Worse Physical Health-related Quality Of Life Research Articles

Correlates of health-related quality of life in African American and Caucasian stroke caregivers.

Stroke is a leading cause of long-term disability in the United States. Family caregivers are susceptible to negative outcomes as a result of their caregiving role. A stress process model was utilized to identify characteristics of stroke caregivers who are at risk for poor physical and mental health-related quality of life (QOL). Individuals who experienced an incident stroke event within the previous year were identified from a larger epidemiologic study of stroke incidence. These stroke survivors were enrolled in the Caring for Adults Recovering from the Effects of Stroke (CARES) study along with their primary family caregivers (N = 146 dyads). Caregivers completed a baseline telephone interview that assessed physical and mental health-related QOL, problems their family members were experiencing, appraisals of those problems, and caregiver resources. Objective stressors, appraisals, and caregiver resources were related to caregiver physical and mental health-related QOL, ps <.05. Objective stressors were found to have a stronger association with caregiver mental health than physical health. Hierarchical regression models showed the relative importance of each category of predictors. In the final models, older age and receiving more support were associated with worse physical health-related QOL whereas African American race and fewer stroke survivor problems were associated with better mental health. The correlates of health-related QOL identified in this national sample of caregivers can help identify stroke caregivers who are at risk for poor adjustment to the caregiving role and aid in identifying areas that can potentially be intervened upon for these caregivers.

Journal Digest

Journal Digest

Mental and Physical Health–Related Quality of Life among U.S. Cancer Survivors: Population Estimates from the 2010 National Health Interview Survey

Despite extensive data on health-related quality of life (HRQOL) among cancer survivors, we do not yet have an estimate of the percentage of survivors with poor mental and physical HRQOL compared with population norms. HRQOL population means for adult-onset cancer survivors of all ages and across the survivorship trajectory also have not been published. Survivors (N = 1,822) and adults with no cancer history (N = 24,804) were identified from the 2010 National Health Interview Survey. The PROMIS® Global Health Scale was used to assess HRQOL. Poor HRQOL was defined as 1 SD or more below the PROMIS® population norm. Poor physical and mental HRQOL were reported by 24.5% and 10.1% of survivors, respectively, compared with 10.2% and 5.9% of adults without cancer (both P < 0.0001). This represents a population of approximately 3.3 million and 1.4 million U.S. survivors with poor physical and mental HRQOL. Adjusted mean mental and physical HRQOL scores were similar for breast, prostate, and melanoma survivors compared with adults without cancer. Survivors of cervical, colorectal, hematologic, short-survival, and other cancers had worse physical HRQOL; cervical and short-survival cancer survivors reported worse mental HRQOL. These data elucidate the burden of cancer diagnosis and treatment among U.S. survivors and can be used to monitor the impact of national efforts to improve survivorship care and outcomes. We present novel data on the number of U.S. survivors with poor HRQOL. Interventions for high-risk groups that can be easily implemented are needed to improve survivor health at a population level.

Health-related quality of life of mothers of very low birth weight children at the age of five: results from the newborn lung project statewide cohort study

This study aimed to determine the health-related quality of life (HRQoL) in mothers of 5-year-old very low birth weight (VLBW) and normal birth weight (NBW) children, with a focus on the role of stress. This cohort study is ancillary to the Newborn Lung Project. A telephone interview collected information on symptoms of stress and HRQoL from 297 mothers of VLBW children and 290 mothers of NBW children who were enrolled in the Newborn Lung Project Statewide Cohort Study. Staged multiple regression analyses were used to evaluate the relationship between caregiver status and maternal HRQoL and the role stress played in this relationship. Additional multiple regression analyses were also used to evaluate the correlates of poor maternal HRQoL among VLBW mothers. Mothers of VLBW children experienced worse physical and mental HRQoL than mothers of NBW children. Adjusted analyses showed that physical HRQoL was significantly different between these mothers (β: -1.87, P=0.001); this relationship was attenuated by maternal stress. Among the mothers of VLBW children, stress significantly contributed to adverse HRQoL outcomes when children were aged five. Child behavior problems at the age of two were also associated with worse subsequent maternal mental HRQoL (β: -0.18, P=0.004), while each week of neonatal intensive care unit stay was associated with worse physical HRQoL (β: -0.26, P=0.02). Caring for a VLBW child is negatively associated with the HRQoL of mothers; this relationship might be, in part, explained by maternal stress. Addressing maternal stress may be an important way to improve long-term HRQoL.

Co-occurring Conditions and Health-Related Quality of Life in Patients With Bipolar Disorder

To assess changes in health-related quality of life (HRQOL) and to determine whether co-occurring substance use and medical comorbidities were associated with worse HRQOL over a 1-year period in a naturalistic sample of patients with bipolar disorder. Patients enrolled in the Continuous Improvement for Veterans in Care: Mood Disorders (CIVIC-MD), a large prospective study from July 2004 to July 2006, completed baseline and follow-up assessments related to bipolar symptoms, comorbidity, and Short Form 12 HRQOL assessment at baseline and at 1 year later. Predictors of changes in HRQOL mental and physical health component scores were determined, using multivariable linear regression models and path analyses. Of 334 participants, the mean age was 49 years (standard deviation [SD] = 10.1 years; range = 21-78 years), 15.9% women, and 10.8% African American. At baseline, 19.8% reported hazardous drinking, 25.5% reported illicit drug use, and the mean number of co-occurring medical conditions was 2.70 (SD = 2.02). Illicit drug use was associated with worse mental HRQOL (beta = -2.01; p < .05), and increased number of medical comorbidities was significantly associated with worse physical HRQOL over time (beta = -0.71; p < .01). Depressive symptoms exhibited a strong and consistent influence on mental health scores over time, but path analyses revealed that they did not seem to mediate effects of comorbidities on lower HRQOL. Illicit drug use and medical comorbidity negatively affected mental HRQOL over time, independent of bipolar symptoms, suggesting the need for interventions that address physical health and drug treatment needs for patients with bipolar disorder.