Health-related and overall quality of life of patients with chronic hip and knee complaints in general practice

Background: Information about quality of life of patients with chronic hip or knee complaints in general practice is scarce. This study describes the health-related and overall quality of life (HRQL) of these complaints. Methods: Data were obtained from a cohort study in general practice. HRQL at three months follow-up was analysed. HRQL was measured as: symptoms, physical, psychological and social functioning, and general health perceptions, using the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and the MOS 36-item short-form-health survey (SF-36). Overall quality of life was measured using a 5-point rating scale. Results: The results show that patients with chronic hip or knee complaints have a substantial lower HRQL compared to patients who had recovered from baseline hip or knee complaints. The largest effect was found on symptoms and physical functioning: up to 2.9 standard deviations below patients who had recovered from baseline hip or knee complaints. Scores of patients with both chronic hip and knee complaints were significantly worse than scores of patients with only knee complaints on most subscales. Conclusion: In patients with chronic hip or knee complaints the worst scores were seen on scales that measure symptoms and physical functioning, but still a substantially lower score was obtained for overall quality of life. Quality of life was poorer for patients with both chronic hip and knee complaints compared to those with chronic hip or knee complaints only.     

Relation of certain psychological factors with degenerative diseases and disorders of the locomotor system

The incidence of neuroticism, extroversion-introversion and astenic personality characteristics was studied in three groups of 50 subjects each: controls, rheumatic patients in whom subjective complaints and objective medical status of the locomotor system were not analogous, and rheumatic patients in whom complaints and objective medical status of the locomotor system were analogous. All subjects were examined by a rheumatologist and interviewed by a psychologist. The psychological methods applied were: short interview, Eysenck Personality Questionnaire (EPQ) and Cornell Index. According to the results of univariate analysis of variance the group of subjects with inadequate complaints had significantly higher scores on the scales of neuroticism and astenic personality characteristics than the control group and the group of subjects with adequate subjective complaints. The results of this work indicate that some health complaints can be partly attributed to superposition of symptoms and neurotic personality characteristics.     

Determinants of the quality of life of patients with congenital heart disease

Objective: The improvement of the quality of life of chronically ill patients has become an important goal in treatment. However, it is seldom taken into account that many other factors, in addition to somatic factors, have an influence on the quality of life of patients. Using patients with congenital heart defects as an example, we examined the relative significance of biological factors, compared to psychological and social factors, for the various quality of life dimensions. Research design and methods: One hundred and eleven patients (aged 33 ± 12 years) with different degrees of cardiac dysfunction were examined (NYHA 0: 2 I: 56, II: 38, III: 13, IV: 2). All patients for whom there was no contra-indication underwent a treadmill ergometry in order to determine their level of cardiopulmonary functioning (peak oxygen consumption: ). All patients were asked to fill out questionnaires concerning their quality of life (WHOQOL-Bref), their cardiac complaints (Giessener Complaint Questionnaire GBB), their personality traits (Giessen Test GTS), and the social support they experience (Social Support Questionnaire SOZU-k22). The data were analyzed using a linear structural equation model (SEM). Results: In all aspects but the social domain, the HRQL of CgHD patients was significantly diminished compared to the normal population. The SEM proposed was valid, showing good indices of fit (χ²=1.18; p=0.55; AGFI=0.92). The level of cardiopulmonary functioning was most significant for the reporting of specific cardiac complaints (β=−28) and for the physical component of the general HRQL (β=32), although the former was also influenced by a depressed disposition (β=−0.20) and the extent of social support experienced (β=0.18). The objective findings, however, had virtually no individual significance for the psychological (β=0.09) and social domains (β=−0.02). These HRQL domains are primarily influenced by depressive personality traits (β=−26/−0.16) and the social support experienced (β=0.51/0.51). Conclusions: The patient’s organic dysfunction primarily determines illness-specific complaints but has little relevance for the psychological and social aspects of the HRQL. These aspects are predominantly determined by the patient’s depressive disposition and by the experienced social support. A successful therapy should therefore take biological as well as psycho-social determinants of the quality of life into account.     

Investigating correlates of health related quality of life in a low-income sample of patients with diabetes

Objective: We sought to describe and find correlates of health-related quality of life among under-served low-income patients in North Carolina with diabetes mellitus. Methods: A telephone survey of 310 patients recording quality of life, patient satisfaction, self-reported health, and patient complaints was conducted as part of a diabetes care improvement project. Demographic and clinical records were available for 249 of these patients: 69% were female, 45% were minority, and 84% had type 2 diabetes. Ages ranged from 18 to 88 years with a mean of 56. Quality of life indices consisted of SF-36 physical functioning, mental health and diabetes-39 sub-scores. Results: Comparison to SF-36 norms showed the sample had lower sub-scores than expected. The multivariate analysis suggested that being within an acceptable metabolic control predicted better quality of life physically, mentally, and sexually. Strong associations were detected between most sub-scores and complaints involving legs and feet, self-rated vision, and hassles in self-management. Conclusions: The consistent associations between the sub-scores and complaints, symptoms, and hassles underscore the strong relationship quality of life may share with the severity of diabetes complications as well as with psychosocial factors. Significantly lower quality of life in this sample highlights the need to improve the care of minority low-income diabetes patients.     

父母生存质量对学龄儿童智力和个性发育的影响

目的 探讨父母生存质量对学龄儿童智力及个性发育的影响。方法 采用联合型瑞智力测验（CRT－C2），艾森克人格问卷（EPQ）对哈尔滨市1961名城乡7－12岁学龄儿童进行智力及个性发育测试，同时采用WHO生存质量测定量表简表（WHOQOL－BREF）对其父母进行生存质量问卷调查。结果 单因素分析发现，父母生存质量的生理，心理领域均对儿童智力，个性发育有显影响（P＜0．001）。结论父母生存质量对学龄儿童智力及个性发育有明显影响，改善家庭成员的生存质量对提高儿童心理健康水平有重要意义。     

Construction and validation of a quality of life questionnaire in Chronic Lower Limb Venous Insufficiency (CIVIQ)

Quality of life may be considerably reduced in patients who are suffering from chronic lower limb venous insufficiency, although existing generic quality of life instruments (NHP, SF-36 or SIP) cannot completely identify their specific complaints. The Chronic Venous Insufficiency Questionnaire (CIVIQ) has been developed by iterative process. First, a pilot group of 20 patients was used to identify a number of important features of quality of life affected by venous insufficiency, other than physical symptoms of discomfort. A second study involving 2,001 subjects was used to reduce the number of items. Subjects were asked to score both the severity of their problems and the importance they attributed to each problem on a 5-point Likert scale. The importance items found in patients with venous insufficiency were subjected to factorial analyses (PCA, PAF). The final version is a 20-item self-administered questionnaire which explores four dimensions: psychological, physical and social functioning and pain. Internal consistency of the questionnaire was validated for each dimension (Cronbach's alpha > 0.820 for three out of four factors). Reproducibility was confirmed in a 60 patient test-retest study. Pearson's correlation coefficients for both the four dimension subscales and for the global score at 2-week intervals were greater than 0.940. Finally, the questionnaire was tested in a randomized clinical trial of 934 patients in order to assess responsiveness and the convergent validity of the instrument, together with the patient's own quality of life. This study demonstrated that convergence was valid: Pearson's correlation coefficients between clinical score differences and quality of life score differences were small (from 0.199–0.564) but were statistically different from 0 (p<0.001). Standardized response mean (SRM) and effect size (ES) were calculated to assess sensitivity to change. SRM and ES both demonstrated considerble responsiveness to change (>0.80). Reliability, face, content, construct validity and responsiveness were also determined for this specific quality of life questionnaire relating to venous insufficiency. Results suggest that this questionnaire may be used with confidence to assess quality of life in clinical trials on chronic venous insufficiency.     

Neuroticism and extraversion in association with quality of life in patients with Parkinson’s disease

Purpose  Personality traits appear as determinants of quality of life (QoL) in most chronic diseases. The aim of this study is to explore whether neuroticism and extraversion contribute to the variance in QoL in patients with Parkinson’s disease (PD) when controlled for age, functional status and disease duration. Methods  The Parkinson’s Disease Quality of Life Questionnaire (PDQ-39) was used to assess QoL and the Unified Parkinson’s Disease Rating Scale (UPDRS) for disease severity. Neuroticism and extraversion were measured with the Eysenck Personality Questionnaire (EPQR-A). Multiple linear regression analysis was then used to assess the contribution of neuroticism and extraversion to QoL. Results  The sample consisted of 153 PD patients (48.4% women; 67.9 ± 9.3 years; mean disease duration 7.5 ± 5.8 years). Neuroticism was, after disease severity, the second most important variable associated with QoL in PD patients, in particular for domains associated with psychological processes: emotional well-being, social support, stigma and communication. A higher score in extraversion was significantly associated with better emotional well-being in males, but surprisingly, with worse emotional well-being in females. Conclusions  After functional status, personality traits were clearly associated with QoL in PD patients. Therefore, they should be taken into account by health-care professionals in their appraisal of patient complaints.     

心理干预对胃癌术后吻合口瘘患者生活质量的影响

目的探讨心理护理干预方法对胃癌术后吻合口瘘患者生活质量的影响，为提高其生活质量提供参考。方法通过对确诊的胃癌术后吻合口瘘患者26例术前进行SF-36生存质量调查，从人院、术后及恢复期对其实施心理护理干预，于出院前再次进行生活质量调查，分析患者术前及康复期生活质量的变化。结果总体健康、生理功能、生理职能、躯体疼痛、活力、社会功能、情感职能及精神健康八个角度的评分显著高于术前。结论对胃癌患者进行系统的心理护理干预，能显著改善其生活质量。     

Relationship between personality types and musculoskeletal disorders among office staff

Background:Musculoskeletal disorders (MSDs) have been recognized as common health-related problems in the workplace. Accordingly, poorly-designed workstations and assigned tasks can lead to exposure to risk factors inducing MSDs among office staff. Accompanied by physical risk factors, psychological ones in working environments can also contribute to MSDs occurrence. Thus, the purpose of this study was to examine the relationship between personality types as a psychological factor and MSDs occurrence among office staff.Methods:This cross-sectional study was carried out on office staff working at Shiraz University of Medical Sciences (SUMS) in 2016. The participants included 339 employees recruited using multi-stage simple random sampling method. The required data were likewise collected via a demographic characteristics information checklist, the Personality Pattern Questionnaire (PPQ), as well as the standardized Nordic Musculoskeletal Questionnaire (NMQ).Results:The findings revealed that the participants’ mean±standard deviation (SD) age were 36.4±7.8 years. As well, the most prevalent MSDs complaints were reported in lower back, knee, and neck regions with relative frequencies of 35%, 30%, and 25% respectively. Moreover, the results demonstrated that 0.6% of the participants were determined as individuals having a strong tendency for type A personality, 26.8% of them showed tendency for type A personality, 63.1% of these employees were categorized into those having a tendency for type B personality, and 9.4% of them were identified as participants who showed a strong tendency for type B personality. Additionally, statistically significant relationships were observed between personality types and MSDs occurrence (p=0.023). Furthermore, musculoskeletal symptoms were reported more prevalent among individuals having tendency for type A personality.Conclusion:Personality types and MSDs occurrence seemed to be associated. It was thus suggested to take account of psychological factors (e.g., personality types) in macro policy-making, employee selection, and professional staff training programs.Key words: Musculoskeletal disorders, office employees, personality type, psychological factors     

The Relative Contribution of Domains of Quality of Life to Overall Quality of Life for Different Chronic Diseases

This study examined the contribution of the quality of life (QoL) domains physical, social and psychological functioning to the explanation of overall QoL. Various disorders may differentially affect QoL domains due to disease-specific factors and, consequently, the relationship between QoL domains and overall QoL may vary between diseases. We therefore studied this relationship for several diseases as well as the differential impact of these diseases on QoL. The present study had a cross-sectional design. We selected patients (aged 57 years and older) with one of the following eight chronic medical conditions: lung disorder, heart condition, hypertension, diabetes mellitus, back problems, rheumatoid arthritis, migraine, or dermatological disorders. The total group of respondents included 1457 patients and 1851 healthy subjects. Regression analyses showed that the domain of psychological functioning contributed to overall QoL for all disorders, whereas physical and social functioning contributed to overall QoL for some disorders. Differences were found between most patient groups and healthy subjects with respect to physical functioning; with respect to social and psychological functioning some groups differed from the healthy group. Explanations for the findings and implications for clinical practice are discussed.     

Subjective complaints in orthopedists and general surgeons

The aim of this study was to investigate the prevalence of subjective complaints among two groups of health care personnel. Using a mail questionnaire, 63 male orthopedists and 78 male general surgeons were asked to respond to questions on their subjective musculoskeletal complaints as well as their age, occupational career, and daily working time. In the final analysis, 54 orthopedists and 63 general surgeons who were aged 59 years and had worked for at least 5 years in clinical practice were considered. The mean age was 43.3 (SD 7.6) years for the orthopedists and 41.8 (SD 9.5) years for the general surgeons. Their mean employment time was 18.1 (SD 8.9) years and 16.6 (SD 9.5) years, respectively. The average working time per day was 9.5 h. In general, the orthopedists had a higher prevalence of subjective complaints than the general surgeons. Problems in the shoulders and lower back were the most frequently reported complaints, followed by neck problems. There were significant differences (P < 0.05) between the two groups regarding stiffness in the shoulders, stiffness in the lower back, pain in the neck, and numbness in the fingers. When subjective complaints were compared between the junior (employment time: < 20 years) and senior (employment time: 20 years) staff, the junior orthopedists had significantly higher prevalence rates for stiffness in the shoulders, pain in the neck, and stiffness in the lower back. This subgroup had significantly higher odds ratios (ORs) for some subjective complaints as compared to the junior surgeons, e.g., pain in the neck [OR = 6.19, 95% confidence interval (95% Cl) 1.91–20.04], shoulder stiffness (OR = 3.75, 95% Cl 1.36–10.31), pain in the shoulders (OR = 4.41, 95% Cl 3.64–4.70), and stiffness in the lower back (OR = 4.93, 95% Cl 1.74–13.94). It was concluded that ergonomic intervention to improve the working environment is imperative. In addition to ergonomic factors, consideration might also be given to psychological factors with a view to reducing the risk of subjective complaints among these subjects.     

人格特征与乳腺癌患者生存质量的相关性研究

目的　探讨哈尔滨市乳腺癌患者生存质量与人格特征的相关性。方法　普通住院乳腺癌患者 5 2例 ,癌症康复协会乳腺癌患者 6 7例 ,共 119例 ,均使用世界卫生组织生存质量调查问卷 (WHOQOL 10 0 )、艾森克人格问卷(EPQ)、Zung’s抑郁自评问卷和Zung’s焦虑自评问卷进行调查。 结果　EPQ测量中的N因子与总的生存质量和生存质量的心理领域呈负相关 (P <0 0 5 )。乳腺癌患者的生存质量低于常模 ,焦虑、抑郁高于常模。结论　乳腺癌患者人格中情绪不稳定性高 ,降低生存质量 ,因此 ,必须把心理治疗和躯体治疗相结合来提高整体的疗效。     

Health-related quality of life varies with personality types: a comparison among cancer patients,non-cancer patients and healthy individuals in a Japanese population

In an attempt to examine differential effects of personality on health-related quality of life (HRQoL) without regard to disease type, we used the HRQoL-20, a general questionnaire (Japanese original scale) we developed (comprising 20 questions related to physiological, psychological or social HRQoL) and the Eysenck Personality Questionnaire (EPQ), which measures personality traits of extraversion (E), neuroticism (N) and psychoticism (P). The subjects (399 males and 429 females), stomach cancer patients, non-cancer patients (who had received acupuncture or moxibustion treatment) and healthy controls, were classified into three personality types. The results indicated that the HRQoL score of the tolerable/tolerant type (high E, low N and high P scorers) was greater than the intolerable/intolerant type (low E, high N and low P scorers) and also the unclassified type (neither of above scorers). The HRQoL correlated positively with the E and P scales and negatively with the N scale, in the case of all subjects, with the exception of N in male cancer patients and E in male non-cancer patients. The results supported the hypothesis that the HRQoL varies with personality variables, in that each patient, in different treatment settings, strives for the situation that is congruent with his/her personality to attain a better HRQoL.     

Study of quality of life on rural hypertensive patients. Comparison with the general population of the same environment

A comparative study about quality of life was made in the community of Riosa-north of Spain—on two groups of subjects: one affected by hypertension (n = 115), stage I and II of WHO, and another of the general population, matched in age, sex and residence with the former group and of the same size. The subjects with loss of self-care or mobility were excluded. The quality of life was evaluated with a standardized measurement approach referring to the spheres of physical, emotional, social and sexual functions.

With this study the validation of the Spanish version of the questionnaire was made and the results obtained were found to be more or less the same as those reported by authors in other European countries of similar sociodemographic conditions. Hypertensive patients reported significant lower scores of quality of life than the general population in more than half of the dimensions explored: well-being and physical capacity, social functioning, positive mood and psychological functioning.

In conclusion, despite the many limitations inherent to this area of research, a standardized and valid measure of relevant aspects of quality of life in the general population and especially in patients with hypertension, is available in the Spanish language.     

Health-related quality of life of patients with HIV: Impact of sociodemographic, clinical and psychosocial factors

Objectives: This study aims to analyse how a wide group of clinical, social, demographic and psychological factors are related to both physical and mental quality of life in HIV+ patients. Design: A cross-sectional study was carried out of 320 HIV+ patients in antiretroviral treatment who attended infectious diseases units in four hospitals in the region of Andalusia (Spain). Methods: Health-Related Quality of Life was measured by the MOS-HIV. Included as independent variables were: sociodemographic variables, variables related to antiretroviral therapy, psychosocial variables like social support (Duke-UNC-11) and psychological morbidity (GHQ-28), variables related to main risk behaviours and clinical variables. Results: In the multiple linear regression analysis, a better PHS quality of life was found to be associated with the absence of mental illness, social support, not being an intravenous drug user and using more than one type of non-injectable drug. A better quality of life, in mental terms, was found to be associated with fewer years as a non-intravenous drug user, having social support, absence of mental illness, not being an intravenous drug user taking only one additional pill, not having any difficulty in taking the medication, and being female. Conclusions: The study of other non-biological factors that may be related to quality of life has been limited practically to social support and the emotional state. This study highlights the importance of these factors independently from the clinical state, as well as the existence of other psychological and behavioural factors that are also related.     

Psychological Correlates of Quality of Life in Atrial Fibrillation

Objective: Atrial fibrillation (AF) is associated with significant health-related quality of life (QoL) impairments. Markers of heart disease severity have explained little variance in QoL and it is unclear what other factors will better account for the observed differences in adjustment. We examined whether specific personality traits and illness management styles would help explain the severity of QoL impairments reported in this population.Methods: Patients with AF (N = 93) completed validated questionnaires measuring disease burden (dependent variables: physical and mental QoL, symptom severity, psychological distress), personality (independent variables: anxiety sensitivity, optimism), and illness management style (mediating variable: symptom preoccupation). Hypothesized relationships were evaluated using mediation models.Results: Anxiety sensitivity was associated with poorer physical and mental QoL, greater symptom severity, and higher distress. Optimism was correlated with better mental QoL and lower distress, but unrelated to physical QoL and symptom severity. Symptom preoccupation significantly mediated the relationships between anxiety sensitivity and each of the QoL measures, as well as the relationships between optimism and mental well-being.Conclusions: Personality traits and illness management styles are important to consider when assessing the impact of AF on QoL. The data support a cognitive-behavioral model that explains the direct and indirect relationships between psychological predictors and multiple indices of QoL.     

Women’s Quality of Life in the Premenopausal and Postmenopausal Periods

Purpose The purpose of this research was to determine the relationship between menopausal symptoms and quality of life in women in the pre and postmenopausal periods.Methods and instruments All 171 women in the climacteric period who registered at the Pamukkale University Education and Research Hospital Obstetrics and Gynecology Clinic between January and July 2001 were included in the study. A questionnaire asking for sociodemographic information, complaints related to the climacteric period, and HRT use, as well as the WHOQOL brief, were used in order to obtain data.Findings One hundred of the women who participated in the study were premenopausal and 71 were postmenopausal and the mean age was 47.39 (SD=6.65). No significant difference was found in pre and postmenopausal women in the comparison of their quality of physical life, psychological, social relationships and environment scores (p>0.05). The physical quality of life scores for those without vasomotor complaints in the pre and postmenopausal periods were significantly higher in those with a high educational level and women who had been menopausal between 1–5 years and more than 10 years (p<0.05). Age and HRT use in postmenopausal women were not found to affect quality of life scores (p>0.05).Result We did not find any significant difference in the quality of life of pre and postmenopausal women.     

Assessing quality of life in eating disorder patients

Objective: To examine quality of life among subgroups of eating disorder patients. Method: Self-report questionnaires which included two quality of life measures were completed by 87 individuals referred for treatment to the Australian Capital Territory Eating Disorders Day Program. Health-related quality of life, as measured by the Medical Outcomes Study 12-item Short Form Mental Component Summary scale, and subjective quality of life, as measured by subscales of the World Health Organization Brief Quality of Life Assessment Scale (WHOQOL-BREF), were compared among individuals who received the diagnosis of anorexia nervosa purging subtype (n=15), anorexia nervosa restricting subtype (n=19), bulimia nervosa (n=40) and binge eating disorder (n=10), and among a general population sample of young adult women employed as a control group (n=495). Results: Eating disorder patients, when considered together, showed marked impairment in both health-related and subjective quality of life relative to normal control subjects. However, in both domains, restricting anorexia nervosa patients reported significantly better quality of life than other patient groups, after controlling for levels of general psychological distress. Scores on the Social Relationships subscale of the WHOQOL-BREF among individuals in this subgroup were similar to those of normal control subjects. Conclusions: Reliance on any one instrument is likely to be misleading in assessing the quality of life of eating disorder patients. Careful consideration needs to be given to the assessment of restricting anorexia nervosa patients in particular.     

Coping styles, psychological functioning and quality of life in children with asthma

BACKGROUND: Previous research suggests that children dealing with the asthma are at a greater risk for experiencing psychological maladjustment than children without asthma. Research also suggests that coping is a factor in psychological adaptation to chronic stressors such as physical illnesses. The question as to how coping relates to psychological functioning and quality of life in the paediatric asthma population has not yet been answered. The objective of the current study was to examine the relationships among coping, psychological functioning and quality of life in children diagnosed with asthma and to investigate the relationship that mothers' quality of life has with these variables. METHODS: Forty-seven youths (aged 8-15 years) diagnosed with asthma completed measures of coping with asthma and quality of life. Each youth's mother completed measures of her child's coping, psychological functioning and her own quality of life. RESULTS: Mothers and children with asthma both reported that children used significantly more approach coping than avoidant coping when dealing with asthma. Three regression analyses indicated that avoidant coping negatively predicted psychological functioning, child's quality of life and mother's quality of life. Bivariate analyses also indicated a positive relationship between child's quality of life and mother's quality of life. CONCLUSIONS: Results indicate that, in children with asthma, coping style plays an important role in the child's psychological functioning and quality of life and mother's quality of life. Therefore, it is recommended that type of coping be assessed when developing comprehensive treatment plans for children with asthma. Further research is needed to determine the efficacy of focused coping interventions in improving quality of life and psychological functioning in children with asthma.