Socioeconomic Domains Research Articles

Qualidade de vida de adolescentes após a maternidade

OBJETIVO: Avaliar a influência de variáveis sociodemográficas, obstétricas e neonatais no índice de qualidade de vida de adolescentes após a maternidade. MÉTODOS: Estudo transversal com 96 adolescentes que parturiram em um hospital de ensino, com coleta de dados realizada por meio de questionário aplicado em visita domiciliar. RESULTADOS: Índice Qualidade de Vida geral: 21,48. O domínio socioeconômico teve o menor escore atribuído (17,34) e o domínio família teve o maior escore (25,31). Variáveis estatisticamente significativas: escolaridade materna, renda própria, idade gestacional no momento do nascimento e o número de filhos vivos. CONCLUSÃO: Tais variáveis impactaram negativamente na qualidade de vida das adolescentes.

Reforming the CAP—With area-based payments, who wins and who loses?

This paper reports on the use of a spatial analysis framework to assess the consequences for business incomes of alternative area-bases for Pillar 1 CAP Single Farm Payments, integrating spatial data from both biophysical and socio-economic domains. The results from the Scotland analysis are likely to have wider significance for policy makers confronting decisions on how best to implement reforms of Pillar 1 CAP payments elsewhere in the EU. Introduction of area-based payment to replace historic entitlement is particularly challenging in regions with a wide range of bio-physical conditions that are spatially heterogeneous and only weakly related to intensity of agricultural use, management or previous support. The analysis shows that, while the basis of payments and payment rates can have substantial effects on the nature of the impact, it is the change to an area-based payment system alone that has the biggest redistributive impact. For Scotland, there are larger numbers of businesses that gain rather than lose, and, because the average losses are much larger than the average gains, a move towards area-based payments is likely to encounter strong opposition and only weak support from the agricultural community. In all the options for area-based payments examined, there is substantial redistribution between agricultural sub-sectors and between geographical regions. Substantial reductions in support affect agricultural sub-sectors that are significant for the wider agri-food sector (cereals, general cropping, dairy and lowland livestock) and regions where agriculture plays a significant role in the economy (particularly south-west Scotland). Yet the greater redistribution quantified by this research is within sub-sectors; that is from businesses with more intensive management to those with more extensive. Such within-sector redistributions will have policy significance and mean that analysis of the consequences of area-based payment options conducted only at sub-sectoral level is likely to be inadequate. It is concluded that the analysis approach used has successfully revealed the potential consequences of area-based CAP support payment options and this has been of direct value by informing ongoing negotiations on reform of the CAP. However, the research also highlights the serious challenges that remain in defining schemes that meet the objectives of policy makers, can be administered cost-effectively and are politically acceptable. The research may thus have implications for other EU member states considering how best to implement area-based Pillar 1 payment schemes.

Before Genealogy? Marking Descent in the Inscriptions of Early Historic India

This paper examines the forms of descent recorded in the Brahmi inscriptions of early historic India (c. 300 bce–300 ce). I will argue that they afford us the possibility of viewing how non-noble groups traced kinship, lineage and ancestry. We see this in the development of kin networks; in the articulation of descent and proprietal control among landed and mercantile groups; in the patriarchal norms laid down for women; and in the use of metronymics and gotras. Finally, by tracing the slow emergence of genealogies in the inscriptional record, I show that they must be linked to changes in socio-economic, literary and political domains.

The evolution of policy attitudes in France

The theory of issue evolution predicts that the dimensional space of party competition is simple. We contrast this prediction with the expectation that a complicated multi-party system, such as the one in France, produces a more complicated dimensional structure. To test this claim, we examine the longitudinal structure of the policy preferences that underlie public opinion in France. Using surveys of preferences as a basic data source, we are able to extract two latent dimensions that almost fully explain the reported preferences. Both dimensions are defined by the left–right structure of the French party system. Whereas one is the traditional socioeconomic domain, the other comprises a wide array of new cultural issues. The orthogonal solution, however, does not produce the expected socioeconomic and cultural dimensions. Thus we impose our prior belief in the socioeconomic and cultural content and rotate the two dimensions independently to maximize fit with the two prior dimensions. We show that the same two-dimensional structure is also present in cross-sectional data, and can be used to position parties in the two-dimensional space. Moreover, we find that the two dimensions are closely connected, despite their completely different content. The explanation, which arises from the theory of issue evolution, is that the meaning of left–right is dynamic as well as elastic and incorporates new issues as they arise.

Quality of life domains relevant to people living with HIV and AIDS who are on antiretroviral therapy in Swaziland

Quality of life (QOL) domains that are context specific to people living with HIV and AIDS (PLWHA) who are on antiretroviral therapy (ART) in Swaziland are unknown. This presents a problem when research has to be conducted on QOL of PLWHA who are on ART. As a result, this study was conducted to identify, validate and describe domains necessary to assess QOL of PLWHA, who are on ART in Swaziland. A qualitative, explorative, descriptive, and contextual design was used for this study. The first phase dealt with a review of fifty existing QOL definitions and the identification of the common domains amongst them. Findings from this review revealed that the most common domains of QOL are the physiological, psychological, spiritual and socio-economic domains. The second phase was the validation of the above common domains identified from the examined QOL definitions to make them context specific to PLWHA who are on ART in Swaziland. A workshop was used to validate the domains with expert nurses involved in the care of PLWHA in Swaziland. The experts in ART care were trained on ART and had more than a year's experience of working with PLWHA who are on ART. The validation process revealed that the essential context specific domains to consider when assessing QOL of PLWHA who are on ART are, (1) physiological domain, (2) psychological domain, (3) spiritual domain, (4) socio-economic domain, (5) cognitive domain, and (6) environmental domain. The process of validation of the domains was important as two extra domains were revealed, which were not initially recognised by the researcher during literature review.

Two Tales of Viking Diversity: A Comparative Study of the Immigrant Integration Policies of Denmark and Sweden,1960-2006

The perspective of this dissertation is a comparison between the integration policies of Denmark and Sweden between 1960, when there was a shift toward non-Nordic and non-European immigration, and 2006. The two countries’ policies continued to diverge in the cultural integration domain. In Denmark, ideas stemming from a policy legacy, and promoting the national culture, prevented multiculturalism from taking root. In Sweden, it was— above all—Olof Palme, the slain activist, in his capacity as Minister of Culture and Prime Minister, who engineered the advent of multiculturalism. Danish policy makers chose a policy of toleration. That is, the disapproval of immigrants’ cultural practices in the public sphere but the non-interference of the state in the private sphere as long as these practices did not harm the majority. In Sweden, the cultural embeddedness of immigrants was promoted until the mid-1990s. After that time ethnocultural diversity was portrayed as a source of cultural enrichment, a remedy against racism and xenophobia, and lastly as a means of taking advantage of globalization especially in economic terms. Their policies converged in the socioeconomic and political integration domains. Both states sought to maximize their interests by emphasizing employment and self-help among immigrants, but they continued to consolidate immigrants’ socioeconomic rights, mainly through anti-discrimination policies. Despite the fear of globalization, a rise in the number of refugees, and xenophobia from the 1990s onwards, all these policies were “locked” in their trajectories.

Predictors of Occurrence and Severity of First Time Low Back Pain Episodes: Findings from a Military Inception Cohort

Primary prevention studies suggest that additional research on identifying risk factors predictive of low back pain (LBP) is necessary before additional interventions can be developed. In the current study we assembled a large military cohort that was initially free of LBP and followed over 2 years. The purposes of this study were to identify baseline variables from demographic, socioeconomic, general health, and psychological domains that were predictive of a) occurrence; b) time; and c) severity for first episode of self-reported LBP. Baseline and outcome measures were collected via web-based surveillance system or phone to capture monthly information over 2 years. The assembled cohort consisted of 1230 Soldiers who provided self-report data with 518 (42.1%) reporting at least one episode of LBP over 2 years. Multivariate logistic regression analysis indicated that gender, active duty status, mental and physical health scores were significant predictors of LBP. Cox regression revealed that the time to first episode of LBP was significantly shorter for Soldiers that were female, active duty, reported previous injury, and had increased BMI. Multivariate linear regression analysis investigated severity of the first episode by identifying baseline predictors of pain intensity, disability, and psychological distress. Education level and physical fitness were consistent predictors of pain intensity, while gender, smoking status, and previous injury status were predictors of disability. Gender, smoking status, physical health scores, and beliefs of back pain were consistent predictors of psychological distress. These results provide additional data to confirm the multi-factorial nature of LBP and suggest future preventative interventions focus on multi-modal approaches that target modifiable risk factors specific to the population of interest.

Chemotherapy treatment decision making by professionals and older patients with cancer: a narrative review of the literature

This narrative review of the literature examines the issues influencing chemotherapy treatment of older patients with cancer. Increasing age is associated with physical, social and psychological changes, but the rate of change differs widely between people, such that chronological age is not a good determinant of fitness for treatment. Changes in old age can affect disease processes and treatments that are offered. Clinical trials suggest that older patients gain benefits from chemotherapy, but with increased toxicity profile. Dose reductions may be required, but the effect on outcome is not known. Adjuvant chemotherapy is likely to benefit patients with a life expectancy over 5 years, although mortality benefits become less pronounced with increasing age. Older patients want chemotherapy, as long as side effects do not reduce quality of life or ability to function independently. Older patients face barriers to communication with professionals, including sensory and memory problems and poorer health literacy. Patients should be assessed covering functional, physiological and socio-economic domains that identify significant comorbid disease and frailty, to ensure that planned chemotherapy is appropriate. Successful treatment of older patients with chemotherapy may require interventions to support them to ensure all patients who may derive benefit can undergo treatment, if they so wish.

FUTURE ENVIRONMENTAL HEALTH ALONG THE LINES OF FOOD, WATER, ENERGY AND CLIMATE: AN INTEGRATED MODELLING APPROACH

Background Aims: Health can be considered as one of the most important constituents of quality of life. In many of the global assessments, the health dimension was underrepresented. The health module of the Population & health model PHOENIX has been refined and further developed to be able to explore how future health will evolve. The main purpose of it is to describe future health status using of the concept of the health transition, given changes in socio-economic and environmental conditions. The main purpose of the health model is to describe the burden of disease by sex and age. Methods: The methodology is a multi-state modeling approach which largely follows the approach as described in the World Health Report 2002 (WHO, 2002), the Disease Control Priorities Project (DCPP) (Cairncross and Valdmanis, 2006) in combination with that Global Burden of Disease methodology (Mathers and Loncar ,2005). The states distinguished in the model are exposure, disease states and death. The dynamic and integrated character of the proposed methodology is represented by the risk factor-attributable mortality and morbidity. This component is strongly connected with the socio-economic and environmental domain. Results: The most relevant health risk factors and the associated diseases have been included, with a special focus on environmental risks. Food and hunger, Water supply and sanitation, climate change and malaria, energy supply and indoor / outdoor air pollution are amongst the risk factors included, covering already a substantial part of the health-related Millennium Development Goals (MDG). Conclusions: Exploration of existing consistent socio-economic and environmental baseline scenario shows that many of the health-MDGs will not be attained, given current MDG-policy targets. Additional analyses also show that health loss can be substantially reduced by various health policy packages, especially in South Asia and Sub Saharan Africa.

Determinants of reproductive health and related quality of life among Indian women in mining communities

This article is a report of a mixed method to examine the determinants of reproductive health and quality of life among Indian women. Reproductive health among married women in stressed regions of industrialized countries is an increasingly important consideration, but little is known about the important factors influencing reproductive health and quality of life. A descriptive correlational research design was used between January and April 2006 with 145 randomly selected married women in a rural mining region of India. The instruments used were the Reproductive Health Index Questionnaire and Interview and Ferrans and Power's Quality of Life Index. Inferential statistics were done using anova and manova. Thematic content analysis was used to analyse qualitative data. Reproductive health and quality of life was low among Indian women in mining communities. Higher age groups, better economic status, higher age at menarche, fewer number of children, absence of long-term illness, reproductive illness and domestic violence were important determinants of reproductive health and quality of life among these women in mining communities. The findings suggest that physical, psychological, sexual, family, socio-economic, energy level and cognitive domains of reproductive health and quality of life need to be assessed and are influenced by important determinants among women. These domains reflected in the theory of goal attainment should be an essential part of nursing process for providing women's reproductive health care in the mining community.

The challenges facing sustainable and adaptive groundwater management in South Africa

Long-term population growth and economic development are placing ever-increasing pressure on South Africa’s freshwater supply. On the basis of the current climate change predictions, which often entail uncertain consequences for aquifer systems and the associated groundwater goods and services, it is expected that the stress on water will increase even further. Currently, South Africa’s groundwater governance regime does not provide the capacity to assure effective and sustainable resource regulation and allocation. To date, the management of groundwater is hampered by a variety of uncertainties, such as global climate change and socio-economic growth, as well as ineffective governance structures affecting resource use, regulation, protection and the implementation of alternative strategies needed to achieve sustainable management. This paper presents the results of a qualitative assessment of interviews conducted with experts in South Africa. Four key challenges are identified to the development of adaptive and sustainable groundwater management and the successful implementation of current water legislation in South Africa. These are: the undervaluation of groundwater importance and significance; the need for expertise and information at all scales; the centralisation of power; and the disregard of ecosystems and the associated goods and services. As a means to tackle these challenges, it has been assumed that the concept of adaptive water management represents a suitable approach to governing groundwater resources, by taking into account complex system linkages between hydrogeological, political, socio-economic and environmental domains. Supporting principles, such as tools for cooperation, participation and information networks, have been developed to facilitate the implementation of adaptive water management approaches and hence to achieve institutional change in the political arena of groundwater management.Keywords: groundwater, South Africa, ecosystem services, adaptive water management, qualitative assessment

Correlation between coping strategies and health status of burn patients after discharge at burn centers in Tehran

Background and aim Burn is the third leading cause of death leading to decreased quality of life and disability. Deformity and dysfunction in afflicted patients make their return to community hard. They often apply inappropriate coping strategies, resulting in incompliance with the disease, lack of seeking assistance and impairment of health condition. This descriptive-correlational study was conducted to identify the correlation between coping strategies and health condition of burned patients after discharge at burn centers of Tehran in 2009. Materials and methods 89 patients experiencing moderate to severe burns over the age of 15 after at least 1 month or at most 5 years were selected with convenience sampling method. 3 questionnaires including “Personal Characteristics,” “Burn Specific Health Status Scale” and “Coping with Burn” were used for data collection. After identifying content and face validities of the questionnaires, their reliabilities were identified by internal consistency. Data were gathered by self-report and medical records of patients and also were analyzed by SPSS 14. Findings Most subjects (%41.6) had moderate health status. None had very good health status. Physical domain (%44) was better than other aspects. Psychological (%40.2) and socioeconomic (%39.3) domains were in the second and third ranks. In addition, most subjects (%56.8) had used avoidance coping strategy after discharge while least of them (%51) had used emotionally-focused strategy. A correlation was found between health status and coping strategy. Those using avoidance had weaker heath condition than others with a statistical significance in psychological domain (P=0.01). Conclusion Findings showed that the subjects had better status in physical domain than socioeconomic one. Most of them had used avoidance strategy and health status was correlated with coping strategies. Keywords: Coping strategies, Health status, Discharge, Burn patient. * Corresponding Author: Lecturer, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran. E-mail: zahrasb16@yahoo.com

Child maltreatment and adult socioeconomic well-being

Objective Little empirical research has examined the impact that child maltreatment may have on victims’ long-term socioeconomic well-being. The current study sought to address this gap by exploring the relationship between childhood experiences of abuse and neglect and several indicators of socioeconomic well-being in adulthood. Method Data from the nationally representative National Comorbidity Survey (NCS) ( n = 5004) were analyzed using logistic regression models to examine whether maltreatment in childhood (any maltreatment, physical abuse, sexual abuse, severe neglect, and multiple types of maltreatment) affected employment status, income, and health care coverage in adulthood. Several potential confounds of this relationship were included as covariates in the models, including race, sex, age, and several indicators of childhood socioeconomic status (SES). Results The results show that adults who had experienced maltreatment differed significantly from non-maltreated adults across each of the socioeconomic domains examined. Effects were additionally found to differ depending on the number of types of maltreatment experienced. Conclusions Increased rates of unemployment, poverty, and Medicaid usage indicate the significant long-term personal impact of early victimization. They also suggest a substantial societal cost from this problem through lost economic productivity and tax revenue, and increased social spending. Low socioeconomic status among parents has also been identified as a salient risk factor for the perpetration of maltreatment, and, as such, these results indicate a potential mechanism in the intergenerational transmission of violence. Practice implications The findings from this study suggest that victims of child maltreatment are at increased risk for financial and employment-related difficulties in adulthood. Approximately one million children are identified each year by state agencies as victims of maltreatment in the United States. Many maltreated children, furthermore, go undetected by protective service agencies, indicating the high prevalence of this problem, and underscoring its large economic costs to society. By highlighting the long-term socioeconomic costs of maltreatment, this research should encourage policy makers to focus on improving prevention, intervention, and treatment efforts for victims of abuse and neglect.

Socioeconomic domains and associations with preterm birth

Neighborhood socioeconomic effects on health have been estimated using multiple variables and indices. This inconsistent estimation approach makes comparison across geographic areas challenging. In this paper, we developed indices representing specific socioeconomic domains that can be reproduced in other areas to estimate elements of the neighborhood socioeconomic environment on health outcomes, specifically preterm birth. Using year 2000 U.S. census data and principal components analysis, socioeconomic indices were developed representing a priori – defined domains of education, employment, housing, occupation, poverty and residential stability. These socioeconomic indices were subsequently used in race-stratified multilevel logistic regression models of preterm birth in eight socioeconomically distinct study areas in the U.S. Maternal residence was obtained from birth records and was geocoded to census tracts. In maternal age and education adjusted models, living in tracts with high unemployment, low education, poor housing, low proportion of managerial or professional occupation and high poverty was associated with increased odds of preterm birth for non-Hispanic white women at most sites. Among non-Hispanic black women, similar associations were noted for tract-level low education, high unemployment, low occupation, and high poverty, but the effect estimates were generally smaller than those seen for white women. Increasing amounts of residential stability were not associated with preterm birth in these analyses. We combined the domain estimates across the eight study sites to produce pooled effect estimates for the socioeconomic domains on preterm birth. The research reported here suggests that specific neighborhood-level socioeconomic features may be especially influential to health outcomes. These socioeconomic domains represent potential targets for intervention or policy efforts designed to improve maternal and child health and reduce health disparities.

Development of fishery indicators for local management initiatives — a case study for Plettenberg Bay, South Africa

In attempts to achieve sustainability, ecosystem-based approaches to fisheries management are becoming increasingly applicable. Indicators to assess the success of management measures are an important component of this approach. Data from a recreational linefishery are used to develop and propose a simple set of indicators to assess local fishery sustainability. The indicators have been organised within a framework based on the ecological, institutional and social sustainability domains and scored through a rapid assessment matrix. Results indicate that the estuarine, rock-and-surf (coastal) and skiboat-based fisheries in Plettenberg Bay on the south coast of South Africa are presently non-sustainable. The institutional domain had very low scores whereas the socio-economic domain had the highest scores. The validity and usefulness of the indicators as a tool for the development of local fishery management plans are discussed.

Rural tourism and protected areas – factors to increase resilience of rural areas

The study analysed the influence of presence of protected area on the vulnerability and resilience of the surrounding region in different socio-economic and natural shocks and perturbations. For the study two areas were selected: area of Triglav national park (TNP), as area with highly diversified rural tourism and area of Kozjansko regional park (KRP) as area with low level of rural tourism diversification. The primary data collection was conducted with use of in-depth interviews among relevant stakeholders. In each area some interviews were carried out, where some interviews were representing multiple stakeholders also. The results of the analysis mostly confirmed our hypothesis. We could recognize that the diversity of actors and social roles are essential as sources of stabilty, resilience, robustness and integrity in the social dimension of natural resource management, that an ecological regime shift or collapse does not necessarily result in a regime-shift or collapse of the social[1]ecological system, that an adaptive governance framework relies critically on the collaboration of a diverse set of stakeholders operating at different social and ecological scales, that good governance of the socio-economic domain does not necessarily imply maintaining a stable / resilient / robust / integer social-ecological system and that institutions, social networks and organisation interact across scales. On the other hand a hypothesis that more diverse tourism leads to higher stabilty, resilience, robustness and integrity of social[1]ecological systems was not confirmed.

QUALITY OF LIFE IN STROKE PATIENTS AT A HOSPITAL AFFILIATED TO QOM UNIVERSITY OF MEDICAL SCIENCES

Background Stroke is the first neurologic problem worldwide and the most common disabling neural disorder with severe complications threatening the life of patients and their families and affecting on their quality of life (QOL). Purpose This descriptive-correlational study was conducted to identify QOL of stroke patients referring to Kamkar-Arabnia Hospital affiliated to Qom University of Medical Sciences in 2002. Methods 70 stroke patients (27 Women and 43 men) between 40 and 90 with no history of chronic diseases and aphasia were selected by convenience sampling method. The patients suffered from the condition at least 2 months and at most 14 months (1-year duration). Data collection tools included a questionnaire in two parts: demographics and QOL domains. Results Mean age of the subjects was 63.7. Most patients considered their physical and psychological condition moderate but their socioeconomic condition weak. Conclusion Stroke lowers QOL in all physical, psychological, and socioeconomic domains. Therefore, it is suggested that health centers revise their plans to promote QOL while evaluating their therapeutic as well as supportive programs. Keywords: Quality of life (QOL), Stroke, Domains of QOL

Summer Floods in Central Europe – Climate Change Track?

In Central Europe, river flooding has been recently recognized as a major hazard, in particular after the 1997 Odra /Oder flood, the 2001 Vistula flood, and the most destructive 2002 deluge on the Labe/Elbe. Major recent floods in central Europe are put in perspective and their common elements are identified. Having observed that flood risk and vulnerability are likely to have grown in many areas, one is curious to understand the reasons for growth. These can be sought in socio-economic domain (humans encroaching into floodplain areas), terrestrial systems (land-cover changes – urbanization, deforestation, reduction of wetlands, river regulation), and climate system. The atmospheric capacity to absorb moisture, its potential water content, and thus potential for intense precipitation, are likely to increase in a warmer climate. The changes in intense precipitation and high flows are examined, based on observations and projections. Study of projected changes in intense precipitation, using climate models, for several areas of central Europe, and in particular, for drainage basins of the upper Labe/Elbe, Odra/Oder, and Vistula is reported. Significant changes have been identified between future projections and the reference period, of relevance to flood hazard in areas, which have experienced severe recent floodings.

Farmers' perceptions of benefits and factors affecting the adoption of improved dual‐purpose cowpea in the dry savannas of Nigeria

AbstractThis study links participatory research methods, geographic information systems (GIS) techniques, village and household‐level surveys, and a tobit analysis to examine the adoption and impact issues related to a new technology, improved varieties of dual‐purpose cowpea (IDPC), developed by International Institute of Tropical Agriculture (IITA) and International Livestock Research Institute (ILRI) and recently released in Nigeria. The article analyzes factors affecting the adoption and impact of the technology across different socioeconomic domains as defined by degree of market access and population density. The results show multiple benefits from this flexible leguminous crop, many of which relate to the fodder and soil fertility‐enhancing aspects of IDPC rather than higher grain yields per se. The intensity of adoption was affected by different village‐ and household‐level factors in each socioeconomic domain, allowing more sharply defined recommendation domain‐targeting strategies. The multiple research approaches taken also provided useful lessons at different system levels regarding the benefits of, and perceived problems with, this technology for researchers, development practitioners, and policy makers. The collaborative research approaches taken in this study are helping to close the “feedback loop” from farmers back to researchers and others attempting to disseminate the technology, and by doing so, should contribute to faster and more widespread uptake of this technology.

Prize Winning Abstracts from the 4th Annual Spring Meeting of the ESC Working Group on Cardiovascular Nursing

Aim: Treatment with implantable cardioverter defibrillators (ICDs) increases survival in patients suffering from ventricular tachyarrhythmias. The physiologic effects of having an ICD implanted are well-known but there is still limited knowledge about quality of life (QoL), especially in a long-term perspective. Therefore, the aim of this prospective, follow-up study was to describe and compare uncertainty and QoL at year 1 and year 5 after implantation in patients living with an ICD.Methods: The Mishel Uncertainty in Illness Scale-community version (MUIS-C) and Quality of Life Index-cardiac version (QLI) was used for 35 patients, living with an ICD in average 6 years 9 months. Higher scores indicate higher uncertainty and QoL.Results: An improvement in uncertainty was found at year 5 compared to year 1 (p=0.009), and at year 5 compared to baseline (p = 0.009). Overall QoL decreased at year 1 compared to baseline (p = 0.033). QoL in the socioeconomic domain decreased at year 1 compared to baseline (p = 0.006), and increased at year 5 compared to year 1 (p=0.027). QoL in the family domain decreased at year 5 compared to year 1 (p=0.039), and at year 5 compared to baseline (p=<0.001).Conclusion: Patients with ICD feel better at year 5 than at year 1. The QoL is reasonable good 5 years after implant once they have passed the first years and adapted to lifestyle changes, and patients are more certain and perceive the ICD as a parachute of life.