Measuring functional skills in preschool children at risk for neurodevelopmental disabilities

Approximately 400,000 preschool children have a major neurodevelopmental disorder impacting on mobility, cognitive-adaptive, or communicative skills. As many as 1 in 3 children live at psychosocial disadvantage because of poverty, parental mental illness or substance misuse, or low parental educational (i.e. less than high school). In the past decade over 500,000 preschool children have survived being born with very low birth weight (1001-1500 g) or extremely low birth weight status (< or =1000 g). Given the scope of these risks and the importance of optimizing outcomes for vulnerable children, this review will highlight advances in functional assessment using adaptive and multiattribute health-related quality of life measures. A framework based on the International Classification of Functioning, (ICF) World Health Organization and the Dynamic Kaleidoscope Model of the Institute of Medicine (IOM) will be described and illustrated with examples of children receiving new biomedical technologies. Assessment scales were chosen for review if they measured adaptive skills or multiattribute health status and had been used in child disability populations. Instruments reviewed include the Infant and Toddler Quality of Life Questionnaire (ITQOL), The Netherlands Office of Prevention Assessment of Preschool Quality of Life (TAPQOL), the Health Status Classification System-PreSchool (HSCS-PS), the Pediatric Evaluation of Disability Inventory (PEDI), the Vineland Adaptive Behavior Scale (VABS), the Warner Inventory of Developmental and Emerging Adaptive and Functional Skills (Warner IDEA-FS), the Scales of Independent Behavior Revised (SIB-R) Early Development Form, the Pediatric Functional Independence Measure (WeeFIM), and the Pediatric Quality of Life Inventory Version 4 (PedsQL 4.0). By measuring functional and adaptive skills and health-related quality of life, we can help devise intervention strategies that optimize developmental independence, family supports, and community participation among children who are at risk for neurodevelopmental disabilities or who have evolving established neurodevelopmental disabilities.     

Pilot study of hormone replacement therapy and menopausal symptoms, depression, and quality of life in Korean climacteric women

This cross-sectional survey compared scores on the Menopausal Symptoms Index, Depression, and the Quality of Life for 65 Korean climacteric women receiving regular hormone replacement therapy (M age=52.8 yr., SD=6.3) and 70 Korean climacteric patients not receiving such therapy (M age =51.6 yr., SD=7.1). Depression scores were positively correlated with the Menopausal Symptoms Index in both groups (r = .58 in the Therapy group and r = .50 in the Control group) and negatively correlated with scores for Quality of Life (r = -.48 in the Therapy group and r = -.68 in the Control group). Scores on the Menopausal Symptoms Index were negatively correlated with ratings of Quality of Life in both groups (r = -.53 in the Therapy group and r = -.45 in the Control group). These results suggest that hormone replacement therapy is associated with reduced Depression scores and higher Quality of Life scores in this sample of Korean climacteric women.     

Subjective and objective measures of quality of life have different predictors for people with schizophrenia

This study investigated the relationship between subjective and objective quality of life and assessed predictors in people with schizophrenia. The study population consisted of 99 stabilized outpatients with schizophrenia (DSM-IV) who had been regularly receiving outpatient treatment at the Department of Psychiatry, The Tokushima University Hospital. Subjective and objective quality of life were estimated using the Schizophrenia Quality of Life Scale and the Quality of Life Scale, respectively. Psychiatric symptoms were also measured with the Brief Psychiatric Rating Scale and the Calgary Depression Scale for Schizophrenia. Scores on the Schizophrenia Quality of Life Scale Motivation and Energy scales significantly correlated with the Quality of Life Scale total scores -.40 (p <.001), and with the scores on Interpersonal Relations subscale -.42 (p <.001), Instrumental Role subscale -.28 (p = .005), Intrapsychic Foundations subscale -.39 (p<.001), and Common Objects and Activities subscale -.25 (p =.014). The Schizophrenia Quality of Life Scale Psychosocial scale significantly correlated with only the Quality of Life Scale total score -.20 (p =.05), and there was no significant correlation between the scores on the Schizophrenia Quality of Life Scale Symptoms and Side-effects scales and the Quality of Life Scale. Stepwise regression analyses showed that the Calgary Depression Scale for Schizophrenia score was the most important predictor of each scale of the Schizophrenia Quality of Life Scale, and the Brief Psychiatric Rating Scale Negative Symptoms score was the most important predictor of the Quality of Life Scale total score and each subscale. These results suggest that subjective and objective quality of life have different predictors and should be considered as separate and complementary outcome variables.     

Quality of life before and after lung transplantation in patients with emphysema versus other indications

Whether lung transplantation improves Health-related Quality of Life in patients with emphysema and other end-stage lung diseases before and after lung transplantation was examined. Between 1992 and 1999, 23 patients with emphysema and 19 patients with other indications completed self-administered questionnaires before lung transplantation, and at 4, 7, 13, and 25 mo. after transplantation. The questionnaire included the Nottingham Health Profile, the State-Trait Anxiety Inventory, the Self-rating Depression Scale, the Index of Well-being, the self-report Karnofsky Index, and four respiratory-specific questions. Neither before nor after transplantation were significant differences found on most dimensions of Health-related Quality of Life between patients with emphysema and other indications. Before transplantation, both groups report major restrictions on the dimensions Energy and Mobility of the Nottingham Health Profile, low experienced well-being, depressive symptoms, and high dyspnea. About 4 mo. after transplantation, most Health-related Quality of Life measures improved significantly in both groups. These improvements were maintained in the following 21 mo.     

Comparing Quality of Life Instruments in a Population of Abused Women

The SF-36 Health Survey and the WHO Quality of Life Index—BREF (WHOQOL-BREF) were used to study quality of life among women who had experienced intimate partner violence (IPV). The aim was to determine how these instruments correlated with each other and with physical and psychological IPV, in order to find the best instrument to use. IPV was measured using the Severity of Violence against Women Scale (SVAWS) and the Psychological Maltreatment of Women Index (PMWI). A self-administrated questionnaire was given to women able to understand Norwegian who were staying at a women’s shelter in Norway for more than 1 week. 87 of 212 women asked to participate completed the questionnaire. The physical acts of violence in SVAWS correlated significantly (P<0.001) with both the general health and bodily pain dimensions in SF-36 and global overall health (OH) in WHOQOL-BREF. Most correlations between WHOQOL-BREF and SF-36 were moderate. The WHOQOL-BREF domains explained 46% of the variance in OH and 40% of the variance in the global overall quality of life (OQOL). The SF-36 domains explained 66% of the variance in OH and 27% of OQOL. The mean WHOQOL-BREF and SF-36 scores were all low. The SF-36 correlated better with physical and psychological IPV in this population than the WHOQOL-BREF. The significant correlations between the OH, general health and bodily pain domains and acts of violence show the importance of including questions concerning bodily symptoms in determining the quality of life in a population of abused women.     

Psychometric Properties of the WHOQOL-BREF Questionnaire among Disabled Students in Malaysian Higher Learning Institutions

This study aims to evaluate reliability, internal consistency and dimensional structure of the World Health Organization Quality of Life (WHOQOL-BREF) among disabled students. The study covers 127 disabled students studying in public universities, 26 in private universities, 109 in polytechnic and 19 studying in community colleges. The World Health Organization Quality of Life Abbreviation (WHOQOL-BREF) has been used to assess QOL. The reliability and validity of the questionnaire were evaluated by Cronbach’s alpha (α) and Pearson’s correlation coefficients. Alpha scores greater than or equal to 0.6 are considered to denote acceptable and adequate internal consistency. Correlation matrix also showed satisfactory results in all domains. Factor analysis was carried out using the principal components method with varimax rotation to examine the dimensional structure of the questionnaire. This study has provided some preliminary evidence of the reliability and validity of the WHOQOL-BREF to be used for evaluating quality of life among disabled students.     

The effect of job quality on quality of life and wellbeing in later career stages: A multilevel and longitudinal analysis on older workers in Europe

Applied Research in Quality of Life - This paper uses data from four waves of the Survey of Health, Ageing and Retirement in Europe (SHARE) and investigates the effect of job quality on CASP-12,...     

Reliability,Validity and Measurement Invariance of the WHO’s Quality of Life Scale among Women of Reproductive Age Living with HIV in Ethiopia - a Quasi-Experimental Study

Applied Research in Quality of Life - Despite its widespread global adoption and use, studies have not examined measurement invariance of the 31-question World Health Organization Quality of...     

Posttraumatic Growth, Posttraumatic Stress Symptoms and Mental Health Among Coronary Heart Disease Survivors

The present study aimed to estimate posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG) among heart disease survivors and examine whether PTG moderates the association between PTSS and mental health. Data from 82 myocardial infarction and acute coronary artery bypass graft survivors (aged 46–82) was obtained at admission to a cardiac rehabilitation unit. Mental status was assessed by the PTSD Inventory, Posttraumatic Growth Inventory (PTGI), Mental Health Inventory and Health Related Quality of Life (HRQOL). 17.1 % of the participants suffered significantly from PTSS and most of the study sample (71.2 %) reported PTG. PTSS were positively associated with PTG and psychological distress and negatively with well-being and HRQOL. PTG moderated the association between PTSS and most mental health outcomes. We conclude that posttraumatic growth may attenuate the negative effect of posttraumatic stress symptoms on mental health.     

Exposure to domestic violence and identity development among adolescent university students in South Africa

This study examined the relationship between exposure to domestic violence and identity development in a sample of 108 undergraduate students with an average age of 18.7 yr. from University of Limpopo in South Africa. There were more women (n = 64; 58.7%) in the study than men (n = 45; 41.3%). Participants were classified into high and low domestic violence exposure groups on the basis of a median split in physical violence scores from the Child Exposure to Domestic Violence Scale (CEDV). Exposure was then compared with identity development as measured by the Ochse and Plug Erikson scale. The results indicated a significant mean difference between the two groups on identity development. Furthermore, exposure to domestic violence was significantly associated with lower scores for identity development as represented by subscales measuring trust, autonomy, initiative and other Eriksonian constructs. Implications and limitations of the study are discussed.     

Validation of a single-item measure of usual physical activity

The purpose of this study was to assess the reliability and validity of a single-item measure of Usual Physical Activity and to assess its usefulness as a physical activity tool for perimenopausal women. 188 perimenopausal women participated (age: M = 47 yr., SD = 3; range = 40-55). Data were collected using the Women's Health Assessment Scale, the Physical Activity Questionnaire, the Perimenopause-related Quality of Life Scale, a health history and demographic questionnaire, and the rater. Scores were stable over a 2-wk. interval. Convergent validity was supported by a correlation of .66 between ratings on Usual Physical Activity and the Physical Activity Questionnaire. Concurrent validity was supported by the association of the rating of Usual Physical Activity with three parameters of Body Mass Index, psychosomatic symptoms, and perimenopause related quality of life, known to be associated with physical activity. Highly active women had a lower Body Mass Index than less active and inactive women. Active women tended to report fewer and less distressing psychosomatic symptoms and better quality of life. These findings support the use of rating of Usual Physical Activity to classify perimenopausal women into categories of physical activity.     

A review of: “Quality of life and mental health services”

Joseph Oliver, Peter Huxley, Keith Bridges and Hadi Mohamad (1996) Quality of Life and Mental Health Services, London: Routledge, $16.99 (pb)     

Are life satisfaction and self-esteem distinct constructs? A black South African perspective

As part of a longitudinal project on Quality of Life, a study was undertaken to extend the applicability of the 5-item Satisfaction With Life Scale, developed in the USA, in South Africa. Data on basic sociodemographic characteristics, the scale, and the 10-item Rosenberg Self-esteem scale were available for 360 Black South Africans (151 men and 209 women), ages 21 to 83 years (M = 38.6 yr., SD = 10.3). Factor analysis applied to scale scores gave two factors, accounting for 71% of the variance. Factor I was loaded by 10 Self-esteem items and Factor II by four of the five Life Satisfaction items. Coefficient alpha was .77 for the Satisfaction With Life Scale and .97 for the Rosenberg Self-esteem Scale. Life Satisfaction was related to Self-esteem (r = .17, p < .01). It was concluded that Life Satisfaction and Self-esteem appear to be distinct, unitary constructs, but responses to Item 5 on the Satisfaction With Life Scale require cautious interpretation and may contribute to the weak r, although so may the collectivist culture of Black South Africans.     

A Path Model of Meaning in Life among University Students: The Roles of Gratitude,Self-Concept Clarity and Self-Construal

Applied Research in Quality of Life - The current study aimed to investigate the relationships between meaning in life (presence of meaning, search for meaning), self-construal (integration,...     

Psychological Well-Being and Health Related Quality of Life among a Group of Low-Income Women Living with HIV/AIDS in South Africa

This study documented the relationships among biomedical factors, psychosocial factors, health related quality of life (HRQOL) and suicidality in respect of HIV positive women in KwaZulu-Natal. One hundred and thirty three (133) women over the age of 18 years (mean age 32.96 yrs; SD = 7.28) participated in the study. Participants completed a Suicidality Measure (SM: Sheebhan, Janavs, Amorim, Janavs, Weiller, Hergueta, Baker & Dunbar, 1998), Multidimensional Scale of Perceived Social Support (MPSS: Zimet, Dahlem, Zimet & Farley, 1988) and the Health Related Quality of Life Survey—SF-36 (Ware, Kosinski & Dewey, 2002). Information on social/contextual variables including income, marital status, employment status, number of children was obtained. Participants completed two biomedical measures, CD4 count and time since diagnosis information. The findings revealed a compromised level of HRQOL in the participants. After controlling for biomedical factors, psychosocial measures did not explain differences in quality of life. Perceived social support was inversely related to suicidality. Newly diagnosed patients were less likely to think of suicide as an option.     

The role of social desirability, negative affectivity, and female reproductive system symptoms in differences in reporting symptoms by men and women

52 women and 38 men completed the Inventory of Health Status, Version 2, a measure of somatic health, and the Cornell Medical Index which provided separate scores for somatic and emotional health. The Personal Style Inventory was given, from which measures of Social Desirability and Negative Affectivity were utilized. Multiple regressions were done separately with scores on the Inventory of Health Status and the Cornell Emotional component, and scores on Social Desirability, Negative Affectivity, and sex as predictors. Scores on Social Desirability and Negative Affectivity were forced into the equation first. For the Inventory of Health Status, sex alone contributed significantly to the final equation. For scores on the Cornell Index's emotional component both sex and scores on negative affectivity had significant beta weights. Analysis of items from the Inventory of Health Status was done to examine the role of symptoms pertaining to women's reproductive system, and almost all the items that differed by sex were either clearly or possibly specific female reproductive items, e.g., "Abnormal menstruation." Similar analyses were not possible for the organic component of the Cornell Index, which has different items for reproductive systems of men and women. The complexity of the female reproductive system may play a central role in sex differences in symptom reporting and perhaps of emotional distress, but other interpretations are discussed.     

Quality of life and family functioning in schizophrenia patients

Quality of life and family functioning of patients with schizophrenia are described. A sample of 49 schizophrenic patients and their 70 relatives, treated at the Mental Health Services of Arica, Chile, were included in the study. The Quality of Life Questionnaire of Sevilla (CSCV), the General Health Questionnaire (GHQ-12) and the Family Function Questionnaire (APGAR) were used to assess the patients, the last one also administered to their caregivers. Contrary to the results found in researches done in developed countries, the patients of this sample indicated suitable levels of quality of life, to a great extent, related to the perception of their family functioning. This confirms the importance of the family as social network of emotional support. Nevertheless, perceived family functioning is different in patients and their caregivers. Higher scores were obtained in caregivers who participated in a family psychoeducational program. The conclusion reached was that there are differences in the levels of quality of life perceived by patients of developed countries and those of developing countries, being higher in the latter ones, despite limitations in economic, sanitary and community resources. Future research should study why the variables that explain these levels of quality of life differ.     

Differential Influence of Social Support in Emerging Adulthood Across Sources of Support and Profiles of Interpersonal and Non-Interpersonal Potentially Traumatic Experiences

Social support is protective against the negative effects of trauma, yet how these effects vary across sources of support and patterns of trauma exposure has not been examined. High co-occurrence exists among different types of trauma across domains and ages, yielding patterns of trauma exposure that may affect social support. This study identified profiles of potentially traumatic events (PTEs) experienced by 252 college students and examined the relationships between social support and mental health across these profiles. Five profiles emerged: “Non-Interpersonal Trauma Exposure,” “Adult Intimate Partner Violence,” “Poly-trauma Exposure,” “Low Trauma Exposure,” and “Childhood Family Violence.” The link between social support and adjustment differed across profiles. Family support was valuable for promoting resilience across patterns of PTEs. Friend and romantic partner support were related to lower mental health problems. Support from family and friends is particularly valuable in the context of adult intimate partner violence and childhood family violence.     

Different Perspectives Regarding Quality of Life in Chronically ill and Healthy Individuals

The areas that were suggested as most important with regard to Quality of Life (QoL) were examined in groups of individuals who were healthy, and those with a chronic condition. An electronic survey was completed by 892 participants (261 healthy and 631 with a chronic condition). They answered three questions relating to QoL: what is most important to you; what areas most impact your QoL; and an open question what does QoL mean to you. Across the three questions both groups highlighted physical functioning, independence and mobility as key areas for QoL. However, the group with a chronic condition tended to find issues of functioning such as pain, fatigue, and sleep as more important to their QoL than the healthy participants. In contrast, the healthy participants tended to note the importance of relationships and family as more important than the group with a chronic condition. That there were such differences between the groups might suggest that different aspects of QoL could be rated as more important when examining this issue with samples with a chronic condition and those without such a condition.     

Do Involuntary Longer Working Careers Reduce Well-being?

Applied Research in Quality of Life - This study examines the impact of working at older age on the individual’s overall well-being. The paper uses microdata from the Survey of Health, Aging...