Psychological assessment of quality of life following liver transplantation

Administered measures of functional status, psychological distress, and quality of life to a consecutive series of 48 liver transplant recipients in follow-up clinic. Results showed that nearly total functional recovery was the norm. Thirty-six patients (75%) had a Karnofsky Performance Status (KPS) score of 80–100. Twelve transplant recipients had KPS scores below 80; none were employed, and most had been transplanted within 1 year. In spite of their impaired financial status, eight of these 12 reported being mostly satisfied on the self-report Quality-of-Life Scale (QLS). For the posttransplant sample as a whole, 83% were mostly satisfied with their quality of life. Pre- and posttransplant patient samples were not significantly different in reporting mild emotional distress. Results for the small subgroup with significant objective or subjective problems in achieving acceptable quality of life following liver transplantation were reviewed. Higher than normal emotional distress on the Symptom Checklist (SCL-90-R) was consistently reported by these patients. Prospective studies are needed to identify predictor variables of quality-of-life problems and to develop prevention and rehabilitation interventions.     

Prospective associations between changes in mental health symptoms and health-related quality of life in veterans seeking posttraumatic stress disorder residential treatment

Background and Objectives: This study examined prospective associations between changes in mental health symptoms (posttraumatic stress disorder [PTSD], depression) and health-related quality of life (physical health, psychological well-being) for veterans with PTSD. Design: This study focused on 139 patients who completed a residential treatment program for PTSD in the Veterans Health Administration. Methods: Patients completed the veteran-specific, 12-item Medical Outcomes Study Short Form, PTSD Checklist – Military version, and Beck Depression Inventory at pre-treatment, discharge, and a four-month follow-up. When accounting for demographic factors, combat exposure, and baseline scores on the respective outcome variables (e.g. mental health, physical health, PTSD, and depressive symptoms), a series of multivariate analyses were conducted for treatment-related changes in mental and physical health on the outcome measures. Results: Reductions in PTSD symptomatology during the treatment period were prospectively linked with better health-related outcomes at the four-month follow-up. In addition, improved physical health and psychological well-being during treatment were each similarly associated with better PTSD and depression outcomes in the months following treatment. Conclusions: Addressing concerns in mental and physical health might have synergistic effects across both domains, supporting the need for holistic models and integrated health care strategies for treating veterans with PTSD.     

Dental pain related to quality of life and mental health in South Korean adults

High levels of stress, anxiety and depression have been reported in patients with orofacial pain. Dental pain has the potential to reduce quality of life (QOL), and pain relief is important aspect of QOL. The purpose of this study was to assess the relationships of dental pain with QOL and mental health using a nationally representative, population-based study. This study analyzed data from the 2012 Korea National Health and Nutrition Examination Survey (N = 5469). Oral health status was assessed using the oral health questionnaire, and oral examination was performed by trained dentists. Health-related QOL (HRQOL) was evaluated using EQ-5D and EQ-VAS, and mental health was evaluated by questionnaires. Logistic regression was applied to estimate adjusted odds ratios (AOR) and 95% confidence intervals (CI). Among 5469 adults, 1992 (36.42%) presented self-reported dental pain. Participants with anxiety/depression or pain/discomfort, and participants with stress, melancholy, suicidal thought or depression showed significantly higher prevalence of dental pain. After adjusting for covariates, five aspects of QOL and five aspects of mental health were related with dental pain. The AORs (95% CI) for dental pain were 1.39 (1.06–1.81) for mobility, 1.77 (1.19–2.63) for self-care, 1.38 (1.02–1.85) for usual activities, 1.73 (1.43–2.09) for pain/discomfort and 1.50 (1.13–1.98) for anxiety/depression. For mental health status factors, the AORs (95% CI) for dental pain were 1.29 (1.11–1.51) for stress, 1.37 (1.09–1.74) for melancholy, 1.26 (1.01–1.58) for suicidal thoughts, 1.43 (.93–2.19) for consultation to psychiatrist and 1.53 (1.07–2.19) for depression. This study showed that dental pain has an association with lower HRQOL and worse mental health status in South Korean adults.     

贫困问题:基于心理学的视角

贫困心理学,是在心理学视角下研究贫困问题的一种新研究取向,是心理学在贫困领域的最新运用。现阶段贫困心理学研究主要集中在主观幸福感、心理健康、行为决策等三个方面。贫困文化理论、稀缺理论、自我损耗论分别从贫困文化、稀缺心态以及意志力资源视角解释了贫困产生的心理机制。在摆脱贫困过程中需要打破贫困循环,未来贫困心理学研究需要进一步探讨贫困的产生机制、神经生理机制,贫困心理学的本土化研究以及心理学在扶贫工作中的应用等。     

Measurement issues in health-related quality of life: Challenges for health psychology

Abstract

Quality of life assessment is a central element of clinical trials and related forms of evaluative research. Early efforts to establish appropriate methods of measuring quality of life drew on psychometric principles and emphasised the need for validated measures. However, it is increasingly clear that, whilst still a central requirement of quality of life measures, validity needs to be emphasised alongside a number of other essential properties that have become clearer as the field has developed. Moreover formal psychometric methodology has to be adapted to take account of the specific needs of evaluative research. Research is beginning to develop more appropriate methods of outcome assessment in this area. Further lines of research are suggested to examine psychometric with other approaches to measurement of health-related quality of life.     

The role of coping in the relationship between stressful life events and quality of life in persons with cancer

Objective: Stressful life events (SLEs) impact the quality of life (QOL) of cancer patients. This study investigated the mediation of the relationship between SLEs and QOL (Model 1: Emotional-EQOL and Model 2: Physical/Functional-PFQOL by three types of coping: Action/Planning, Support/Advise-Seeking, and Disengagement/Denial). Design and Main Measures: 662 persons with cancer completed a Stressful Life Events Checklist, the Brief COPE scale, the FACT Emotional, Physical, and Functional Scales, and the Physical Impact Scale of the Sickness Impact Profile. Results: SLEs were positively associated with Action/Planning (Model 1: B?=?0.195, 95% CI = [0.089, 0.304]; Model 2: B?=?0.192, 95% CI = [0.086, 0.289]) and Disengagement/Denial (Model 1: B?=?0.394, 95% CI = [0.281, 0.513]; Model 2: B = .392, 95% CI = [0.285, 0.508]) but not Support/Advice-Seeking; however, only Disengagement/Denial was related to Emotional-QOL (Model 1: B = ?0.659, 95% CI = [?0.848, ?0.498]) and Physical/Functional-QOL (Model 2: B = ?1.460, 95% CI = [?1.856, ?1.069]). Thus, only Disengagement/Denial mediated the relationship between SLEs and QOL. Conclusions: The results indicated that SLEs represent a class of events for which there may be only one dominant coping response, disengagement. SLEs may not be controllable or predictable and reduce capacity for active coping with serious illness. However, SLEs may be detected at any point in the cancer trajectory so that supportive services might be provided.     

Apathy is associated with lower mental and physical quality of life in persons infected with HIV

HIV infection is associated with lower health-related quality of life (HRQoL), which is influenced by immunovirological factors, negative affect, neurocognitive impairment, and functional dependence. Although apathy is a common neuropsychiatric sequela of HIV infection, emerging findings regarding its unique role in lower HRQoL have been mixed. The present study was guided by Wilson and Cleary's (1995), model in examining the association between apathy and physical and mental HRQoL in 80 HIV+ individuals who completed a neuromedical examination, neuropsychological assessment, structured psychiatric interview, and a series of questionnaires including the SF-36. Apathy was measured using a composite of the apathy subscale of the Frontal Systems Behavioral Scale and the vigor-activation subscale of the Profile of Mood States. Independent of major depressive disorder, neurocognitive impairment, functional status, and current CD4 count, apathy was strongly associated with HRQoL. Specifically, apathy and CD4 count were significant predictors of physical HRQoL, whereas apathy and depression were the only predictors of mental HRQoL. All told, these findings suggest that apathy plays a unique role in HRQoL and support the importance of assessing and managing apathy in an effort to maximize health outcomes among individuals with HIV disease.     

Mental health and quality of life in non-binary transgender adults: a case control study

Abstract

Background: The social challenges that non-binary people experience, due in part to social intolerance and the lack of validation of non-binary gender identities, may affect the mental health and quality of life of this population. However, studies that have distinguished between non-binary and binary transgender identities are lacking.

Aim: To compare the mental health and quality of life of a community sample of non-binary transgender adults with controls (binary transgender people and cisgender people) matched on sex assigned at birth.

Method: A total of 526 participants were included. Ninety-seven were classified as non-binary and were compared with two control groups: 91 people classified as binary and 338 cisgender people. Only transgender people not on gender affirming hormone treatment or who had not undergone gender affirming surgery were included. Participants were invited to complete an online survey that included mental health and quality of life measures.

Results: Non-binary people reported significantly better mental health than binary transgender people, but worse than cisgender people. Overall, there were no significant differences in quality of life between non-binary and binary transgender participants assigned male at birth and transgender females, but non-binary assigned males at birth had better scores on the psychological and social domains of quality of life than transgender males. Quality of life was better across all domains in cisgender people than transgender groups.

Conclusion: There is an inequality with regard to mental health and quality of life between non-binary (and binary) transgender people and the cisgender population that needs to be addressed. The better mental health scores in non-binary people may reflect lower levels of body dissatisfaction among the non-binary population. Mental health problems and poor quality of life are likely to have social causes and hence legislative measures and broader government-led inclusive directives should be put in place to recognize and to validate non-binary identifying people.     

Ghrelin level negatively predicts quality of life in obese women

A cross-sectional cohort study was conducted to investigate whether ghrelin level in obese women predicts the quality of life (QOL). A total of 307 subjects fulfilled the criteria: (1) age between 20 and 65 years old, (2) body mass index ≥27 kg/m² (3) waist circumference ≥80 cm were enrolled in the study. All subjects were assigned to one of the plasma ghrelin level categories according to the quartiles. The median of age and BMI of the 307 obese women were 45 ± 18 years and 29.9 ± 4.1 kg/m², respectively. The main outcome evaluated is the associations of plasma ghrelin level and QOL, which were evaluated using multiple linear regression analysis. Results of linear trend test show significant statistical difference in plasma lipoproteins (triglyceride, cholesterol, HDL-cholestero and LDL-cholesterol = and levels of obesity-related hormone peptides, including leptin, adiponectin, insulin among quartiles of ghrelin. Multiple liner regression analysis of serum obesity-related hormone peptide level and QOL using stepwise method shows ghrelin concentration was the only predictor of QOL, including PCS-12 level (β = ?0.18, p = 0.001), MCS-12 level (β = ?0.14, p = 0.009), WHOQOL-BREF scores: physical (β = ?0.13, p = 0.03), psychological (β = ?0.16, p = 0.007), social (β = ?0.21, p?= < 0.001), and environmental (β = ?0.22, p?= <0.001), after adjusting other factors for obese female subjects. This study demonstrated that ghrelin concentration is strongly associated with QOL level among obese women. Hence, ghrelin concentration might be a valuable marker to be monitored in obese women.     

Physical activity and psychosomatic-related health problems as correlates of quality of life among university students

This study aimed to investigate the role of psychosomatic problems in the relationship between physical activity and healthrelated quality of life. Participants were a convenience sample of 703 students from a South African university (males = 38.8%, females = 61.2%, mean age = 19.6 years, SD = 1.26 years). The students completed measures of physical activity, psychosomatic-related health problems and quality of life-related. The hypothesised model was tested using structural equation modelling (SEM). The empirical findings revealed that psychosomatic problems mediated the relationship between physical activity and quality of life. In fact, the mediation analyses showed a partial effect of physical activity on quality of life in that those students with less self-reported activity experienced several psychosomatic-related health problems.     

Social-emotional aspects of quality of life in multiple sclerosis

Multiple sclerosis (MS) is an inflammatory auto-immune disease of the central nervous system. It leads to many impairments including physical, cognitive, psychological, and social challenges. Our study examined gender and cultural associations with quality of life (QoL), personal characteristics, and benefits from having MS among those with MS. The study was conducted in Austria and the United States. The sample included 128 participants, 64 in each country, of whom 78 were women and 50 were men aged between 20 and 57 years. We used standard statistical tests, including analyses of covariance (ANCOVA) and partial correlations for the analysis of quantitative data. For the qualitative part of the survey we used semi-structured interviews, which we transcribed and coded to identify categories in the answers for qualitative analyses. Austrian participants with MS perceived a higher social-emotional QoL in comparison to American participants. American participants expressed a higher self-esteem in comparison to Austrian participants. Men reported a lower ability to express love than women. Independent of sex/gender and nationality, participants reported benefits through the disease, especially with regard to improved compassion, mindfulness, improved family relations and lifestyle gains. The qualitative interviews revealed additional gender differences for coping with the illness; and in experiences, expectations, and challenges related to MS. These insights can be used to develop targeted psychological and social support interventions aimed toward improving social-emotional QoL for persons with MS.     

Perceived quality of life in Taiwan and Hong Kong: an intra-culture comparison

Cross-society comparisons have become increasingly important to the study of the perceived quality of life. A major critique of these studies, however, is the lack of attention to intra-culture variation. This paper examines how subjective quality of life differs, at both societal and individual levels, between Taiwan and Hong Kong, two Chinese societies that share their cultural heritage but vary in their social and political systems. We draw upon data from synchronic surveys conducted in November 2000 in Taiwan (n=1222) and Hong Kong (n=1044). Ordinal regression analyses confirm that, for both societies, reported satisfaction at the societal level contributes to the variance in individuals quality of life. Moreover, the perceived fairness with regard to personal effort within the opportunity structure provided by the society also significantly affects an individuals quality of life. Different factors accounting for quality of life variation in Taiwan and in Hong Kong are discussed. This paper suggests that for the intra-cultural, cross-society comparisons on quality of life, inclusion of various societal level indicators is not only important, but the subjective perception of the fairness that society also contributes a significant effect.     

Spirituality,quality of life,and depression in older people with dementia

ABSTRACT

This study aimed to observe dementia’s role in the relationship between spirituality, quality of life, and depression in aging. The sample included 61 participants between 65 and 98 years old, separated into two groups: participants diagnosed with dementia (N = 31) and control participants (N = 30). There was no significant difference in spirituality between demented and control participants; however, different patterns of correlation were observed between spirituality, depression, and quality of life in these groups. Although the level of spirituality did not differ despite dementia, this pathology would appear to play a role in the relationship between spirituality, quality of life, and depression.     

Factors associated with poor quality of life among Iranian infertile women undergoing IVF

Infertility is a medical and social condition and has a considerable impact on a person’s quality of life (QoL). The aim of the study was to determine the QoL of women with fertility problem, and identify factors associated with poor QoL. This cross-sectional study included 155 women with fertility problems undergoing IVF in a referral fertility center in Tehran, Iran. The Fertility Quality of Life, the Hospital Anxiety and Depression Scale and demographic and fertility information questionnaire were administered to all women. The mean total QoL score was 62.57 ± 16.89. Multivariate analysis showed that the anxiety (β = ?1.59, p < 0.001) and depression (β = ?2.09, p < 0.001) had a negative impact on QoL. Cause of infertility and failure in previous treatment were also significant factors of poorer QoL. The findings indicate that the QoL was worse in women with high depression and anxiety level, failure in previous treatment and unknown cause of infertility. Thus, a comprehensive approach, including psychosocial interventions and support, is absolutely essential to improve the QoL in these women.     

Effectiveness of cognitive behavioral therapy on health‐related quality of life: An evaluation of therapies provided by trainee therapists

The present study was carried out to examine the treatment effect of cognitive behavioral therapy provided by trainee therapists at a university clinic, focusing on health‐related quality of life (HRQOL) optimism and symptoms. The study was conducted through a repeated measures design and included a treatment group (n = 21), which received cognitive behavioral therapy for an average of 10.7 therapy sessions and a control group (n = 14), that was put on a wait list for 8.6 weeks on average. After treatment, the treatment group improved significantly concerning general health (p = 0.028) and optimism (p = 0.027). In addition, clients improved in several areas within mental health and displayed some reduction in anxiety symptoms. Concurrently, the results also indicated some improvement within the control group, which may have been caused by the initial therapeutic contact, expectancy effects or spontaneous remission. The study concluded that cognitive behavioral therapy provided by trainee therapists may have a positive effect on areas within HRQOL and optimism.     

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.     

Perceived positive and negative consequences after surviving cancer and their relation to quality of life

Surviving childhood cancer has multiple implications on both physical and psychological domains of the individual. However, its study and possible effects on health‐related quality of life (HRQoL) outcomes of adolescent survivors has been understudied. The objective of this study was twofold; to assess positive and negative cancer‐related consequences (psychosocial and physical) in a sample of adolescent cancer survivors and to explore their relationship with HRQoL outcomes. Forty‐one participants answered two questions about positive and negative consequences in the aftermath of cancer and filled in the KIDSCREEN‐52 self‐reported version. Data were analysed using mixed methods approach. Overall, 87.8% of the studied sample identified positive consequences and 63.4% negative consequences in survivorship. Four positive categories and five negative categories with regard to cancer‐related consequences were found. Changed perspectives in life narratives seem to be the positive consequence more related to HRQoL (physical well‐being, mood & emotions, autonomy, social support & peers), followed by useful life experience (physical well‐being, autonomy, social support & peers). Psychological impact was the most referred negative consequence with a significant detrimental effect on social support and peers HRQoL dimension. Even if the majority of survivors reported benefit finding in the aftermath of cancer, concomitant positive and negative consequences have been found. However, findings only reveal a significant relationship between positive narratives and HRQoL, and negative consequences do not seem to have a significant influence on overall HRQoL in survivorship.     

Assessing the quality of life in patients with multiple sclerosis in Kuwait: a cross sectional study

The main objective of this paper was to assess the level and the determinants of quality of life (QOL) amongst patients with multiple sclerosis (MS). A cross-sectional study was conducted among a convenience sample of 200 adult MS patients. Inclusion criteria were: MS diagnosis for at least one year, and aged 21+ years. However, exclusion criteria were: having other neurological diseases, serious cardiovascular, orthopedic or other disability precluding participation. Self-administered questionnaire employed MSQOL-54 with two outcomes: Physical Health Composite (PHC) and mental health composite (MHC). Satisfaction with Daily Occupation scale was adopted through face to face interviews. The median of PHC and MHC scores were 48.9/100, and 53.4/100 respectively. Multivariate analysis revealed that unemployment was a determinant of poor PHC, while low monthly income was a predictor of poor MHC. Additionally, low endurance and sensory problems were associated with poor PHC, and MHC, while motor problems were allied with only poor PHC. Patient’s satisfaction level with performing activities of daily living was positively associated with PHC and MHC. Assessment of QOL is suggested to be comprised in medical settings.     

Managing stress and managing illness: Survival and quality of life in chronic disease

Interest has been steadily building in the impact of stress on psychological and physiological functioning, in particular on immune system responses, furthering the concept of a strong connection between the mind and the body. Implications for prevention of disease onset or treatment of stress-induced illness or immunocompromised conditions have been explored through the implementation of stress management techniques. Cognitive behavioral stress management interventions, biofeedback, relaxation, guided imagery, hypnosis, individual and group psychotherapy, aerobic exercise, and guided self-efficacy treatment are briefly reviewed to identify possible treatment mechanisms that may affect immune function and promote quality of life. The application of behavioral techniques to reduce distress and sharpen coping skills has great promise in reducing the costs associated with chronic disease and in enhancing quality of life among those afflicted.Presented at the APA Presidential Miniconvention, To Your Health: Psychology Through the Life Span, Session VIII, Assuring a Healthy Lifestyle: Psychology Delivers. Chair: Diane J. Willis, Ph.D. The third author received partial funding through the Terry Fox Research Fellowship 5257, National Cancer Institute of Canada.