Quality of Life Before and After Cataract Surgery: Research in a Sample of Polish Patients

The goal of this paper is to present possible change in quality of life (QoL) in older sample of people with vision disturbances. The patients were investigated twice: before (N = 193) and 4 month after the cataract surgery (N = 69), by means of the scale for vision functioning, and the Life Quality Questionnaire (Schalock & Keith, 1993) extend with the items measuring health related quality of life (HRQoL). Two problems were formulated: To what extent are visual defects associated with the decreased subjective QoL? What changes are observed in perceived QoL during the period of treatment of visual defects? The patients reported significant increase of HRQoL, however they did not report similar increase of a general QoL. Few reasons are considered: overlapping of the content of visual function scales and HRQoL and different indices of a general QoL and HRQoL, lack of a proper postoperative care, low socio-economic status of the participants, and too high expectation concerning better functioning after the surgery.     

The Farage Quality of Life Measure for Consumer Products: Development and Initial Implementation

Despite the existence of numerous health-related quality of life (HRQoL) measures, few if any are geared to evaluating the impact of consumer products. We describe the development and initial implementation of the Farage Quality of Life (FQoL™) general questionnaire, a self-administered questionnaire to assess the potential impact of a variety of consumer products on overall well-being and HRQoL. We developed the 27-item FQoL™ measure, scored on a Likert scale and covering Overall Quality of Life (1 item), Well-Being (12 items), and Energy and Vitality (14 items), and a 3-item Menstrual Module for use with menstruating women. We assessed test-retest reliability by administering the items twice to a sample of 20 women 3 days apart, calculating mean absolute differences in responses. Then, in a study of 119 women ages 18–55 years who were randomly assigned to use a new brand of menstrual pad vs. their usual menstrual pads for 1 menstrual period, we administered the FQoL™ questionnaire 5–7 days before their menstrual period and 5–7 days after the start of their period. We compared changes in responses within groups and between groups pre- vs. during menstruation. Overall, test-retest reliability was good, with a mean (SD) absolute difference for the 27 general items of 0.51 (0.31). In the menstrual pad study, the mean (SD) age of responders was 35.3 (7.9) years; 59 (50%) were age 18–35 and 60 (50%) were age 36–55. Relative to the intervention group, the usual pads group reported worse HRQoL during vs. pre-menstruation on items addressing self-confidence, managing stress, energy, and fatigue (P ≤ 0.05 for each comparison). In subgroup analyses, relative to intervention patients, women age 18-35 in the usual pads group reported greater changes for the worse during vs. pre-menstruation in managing stress; energy; and fatigue, but relatively better work or school attendance during vs. pre-menstruation, and women age 36–55 in the usual pads group reported greater changes for the worse in self-confidence and in desire to go out in public (P ≤ 0.03 for each comparison). The general FQoL™ is a new measure of HRQoL applicable to consumer product evaluation. It has good test-retest reliability. The FQoL™ menstrual module detects changes in HRQoL during vs. before the menstrual period associated with menstrual pad use. Further research is needed to assess the construct validity of the HRQoL.     

Development of a Health Related Quality of Life Measure for Adolescents and Young Adults Following Invasive Meningococcal Disease

This study describes the key areas that matter to adolescent survivors of Invasive Meningococcal Disease (IMD). Satisfaction with Life After Meningitis is a brief multidimensional measure of health related quality of life that is reliable and correlates with criterion variables in a theoretically meaningful way. To develop a Health Related Quality of Life (HRQoL) measure for adolescent and young adult survivors of (IMD) we used a cross-sectional study and focus groups. The study was conducted in two phases. In Phase 1 a pool of potential items were generated based on the following: a review of existing measures, focus groups with IMD survivors, and an expert group consultation. Phase 2 involved administration of the questionnaire to a sample of adolescent and young adult IMD survivors. Factor analysis suggested a correlated four factor solution: Wellbeing, Positive about Future, Social Support, and Confidence. These factors were significantly correlated in a theoretically predictable way with scores from the Beck Depression Inventory (correlations ranged from ?0.77 to ?0.81) and the eight domains of the SF-36 Health Survey (correlations ranged from 0.32 to 0.79). The reliability of all subscales was high ranging from 0.85 to 0.92. The Satisfaction with Life After Meningitis (SLAM) questionnaire is a HRQoL self-report measure that produces reliable scores and is appropriate for use with young survivors of IMD. There is also evidence of concurrent validity with existing measures of physical and psychological well-being.     

Crafting the TALE: construction of a measure to assess the functions of autobiographical remembering

Theory suggests that autobiographical remembering serves several functions. This research builds on previous empirical efforts (Bluck, Alea, Habermas, & Rubin, 2005) with the aim of constructing a brief, valid measure of three functions of autobiographical memory. Participants (N=306) completed 28 theoretically derived items concerning the frequency with which they use autobiographical memory to serve a variety of functions. To examine convergent and discriminant validity, participants rated their tendency to think about and talk about the past, and measures of future time orientation, self-concept clarity, and trait personality. Confirmatory factor analysis of the function items resulted in a respecified model with 15 items in three factors. The newly developed Thinking about Life Experiences scale (TALE) shows good internal consistency as well as convergent validity for three subscales: Self-Continuity, Social-Bonding, and Directing-Behaviour. Analyses demonstrate factorial equivalence across age and gender groups. Potential use and limitations of the TALE are discussed.     

Health-Related Quality of Life,Functioning and Social Experiences in People with Psychotic Disorders

Applied Research in Quality of Life - To inform development of a model for health-related quality of life (HRQoL) in people with psychotic disorders, we aimed to assess correlations between...     

Crafting the TALE: Construction of a measure to assess the functions of autobiographical remembering

Theory suggests that autobiographical remembering serves several functions. This research builds on previous empirical efforts (Bluck, Alea, Habermas, & Rubin, 2005) with the aim of constructing a brief, valid measure of three functions of autobiographical memory. Participants (N=306) completed 28 theoretically derived items concerning the frequency with which they use autobiographical memory to serve a variety of functions. To examine convergent and discriminant validity, participants rated their tendency to think about and talk about the past, and measures of future time orientation, self-concept clarity, and trait personality. Confirmatory factor analysis of the function items resulted in a respecified model with 15 items in three factors. The newly developed Thinking about Life Experiences scale (TALE) shows good internal consistency as well as convergent validity for three subscales: Self-Continuity, Social-Bonding, and Directing-Behaviour. Analyses demonstrate factorial equivalence across age and gender groups. Potential use and limitations of the TALE are discussed.     

A brief assessment tool for body image in systemic lupus erythematosus

Systemic lupus erythematosus (SLE) may adversely affect body image in multitude ways. Development and validation of a brief and valid SLE specific body image tool were undertaken. Eleven items were identified on interview of 21 SLE patients for the Body Image Lupus Scale (BILS v1.0). The tool was administered to 70 SLE patients. Based on analysis, feedback, and refinement of items, the final iteration BILS v1.2 with five items was administered to 233 SLE patients along with validated body image measures (Situational Inventory of Body Image Dysphoria and Body Image Quality of Life Inventory) and health-related quality of life measures for a subsample. The BILS scores' had an internal consistency reliability of .94. It correlated with both the referent body image measures, and with health-related quality of life. It differentiated participants by health status and disease activity. Test-retest reliability estimates exceeded .90. These results support the psychometric properties of BILS.     

The Impact of Demographic Characteristics on Health-related Quality of Life Profile of Malaysian Epilepsy Population

The possibilities of adverse drug reactions and disease-related psychosocial implications have led to the current emphasis on health-related quality of life (HRQoL) assessment in epilepsy. The main objective of this study was to determine the impact of various demographic characteristics i.e. gender, age, marital status, ethnic origin, religion, and employment status on HRQoL profiles in Malaysian epilepsy patients. Patients with epilepsy were recruited from ten public hospitals in Sabah, Malaysia. Upon written consents, they completed the Malay Quality of Life In Epilepsy-30 (QOLIE-30) instrument which assesses Seizure Worry, Overall QoL, Emotional Well-Being, Energy/Fatigue, Cognitive Functioning, Medication Effects and Social Functioning. An Overall Score was generated to represent a summarised HRQoL score. Univariate and multiple linear regression analyses were both carried out using SPSS 14 for (1) all patients and (2) patients possessing Poor QoL (Overall Score < median) and Good QoL (Overall Score ≥ median). One-hundred-and-thirteen patients participated in the study. The respondents ranged from 18–76 years with a mean age of 31 years. Majority were Kadazandusuns (n = 46; 40.7%) and many were unmarried (n = 68; 60.2%), Muslims (n = 50; 44.2%) and unemployed (n = 54; 47.8%). Age was the most significant factor across all patients (B = −0.372, t = −2.238, p = 0.027), regardless of Poor or Good QoL level. Older patients (>56 years) fared the worst in many HRQoL areas. Those with Poor QoL were mostly affected by marital status (widowed/divorced) and ethnic origin (Kadazandusun/Chinese). Religion (Buddhism/Hinduism) emerged as the most prominent HRQoL predictor for patients experiencing Good QoL and being Chinese too played a role. These outcomes indicate that specific demographic characteristics are influential in determining the HRQoL of epilepsy patients. Consequently, healthcare professionals could utilise such information in planning the best treatment and care by considering both the medical and psychosocial impacts towards patients. This paper was part of a research project and majority of its components had been presented at the 7th Conference On International Society For Quality Of Life Studies (ISQoLS) 2006, Rhodes University, Grahamstown, South Africa, 17–20 July 2006.     

Item Screening in Graphical Loglinear Rasch Models

In behavioural sciences, local dependence and DIF are common, and purification procedures that eliminate items with these weaknesses often result in short scales with poor reliability. Graphical loglinear Rasch models (Kreiner & Christensen, in Statistical Methods for Quality of Life Studies, ed. by M. Mesbah, F.C. Cole & M.T. Lee, Kluwer Academic, pp. 187–203, 2002) where uniform DIF and uniform local dependence are permitted solve this dilemma by modelling the local dependence and DIF. Identifying loglinear Rasch models by a stepwise model search is often very time consuming, since the initial item analysis may disclose a great deal of spurious and misleading evidence of DIF and local dependence that has to disposed of during the modelling procedure.     

Effect of aerobic training on inter-arm coordination in highly trained swimmers

The effect of three months of aerobic training on spatio-temporal and coordination parameters was examined during a swim trial at maximal aerobic speed. Nine male swimmers swam a 400-m front crawl at maximal speed twice: in trial 1, after summer break, and trial 2, after three months of aerobic training. Video analysis determined the stroke (swimming speed, stroke length, and stroke rate) and coordination (Index of Coordination and propulsive phase duration) parameters for every 50-m segment. All swimmers significantly increased their swimming speed after training. For all swimmers except one, stroke length increased and stroke rate remained constant, whereas the Index of Coordination and the propulsive phase duration decreased (p < .05). This study suggests that aerobic training developed a greater force impulse in the swimmers during the propulsive phases, which allowed them to take advantage of longer non-propulsive phases. In this case, catch-up coordination, if associated with greater stroke length, can be an efficient coordination mode that reflects optimal drag/propulsion adaptation. This finding thus provides new insight into swimmers’ adaptations to the middle-distance event.     

Does Posttraumatic Growth Buffer the Association Between Death Anxiety and Quality of Life Among People living with HIV/AIDS?

People living with HIV (PLWH) may experience death anxiety (DA), which can be detrimental to quality of life. Posttraumatic growth (PTG), however, is antithetical to DA, with its positive attributes at odds with negative psychosocial outcomes. Previous research has not examined the buffering effect of PTG on the association between DA and quality of life. Therefore, in addition to the direct effects of DA and PTG on health-related quality of life (HRQoL), we investigated the moderating role of PTG on the relationship between DA and HRQoL among people living with HIV/AIDS (PLWH) in Nigeria. Using cross-sectional design and availability sampling method, we selected 201 outpatients (men, n?=?63, 31.3%, women, n?=?138, 68.7%, mean age?=?40.1, SD?=?10.5) managed for HIV/AIDS in a Nigerian tertiary healthcare institution. Death Anxiety Inventory-Revised, Posttraumatic Growth Inventory-Short Form, and Patient-Reported Outcome Quality of Life-HIV were used to access DA, PTG and HRQoL, respectively. Results showed that while adjusting for socio-demographic factors (age, gender, time since diagnosis and educational status), DA was associated with physical health, mental health and social relationships domains of HRQoL as well as overall HRQoL. In contrast, PTG did not evidence significant association with HRQoL dimensions and overall HRQoL. The moderation effect of PTG on the association between DA and HRQoL was not supported. Independent of PTG, alleviating DA may be an important target in terms of therapeutic intervention towards improving quality life of PLWH.

     

Determination of Weights for Health Related Quality of Life Indicators among Kidney Patients: A Fuzzy Decision Making Method

Health-Related Quality of Life (HRQoL) is one of the significant current discussions in the health fraternity. It encompasses multidimensional indicators and serves the purpose of evaluating health quality among patients. Patients’ perceptions of the impact of disease and treatment and the indicators such as physical, psychological, social function and well being are normally investigated. However there is no clear suggestion of which indicators contributed more than others. The arbitrary nature of HRQoL paves the way for fuzzy theory in evaluation of indicators. This paper describes the application of a fuzzy decision making method in ranking indicators of HRQoL among kidney patients. Four experts in health fraternity were selected as decision makers to elicit information regarding health related status of chronic kidney disease patients over eight HRQoL indicators. The decision makers were required to rate the regularity of experiencing health-related problems in linguistic judgment among the patients. The five linguistics variables were used as input data to a modified version of Fuzzy Simple Additive Weight decision making model. The modified six-step method was possible to tap the extent of decision makers’ opinions on the severity of HRQoL experienced by the patients. It is shown that the indicator of role-physical recorded the lowest problematic level while the indicator of mental health recorded the highest problematic level experienced by the patients. The ranking signifies the impact of the indicators to health quality specifically the chronic kidney disease patients.     

Development and Psychometric Evaluation of an Item Bank for Computerized Adaptive Testing of the EORTC Insomnia Dimension in Cancer Patients (EORTC CAT-SL)

To further advance assessment of patient-reported outcomes, the European Organisation of Research and Treatment of Cancer (EORTC) Quality of Life Group has developed computerized adaptive test (CAT) versions of all EORTC Quality of Life Core Questionnaire (QLQ-C30) scales/items. The aim of this study was to develop and evaluate an item bank for CAT measurement of insomnia (CAT-SL). In line with the EORTC guidelines, the developmental process comprised four phases: (I) defining the concept insomnia and literature search, (II) selection and formulation of new items, (III) pre-testing and (IV) field-testing, including psychometric analyses of the final item bank. In phase I, the literature search identified 155 items that were compatible with our conceptualisation of insomnia, including both quantity and quality of sleep. In phase II, following a multistep-approach, this number was reduced to 15 candidate items. Pre-testing of these items in cancer patients (phase III) resulted in an item list of 14 items, which were field-tested among 1094 patients in phase IV. Psychometric evaluations showed that eight items could be retained in a unidimensional model. The final item bank yielded greater measurement precision than the original QLQ-C30 insomnia item. It was estimated that administering two or more items from the insomnia item bank with CAT results in a saving in sample size between approximately 15–25%. The 8-item EORTC CAT-SL item bank facilitates precise and efficient measurement of insomnia as part of the EORTC CAT system of health-related quality life assessment in both clinical research and practice.

     

Validity evidence of the Health-Related Quality of Life for Drug Abusers Test based on the Biaxial Model of Addiction

The aim of this work is to show evidence of the validity of the Health-Related Quality of Life for Drug Abusers Test (HRQoLDA Test). This test was developed to measure specific HRQoL for drugs abusers, within the theoretical addiction framework of the biaxial model. The sample comprised 138 patients diagnosed with opiate drug dependence. In this study, the following constructs and variables of the biaxial model were measured: severity of dependence, physical health status, psychological adjustment and substance consumption. Results indicate that the HRQoLDA Test scores are related to dependency and consumption-related problems. Multiple regression analysis reveals that HRQoL can be predicted from drug dependence, physical health status and psychological adjustment. These results contribute empirical evidence of the theoretical relationships established between HRQoL and the biaxial model, and they support the interpretation of the HRQoLDA Test to measure HRQoL in drug abusers, thus providing a test to measure this specific construct in this population.     

Impaired Health-Related Quality of Life in Children and Families Affected by Methylmalonic Acidemia

An understanding of health related quality of life (HRQoL) in children and families affected by methylmalonic acidemia (MMA) is important in planning counseling and therapeutic intervention. Liver transplantation (LT) is used as a treatment for MMA; however, its risks and benefits continue to be investigated. The purpose of this study was twofold: (1) to measure HRQoL in children and families affected by MMA using the Pediatric Quality of Life Inventory (PedsQL?) parent version, and (2) to assess the impact of LT on HRQoL by comparing LT and non-LT patient scores and free responses. Parents/caregivers reported lower scores on the majority of the PedsQL? scales as compared to samples of healthy children, children with solid organ transplants for indications other than MMA, and families affected by chronic conditions. Scores for children with MMA were lowest in school and social functioning and scores for families were lowest in worry and activity impairment. There were no significant differences in LT and non-LT patient scores on the PedsQL? scales. Our results document the negative impact of MMA on HRQoL.     

Effects of Neuro-Linguistic Psychotherapy on psychological difficulties and perceived quality of life

Aims: The purpose of this study was to examine the effects of Neuro-Linguistic Psychotherapy on psychological difficulties and perceived quality of life of clients who came for psychotherapy during free practice. Method: A total of 106 psychotherapy clients were randomly assigned to a therapy group or a control group. The outcome was assessed by the Structured Clinical Interview for DSM-IV Personality Disorders (SCID II) with respect to clinical symptoms and by the Croatian Scale of Quality of Life (KVZ) with respect to Quality of Life. The therapy group received the measures at pre-, post- and five-months follow-up occasions, whereas the control group received them initially and after a period of three months. Results: In the therapy group, as compared to the control group, there was a significant decrease of clinical symptoms and increase in the quality of life. With respect to clinical symptoms, effect sizes were 0.65 at post-measurement and 1.09 at follow-up, indicating a substantial reduction of symptom strain, which is comparable to the well established effects of Cognitive Behavior Therapy. We also found a significant increase in perceived quality of life after therapy, as compared to the wait-list control group, with effect sizes between 0.51 and 0.73. Therapeutic improvements were still present five months after the end of therapy, showing further development in the same direction. Conclusions: Neuro-linguistic psychotherapy is an efficient intervention, which is on a par with other, well-established psychotherapeutic techniques.     

A New Questionnaire (QRFPC25) Regarding the Religiosity and Spirituality in People with Life-Threatening Disease: Reliability and Validity in a Population of Cancer Patients Undergoing Radiotherapy

The development of a questionnaire (QRFPC25) assessing the religiosity of cancer patients. The method used for the questionnaire comprises seven multi-item and three single-item scales formed from a 25-question module. The questionnaire was completed on-site and a week after antineoplastic therapy. The final sample included 156 patients. The main topics of the QRFPC25 are the following: worship, relationship with the divine, spiritual discussion, hope, participation in holly communion, faith, life after death, love, bioethics and global quality of life (QoL). The average time of both times taken to complete the questionnaire was approximately 10 min. All multi-item scales met the minimal standards of reliability (Cronbach’s alpha coefficient ≥.70) before or after treatment. Test–retest reliability in terms of the intraclass correlation coefficient was also satisfactory (p < 0.01). Validity was assured by inter-item correlations and correlations with the European Organisation for Research and Treatment of Cancer’s Core Quality of Life Questionnaire (QLQ-C30, version 3.0), along with factor analysis which showed eight factors incorporated in the model. The QRFPC25 is a reliable and valid gauge for the assessment of religiosity in cancer patients undergoing radiotherapy.     

Health-related quality of life in children and adolescents: subjective well being

The main objective of this study was to build a model, which includes personal and social factors, that helps to highlight factors that promote health-related quality of Life (HRQoL) in children and in adolescents. A sample of 3195 children and adolescents was acquired from 5th and 7th graders from all five Portuguese regions. In this study three independent latent variables were specified--Physical, Psychological and Social and two dependent latent variables were measured: Health behavior and Quality of Life. The integrative model was composed by different components: (1) health-related quality of life, integrated by 8 dimensions from KIDSCREEN-52; (2) health behavior, (3) variables related to physical health; (4) variables related to social health; (5) variables related to psychological health. As results were found strong correlation between psychological dimensions and self-esteem and other factors and a structural equation model was developed. The model presented a RMSEA index of .08. Similarly, adjustment levels for the CFI, NFI and IFI vary above or around .90, which suggests a good adjustment for the hypothesized model. The model presented significant qui-square. This study showed that in all the samples studied, the psychological variables were those that contributed at a superior level to HRQoL.     

Do They Know How Happy They Are? On the Value of Self-Rated Happiness of People With a Mental Disorder

Quality of life is often measured using questions about happiness. This method presumes that respondents are able to judge their life. Research suggest that this is typically the case, but this is not to say that everybody can. In that context one may doubt whether people with a mental disorder can judge their life adequately. Happiness can be rejected as a indicator for quality of life for people with mental disorders, because of affective and cognitive distortions. We therefore checked the validity of happiness and satisfaction measures in the context of mental disorders. Psychiatric diagnoses were determined at baseline and at 12 and 36 months follow-up in a representative sample (N = 7,076) of the Dutch population, using a full Composite International Diagnostic Interview. Respondents indicated how often they had felt happy during the past month and how satisfied they were with their lives in general. The measurements have a satisfactory concurrent, ecological and predictive validity for people with mental disorders. Though the level of happiness is lower among the people with mental disorders, conditions for happiness and contentment appear to be similar.