Significant Predictors Of Health-related Quality Research Articles

Mind Over Body Connection: Aging expectations and subjective health and well-being among older adults

Background: There is credible evidence that a person's beliefs about the aging process are linked to and influence a variety of health outcomes. Purpose: This study determined whether aging expectations predict health-related quality of life. Furthermore, the study determined whether engagement in healthy lifestyles mediates the relationship between these variables. Methods: A descriptive-correlational study. This study enlisted a total of 95 respondents aged 60 to 85 years old in a large metropolitan area. Data were analyzed using linear regression and mediation analysis. Results: Aging expectations and engagement in healthy lifestyles are a significant predictor of health-related quality of life (p< 0.05). Moreover, engagement in healthy lifestyles is found to be a significant mediator between the variables. Conclusion: Older adults who have positive aging expectations and engage in health promotion activities are more likely to report better health. Therefore, programs that promote a positive aging expectation and engagement in health-promoting activities should be implemented.

Predictors of health-related quality of life in Parkinson's disease

BackgroundHealth-related quality of life in Parkinson's disease may be affected by a wide range of motor and non-motor symptoms. Identifying which symptoms are significant predictors of health-related quality of life in Parkinson's disease prioritizes symptoms for treatment, therapeutic development, and clinical outcomes. ObjectivesTo determine predictors of health-related quality of life in patients with Parkinson's disease. MethodsWe recruited 102 subjects into a prospective study to investigate neuropsychiatric symptoms in Parkinson's disease. Health-related quality of life was measured with the 39-item Parkinson's Disease Questionnaire. Subjects completed the Movement Disorder Society Unified Parkinson's Disease Rating Scale Parts I-IV as well as validated scales to assess anxiety, depression, apathy, cognition, psychosis, impulsive-compulsive disorder, autonomic dysfunction, sleep quality, excessive daytime sleepiness, and rapid eye movement sleep behavior disorder. We used univariate analyses to select clinical predictors to construct a multivariate regression model to determine which predictors were independently associated with worse health-related quality of life. ResultsIn a multivariate linear regression model adjusted for age and gender, higher scores for the International Parkinson and Movement Disorder Society Unified Parkinson's Disease Rating Scale part II as well more severe symptoms of depression, anxiety, apathy, and excessive daytime sleepiness were associated with worse health-related quality of life. The model explained 78% of the variance of health-related quality of life, and the non-motor symptoms explained 49% of the variance. ConclusionsAnxiety, depression, excessive daytime sleepiness, apathy, and impairment in activities of daily living related to motor symptoms were independently associated with worse health-related quality of life.

Frequentist and Bayesian meta-regression of health state utilities for multiple myeloma incorporating systematic review and analysis of individual patient data.

This analysis presents the results of a systematic review for health state utilities in multiple myeloma, as well as analysis of over 9,000 observations taken from registry and trial data. The 27 values identified from 13 papers are then synthesised in a frequentist nonparametric bootstrap model and a Bayesian meta-regression. Results were similar between the frequentist and Bayesian models with low utility on disease diagnosis (approximately 0.55), raising to approximately 0.65 on first line treatment and declining slightly with each subsequent line. Stem cell transplant was also found to be a significant predictor of health-related quality of life in both individual patient data and meta-regression, with an increased utility of approximately 0.06 across different models. The work presented demonstrates the feasibility of Bayesian methods for utility meta-regression, whilst also presenting an internally consistent set of data from the analysis of registry data. To facilitate easy updating of the data and model, data extraction tables and model code are provided as Data S1. The main limitations of the model relate to the low number of studies available, particularly in highly pretreated patients.

Relationship between activity limitation and health-related quality of life in school-aged children with cerebral palsy: a cross-sectional study

BackgroundInformation on health-related quality of life is becoming increasingly important in children with cerebral palsy. This study investigated the relationship between activity limitation and health-related quality of life in school-aged children with cerebral palsy.MethodsData were collected from 71 children aged 6–15 years with cerebral palsy. Activity limitations were assessed using functional classification systems, including the Korean-Gross Motor Function Classification System (K-GMFCS) and the Korean-Manual Ability Classification System (K-MACS). Health-related quality of life was assessed using the Korean version of the Childhood Health Assessment Questionnaire. Physical therapists collected the data by interviewing the parents of the subjects.ResultsBoth the K-GMFCS and the K-MACS were significantly positively correlated with the Childhood Health Assessment Questionnaire. The Childhood Health Assessment Questionnaire score differed significantly with respect to the functional classification systems. The differences in the ratings according to the K-GMFCS levels were significant, except those between levels I and II, levels II and III, levels III and IV, and levels IV and V. In the K-MACS, there were no significant differences between levels I and II, levels III and IV, and levels IV and V. The K-GMFCS and the K-MACS were significant predictors of health-related quality of life, demonstrating 75.5% of the variance (p < 0.05).ConclusionComprehensive information on children with cerebral palsy should be gathered to provide professionals with a better understanding of health-related quality of life.

Determinants of disease severity in adults with epilepsy: Results from the Neurological Diseases and Depression Study.

Epilepsy severity has been recognized as a significant predictor of health-related quality of life in patients with epilepsy. However, clinical markers of epilepsy severity such as seizure frequency often fail to capture important aspects of the disease. This study investigates the factors associated with patient-reported severity of epilepsy, assessed by the Global Assessment of Severity of Epilepsy (GASE) scale in adults with epilepsy. Data from a cohort of 250 patients consecutively enrolled in the Neurological Diseases and Depression Study (NEEDS) were used to assess the determinants of epilepsy severity as measured by the GASE scale. Multiple linear regression analyses were used to examine the mediation effect of clinical and sociodemographic characteristics on patients' ratings on the GASE scale. The mean age of the study participants was 39.8 (SD=14.9) years, of which 44.4% were male. About 66.8% of the participants reported "not at all severe" or "a little severe" epilepsy, while 0.4% reported "extremely severe" epilepsy. One-year seizure freedom, number of antiseizure medications, medication side effects, depression, anxiety, and seizure-related disability were identified as significant determinants of patients' ratings of epilepsy severity. Seizure-related disability mediated the effects of 1-year seizure freedom, number of antiseizure medications, and medication side effects on epilepsy severity. Overall, patients with epilepsy who reported higher GASE scores were less likely to achieve 1-year seizure freedom and more likely to be on more antiseizure medications, experience more side effects from medication, endorse more depression and anxiety symptoms, and have increased self-reported seizure-related disability. The identified determinants of global, self-rated epilepsy severity can aid the design of appropriate interventions and support services for patients with severe epilepsy.

Tourette syndrome, co-morbidities and quality of life.

Tourette syndrome is often associated with attention deficit hyperactivity disorder, obsessive compulsive disorder and other co-morbidities, the presence of which can reduce health-related quality of life. The relationship between the number and type of co-morbidities and tic severity upon health-related quality of life has been insufficiently examined in Tourette syndrome populations and not at all in the Australian context. We hypothesised that an increased number of co-morbid diagnoses would be inversely related to health-related quality of life and that the presence of attention deficit hyperactivity disorder and obsessive compulsive disorder in particular would negatively impact health-related quality of life. In all, 83 people with a previously established diagnosis of Tourette syndrome, who responded to a letter of invitation sent to the Tourette Syndrome Association of Australia past-member database, formed the study sample. Participants completed the Gilles de la Tourette Syndrome-Quality of Life Scale and a short form of the National Hospital Interview Schedule to assess tics and related behaviours. Participants with pure-Tourette syndrome had significantly better health-related quality of life than those with Tourette syndrome and three or more co-morbid diagnoses. Few differences were observed between the pure-Tourette syndrome and Tourette syndrome and one or two co-morbid diagnoses groups. Analysis of the impact of individual co-morbid disorders and Tourette syndrome symptoms on health-related quality of life indicated that attention deficit hyperactivity disorder exerted a significant negative effect, as did the presence of complex tics, especially coprolalia and copropraxia. When these variables were examined in multiple regression analysis, number of co-morbidities and the presence of coprophenomena emerged as significant predictors of health-related quality of life. While tics are the defining feature of Tourette syndrome, it appears to be the presence of co-morbidities, attention deficit hyperactivity disorder, in particular, and coprophenomena that have the greater impact on health-related quality of life. This has implications for symptom-targeting in the treatment of Tourette syndrome since all available treatments are symptomatic and not disease modifying.

Association between physical fitness, quality of life, and depression in stage II-III colorectal cancer survivors.

The impact of cancer on quality of life and depression is an important issue. The purpose of this study was to identify the impact of physical fitness on quality of life and depression in stage II-III colorectal cancer survivors. Participants in the current study included 122 stage II-III colorectal cancer survivors (57 females; 56.67 ± 9.16 years of age and 55 males; 54.69 ± 9.78 years of age). Fitness was assessed using the 6-min walk test, chair stand test, and push-up test. Quality of life and depression were measured using the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) scale and a 9-item patient health questionnaire interview, respectively. There was a significant association between physical fitness and quality of life and depression in colorectal cancer survivors. The 6-min walk test results were associated with FACT-C total (r = 0.298, p < 0.05), physical well-being (r = 0.230, p < 0.05), functional well-being (r = 0.234, p < 0.05), colorectal cancer concern (r = 0.229, p < 0.05), and depression (r = -0.228, p < 0.05), and the chair stand test results were associated with functional well-being (r = 0.231, p < 0.05), colorectal cancer concern (r = 0.242, p < 0.05), and depression (r = -0.227, p < 0.05) even after controlling for all potentially confounding variables. A multiple regression analysis indicated that the 6-min walk was a significant predictor of health-related quality of life, and participants in the lowest tertile of the 6-min walk test results had lower quality of life and greater depression than those in the highest tertile. Improving and maintaining physical fitness are important for quality of life and depression in stage II-III colorectal cancer survivors.

Relationship between asthma control, health-related quality of life and subjective well-being in Czech adults with asthma

Aims: To investigate the relationship between asthma control, health related quality of life and subjective well-being in Czech adult patients with asthma. Design: A prospective observational cohort study. Methods: The sample included 316 people with asthma. In this 12-month observational study, patients were tested three times - at the baseline and after six and 12 months. Asthma control, health related quality of life and subjective well-being were assessed at the initial time point and followed up at six and 12 months by using the Asthma Control Test, the Mini Asthma Quality of Life Questionnaire and the Personal Well-being Index. Results: Level of asthma control and health related quality of life improved during the 12-month period, although spirometric parameters and subjective well-being were without significant change. Asthma control remained a significant predictor of health-related quality of life and general subjective well-being in linear regression models. Conclusions: Health-related quality of life is a construct based on a larger set of clinical variables when compared to subjective well-being. The regular monitoring of asthma control is associated with increased awareness and therapeutic expectations in patients, and better asthma control and health-related quality of life.

Health impact of sport and exercise in emerging adult men: a prospective study

Health benefits of sport and exercise are well documented in children, adolescents and adults, but little is known about emerging adulthood-a period of life characterized by significant demographic and developmental changes. The present study aimed to assess the health impact of changes in sport and exercise levels during that specific period of life. The analysis used baseline and 15-month follow-up data (N=4,846) from the cohort study on substance use risk factors. Associations between baseline exercise levels or changes in exercise levels and health indicators (i.e., health-related quality of life, depression, body mass index, alcohol dependence, nicotine dependence and cannabis use disorder) were measured using chi-squared tests and ANOVA. Direction of effects was tested using cross-lagged analysis. At baseline, all health indicator scores were observed to be better for regular exercisers than for other exercise levels. At follow-up, participants who had maintained regular exercise over time had better scores than those who had remained irregular exercisers or had discontinued, but their scores for health-related quality of life and depression were close to those of participants who had adopted regular exercise after the baseline questionnaire. Cross-lagged analysis indicated that regular exercise at baseline was a significant predictor of health-related quality of life and substance use dependence at follow-up, but was itself predicted only by health-related quality of life. From a health promotion perspective, this study emphasizes how important it is for emerging adult men to maintain, or adopt, regular sport and exercise.

Depression and anxiety symptoms in bronchiectasis: associations with health-related quality of life

Bronchiectasis causes pulmonary infections and loss of lung function, resulting in chronic respiratory symptoms and worsening health-related quality of life. The aims of this study were to measure symptoms of depression and anxiety in a sample of patients with bronchiectasis and evaluate their relationship to health outcomes and health-related quality of life. This cross-sectional study included adolescents and adults with bronchiectasis. Patients completed the hospital anxiety and depression scale and the St. George respiratory questionnaire. Health outcome data, including clinical, radiological and spirometric values, were recorded from medical charts. Ninety-three participants with bronchiectasis of any aetiology were recruited: 20% had elevated depression-related scores and 38% had elevated anxiety-related scores. Increased symptoms of depression and anxiety were significantly associated with age; anxiety was associated with more frequent exacerbations. Regression analyses indicated that after controlling for demographic (gender and age) and clinical variables (exacerbations frequency, daily sputum, aetiology and spirometry), both depression and anxiety symptoms predicted significantly worse health-related quality of life. In comparison with other predictors, psychological symptoms explained the largest amount of variance in health-related quality of life. Symptoms of depression and anxiety were significant predictors of health-related quality of life in patients with bronchiectasis, independently of respiratory involvement, gender, age or other variables.

Health-Related Quality of Life in Patients With Multiple Injuries and Traumatic Brain Injury 10+ Years Postinjury

The aim of this study was to examine the long-term physical and psychological consequences of multiple blunt forced trauma at ≥ 10-year follow-up for patients with and without traumatic brain injury (TBI). A total of 620 patients with multiple injuries were assessed with the Medical Outcomes Study-Short Form-12 and a physical reexamination at ≥ 10-year follow-up. Injury-related characteristics were collected from patients' medical record. Chi-square analysis, Analysis of Variance, and linear and logistic regression were performed to test differences between groups and examine predictors of physical and psychological functioning at ≥ 10-year follow-up. Patients with multiple injuries who sustained a TBI (n = 398) were more likely to be female (p = 0.001), younger in age at the time of injury (p = 0.02), have higher Injury Severity Scores (p = 0.001), shorter ward stays (p = 0.001), and a greater number of upper extremity injuries (p = 0.02) when compared with those without TBI (n = 222). Patients with TBI reported poorer psychological functioning (p = 0.02) and more frequently reported chronic pain (p = 0.01). Patients with TBI used medical aids (p = 0.002) less frequently at follow-up when compared with patients without TBI. Significant predictors of health-related quality of life at ≥ 10-year follow-up included age at the time of injury (physical; p = 0.001), gender (p = 0.05), number of ventilation days (p = 0.02), satisfaction with rehabilitation (p = 0.001), disability caused by the injury (p = 0.001), and use of medical aids (physical p = 0.02). Prospective studies are needed with a broader range of measures that may be sensitive to the consequences of TBI. Evidence-based interventions to facilitate physical and psychological rehabilitation, designed to target at risk patients, are warranted.

Predictors of Health-Related Quality of Life in Asthmatic Children

For children with asthma, their perceived health-related quality of life (HRQL) is viewed as a valid outcome measure with which to evaluate care and guide clinical interventions. Numerous clinical variables have been associated with HRQL, but few studies have addressed the role of family functioning in relationship to this outcome. The current study extends the findings of an earlier meta-analysis that indicated that family functioning and illness severity were significant predictors of health-related quality of life in children with asthma. Sixty children and 60 parents or guardians participated in this study of school-age asthmatic children who, over the preceding year, received regular care at a pediatric respiratory clinic for their asthma symptoms. Demographic information was obtained from the adults, who also completed standard measures assessing family stress, adaptation, and cohesion. The children were interviewed by the investigator and completed scales to assess HRQL. The major outcome of interest was the child’s HRQL. The child’s level of control over symptoms and the accumulation of family demands, particularly those related to loss, transition, and illness/family care, negatively affected the child’s quality of life. Multiple regression analysis further revealed that level of control and transitions within the family accounted for 23% of the variance of scores measuring HRQL. Family cohesion emerged as a potential mediating factor that may buffer the negative effects of family stress and the lack of control that an asthmatic child may experience in symptom management. An appreciation of the relationships between family stress, cohesion, and HRQL for children with asthma will directly inform clinical practice. Additional family-centered clinical research that fully incorporates HRQL into a theoretical model of health outcomes will continue to refine effective clinical interventions for asthmatic children.

A multivariate analysis of prognostic factors for health-related quality of life in patients with surgically managed meningioma

The objective of this study was to examine the prognostic significance of health-related quality of life (HQOL) parameters combined with baseline clinical factors in patients undergoing neurosurgery for treatment of meningioma. A total of 147 patients (61 male, 86 female; mean age 43 years, range 5–77 years) who underwent resection of a meningioma between January 2002 and December 2004 were studied. HQOL was evaluated using a modified questionnaire based on the World Health Organization Quality of Life-100 Scale and the Karnofsky Performance Scale. The relationships between HQOL and clinical history, radiological findings, extent of resection, histological grade and recurrence were investigated using multivariate analysis. The mean HQOL score was 73.94 ± 1.79 for preoperative patients with meningioma, 84.88 ± 2.14 for postoperative patients, and 91.13 ± 1.61 for healthy controls. HQOL for patients with meningioma was significantly lower than that for normal controls ( P < 0.001), and postoperative patients had a more satisfactory HQOL than preoperative ( P < 0.05). Cox proportional hazards analysis showed that significant predictors of health-related quality of life were tumor size, extent of surgical excision, and histologic grade. Multivariate backward logistic regression yielded the regression equation HQOL = 119.1097 – 1.5002 X 3 – 8.6650 X 6 – 10.4210 X 7 (R = 0.7466; where X 3 is tumor size, X 6 is extent of surgical excision, and X 7 is the histologic grade of the tumor). This equation can be used preoperatively to predict the HQOL of meningioma patients after neurosurgery. A specialized HQOL questionnaire for patients with meningioma provides useful information when planning the operative procedure, and may make it more likely that patients have a satisfactory HQOL after surgery.

The Effects of Related Factors on Health-related Quality of Life for the Frail Elderly

Purpose:The purpose of this study was to identify the predictors of health-related quality of life and to examine their effects in frail elderly. Methods:This was a correlation study. The subjects were 680 frail elders aged over 65whowerereceiving home carefromone of 253publichealthcentersin16provinces, anddatawerecollected from the 1st to 30th of April, 2008. Results: The mean health-related quality of life in the subjects was 6.0±2.0. The predictors identified in this study significantly explained 41.3% of health-related quality of life. Self-rated health was the most significant predictor of health-related quality of life. ADL and depression had an effect on health-related quality of life. Conclusion: Self-rated health, ADL and depression were the predictors of health- related quality of life in the frail elderly.

The relationships of Functional Fitness, Stages-of-Change, and Health-Related-Quality-of-Life in Physically Independent Elderly Women

PURPOSE: The aim of this study were: 1) to compare functional fitness and health-related quality of life among elderly women who were in different group of stages of change; 2) to examine the relationships among stages of change, functional fitness, health-related quality of life; and 3) to determine the predictability of six parameters of functional fitness towards health-related quality of life (HRQOL) in physically independent elderly women. METHODS: Three hundred and six physically independent elderly female volunteers (aged 65 or above) were investigated on their stages of change, levels of physical activity, functional fitness, and health quality of life. Objective measure included Senior Fitness Test (one-arm curl, chair-stand, back-scratch, chair sit and reach, 2.44 meters up-and-go, and 6-min-walk). Self-administered questionnaires included MOS Short Form-36 Health Survey (SF-36) and Stages of Exercise Scale. Pearson's product moment correlation coefficient, chi-square, one-way analysis of variance, and multiple regression analysis were utilized for the data analysis. RESULTS: The results were as follows: 1). The classification of elderly women into the different stages of change were: 10.5% were in the stage of precontemplation; 3.3% in contemplation; 13.4% in preparation;9.5% in action while 63.4% were in maintenance stage. 2). Stages of change was significantly associated with health-related quality of life in elderly women; 3) Elderly women classified as stage of maintenance were significantly higher in scores of physical functioning, bodily pain, general health perceptions, vitality, social functioning, physical component summary scores, mental component summary scores and total component summary scores than their counterparts; 4). Bodily Strength, Bodily Flexibility, and Aerobic Endurance were significant predictors of health-related quality of life. CONCLUSIONS: The above findings provided support for the usefulness of the five-stage distinction, and the stage-specific prediction of functional fitness, health quality of life, and exercise behavior in the physically independent elderly women.

Evaluation of health-related quality of life using the MOS 36-Item Short-Form Health Status Survey in patients receiving noninvasive positive pressure ventilation.

To collect benchmark data on the MOS 36-Item Short-Form Health Status Survey (SF-36) in patients receiving noninvasive positive pressure ventilation and to examine whether health-related quality of life is influenced by the underlying disease or by physical parameters. Multicentric clinical cross-sectional trial in four general wards specialized in noninvasive positive pressure ventilation. 226 patients (78 chronic obstructive pulmonary disease, 57 kyphoscoliosis, 20 posttuberculosis sequelae, 17 Duchenne muscular dystrophy, 13 polyneuropathy, 13 myopathy, 6 amyotrophic lateral sclerosis, 12 obesity-hypoventilation syndrome, 4 poliomyelitis sequelae, 3 phrenic nerve lesion, 3 central hypoventilation syndrome) who used noninvasive positive pressure ventilation for home mechanical ventilation. Health-related quality of life as assessed by the SF-36 was lower than in the general population. Overall the Physical Component Summary (PCS) was significantly lower than the general population norm; the Mental Component Summary (MCS) was also reduced but less markedly. Patients with chronic obstructive pulmonary disease were more impaired in MCS than those with kyphoscoliosis. PCS was significantly associated with age. Gender, lung function, and arterial blood gas values were not significant predictors of health-related quality of life. Benchmark SF-36 data in patients receiving noninvasive positive pressure ventilation are given. Although physical health is significantly impaired in these patients, this does not necessarily lead to mental limitation, and mental health is influenced by the underlying disease, but not by physical parameters.