The impact of perceived tinnitus severity on health-related quality of life with aspects of gender

The Nottingham Health Profile (NHP) has been used to investigate the health profiles in different medical conditions. It has, however, never been applied to tinnitus sufferers. The present study aimed at investigating relationships between the perceived severity of tinnitus, audiometric data, age, gender and non-disease specific health-related quality of life measured with the NHP divided into two sections; NHP I (topics related to health status) and NHP II (health induced problems in daily life). These parameters were statistically analysed to identify predictive factors to the perceived severity of tinnitus, described by the Tinnitus Severity Questionnaire (TSQ). A total of 186 consecutive tinnitus patients (57 females and 129 males) attending an audiological specialist clinic in Sweden were included in the study. The stepwise regression model used explained 37.8 per cent of the variance in the perceived severity of tinnitus, and the significant predictors were: "Emotions", "Sleep", and "Pain", three of the six dimensions of the NHP I. Differences between gender were found in NHP II and age-related differences emerged in NHP I when male and female patients were compared to normal controls.     

Diabetes and its impact on health-related quality of life: a life table analysis

Purpose  

To investigate the health burden of diabetes and determine its impact on health-related quality of life (HRQOL) in a population with a high prevalence of chronic conditions.     

Health-related quality of life is related to COPD disease severity

Background  

The aim of this study was to evaluate the association between health-related quality of life (HRQL) and disease severity using lung function measures.     

Socioeconomic variation in the impact of obesity on health-related quality of life

There is evidence that obesity has a negative impact on health-related quality of life (HRQL). However, little attention has been paid to variations in this impact between population groups. This study investigates the relationship between HRQL and obesity, and whether or not this relationship varies by socioeconomic status (SES). Data were taken from four rounds of the Health Survey for England (2003-2006; n = 33,716) for persons aged 16 and above. Banded total annual household income is regressed against a comprehensive set of SES indicators using interval regression. We use the equivalised predicted values from this model, categorised into quartiles, as our measure of SES. We regress EQ-5D scores against interactions between body mass index and SES categories. Obesity is negatively correlated with HRQL. The negative impact of obesity is greater in people from lower SES groups. Overweight and obese people in lower SES groups have lower HRQL than those of normal weight in the same SES group, and have lower HRQL than those in higher SES groups of the same weight. This trend is also observed after controlling for individual and household characteristics, although the statistical significance and magnitude of effects is diminished.     

HIV and COPD: impact of risk behaviors and diseases on quality of life

Purpose  

Smoking worsens quality of life among HIV-infected individuals, but it remains unclear if this association is related simply to smoking or to chronic obstructive pulmonary disease (COPD), the end-organ disease caused by smoking.     

Assessing the socio-economic and demographic impact on health-related quality of life: evidence from Greece

Objectives:  The impact of socioeconomic status on health has been extensively studied and studies have shown that low socio-economic status is related to lower values of various health and quality-of-health measures. The aim of this study was to assess the influence of demographic and socio-economic factors on health- related quality of life (HRQoL). Methods:  A cross-sectional study was carried out in 2003 using a representative sample of a Greek general population (n = 1007, 18+ years old), living in Athens area. Multivariate stepwise linear regression analyses were performed to investigate the influence of socio-demographic and economic variables on HRQoL, measured by eight scales of the SF-36. Interaction effects between socioeconomic status (SES) and demographic variables were also performed Results:  Females and elderly people were associated with impaired HRQoL in all SF-36 scales. Disadvantaged SES i. e. primary education and low total household income was related to important decline in HRQoL and a similar relation was identified among men and women. Only the interaction effects between age and SES was statistically significant for some SF-36 scales. Multiple regression analyses produced models explaining significant portions of the variance in SF-36 scales, especially physical functioning. Conclusions:  The analysis presented here gives evidence of a relationship existing between SES and HRQoL similar to what has been found elsewhere. In order to protect people from the damaging effects of poverty in health it is important to formulate health promotion educational programs or to direct policies to empower the disposable income etc. Helping people in disadvantaged SES to achieve the good health that people in more advantaged SES attained would help to prevent the widening of health inequalities. Submitted: 05 May 2008; revised: 13 November 2008, 23 March 2009; accepted: 26 March 2009     

The impact of denial on health-related quality of life in patients with HIV

Background/purpose

The purpose of this study was to examine the influence of denial coping on quality of life (QOL) over time among individuals living with HIV, as denial has been understudied as a coping strategy within the literature on HIV/AIDS.

Methods

In a sample of 65 adult men and women, we used multilevel linear modeling to test trajectories of change in physical and mental health-related QOL across baseline, 3, 6, and 12?months, including denial as a predictor and gender as a moderator.

Results

The use of denial coping was associated with lower physical and mental health-related QOL at baseline. Denial coping predicted an increase in QOL over time, though QOL remained low in those who practiced denial coping. Men??s baseline mental health-related QOL was more negatively affected by denial coping than women??s. Women tended to increase in QOL more slowly over time compared to men.

Conclusion

Reliance on denial as a coping strategy is associated with poorer physical and mental health-related QOL in an HIV-positive population, though participants who engaged in denial also displayed more rapid improvement in their QOL over time. Men and women displayed different rates of improvement in QOL, indicating a need for gender-based treatment approaches. Future research should examine the complex role of denial on change in QOL.     

Evaluating the impact of wind turbine noise on health-related quality of life

We report a cross-sectional study comparing the health-related quality of life (HRQOL) of individuals residing in the proximity of a wind farm to those residing in a demographically matched area sufficiently displaced from wind turbines. The study employed a nonequivalent comparison group posttest-only design. Self-administered questionnaires, which included the brief version of the World Health Organization quality of life scale, were delivered to residents in two adjacent areas in semirural New Zealand. Participants were also asked to identify annoying noises, indicate their degree of noise sensitivity, and rate amenity. Statistically significant differences were noted in some HRQOL domain scores, with residents living within 2 km of a turbine installation reporting lower overall quality of life, physical quality of life, and environmental quality of life. Those exposed to turbine noise also reported significantly lower sleep quality, and rated their environment as less restful. Our data suggest that wind farm noise can negatively impact facets of HRQOL.     

Urinary incontinence in the puerperium and its impact on the health-related quality of life

This case-control study evaluated whether UI in the puerperium compromises the health-related quality of life (HRQoL) and if so, in which aspects. The study included 344 women (77 case group and 267 control group) up to 90 days postpartum, who were attended the Obstetrics Outpatient Clinic of a public teaching hospital, for the postpartum follow up consultation. A socio-demographic and clinical data questionnaire formulated and validated for the study, the International Consultation on Incontinence Questionnaire - Short-Form (ICIQ-SF), the King's Health Questionnaire (KHQ) and the Medical Outcomes Study 36 - Item Short Form Health Survey (SF-36), were applied. The mean score of the ICIQ-SF was 13.9 (SD: 3.7). The case group presented high mean scores in the domains Impact of the Incontinence, Emotions, Daily Activity Limitations and Physical Limitations, of the KHQ. The groups differed significantly in the domains Physical Aspects, Pain, General Health Status, Vitality, Social Aspects and Mental Health of the SF-36. It is concluded that UI significantly affects the physical and mental health of puerperae.     

The effects of clinical illness severity and physical activity on health-related quality of life in schizophrenia

Background

Quality of life is an important clinical outcome in individuals with schizophrenia. Illness severity and physical activity (PA) were independently reported to influence health-related quality of life (HRQoL) in people with schizophrenia. This study attempts to examine the intensity and types of PA and their impact on HRQoL, as well as the relative contributions of illness severity, PA, and sedentary behavior (SB) to HRQoL in people with schizophrenia.

Methods

Demographic information was collected from 297 community-dwelling individuals with schizophrenia. Severity of illness was assessed on the Clinical Global Impression—Severity (CGI-S); PA and SB were assessed on the Global Physical Activity Questionnaire (GPAQ); HRQoL was assessed on the RAND-36. Regression analyses were conducted to examine the impact of different types and intensities of PA on HRQoL, and the relative impact of CGI-S, GPAQ-PA, and GPAQ-SB on HRQoL.

Results

Most participants had low PA level, and travel is the main type of PA adopted. Leisure time, travel-related, work-related, moderate-, and vigorous-intensity PA were all not associated with HRQoL. Lower severity of illness was significantly associated with better physical (PHC), mental (MHC) and global (GHC) health composites of the RAND-36 (GHC: t?=???5.628, p?<?0.001, PHC: t?=???4.026, p?<?0.001, MHC: t?=???5.534, p?<?0.001). Both PA and SB were not significantly associated with PHC, MHC, and GHC.

Conclusion

Severity of illness has a significant impact on HRQoL in people with schizophrenia. However, we found no evidence to support the association between physical activity and sedentary behavior with HRQoL.

     

The influence of COPD on health-related quality of life independent of the influence of comorbidity

BACKGROUND/OBJECTIVES: The goal of this study was to determine the influence of chronic obstructive pulmonary disease (COPD) on health-related quality of life (HRQL) independent of comorbidity. METHODS: Patients with COPD in general practice, >/=40 years, were selected. To recruit controls, a random sample of persons without COPD and >/=40 years, was taken. HRQL was assessed with the SF-36 and comorbidity was determined by questionnaire. RESULTS: The influence of COPD on HRQL independent of comorbidity (represented by adjusted regression coefficients) was significant for physical functioning (-27.6), role functioning due to physical problems (-21.6), vitality (-14.4), and general health (-25.7), and was minor and not significant for social functioning (-5.6), mental health (-1.3), role functioning due to emotional problems (-2.7), and bodily pain (-2.5). Comorbidity contributed significantly to the HRQL of all domains (-7.6 to -27.1). CONCLUSIONS: COPD patients can be impaired in all domains of HRQL. However, impairments in physical functioning, vitality, and general health are related to COPD and to some extent to comorbidity, while impairments in social and emotional functioning do not seem to be related to COPD, but only to comorbidity.     

The impact of literacy on health-related quality of life measurement and outcomes in cancer outpatients

Background Limited evidence exists regarding the relationship between literacy and health-related quality of life (HRQL). Research is needed to develop measurement techniques for low literacy populations and to evaluate potential literacy-related measurement bias. Methods A Talking Touchscreen (TT) was developed for an HRQL study. Low (n = 214) and high literacy (n = 201) adult cancer outpatients participated, 70% of whom were from racial/ethnic minorities. Patients completed three questionnaires by TT: FACT-G (cancer-specific), SF-36 (generic health status), and a standard gamble utility questionnaire. Measurement bias was evaluated using item response theory (IRT). Effects of literacy on HRQL were evaluated using regression models. Results Most (97%) patients rated the TT easy to use. In IRT analysis, 6/27 FACT-G and 12/31 SF-36 items demonstrated literacy bias; this was relatively balanced (10 items ‘biased against’ low literacy; 8 ‘biased against’ high literacy). Mean literacy group differences were statistically and clinically non-significant for 9/14 HRQL outcomes. Adjustment for bias and/or covariates eliminated most remaining differences. Conclusions The TT is valid and useful for HRQL assessment in low literacy populations. There appears to be no systematic literacy bias in reporting HRQL, and low literacy is not an independent risk factor for poorer HRQL.     

The impact of metabolic syndrome on mental health-related quality of life and depressive symptoms

Quality of Life Research - Results examining associations between metabolic syndrome (MetS) and depression, as well as on quality of life (QoL), are inconsistent. We aimed to determine whether...     

The impact of chronic hepatitis C and co-morbid illnesses on health-related quality of life

OBJECTIVES: Determine the relative impact of chronic hepatitis C (CHC) and co-morbid illnesses on health-related quality of life (HRQoL) in 3023 randomly selected veterans with known hepatitis C virus antibody (anti-HCV) status who previously completed a veteran-specific HRQoL questionnaire (SF-36V). METHODS: Multiple regression analyses were performed to measure the relative contribution of anti-HCV status, four demographic variables, and ten common medical and six psychiatric co-morbidities to HRQoL between 303 anti-HCV(+) and 2720 anti-HCV(-) patients. RESULTS: Anti-HCV(+) veterans were younger, reported a lower HRQoL on seven of eight 36-Item Short Form Health Survey for Veterans (SF-36V) subscales (P < or = 0.001) and the mental component summary (MCS) scale (P < 0.001). The ten medical and six psychiatric co-morbidities had variable impact on predicting lower HRQoL in both groups. After adjusting for demographic variables and co-morbid illnesses, we found that anti-HCV(+) patients reported a significantly lower MCS score (P < 0.001) and a trend toward a lower physical component summary (PCS) score (P < 0.07) compared to anti-HCV(-) veterans. Among the anti-HCV(+) veterans, co-morbid medical illnesses contributed to impaired PCS but not to MCS. CONCLUSIONS : Veterans with CHC were younger than HCV(-) veterans and hence less likely to have other co-morbid medical illnesses. Medical co-morbidities seen in those veterans with CHC contribute to impaired PCS but not MCS. Anti-HCV(+) status negatively affects HRQoL, particularly MCS, independently of medical and psychiatric co-morbidities.     

Differential impact of systemic lupus erythematosus and rheumatoid arthritis on health-related quality of life

Purpose

This study examined and compared health-related quality of life (QoL) in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA).

Methods

We included patients from two multicentric cohorts, the Swiss SLE cohort study (SSCS) and the Swiss Clinical Quality Management Program for RA (SCQM-RA). Patients were matched by age, sex and disease duration using the propensity score. Disease activity was assessed by SELENA-SLEDAI in SLE and by DAS-28 in RA. QoL was captured by the short-form 36 (SF-36). The primary outcomes were physical component summary (PCS) and mental component summary (MCS) of the SF-36. Generalized estimating equation models were used to assess evolution over time.

Results

We analyzed 267 SLE patients and 267 matched RA patients. More patients with RA had active disease and more patients with SLE had immunosuppressant therapies at baseline. The median [interquartile range (IQR)] MCS and PCS scores were 45.1 [33.7–52.6] and 45.6 [38.0–53.0] in SLE and 48.8 [37.6–56.7] and 34.7 [26.8–43.0] in RA, respectively (ps?<?0.001). Over one year the differences persisted, although PCS and MCS increased in RA (ps?<?0.001) but not in SLE in the univariate analysis. The differences in MCS and PCS scores between RA and SLE remained qualitatively similar after adjustment for patient characteristics, treatment, and activity disease.

Conclusions

SLE and RA both affect QoL. Patients with SLE have lower MCS, whereas patients with RA have lower PCS. These differences remained over 1 year of follow up, suggesting fundamental dissimilarities between SLE and RA in their impact on QoL.

     

欧洲五维健康量表(EQ-5D)中文版应用介绍

  目的  了解上海市老年人健康相关生命质量及其影响因素,为提高老年人生存质量提供参考依据。  方法  收集上海市2013年第五次国家卫生服务调查数据,对上海市17个区县11 103名老年人的健康相关生命质量及其影响因素进行分析。  结果  上海市11 103名老年人中,欧洲五维健康量表（EQ-5D）健康描述系统行动能力、自我照顾能力、日常活动能力、疼痛或不舒服、焦虑或抑郁5个维度均没有任何困难者8 136人（73.28 %）,有极度困难者16人（0.14 %）。上海市老年人EQ-5D量表视觉模拟标尺（EQ-VAS）得分为0～100分,25 %分位数为70分,中位数为80分,75%分位数为85分。多因素分位数回归分析结果显示,婚姻状况已婚和丧偶、每天吸烟、饮酒 ≥ 1次/周、体育锻炼 ≥ 1次/周和1年内进行健康体检的EQ-VAS得分Q₅老年人得分较高,年龄 ≥ 70岁和患慢性病的EQ-VAS得分Q₅老年人得分较低;婚姻状况已婚和丧偶、饮酒 ≥ 1次/周、体育锻炼 ≥ 1次/周和1年内进行健康体检的EQ-VAS得分Q₂₅老年人得分较高,农业户口、年龄 ≥ 70岁、患慢性病和体育锻炼 < 1次/周的EQ-VAS得分Q₂₅老年人得分较低;女性、饮酒 ≥ 1次/周和体育锻炼 ≥ 3次/周的EQ-VAS得分Q₅₀老年人得分较高,年龄 ≥ 70岁和患慢性病的EQ-VAS得分Q₅₀老年人得分较低;婚姻状况已婚、离异和丧偶的EQ-VAS得分Q₇₅老年人得分较高,年龄 ≥ 70岁和患慢性病的EQ-VAS得分Q₇₅老年人得分较低;农业户口和患慢性病的EQ-VAS得分Q₉₅老年人得分较低。  结论  上海市老年人健康相关生命质量较好,户籍类型、年龄、婚姻状况、是否患慢性病、吸烟情况、饮酒情况、体育锻炼和1年内是否进行健康体检是该地区老年人健康相关生命质量的主要影响因素。     

The impact of menopause on health-related quality of life: results from the STRIDE longitudinal study

Purpose  

We examine the impact of menopausal status, beyond menopausal symptoms, on health-related quality of life (HRQoL).     

A systematic review and meta-analysis of the impact of tuberculosis on health-related quality of life

Purpose

To summarize the impact of tuberculosis (TB) on quantitative measures on self-reported health-related quality of life (HRQOL).

Methods

We searched eight databases to retrieve all peer-reviewed publications reporting original HRQOL data for persons with TB. All retrieved abstracts were considered for full-text review if HRQOL was quantitatively assessed among subjects with TB. Full-text articles were reviewed by two independent reviewers using a standardized abstraction form to collect data on socio-demographic characteristics, questionnaire administration, and mean HRQOL scores. Meta-analyses were performed for standardized mean differences in HRQOL scores, comparing subjects treated for active TB with subjects treated for latent TB infection (LTBI), or with healthy controls, at similar time points with respect to diagnosis and/or treatment.

Results

From over 15,000 abstracts retrieved, 76 full-text articles were reviewed, which represented 28 unique cohorts (6,028 subjects) reporting HRQOL among subjects with active TB; 42 % were women and mean age was 42 years. Data on key social and behavioral determinants were limited. Within individual studies and in meta-analyses, subjects with active TB disease consistently reported worse HRQOL than concurrently evaluated subjects treated for LTBI. However, meaningful improvements in HRQOL throughout active TB treatment were reported by longitudinal studies.

Conclusions

In a variety of studies, in different settings and using different instruments, subjects with active TB consistently reported poorer HRQOL than persons treated for LTBI. Future research on HRQOL and TB should better address social and behavioral health determinants which may also affect HRQOL.     

The impact of incontinence on health-related quality of life in a South Australian population sample

OBJECTIVE: To assess prevalence of incontinence in a South Australian representative population sample and compare the health-related quality-of-life impact of incontinence with other chronic conditions. METHOD: The 1998 South Australian Health Omnibus Survey interviewed 3,010 male and female respondents aged 15 to 97 years (response rate 70.2%). This representative population survey included questions to determine the prevalence of urinary (stress and urge), and anal (faecal and flatus) incontinence, and other chronic conditions. Respondents also completed the MOS SF-36 questionnaire. RESULTS: Self-reported prevalence of all types of incontinence was 26.0%. The prevalence of anal and urinary incontinence were 10.5% and 20.3% respectively, with 4.8% of respondents experiencing both. Univariate analysis found the prevalence of incontinence was statistically significantly higher among females, and those who were older, widowed, had no post-school education, and lower incomes. After adjusting for differences in age and sex, it was found that people with incontinence were significantly impaired across all dimensions of the SF-36, scoring in the lowest 42% of the population, compared with those people without incontinence. People with incontinence exhibited different SF-36 profiles to those with other chronic conditions. CONCLUSIONS: Incontinence is common in South Australia, affecting more than one-quarter of the population, particularly older women (56.2% for 60 years and over). The impact of incontinence on health-related quality of life is characteristically different to that demonstrated by other chronic conditions. IMPLICATIONS: In an ageing population, identification of the impact of incontinence is necessary to direct policy development and resource allocation to this area.