Variance In Overall Quality Of Life Research Articles

The personal impact of living with a myeloproliferative neoplasm.

The aim of this study is to gain insight into the physical, psychological and social impact of having a myeloproliferative neoplasm (MPN), a rare type of cancer with an often chronic course. An online survey was conducted among 455 Dutch MPN patients (62.7% female, age M 63) to explore the impact of the disease by measuring the MPN symptom burden (MPN-SAF TSS) and quality of life (QoL) (EORTC QLQ-C30) and its subscales within a hierarchical QoL model. We examined differences in MPN symptom burden and QoL in relation to sociodemographic and disease-related factors. Hierarchical regression analysis was used to explain variances in QoL. Most patients (97%) experienced MPN-related health complaints, with a significantly higher MPN symptom burden in women (M 31.50) compared to men (M 24.10). Regarding to fatigue and cognitive functioning MPN patients suffered more compared to a reference group of other cancers. MPN subtype or type of treatment did not show significant differences in MPN symptom burden or QoL. However, experiencing side effects, complications or comorbidities significantly negatively affected MPN symptom burden and QoL. 48.8% of patients reported that MPN affected their ability to work. The explained variance in overall QoL was 58%, most importantly by disease progression, comorbidities, MPN symptom burden and role, emotional and social functioning. This study revealed that having an MPN has a negative impact on several domains of QoL. Symptom assessment and support should be included in the healthcare management of MPN patients.

The Impact of Depressive Symptoms and Traumatic Experiences on Quality of Life in Adults With ADHD

Objective: We assessed factors influencing quality of life (QoL) in adults with ADHD. Method: QoL, traumatic childhood experiences, and depression were assessed using the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), Childhood Trauma Questionnaire (CTQ), and Beck Depression Inventory (BDI), respectively, in 60 adult ADHD outpatients and 60 age- and gender-matched controls. Results: Emotional neglect or abuse had occurred significantly more often during childhood in adults with ADHD. Depressive symptoms were rated significantly higher by ADHD patients. QoL was significantly lower in adults with ADHD, and the variables depression, ADHD symptom severity, and traumatic load, accounted for ~60% of variance in overall QoL. Conclusion: QoL is significantly reduced in adult ADHD patients. Depressive symptoms and traumatic childhood experiences influence QoL. Treatment for adult ADHD patients should take the high interdependence of depressive symptoms, childhood trauma, and QoL into consideration.

Exploring the quality of life of depressed and nondepressed, home-dwelling, Norwegian adults.

This study aims to explore how intimacy, physical and psychological health, loneliness, and attitudes to ageing at a time of loss affect the overall quality of life (QoL) of nondepressed and depressed older adults. This was a randomised, stratified, cross-sectional study with two subsamples: depressed (n=74; mean: 77.9 years; 65% female) and nondepressed (n=356; mean: 75.0 years; 55% female), and based on the Geriatric Depression Scale-15. Physical health accounted for the greatest variance in overall QoL in the nondepressed group; psychological health, losses, and feelings of intimacy also made significant contributions. In the depressed group, intimacy made the strongest contribution, while psychological health came a close second. Physical health, psychological health, and loss were important to the QoL of nondepressed older adults, while intimacy was important for QoL in both depressed and nondepressed older adults. For those who are depressed, feelings of intimacy, in the form of having opportunities to express and receive love, are especially relevant and should be assessed by health professionals when planning interventions.

Influence of comorbid depression, sociodemographic and seizure-related variables on quality of life of adults with epilepsy

Quality of life (QOL) is recognised as an important concept to better understand the distress of living with epilepsy. As it is a multidimensional construct it can be influenced by many and different factors including sociodemografic, disease-specific and psychosocial ones. AIM AND METHOD: We assessed the influence of comorbid depressive disorder, some sociodemografic and seizure-related variables on QOL of people with epilepsy (PWE). The sample included 106 adult patients with idiopathic epilepsy (41 males and 65 females). All subjects underwent clinical psychiatric examination, including evaluation on Hamilton Depression Rating Scale (HAM-D-17) and completed Quality of Life in Epilepsy Inventory-31 (QOLIE-31). Seizure severity was measured by Seizure Severity Questionnaire (SSQ). A questionnaire for demographic and seizure-related variables was also completed. Comorbid depressive disorder was diagnosed according to ICD-10 diagnostic criteria for affective and delusional disorders and ILAE classification for epilepsies and epileptic syndromes was used. Statistical analysis included correlation analysis, t-tests and multivariation analysis. RESULTS: Employment, education and age, seizure frequency and seizure severity were associated with QOL scores. Comorbid depressive disorder was associated with QOL scores accounting for 32% of the variance in QOLIE-31 overall score and was a strong predictor for the variance in overall QOL, emotional well-being, energy/fatigue and cognitive functioning scores. Seizure severity influenced most the variance in seizure-worry score. Seizure frequency accounted most for social functioning and medication effects scores. Gender, marital status, seizure type, age at seizure onset, duration of seizures and antiepileptic medication intake had no significant association with QOLIE-31scores in this study. CONCLUSIONS: Multiple factors determine QOL of PWE. Detection and treatment of comorbid depressive disorder, being the most frequent psychiatric comorbidity in epilepsy, is a challenge for improving the QOL these patients and future research should give priority to this issue.

Sexuality and Quality of Life

The purpose of this research was to explore the relationships between sexual activity and intimacy and quality of life (QOL) of older adults. The authors' research question was "To what extent do age, gender, marital status, health status, education, satisfaction with personal relationships, sexual activity, and satisfaction with intimacy explain older adults' ratings of QOL?" A secondary analysis was conducted using results from a cross-sectional survey. Data were available from a convenience sample of 426 individuals living in British Columbia, Canada, who volunteered to complete the questionnaire. Instruments included the WHOQOL-100, WHOQOL-OLD, and a demographic data sheet. It was found that the strongest contributors to the variance of overall QOL were satisfaction with personal relationships, followed by health status andsexual activity. Age, gender, marital status, and education were not significant. The implications for gerontological nurses include the need to support personal relationships for older adults, to encourage health promotion, and to ensure sexuality is discussed with older adults.

Quality of life in Polish respondents: psychometric properties of the Polish WHOQOL – Bref

The aim of this study was to examine the validity and reliability of the Polish WHOQOL - Bref in a sample of 908 respondents. The Bref is a generic quality of life (QoL) instrument designed for cross - cultural use. Correlational and multivariate analyses confirmed the relevancy of individual items and domains supporting the construct validity of the scale. Multiple regression analyses of the domain scores with two overall questions (dependent variable) showed that all four domains made a significant contribution in explaining the variance in overall QoL. The psychological domain made the strongest contribution (unstandardized B coefficient = 0.10, r2 = 0.41), followed by the social, environmental and physical domains. When overall health satisfaction was considered as the dependent variable, the physical domain contributed most strongly (unstandardized B coefficient = 0.21, r2= 0.43) followed by the psychological and environmental domains. Exploratory factor analyses resulted in a four factors solution with 24 items explaining 49.6% of the cumulative variance. Confirmatory factor analyses lended marginal support for the goodness of fit of the four-domain model. The physical domain was found to be strongest in differentiating between unhealthy and healthy subjects, followed by psychological and social domains. Acceptable internal consistency was shown with Cronbach's alpha coefficients being greater than 0.70 for all domains with the exception of the social domain. Further exploration of the scales validity and conceptual clarity need further testing in Polish and international samples.

Quality of life in newly diagnosed cancer patients waiting for surgery is seriously impaired

Newly diagnosed cancer patients waiting for initial surgery experience a stressful time. Study objectives were (1) to examine the quality of life (QL) of these patients by comparing QL (a) between the four diagnostic groups included in this study, (b) to the QL of the general population, (2) to determine the factors that contribute most to patients' overall QL. One hundred ninety six patients with lung, periampullary, oesophageal and cervical cancer completed questionnaires on generic QL (SF-36), overall QL, cancer-site specific symptoms (EORTC-modules), anxiety (STAI), health expectations, demographics and comorbidity. Between diagnostic groups no significant differences were found on generic QL. As compared to the general population, generic QL was impaired on all aspects except bodily pain. Using stepwise regression analysis, 46% of the variance in overall QL was explained with the SF-36 scales vitality (Beta = 0.43) and mental health (Beta = 0.23) being the most important predictors. The QL of these patients is seriously impaired. In this stage, not cancer-site specific aspects but fatigue and emotions colour their lives. It is recommended to keep the waiting period brief. In addition, suggestions are offered by which physicians might help their patients in alleviating the distress.

Functional status and perceived control influence quality of life in female heart transplant recipients

Background The purpose of this study was 2-fold: (1) to describe and compare the quality of life (QOL) and psychologic well-being of 2 groups of women matched for age and functional status (6-minute walk distance), including those who had received a heart transplant and those who were candidates on a transplant waiting list; and (2) to identify correlates of QOL in female heart transplant recipients. Methods Data were collected from 50 female recipients (mean age 54.7 ± 13.0 years) and 50 female candidates (mean age 56.8 ± 12.2 years) from a major heart transplant facility using the Minnesota Living with Heart Failure Questionnaire, the Beck Depression Inventory and the Control Attitude Scale. Results The overall QOL scores were 28.0 ± 26.4 and 56.3 ± 26.1 for recipients and candidates, respectively ( p < 0.01), with lower scores denoting higher QOL. The mean physical health (11.3 ± 11.2 vs 19.9 ± 12.1, p < 0.01) and emotional health (7.5 ± 8.2 vs 12.8 ± 7.8, p < 0.001) scores were also lower (reflecting higher physical and emotional health) for recipients as compared with candidates. Likewise, recipients reported significantly ( p < 0.001) lower depressive moods (23.2 ± 8.2 vs 45.8 ± 16.3) and higher perceived control (10.9 ± 4.3 vs 8.6 ± 1.9) compared with candidates. Functional status, depression and perceived control were significant correlates of QOL among female recipients and accounted for 49% variance in overall QOL. Conclusions Although overall QOL of was better among female heart transplant recipients than candidates, both groups of women reported poor QOL. Clinicians need to identify potential resources and interventions to improve QOL both before and after heart transplant surgery.

Explaining quality of life with crisis theory.

Based on the premises of crisis theory, we expected cancer patients in-crisis to report a poorer quality of life (QL) and cancer patients post-crisis to report a similar level of overall QL in comparison to healthy individuals. To explain these hypothesized findings, we expected the coping resources and strategies of patients in-crisis to be equally effective and those of patients post-crisis to be more effective as compared to those of healthy individuals. The sample consisted of: (a) 217 consecutive cancer patients in the acute phases of their illness (patients in-crisis); (b) 192 disease-free cancer patients (patients post-crisis); and (c) 201 randomly selected healthy individuals. Established measures of QL, self-esteem and neuroticism (coping resources) and coping behavior (coping strategies) were mailed. As expected, patients in-crisis reported a poorer QL (p < 0.001) and patients post-crisis a similar overall QL as compared to healthy individuals. There were no significant or systematic differences between the mean levels of coping resources and strategies between the respective groups. Two-way analysis of variance indicated a group X coping resource interaction effect on overall QL for self-esteem (p < 0.01). As expected, the amount of variance of overall QL explained by self-esteem was largest for patients post-crisis (27%) and comparable for patients in-crisis and healthy individuals (10 and 11%). Patients in-crisis were not able to make their coping resources and strategies more effective, whereas patients post-crisis seemed to have enhanced the effectiveness of self-esteem in restoring their QL as compared to healthy persons.

Assessing the quality of life of the individual: the SEIQoL with a healthy and a gastroenterology unit population

Current methods of measuring quality of life (QoL) impose an external value system on individuals, rather than allowing them to describe their lives in terms of those factors which they consider important. The Schedule for the Evaluation of Individual Quality of Life (SEIQoL) was developed to overcome such limitations. The QoL of 42 healthy attenders at an international immunization clinic was assessed using SEIQoL. Judgement reliability was high (r = 0.74) and individuals' judgement policies accounted for a large percentage of the variance in overall QoL (R2 = 0.75) demonstrating the construct validity of judgement analysis in this context. In a second study of QoL of out-patient suffering from irritable bowel syndrome (IBS) (N = 20) or peptic ulcer disease (PUD) (N = 20) was assessed using SEIQoL. Judgement reliability was lower (r = 0.54) although statistically highly significant (P less than 0.01), and the variance in overall QoL judgements explained was high (R2 = 0.74). SEIQoL is an acceptable, reliable and valid technique for measuring individual QoL that takes greater account of individual perspectives than traditional measurement approaches.