and usual care: 613.8 seconds [SD 264.7] vs 606.1 seconds [SD 277.3], P = 0.01), and the mental component scale (rehabilitation: 47.7 points [SD 10.1] vs 54.8 points [7.1] and usual care: 48.1 points [SD 10.9] vs 51.9 points [SD 9.6], P = 0.05). After ICD implantation, significant gender differences were found in physical health, mental health, and QoL. Effects of rehabilitation were found among men only and gender predicted effect of rehabilitation on the mental component scale.

Voice Quality After Treatment of Early Vocal Cord Cancer: A Randomized Trial Comparing Laser Surgery With Radiation Therapy

Early laryngeal cancer is usually treated with either transoral laser surgery or radiation therapy. The quality of voice achieved with these treatments has not been compared in a randomized trial. Male patients with carcinoma limited to 1 mobile vocal cord (T1aN0M0) were randomly assigned to receive either laser surgery (n=32) or external beam radiation therapy (n=28). Surgery consisted of tumor excision with a CO2 laser with the patient under general anaesthesia. External beam radiation therapy to the larynx was delivered to a cumulative dose of 66 Gy in 2-Gy daily fractions over 6.5 weeks. Voice quality was assessed at baseline and 6 and 24 months after treatment. The main outcome measures were expert-rated voice quality on a grade, roughness, breathiness, asthenia, and strain (GRBAS) scale, videolaryngostroboscopic findings, and the patients' self-rated voice quality and its impact on activities of daily living. Overall voice quality between the groups was rated similar, but voice was more breathy and the glottal gap was wider in patients treated with laser surgery than in those who received radiation therapy. Patients treated with radiation therapy reported less hoarseness-related inconvenience in daily living 2 years after treatment. Three patients in each group had local cancer recurrence within 2 years from randomization. Radiation therapy may be the treatment of choice for patients whose requirements for voice quality are demanding. Overall voice quality was similar in both treatment groups, however, indicating a need for careful consideration of patient-related factors in the choice of a treatment option.

Comparison of Quality of Life, Self-Rated Quality of Sleep, and Respiratory Disorders among Smokers and Nonsmokers

Comparison of Quality of Life, Self-Rated Quality of Sleep, and Respiratory Disorders among Smokers and Nonsmokers

PP147-SUN: The Effect of Omega 3 Fatty Acids with Vitamin D3 on Self-Rated Quality of Life, ADL Function and Pain Level in Patients with Chronic Pain. A Randomized Trial

PP147-SUN: The Effect of Omega 3 Fatty Acids with Vitamin D3 on Self-Rated Quality of Life, ADL Function and Pain Level in Patients with Chronic Pain. A Randomized Trial

Prevalence and Covariates of Elevated Depressive Symptoms in Rural Memory Clinic Patients with Mild Cognitive Impairment or Dementia

Background/Aims: To estimate the prevalence, severity, and covariates of depressive symptoms in rural memory clinic patients diagnosed with either mild cognitive impairment (MCI) or dementia. Methods: In a cross-sectional study of 216 rural individuals who attended an interdisciplinary memory clinic between March 2004 and July 2012, 51 patients were diagnosed with MCI and 165 with either dementia due to Alzheimer's disease (AD) or non-AD dementia. The Center for Epidemiologic Studies of Depression Scale (CES-D) was used to estimate the severity and prevalence of clinically elevated depressive symptomatology. Results: The prevalence of elevated depressive symptoms was 51.0% in the MCI patients and 30.9% in the dementia patients. Depressive symptoms were more severe in the MCI patients than in the dementia patients. Elevated depressive symptoms were statistically associated with younger age for the MCI group, with lower self-rated memory for the dementia group, and with increased alcohol use and lower quality of life ratings for all patients. In the logistic regression models, elevated depressive symptoms remained negatively associated with self-rated memory and quality of life for the patients with dementia, but significant bivariate associations did not persist in the MCI group. Conclusions: The high prevalence and severity of depressive symptoms among rural memory clinic patients diagnosed with either MCI or dementia warrant continued investigation.

THU0570 A Pilot Evaluation of Arthritis Self-Management Program by Lay Leaders in Patients with Chronic Inflammatory Arthritis in Hong Kong

BackgroundHealthcare system has been shifting towards a partnership model of care.ObjectivesTo evaluate the 6-week community based lay-led Arthritis Self-Management Program (ASMP) among patients with chronic inflammatory arthritis in Hong Kong,...

Maintenance cognitive stimulation therapy for dementia: single-blind, multicentre, pragmatic randomised controlled trial

There is good evidence for the benefits of short-term cognitive stimulation therapy for dementia but little is known about possible long-term effects. To evaluate the effectiveness of maintenance cognitive stimulation therapy (CST) for people with dementia in a single-blind, pragmatic randomised controlled trial including a substudy with participants taking acetylcholinesterase inhibitors (AChEIs). The participants were 236 people with dementia from 9 care homes and 9 community services. Prior to randomisation all participants received the 7-week, 14-session CST programme. The intervention group received the weekly maintenance CST group programme for 24 weeks. The control group received usual care. Primary outcomes were cognition and quality of life (clinical trial registration: ISRCTN26286067). For the intervention group at the 6-month primary end-point there were significant benefits for self-rated quality of life (Quality of Life in Alzheimer's Disease (QoL-AD) P = 0.03). At 3 months there were improvements for proxy-rated quality of life (QoL-AD P = 0.01, Dementia Quality of Life scale (DEMQOL) P = 0.03) and activities of daily living (P = 0.04). The intervention subgroup taking AChEIs showed cognitive benefits (on the Mini-Mental State Examination) at 3 (P = 0.03) and 6 months (P = 0.03). Continuing CST improves quality of life; and improves cognition for those taking AChEIs.

Factors influencing adult quality of life: Findings from a nationally representative sample in the UK

ObjectivesTo understand the effects of personality traits on self-rated quality of life. DesignThis was the exploration of a large longitudinal data base. MethodsThis study explored a longitudinal data set of over 5000 adults examining the effects of childhood cognitive ability (measured at age 11), parental social class (measured at birth), personality, educational qualifications and current occupational attainment (all measured at age 50) on adult quality of life (measured at age 50). ResultsCorrelational analysis showed childhood cognitive ability, parental social class, education and occupation, and personality traits (emotional stability, extraversion, conscientiousness) were all significantly associated with adult quality of life. The strongest correlates of adult quality of life were personality traits, followed by current occupational levels and educational qualifications, childhood ability, and parents’ social class. Structural equation modelling showed parental social class had modest but significant direct influence in adult levels of quality of life. Personality traits, educational qualifications and occupational attainment were also the direct predictors of adult quality of life, and the effect of childhood cognitive ability on adult quality of life was mainly through these variables. The implications for policy with respect to improving population level self-rated quality of life are discussed.

Reproductive Health Needs Among Drug Treatment Clients

INTRODUCTION: Substance users are at increased risk of unintended pregnancy and sexually transmitted infections and human immunodeficiency virus (HIV). The objective of this study is to explore the prevalence of contraceptive use and reproductive health care uptake among drug treatment clients. METHODS: Between August 2012 and October 2013, clients of four Baltimore city drug treatment centers completed a one-time survey adapted from the National Survey of Family Growth. χ2 tests and logistic regression assessed associations between demographic variables and contraception use. RESULTS: A total of 95 men and 54 women participated. Most were younger than 50 years (74% women; 72% men), sexually active (68% women; 85% men), and did not desire pregnancy (74% women; 63% men). However, many did not use contraception most of the time (54% women; 39% men) with few women reporting use of a nonbarrier method (7%). Although condoms were the most common method (35% women; 45% men), only one fourth (28% women; 26% men) reported consistent use. Most women (70%) completed an obstetrics–gynecology appointment in the past year, but fewer had received an annual examination (37%), Pap test (53%), mammogram (20%), or HIV (59%) or sexually transmitted infection testing (45%). Contraception use among women was not associated with age (P=.7), parity (P=.7), self-rated health quality (P=.4), HIV (P=1.0), or hepatitis C virus status (P=1.0). Most (74% women; 57% men) stated they would definitely or maybe use family planning services at their treatment site if available. CONCLUSIONS: Drug treatment clients have high unmet reproductive health needs. Tailored family planning interventions are needed and should be incorporated into substance use programs.

A study on relationship between compliance with anti-hypertension therapy and assessment of quality of health care in patients with hypertension in community

To study the relationship between compliance with anti-hypertension therapy and assessment of quality of health care in hypertensive patients in community. According to multi-stage cluster random sampling, we selected two communities from 36 streets in certain areas of Shanghai respectively using random number method on May, 2013, 72 communities in total, then we randomly selected 25 patients who were archived in the community health center from each community of the street.We conducted 1 800 questionnaires in total in which 1 172 patients were under medication study. The Morisky Medication Adherence Scale was used to evaluate medication compliance while the Patient Assessment of Chronic Illness Care Scale was applied to measuring the quality of patient's self-reported health service. The Spearman rank correlation analysis was used to evaluate the relationship between assessment of quality of health care for chronic illness and compliance with anti-hypertension therapy. Binary logistic analysis was applied to evaluate the factors which influenced patient's medicine compliance. There were 567(48.4%) respondents with good compliance. Age less than or equal to 65 accounted for 43.3% (245 people) while age greater than 65 accounted for 56.7% (321 people). The average scores of total and difference dimensions remained at a low level, ranging from 1.97 to 2.67 out of 5. The Assessment of quality of health care score was (2.67 ± 1.33)scores, in which the highest score of the dimensions was patient activation which was (2.56 ± 1.41)scores and the lowest was follow-up / collaboration which was (1.97 ± 1.49)scores. The Spearman rank correlation analysis showed that negative association between accumulate points of patient medicine compliance and patient activation was found (rs = -0.09, P < 0.01). The result of binary logistic analysis indicated that medication adherence of age greater than 65 was 1.49 times (95%CI: 1.11-2.00) higher than age less than or equal to 65. The patient activation was a protective factors of good medicine adherence (OR = 1.35, 95%CI:1.14-1.59). The medicine adherence of hypertension patients in community medication compliance is not very good at the moment. The self-rated quality of health care is still relative poor. Positive activation from interaction of physicians and patients can help enhancing patient's medicine compliance.

Quality of Life and Psychological Distress Among Older Adults

This study asks (a) What are the relationships between types of living arrangements and psychological well-being for older adults? and (b) How do these relationships differ by gender? Data come from the 2010 wave of the National Health Interview Survey and include non-institutionalized adults aged 65 and older (N = 4,862). Dependent variables include self-rated quality of life and psychological distress. The study finds that older adults living alone or with others fare worse than those living with a spouse only. Yet, the outcomes of different types of living arrangements for older adults vary by gender. Women living with others are at greater risk of worse quality of life and serious psychological distress than men. Programs and policies must be responsive to the diverse needs of this population, rather than attempting a "one-size-fits-all" approach to housing and community-based services designed to promote older adults' psychological well-being and independence.

Cultural services and activities: The association with self-rated health and quality of life

Background: Previous studies have shown that cultural participation has a positive effect on health and well-being. The aim of this study was to analyse how use of cultural services and participation in cultural activities is associated with self-rated health (SRH) and quality of life (QOL), using validated outcome measurements and key socio-demographic factors. Methods: The study data are drawn from the Regional Health and Well-being Study conducted in 2010 in Finland. (N = 31,000, response rate 48%). The data analysed in this paper consist of 11,905 respondents. Results: Logistic regression models adjusted for key socio-demographic factors showed that use of cultural services was associated with good SRH and good QOL. Also, associations were found between the practice of cultural activities and good SRH and QOL. However, the associations between activities and SRH and QOL were somewhat weaker. Conclusions: Use of cultural services and practicing cultural activities seem to have a positive association with SRH and QOL. Providing citizens with cultural services and activities can be seen as a silent social policy that has the potential to improve SRH and QOL. Further studies with a longitudinal design are needed to examine the causality.

Influence of health locus of control on recovery of function in recently hospitalized frail older adults

To investigate the influence of health locus of control on physical function, quality of life, depression and satisfaction with care transition in a sample of older adults after a hospital admission. A total of 230 older adults referred for transition care after a hospital admission (mean length of stay 25.7 days, SD 17.2) were recruited into a randomized controlled intervention trial investigating the effect of specialized coaching compared with usual care. Older adults completed the multidimensional health locus of control (MHLC) survey at baseline. Self-rated quality of life, depression and physical function were assessed at baseline and 12 months using the EuroQol five-dimension, Geriatric Depression Scale (GDS) and Modified Barthel Index (MBI), respectively. Results from hierarchical multiple regression analysis in 136 participants (70 usual care and 66 specialized care) with complete data showed that higher scores on the MHLC internal subscale were related to better quality of life, and better physical function in the usual care group at 12 months, but not depression or transition process satisfaction at 3 months. No relationships between MHLC subscales and outcome measures were observed in the specialized care group, where the coaching intervention might have precluded any relationship observed. A stronger sense of personal control over health was associated with better maintenance of quality of life and physical function at 12 months in older adults undergoing usual care transition after acute hospitalization. Modification of control beliefs has the potential to promote resilience and impact on health outcomes in older adults during care transitions.

Burnout and self-reported quality of care in community mental health.

Staff burnout is widely believed to be problematic in mental healthcare, but few studies have linked burnout directly with quality of care. The purpose of this study was to examine the relationship between burnout and a newly developed scale for quality of care in a sample of community mental health workers (N=113). The Self-Reported Quality of Care scale had three distinct factors (Client-Centered Care, General Work Conscientiousness, and Low Errors), with good internal consistency. Burnout, particularly personal accomplishment, and to a lesser extent depersonalization, were predictive of overall self-rated Quality of Care, over and above background variables.

The impact of reminiscence on the quality of life of residents with dementia in long‐stay care

There is increasing recognition of the potential use of reminiscence in maintaining or improving the quality of life of people with dementia. Despite being used widely in dementia care, evidence on the effectiveness of reminiscence remains uncertain. This study aims to evaluate the effectiveness of a structured education-based reminiscence programme-the Dementia Education Programme Incorporating Reminiscence for Staff-for people with dementia residing in long-stay care settings in Ireland. Dementia Education Programme Incorporating Reminiscence for Staff is a two-group, single-blind, cluster randomised trial conducted in long-stay residential care settings in Ireland. The primary outcome was the self-rated quality of life of residents as measured by the Quality of Life-Alzheimer's Disease instrument. Using an intention-to-treat analysis, we found that the estimated effect of the intervention on the quality of life of residents was a non-significant 3.54 (p = 0.1; 95% confidence interval -0.83, 7.90), expressed as the difference in mean improvement between the intervention and control groups. However, the per-protocol analysis yielded a significant effect for the intervention on the quality of life of residents of 5.22 (p = 0.04; 95% confidence interval 0.11, 10.34). Reminiscence may, in certain circumstances, be an effective care option for people with dementia in long-stay settings with potential to impact positively on the quality of life of residents.

Naturalistic Effects of Five Days of Bedtime Caffeine Use on Sleep, Next-Day Cognitive Performance, and Mood.

Background: Disruptive effects of caffeine on sleep have previously been reported, although measures of next-day mood and performance have rarely been included. The present study aims to evaluate the effects of caffeine on sleep and associated next-day effects in a naturalistic field setting. Methods: Nineteen participants (daily caffeine intake 0-141 mg), assessed as good sleepers, took part in a randomized, placebo-controlled, double-blind, 2-week crossover study to assess the effects of bedtime caffeine use (250 mg) on sleep and next-day cognitive performance and mood, which were assessed on a mobile phone in the morning and afternoon. Sleep was assessed objectively (actiwatch) and subjectively (sleep diary). Results: Caffeine's effects on sleep were largely restricted to the first day of administration, with actigraphically measured reduced sleep efficiency, increased activity score and fragmentation index, decreased self-rated sleep quality, and an increased occurrence of participants waking early; only decreased sleep efficiency remained over the week. Effects on next-day performance and mood were evident over the whole week, although despite disrupting sleep, accuracy on a working memory task was higher after caffeine than placebo administration. Conclusions: Caffeine disrupted sleep, although when assessing next-day performance, which may have been affected by the presence of residual caffeine, performance appeared better after caffeine compared to placebo, although this was most likely due to prevention of the effects of overnight withdrawal from caffeine rather than representing a net benefit. Furthermore, partial tolerance developed to the effects of caffeine on sleep.