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1.
Purpose
Summary scores derived from the Medical Outcomes Study HIV Health Survey (MOS-HIV) are used to assess treatment impacts among HIV-infected patients in Western settings, but have yet to be validated in rural, African settings. We examined the reliability, validity and responsiveness of scores among a prospective cohort of 947 HIV-1-infected adults initiating antiretroviral therapy between May 2003 and May 2004 in rural Uganda.Methods
Physical (PHS) and mental health (MHS) summary scores were developed from baseline MOS-HIV sub-domains using exploratory factor analysis. Construct and discriminant validity were established by comparing mean summary scores across known groups of sociodemographic, clinical and health status characteristics. Effect sizes were calculated to assess responsiveness to therapy.Results
Reliability of the PHS and MHS scores was 0.79 and 0.85, respectively. Mean baseline PHS and MHS scores varied significantly by CD4 cell count, HIV viral load, WHO stage of disease and Karnofsky performance status scores. By 12?months on antiretroviral therapy, PHS and MHS scores improved by 14.6 points (P?0.001) and 13.9 points (P?0.001), respectively.Conclusions
PHS and MHS scores can be derived from the MOS-HIV and used to assess health status among cohorts of patients taking antiretroviral therapy in rural Uganda. 相似文献2.
Adam J. Rose Elizabeth Bayliss Wenjing Huang Lesley Baseman Emily Butcher Rosa-Elena García Maria Orlando Edelen 《Quality of life research》2018,27(11):2935-2944
Purpose
The Patient-Reported Outcomes Measurement Information System 29-item profile (PROMIS-29 v2.0), which measures health-related quality of life (HRQoL), has had limited evaluation among older adults (age 65+) with multiple chronic conditions. Our purpose was to establish convergent validity for PROMIS-29 in this population.Methods
We collected the PROMIS-29 v2.0 and the Veterans RAND 36 (VR-36) for 1359 primary care patients aged 65?+?with at least 2 of 13 chronic conditions, oversampling those aged 80+. We conducted multiple analyses to examine score differences across subgroups, differential item functioning (DIF), and comparisons of PROMIS-29 v2.0 and VR-36 scores.Results
The mean age was 80.7, and all patients had at least 2 of 13 chronic conditions. Older age, female sex, Hispanic ethnicity, and more chronic conditions were associated with worse physical health scores (PHS) and mental health scores (MHS) on the PROMIS-29 v2.0—findings which are in the expected direction. None of the 700 pairs of items met criteria for DIF. PHS and MHS were highly intercorrelated (r?=?0.74, p?<?0.001 for this and all other findings). PHS was more highly correlated with the VR-36 Physical Component Score (PCS) than the Mental Component Score (MCS) (r?=?0.85 and 0.32, respectively), while MHS was highly correlated with both (r?=?0.70 and 0.64, respectively).Conclusions
PROMIS-29 v2.0 demonstrates expected bivariate relationships with key person-level characteristics and does not show DIF. PROMIS-29 v2.0 scores are highly correlated with VR-36 scores. These results provide support for the validity of PROMIS-29 v2.0 as a measure of HRQoL among older adults with multiple chronic conditions.3.
Validation of a Chinese version of the Medical Outcomes Study HIV Health Survey (MOS-HIV) among Chinese people living with HIV/AIDS in Hong Kong 总被引:1,自引:0,他引:1
Joseph T. F. Lau Hi Yi Tsui Li C. K. Patrick Chung W. Y. Rita Alexander Molassiotis 《Quality of life research》2006,15(6):1079-1089
Objectives: To evaluate the Chinese version of the 35-item Medical Outcomes Study HIV Health Survey (MOS-HIV) in Chinese people living
with HIV/AIDS (PLWHA). Methods: A cross-sectional survey of 242 ethnic Chinese PLWHA in Hong Kong was conducted. Results: Cronbach’s αs of the eight multi-item scales of the MOS-HIV ranged from 0.78 to 0.90. Item-total and inter-scale correlation
coefficients were acceptable. Factor analysis of the MOS-HIV identified two factors (Mental Health Summary scores and Physical
Health Summary scores, or MHS and PHS), accounting for 63% total variance. The PHS and MHS correlated significantly with the
WHOQOL-BREF(HK) and the three sub-scales of Profile of Mood States used in this study. Both PHS and MHS were significantly
associated with self-perceived change in health status. PHS but not MHS was associated with Karnofsky Performance Status scores.
PHS was also associated with disease stage. The MOS-HIV however, did not distinguish between groups of different CD4 cell
counts. It is likely that the quality of life of these PLWHA of different disease stages was good in general. Conclusions: There is a large demand for evaluating treatments and services programs offered to PLWHA in China. The validated Chinese
MOS-HIV would facilitate such research activities. 相似文献
4.
Kamen C Taniguchi S Student A Kienitz E Giles K Khan C Lee S Gore-Felton C Koopman C 《Quality of life research》2012,21(8):1327-1336
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. 相似文献5.
Marcin Rzeszutek Ewa Gruszczyńska Ewa Firląg-Burkacka 《Quality of life research》2017,26(10):2805-2814
Purpose
The aim of this study was to investigate the relationship between coping strategies and subjective well-being (SWB) among people living with HIV (PLWH) using the latent profile analysis (LPA) with control for socio-medical covariates.Methods
The sample comprised five hundred and thirty people (N = 530) with a confirmed diagnosis of HIV+. The study was cross-sectional with SWB operationalized by satisfaction with life (Satisfaction with Life Scale) and positive and negative affect (PANAS-X). Coping with stress was measured by the Brief COPE Inventory, enriched by several items that assessed rumination and enhancement of positive emotional states. Additionally, the relevant socio-medical variables were collected.Results
The one-step model of LPA revealed the following: (1) a solution with five different coping profiles suited the data best; (2) socio-medical covariates, except for education, were not related to the profiles’ membership. Further analysis with SWB as a distal outcome showed that higher intensity coping profiles have significantly worse SWB when compared with lower intensity coping profiles. However, the lowest SWB was noted for mixed intensity coping profile (high adaptive/low maladaptive).Conclusions
The person-centered approach adopted in this study informs about the heterogeneity of disease-related coping among PLWH and its possible reactive character, as the highest SWB was observed among participants with the lowest intensity of coping.6.
Purposes
To test the feasibility, reliability and validity of the Chinese simplified version of the MOS-HIV health survey among AIDS patients in China.Methods
A cross-sectional survey of 120 patients receiving highly active antiretroviral treatment was conducted. Feasibility was assessed using the time of administration and the response rate. Reliability was estimated using Cronbach’s α. Validity was analyzed by construct and discriminant validity.Results
The time of administration was about 12 min, and the response rate was 100%. The MOS-HIV showed a good internal reliability and Cronbach’s α of eight multi-item scales ranged from 0.75 to 0.91. Correlations between scales were all significant. The majority of the correlations between pairs of scales were within the acceptable range (0.4–0.8). The scores of role function, pain, physical health summary scales were significantly higher for patients with time on antiretroviral treatment >1 year compared to those with time ≤1 year. Patients >40 years had significantly higher scores than those of ≤40 years on energy and mental health summary scales.Conclusions
The Chinese simplified version of MOS-HIV health survey had good feasibility, reliability and validity. It was successfully adapted for AIDS patients in rural areas and could be a valuable tool in evaluating the quality of life of AIDS patients. 相似文献7.
Eleni Lahana Evelina Pappa Dimitris Niakas 《International journal of public health》2010,55(5):391-400
Objectives
The impact of socioeconomic status (SES) on health previously studied demonstrates that low SES relates to lower health. In Greece, related studies are limited and focused on native population. The aim of this study was to assess the influence of residence, ethnicity and SES on health-related quality of life (HRQoL).Methods
The study was carried out in Thessaly using a sample of 1,372 individuals (18+ years old, response rate 91.4%) via face-to-face interview. Multiple stepwise linear regression analyses were performed investigating the impact of the above factors on HRQoL, measured by SF-36. Interaction effects between socioeconomic and demographic variables were performed.Results
Disadvantage of SES, i.e. primary education and low income, was associated with impaired HRQoL in physical and mental health. Albanians reported better HRQoL compared to Greeks but after controlling for SES factors health disparities became insignificant. Rural residents were related to better general and mental health.Conclusions
SES is an independent predictor of HRQoL, but ethnicity and place of residence had weak impact. Investigating the underline mechanisms that impair HRQoL, so as to take policies that will elucidate the risk of poor health in disadvantage groups, is important. 相似文献8.
9.
Witt WP Litzelman K Spear HA Wisk LE Levin N McManus BM Palta M 《Quality of life research》2012,21(9):1565-1576
Purpose
This study aimed to determine the health-related quality of life (HRQoL) in mothers of 5-year-old very low birth weight (VLBW) and normal birth weight (NBW) children, with a focus on the role of stress.Methods
This cohort study is ancillary to the Newborn Lung Project. A telephone interview collected information on symptoms of stress and HRQoL from 297 mothers of VLBW children and 290 mothers of NBW children who were enrolled in the Newborn Lung Project Statewide Cohort Study. Staged multiple regression analyses were used to evaluate the relationship between caregiver status and maternal HRQoL and the role stress played in this relationship. Additional multiple regression analyses were also used to evaluate the correlates of poor maternal HRQoL among VLBW mothers.Results
Mothers of VLBW children experienced worse physical and mental HRQoL than mothers of NBW children. Adjusted analyses showed that physical HRQoL was significantly different between these mothers (??: ?1.87, P?=?0.001); this relationship was attenuated by maternal stress. Among the mothers of VLBW children, stress significantly contributed to adverse HRQoL outcomes when children were aged five. Child behavior problems at the age of two were also associated with worse subsequent maternal mental HRQoL (??: ?0.18, P?=?0.004), while each week of neonatal intensive care unit stay was associated with worse physical HRQoL (??: ?0.26, P?=?0.02).Conclusions
Caring for a VLBW child is negatively associated with the HRQoL of mothers; this relationship might be, in part, explained by maternal stress. Addressing maternal stress may be an important way to improve long-term HRQoL. 相似文献10.
Carolin Berner Ludwig Erlacher Karl Heinrich Fenzl Thomas E. Dorner 《Health and quality of life outcomes》2018,16(1):238
Background
Psychosocial models including illness perception might explain individual differences in health-related quality of life (HRQoL) and daily functioning in chronically ill patients. The aim of this study was to assess the association of illness perception among rheumatoid arthritis (RA) patients with physical and mental HRQoL, adjusted for demographic variables, clinical variables and social support.Methods
A cross-sectional study conducted at a Viennese rheumatology outpatient clinic on 120 RA patients. Participants completed questionnaires on demographic and clinical characteristics, HRQoL (SF-36 Questionnaire), illness beliefs (Brief Illness Perception Questionnaire) and social support (Social Support Scale-8). Analyses were performed with multivariate linear regression.Results
The mean physical was lower (38.38) than the mean mental SF-36 summary score (46.94). In univariate analysis, all domains of illness perception except belief in a chronic disease course were associated with physical and mental HRQoL. In multivariate analyses, illness perception accounted for 51% of variance in physical HRQoL. A stronger belief in the consequences of RA (consequences, β?=???0.33) and a stronger belief in repeated disease recurrence (timeline cyclical, β =???0?.31) were significantly associated with physical HRQoL in the fully adjusted model. Illness perception accounted for 45% of variance in mental HRQoL. Emotional representation (β?=???0?.27) and fatigue (β?=???0?.36) were significantly associated with mental HRQoL in the fully adjusted model.Conclusion
This study highlights the importance of RA patients’ beliefs about their illness and symptoms in relation to HRQoL. Identification of patients’ perception of RA may be a way to positively influence disease outcomes such as quality of life as illness perception is amenable to intervention.11.
Purpose
To examine and identify predictors of parental health-related quality of life (HRQoL) in a sample of obese and very obese children participating in an inpatient program for treating obesity.Methods
Data are part of a prospective multicenter randomized-controlled intervention trial. Parents (n = 463) of obese and very obese children (7–13 years) completed standardized questionnaires assessing their own and their child’s HRQoL, psychosocial functioning, demographics and parental weight-specific self-efficacy on the child’s admission to an inpatient pediatric weight management program. Weight and height of the children were measured by trained personnel; parental weight was assessed via self-report.Results
Parents reported lower mental HRQoL compared to healthy adults and even lower than reference values for acute or chronic illness. With respect to physical HRQoL, parents of obese children reported higher scores than both groups. Effect sizes were small to medium. Overweight parents reported a lower physical HRQoL. Mental HRQoL was higher for married parents with a higher educational level and a higher self-efficacy and for those whose children depicted fewer behavioral problems and reported a higher HRQoL. Hierarchical regression analyses revealed that weight-specific self-efficacy explained 3 % of variance in mental HRQoL in addition to the demographic and child psychosocial variables. Parental self-efficacy also partially mediated the association between the child’s HRQoL and parental mental HRQoL.Conclusion
Childhood obesity is associated with reduced parental HRQoL. Interventions for obesity in children should consider the parents’ psychosocial situation as well. Enhancing parental self-efficacy may be a promising approach. 相似文献12.
Jacobson DL Wu AW Feinberg J;Outcomes Committee of the Adult AIDS Clinical Trials Group 《Journal of clinical epidemiology》2003,56(9):874-879
We tested whether health related quality of life (HRQOL) predicts mortality, development of active cytomegalovirus (CMV) disease, and study retention. We studied 957 patients with CD4 counts <100 cells/mm(3) in AIDS Clinical Trials Group Protocol 204, a randomized, double-blind trial comparing three prophylactic regimens against CMV end-organ disease. The MOS-HIV, a brief HRQOL questionnaire, generated physical health summary (PHS) and mental health summary (MHS) scores. We used Cox proportional hazards to predict events by baseline HRQOL, adjusted for treatment, demographics, and CD4. Each point increase in baseline PHS decreased the risk of death by 4%, CMV by 2%, and dropout by 2%. Each point increase in baseline MHS decreased the risk of death by 4% and study dropout by 1%. In conclusion, self-rated physical and mental health demonstrated predictive validity for survival, CMV end-organ disease, and retention in advanced HIV patients. The results show the clinical importance of HRQOL and may facilitate interpretation by clinicians. 相似文献
13.
Purpose
We examined the main and interactive effects of race, BMI, and social support on physical and mental health-related quality of life (HRQoL) among male and female cancer survivors using the stress and coping theory to inform findings.Methods
HRQoL issues among 1768 cancer survivors were examined using the American Cancer Society’s cross-sectional Study of Cancer Survivors II. Two-step multiple linear regressions were conducted to assess the physical and mental HRQoL of male and female cancer survivors, respectively.Results
The average age of participants was 67.36 (SD = 11.51); the majority were female (53.3 %; n = 941) and non-Hispanic White (85.9 %; n = 1517). The average BMI measurement for participants was 28.33 (SD = 5.90), with 41.3 % (n = 729) overweight and 30.3 % (n = 535) obese. Higher BMI was significantly associated with lower physical HRQoL across gender, while social support had significant main effects on physical and mental HRQoL across gender. Race moderated the relationship between social support and physical HRQoL among female cancer survivors and between BMI and mental HRQoL for both genders.Conclusions
The results of this study contribute a unique gender- and racial-specific perspective to cancer survivorship research. While the buffering hypothesis of the stress and coping theory was not supported, the main effects of BMI and social support on HRQoL were different across gender and race.14.
Laura H. Aversa Jill A. Stoddard Neal M. Doran Selwyn Au Bruce Chow Miles McFall Andrew J. Saxon Dewleen G. Baker 《Quality of life research》2013,22(6):1381-1389
Purpose
Posttraumatic stress disorder (PTSD) symptoms, particularly numbing and hyperarousal symptoms, are related to poor physical health-related quality of life (HRQoL). Tobacco dependence is also associated with poor HRQoL, and individuals with PTSD may smoke at higher rates than the general population. Our study aimed to examine the impact of quitting smoking and changes in PTSD symptoms over time on changes in physical HRQoL.Methods
The study used archival data from enrollees (N = 943) in a smoking cessation clinical trial for veterans with PTSD (VA Cooperative study #519).Results
Two of the physical HRQoL domains were sensitive to changes in PTSD symptoms over time: General Health and Vitality.Conclusions
Our findings suggest that particular physical HRQoL domains may be subject to improvement if PTSD symptoms decrease over time. 相似文献15.
Niilo Färkkilä Saku Torvinen Risto P. Roine Harri Sintonen Juha Hänninen Kimmo Taari Tiina Saarto 《Quality of life research》2014,23(4):1387-1394
Purpose
To explore end-stage breast, prostate, and colorectal cancer patients’ health-related quality of life (HRQoL); to compare results obtained by different HRQoL instruments; and to explore factors related to impaired HRQoL.Methods
A cross-sectional observational study utilized two generic HRQoL instruments, the 15D and the EQ-5D, and a cancer-specific instrument, the EORTC QLQ-C30. Patients were recruited from the Helsinki University Hospital’s Department of Oncology and from a local hospice.Results
Of the 114 palliative care patients included in the analysis, 27 had breast cancer, 30 had prostate cancer, and 57 had colorectal cancer. Of these, 28 % died within 3 months after their response, while 32 % died within three to 6 months, and 39 % died more than 6 months after. Utility values varied widely by instrument: the 15D gave the highest utility values and VAS the lowest (15D: 0.74, EQ-5D: 0.59 and VAS: 55). Patients close to death had lower HRQoL scores independently from the instrument used. The EQ-5D showed a pronounced ceiling effect, with 13 % of patients reporting full health, whereas the corresponding figures for the 15D and VAS were 1 and 0 %, respectively. Fatigue was the most common symptom and also predicted impaired HRQoL most significantly.Conclusions
All instruments were applicable for the evaluation of HRQoL among end-stage cancer patients. Fatigue seemed to be the most significant deteriorating factor, whereas clinical and demographic factors had less of an effect on HRQoL. 相似文献16.
Joseph J Knapik Tyson Grier Anita Spiess David I Swedler Keith G Hauret Bria Graham James Yoder Bruce H Jones 《BMC public health》2011,11(1):1-16
Background
The continual monitoring of population health-related quality of life (HRQoL) with validated instruments helps public health agencies assess, protect, and promote population health. This study aimed to determine norms for the French adolescent and adult general population for the Duke Health Profile (DUKE) questionnaire in a large representative community sample.Methods
We randomly selected 17,733 French people aged 12 to 75 years old in 2 steps, by households and individuals, from the National Health Barometer 2005, a periodic population study by the French National Institute for Prevention and Health Education. Quality of life and other data were collected by computer-assisted telephone interview.Results
Normative data for the French population were analyzed by age, gender and self-reported chronic disease. Globally, function scores (best HRQoL=100) for physical, mental, social, and general health, as well as perceived health and self-esteem, were 72.3 (SEM 0.2), 74.6 (0.2), 66.8 (0.1), 71.3 (0.1), 71.3 (0.3), 76.5 (0.1), respectively. Dysfunction scores (worst HRQoL=100) for anxiety, depression, pain and disability domains were 30.9 (0.1), 27.6 (0.2), 34.3 (0.3), 3.1 (0.1), respectively.Conclusion
The French norms for adolescents and adults for the DUKE could be used as a reference for other studies assessing HRQoL, for specific illnesses, in France and for international comparisons. 相似文献17.
Luisa Baladón Maria Rubio-Valera Antoni Serrano-Blanco Diego J. Palao Ana Fernández 《Quality of life research》2016,25(6):1461-1474
Purpose
This paper aims to estimate the comorbidity of mental disorders and chronic physical conditions and to describe the impact of these conditions on health-related quality of life (HRQoL) in a sample of older primary care (PC) attendees by gender.Methods
Cross-sectional survey, conducted in 77 PC centres in Catalonia (Spain) on 1192 patients over 65 years old. Using face-to-face interviews, we assessed HRQoL (SF–12), mental disorders (SCID and MINI structured clinical interviews), chronic physical conditions (checklist), and disability (Sheehan disability scale). We used multivariate quantile regressions to model which factors were associated with the physical component summary—short form 12 and mental component summary—short form 12.Result
The most frequent comorbidity in both men and women was mood disorder with chronic pain and arthrosis. Mental disorders mainly affected ‘mental’ QoL, while physical disorders affected ‘physical’ QoL. Mental disorders had a greater impact on HRQoL than chronic physical conditions, with mood and adjustment disorders being the most disabling conditions. There were some gender differences in the impact of mental and chronic physical conditions on HRQoL. Anxiety disorders and pain had an impact on HRQoL but only in women. Respiratory diseases had an effect on the MCS in women, but only affected the PCS in men.Conclusions
Mood and adjustment disorders had the greatest impact on HRQoL. The impact profile of mental and chronic physical conditions differs between genders. Our results reinforce the need for screening for mental disorders (mainly depression) in older patients in PC.18.
Background
Older persons with earlier trauma are often more vulnerable to stresses of old age.Aims
To examine the levels of emotional distress in relation to cognitive appraisal of acute hospitalization and coping strategies in Holocaust survivors compared with an age- and education-matched group of elderly persons without Holocaust experience.Methods
This is a cross-sectional study of 63 Holocaust survivors, 65 years and older, hospitalized for an acute illness, and 57 age-, education- and hospital unit-matched people without Holocaust experience. Participants completed appraisal and coping strategies (COPE) questionnaires, and the brief symptoms inventory (BSI-18).Results
Holocaust survivors reported higher levels of emotional distress, appraised the hospitalization higher as a threat and lower as a challenge, and used more emotion-focused and less problem-focused or support-seeking coping strategies than the comparison group. Study variables explained 65% of the variance of emotional distress; significant predictors of emotional distress in the final regression model were not having a partner and more use of emotion-focused coping. The latter mediated the relation of group variable and challenge appraisal to emotional distress.Conclusions
Health professionals must be aware of the potential impact of the hospital environment on the survivors of Holocaust as well as survivors of other trauma. Being sensitive to their specific needs may reduce the negative impact of hospitalization. 相似文献19.
Barbora Silarova Iveta Nagyova Jaroslav Rosenberger Martin Studencan Daniela Ondusova Sijmen A. Reijneveld Jitse P. van Dijk 《Quality of life research》2012,21(10):1863-1871
Purpose
The aim of this study was to determine whether sense of coherence (SOC) at baseline predicts health-related quality of life (HRQoL) at 12–28-month follow-up among patients with coronary heart disease when controlled for sociodemographic and medical variables.Methods
A total of 179 consecutive patients (58.28 ± 6.52 years, 16.8% women) scheduled for coronary angiography (CAG) were interviewed before CAG and 12–28 months after. SOC was measured with the 13-item Orientation to Life Questionnaire. HRQoL was measured using the Short Form Health Survey 36 (SF-36), from which the mental and physical component summaries (MCS, PCS) were calculated. The relationship between SOC and HRQoL was examined using regression analyses.Results
SOC proved to be a significant predictor of the MCS-score (B = 0.29; 95% CI = 0.17–0.41) and PCS-score (B = 0.18; 95% CI = 0.06–0.31) when not adjusted for possible confounding sociodemographic and medical variables. After adjustment for sociodemographic and medical variables, SOC remained a predictor of the MCS-score (B = 0.26; 95% CI = 0.14–0.39). SOC also remained a predictor of the PCS-score when controlled for gender, age and family income; however, the association disappeared after adjustment for functional status (B = 0.07; 95% CI = ?0.05 to 0.19).Conclusions
SOC is a predictor of mental and physical HRQoL at 12–28-month follow-up, crude and also after adjustment. Patients undergoing CAG with low SOC thus deserve particular attention in regard to the maintenance and improvement of their HRQoL. 相似文献20.
R. M. Alfonso-Rosa Borja del Pozo-Cruz J. Del Pozo-Cruz J. T. Del Pozo-Cruz B. Sañudo 《The journal of nutrition, health & aging》2013,17(4):315-321