Specific Quality Of Life Domains Research Articles

Defense mechanisms and quality of life of medical students according to graduation phase.

To compare health-related quality of life (QoL) of medical students in initial and final phases of the program, and to evaluate the association between ego defense mechanisms and specific health-related QoL domains within each group. This was an observational, cross-sectional study. Quality of life was assessed according to the World Health Organization Quality of Life instrument - Abbreviated Version (WHOQOL-Bref); anxiety and depression symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS); defense mechanisms were assessed using the Defense Style Questionnaire (DSQ-40). A total of 139 medical students were evaluated. Students in the initial semesters of the program (1st and 3rd) presented more depressive symptoms and worse quality of life in the psychological domain of WHOQOL-Bref when compared to those in the final semesters (8th and 12th). In a later analysis, conducted to identify the variables associated with the psychological domain of the WHOQOL-Bref for each group, both depressive symptoms and defense mechanisms were independently associated with the outcome for medical students in the beginning and in the end of the graduation program. Students in the initial phases of medical school may need more specific attention from educational managers. Understanding the role of ego defense mechanisms in the quality of life of medical students may help identify effective psychopedagogical interventions for this population. In addition, the results reinforce the impact of depressive symptoms on quality of life, an association already well evidenced in the literature.

The impact of age on general and bladder cancer-specific quality of life among bladder cancer survivors.

463 Background: Quality of life among cancer survivors has been shown to vary by age. Our objective was to evaluate differences in general and bladder cancer-specific quality of life based on age among a large cross-sectional bladder cancer cohort. Methods: We performed a cross-sectional survey of bladder cancer patients using the Bladder Cancer Advocacy Network Patient Survey Network and Inspire platforms to determine general and bladder cancer-specific quality of life (QOL) using the EORTC QLQ-C30 and Bladder Cancer Index. Patients were also queried regarding demographic, socioeconomic and clinical characteristics. We present descriptive statistics and a multiple linear regression model to identify factors independently associated with QOL domain score. Results: 972 respondents self-identified as patients with bladder cancer, of whom 41% were female and 97 % were white. The mean age was 67.6 years (range 29 to 93 years). Respondents were highly educated (67% completed college). 63% of patients identified as having non-invasive (NMIBC) cancer (n=578), 30% had MIBC (n=270), and 7% had metastatic bladder cancer (n=63). On multivariable analysis, older age was significantly associated with better generic QOL and urinary function ( Table), but not sexual function (p=0.19) or bowel function (p=0.73), controlling for sex, race, stage, comorbidity and years since diagnosis. Conclusions: Higher general and domain-specific QOL scores are more common among older bladder cancer patients. Differential impact by age may be important for the development of tailored interventions to improve QOL for bladder cancer patients. [Table: see text]

Gender and quality of life in bladder cancer.

464 Background: Quality of life among cancer survivors has been shown to vary by gender. Our objective was to evaluate differences in generic and bladder cancer-specific quality of life (QOL) based on gender among a large bladder cancer cohort. Methods: We performed a cross-sectional survey of bladder cancer patients using the Bladder Cancer Advocacy Network Patient Survey Network and Inspire platforms to determine generic and bladder cancer-specific QOL using the EORTC QLQ-C30 and Bladder Cancer Index. Patients were also queried regarding demographic, socioeconomic and clinical characteristics. The survey was advertised. We present descriptive statistics and a multiple linear regression model to identify factors independently associated with QOL domain score. Results: 972 respondents self-identified as patients with bladder cancer. Among respondents, 41% were female and 97% were white. The mean age was 67.6 years (range 29 to 93 years). Respondents were highly educated (67% completed college). 63% of patients identified as having non-invasive (NMIBC) cancer (n=578), 30% had MIBC (n=270), and 7% had metastatic bladder cancer (n=63). On multivariable analysis ( Table), female gender was significantly associated with worse generic QOL (p<0.001), bowel function (p=0.001), and sexual function (p=0.02), and women trended toward worse urinary function (p=0.06), controlling for age, race, stage, comorbidity and years since diagnosis. Conclusions: Lower generic and domain-specific QOL scores are more common among female bladder cancer patients. Differential impact by gender may be important for the development of tailored interventions to improve QOL for bladder cancer patients. [Table: see text]

Mining Facebook data for Quality of Life assessment

ABSTRACT Research indicates that how individuals utilise language to express themselves reflects individual-level differences regarding psychosocial characteristics, including perceived Quality of Life (QoL). In this study, we apply a language modelling technique to the natural user-generated language from Facebook to examine associations between language expressed on Facebook and self-reported QoL. Specifically, we collected the user-generated language from a sample of 603 Facebook users (76.3% females), mined emerging text corpora using the LIWC closed-vocabulary approach, and examined associations between LIWC features and self-reported domain-specific QoL (Physical, Psychological, Social), and General QoL. In line with previous research, we found use of pronouns, negative emotions, death and sleep words, and use of profanity to be significantly associated with QoL. Next, we used the Random Forest algorithm to test the predictability of QoL dimensions based on LIWC features and posting activity statistics. The models achieved moderate predictive power (r ranging from .22 to .33), the Psychological and General QoL dimensions showing the highest accuracy. An alternative approach combining LIWC features, posting activity, and predicted scores for domain-specific QoL components showed increased accuracy when predicting General QoL (r = .43). Findings are discussed in light of previous literature. Suggestions for improving models in future studies are provided.

A Comparison of Patient-Reported Outcome Measures of Quality of Life By Dialysis Modality in the Treatment of Kidney Failure: A Systematic Review.

Background:There is an increasing demand to incorporate patient-reported outcome measures (PROMs) such as quality of life (QOL) in decision-making when selecting a chronic dialysis modality.Objective:To compare the change in QOL over time among similar patients on different dialysis modalities to provide unique and novel insights on the impact of dialysis modality on PROMs.Design:Systematic reviews, randomized controlled trials, and nonrandomized controlled trials were examined via a comprehensive search strategy incorporating multiple bibliographic databases.Setting:Data were extracted from relevant studies from January 1, 2000 to December 31, 2019 without limitations on country of study conduction.Patients:Eligible studies included adults (≥18 years) with end-stage kidney disease of any cause who were prescribed dialysis treatment (either as lifetime treatment or bridge to transplant).Measurements:The 5 comparisons were peritoneal dialysis (PD) vs in-center hemodialysis (ICHD), home hemodialysis (HHD) vs ICHD, HHD modalities compared with one another, HHD vs PD, and self-care ICHD vs traditional nurse-based ICHD.Methods:Included studies compared adults on different dialysis modalities with repeat measures within individuals to determine changes in QOL between dialysis modalities (in-center or home dialysis). Methodological quality was assessed by the Scottish Intercollegiate Guidelines Network (SIGN 50) checklist. A narrative synthesis was conducted, synthesizing the direction and size of any observed effects across studies.Results:Two randomized controlled trials and 9 prospective cohort studies involving a combined total of 3711 participants were included. Comparing PD and ICHD, 5 out of 9 studies found significant differences (P < .05) favoring PD in the change of multiple QOL domains, including “physical component score,” “role of social component score,” “cognitive status,” “role limitation due to emotional function,” “role limitation due to physical function,” “bodily pain,” “burden of kidney disease,” “effects of kidney disease on daily life,” “symptoms/problems,” “sexual function,” “finance,” and “patient satisfaction.” Conversely, 3 of these studies demonstrated statistically significant differences (P < .05) favoring ICHD in the domains of “role limitation due to physical function,” “general health,” “support from staff,” “sleep quality,” “social support,” “health status,” “social interaction,” “body image,” and “overall health.” Comparing HHD and ICHD, significant differences (P < .05) favoring HHD for the QOL domains of “general health,” “burden of kidney disease,” and the visual analogue scale were reported.Limitations:Our study is constrained by the small sample sizes of included studies, as well as heterogeneity among both study populations and validated QOL scales, limiting inter-study comparison.Conclusions:We identified differences in specific QOL domains between dialysis modalities that may aid in patient decision-making based on individual priorities.Trial registration:PROSPERO Registration Number: CRD42016046980.Primary funding source:The original research for this study was derived from the Canadian Agency for Drugs and Technologies in Health (CADTH) 2017 optimal use report, titled “Dialysis Modalities for the Treatment of End-Stage Kidney Disease: A Health Technology Assessment.” The CADTH receives funding from Canada’s federal, provincial, and territorial governments, with the exception of Quebec.

A prospective study of psychological distress after prostate cancer surgery.

Men treated for prostate cancer experience heightened psychological distress and have an increased risk of suicide. Management of this distress and risk is crucial for quality urological care. To identify risk indicators for poorer trajectories of psychological adjustment and health-related quality of life (QoL) after surgery for localised prostate cancer. Patients were newly diagnosed with localised prostate cancer scheduled for surgical treatment. Patients were assessed at baseline (pre-surgery) and 6 weeks, 3 months, 6 months, 12 months, and 24 months post-surgery. Assessment measures included sociodemographics, domain-specific and health-related QoL, and psychological distress. Mixed effects regression models were used to analyse the data. A total of 233 patients provided data for this analysis (Mage = 60 years, standard deviation [SD] = 4.02; MPSA = 7.37 ng/mL). At baseline, the prevalence of high psychological distress was 28% reducing to 21% at 24 months. Before treatment, younger age, more comorbidities, and worse bowel function were related to greater psychological distress; and younger age and better urinary, sexual, and bowel function were related to better health-related QoL. By contrast, for changes over time, only bowel function was important with better bowel function predicting decreasing psychological distress for men. Regular distress screening is indicated over the 24 months after surgery for localised prostate cancer. Care pathways for men with prostate cancer need also to respond to age-specific concerns and health problems associated with comorbidities in aging men. Focussed symptom control for bowel bother should be a priority.

Effects of use of an eHealth platform e-Vita for COPD patients on disease specific quality of life domains

BackgroundIntegrated disease management with self-management for Chronic Obstructive Pulmonary Disease (COPD) is effective to improve clinical outcomes. eHealth can improve patients’ involvement to be able to accept and maintain a healthier lifestyle. Eventhough there is mixed evidence of the impact of eHealth on quality of life (QoL) in different settings.AimThe primary aim of the e-Vita-COPD-study was to investigate the effect of use of eHealth patient platforms on disease specific QoL of COPD patients.MethodsWe evaluated the impact of an eHealth platform on disease specific QoL measured with the clinical COPD questionnaire (CCQ), including subscales of symptoms, functional state and mental state. Interrupted time series (ITS) design was used to collect CCQ data at multiple time points. Multilevel linear regression modelling was used to compare trends in CCQ before and after the intervention.ResultsOf 742 invited COPD patients, 244 signed informed consent. For the analyses, we only included patients who actually used the eHealth platform (n = 123). The decrease of CCQ-symptoms was 0.20% before the intervention and 0.27% after the intervention; this difference in slopes was statistically significant (P = 0.027). The decrease of CCQ-mental was 0.97% before the intervention and after the intervention there was an increase of 0.017%; this difference was statistically significant (P = 0.01). No significant difference was found in the slopes of CCQ (P = 0.12) and CCQ-function (P = 0.11) before and after the intervention.ConclusionThe e-Vita eHealth platform had a potential beneficial impact on the CCQ-symptoms of COPD patients, but not on functional state. The CCQ-mental state remained stable after the intervention, but this was a deterioration compared to the improving situation before the start of the eHealth platform. Therefore, health care providers should be aware that, although symptoms improve, there might be a slight increase in anxiety and depression after introducing an eHealth intervention to support self-management.Trial registrationOur study is registered in the Dutch Trial Register (national registration of clinical trails, mandatory for publication) with number NTR4098 and can be found at http://www.trialregister.nl/trial/3936.Date registered: 2013-07-31.First participant: 2014-01-01.

Spatial Patterns of Residential Fragmentation and Quality of Life in Nairobi City, Kenya

Residential fragmentation undermines integration by physically excluding some urban dwellers through walling, fencing and use of barriers limiting interactions. Research has shown that many cities in the Global South are experiencing spatial fragmentation issues associated with increasing inequalities, social exclusion and proliferation of gated communities. This results in distinct residential fragments with limited interactions and unequal quality of life (QoL) conditions of the residents of the fragments. The aim of this paper is to describe the association between residential fragmentation and QoL based on three residential fragments in the city of Nairobi (Kenia). A mixed method approach was applied to understand fragmentation in the city and analyse integration and QoL satisfaction in the fragments. Household surveys and key informant interviews were main data collection methods. Data analysis methods used included descriptive statistics, spatial and content analysis. The results show, as expected, slum residents felt the least integrated symbolically compared to the planned non-gated and gated community residents. Similarly, gated community residents have higher QoL satisfaction compared to other types of fragments. There is a strong positive correlation between symbolic integration and QoL domains related to housing and safety in the slum, indicating that people who are satisfied with housing also have a sense of belonging to their neighbourhood. In contrast, community integration has a negative correlation with safety in the gated community implying that when the residents are satisfied with safety, they tend to have low social networks. Based on the empirical evidence, fragmentation is related to specific domains of QoL as it is associated with spatial exclusion through barriers and gating and marginalization of the poor making it harder for them to feel integrated. The residential fragments reflect the intense divides in Global South cities in terms of QoL conditions and access to services.

PGI20 A REPORT ON THE QUALITY OF LIFE OF OSTOMATES IN THE NETHERLANDS

The creation of an abdominal stoma for the discharge of bodily waste is a life-altering event. This study examined the quality of life (QoL) and wellbeing of those living in the Netherlands that have undergone ostomy surgery. A cross-sectional survey was developed to assess a random selection of post-surgical patients residing in the Netherlands. This study included questions from The City of Hope Ostomy Quality of Life Survey allowing an assessment of physical, psychological, social, and spiritual well-being. Data was collected from 2127 respondents providing a margin of error of 2.1 percent and found to be highly reliable (Cronbach’s alpha 0.9157). Fifty-five percent of the respondents were colostomates, 25% ileostomates, 17% urostomates, 2% have multiple stomas, and <1% did not know their stoma type. The respondents have an average age of 64.1 years, and an average time from surgery of 6.6 years. When responding to questions pertaining to specific QoL domains, on a scale of 0 to 10, where 10 equals best possible, Physical well-being was given an average rating of 7.65; Psychological well-being 7.19, Social well-being 6.86, and Spiritual well-being 5.85. Other aspects of the individuals’ life with a stoma were queried, including concerns with body image, skin irritation around their stoma, and issues with their skin barrier. 58% indicated they usually have some degree of irritated skin around their stoma and stated leakage under the barrier was the primary problem, with ballooning being the second most common problem (with the exception of urostomates). Overall, this study finds that the participants sampled, as a representation of the people with an ostomy in the Netherlands, enjoy a quality of life similar to that experienced in other countries. The study also found that on the whole, the respondents are well adjusted and knowledgeable regarding their stoma.

Measuring the quality of life of family carers of people with dementia: development and validation of C-DEMQOL

PurposeWe aimed to address gaps identified in the evidence base and instruments available to measure the quality of life (QOL) of family carers of people with dementia, and develop a new brief, reliable, condition-specific instrument.MethodsWe generated measurable domains and indicators of carer QOL from systematic literature reviews and qualitative interviews with 32 family carers and 9 support staff, and two focus groups with 6 carers and 5 staff. Statements with five tailored response options, presenting variation on the QOL continuum, were piloted (n = 25), pre-tested (n = 122) and field-tested (n = 300) in individual interviews with family carers from North London and Sussex. The best 30 questions formed the C-DEMQOL questionnaire, which was evaluated for usability, face and construct validity, reliability and convergent/discriminant validity using a range of validation measures.ResultsC-DEMQOL was received positively by the carers. Factor analysis confirmed that C-DEMQOL sum scores are reliable in measuring overall QOL (ω = 0.97) and its five subdomains: ‘meeting personal needs’ (ω = 0.95); ‘carer wellbeing’ (ω = 0.91); ‘carer-patient relationship’ (ω = 0.82); ‘confidence in the future’ (ω = 0.90) and ‘feeling supported’ (ω = 0.85). The overall QOL and domain scores show the expected pattern of convergent and discriminant relationships with established measures of carer mental health, activities and dementia severity and symptoms.ConclusionsThe robust psychometric properties support the use of C-DEMQOL in evaluation of overall and domain-specific carer QOL; replications in independent samples and studies of responsiveness would be of value.

Objectively-Measured Neighbourhood Attributes as Correlates and Moderators of Quality of Life in Older Adults with Different Living Arrangements: The ALECS Cross-Sectional Study.

With an ageing world population, preservation of older adults’ health and quality of life (QoL) is paramount. Due to lower levels of physical functionality, older adults are particularly susceptible to local environment influences, especially those living alone and lacking family support. Using generalised additive mixed models, we examined associations and confounder-adjusted associations between objectively-measured neighbourhood attributes and QoL domains in 909 Hong Kong Chinese elderly community dwellers. Most examined neighbourhood attributes were not associated with QoL in the whole sample. Neighbourhood residential and entertainment density was curvilinearly and/or linearly related to specific QoL domains. Number of parks was negatively associated with social QoL and having well-treed parks with higher levels of social QoL. Older adults living alone in neighbourhoods with poor access to destinations and few activities in parks showed lower environmental and/or social QoL than their counterparts. Neighbourhood built environment characteristics do not seem to impact Hong Kong older adults’ physical and psychological QoL. Medium-to-high density, well-ordered neighbourhoods with optimal mixes of well-treed public open spaces and services meeting their daily needs may significantly contribute to social and environmental QoL in this population and appear particularly important to those living alone.

The association between frailty and quality of life among rural community-dwelling older adults in Kegalle district of Sri Lanka: a cross-sectional study.

The objective of this study was to estimate the cross-sectional association of frailty statuswith overall and domain-specific quality of life (QoL) in rural community-dwelling older adults in Kegalle district of Sri Lanka. A population-based cross-sectional study was conducted with 746 community-dwelling older adults aged ≥ 60years living in the rural areas of Kegalle district of Sri Lanka in 2016. A three-stage probability sampling design was used to recruit participants. Frailty and QoL were assessed using the Fried phenotype and Older People's Quality of Life Questionnaire, respectively. Multivariable linear regression was used to estimate the association of frailty with QoL after accounting for the complex sampling design. The median (IQR) age of the sample was 68 (64:75) years and comprised of 56.7% women. 15.2% (95% CI 12.4%, 18.7%) were frail and 48.5% (95% CI 43.9%, 53.2%) were pre-frail. The unadjusted means (SE) of the total QoL score for the robust, pre-frail and frail groups were 139.2 (0.64), 131.8 (1.04) and 119.2 (1.35), respectively. After adjusting for covariates in the final multivariable model, the estimated differences in mean QoL were lower for both frail and pre-frail groups versus robust. The estimated reduction in the total QoL score was 7.3% for those frail and 2.1% for those pre-frail. All QoL domains apart from 'social relationships and participation', 'home and neighbourhood' and 'financial circumstances' were associated with frailty. Frailty was associated with a small but significant lower quality of life in this rural Sri Lankan population, which appears largely explained by 'health' and 'independence, control over life and freedom' QoL domains. Interventions aiming to improve quality of life in frail older adults should consider targeting these aspects.

A Novel Quality of Life Instrument for Patients with an Abdominal Aortic Aneurysm

The surveillance and treatment of abdominal aortic aneurysms (AAAs) may impact patient quality of life (QOL). A novel AAA specific QOL instrument was developed and validated to quantify the impact of AAA surveillance on QOL. The study was performed in two phases: development (2011-2013) and validation (2013-2014) of a survey instrument. Content was informed by focus groups at three centres (22 patients) and two multidisciplinary physician focus groups (6 vascular surgeons, 7 primary care providers). Cognitive interviews (17 patients) ensured questions were understood as intended. The final survey was mailed to AAA patients at six US institutions. Patients were scored on two AAA specific domains of QOL: emotional impact (EIS) and behavioural change (BCS), range 0-100 with higher scores indicating worse quality of life. Test retest reliability and internal consistency were assessed. Discriminant validity was determined by comparing scores between patients under surveillance vs. those who had undergone AAA repair. Scores were externally validated by correlation with the Short Form (SF)-12. A total of 1,008 (73%) of 1,373 patients returned surveys: 351 (35%) were under surveillance, 657 (65%) had undergone repair (endovascular, 414; open, 179; unsure, 64). Median EIS was 11 (range 0-95; IQR 7-26). Median BCS was 13 (range 0-100; IQR 9-47). To test reliability, 337 patients repeated the survey after four weeks with no significant differences between scores over time. EIS and BCS demonstrated good internal consistency (Cronbach's Alpha 0.85 and 0.75 respectively). There was strong correlation between scores (r=0.53) and both related moderately to SF-12 scores (r=0.45 and r=0.39, respectively). Patients under AAA surveillance had worse EIS than repair patients (22 vs. 13; p<.001). Patients with a higher perceived rupture risk had a worse EIS (45 vs. 12; p<.001) and BCS (30 vs. 13; p<.001). An AAA specific QOL instrument was successfully created and validated. The range of impact on QOL by AAA surveillance is broad. For most patients the impact is minimal, but for some, especially those with a greater perceived rupture risk, it is severe.

Discomfort Intolerance in Relation to Asthma Outcomes.

Anxiety symptoms and disorders are common among those with asthma and contribute to poorer health outcomes. Building on work examining anxiety-related cognitive-affective risk factors in asthma, the current study sought to explore associations between discomfort intolerance (i.e., the inability to withstand or tolerate unpleasant bodily sensations) in relation to lung function, asthma control, and quality of life. Participants were 61 adults with asthma (61.9% female; 54.8% African American; M age = 34.72, SD = 13.58) who were administered a self-report assessment battery and a lung function assessment. We found that, above and beyond the effects of anxiety sensitivity-physical concerns, greater discomfort intolerance was significantly associated with poorer lung function (9.5% variance), asthma control (9.9% variance), and overall asthma-related quality of life (11.7% variance) as well as the specific quality of life domains of activity limitations (12.6% variance) and asthma symptoms (6.8% variance). Thus, individuals with asthma who are unable to tolerate physical discomfort may be at risk for poor asthma outcomes and interventions to reduce discomfort intolerance could potentially be useful in this population.

Temporal changes in importance of quality of life domains: a longitudinal study in community-dwelling Swiss older people.

Population aging is a global phenomenon requiring interventions to improve quality of life (QoL), a subjective and dynamic concept. Such interventions should be based on QoL domains considered as important from older people's viewpoint. It is unclear whether and how much these domains may vary over time as people age. This study aims to assess the importance of QoL domains, their pattern and determinants of change among the non-institutionalized older population over a 5-year period. This longitudinal study included community-dwelling older adults (N = 1947, aged 68-77years at baseline) from the Lausanne cohort 65+. In 2011 and 2016, participants rated the importance of 28 QoL items in seven domains. The difference between scores (0-100) of importance attributed to each QoL domain between two assessments was calculated and used as a dependent variable to assess the associations with covariates in multivariable analysis for each domain. Importance scores slightly but significantly decreased in five of the seven QoL domains. Despite the majority of participants did not modify their ranking of importance for each QoL domain between the two time points, the proportion of change was still substantial. Bivariate and multivariable analyses showed that education and to a lesser extent age, living arrangement and morbidity, were associated with decrease in the importance of specific QoL domains; characteristics indicating vulnerability (e.g., low education or morbidity) were associated with a decline in the importance. Although aging individuals modified the importance they give to the seven QoL domains, at population level, changes in opposite directions overall resulted in only small decline; importance seems less stable over time among individuals with vulnerable sociodemographic and health profiles.

Quality of life of children and adolescents with chronic kidney disease: a cross-sectional study

ObjectiveThe aim was to compare quality of life (QoL) among children and adolescents with different stages of chronic kidney disease (CKD) and determine factors associated with changes in QoL.DesignCross-sectional.SettingThe Kids...

Flatfoot decreases school functioning among children &lt; 11 years of age

Background Flatfoot is a musculoskeletal abnormality commonly found in children that could result in a reduction of quality of life because of its related symptoms and functional abnormalities. This study aimed to determine the association between flatfoot and the quality of life among children 5-18 years of age. Methods A cross sectional design was used in this study of children aged 5-18 years. The diagnosis of flatfoot was made in accordance with the Chippaux-Smirak Index classification, whereas general and domain-specific quality of life were measured using the Indonesian version of PedsQL™ that has been previously validated. Mann Whitney test was used to compare quality of life between children with flatfoot and normal feet, along with other variables that potentially may influence a child’s quality of life. Results A total of 79 out of 120 subjects was used to analyze the data. There was a statistically significant difference in the quality of life score in the school functioning domain between children with flatfoot (64.46 ±18.22) and those with normal feet (75.90 ±17.29) in children &lt;11 years of age (p=0.029). Apart from this, the study did not find any statistically significant differences in the total quality of life score or in other quality of life domains between the two groups. Conclusions Flatfoot significantly decreases children’s quality of life in the school functioning domain. Early detection and correction of flatfoot may be necessary to improve the educational attainment of children suffering from this condition.

Predictors of quality of life among inpatients in forensic mental health: implications for occupational therapists

Optimising quality of life (QOL) for service users in a forensic hospital is an important treatment objective. The factors which contribute to QOL in this setting are currently unclear. The aim of this study was to analyse the predictors of QOL amongst service users within an inpatient forensic mental health hospital. This study is a naturalistic, cross-sectional, observational study. Fifty-two male service users with schizophrenia or schizoaffective disorder participated in the study. QOL was measured using the World Health Organisation QOL Bref. We used the Engagement in Meaningful Activity Survey (EMAS), ward atmosphere was measured using the Essen Climate Evaluation Schema (EssenCES), occupational functioning was assessed using the Social and Occupational Functioning Scale (SOFAS). We also collected level of ward security, length of stay and community leave data. Stepwise regression showed that meaningful activity, level of ward security, and therapeutic hold on the EssenCES significantly predicted QOL on a range of specific QOL domains. These variables accounted for 40% of the variance for total QOL score. Engagement in meaningful activity added the largest contribution to total QOL score accounting for 30% of the variance. This study shows that provision of meaningful activities, level of ward security and therapeutic hold may contribute to QOL amongst forensic mental health inpatients.

Cytokine Gene Polymorphisms Associated With Various Domains of Quality of Life in Women With Breast Cancer

ContextLittle is known about the phenotypic and molecular characteristics associated with various domains of quality of life (QOL) in women after breast cancer surgery. ObjectivesIn a sample of women with breast cancer (n = 398), purposes were as follows: to identify latent classes with distinct trajectories of QOL from before surgery through six months after surgery and to evaluate for differences in demographic and clinical characteristics, as well as for polymorphisms in cytokine genes, between these latent classes. MethodsLatent class analyses were done to identify subgroups of patients with distinct QOL outcomes. Candidate gene analyses were done to identify cytokine gene polymorphisms associated with various domains of QOL (i.e., physical, psychological, spiritual, social). ResultsOne latent class was identified for the psychological and spiritual domains. Two latent classes were identified for the social domain and overall QOL scores. Three latent classes were identified for the physical domain. For the physical and social domains, as well as for the overall QOL scores, distinct phenotypic characteristics (i.e., younger age, poorer functional status, higher body mass index, and receipt of adjuvant chemotherapy) and a number of cytokine gene polymorphisms (CXCL8, NFKB2, TNFSF, IL1B, IL13, and NFKB1) were associated with membership in the lower QOL classes. ConclusionsFindings suggest that women experience distinctly different physical well-being, social well-being, and total QOL outcomes during and after breast cancer surgery. The genetic associations identified suggest that cytokine dysregulation influences QOL outcomes. However, specific QOL domains may be impacted by different cytokines.

STUDY ON QUALITY OF LIFE OF POST STROKE SURVIVORS BY&amp;NBSP; WHOQOL-BREF SCALE

Objective: To examine overall and domain-specific quality of life in stroke survivors after 3 months and to identify variables that predict quality of life after stroke. Methods: A cross-sectional, descriptive correlational designing on 190 stroke survivors who were interviewed to 3 months after stroke. Quality of life was measured with the use of the WHOQOL-BREF which have 26-item instrument consisting of four domains: physical health (7 items), psychological health (6 items), social relationships (3 items) and environmental health (8 items); and two overall QOL and general health items. Multiple regression analysis was used to predict quality of life. Results: 79.5% percent of subjects scored in the depressed range which the mean of BECK scale was 20.48 ± 7.24. The mean of quality of life score in all domains were low comparable to that of a normal range. There was a significantly difference in the overall quality of life, general health, psychological health, social relationships and environmental health between the groups patient with and without depression. There was not the relationship between the WHOQOL-BREF in all domains with age, Glasgow scale, NIHSS scale, mRankin scale. Age and total BECK scale were the independent factor predicting the low quality of life in post stroke patient after 3 months by analysing the multiple regression. Conclusions: The identification of depression and age as predictors of quality of life suggests the need to assist stroke survivors in maintaining and strengthening their support systems. Key words: Cerebrovascular Disorders, depression, quality of life