World Health Organization QOL-BREF Research Articles

Dimensions and determinants of quality of life among senior citizens of Lucknow, India

Background : In India, there is low awareness about special needs of the elderly and their care takers. We are yet to understand the basics of elderly care (physical and mental health, psychological and social support). Objectives : (1) To study the dimensions of quality of life (QOL) of elderly people living in community and in old age homes (OAHs). (2) To determine the predictors of QOL among elderly people. Materials and Methods : A cross-sectional descriptive study was undertaken with elderly people (age ≥60 years) from the community and from OAHs residing in Lucknow city, India were the participants. Multistage sampling technique was used in the general population and all the elderly people living in OAHs were included in the study. 141 elderly people from community and 101 elderly people from OAHs were studied after taking oral consent and scoring ≥20 on Mini Mental State Examination instrument. Instrument used for assessing QOL was World Health Organization QOL-bref. Tools used to screen out anxiety and depression cases were Geriatric Depression Scale - Hindi version and Hamilton Anxiety Rating Scale. Results : The mean scores of QOL domains were higher among married elderly people, elderly people without mental health problem and elderly people without psychosocial issue/s. Similarly, it was higher among elderly people living in the community and paid OAHs than in free OAHs. Conclusion : QOL of elderly residing in paid OAHs were similar to those from the community. Financial dependency was the strongest predictor of QOL.

Family Satisfaction, Pain, and Quality-of-Life in Emerging Adults with Spina Bifida

This study uses the Life Course Model for Spina Bifida (SB) to advance knowledge of factors associated with change in quality-of-life (QOL) among emerging adults with SB. Forty-eight participants (mean [SD], 22.04 [2.16] yrs) completed self-report questionnaires at two time points, 15 mos apart. Four QOL domains (physical health, psychological, social relationships, and environment) were measured using the World Health Organization QOL-BREF version. SB clinical data were collected via chart reviews. Paired t tests and reliable change indices evaluated group- and individual-level QOL change, respectively. Multiple regression analyses tested the contributions of the Life Course variables in explaining change in QOL over time. No significant group-level differences in the QOL domains were found between time 1 and time 2, but there was substantial individual variation in QOL over time. SB severity was related to a decline only in psychological QOL (B = -0.68, P = 0.02). Increased pain was associated with reduced physical health (B = -0.29, P = 0.049) and psychological (B = -0.29, P = 0.03) QOL at time 2, whereas greater family satisfaction was related to improved QOL in several domains. Clinicians should be aware of the negative impact of pain and the protective influence of family satisfaction on QOL in emerging adults with SB.

Prevalence of fatigue in patients with multiple sclerosis and its effect on the quality of life

Objective:This prospective study was carried out to observe the prevalence of fatigue in patients with multiple sclerosis (MS) and its effect on quality-of-life (QoL).Study Design and Setting:Prospective observational study in a University Tertiary Research Hospital in India.Patients and Methods:A total of 31 patients (25 females) with definite MS according to McDonald's criteria presented in out-patient/admitted in the Department of Neurology (between February 2010 and December 2011) were included in the study. Disease severity was evaluated using the Kurtzke's expanded disability status scale (EDSS). Fatigue was assessed using Krupp's fatigue severity scale (FSS). QoL was assessed by the World Health Organization QoL-BREF questionnaire.Results:The mean age of patients was 30.1 ± 9.1 years. The mean age at first symptom was 25.23 ± 6.4 years. The mean number of relapses was 4.7 ± 3.6 in the patients. The mean duration of illness was 4.9 ± 4.4 years. The mean EDSS score was 3.5 ± 2.2. Mean fatigue score was 38.7 ± 18.5 (cut-off value 36 in FSS). The prevalence of fatigue in patients with MS was 58.1% (18/31). MS patients with fatigue were significantly more impaired (P < 0.05) on all QoL domains (i.e., physical, psychosocial, social, and environment) than MS patients without fatigue.Conclusion:Prevalence of fatigue was found to be high in the MS patients in the study. All four domains of QoL were significantly more impaired in the group with fatigue than in those without fatigue.

Investigation of Quality of Life Determinants Among Mothers of Children with Pervasive Developmental Disorders in Iran

Objective/Background The objective of the study was to examine the association between socio-economic status (SES), marital satisfaction, and subtypes of pervasive developmental disorders (PDDs) with quality of life (QOL) in mothers of children with PDDs. Methods The study was conducted using a convenience sample of 210 mothers of children with PDDs. Data were collected using the World Health Organization QOL-BREF, Index of Marital Satisfaction, and SES Questionnaires. Data analysis was done by analysis of variance and multivariate analysis of variance tests. Results The findings of the study showed that SES is associated strongly with the environmental domain (p &lt; .001, r2 = .421), marital satisfaction with the social domain (p &lt; .001, r2 = .394), and PDDs’ subtype with the psychological domain (p &lt; .001, r2 = .283). Mothers of children with autistic disorder subtype reported lower QOL in all domains compared with other subtypes (p &lt; .05). Conclusion The determinants such as SES, marital satisfaction, and subtypes of PDDs have an important influence on QOL of mothers of children with PDDs. Further investigation in this regard is warranted.

Chinese medicine improves postoperative quality of life in endometriosis patients: A randomized controlled trial

To investigate the effect of Chinese medicine (CM) and Western medicine (WM) on quality of life (QOL) after conservative surgery for endometriosis. A total of 320 patients with endometriosis were randomized into two groups by using random block design, CM group (160 cases, activating blood circulation and removing blood stasis treatment based on syndrome differentiation) and WM group (160 cases, gonadotropin-releasing hormone agonist or gestrinone treatment) after conservative surgery. Treatment was given for 3-6 months (according to the revised American Fertility Society scoring system stage), and the World Health Organization QOL-BREF (WHOQOL-BREF) was applied to patients before and after treatment to assess QOL. There were 136 cases in the CM group and 141 cases in the WM group completing therapy. In the CM group, the use of the WHOQOL-BREF showed that the physical, psychological and environmental scores posttreatment were significantly higher than those at pre-treatment (P < 0.05), and for 12 items (pain and discomfort, energy and fatigue, sleep and rest, mobility, activities of daily living, work capacity, negative feelings, health and social care: accessibility and quality, participation in and opportunities for recreation/leisure activities, appetite, QOL score, overall health status and QOL), the difference in scores was significant (P < 0.05). In the WM group, 4 items (pain and discomfort, opportunities for acquiring new information and skills, QOL score, overall health status and QOL) had significantly different scores post-treatment compared with those at pre-treatment (P < 0.05). Before treatment, the QOL in the two groups of patients showed no significant difference (P > 0.05). After treatment, the scores for physical health in the CM group were significantly higher than those of the WM group (P < 0.05) and the scores of 4 items (mobility, activities of daily living, sexual activity, QOL score) in the CM group were significantly higher than those in the WM group (P < 0.05). CM and WM treatment could improve the QOL of patients with endometriosis after conservative surgery. CM treatment is more effective than WM.

Survey of patients with chronic hepatitis B to identify factors that influence quality of life

To survey patients with chronic hepatitis B (CHB) to determine their perceptions of CHB-related quality of life (QOF) and to determine the factors influencing this measure. A total of 268 patients with CHB (disease group) and 205 healthy individuals (control group) completed the World Health Organization (WHO)QOL-BREF life assessment survey and a self-designed questionnaire of health and QOL. The groups' responses were comparatively analyzed by the cluster sampling method and the independent samples t-test. The strength of influence of each factor on the patients' perceptions of QOL was determined by multiple stepwise regression and one-way ANOVA. The disease group had significantly lower scores than the control group for overall QOL (62.88 ± 8.22 vs. 67.31 ± 5.82), the physiological area (PHYS: 64.71 ± 15.05 vs. 73.21 ± 11.26), the psychological area (PSYCH: 64.35 ± 14.71 vs. 68.94 ± 10.13), the social relations area (SOCIL: 67.20 ± 12.98 vs. 69.83 ± 8.65), the environmental area (ENVIR: 59.58 ± 13.23 vs. 63.97 ± 10.24), the QOL self-assessment (60.75 ± 21.54 vs. 66.90 ± 17.57) and the health self-assessment (58.13 ± 19.15 vs. 76.26+/-14.27) (all, P less than 0.05). Multiple stepwise regression analysis identified the following parameters as risk factors of PHYS: depression (P less than 0.001), perception of being seriously ill (P less than 0.001), self-payment for treatment (P = 0.003), CHB significant impact on income (P = 0.002), poor appetite (P = 0.002), langur (P less than 0.001), and fear of infecting others (P = 0.022). Confidence of treatment was a protective factor of PHYS (P = 0.001). The risk factors of PSYCH were depression (P less than 0.001) and recurrence (P less than 0.001), and the protective factors were confidence of treatment (P = 0.003) and male sex (P = 0.014). The risk factors of SOCIL were depression (P less than 0.001, dissatisfaction with the attitude of the people around (P = 0.001), recurrence (P = 0.008), and advanced age (P = 0.009), and the protective factors were social support (P less than 0.001) and confidence of treatment (P = 0.015); however, the scores were significantly different for different occupations (P = 0.008). The risk factors of ENVIR were depression (P less than 0.001), dissatisfaction with the attitude of the people around (P less than 0.001), living in rural area (P = 0.007), and recurrence (P = 0.016). Patients should be monitored for depressive symptoms during the course of clinical medical care for CHB so that psychological care may be initiated in a timely manner. It is important to strengthen communication between healthcare professionals and patients in order to improve the patient's perception of social support and quality of life.

Assessment of quality of life of Iranian nurses

Nurses&amp;rsquo; Quality Of Life (QOL) may be affected by many different factors that can in turn influence their job competency. The aim of this study was to assess the QOL of Iranian nurses to provide evidence to enable policy makers to take the necessary steps needed to make improvements. Using a cross-sectional study design, we evaluated the QOL of Iranian nurses by the assessment of four health indicators: physical, psychological, social and environmental. A total of 850 nurses from 17 different provinces of Iran were recruited by random sampling. They were requested to complete the World Health Organization QOL-BREF questionnaire. Data were then analyzed. Results indicated that half of the nurses scored in the moderate range, suggesting that they had a reasonably good QOL. They scored considerably higher in terms of physical health indicators and achieved significantly lower scores regarding environmental health issues. Although the &amp;chi;&lt;sup&gt;2&lt;/sup&gt; test did not show any significant association between the QOL indicators and different factors such as work experience, gender, job position and patients group. We found a significant association between the subject&amp;rsquo;s position at work in the hospital shift pattern and their overall QOL score. The results of our study showed that more than half the nurses evaluated their QOL to be at a moderate level. The results from this study can be used by policy makers to help make improvements to nurses&amp;rsquo; QOL that may enhance the quality of care they deliver to their patients. Future research including a group of nurses from over the whole country is essential so that a more representative cohort can be studied. It would also pave the way for the establishment of a QOL database for nurses in Iran that could monitor changes in the nursing population.

Psychosocial Problems, Quality of Life, and Functional Independence Among Indian Stroke Survivors

Data regarding psychosocial problems and quality of life (QoL) among stroke survivors from developing countries are scarce. The purpose of this study is to examine QoL, anxiety, depression, and functional independence of stroke survivors and the relationship of these variables with stroke characteristics. This was a prospective hospital-based study. Patients were interviewed after ≥ 1 month post stroke. World Health Organization QoL-BREF was used to assess QoL. Anxiety and depression measures were recorded using the Hospital Anxiety Depression Scale, and functional independence was evaluated using the Functional Independence Measure. Demography, stroke severity (measured by the National Institute of Health Stroke Scale), and stroke outcome (measured by the modified Rankin scale) were also documented. Univariate and multivariate analysis were completed using SPSS Statistics version 17.0 (SPSS, Inc, Chicago, Ill). One hundred sixty-two patients participated (men = 113, 69.8%); mean age was 54.3 ± 12.9 years (range, 21-88 years). The mean duration of follow-up was 18.3 ± 24.9 months (range, 1-180 months), and the mean National Institute of Health Stroke Scale score was 2.1 ± 2.1 (range, 0-10). Presence of anxiety (odds ratio [OR] 0.20, CI 0.80-0.51, P=0.001), depression (OR 0.22, CI 0.10 to 0.47, P < 0.0001), and functional dependence in Functional Independence Measure (OR 3.56, CI 1.70 to 7.42, P = 0.001) were predictors of impaired QoL in the multivariate logistic regression analysis. Anxiety was seen in 39 patients (24%), and 60 patients (37%) had depression. Poor outcome predicted depression in logistic regression model (OR 4.40, CI 1.80 to 10.76, P = 0.001). Functionally dependent patients were more likely to be older (OR 0.94, CI 0.92 to 0.97, P = 0.001) and had severe stroke (OR 0.69, CI 0.53 to 0.88, P = 0.004). Presence of anxiety, depression, and functional dependence were associated with impaired QoL. There was low prevalence of anxiety and depression. Older age and stroke severity resulted in increased functional dependence.