Perceived stress,resilience, and health‐related quality of life among Parkinson's disease caregivers in Mexico

The stress process model of caregiving posits that caregivers' internal psychosocial resources may serve as buffers between the stress associated with caregiving and well‐being. Empirical support for the stress process model exists for several caregiving contexts, but little research has investigated the Parkinson's disease caregiving experience in Mexico. Using a cross‐sectional, correlational design, the objective of this study was to examine whether resilience moderates the relation between perceived stress and health‐related quality of life (HRQOL) among Parkinson's disease caregivers in Mexico. Data were collected from April 2015 to February 2016 during outpatient neurology appointments in Mexico City, Mexico. Participants included informal caregivers (N = 95) for a family member with Parkinson's disease. Participants completed a battery of questionnaires assessing their level of perceived stress, resilience, and HRQOL. Regression analyses indicated that resilience moderated the inverse relation between perceived stress and mental HRQOL. However, contrary to hypotheses, resilience did not moderate the relation between stress and physical HRQOL. Findings shed light on resilience as a potential protective factor for mental HRQOL among Parkinson's disease caregivers in Mexico and indicate that resilience may be beneficial to target in mental health promotion interventions.     

The added value of propensity score matching when using health‐related quality of life reference data

Direct comparisons of health‐related quality of life (HRQoL) outcomes between non‐randomized groups might be biased, as outcomes are confounded by imbalance in pre‐treatment patient characteristics. Such bias can be reduced by adjusting on observed covariates. This is the setting of HRQoL comparisons with reference data, where age and gender adjustment is commonly used for this purpose. However, other observed covariates can be used to lessen this bias and yield more precise estimates. The objective of this study is to show that more accurate HRQoL comparisons with reference data can be obtained, accounting for few covariates in addition to age and gender by a propensity score matching approach. Copyright © 2013 John Wiley & Sons, Ltd.     

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 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.     

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 quality of life (HRQoL) in patients with cancer and other concurrent illnesses

This study analyzed the impact of eight common chronic medical conditions on cancer patients' health-related quality of life (HRQoL) as measured by the functional living index-cancer (FLIC). The FLIC was administered to a population of 405 people in 14 communities in the North Central US within 4-8 weeks of diagnosis with breast or colorectal cancer. At that time, patients also self-reported any other health conditions for which they had been receiving medical treatment. The impact of the selected chronic conditions on the FLIC scores was analyzed using Student's t-tests and linear multiple regression. In the bivariate analysis, patients with heart/circulation problems had lower FLIC total scores (p < 0.05), physical well-being subscale scores (p < 0.05), and nausea subscale scores (p < 0.01). Patients with diabetes had lower nausea subscale scores (p < 0.05). The social well-being subscale score was higher with the report of arthritis/joint problems (p = 0.001). In multivariate analysis adjusted for age, arthritis/joint problems were predictive of the social well-being (p < 0.01) and hardship due to cancer (p < 0.05) subscale scores; heart/circulation problems (p < 0.001) and diabetes were predictive of the nausea subscale scores. ECOG performance status was significant predictor for the FLIC total and all of the subscale scores. HRQoL as measured with the FLIC scores in patients with cancer is impacted by the presence of other concurrent health conditions; this finding has implications for HRQoL theory and application.     

Valuing health‐related quality of life: An EQ‐5D‐5L value set for England

A new version of the EQ‐5D, the EQ‐5D‐5L, is available. The aim of this study is to produce a value set to support use of EQ‐5D‐5L data in decision‐making. The study design followed an international research protocol. Randomly selected members of the English general public completed 10 time trade‐off and 7 discrete choice experiment tasks in face‐to‐face interviews. A 20‐parameter hybrid model was used to combine time trade‐off and discrete choice experiment data to generate values for the 3,125 EQ‐5D‐5L health states. Valuation data are available for 996 respondents. Face validity of the data has been demonstrated, with more severe health states generally given lower values. Problems with pain/discomfort and anxiety/depression received the greatest weight. Compared to the existing EQ‐5D‐3L value set, there are considerably fewer “worse than dead” states (5.1%, compared with over one third), and the minimum value is higher. Values range from ?0.285 (extreme problems on all dimensions) to 0.950 (for health states 11211 and 21111). Results have important implications for users of the EQ‐5D‐5L both in England and internationally. Quality‐adjusted life year gains from interventions seeking to improve very poor health may be smaller using this value set and may previously have been overestimated.

     

Mediating effects of psychological resilience on life satisfaction among older adults: A cross‐sectional study in China

The mediating effects of psychological resilience on quality of life among older adults were rarely examined empirically. Based on the literature on the relationship between psychological resilience and quality of life and the factors associated with psychological resilience among older adults, a theoretical model was proposed with the hypothesis that psychological resilience would mediate the relationships between both filial support and sense of community and life satisfaction among older adults. The research used a cross‐sectional design. Non‐probability sampling method was applied to recruit 418 community‐dwelling older adults in two adjacent cities in Fujian, China in 2017. A face‐to‐face structured Chinese questionnaire was adopted to collect data. The structural equation modeling showed that psychological resilience mediated the relationships between both filial support and sense of community and life satisfaction. The findings confirmed the positive impacts of psychological resilience on older adults’ life satisfaction and highlighted the importance of family and community contexts to older adults’ psychological resilience and life satisfaction. Interventions and programmes that aim to promote filial support towards older adults and enhance their sense of community would contribute to both their psychological resilience and life satisfaction.     

农村居民高血压患者生存质量的评价

目的　探讨汉化的SF - 36生存质量量表在农村居民高血压患者中的适用性。方法　在基线调查的基础上按照性别、民族、年龄 (± 2岁 )按 1∶2配比抽出 1 90例高血压患者和 380例正常对照 ,用SF - 36量表进行调查。结果　在躯体疼痛、总体健康、活力、社会功能和精神健康等 5个维度中 ,高血压患者的得分均比血压正常者的得分低 ,有显著性差异 (P <0 0 5) ;总的内部一致性是 0 89,生理功能、生理职能、躯体疼痛、情感职能、总体健康和精神健康 6个维度的Cronbach’sα系数大于 0 6 ;生理功能、生理职能、躯体疼痛、总体健康和情感职能 5个维度的相关系数均比其Cronbach’sα系数低。结论　用汉化的SF - 36生存质量量表评估农村居民高血压患者 ,显示了比血压正常者较低的生存质量 ,并且也显示了较好的内部一致性信度和结构效度 ,认为此表用于农村居民高血压患者生存质量的评价是可行的