Quality of life in patients before and after kidney transplantation

Abstract

The aim of the present study was to differentially determine quality of life (QOL) in patients with end-stage renal disease (ESRD) after successful kidney transplantation (RT, Group A) compared with ESRD patients on a waiting list for RT (Group B). and with healthy controls (Group C) because opinions vary as to which treatment modality can best assure ESRD patients a high QOL.

Groups A, B and C each consisted of 149 persons, matched for age and gender. The Munich Quality of Life Dimensions List (MLDL) was used to measure global aspects of QOL. Distinct aspects of QOL were investigated by the Brief Symptom Inventory (BSI) and the Questionnaire for Social Support (K-22).

Groups A and C reported similar QOL. Which was significantly higher than in group B (p < .0001). This was particularly true for the physical and psychological status and daily activities, but not for the social situation. Groups A and B reported similar social support, which was significantly, lower than in group C (p < 006). Both ESRD groups reported higher satisfaction with social support than healthy controls (p < .0001).

Successful RT nor only improved distinct aspects of QOL in patients with ESRD, but even put them on par with healthy controls regarding physical and psychological QOL.

Lower social support and higher satisfaction with social support in both groups of ESRD patients should be evaluated further. From a clinical viewpoint. the improvement of physical and psychological aspects of QOL in RT patients is impressive; but more attention should be paid to constantly low social support in this group of patients. International multi center longitudinal studies to investigate QOL in ESRD patients under different treatments am necessary.     

离退休与在职人员生命质量的比较研究

为了寻找离退休人员生命质量 (QOL)影响因素 ,指导有限资源投入 ,本研究以问卷形式对该单位 1 4 2名离退休人员、66名在职人员随遇抽样调查。从物质生活状态、躯体功能、心理功能和社会功能四个方面对其QOL进行了多维评估研究。结果显示 :①该单位离退休人员QOL与在职人员有明显差异 ,其中离退休人员QOL总评、躯体、心理、社会功能评分等均低于在职人员 ;②躯体功能与离退休人员年龄呈负相关性趋势 ,其他维度与年龄相关性不显著。因此 ,离退休人员QOL总体上低于在职人员 ,因子、维度及QOL总评之间的相关性也有其特点 ,且年龄不是差异的决定因素 ,应通过改善主导需要的相关因子等手段提高离退休人员QOL ,为全社会的可持续发展服务。     

The refractory headache patient--I. Chronic, daily, high intensity headache

Two studies on patients with Chronic, Daily, High Intensity Headache (CDHIHA) are presented. In the first, their response to various self-regulatory (biofeedback, relaxation) treatments was compared to that of case controls matched for age, duration and Ad Hoc Committee diagnoses who had 1-2 headache-free days per week (Group II) and 3-5 headache-free days per week (Group III). The CDHIHA patients had a significantly poorer response to treatment (12.7 vs 49.8% improvement for Groups II and III combined). In the second study, the psychological profiles of an enlarged sample of CDHIHA patients were compared to matched case controls from Group II and Group III. The CDHIHA patients tended to be more anxious, more hysterical and to have more non-headache somatic complaints than Groups II and III combined.     

A Comparison of Mood and Quality of Life Among People with Progressive Neurological Illnesses and Their Caregivers

The current study was designed to investigate differences in mood and a range of QOL domains among 423 patients and 335 caregivers of people with motor neurone disease (MND), Huntington’s disease (HD), Parkinson’s, and multiple sclerosis (MS). Patients and caregivers completed an anonymous questionnaire that evaluated their mood (anxiety, depression, fatigue, confusion) and QOL (physical, psychological, social, environment). The results demonstrated that caregivers of people with MND and HD experienced most problems with their mood and QOL compared to caregivers of people in the other illness groups. There were few differences in mood or QOL between patients and caregivers. Patients generally showed greater confusion, physical impairment, and psychological maladjustment. The findings suggest that educational and intervention programs need to be developed to help both patients and their caregivers to adjust and cope with these illnesses, particularly caregivers of people with MND and HD.     

Positive and problematic support,stress and quality of life in patients with systemic lupus erythematosus

Background and Objectives: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease. Previous studies showed that perceived social support has an important role in enhancing patient's quality of life (QOL). However, the precise mechanisms through which social support exerts such an effect are not completely understood. The aim of this paper is to test two alternative models explaining the relationship between social support (positive and problematic) and two dimensions of QOL: Health-Related (HR-QOL) and Non-Health-Related (NHR-QOL). Design: Model A (mediation) hypothesized that positive support would reduce stress while problematic support would increase stress), and that this in turn would reduce QOL. Model B (moderation) hypothesized that the effect of support on QOL would be moderated by the experience of stress in that more stressed individuals would show stronger effects. Methods: Three hundred and forty-four Italian patients with SLE completed an online questionnaire. Results: Stress partially mediated the relationship between support and QOL dimensions (either HR-QOL and NHR-QOL) thus supporting Model B. As hypothesized, positive support reduced stress, while problematic support increased stress. Conclusions: These findings help to explain the complex relationship between social support, stress and QOL in patients with SLE.     

Risk factors associated with suicide attempts and other self-injury among Hong Kong adolescents

This study examined 1,361 Chinese adolescents who reported self-injurious behaviors. Groups A and B both acknowledged deliberate self-injury, but only Group A had made a suicide attempt. Group C reported accidental self-injury. Deliberate self-injurers (Groups A and B) were more frequently girls, older, and with more suicidal ideation. Group A had more psychopathology, environmental and suicide-related risk factors than group B and C. Group C had higher depressive symptoms than noninjured controls. The study clarifies differences among self-injurious behavior groups based on expressed deliberate self-injury and self-reported suicide attempt. These three groups appear to present a continuum of risk.     

A Longitudinal Study of Coping Strategies and Quality of Life Among People with Multiple Sclerosis

The current study was designed to examine the role of coping strategies on quality of life (QOL) of people with multiple sclerosis (MS) over a period of 12 months. Respondents were 321 people with MS and 239 people from the general population who completed measures of QOL on two occasions, 12 months apart. People with MS also completed measures of how they coped with their illness. The results demonstrated that people with MS experienced lower levels of QOL at both points in time. For people with MS, QOL domains strongly predicted other QOL domains at both time 1 and time 2. The coping strategies of social support, focusing on the positive and wishful thinking were consistent predictors of physical QOL, psychological QOL, social QOL and environmental QOL. These findings indicate that coping strategies play an important role in predicting the QOL of people with MS.     

Quality of Life in Gulf War Veterans: the Influence of Recency and Persistence of Psychiatric Morbidity

Important contributors to quality of life (QOL), such as psychosocial factors, have received limited exploration in veteran populations, in contrast to a significant amount of research focused on health-related quality of life (HRQL). This study investigated QOL and HRQL amongst Gulf War veterans compared with an era-military comparison group 20 years after the 1990/91 Gulf War, and whether psychiatric status over time and psychiatric comorbidities predicted QOL and HRQL. We then investigated which of a range of psychological health, physical health and social factors contribute greatest to QOL. Psychological interviews and postal questionnaires were administered to a cohort of Gulf War veterans and a military-era comparison group in 2000–02 and 2011–12. Gulf War veterans had poorer QOL and HRQL compared with a military comparison group, but the pattern of factors that influenced QOL was the same for both groups. Poorer QOL and HRQL were significantly associated with more recent and persistent psychiatric morbidity over time. Further analyses showed that affective disorders, followed by anxiety disorders had the largest impact on QOL and HRQL, and that QOL and HRQL were negatively affected by each additional psychiatric diagnosis. The importance of these findings was highlighted in a structural equation model that revealed psychological health contributed most to QOL, social support contributed a moderate amount, but physical health contributed only a very small amount. QOL in veterans is an important issue even many years after deployment and psychological health plays a predominant role in QOL.

     

The dermatology life quality index (DLQI) and the hospital anxiety and depression (HADS) in Chinese rosacea patients

The study aims to investigate the quality of life (QOL) and the psychological situation in Chinese patients with rosacea. A total of 196 healthy controls and 201 rosacea patients were involved in the final analysis. The general information, the Dermatology Life Quality Index (DLQI) and the Hospital Anxiety and Depression Scale (HADS) were collected. Significantly higher DLQI, anxiety and depression score were observed in the rosacea group compared to the control group (p < .01). Total DLQI score of patients was positively related with anxiety (r = .526, p < .001) and depression scores (r = .399, p < .001) in HADS. Rosacea had significant psychological impact on Chinese patients and had substantial influence on their QOL. Physicians should address the psychosocial needs of rosacea patients as much as its physical symptoms.     

Quality of Life and Multiple Sclerosis: Comparison Between People with Multiple Sclerosis and People from the General Population

This paper evaluated the quality of life (QOL) of people with multiple sclerosis (MS) and people from the general population. Gender differences between the 2 groups of respondents and the influence of coping style on adjustment were also evaluated. The participants were 381 (144 males, 237 females) people with MS, and 291 (101 males, 190 females) people from the general population. The results demonstrated that people with MS experienced lower levels of QOL than people from the general population for both the objective and subjective dimensions of all domains (physical health, psychological adjustment, social relationships, environmental adjustment). All coping strategies (problem-focused, focusing on the positive, detachment, wishful thinking, seeking social support) were important predictors of QOL for both males and females with MS, with wishful thinking being the strongest predictor of poor QOL. These results are discussed in terms of the various factors that impact on QOL among people with MS, and the types of coping strategies that are most adaptive in improving the QOL of people with this illness.     

Quality of life and mental health among women with ovarian cancer: examining the role of emotional and instrumental social support seeking

The purpose of the present study was to examine the role of emotional and instrumental social support seeking in the quality of life (QOL) and mental health of women with ovarian cancer. Participants were recruited through the Pennsylvania Cancer Registry, and one hundred women took part in a mail questionnaire that collected information on their demographics, medical status, social support seeking, QOL and mental health including anxiety, depression and stress. Hierarchical linear regression analyses were conducted to assess the influence of emotional and instrumental social support seeking on QOL and mental health. After controlling for remission status, greater emotional social support seeking was predictive of higher overall QOL, social/family QOL, functional QOL and lower depression scores. Instrumental social support seeking was not significant in the models. The results illustrate that social support seeking as a coping mechanism is an important consideration in the QOL and mental health of women with ovarian cancer. Future studies should examine the psychological and behavioral mediators of the relationship to further understand the QOL and mental health of women with ovarian cancer.     

Different Associations of Health Related Quality of Life with Pain,Psychological Distress and Coping Strategies in Patients with Irritable Bowel Syndrome and Inflammatory Bowel Disorder

The primary aim of this study was to measure psychological distress, pain severity, health related quality of life (QOL) and pain coping strategies in patients with irritable bowel syndrome (IBS) and ulcerative colitis (UC). A second aim was to determine the influence of somatic and psychological variables on health related QOL. Eighty-eight IBS and 66 UC patients completed the Irritable Bowel Syndrome Quality of Life Questionnaire (IBSQOL), Pain Severity Scale of West Haven Yale Multidimensional Pain Inventory (WHYMPY), Symptom Checklist-90-R (SCL-90-R) and Coping Strategies Questionnaire (CSQ). T-tests and GLM Analysis of Covariance were used for statistical analysis. IBS patients had significantly higher levels of psychological distress, pain severity and maladaptive pain coping strategies (catastrophization), and lower QOL than UC patients. Variance of QOL in IBS was explained for the most part by catastrophization (15%), then by psychological distress (8%), and for the less part by pain severity (5%). In UC, pain severity explained 21%, psychological distress 8%, and catastrophization 3% of the variance of QOL. These results suggest there are differences between IBS and UC patients in the role of physical and psychological factors in QOL and emphasize the importance of cognitive processes in IBS.     

Increased use of safety-seeking behaviors in chronic back pain patients with high health anxiety

Many patients with chronic pain also exhibit elevated levels of health anxiety. This study examined the effect of health anxiety on the use of safety-seeking behaviors (SSBs) in pain-provoking situations. Participants were 20 chronic back pain patients with high health anxiety (Group H), 20 with low health anxiety (Group L) and 20 pain-free controls (Group C). Two physical tasks were video recorded, and compared both for overt pain behavior (identified by blind observers following a standardized procedure) and for the occurrence of SSB (identified by showing the participants video playback and asking them to specify motivation for all actions/behaviors displayed during the tasks). While there were no differences in the display of overt pain behaviors, Group H deployed a greater number of SSBs than Groups L and C. This finding held true for both tasks and remained significant when concurrent pain and mood ratings were statistically controlled for. SSB was correlated with catastrophizing thoughts but not pain intensity; pain intensity was correlated with overt pain behavior but not catastrophizing. Taken together, these findings suggest that SSB is distinct from overt pain behavior and may be a defining characteristic of chronic pain patients reporting high levels of health anxiety.     

A case-control study of psychosocial and aerobic exercise factors in women with symptoms of depression

The study is an examination of specific aspects of psychosocial constructs and health-promoting behavior that may be related to symptoms of depression. The authors used a case-control design to investigate possible differences between provisional social support, hardiness dimensions, and exercise behavior and related perceptions in a sample of 94 White, middle-aged women with and without symptoms of depression. The results indicated that women with symptoms of depression have significantly fewer (p < .001) specific forms of social support resources (i.e., reassurance of worth, social integration, guidance, and attachment) and significantly lower (p < .0001) perceptions of control and commitment in their lives. The results also indicated no difference in perceptions and behaviors related to physical activity between women with and without symptoms of depression. Those results suggest that provisional social support, as well as specific dimensions of hardiness, should be the focus of interventions for women with symptoms of depression.     

The Relation of Social Support and Coping to Positive Adaptation to Breast Cancer

Survivors of childhood cancer are at risk of compromised physical and psychological functioning as a result of disease and treatment. However, survivors experiencing similar physical problems vary considerably in their self-reported Quality of Life (QOL) raising questions about the processes underlying adjustment and maintenance of QOL. Seventy seven survivors of either Acute Lymphoblastic Leukaemia (ALL) or tumours of the Central Nervous System (CNS) completed a standardised measure of QOL and semi-structured interview. Based on theoretical assumptions that QOL reflects a difference between what survivors can, and would like to be able to do, interviews were coded for reports of discrepancies and any coping strategy employed. Survivors of tumours of the CNS reported worse QOL and more discrepancies than survivors of ALL. A significant relationship was found between QOL measured by questionnaire and number of reported discrepancies. Five kinds of strategies to reduce discrepancies were identified: changing activity, devising a “plan of action”, emotional denial, making social comparisons, and seeking social support. Survivors who reported neither discrepancies nor strategies had better QOL than those who reported both discrepancies and strategies or discrepancies but no strategies. Data are discussed in terms of rehabilitation of survivors of childhood cancer.     

Social cognitive theory and cancer patients' quality of life: a meta-analysis of psychosocial intervention components.

Social cognitive theory (SC) provides a theoretical framework to evaluate improved quality-of-life (QOL) outcomes through interventions with cancer patients To assess whether inclusion of SCT components predicted better outcomes, focused comparisons were used to integrate results from 38 randomized studies. Interventions with more SCT components had significantly larger effect sizes than studies with fewer or no SCT components for the overall analysis (Z = 3.72, p < .01). Subanalyses of affective, social, objective physical outcome, and specific QOL measures revealed that SCT-based interventions had significantly higher effect sizes; inclusion of SCT components resulted in significantly lower effect sizes on subjective physical and functional outcomes. Results suggest that using SCT-based interventions maximizes improvement in overall QOL outcomes for adult cancer patients.     

Body image of children and adolescents with cancer: A systematic review

We report a systematic literature review to identify (1) differences in body image (BI) between children and adolescents with cancer and healthy controls; (2) relationships between BI and demographic or medical variables; (3) implications of BI for psychological adjustment; and (4) relationship between BI and social support. Thirty-two studies were identified from computerized databases including BNI (1985-March, 2008), CINAHL (1982-March, 2008), MEDLINE (1950-March, 2008), PsychInfo (1806-March, 2008), and PubMed (1950-March, 2008). There was no consistent evidence regarding BI differences between children and adolescents with cancer and healthy controls. Relations between BI and gender, disease characteristics, and psychological adjustment were found. Changes in BI have adverse implications for self-esteem and adjustment, but can be moderated by social support. Future research should also adopt broader definitions of BI, and cancer-specific age-appropriate BI measures are needed to increase sensitivity of this work.     

Coping styles in adults with cystic fibrosis: implications for emotional and social quality of life

As life expectancy increases, interest has grown surrounding the factors that may influence quality of life (QOL) for people with cystic fibrosis (CF). The aim of the current study was to examine which specific coping styles were positively or negatively associated with social and emotional QOL in a CF sample. One hundred and twenty-two respondents aged 18 and over were recruited through an online support group. Respondents completed the ‘CF Questionnaire-Revised (CFQ-R)’ and the ‘Brief COPE’. The CFQ-R is a disease-specific instrument designed to measure the impact of CF on nine QOL domains and the Brief COPE is a 28 item questionnaire which assesses 14 coping scales. A multivariate regression model revealed that higher substance abuse and disengagement was associated with lower emotional QOL whereas greater use of religion, instrumental coping and acceptance was positively associated with emotional QOL. Active coping was linked to better social QOL and a negative association was reported between distraction coping with both emotional and social domains. Given the burden of CF, ascertaining which factors enhance or diminish emotion and social well-being is now an integral component of QOL research. The current findings may therefore have value in informing clinical interventions which aim to cater for the psychological needs of individuals with CF.     

Quality of Life in the Decayed Historic Areas of Isfahan (DHI) Using the World Health Organization Quality of Life Instrument (WHOQOL-BREF)

The aim of this paper is to measure the quality of life (QOL) in the decayed historic areas of Isfahan (DHI). The WHOQOL-BREF instrument was used in order to find the strengths and weaknesses of these areas with regard to the domains and determine the most effective domains and indicators that would show the best ways to improve QOL in DHI. We used the multi-stage sampling technique for sampling. In the first stage the Neyman??s allocation method was used to determine sample sizes which were then distributed among the districts using the systematic sampling method (in the second stage). Household interviews were conducted to gather the needed data. Subsequently the Cronbach alpha test and second-order confirmatory factor model were used to determine the internal consistency and fitness of the WHOQOL-BREF model in DHI. The WHOQOL-BREF model provided an adequate fit to the data. Also, according to our model, the psychological domain has the highest association with QOL (0.93). This indicates that the psychological domain should have priority in improvement plans. The results show that the most significant problems are related to the physical (12.13) and psychological (12.58) domains and the highest scores among the WHOQL-BREF domains relate to the social relationships (13.24) and environment (12.61) domains. Thus, in spite of the fact that DHI have environmental difficulties from the objective point of view, they do, nevertheless, have a high score from a subjective point of view among WHOQL-BREF domains. Therefore the necessity of improvement in the DHI should be considered not only in relation to the environmental domain but also the physical, psychological and social domains.     

Psychosocial Conditions of Quality of Life Among Undergraduate Students: A Cross Sectional Survey

Quality of life (QOL) in the context of education is an understudied topic and research related to its’ relation to the sense of coherence (SOC), level of optimism (LOO) and self-efficacy (SE) among students seems to be missing. The rationale for this survey was to fill this gap in knowledge and therefore, the aim of the study is to examine the relationship between students’ QOL and psychological variables such as SOC, LOO and SE, and social ones such as type of faculty, students’ social background and sex. The quantitative cross sectional survey has been conducted at three higher education institutions in Poland in January 2006. The random sample of 396 undergraduate students (average age was 20.5 years) representing 5 different faculties namely physiotherapy, physical education, tourism and recreation, English and Polish philology has been selected and participated in the study. Four reliable and validated research tools have been used to collect the data. These included the SF-36, SOC-29, Seligman’s scale, and GSES. The results have shown to indicate that different variables had a significant effect on particular subscales of the QOL outcomes. For example, among social variables faculty had a significant effect on physical functioning, role limitation due to physical functioning, and changes in health. Sex had a significant effect on role limitation due to emotional problems, social functioning, and energy vitality. Social background had a significant effect on general health. Among psychological variables the sense of coherence was significantly related to all subscales of QOL. A significant effect was noted by self-efficacy on physical and social functioning. Level of optimism had a significant effect on energy-vitality and general health. This research survey has suggested that changes in academic curriculum might be implemented to improve students QOL.