Measuring elderly people's quality of life through the Beck Hopelessness Scale: a study with a Spanish sample

Objectives: Hopelessness is a key element of suicidal intent. It can instill a pessimistic outlook on the future, leading an individual to believe that suicide is the only answer to their problems. Hopelessness operates as a modulating variable between depression and suicidal behavior. The aim of this study was to confirm the factor structure of the Beck Hopelessness Scale (BHS) in a non-clinical sample.

Method: Three hundred and sixty-two Spanish individuals, aged over 60, free of cognitive impairment and depressive symptoms, completed the BHS scale. Participants were tested using confirmatory factor analysis (CFA), using one-, two- and three-factor models.

Results: The one- and two-factor models presented adequate fit indices. Specifically, the indices of the two-factor models were better than those of the one-factor model. The two-factor model, without items 4, 9 and 14, provided the best fit, given that the indices obtained in the CFA and their internal consistency were better than those of the other models.

Conclusion: The validation of the BHS for a population of Spanish older adults provides a reliable and valid measure of hopelessness and could be useful in clinical practice and research as an effective tool for the early detection of suicidal behaviors.     

Coping with institutional life at the old people's therapeutic community

A research project at a Finnish old people's home was carried out in 1983-1989, its aim being to explore whether therapeutic community principles can be applied to the institutional care of the elderly. Some aged seemed to adapt better to the community than others. In 1987 the group "excellent coping in institution" (N = 14) was formulated for this study, on the basis of favorable outcome, good adaptation to aging, nonproblematic behavior and a high subjective satisfaction with life. Using logistic regression analysis, the properties of this group were compared with the group "problem coping in institution" (N = 32). The following variables discriminated the excellent coping group best: therapeutic community activity, current mental health, and a socio-economically deprived childhood. This result suggested that active and mentally strong elderly coped better with the "homelike" therapeutic community method executed between 1983-87, which focused only on a pleasant atmosphere in which the old people could live together. Therefore the treatment policy has been partially reorganized since 1987, so as to include special attention for passive and mentally fragile residents. The modified therapeutic community that was developed seems to help coping in geriatric institutions if its working methods permit 1) active participation, 2) passive rest and reminiscence, and 3) support, holding, and even psychiatric intervention.     

老年精神分裂症患者生活质量和自我管理相关性研究

目的探讨老年精神分裂症患者生活质量现状与自我管理的相关性。方法采用便利取样法选取2014年1月-12月在大理州民政精神病医院住院的115名符合《国际疾病分类(第10版)》(ICD-10)诊断标准、年龄60岁的老年精神分裂症患者并进行随访,采用一般情况调查表、精神分裂症患者自我管理量表(SSMIS)、精神分裂症患者生活质量量表(SQLS)进行问卷调查。结果老年精神分裂症患者SQLS总评分及各分量表评分均高于常模(P0.05);生活质量与自我管理能力呈显著相关(r=-0.52~0.67,P0.05或0.01)。结论老年精神分裂症生活质量较差,提高患者自我管理能力可能有助于提高其生活质量。     

重视癫痫病人的生活质量,制定我国癫痫病人的生活质量量表

目前 ,判断癫痫病人是否治愈或好转仅仅以发作是否得到控制或减少为标准。判断一种新的疗法或药物是否有效也以发作是否减少为唯一标准。但是 ,194 7年ＷＨＯ对健康的定义为“一种身体上、精神上和社会活动上的良好状态 ,而不仅仅是无病”。就癫痫病人而言 ,没有发作是否就等于健康了 ?少数医生对同一个病人采用多种抗癫痫药治疗 ,或一种抗癫痫药用量过大 ,虽然部分病人能够控制发作 ,但由于副作用大以致于病人不能上学 ,不能工作 ,甚至不能自理生活。这能称之为健康吗 !现代医学已从单纯的生物学模式转变为生物、心理及社会医学模式。因此 …     

Measuring quality of life]

The four broad domains of quality of life are the physical status and functional abilities, the psychological status and well-being, the social interactions and the economic status and factors. Health profiles attempt to measure all important aspects of Quality of Life (QOL). They offer a number of advantages and they also have some limitations. A number of QOL indexes have been recently developed to measure emotional and social functions, well-being as well as overall health status. Some scales used to evaluate QOL are function-specific as social interactions scales or daily living scales; others are disease-specific. For the severely mentally ill patients the most comprehensive and psychometrically best characterized scales have been recently reviewed. The Lehman's Structured Quality of Life interview for example based on comprehensive quality of life models, includes both subjective and objective QOL indicators and should be extensively used in french clinical studies.     

Schizophrenia and quality of life

OBJECTIVE: The purpose of this paper is to examine critically results of quality-of-life research in schizophrenic patients living in the community. METHOD: Based on the relevant literature results of specific studies are discussed in the light of the methodological problems of assessing quality of life in these people. RESULTS: Subjectively assessed quality of life was found to be higher in the less educated and in female patients, and when a sense of control is experienced. If negative or extrapyramidal symptoms are experienced and stigmatization is perceived, subjective quality of life is reported as being poorer. These results are discussed in view of the additional needs and fewer resources of this population, their stigma-dilemma and their occasional difficulties in adequately assessing quality of life. CONCLUSION: It is argued that subjective and quantitative measures of quality of life in schizophrenic patients should be supplemented by external assessment and qualitative methods.     

The application of quality of life

Background Despite its popularity, to date little systematic work has been done in the application of the quality of life (QOL) concept to persons with intellectual disability (ID) and its impact on individuals and families. This article addresses that need. Method The article summarizes the four application strands suggested by the IASSID SIRG on Quality of Life regarding the application of the QOL concept and discusses critical aspects of each. Results Examples and guidelines regarding each strand are presented, along with the ongoing need to align conceptualization, application, and research efforts and integrate QOL principles into professional education and training programmes. Conclusions The QOL concept is now challenging some of the more traditional views and approaches to ID. These challenges are resulting in modifications and adaptations in current services and supports, along with the need to evaluate the outcomes from the application of QOL principles to persons with ID.     

Health-related quality of life in neurology

CONTEXT: In a climate of growing concern about costs of health care, professional accountability, and the effectiveness and efficiency of treatment, neurologists should understand measures of health-related quality of life (HRQoL) and appreciate both their values and their limits. OBJECTIVE: To provide a critical review of current concepts in the measurement of HRQoL, with particular emphasis on those pertaining to neurologic conditions. DESIGN: A selective overview of measurement strategies and specific instruments. SETTING: Clinical and research settings. PARTICIPANTS: Special attention to people with such conditions as multiple sclerosis and Parkinson disease. MAIN OUTCOME MEASURES: The utility and relevance to neurologists of available measures of HRQoL. RESULTS: There are both generic and condition- or disease-specific measures of HRQoL. Though many measures do not elicit response or are even offensive to people with such conditions as multiple sclerosis and Parkinson disease, other measures pertain directly to their circumstances and needs. CONCLUSIONS: Measures of HRQoL are both meaningful and relevant to neurologists. However, they must be refined-enabled-and used in combinations to address the clinical and existential realities of many neurologic conditions. Arch Neurol. 2000;57:1224-1227     

Medical residents and quality of life

This research has explored the quality of life in Medical Residents of General and Familiar Medicine. Fifty-one woman and forty-six males were interviewed. The following technique was applied: PECVEC (Perfil de Calidad de Vida). The results in the present sample indicate that is necessary to protect the future specialists where the quality of life obtain an important role.     

Assessing quality of life in ALS

The issue of quality of life is important for the patient with amyotrophic lateral sclerosis (ALS) and his or her family. Although initial thoughts frequently are that quality of life will be poor, there are strong data to support a relatively good quality of life despite the inexorable decline in strength and loss of function with disease progression. This article discusses how quality of life can be measured in ALS patients and caregivers, the results of studies, and factors affecting quality. It ends with 10 suggestions for clinicians who care for ALS patients and their caregivers.     

Schizophrenia and the quality of life

This paper discusses opportunities and constraints for psychiatry to exert an influence on the quality of life of people suffering from schizophrenia. Using the example of neuroleptic drug treatment, the opportunities to both positively and adversely affect quality of life by means of psychiatric treatment are illustrated. De-institutionalisation was used as an example for demonstrating the effect of the quality of mental health services. The fact that efforts on the part of professional helpers to achieve improvements in their patients' quality of life are constrained by existing economic and socio-cultural conditions is shown by discussing the stigmatization of people with schizophrenia and their situation on the labour market.     

Health-related quality of life in narcolepsy

OBJECTIVES: To describe health-related quality of life in Norwegian patients with narcolepsy compared with data from the general population. PATIENTS AND METHODS: Seventy-seven patients with narcolepsy with cataplexy were included in the final analysis. Health-related quality of life was assessed by SF-36 questionnaire. RESULTS: Men and women with narcolepsy had lower scores in all SF-36 domains, except vitality. Most profoundly affected were bodily pain (men: p = 0.0001, women: p = 0.0001), social function (men: p = 0.0001, women: p = 0.0001) and general health (men p = 0.04, women: p = 0.0001). CONCLUSIONS: Narcolepsy has a clear negative effect on quality of life which is not sufficiently counteracted by medical treatment. We suggest that earlier diagnosis and treatment after onset of symptoms may be important in reducing the negative effects on quality of life. Special attention should be paid to the patients social functioning and general well-being.     

Depression and health-related quality of life

Chronic medical conditions drastically affect the lives of those afflicted, leading to pain, disability, and disruption. Comorbid depression can exacerbate the effects of medical illness and may be an independent source of suffering and disability. Data from the Epidemiological Follow-Up Study (NHEFS) of the first National Health and Nutrition Examination Survey (NHANES I) are used to examine the manner in which depression and comorbid medical conditions interact to affect health-related quality of life (HRQOL). The findings suggest a) that the effects of depression are comparable with those of arthritis, diabetes, and hypertension; and b) that depression and chronic medical illnesses interact to amplify the effects of the medical illness. The data also support the merit of adopting a multidimensional approach to HRQOL rather than treating it unidimensionally.     

Assessing quality of life in dementia

Quality of Life (QOL) data are an established outcome measure in the assessment of therapeutic interventions. Combined QOL and pharmacoeconomic data are now routinely used to inform decisions about the optimum use of health care resources. All pharmacological, and other therapeutic interventions, have implications for quality of life, and the prospect of drug treatment for Alzheimer's disease (AD) raises important questions about the QOL of patients with dementia. Careful economic evaluation of the benefits of potential drug treatments will have to be made, and additional expenditure on drugs balanced against reduced expenditure on hospital and residential care.The assessment of QOL in dementia, however, raises a number of methodological issues and research in this patient group is just beginning.This paper presents a summary of the conceptual issues and a review of the current literature.