Quality of Life of Individuals with Acquired Brain Injuries

This study investigated the quality of life of individuals with acquired brain injuries (ABI) across a one- to fifteen-year post-injury time span. This allows us to identify the health and service needs of individuals with ABI and provide direction for further improvement. Twenty-nine individuals were invited from the local Self-Help Group for the Brain-Damaged to participate in this study. Four instruments were used to help in the investigation of the subjective components of the quality of life, including the Personal Wellbeing Index (PWI) and Positive and Negative Affect Scales (PANAS). The instruments used were the Modified Barthel Index (MBI) and Lawton Instrumental Activity of Daily Living (IADL) Scale. After analysis of the results and their interpretation, there was no significant difference between the post-injury groups in their scores of negative affect. It is suggested that there should be services, such as psychotherapy, to help reduce the existence of negative moods. Improvement in the IADL aspect should be more focused in future rehabilitation services to allow people to enjoy a fuller life.     

Differential Outcomes of Adolescents with Chronically Ill and Healthy Parents

Approximately 10% of children grow up with a parent who has been diagnosed with a chronic medical condition (CMC) and seem to be at risk for adjustment difficulties. We examined differences in behavioral, psychosocial and academic outcomes between 161 adolescents from 101 families with a chronically ill parent and 112 adolescents from 68 families with healthy parents, accounting for statistical dependence within siblings. Children between 10 and 20 years and their parents were visited at home and filled in questionnaires. Multilevel analyses showed that 20–60% of the variance in most adolescent outcomes was due to the family cluster effect, especially in internalizing problem behavior, caregiving variables and quality of parent attachment. Conversely, the variance in stress and coping variables and grade point average (GPA) was mainly due to individual characteristics. Adolescents with parents affected by CMC displayed more internalizing problems than the comparison group and scored higher on frequency of household chores, caregiving responsibilities, activity restrictions, isolation, daily hassles and stress. In addition, their grade point average was comparatively worse. No group differences in externalizing problems, coping skills and quality of parent attachment were found. In conclusion, the family cluster effect largely explains adolescent outcomes and should be accounted for. Adolescents with parents affected by CMC are subject to an increased risk for internalizing problems, adverse caregiving characteristics, daily hassles, stress and a low GPA. According to a family-centered approach, school counselors and health care practitioners should be alert to adjustment difficulties of children with a chronically ill parent.     

Stigma,Expressed Emotion,and Quality of Life in Caregivers of Individuals with Dementia

Expressed emotion (EE) is a measure of a caregiver's critical and emotionally overinvolved (EOI; e.g., intrusive, self‐sacrificing) attitudes and behaviors toward a person with a mental illness. Mounting evidence indicates that high levels of these critical and EOI attitudes and behaviors (collectively termed high EE) in family members are associated with a poorer course of illness for people with a range of disorders, including dementia (Nomura et al., 2005). However, less is known about factors that might trigger high EE and how high EE might impact dementia caregivers’ own mental health. In this study we propose that caregivers who perceive stigma from their relative's illness may be more likely to be critical or intrusive (high EOI) toward their relative in an attempt to control symptomatic behaviors. We further hypothesized that high EE would partially mediate the link between stigma and quality of life (QoL) as there is some evidence that high EE is associated with poorer mental health in caregivers themselves (Safavi et al., 2015). In line with study hypotheses and using a sample of 106 dementia caregivers, we found that greater caregiver stigma was associated with both high EE (for criticism and EOI) and with poorer QoL. Mediational analyses further confirmed that high EE accounts for much of the association between stigma and poorer QoL. Study results suggest that addressing caregiver stigma in therapy could reduce levels of high EE and indirectly therefore improve caregiver QoL. Intervening directly to reduce high EE could also improve caregiver QoL.     

Current Perspectives Regarding Institutional Conflict of Interest

Science and Engineering Ethics - Policies and processes dealing with institutional conflict of interest (iCOI) lag well behind those dealing with individual COI. To remediate this, academic...     

Obstacle Avoidance Increases Asymmetry of Crossing Step in Individuals With Parkinson's Disease and Neurologically Healthy Individuals

The authors' aim was to investigate gait asymmetry of crossing step during obstacle avoidance while walking in people with Parkinson's disease (PD) under and without the effects of dopaminergic medication. Thirteen individuals with PD and 13 neurologically healthy individuals performed 5 trials of unobstructed gait and 10 trials of obstacle crossing during gait (5 trials with each leg) and spatiotemporal parameters were analyzed. Obstacle crossing increased step duration of the crossing step for the most-affected or nondominant limb compared to the crossing step with the least-affected or dominant limb. Individuals with PD without the effects of medication increased step duration for the step with the least-affected limb compared to the step with the most-affected limb during obstacle crossing.     

Chronically ill and handicapped children and adolescents: Personality studies in relation to disease

Personality was studied in three groups of chronically ill and handicapped children and adolescents and compared to that of healthy control groups. Among physically handicapped children a pattern emerged indicating lack of emotional integration into environment without conflict. Hemophiliacs and diabetics did not differ from controls. However, there were important correlations between personality variables and clinical parameters for all three groups.     

The Longitudinal Relationship Between Satisfaction with Transitional Care and Social and Emotional Quality of Life Among Chronically Ill Adolescents

This study aimed to identify the relationship between satisfaction with transitional care and quality of life of chronically ill adolescents over time. This longitudinal study included adolescents with type I diabetes, juvenile idiopathic arthritis (JIA), and neuromuscular disorders (NMD). At baseline 138 respondents (response rate 31 %) filled in a questionnaire and 188 about 1 year later (response rate 43 %). Analysis of variance showed that adolescents with diabetes reported the highest physical quality of life, followed in order by those with NMD and JIA (p?≤?0.01). Adolescents with diabetes reported the highest social quality of life, followed in order by those with JIA and NMD (both at p?≤?0.001). Univariate analyses showed that satisfaction with transitional care at T0 was significantly related to emotional and physical quality of life at T1 (both at p?≤?0.05). At T1, satisfaction with transitional care was significantly related to the emotional, physical, and social domains of quality of life (all at p?≤?0.001). Multiple regression analyses revealed that satisfaction with transitional care at T1 was related to emotional (β -0.20; p?≤?0.05) and social (β -0.35; p?≤?0.01) quality of life domains over time. This indicates that lower gap scores, which measured differences between ‘best care’ and ‘current care,’ are associated with better social and emotional quality of life in this sample of adolescents. Satisfaction with transitional care and social and emotional quality of life are related over time.     

Exploring Recovery Perspectives in Individuals Diagnosed with Mental Illness

Using a phenomenological research design with a photovoice method, we aimed to understand the lived experience of eight individuals diagnosed with mental illness and identify factors affecting their recovery. We conducted focus group interviews whereby participants discussed their recovery, shared photographs taken of items symbolizing their recovery, and created personalized photobooks or scrapbooks. Data analysis yielded the following themes: (1) caring relationships, (2) leisure and outings, and (3) relaxation, stress reduction, and coping. Findings revealed factors influencing recovery from mental illness and can be used to develop person-centered and occupation-based interventions to promote recovery in clients with mental health issues.     

Views on Quality of Life Differ Between Alcohol Related Brain Damaged Individuals and Their Healthcare Professionals

Measuring quality of life (QoL) in alcohol related brain damaged individuals (ARBDs) is challenging, mostly because patients are characterized by important cognitive impairments and are generally unaware of their defects. However, quality of life assessments are essential to help inform care and rehabilitative settings; thus introducing and including views from healthcare professionals on ARBDs’ quality of life is a reasonable approach. We examine QoL and the perception of cognitive defects among ARBDs and compare them to expert appraisals by acquainted healthcare professionals. We hypothesize that ARBDs self-assessments outscore QoL expert-ratings by professionals and demonstrate an unawareness of their cognitive deficits, with anosognosia being related to the QoL domains of interest. Six domains of QoL and the occurrence of cognitive problems in 14 detoxified alcoholics are investigated by means of self-ratings and expert-ratings from two acquainted healthcare professionals. Anosognosia is assessed by using difference scores between self- and expert-ratings on the manifestation of everyday executive dysfunctions. We find that ARBDs experience anosognosia (ps?<?.001) and outscore systematically expert-ratings on the investigated QoL domains (ps?<?.03). Complex patterns of relationships between self-/expert-rated QoL relate mostly negatively and moderately with anosognosia, confirming some of our assumptions and informing others. ARBDs are characterized by anosognosia and differ largely from expert’s views on patient QoL. Professionals relate compromised patient QoL to the inability of the patient to have insight of his/her dysfunctions; whereas among patients, QoL relates less strongly to anosognosia. Remaining doubts on the validity of QoL self-/expert-ratings in ARBDs are discussed.     

Assessment of Identity and Quality of Life in Diabetic and Renal Transplant Adolescents in Comparison to Healthy Adolescents

Identity development represents a central task of adolescence. Identity achievement is characterized by a coherent sense of who one is following a period of exploration and can help navigate the challenges of adulthood. This study examined identity within a quality of life (QOL) context in 85 adolescents with a renal transplant or with Type 1 diabetes in comparison to 90 healthy controls. Results revealed significant differences in ideological identity, with patients showing higher levels of diffusion and controls showing higher levels of foreclosure. No differences with respect to interpersonal identity, QOL, perceived control over the QOL domains, and perceived opportunities for growth and development were found. Future research should assess identity and QOL over a longer period of time to determine whether differences between chronically ill and healthy young adults can be detected.     

Domain Compensation in Quality of Life of Individuals with Vasovagal Syncope: a Test of Homeostasis Theory

Although health-related quality of life is often diminished in populations characterised by physical illness, this does not necessarily imply lower overall assessments of general life satisfaction (GLS) and greater incidence of mental illness. According to Homeostasis Theory, this limited impact of health on these more global wellbeing indices may be due to internal and external buffers that serve to maintain one’s overall sense of wellbeing and GLS in the face of adversity. Thus, the present study tested in a sample of 212 individuals (48 with vasovagal syncope, 62 cardiac patients, and 102 healthy control participants) the possibility that poor health-related quality of life (as expected for the cardiac and vasovagal syncope groups) may be offset by relatively higher satisfaction with other aspects of one’s life (the domain compensation hypothesis). Consistent with this view, present findings showed that although individuals in the two health-risk groups reported lower health satisfaction (HSat) than the control group, they had comparable levels of mental health, GLS satisfaction, and subjective wellbeing (minus health; PWI-H). Moreover, moderation analyses confirmed that the relationship between HSat and GLS reduced to non-significance for individuals with PWI-H higher than nationally representative, normative levels. Collectively, these findings suggest that a broader context is necessary to understand the impact that illness may have on one’s sense of GLS and mental health. In particular, the provision of support and satisfaction with other life domains may serve to buffer concerns about one’s health.     

Psychosocial Factors Associated with Quality of Life Among Individuals Attending Genetic Counseling for Hereditary Cancer

The aim of this multicenter study was to explore associations between psychosocial factors (general self-efficacy, perceived availability of social support, cancer-related distress) and health-related quality of life, among individuals at risk for hereditary cancer. One-hundred and twenty one participants with a family history of breast-cancer or colorectal cancer answered a questionnaire 2-4 weeks prior to genetic counseling. The two dimensions of the health-related quality of life measure, mental and physical health were both used as outcome variables. Multiple regression (linear) analyses revealed that increasing degrees of cancer-related distress was related to decreasing degrees of mental health whereas increasing degrees of self-efficacy and social support were related to increasing degrees of this outcome variable. Self-efficacy, self-esteem support and tangible aid seemed to moderate the relationship between cancer-related distress and mental health. These results suggest that self-efficacy and certain resources of social support buffer the negative association between cancer-related distress and mental health, and might be suitable for interventional efforts. Implications for genetic counseling practice are discussed.     

Relationship Quality among Chronically Ill Children and their Parents

The present study examined the quality of parent–child relationships as reported by 383 parents of chronically ill children. The medical condition category, child’s mobility, education type and childcare assistance were examined. Parents answered the Parent–Child Relationship Inventory (PCRI). In addition, 45 parents of chronically ill children were interviewed. The results indicated a significant difference in most aspects of the PCRI (limit setting, promotion of autonomy, communication, satisfaction and involvement) across medical condition categories. Further child variables (mobility, assistance and education type) had an effect on the PCRI subscales as well. Interview analysis revealed a difference in the reported quality of parent–child relationships between medical conditions categories. Parents of mentally ill children primarily felt anger and guilt in their relationship with their ill children, whereas parents of children with cancer and autoimmune disease primarily felt depressed. Our results suggest the need for further study of parent–child relationships in and between different chronic childhood medical conditions in an attempt to address parents’ and children’s needs in an optimal way.     

Perfectionism and Life Aspirations in Intrinsically and Extrinsically Religious Individuals

Religiosity is related to positive health and life satisfaction but the pathways through which this occurs have not been clearly delineated. The purpose of this study was to examine potential mediators of the relationships between intrinsic and extrinsic religiosity and negative affect and life satisfaction. Perfectionism and life aspirations are two possible pathways through which religious orientation is related to outcome. It was hypothesized that adaptive perfectionism and intrinsic life aspirations would act as mediators between intrinsic religiosity and negative affect and life satisfaction, and that maladaptive perfectionism and extrinsic life aspirations would act as mediators between the extrinsic religiosity and negative affect and life satisfaction. Two consecutive samples of religious college students (N = 540 and N = 485) completed measures of the Age Universal Religious Orientation Index, the Frost Multi-Dimensional Perfectionism Scale, the Aspiration Index, the Beck Depression Inventory-II, the Spielberger State-Trait Anxiety Inventory, and the Satisfaction with Life Scale. Intrinsic religiosity had a direct negative relationship with negative affect and positive relationship with life satisfaction. Contrary to the hypotheses, intrinsic religiosity had its strongest indirect effect via maladaptive perfectionism such that increased intrinsic religiosity was related to decreased maladaptive perfectionism which in turn lead to better negative affect and life satisfaction. Extrinsic religiosity was related to increased maladaptive perfectionism and thereby indirectly contributed to worse negative affect and life satisfaction. Interestingly, when the effects of maladaptive perfectionism were controlled, the direct effects of extrinsic religiosity were related to reduced negative affect and increased life satisfaction. Overall, the strongest mediator in this study of both intrinsic and extrinsic religiosity was maladaptive perfectionism, with intrinsic religiosity related to decreased maladaptive perfectionism and extrinsic religiosity related to increased maladaptive perfectionism.     

Internal and External Shame in Healthy and Chronically Ill Samples: Exploring Links to Psychological Health

Journal of Clinical Psychology in Medical Settings - This study aimed to examine the role of decentering and committed action as mediators of the link of external and internal shame with...     

Infant Socioeconomic Position and Quality of Life in Midlife: A 50-Year Follow-Up Study of 2079 Individuals in Denmark

Applied Research in Quality of Life - During the last decades, an important line of public health research has focused on the influence of socioeconomic position (SEP) on the quality of life (QoL)...     

Quality of Life of HIV-Infected People Across Different Stages of Infection

Quality of life is an important component in the evaluation of the well-being of HIV-infected patients. In the present study, an attempt has been made to compare HIV-infected patients across the three stages namely, asymptomatic, symptomatic, and AIDS-related conditions. This is a cross-sectional study. For this study, a total number of 90 subjects, 30 each in asymptomatic, symptomatic, and AIDS-related conditions, were taken. The study population consisted of HIV positive individual already enrolled in Voluntary Counseling and Testing Center, Institute of Medical Science, Banaras Hindu University, Varanasi, India. The WHOQOL-HIV BREF was used to assess quality of life across the group of patients. One-way analysis of variance was performed to find out significant difference between the clinical categories. On average AIDS patients experienced significantly poorer quality of life in all the six domains, namely physical (M = 7.87, SD = 1.83), psychological (M = 8.50, SD = 1.54), level of independence (M = 8.57, SD = 1.59), social relation (M = 9.17, SD = 2.59), environment (M = 8.78, SD = 1.50), and spirituality/religion/personal belief (M = 6.93, SD = 1.26) to symptomatic and asymptomatic HIV-infected people (p = .000). Result suggested that there is an inverse relationship between quality of life and different stages of HIV infection.     

Memory Scanning Performance in Healthy Young Adults,Healthy Older Adults,and Individuals with Dementia of the Alzheimer Type

A memory scanning (Sternberg, 1966, 1975) task was administered to healthy young adults, older adults, and two groups of individuals with dementia of the Alzheimer's type (DAT) to determine age- and disease-related changes in the retrieval of information from short-term memory. Healthy older adults, in comparison to healthy young adults, displayed increases in both slopes and intercepts in memory scanning. Individuals at various stages of DAT (very mild, mild, moderate) displayed increases in both slopes and intercepts compared to nondemented age-matched control individuals. There was also some evidence that DAT individuals are more likely to engage in a self-terminating search instead of an exhaustive search of short-term memory.