Generic,Disease-Specific and Individualised Approaches to Measuring Health-Related Quality of Life Among People With Heart Disease - A Comparative Analysis

Increasing emphasis is being placed on the evaluation of health-related quality of life. However, there is no consensus on the definition of this concept and as a result there are a plethora of existing measurement instruments. Head-to-head comparisons of the psychometric properties of existing instruments are necessary to facilitate evidence-based decisions about which instrument should be chosen for routine use. Therefore, an individualised instrument (the modified Patient Generated Index (PGI)), a generic instrument (the Short Form 36) and a disease-specific instrument (the Quality of Life after Myocardial Infarction questionnaire) were administered to patients with ischaemic heart disease ( n = 117) and the evidence for the validity, reliability and sensitivity of each instrument was examined and compared. The modified PGI compared favourably with the other instruments but none of the instruments examined provided sound evidence for sensitivity to change. Therefore, any recommendation for the use of the individualised approach in the routine collection of health-related quality of life data in clinical practice must be conditional upon the submission of further evidence to support the sensitivity of such instruments.     

Cognition, daily living, and health-related quality of life in 85-year-olds in Sweden

This study investigates how cognition influences activities of daily living and health-related quality of life in 85-year-olds in Sweden (n = 373). Data collection included a postal questionnaire comprising demographics and health-related quality of life measured by the EQ-5D. The ability to perform personal activities of daily living (PADL) was assessed during a home visit that included administering the Mini Mental State Examination (MMSE). Cognitive impairment was shown in 108 individuals (29%). The majority were independent with respect to PADL. A larger number of participants with cognitive impairment reported that they needed assistance in instrumental activities of daily living (IADL) compared to the group without cognitive impairment. Impaired cognition was significantly related to problems with IADL. Significant but low correlations were found between cognition and health-related quality of life - higher ratings on perceived quality of life correlated with higher results on the MMSE.     

Cognition,daily living,and health-related quality of life in 85-year-olds in Sweden

ABSTRACT

This study investigates how cognition influences activities of daily living and health-related quality of life in 85-year-olds in Sweden (n?=?373). Data collection included a postal questionnaire comprising demographics and health-related quality of life measured by the EQ-5D. The ability to perform personal activities of daily living (PADL) was assessed during a home visit that included administering the Mini Mental State Examination (MMSE). Cognitive impairment was shown in 108 individuals (29%). The majority were independent with respect to PADL. A larger number of participants with cognitive impairment reported that they needed assistance in instrumental activities of daily living (IADL) compared to the group without cognitive impairment. Impaired cognition was significantly related to problems with IADL. Significant but low correlations were found between cognition and health-related quality of life – higher ratings on perceived quality of life correlated with higher results on the MMSE.     

自我同情和睡眠质量的关系：积极和消极情绪与自我控制的中介作用

为探究积极和消极情绪与自我控制在自我同情与睡眠质量间的中介机制,采用问卷法对477名成人进行调查,建立结构方程模型对中介效应进行检验。结果发现：（1）自我同情、积极情绪、自我控制和睡眠质量两两之间均为显著正相关,而上述变量与消极情绪均为显著负相关;（2）自我同情可分别以积极情绪、消极情绪和自我控制为中介来预测睡眠质量;还可依靠消极情绪与自我控制的链式中介效应来间接预测睡眠质量,但自我同情对睡眠质量的直接效应不显著。该研究结果为改善睡眠质量提供了新的干预视角。     

Sleep Quality and the Subjective Experience of Autobiographical Memory: Differential Associations by Memory Valence and Temporality

The primary goal of the present research was to examine associations between sleep quality and the subjective experience of autobiographical events. In an online study, 141 university students reported on past events that varied by valence (positive or negative) and temporality (most significant or from the previous 2 weeks); they also completed measures of sleep quality and depression. Relative to participants with good sleep quality, participants with poor sleep quality thought more about their negative experiences, reported negative events that occurred more frequently, and used more negative emotion words when describing recent negative events. In some instances, depressive symptoms mediated the relation between sleep quality and elements of autobiographical reports. Future experimental work should examine the directionality of these effects, with the ultimate goal of improving sleep quality, mental health, and the manner in which individuals discuss and make meaning of their negative life events. Copyright © 2017 John Wiley & Sons, Ltd.     

A Systematic Review of Quality of Life Measures in Pregnant and Postpartum Mothers

Quality of life has emerged as an essential health component that broadens the traditionally narrow concerns focused on only morbidity and life expectancy. Although a growing number of tools to measure quality of life are in circulation, there is a lack of guidelines as well as rigorous assessment for their use with pregnant and postpartum populations. It is also unclear whether these instruments could validly be employed to measure patient-reported outcomes in comparative effectiveness research of maternal care interventions. This paper reviews articles cited in CINAHL, COCHRANE, EMBASE, PSYCINFO, and PUBMED that addressed quality of life in pregnant and postpartum populations. Instruments used to measure quality of life in selected articles were assessed for their adherence to international guidelines for health outcomes instrument development and validation. The authors identified 129 articles that addressed quality of life in pregnant and/or postpartum women. Out of these, only 64 quality (generic and specific) scales were judged relevant to be included in this study. Analysis of measurement scales used in the pregnant and/or postpartum populations revealed important validity, reliability and psychometric inadequacies that negate their use in comparative effectiveness analysis in pregnant and post-partum populations. Valid, reliable, and responsive instruments to measure patient-reported outcomes in pregnant and postpartum populations are lacking. To demonstrate the effectiveness of various treatment and prevention programs, future research to develop and validate a robust and responsive quality of life measurement scale in pregnant and postpartum populations is needed.     

Good Societies,Financial Inequality and Secrecy,and a Good Life: from Aristotle to Piketty

In this paper we show that for a dataset of 105 countries, four candidate objective indexes (Human Development Index (HDI), Weighted Index of Social Progress (WISP), Social Progress Index (SPI) and Sustainable Society Index (SSI)) and one subjective index (World Happiness Survey (WHS)) of at least aspects of the quality of life or human well-being have good convergent validity among themselves and expected statistically significant negative correlations with Gini measures of wealth and income, and a measure of political jurisdictions’ institutionalized financial secrecy (Financial Secrecy Scores (FSS)). A measure of offshore wealth as a fraction of GDP (FOW) showed only a couple significant correlations with one overall quality of life index (SSI). When we combined the four objective indexes to the subjective index to create overall measures of the quality of life (including Happy Life Years (HLY)), the correlations among the indexes increased. Most of the correlations increased again when we used Gini indexes to create wealth-equality overall quality of life indexes and these correlations were higher on average than those among income-equality overall quality of life indexes. Combining results using 21 quality of life/well-being indexes, we rank ordered 105 countries from best to worst. The top 10 in order were Switzerland, Norway, Iceland, Australia, Finland, Netherlands, Slovakia, Belgium, Sweden and Denmark. This is the first time anyone has built the array of index options presented here based on a handful of originals. We offer them as another potential starting point for the next generation of researchers.

     

A randomised controlled trial to assess the effectiveness of providing self-help information to people with symptoms of acute stress disorder following a traumatic injury

BACKGROUND: Patients attending accident and emergency (A&E) may develop long-term psychological difficulties. Psycho-education has been suggested to reduce the risk of post-injury disorders. AIMS: We tested the efficacy of providing self-help information to a high-risk sample. METHODS: A&E attenders were screened for acute stress disorder and randomised to two groups: patients (n=116) receiving a self-help booklet and those who did not (n=111). A sample of 'low' scorers was also included (n=120); they did not receive a booklet. Psychological assessments were completed at baseline (within 1 month post-injury) and 3 and 6 months post-injury. RESULTS: Post-traumatic stress disorder (PTSD), anxiety and depression decreased (p<0.001) across time but there were no group differences in these measures or quality of life. However, subjective ratings of the usefulness of the self-help booklet were very high. CONCLUSIONS: This trial failed to support the efficacy of providing self-help information, as a preventative strategy to ameliorate PTSD.     

Hope as a Psychological Factor Affecting Quality of Life in Patients With Psoriasis

Clinical observations and medical reports indicate that psoriasis has a tremendous impact on patients’ lives, lowering their quality in many important areas. However, the vast majority of research deals only with health-related issues. This study aimed to compare the general quality of life of psoriasis patients and healthy volunteers by examining psychological variables thought to modify the quality of life. 42 patients with psoriasis and 42 healthy volunteers matched for gender, age and education level were tested. Flanagan Quality of Life Scale was used to evaluate general quality of life. Basic hope level was assessed with Basic Hope Inventory. Trait hope was estimated using Trait Hope Scale. Psoriasis Area Severity Index was used to assess the severity of the disease. Psoriasis patients have a significantly lower overall quality of life (p?=?0.05), modified by Physical and Material Well-being (p?=?0.01), Personal Development and Fulfillment (p?=?0.03), and Recreation (p?=?0.04). They also have lower levels of trait hope (p?=?0.04) and its agency component (p?=?0.01). There were moderate, negative significant correlations with basic hope and such components of quality of life as Physical and Material Well-being (p?=?0.03, r?=?? 0.34) and Relations with other People (p?=?0.02, r?=?? 0.35). These results support the hypothesis of a reduced general quality of life and trait hope in psoriatics. Thus, psychological help for people suffering from dermatological disorders might be as important as medical intervention. Basic hope can be treated as a resource in coping with these disorders and trait hope as a resource conducive to well-being.     

Does prospective memory influence quality of life in community-dwelling older adults?

Older adults commonly experience declines in prospective memory, which describes one’s ability to “remember to remember,” and can adversely affect instrumental activities of daily living and healthcare compliance. However, the extent to which prospective memory failures may influence quality of life in typically aging older adults is not well understood. One-hundred and four community-dwelling older Australians (aged 50 to 82 years) were administered a comprehensive, neuropsychological battery that included the Memory for Intentions Screening Test (MIST), Prospective and Retrospective Memory Questionnaire (PRMQ), Instrumental Activities of Daily Living Questionnaire (IADLQ), and World Health Organization Quality of Life-8 (WHOQOL-8). Multiple regressions controlling for negative affect, medical comorbidities, and other neurocognitive functions revealed an interaction between prospective memory and instrumental activities of daily living in the concurrent prediction of quality of life. Among the 39 older adults who reported multiple problems on the IADLQ, lower performance-based prospective memory (MIST) and higher self-reported prospective memory failures in daily life (PRMQ) were significantly associated with lower quality of life (WHOQOL-8). Conversely, no significant associations were observed between prospective memory and quality of life in the 65 participants without IADL problems. Prospective memory difficulties adversely impact quality of life in community-dwelling older adults who experience problems independently managing their instrumental activities of daily living. These findings extend prior literature showing that prospective memory plays a unique role in the real-world outcomes of older adults and clinical populations and highlight the need to develop effective strategies to enhance prospective memory functioning in these vulnerable groups.     

Perceived residential environment quality in middle- and low-extension italian cities

This paper presents two updated instruments measuring the inhabitants perceived quality of their neighbourhood in urban places. This sphere is part of the environmental domain, which is considered one of the four components in individuals overall quality of life (Group development of the World Health Organization WHOQOL, 1998). The instruments consist of 11 scales measuring perceived residential environment quality (PREQ) indicators and one scale measuring neighbourhood attachment (NA). PREQ scales are included in the four generative criteria as follows: three scales deal with spatial aspects (i.e. architectural-planning space, organisation and accessibility of space, green areas); one scale concerns human aspects (i.e. people and social relations); four scales relate to functional aspects (i.e. welfare, recreational, commercial and transportation services); three scales deal with contextual aspects (i.e. pace of life, environmental health, upkeep). The objectives are: a) to generalise the structure and number of both the PREQ and NA indexes (previously verified on various residential areas of a large city like Rome; see Landscape and Urban Planning 65 (2003) 41; Housing Surveys. Advances in Theory and Methods, Crad, Quebec, Canada (1997), 99) on medium- and low-extension cities; b) to improve the psychometric qualities (i.e. internal consistency coefficients) of the scales; c) to verify the capacity of PREQ and NA indexes to discriminate between cities. The instruments consist of a self-report questionnaire, which was administered to 1488 residents in different neighbourhoods of 11 Italian middle- and low-extension cities (from 50,000 to 400,000 inhabitants). Results confirm the factorial structure of the scales, which include 19 PREQ indexes and one NA index. The scales show an increased level of reliability with respect to previous studies.     

Narcissism Predicts Therapy Outcome in Psychosomatic Patients

Narcissism can be seen along a continuum of adjustment with well-defended narcissism on the adjusted end, and poorly-defended narcissism on the maladjusted end. Poorly-defended narcissism is associated with negative emotions, and somatic preoccupations. The present study investigated whether aspects of poorly-defended narcissism can be changed during hospital treatment and if the change predicts therapy outcome. Data from 1442 psychosomatic in-patients (70% women, mean age 40.1 years) at admission and discharge were analyzed. Narcissism, mood and quality of life were assessed with standardized instruments. Patients with somatoform, anxiety, depressive or adjustment disorders differed significantly in narcissistic aspects. During inpatient treatment, narcissistic aspects decreased, and mood and quality of life increased. Changes in threatened self were associated with an improvement on all mood dimensions. Psychosomatic hospital treatment can help patients with poorly-defended narcissism to regulate aspects of threatened self with subsequent positive impact on mood and quality of life.     

青少年网络受欺负与自伤的关系:友谊质量与反刍思维的调节作用

为探讨青少年网络受欺负与自伤行为的关系,以及友谊质量和反刍思维在二者关系中的调节作用,采用青少年自我伤害问卷、网络受欺负问卷、友谊质量问卷等对1805名青少年进行调查。结果表明,网络受欺负对自伤行为有正向预测作用,且友谊质量和反刍思维共同调节二者的关系,即在低友谊质量高反刍思维的情况下,网络受欺负对青少年自伤行为有明显影响。提示心理干预者要注意帮助网络受欺负者寻找同伴友谊情感支持和构建理性健康认知模式。     

Health-related quality of life of preterm children and their caregivers

As advances in medical science have extended the limit of viability downward to 23 or 24 weeks gestation, interest has turned from long-term health outcomes to quality of life for survivors. During the last decade, the first studies of the health-related quality of life (HRQOL) of children and young adults who were born extremely preterm were published. Taken from the fields of anthropology, economics, sociology, and psychology, the foundation of HRQOL is formed by theories of functionalism, positive well-being, and utility. HRQOL can be defined as the physical, psychological, and social domains of health, which can be influenced by an individual's experiences and perception. HRQOL instruments are generally composed of multiple domains and measure physical functioning, mental health, and social role functioning in some form. Utilities, or preferences for health outcomes under conditions of uncertainty, are also used. Studies of HRQOL to-date indicate that preterm children have, on average, poorer health than their normal birthweight peers, but the majority do not perceive their quality of life as significantly different than others of their own age. Measures of HRQOL should not replace the traditional measures of morbidity, but should become part of the standard battery of tools used to assess a preterm child's health and well-being. Ultimately, studies of the HRQOL of preterm children should identify aspects of life, physical, psychological, or social, that could be improved with intervention.     

The Citizenship Project Part II: Impact of a Citizenship Intervention on Clinical and Community Outcomes for Persons with Mental Illness and Criminal Justice Involvement

This study assessed the effectiveness of an intervention based on a theoretical framework of citizenship on reducing psychiatric symptoms, alcohol use, and drug use, and increasing quality of life for persons with serious mental illness (SMI) and criminal justice involvement. One-hundred fourteen adults with SMI and a history of criminal justice involvement participated in a 2 × 3 longitudinal randomized controlled trial of a four-month citizenship intervention versus usual services. Linear mixed model analyses were used to assess the intervention’s impact on quality of life, symptoms, and substance use. After controlling for baseline covariates, participants in the experimental condition reported significantly increased quality of life, greater satisfaction with and amount of activity, higher satisfaction with work, and reduced alcohol and drug use over time. However, individuals in the experimental condition also reported increased anxiety/depression and agitation at 6 months (but not 12 months) and significantly increased negative symptoms at 12 months. Findings suggest that community-oriented, citizenship interventions for persons with SMI and criminal justice histories may facilitate improved clinical and community outcomes in some domains, but some negative clinical findings suggest the need for post-intervention support for intervention participants. Implications for practice and future research are discussed.     

A systematic review of the effectiveness of machine learning for predicting psychosocial outcomes in acquired brain injury: Which algorithms are used and why?

Clinicians working in the field of acquired brain injury (ABI, an injury to the brain sustained after birth) are challenged to develop suitable care pathways for an individual client’s needs. Being able to predict psychosocial outcomes after ABI would enable clinicians and service providers to make advance decisions and better tailor care plans. Machine learning (ML, a predictive method from the field of artificial intelligence) is increasingly used for predicting ABI outcomes. This review aimed to examine the efficacy of using ML to make psychosocial predictions in ABI, evaluate the methodological quality of studies, and understand researchers’ rationale for their choice of ML algorithms. Nine studies were reviewed from five databases, predicting a range of psychosocial outcomes from stroke, traumatic brain injury, and concussion. Eleven types of ML were employed with a total of 75 ML models. Every model was evaluated as having high risk of bias, unable to provide adequate evidence for predictive performance due to poor methodological quality. Overall, there was limited rationale for the choice of ML algorithms and poor evaluation of the methodological limitations by study authors. Considerations for overcoming methodological shortcomings are discussed, along with suggestions for assessing the suitability of data and suitability of ML algorithms for different ABI research questions.     

Willingness to Help a Stranger: The Effects of Social Context and Opinion Similarity1

Two field experiments investigate how information about aspects of the social environment affects willingness to help others who are similar or dissimilar. Subjects were pedestrians who found a lost packet of materials containing information about the opinions of the packet's loser and a survey report which claimed that the quality of life in the neighborhood had either improved or deteriorated. In the fiist study, the opinions were varied in order to create different degrees of opinion similarity between the loser and subject. Results showed that relatively slight differences between the loser's and subject's opinions made subjects unwilling to help (return the lost packet) when information about the social environment suggested a negative state of affairs, e.g., quality of life deteriorating. However, when information about the social environment suggested a positive state of affairs, subjects were willing to help, even if there was little similarity of opinion. In the second study, subjects learned that the loser of the packet agreed with their views on one opinion but disagreed on another. In this study, one of the two opinions concerned the same social issue as the one described in the survey report. Results demonstrated that subjects helped when there was agreement on the social issue that was also highlighted in survey reports of a negative state of affairs in the social environment and withheld help when there was disagreement on this issue. There were trends for the same result with information about a positive state of affairs in the social world.     

初中生生活事件、即时通讯与孤独感之间的关系

个体使用互联网对其心理与行为的影响一直是研究者关注的焦点,同时互联网世界是丰富多彩的,不同的互联网服务对使用者的影响是不同的。该研究采用问卷法抽取北京市两所中学初一、初二年级学生进行调查,目的是考察初中生生活事件、即时通讯服务使用偏好与孤独感之间的关系。结果表明:生活事件带来的主观压力能够显著正向预测孤独感;即时通讯能够显著负向预测孤独感;客观压力不能够预测孤独感,但是它可以通过即时通讯间接地影响个体的孤独感水平。从结果中可以看到互联网的使用对个体的发展不全是消极的,即时通讯服务的使用能够缓解生活事件对个体产生的消极影响,对个体起到一定的保护作用。     

Long-term outcomes of pediatric acquired brain injury

Recent studies have shown that persisting deficits remain even in young children with mild brain injuries. Our 2-year study investigated patterns of recovery in children and adolescents with ABI over the past 10 years. In the first year, we retrospectively reviewed demographic information (e.g., age at injury, gender,severity, GCS, coma length, and LOS), medical status, academic and therapy interventions, psychological, emotional and cognitive,physical, social, and family issues reported by parents and clients and outcome data from an adapted version of the Mayo-Portland Adaptability Inventory.In the second year of the study, we prospectively collected in-depth information through the use of new outcome measures, questionnaires and structured interviews. We focused on the relationships between persisting limitations (academic performance, pragmatic communication, social interactions, and physical abilities) and restrictions on participation (i.e., school, social relationships, vocational,and quality of life) of children who are between 3 and 5 years post-injury.     

特质正念与控制点调节日常生活中知觉压力对消极情绪的影响

考察日常生活中知觉压力对消极情绪的动态影响,检验特质正念的调节作用,并进一步探索正念的调节作用是否在不同控制点的个体中存在差异。共有95名在校大学生完成正念注意觉知量表（MAAS）,罗特控制点量表（LOCS）,并通过动态评估的方式,完成每天2次,持续14天的在日常生活情境中针对知觉压力和消极情绪的密集型追踪测量。多层线性模型结果表明：（1）在个体内水平,个体某一时刻的知觉压力可以显著预测个体下一时刻的消极情绪;（2）个体的正念水平越高,日常生活中知觉压力对消极情绪的预测力越低;（3）个体越倾向于内控,日常生活中知觉压力对消极情绪的预测力越低;（4）个体越倾向于外控,正念对日常生活中知觉压力影响消极情绪的调节作用越强。本研究验证了正念对日常生活中压力反应的保护作用,并提示外控者在面临压力时更有可能从正念中获益。