Health‐related quality of life and activities of daily living in 85‐year‐olds in Sweden

Few studies have examined health‐related quality of life (HRQoL) with respect to daily living and health factors for relatively healthy elderly individuals. To this end, this study examines 85‐year‐olds' reported HRQoL in relation to social support, perceived health, chronic diseases, healthcare use and instrumental activities of daily living (IADL). Data were collected from 360 participants (55% response rate) between March 2007 and March 2008 using a postal questionnaire and a home visit interview. HRQoL was assessed using the EQ‐5D‐3L. For the items in the EQ‐5D‐3L, more problems were related to lower HRQoL. Restricted mobility and occurrence of pain/discomfort was common. Lower HRQoL was associated with increased risk for depression, increased use of medication, increased number of chronic diseases and more problems with IADL. Healthcare use and healthcare costs were correlated with lower HRQoL. HRQoL is of importance to healthcare providers and must be considered together with IADL in the elderly population when planning interventions. These should take into account the specific needs and resources of the older individuals.     

Health‐related quality of life in children with myelomeningocele: a systematic review of the literature

Myelomeningocele (MMC) is the most complex congenital birth defect compatible with life. To provide the best health care for children with MMC, clinicians and researchers have to understand health and functional status of their patients as well as factors influencing their quality of life (QOL). The objective is to review studies that assess health‐related quality of life (HRQOL) and determinants of HRQOL in children with MMC. The data sources include MEDLINE, along with reference lists of relevant reviews and included articles. Study eligibility criteria are quantitative studies that assess HRQOL using validated HRQOL instrument. Participants include children aged 0–18 years with diagnosis of MMC or spina bifida. Risk of bias was assessed using the Hayden system for non‐randomized studies. Narrative synthesis and tables of results of HRQOL studies were conducted. Children with MMC have decreased HRQOL compared with normative population. Physical HRQOL is the most exposed aspect of QOL, while discrepancies in psychosocial domains vary by study. Many determinants of QOL have been found, and it is still not clear which determinant can be described as the strongest predictor. Psychosocial factors are the most consistent determinants of HRQOL.Heterogeneous study sample size, study designs, determinant and outcomes measures limited synthesis of findings. The HRQOL in children with MMC is complex and mediated by a number of associated medical problems, together with a variety of psychosocial and environmental factors. Future research is needed (a) on the relation between complex medical problems, functional independence, parent's and clinician's expectation and HRQOL in children and (b) to assess the differences in HRQOL by social environment and healthcare system.     

Evolution of quality of life and health‐related behaviors among Spanish university students

At the beginning of their academic studies (testing phase), the quality of life and certain health‐related behaviors were evaluated. Four years later (retest phase), they were reevaluated. Between the two evaluation periods, a health promotion (HP) program was applied. The battery of instruments included measures: health‐related quality of life (HRQOL), alcoholic and nicotine dependence, eating habits, physical activity, and sexual behaviors. It also included a number of sociodemographic data. The results show that, in general, the students reported adequate levels of HRQOL, and there were no important differences between the two evaluation moments. Regarding dietary behavior, no significant changes were detected in the pattern of adherence to the Mediterranean diet, which remained at an average level of adequacy. On the contrary, significant decreases were detected in relation to alcohol and tobacco dependence as well as significant increases in physical activity levels. Lastly, with regard to sexual behavior, although certain aspects of improvement were perceived, there is a need to increase awareness of the systematic use of condoms. In conclusion, this study provides relevant information that will serve as a starting point for monitoring changes in health behaviors and for the design and implementation of HP actions directed at university students.     

Health‐related quality of life and financial impact of caring for a child with Thalassaemia Major in the UK

Background Thalassaemia Major (TM) is a serious condition characterized by life‐long dependence on blood transfusions and chelation therapy. Our aim was to determine health‐related quality of life (HRQOL) in children with TM living in the UK, and the impact of caring for a child receiving National Health Service treatment on family finances. Methods This was a cross‐sectional assessment of HRQOL in children (n= 22) with TM aged 8–18 years. Children were recruited from three UK Paediatric Haematology and Bone Marrow Transplant centres. Mothers completed measures of their child's HRQOL [PedsQL? 4.0 (Measurement Model for the Pediatric Quality of Life Inventory?, James W. Varni PhD, PedMetrics?, Quantifying the Qualitative SM, Copyright 1998–2009)] and behaviour (Strengths and Difficulties questionnaire), and the impact of caring for the child on family finances. Results Child behaviour was within the normal range but child HRQOL was significantly lower than population norms. Family financial concerns associated with TM were associated with poorer child HRQOL (P= 0.020). Conclusions Thalassaemia Major poses a considerable challenge to child HRQOL, well documented in areas of the world where TM is prevalent. Despite the availability of National Health Service care and financial benefits our study suggests a similar burden in the UK.     

Health‐related beliefs and consumer knowledge as determinants of fish consumption

Background: Despite scientific evidence on the positive effects of seafood consumption on human health, the consumption of fish remains below the recommended intake levels for the majority of Europeans. The present study aimed to explore cultural differences in potential determinants of fish consumption: consumers’ knowledge and health‐related beliefs, as well as the relationship between those variables, socio‐demographics and fish consumption frequency, using data from five European countries. Methods: A cross‐sectional consumer survey was carried out in 2004 with representative household samples from Belgium, the Netherlands, Denmark, Poland and Spain. The sample consisted of 4786 respondents, aged 18–84 years, who were responsible for food purchasing and cooking in the household. Results: European consumers had a very strong belief that eating fish is healthy. Consumers’ belief that eating fish is healthy, their interest in healthy eating and objective fish‐related nutrition knowledge, positively, but only weakly, influenced fish consumption frequency. Subjective knowledge was found to be a stronger predictor of fish consumption than the previously noted factors. Age and education contributed, both directly and indirectly through knowledge, to explain fish consumption behaviour. However, the path coefficients in the estimated model were relatively low, which indicates that fish consumption frequency was also determined by factors other than health‐related beliefs and consumers’ knowledge. Conclusions: The findings of the present study suggest that communication should focus on health‐related benefits other than fish consumption alone. Communicating that eating fish is healthy and stressing the health benefits of fish alone, as is still commonly performed (e.g. in generic promotion and other types of public information campaigns) will be insufficient to achieve higher levels of compliance with fish consumption recommendations.     

Australian health‐related quality of life population norms derived from the SF‐6D

Objective : To investigate population health‐related quality of life norms in an Australian general sample by age, gender, BMI, education and socioeconomic status. Method : The SF‐36 was included in the 2009/10 wave of the Household, Income and Labour Dynamics in Australia (HILDA) survey (n=17,630 individuals across 7,234 households), and converted into SF‐6D utility scores. Trends across the various population subgroups were investigated employing population weights to ensure a balanced panel, and were all sub‐stratified by gender. Results : SF‐6D scores decline with age beyond 40 years, with decreasing education and by higher levels of socioeconomic disadvantage. Scores were also lower at very low and very high BMI levels. Males reported higher SF‐6D scores than females across most analyses. Conclusions : This study reports Australian population utility data measured using the SF‐6D, based on a national representative sample. These results can be used in a range of policy settings such as cost‐utility analysis or exploration of health‐related inequality. In general, the patterns are similar to those reported using other multi‐attribute utility instruments and in different countries.     

医学生负性生活事件与睡眠质量关系

目的 了解医学生睡眠质量的现况,探讨负性生活事件与睡眠质量之间的关系,为改善医学生睡眠质量提供依据。方法 采用青少年生活事件量表(ASLEC)和匹兹堡睡眠质量指数(PSQI)问卷对沈阳医学院预防医学专业学生进行现况调查。结果 364名医学生中20.6%存在睡眠问题,PSQI总分平均得分为(5.73±2.46)分。负性生活事件的发生率在36.81%～89.01%之间,ASLEC总分平均得分为(34.33±13.98)。ASLEC总分与PSQI 总分呈正相关(r=0.270,P<0.001)。ASLEC总分得分越高,PSQI得分可能越高(t=5.530,P<0.001)。结论 睡眠问题在医学生中有一定的发生率,负性生活事件得分越高睡眠质量越差呈正相关。     

生活事件、应付方式对医学生睡眠质量的影响

目的 探讨生活事件和应付方式对医学生睡眠质量的影响。方法 彩和匹兹堡睡眠指数（PSQI）、青少年生活事件量表（ASLEC）和应付方式问郑对409名医学生进行调查。结果 存在睡眠质量问题的学生不仅其生活事件总分明显高于睡眠质量好和睡眠质量一般的学生，且较多地采用不成熟的应付方式，结论 医学生的睡眠质量也受到生活事件和应付方式的影响。