Green space and serious psychological distress among adults and teens: A population-based study in California

There has been mounting evidence for the beneficial effect of green space on mental health among adults, but studies on the same topics are lacking for teens in the US. This study aimed to fill in this research gap by utilizing data from California Health Interview Survey (CHIS) 2011–2014. A total of 81,102 households (composed of 4538 teens and 81,102 adults) were retained for main analyses. Surrounding greenness was assessed by the Normalized Difference Vegetation Index (NDVI) within varying buffers of home residence. Survey logistic regressions accounted for sampling weights and design were conducted to examine the effects of greenness on serious psychological distress (SPD), adjusted for major socio-demographic factors, neighborhood socioeconomic status (SES) and co-respondent's psychological distress level within the same household. An inter-quartile increment of NDVI in 350 m buffer predicted decreased odds of SPDs by 36% in teens (OR = 0.64, 95% CI = [0.46, 0.91]). Mediation analyses revealed that this association remained almost unchanged even after adjusting for social cohesion. The NDVI-SPD association of adults was found to be significant only in the older group (OR = 0.81, 95% CI = [0.68, 0.95]). This study is one of the first population-based US studies extending the epidemiological evidence for benefits of green space on mental health from adults to teens.     

基于EQ - 5D效用积分体系的慢性病患者健康相关生命质量研究

目的 分析慢性病患者健康相关生命质量及其影响因素。方法 利用2018年江苏省第六次卫生服务调查数据,该调查采用多阶段分层整群随机抽样的方法,选择15岁及以上患慢性病的居民为研究对象（3 646人）,基于EQ - 5D健康效用值,利用秩和检验、Tobit回归研究慢性病患者健康相关生命质量的影响因素。结果 58.06%的慢性病患者在EQ - 5D各维度没有任何困难;城市、已婚或其他婚姻状况、文化程度提高、家庭人均年收入增加、BMI升高、参加健康体检、进行体育锻炼是健康的保护因素（OR＜1）,年龄增长是健康的危险因素（OR＞1）。结论 慢性病患者健康相关生命质量较低,提高慢性病患者收入水平、文化程度并改善其健康行为对于提高这类人群的生命质量具有重要意义。     

广东省慢性病患者生存质量及健康调整期望寿命分析

目的 分析广东省慢性病患者生存质量及健康调整期望寿命。方法 基于广东省第五次全国卫生服务调查数据,通过欧洲五维度三水平健康量表对人群生存质量进行评价。运用多重线性回归和等级logistic回归评价慢性病对人群生存质量的影响,并用期望寿命和健康调整期望寿命指标评价慢性病对人群健康的综合影响。结果 共纳入68 550名居民数据进行分析,等级logistic回归显示在校正了社会人口学特征后,慢性病对生存质量各个维度的影响均有统计学意义,其中对疼痛/不舒服维度的影响最大[OR=4.48（95% CI：4.20~4.77）],其余依次为焦虑/抑郁[OR=3.95（95% CI：3.62~4.31）]、日常活动[OR=3.69（95% CI：3.37~4.04）]、行动[OR=3.63（95% CI：3.34~3.94）]和自我照顾[OR=3.30（95% CI：2.98~3.66）]。慢性病患者期望寿命比非慢性病人群平均少12.7年,健康调整寿命平均减少14.6年（男性减少17.8年,女性减少9.7年）。人群去慢性病健康调整期望寿命收益为3.8年（男性为5.1年,女性为2.0年）。结论 慢性病会影响患者生存质量的各维度,从而减少患者的健康调整期望寿命,给人群和社会带来沉重的健康负担。从卫生政策和卫生资源优化配置的角度看,需为慢性病患者尤其是为老年患者提供更全面可及的医疗照护,照护需不仅关注生理健康也要注重心理健康。     

Health-related quality of life of children and adolescents with chronic illness – a two year prospective study

The aim of this study was to compare the self-reported health-related quality of life (HRQL) of children and adolescents with diabetes, asthma or cystic fibrosis (CF) with the HRQL of a large community sample, to assess the extent to which the HRQL of the children and adolescents with chronic illness changes over time, and to examine the consistency of changes in different HRQL domains. One hundred and twenty three young people aged 10-16 years with asthma, diabetes, or CF were recruited from specialist paediatric clinics. Children rated their HRQL using the Child Health Questionnaire (CHQ) and three disease-specific measures at baseline, 6, 12, 18 and 24 months post-baseline. In several areas, the HRQL of children with chronic illness was significantly worse than that of children in the community sample. Over the 2 years of the study, although children with asthma and diabetes did not report significant changes in CHQ scores rating their physical health, they reported significant improvements in scores rating the extent to which health problems interfered with physical and family activities. CHQ scores describing their physical health reported by children with CF declined significantly but there was no significant change in scores rating interference with physical and family activities.     

中国9～18岁儿童青少年心理困扰流行现状

目的描述2019年中国9～18岁儿童青少年心理困扰流行情况, 并分析其影响因素。方法使用2019年全国学生体质与健康调研数据, 纳入148 892名9～18岁汉族儿童青少年。使用凯斯勒心理困扰量表(K10)评分对心理困扰进行测量:≤19、20～、25～、≥30分别表示无、轻度、中度、重度心理困扰(中度和重度心理困扰合称高心理困扰)。使用方差分析、t检验和χ2检验比较不同特征儿童青少年K10评分和高心理困扰率的差异, 使用方差分析和趋势χ2检验分析趋势, 使用修正泊松回归模型分析高心理困扰的影响因素。结果 2019年中国9～18岁儿童青少年K10评分为21.5±9.2, 高心理困扰率为31.6%。9～、13～、16～18岁儿童青少年的高心理困扰率分别为22.3%、35.9%和38.8%, 随着年龄升高其K10评分和高心理困扰率均呈上升趋势(趋势检验均P<0.001)。年龄较高、女生、乡村、中低人均GDP水平地区、父/母亲文化程度较低儿童青少年高心理困扰率更高(均P<0.001)。多因素修正泊松回归模型分析显示, 13～15岁、16～18岁、女生、乡村和中低人均GDP水平地区的...     

Development and pilot-testing of a health-related quality of life chronic generic module for children and adolescents with chronic health conditions: A European perspective

Health-related quality of life (HRQOL) assessment in children and adolescents with chronic health conditions is increasingly considered as a relevant topic. The aim of the EU-funded DISABKIDS project is to develop, test, and implement European instruments for the assessment of HRQOL of children and adolescents with disabilities and their families. The current paper describes the development and pilot testing of a chronic generic HRQOL measure. Using literature searches, expert consulting and focus groups with children/adolescents and their families, items of the instruments were developed and translated into the respective languages. A pilot test with 360 children and adolescents was conducted. Children and adolescents (8–12, 13–16years) with different chronic health conditions (asthma, epilepsy, diabetes, arthritis, atopic dermatitis, cerebral palsy, and cystic fibrosis) as well as their families were included. Data were analysed according to predefined psychometric and content criteria. Psychometric analyses resulted in a 56-item chronic generic HRQOL questionnaire with six domains (Medication, Physical, Emotion, Independence, Social Inclusion, Social Exclusion) with acceptable internal consistency.The DISABKIDS Group - The DISABKIDS Group comprises a coordinating group (Prof. Monika Bullinger, Dr. Corinna Petersen, Dr. Silke Schmidt, Institute of Medical Psychology, University Clinic Hamburg-Eppendorf) and study centres in seven countries: Prof. Michael Quittan, Dr. Nilouparak Hachemian and Dr. Othmar Schuhfried, Department of Physical Medicine and Rehabilitation, University of Vienna, Austria; Dr. Marie Claude Simeoni and Dr. Audrey Clement, Department of Public Health, University Hospital of Marseille, France; Dr. Ute Thyen. and Dipl.-Psych. Esther Müller-Godeffroy, Department of Paediatrics, Medical University of Lübeck, Germany; Dr. Athanasios Vidalis, Ass. Prof. John Tsanakas, Dr. Elpis Hatziagorou and Dr. Paraskevi Karagianni, Department of Psychiatry, Hippocratio Hospital, Greece; Dr. Hendrik Koopmann and Drs. Rolanda Baars, Department of Paediatrics, Leiden University Medical Centre, Netherlands; Dr. John Eric Chaplin, Department of Paediatrics, University Hospital Lund, Sweden; Prof. Mick Power, Dr. Clare Atherton and Dr. Peter Hoare, Department of Psychiatry, University of Edinburgh, United Kingdom.     

Health-related quality of life as a predictor of mortality among community-dwelling older persons

Health-related quality of life (HRQOL) measures predict cause-specific mortality, but few studies have explored whether generic self-reported HRQOL measures are independently associated with mortality in community-dwelling older persons. We postulated that a general measure of HRQOL, the short form 36-item questionnaire (SF-36), would be independently predictive of mortality among community-dwelling older persons. To evaluate this hypothesis, we followed a fixed cohort of 4,424 community-dwelling older persons recruited from a 2000 population-based survey in Taiwan until 2003 and investigated whether HRQOL was predictive of 3-year mortality, even after adjusting for traditional clinical risk variables. The data were collected via a door-to-door survey, and interviewers collected information on the subjects’ demographics, medical history, utilization of health services, functional ability, falls, and self-reported physical and mental symptoms. Of the 6053 eligible subjects, 4,424 residents agreed to participate in the baseline survey and were contacted in 2003. During the 3-year period, the 3-year cumulative mortality rate for the study population was 5%. Mortality was significantly higher among males (5.57% vs. 4.27%, p = 0.049), and cumulative mortality increased with age (χ ²-test for trend; χ ² = 7.734, p = 0.001). For all scales except bodily pain, there was a significant relationship between a 10-point lower baseline score and mortality. Our primary multivariate risk model, which included two summary measures of HRQOL and significant clinical variables, demonstrated that a 10-point decrease in either the baseline Physical Component Summary (PCS) score or the baseline Mental Component Summary (MCS) score was associated with higher mortality (PCS: RR: 1.60, 95% CI: 1.39–1.83; p < 0.001; MCS: RR: 1.16, 95% CI: 1.01–1.34; p = 0.036). The findings suggested that low baseline PCS and MCS scores were important independent risk factors for 3-year mortality among community-dwelling older persons, even after adjusting for other risk factors.     

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.     

Influences of income and employment on psychological distress and depression treatment in Japanese adults

Objectives  

Psychological distress is a health issue of critical importance, especially in people of working age in developed countries, including Japan. This study examined the relationships of income and employment arrangement with psychological distress and treatment of depression in a national sample of Japanese adults.     

Health-related quality of life and healthcare resource utilization by COPD patients: A comparison of three instruments

The aim of this study was to compare the SF-36 and two disease-specific instruments – St. George's Respiratory Questionnaire (SGRQ) and Chronic Respiratory Disease Questionnaire (CRDQ) among chronic obstructive pulmonary disease (COPD) patients using healthcare utilization data. The three instruments were administered twice by telephone interview to 40 COPD patients separated by a 3-month interval. Healthcare utilization data were obtained for the 3 months immediately prior to each administration. Reliabilities for sub-scales on the three instruments ranged from 0.70 to 0.90 for the SF-36, from 0.78 to 0.85 for the SGRQ, and from 0.64 to 0.91 for the CRDQ. In general, the study sample had poor physical health, and somewhat better mental health. None of the demographic variables were significantly associated with either health status or utilization. Among the three instruments, the SF-36 explained the most variance in healthcare utilization. The aggregate scores such as the summary scores of the SF-36 and the total score of the SGRQ did not perform as well as the individual sub-scales of the respective instruments in explaining the variation in utilization. The conclusion that the SF-36 provides the best association to healthcare utilization data from among the three instruments studied should be interpreted with caution given the small sample size and relatively brief duration of the study.     

Health-related quality of life changes among users of depot medroxyprogesterone acetate for contraception

Background

Depot medroxyprogesterone acetate (DMPA) may have other noncontraceptive effects that could impact on the quality of life. The objective of this study was to assess the health-related quality of life changes associated with the use of DMPA for contraception.

Study Design

A prospective, observational study using the Short Form-36 quality of life questionnaire.

Results

After 6 months of use, the participants had an improved physical summary score, mean change [5.64 (95% confidence interval [CI], 1.87–9.4), p=.054]. There was no significant change in sexual function [5.33 (95% CI, −2.15 to 12.81), p=.0858] and mental summary score [−0.51 (95% CI, −1.90 to 2.92), p=.432]. The main side effect of DMPA was menstrual irregularity (32.5%); 17.2% of the participants found amenorrhea desirable.

Conclusion

Besides its contraceptive efficacy, DMPA is associated with an improvement in perceived physical health with no apparent adverse effect on mental health and sexual function.     

Health-related lifestyles and obesity among adults with and without disability in Australia: Implication for mental health care

Background

Numerous studies have reported people with disabilities are more likely to be obese and engaged in unhealthy lifestyles. Few studies explored the mechanism of health-related lifestyles and obesity among people with disabilities.

四川省空巢老人生命质量及影响因素研究

目的 了解四川省空巢老人的生命质量现状并探讨其影响因素,为提高空巢老人生命质量提供参考依据。 方法 本资料来源于2018年国家第六次卫生服务调查四川省调查数据,健康相关生命质量用EQ-5D效用值和EQ-VAS得分进行衡量。采用两水平方差成分模型探索空巢老人生命质量的影响因素。结果 共调查4587名空巢老人, EQ-5D 效用值平均为(74.05±1.39) 分,VAS评分平均为(66.54±0.278) 分。年龄较小、文化程度较高、就业状态为在业、12个月内未饮酒、经常参加体育锻炼、无高血压和糖尿病的空巢老人EQ-5D效用值较高。结论 空巢老人的生命质量整体偏低。可通过倡导健康行为、提高健康意识、加强慢性病防控等途径来提高空巢老人生命质量。     

Health-related quality of life measures for women with urinary incontinence: the Incontinence Impact Questionnaire and the Urogenital Distress Inventory

Urinary incontinence (UI) is a relatively common condition in middle-aged and older women. Traditional measures of symptoms do not adequately capture the impact that UI has on individuals' lives. Further, severe morbidity and mortality are not associated with this condition. Rather, Ul's impact is primarily on the health status and health-related quality of life (HRQOL) of women. Generic measures of HRQOL inadequately address the impact of the condition on the day-to-day lives of women with UI. The current paper presents data on two new condition-specific instruments designed to assess the HRQOL of UI in women: the Urogenital Distress Inventory (UDI) and the Incontinence Impact Questionaire (IIQ). Used in conjunction with one another, these two measures provide detailed information on how UI affects the lives of women. The measures provide data on the more traditional view of HRQOL by assessing the impact of UI on various activities, roles and emotional states (IIQ), as well as data on the less traditional but critical issue of the degree to which symptoms associated with UI are troubling to women (UDI). Data on the reliability, validity and sensitivity to change of these measures demonstrate that they are psychometrically strong. Further, they have been developed for simple, self-administration.The Continence Program for Women (CPW) Research Group is comprised of: Richard C. Bump, MD (1990–1993), Denise P. Elser, MD, J. Andrew Fantl MD, Donna K. McClish, PhD, and Jean F. Wyman, PhD, Schools of Medicine and Nursing, Virginia Commonwealth University/Medical College of Virginia, Richmond, VA; Richard C. Bump MD (1993-present) and James P. Theofrastous, MD, School of Medicine, Duke University, Durham, NC; and Curt D. Furberg, MD, PhD, Samuel S. Lentz, MD, Timothy M. Morgan, PhD, Deirdre Robinson, MD, and Sally A. Shumaker, PhD, The Bowman Gray School of Medicine of the Wake Forest University, Winston-Salem, North Carolina, USA.     

Health-related quality of life in cardiac patients with dyslipidemia and hypertension

BACKGROUND: Hypertension is associated with lower health-related quality of life (HRQOL). Similar association may be found for dyslipidemia. However, controversies exist regarding the HRQOL with dyslipidemia. We evaluated the HRQOL of cardiac patients with and without dyslipidemia and hypertension. METHODS: In a cross-sectional study, 284 cardiac patients rated their HRQOL using SF-36 Health Survey (SF-36), and three preference-based measures (Rating Scale, Time Trade-off and Standard Gamble). RESULTS: Compared to those without dyslipidemia, those with dyslipidemia reported better HRQOL on all preference-based measures and most SF-36 scales particularly on the physical health scales. Adjusted mean differences and 95% confidence interval (95% CI) were equal to 4.5 (0.5, 8.5), 10.8 (2.8, 18.8), and 2.2 (0.2, 4.2) on the Physical Functioning, the Role-Physical and the Physical Component Summary scales, respectively. Exactly the opposite trends were observed among patients with hypertension. The adjusted mean differences (95% CI) were equal to -2.7 (-6.7, 1.4), -10.9 (-19.1, -2.8), and -2.9 (-4.9, -0.9) on the Physical Functioning, the Role-Physical and the Physical Component Summary scales, respectively. CONCLUSION: Cardiac patients with hypertension reported lower physical health than those without hypertension while cardiac patients with dyslipidemia reported better physical health than those without dyslipidemia. The reason for these different trends is not known. Possible explanations are discussed.     

Family caregiving and emotional strain: associations with quality of life in a large national sample of middle-aged and older adults

Purpose  This study examined the quality of life correlates of family caregiving and caregiving strain in a large national epidemiological sample. Methods  Structured telephone interviews were conducted with 43,099 participants as part of the REasons for Geographic and Racial Differences in Stroke (REGARDS) study. Participants completed the 12-item short form health survey (SF-12) and brief measures of depressive symptoms, social contacts, and caregiving strain. Results  Family caregiving responsibilities were reported by 12% of participants. Caregivers reported more quality of life problems than noncaregivers, but these effects were largely dependent on the perceived level of caregiving strain. High strain caregivers reported more problems with emotional distress, worse physical functioning, and fewer social contacts than noncaregivers. Conversely, caregivers who reported no strain from caregiving reported better quality of life than noncaregivers. Caregiving strain effects were not due to demographic differences or to more objective indicators of caregiving demand. Conclusions  Psychological and social indices of quality of life indicate prevalent problems among family caregivers who have experienced high strain from their caregiving responsibilities. Public health programs for disabled individuals should include assessments of strain on family caregivers and support services for those who report high levels of caregiving strain.     

A cardiac-specific health-related quality of life module for young adults with congenital heart disease: Development and validation

This study represents the development and validation of a cardiac-specific module of the generic health-related quality of life (HRQoL) instrument, the TAAQOL (TNO/AZL Adult Quality Of Life), for young adults with congenital heart disease (CHD). Items were selected based on literature, an explorative previous study in CHD patients, interviews with patients, and the advice of experts. The newly developed Congenital Heart Disease-TNO/AZL Adult Quality of Life (CHD-TAAQOL) was tested in 156 patients with mild or complex CHD and consisted of three hypothesised subject scales: 'Symptoms' (9 items), 'Impact Cardiac Surveillance' (7 items), and 'Worries' (10 items). Cronbach's alpha for the three scales were 0.77, 0.78, and 0.82, respectively. Scale structure was confirmed by Principal Component Analysis, corrected item-scale and interscale correlations. Overall, 55% of reported health status problems were associated with negative emotions, which is an argument for assessing HRQoL as a concept distinct from health status. Convergent validity with validated generic instruments (TAAQOL and Short Form-36, SF-36) showed satisfactory coefficients. Discriminant validity was proven by significantly higher scores for mild CHD patients compared with those with complex CHD. In conclusion, the CHD-TAAQOL module together with the generic TAAQOL can be used to assess group differences for cardiac-specific HRQoL in young adults with CHD. Testing psychometric properties of the CHD-TAAQOL shows satisfactory results. However, to detect changes in HRQoL over time, further research is needed.     

The influence of social stigma and discriminatory experience on psychological distress and quality of life among rural-to-urban migrants in China

The global literature has revealed a potential negative impact of social stigma on both physical and mental health among stigmatized individuals; however, the mechanisms through which social stigma affects the individual’s quality of life and mental health are not well understood. This research simultaneously examines the relationships of several determinants and mediating factors of psychological distress and quality of life. Data were collected through a cross-sectional survey among 1006 adult (predominantly male) rural-to-urban migrants in 2004–2005 in Beijing, China. Participants reported on their perceived social stigma, discriminatory experiences in daily life, preparation for migration, discrepancy between expectation and reality, coping with stigma-related stress, psychological distress, and quality of life. Structural equation modeling was performed. We found that perceived social stigma and discriminatory experiences had direct negative effects on psychological distress and quality of life among rural-to-urban migrants. Expectation-reality discrepancy mediated the effects of perceived social stigma and discriminatory experiences on psychological distress and quality of life; coping mediated the effect of social stigma on quality of life. Psychological distress was associated with quality of life. Preparation prior to migration was positively related to coping skills, which were positively related to quality of life. We conclude that perceived social stigma and daily discriminatory experiences have a significant influence on psychological distress and quality of life among rural-to-urban migrants. Pre-migration training with a focus on establishment of effective coping skills and preparation of migration may be helpful to improve their quality of life and mental health.