Narrative review of health‐related quality of life and its predictors among patients with coronary heart disease

This paper summarizes the empirical evidence concerning health‐related quality of life (HRQoL) of patients with coronary heart disease (CHD) and attempts to identify its significant predictors. A systematic search of the literature from 2002 to 2012 was conducted using seven electronic databases (CINAHL, ScienceDirect, Medline, Scopus, PsycINFO, PubMed and Web of Science) using the search terms ‘HRQoL’. ‘CHD’, ‘social support’, ‘depression’, ‘anxiety’, ‘psychosocial factors’, ‘sociodemographic factors’, ‘clinical factors’ and ‘predictors’. A total of 1052 studies were retrieved, of which 24 articles were included in this review. Previous studies have consistently demonstrated the negative impact of CHD on HRQoL, citing three major types of predictive factors: sociodemographic, clinical and psychosocial factors. Studies have also highlighted the advantageous use of HRQoL as a gauge for treatment satisfaction and efficacy. There are, however, few studies that collectively investigate the relationship among concepts such as HRQoL, anxiety and depression, social support, and sociodemographic and clinical factors in relation to CHD. This review highlights the need to conduct further study on HRQoL of patients with CHD in the Asian context. Such research will promote patient‐centric care and improved patient satisfaction through incorporation of the concept of HRQoL into clinical practice.     

Comparison of health‐related quality of life and emotional distress among Chinese cancer survivors

The purpose of this study is to compare health‐related quality of life (HRQoL) and emotional distress among diverse cancer survivors who had completed all treatment within the previous year. A convenience sample of 353 cancers survivors (lung, head and neck, breast and prostate cancers) were recruited to complete a survey, which consisted of (i) Hospital Anxiety and Depression Scales; (ii) Chinese version of the Functional Assessment of Cancer Therapy—General version; and (iii) demographic and clinical data. The HRQoL scores were similar among the four types of survivors. Mild anxiety and depression levels were reported, but no significant difference was noted. Younger females with financial burdens and uncertain prognosis were particularly associated with HRQoL and emotional distress. Further studies are essential to identify specific problems that cancer patients experience after cancer diagnosis that might lead to the early detection of those most at risk of ongoing problems.     

Health‐related quality of life among migrant workers: The impact of health‐promoting behaviors

Health‐related quality of life is an important aspect of migrant workers' overall well‐being and adaptation. The aims of this study were to develop a structural model and test the health‐related quality of life among migrant workers. A cross‐sectional study design was used, and data were collected from 228 migrant workers from China who are currently living in Korea and using the services of free clinics for health issues. The structured questionnaire disseminated for the study was designed to measure health‐related quality of life, health‐promotion behaviors, barriers, resources, and perceptual factors. Structural equation modeling was used to test the hypotheses. Health‐promotion behaviors and self‐efficacy have significant positive direct effects on health‐related quality of life, and acculturative stress has a significant negative direct effect on health‐related quality of life. These findings suggest that certain strategies are needed for developing health‐promotion programs aimed at the betterment of migrant workers' health‐related quality of life. Specifically, health‐promotion behaviors and self‐efficacy among migrant workers should be encouraged, and strategies for decreasing their acculturative stress should be formulated.     

Lifestyle and health‐related quality of life in Asian patients with total hip arthroplasties

Total hip arthroplasty reduces pain and restores physical function in patients with hip joint problems. This study examined lifestyle and health‐related quality of life before and after total hip arthroplasty in Japanese and Chinese patients. Two hospitals in China recruited 120 patients and 120 Japanese patients matched by age and operative status were drawn from a prospective cohort database. Oxford Hip Score, EuroQol, and characteristics of Asian lifestyle and attitudes toward the operation were assessed. There were no differences between patients from the two countries in quality‐of‐life‐scale scores: postoperative patients had significantly better quality‐of‐life scores than preoperative patients in both countries. In China, patients who reported that living at home was inconvenient had significantly worse Oxford Hip Scores than those who did not. Mean scores for anxiety items concerning possible dislocation and durability of the implant were significantly higher in Japanese than in Chinese subjects. Our findings suggest that providing information about housing conditions and lifestyles would result in improved quality of life and reduced anxiety in patients with implanted joints.     

Mediation analysis of health‐related quality of life among people living with HIV infection in China

The effects of stigma, social support, and depressive symptoms on health‐related quality of life are well documented in the literature, but how these psychological factors interact with each other, and the combined effects when taken together on the health‐related quality of life for people living with HIV, remain unclear. This cross‐sectional study investigated 114 people living with HIV who were taking antiretroviral medication using the HIV/AIDS‐related Stigma Scale (Chinese version), the Social Support Rating Scale, the Center for Epidemiological Studies Depression Scale, and the Medical Outcomes Study–HIV health survey. Multiple linear regression analyses were used to examine the mediation effect of the psychosocial factors on health‐related quality of life. Results showed that stigma and social support did not have direct effects, but indirect effects on health‐related quality of life through a full mediation effect of depressive symptoms. The results indicate that interventions targeting depression might be the most effective approach to improving health‐related quality of life among people living with HIV who are taking antiretroviral medication in China.     

Path model of factors influencing health‐related quality of life among older people with knee osteoarthritis

Chronic illness has a significant effect on quality of life, and a critical measure of health outcomes. Correlations between pain, depressive symptoms, fatigue, and physical function and their direct and indirect effects on quality of life were determined among 200 Thai older population with knee osteoarthritis using the Numeric Rating Scale, the Multidimensional Assessment of Fatigue, and the Thai Geriatric Depression Scale‐15. Physical function was investigated by using the Timed Up and Go test. Path analysis revealed significant negative direct paths from pain, depressive symptoms, fatigue, and Timed Up and Go test results to quality of life. Pain, fatigue, and the Timed Up and Go test results had indirect effects on quality of life, while depressive symptoms had no indirect effect on quality of life. Increases in pain, depressive symptoms, fatigue, and Timed Up and Go test results were associated with reductions in quality of life. An understanding of the complex relationship among these variables is beneficial for designing an appropriate intervention for improving quality of life among older people with knee osteoarthritis.