The validity of the Satisfaction with Life Scale in adolescents and a comparison with single-item life satisfaction measures: a preliminary study

Purpose

The validity of the life satisfaction measures commonly used among adults has been rarely examined in adolescent samples. The present research had two main goals: (1) to evaluate the structural validity of the Satisfaction with Life Scale (SWLS) among adolescents and to test measurement invariance across gender; (2) to compare the criterion and convergent validity of the SWLS and single-item life satisfaction measures among adolescents.

Methods

Three samples of Serbian adolescents were recruited for the present research. Study 1 (N = 481, M _age = 17.01 years) examined the structure of the SWLS via confirmatory factor analysis (CFA) and evaluated measurement invariance of the SWLS across gender by a multi-group CFA. Study 2 (N = 283, M _age = 17.34 years) and Study 3 (N = 220, M _age = 16.73 years) compared the convergent validity of the SWLS and single-item life satisfaction measures.

Results

The results of Study 1 supported the original one-factor model of the SWLS among adolescents and provided evidence for strong measurement invariance of the SWLS across gender. The findings of Study 2 and Study 3 showed that the SWLS and single-item measures were equally valid and strongly associated (r = .734 in Study 2 and r = .668 in Study 3). No substantial differences in correlations with school success and well-being indicators were found between the SWLS and single-item measures.

Conclusions

Our findings support the use of the SWLS among adolescents and indicate that single-item life satisfaction measures perform as well as the SWLS in adolescent samples.

     

Using Electronic Health Record Alerts to Increase Safety Planning with Youth At-Risk for Suicide: A Non-randomized Trial

Background

No study to date has examined the effectiveness of integrating clinical decision support tools, like electronic health record (EHR) alerts, into the clinical care of youth at-risk for suicide.

Objective

This study aimed to examine the feasibility and acceptability of using an EHR alert to increase clinicians’ use of safety planning with youth at-risk for suicide in an outpatient pediatric psychiatry clinic serving an urban low-income Latino community.

Methods

An alert intervention was developed to remind clinicians to complete a safety plan whenever they documented that their patient endorsed suicidal ideation, plan, or attempt during a visit in EHR notes. The alert appeared as a separate window containing a reminder message to complete a safety plan once a clinician finished visit documentation.

Results

There were 69 at-risk patients between the ages of 13–21 in the intervention period (M = 15.71; SD = 1.86; 66.7% female) and 64 (M = 15.38; SD = 1.93; 68.6% female) in the control period. Logistic regression analyses indicated that patients in the intervention period were significantly more likely than patients in the control period to receive a safety plan (p < .01). The pattern of results remained the same after adjusting for demographic variables (p = .01). Forty clinicians also completed a questionnaire assessing their satisfaction with the EHR alert, indicating moderate satisfaction (M = 3.01; SD = 0.63; range = 1.11–4.11).

Conclusions

EHR alerts are associated with changes in clinicians’ behavior and improved compliance with best clinical practices for at-risk youth.

     

Lifetime traumatic events,health-related quality of life,and satisfaction with life in older adults

Purposes

The aims were to assess the association between lifetime traumatic events and post-traumatic stress syndrome (PTSS) and health-related quality of life (HRQOL) and satisfaction with life stratified by gender among a community-dwelling sample of older adults.

Methods

Data used came from the ESA-Services study (2011–2013) and included a large convenience sample of 1811 older adults. Traumatic events were measured using a list of 14 events. PTSS was measured using the Impact of Event Scale-Revised. HRQOL and life satisfaction were measured with the EQ-5D-3L and the Satisfaction With Life Scale. Multivariate regression analyses were used to assess the association between traumatic events, PTSS, and quality of life.

Results

Respondents had a mean age of 73.90 years (SD: 6.13, range 65–97). Our results showed that exposure to violence (OR 4.88, CI 2.72–8.77), an accident (OR 2.33, CI 1.29–4.22), and sexual abuse (OR 2.26 CI 1.17–4.37) was associated with PTSS only in women. No traumatic event was associated only in men. The interaction between gender and exposure to violence and life-threatening disease of a close one was significant. Experiencing violence (β = ?0.04, p < 0.01), a natural disaster (β = ?0.04, p = 0.02), a life-threatening disease (β = ?0.04, p < 0.01), and sexual abuse (β = ?0.04, p < 0.01) were associated with a lower HRQOL only in women. No traumatic event was associated in men. Interactions between event and gender were significant for natural disaster, life-threatening disease of a close one, sexual abuse, and other type of traumatic events. A life-threatening disease (β = ?0.90, p < 0.01) was associated with a reduced life satisfaction only in men and the exposure of violence (β = ?1.18, p < 0.01) was associated with lower life satisfaction in women.

Conclusion

Our study could help healthcare professionals to identify and monitor traumatic events that are at higher risk to be associated with PTSS and a lower quality of life for older men and women.

     

Are the EQ-5D-3L and the ICECAP-O responsive among older adults with impaired mobility? Evidence from the Vancouver Falls Prevention Cohort Study

Purpose

Preference-based generic measures are gaining increased use in mobility research to assess health-related quality of life and wellbeing. Hence, we examined the responsiveness of these two measures among individuals at risk of mobility impairment among adults aged ≥70 years.

Methods

We conducted a 12-month prospective cohort study of community-dwelling older adults (n = 288 to n = 341 depending on analysis) who were seen at the Vancouver Falls Prevention Clinic who had a history of at least one fall in the previous 12 months. We compared the responsiveness of the EuroQol-5 Domain-3 Level (EQ-5D-3L) and the index of capability for older adults (ICECAP-O) by examining changes in these measures over time (i.e., over 6 and 12 months) and by examining whether their changes varied as a function of having experienced 2 or more falls over 6 and 12 months.

Results

Only the ICECAP-O showed a significant change over time from baseline through 12 months; however, neither measure showed change that exceeded the standard error of the mean. Both measures were responsive to falls that occurred during the first 6 months of the study (p < .05). These effects appeared to be amplified among individuals identified as having mild cognitive impairment (MCI) at baseline (p < .01). Additionally, the EQ-5D-3L was responsive among fallers who did not have MCI as well as individuals with MCI who did not fall (p < .05).

Conclusion

This study provides initial evidence suggesting that the EQ-5D-3L is generally more responsive, particularly during the first 6 months of falls tracking among older adults at risk of future mobility impairment.

     

Question order sensitivity of subjective well-being measures: focus on life satisfaction,self-rated health,and subjective life expectancy in survey instruments

Purpose

This study examines the effect of question context created by order in questionnaires on three subjective well-being measures: life satisfaction, self-rated health, and subjective life expectancy.

Methods

We conducted two Web survey experiments. The first experiment (n = 648) altered the order of life satisfaction and self-rated health: (1) life satisfaction asked immediately after self-rated health; (2) self-rated health immediately after life satisfaction; and (3) two items placed apart. We examined their correlation coefficient by experimental condition and further examined its interaction with objective health. The second experiment (n = 479) asked life expectancy before and after parental mortality questions. Responses to life expectancy were compared by order using ANOVA, and we examined interaction with parental mortality status using ANCOVA. Additionally, response time and probes were examined.

Results

Correlation coefficients between self-rated health and life satisfaction differed significantly by order: 0.313 (life satisfaction first), 0.508 (apart), and 0.643 (self-rated health first). Differences were larger among respondents with chronic conditions. Response times were the shortest when self-rated health was asked first. When life expectancy asked after parental mortality questions, respondents reported considering parents more for answering life expectancy; and respondents with deceased parents reported significantly lower expectancy, but not those whose parents were alive.

Conclusion

Question context effects exist. Findings suggest placing life satisfaction and self-rated health apart to avoid artificial attenuation or inflation in their association. Asking about parental mortality prior to life expectancy appears advantageous as this leads respondents to consider parental longevity more, an important factor for true longevity.

     

The association between social network factors and mental health at different life stages

Objectives

Psychosocial factors are important determinants of an individual’s health. This study examines the association between health scores and social network factors on mental health across different life stages.

Methods

Data were drawn from the Household Income and Labour Dynamics in Australia survey for adolescents (n = 1739), adults (n = 10,309) and seniors (n = 2287). Hierarchical regression modelling was applied to examine effects within and across age groups. All the variables were derived from the self-completion questionnaire.

Results

The social network factors were statistically significant predictors of mental health outcomes for all three life stages. For adolescents, the three social network factors were statistically significant with social isolation having the largest impact (β = ?.284, p < .001), followed by social connection (β = .084, p < .001) and social trust having a similar effect (β = .073, p < .001). For adults social isolation had the highest impact (β = ?.203, p < .001), followed by social connection (β = .110, p < .001) and social trust (β = .087, p < .001).The results for seniors were social isolation (β = ?.188, p < .001), social connection (β = .147, p < .001) and social trust (β = .032, p < .05).

Conclusions

After adding the social network factors, the models improved significantly with social isolation playing the most significant role across all life stages, whereas the other social network factors played a differentiated role depending upon the life stage. These findings have practical implications in the design of mental health interventions across different life stages.

     

Health-related quality of life in multiple sclerosis: role of cognitive appraisals of self,illness and treatment

Purpose

Health-related quality of life (HRQoL) is considered an important measure of treatment and rehabilitation outcomes in multiple sclerosis (MS) patients. In this study, we used multivariate regression analysis to examine the role of cognitive appraisals, adjusted for clinical, socioeconomic and demographic variables, as correlates of HRQoL in MS.

Methods

The cross-sectional study included 257 MS patients, who completed Multiple Sclerosis Impact Scale, Generalized Self-Efficacy Scale, Rosenberg Self-Esteem Scale, Brief Illness Perception Questionnaire, Treatment Beliefs Scale, Actually Received Support Scale (a part of Berlin Social Support Scale) and Socioeconomic Resources Scale. Demographic and clinical characteristics of the participants were collected with a self-report survey. Correlation and regression analyses were conducted to determine associations between the variables.

Results

Five variables, illness identity (β = 0.29, p ≤ 0.001), self-esteem (β = ?0.22, p ≤ 0.001), general self-efficacy (β = ?0.21, p ≤ 0.001), disability subgroup “EDSS” (β = 0.14, p = 0.006) and age (β = 0.12, p = 0.012), were significant correlates of HRQoL in MS. These variables explained 46 % of variance in the dependent variable. Moreover, we identified correlates of physical and psychological dimensions of HRQoL.

Conclusions

Cognitive appraisals, such as general self-efficacy, self-esteem and illness perception, are more salient correlates of HRQoL than social support, socioeconomic resources and clinical characteristics, such as type and duration of MS. Therefore, interventions aimed at cognitive appraisals may also improve HRQoL of MS patients.

     

Are the Clinical Characteristics of Anxious Youths Participating in Non-treatment-Related Research Comparable to those of Youths Receiving Treatment?

Background

A key element of the evidence-based assessment and treatment movements is ensuring an adequate representation of clients across the different settings in which they receive mental health care (e.g., research and routine or usual care settings). Prior work has focused on comparing clients from research settings to those from usual care settings on various indices of clinical severity, impairment, and symptom levels.

Objective

In this study, we focused on examining clients from different types of research studies not only on levels of clinical severity, impairment, and symptoms, but also on the relations among these domains.

Methods

We addressed our objective in a sample of 73 youths meeting primary diagnostic criteria for generalized anxiety disorder (GAD); n = 32 were recruited specifically for a treatment study or received services from a university-based clinic (Youths Receiving Treatment; YRT), and n = 41 were recruited for a non-treatment assessment study (Non-Treatment Research Youths; NTRY).

Results

Relative to NTRY, YRT displayed greater GAD clinical severity, and higher generalized anxiety and worry levels. However, we observed no differences between groups in relations among measures of GAD clinical severity, generalized anxiety, and worry.

Conclusions

These findings have important implications for evidence-based practice and interpreting studies seeking to compare clients from research and clinical settings on clinical characteristics.

     

Exploring the relationship between EQ-5D,DLQI and PASI,and mapping EQ-5D utilities: a cross-sectional study in psoriasis from Hungary

Background

There is a growing interest in policy making for using utility measures and identifying algorithms to convert disease-specific measures into utilities.

Objectives

To analyse the relationship between EQ-5D, Dermatology Life Quality Index (DLQI) and Psoriasis Area and Severity Index (PASI) in psoriasis. To transform DLQI scores, and key clinical, demographic and health service utilisation variables into utilities.

Methods

A cross-sectional questionnaire survey of 200 consecutive adult patients with moderate to severe psoriasis was carried out in two Hungarian university clinics. The relationship between the outcome measures were analysed with correlations and with the known-groups method. Bivariate and multivariate regression algorithms on EQ-5D scores were formulated.

Results

The mean age of respondents was 51 years (SD = 12.9), 68.5 % were male, and 51.5 % received biological therapy. Median EQ-5D, DLQI, and PASI scores were 0.73, 3.0, and 3.45, respectively. EQ-5D showed a moderate correlation with the DLQI and with the PASI (r _s = ?0.48 and ?0.43, p < 0.05). Strong correlation was found between DLQI and PASI (r _s = 0.81, p < 0.05). DLQI and PASI discriminated better among groups categorised by the localisation of the lesions than EQ-5D. Presence of psoriasis on the neck and/or décolletage was associated with the greatest health related quality of life (HRQOL) impairment. Ten variables were incorporated in a multivariate algorithm that accounted for 48.8 % of EQ-5D variance (ANOVA p < 0.001).

Conclusions

This study provided the first evidence that patients with visible psoriatic lesions have significantly worse HRQOL compared to those with non-visible lesions, measured not only with DLQI but also with EQ-5D. In addition to demographic and clinical variables, our model included health service utilisation variables related to psoriasis, and explained higher proportion of EQ-5D variance than any previous findings in the literature.

     

Correlation of emotional labor and cortisol concentration in hair among female kindergarten teachers

Objectives

The purpose of this study was to explore whether two types of emotional labor, surface acting and deep acting, are related to hair cortisol concentration among kindergarten teachers.

Methods

Surface acting and deep acting over the last month were measured with the Chinese version of the emotional labor scale in 43 kindergarten teachers. Hair samples with 1 cm in length were cut from their posterior vertex region to represent cortisol excretion over one month. Cortisol concentrations were analyzed with high-performance liquid chromatography–tandem mass spectrometry.

Results

Positive association of emotion labor with hair cortisol concentration was significant for surface acting (r = 0.34, p < 0.05) and not significant for deep acting (r = 0.14, p > 0.05).

Conclusions

More surface acting showed to be associated stronger with stress responses or higher HPA axis activity.

     

Kenntnis des Impfstatus,Impfraten und Impfakzeptanz

Background

Vaccination coverage among medical students is often insufficient. Regarding vaccination coverage of students of other fields, there are no currently published data for Germany. Based on high international mobility, an insufficient or unknown vaccination status increases the health risk among students.

Objective

What is the vaccination status among students of different subjects? Are there group-based differences concerning knowledge of ones own vaccination status? Are there differences concerning attitudes towards vaccination?

Material and methods

The survey was conducted at the Technische Universität Dresden during the summer semester 2012 using a semi-standardized questionnaire. Data from 428 students (subjects: medicine, sociology, architecture and physics) were analyzed.

Results

Significantly less medical students reported an unknown vaccination status regarding all the nine vaccinations analyzed compared to students of sociology or technical subjects. Significantly more medical students reported complete vaccination status compared to students of other subjects (χ²-test: p ≤ 0.001; Z?test p ≤ 0.05). Significantly more medical students had the opinion that vaccinations were absolutely necessary compared to students of other subjects (χ²-test: p ≤ 0.001; Z?test p ≤ 0.05).

Conclusion

University students often have insufficient vaccination coverage. Students of subjects other than medicine are often not aware of their own vaccination status. Low-threshold opportunities to check vaccination status and to be vaccinated if necessary should be established, e.?g. at university and the workplace.

     

Books and Toddlers in Child Care: Under What Conditions are Children Most Engaged?

Background

Although shared book reading is seen as an effective way to support children’s early literacy and language development, less is known about the factors associated with toddlers’ engagement with books.

Objective

The goal of the current study was to examine younger and older toddlers’ engagement with books during one-on-one reading with a teacher in an interactive versus non-interactive manner and during independent exploration.

Method

Using single-case design, the study examined how engagement among toddlers (N = 6) in a childcare classroom varied under different book reading/exploration conditions.

Results

Results indicated that overall engagement was greater when teachers read interactively compared to when children explored books on their own, with this effect differing for younger versus older toddlers.

Conclusions

Understanding how teachers reading to younger and older toddlers is associated with children’s engagement with books compared to children’s engagement when exploring books on their own can inform early care and education reading practices with toddlers. Implications for book reading with toddlers in group childcare are discussed.

     

Long-term adherence to the New Nordic Diet and the effects on body weight,anthropometry and blood pressure: a 12-month follow-up study

Purpose

The New Nordic Diet (NND) has induced weight loss in a 26-week controlled intervention. We aim to investigate whether high compliance and satisfaction can be maintained after the active intervention is discontinued thereby maintaining the health effects.

Methods

After 26 weeks of intervention with NND or Average Danish Diet (ADD), 147 participants (mean age 43 years and mean BMI 29.1 kg/m²) were followed for further 52 weeks. All participants were encouraged to follow NND but without further guidance. The study is registered with ClinicalTrials.gov, study id NCT01195610.

Results

One hundred and ten participants (75 %) completed the follow-up. Among participants previously randomised to NND (NND group), dietary compliance and satisfaction decreased from 4.3 to 3.0 and from 4.8 to 4.0, respectively (both p < 0.0001) (1–5 point scale). Among those originally randomised to ADD (ADD group), satisfaction with NND was significantly higher than with ADD during follow-up (3.3 vs. 2.5, p = 0.026). Weight losses during intervention of ?6.2 kg and ?3.0 kg were followed by regains of 4.6 kg (SE 0.5) and 1.1 kg (SE 0.7) for the NND group and ADD group, respectively [adjusted difference; mean (95 % CI): 1.8 kg (0.1–3.4), p = 0.041]. Across diet groups, every 1 score higher in compliance with NND was associated with 0.90 kg less body weight regain (p = 0.026) and those who increased physical activity regained 3.4 kg less compared to those who did not (p < 0.0001).

Conclusions

NND provides higher satisfaction, and body weight regain is reduced with higher compliance with NND and increased physical activity.

     

Erfolgreiches Altern und bürgerschaftliches Engagement

Background

Demographic change in Germany brings with it a higher need for care. Meanwhile, volunteering, especially by senior citizens, continues to increase. This study analyses the relationship between volunteering and life satisfaction as well as performance using the example of brotZeit e.V.

Methods

The total sample consists of 191 volunteers (mean age 64.02 years). In all, 123 active seniors and 68 applicants are analyzed together. Subjective life satisfaction and health are measured by an original questionnaire of 16 items. Also, depressive symptoms are measured using PHQ-9 (Patient Health Questionnaire).

Results

There is no significant difference between active seniors and applicants. All the subjects showed high subjective life satisfaction and health. Furthermore, depressive symptoms could not be diagnosed.

Conclusion

Volunteering can be seen as a kind of self-continuity. As such, it helps in maintaining an active and self-determined life. The diverse tasks in social commitment can support and complement conceptional training.

     

Soziale Unterstützung und Arbeitszufriedenheit

Objectives

The present study takes a closer look at the relationship between social support at work and job satisfaction. The focus lies on differences between different working areas.

Materials and methods

The introduction of an occupational health management in the responsibility of the German Federal Ministry of Defense gave the opportunity to conduct surveys in different departments.

Results and discussion

The response rate was 22.4%; employees in combat units (n = 684), in military command units and the Ministry of Defense (n = 493), in administration offices (n = 375) and in a military hospital (n = 403) were surveyed. A regression model was conducted for every working area. Explained variance was high in every model (0.334 < R ²  < 0.451) and perceived support by colleagues and superiors had a significant impact on job satisfaction across all working areas. The impact of perceived support by colleagues on job satisfaction differed between working areas. It was especially strong in administration offices and the hospital. Perceived support by superiors had a strong impact on job satisfaction across all working areas.

     

In support of an individualized approach to assessing quality of life: comparison between Patient Generated Index and standardized measures across four health conditions

Background

Individualized measures of health-related quality life (HRQL) have been used for decades and shown to provide unique information, but little work has been done to explain this uniqueness particularly across health conditions.

Aims

To estimate, across four health conditions, the magnitude of the association between scores derived from the Patient Generated Index (PGI) and those from fully standardized generic and disease-specific measures of the HRQL; to identify the extent to which the areas generated from the PGI are covered by the content of the fully standardized measures.

Methods

The PGI and other generic and disease-specific measures had been used in four different samples of people: stroke (n = 222), multiple sclerosis (MS; n = 185); advanced cancer (n = 173), and HIV+ (n = 690). Areas nominated on the PGI were harmonized to a standard nomenclature. Pearson correlations were estimated between PGI and other measures.

Results

Data from 1263 people indicated that PGI provided the lowest rating for HRQL across all health conditions. The areas nominated differed across conditions with walking/mobility: the most common for stroke (42%), work/school for MS (62%), health for HIV+ (97%), and fatigue for cancer (39%). Many of the aspects of health included in generic measures were not nominated using the PGI and vice versa. The highest correlations between the PGI and other measures were observed for people with MS, with correlations between 0.53 and 0.59; lowest correlations were observed for people with HIV and cancer, ≤0.33.

Discussion

The PGI scores reflect those aspects of quality of life that are important to patients in which they would most value an improvement. Heterogeneity in HRQL across health conditions is poorly discriminated using standardized measures. A “one-size-fits-all” approach to HRQL assessment may not provide the most useful representation of this important construct.

     

Adaptation and validation of the “tolerability and quality of life” (TOOL) questionnaire in Chinese bipolar patients

Background

It is well known that the antipsychotic drugs impact the health-related quality of life (HRQoL) of the bipolar patients. The side effects had been assessed only from the doctors’ perspective and neglected the patients’ subjective feeling. The aim of the study is to validate the specific instrument “tolerability and quality of life” (TOOL) into Chinese to describe and grade the impact of antipsychotic drugs on HRQoL from patients’ view.

Methods

A psychometric study was conducted with euthymic bipolar disorder patients (N = 105) under antipsychotic treatment. The psychometric properties of the TOOL, including internal consistency, retest reliability, concurrent validity, content validity, discriminative validity, item analysis, confirmatory factor analysis and feasibility, were analyzed.

Results

The internal consistency and intraclass correlation coefficient (ICC) were adequate (Cronbach’s alpha = 0.80 and ICC = 0.81). A confirmatory factor analysis (CFA) validated the one-factor model. Significant Spearman’s rank correlations between the TOOL and both Bref QoL.BD (Brief version of Quality of Life in Bipolar Disorder) (r = ?0.33, P < 0.01) and UKU (Udvalg for Kliniske Undersogelser side effects scale) (r = 0.13, P < 0.05) were found.

Limitations

Small sample size and no specific self-report instrument in Chinese to evaluate the criterion validity.

Conclusions

TOOL appears to be a reliable and valid measure to assess the impact of adverse events of antipsychotic drugs on HRQoL from the patients’ perspective.

     

Efficacy and safety of a natural mineral water rich in magnesium and sulphate for bowel function: a double-blind,randomized, placebo-controlled study

Purpose

The present placebo-controlled, double-blind, randomized trial aimed to investigate whether a natural mineral water rich in magnesium sulphate and sodium sulphate (Donat Mg) may help to improve bowel function.

Methods

A total of 106 otherwise healthy subjects with functional constipation were randomly assigned to consume 300 or 500 mL of a natural mineral water as compared to placebo water, over a course of 6 weeks. The 300-mL arms were terminated due to the results of a planned interim analysis. Subjects documented the complete spontaneous bowel movements, spontaneous and overall bowel movements/week, stool consistency, gastrointestinal symptoms and general well-being in a diary. Change in the number of complete spontaneous bowel movements was defined as the primary outcome.

Results

For the 75 subjects in the 500-mL arms, the change in the number of complete spontaneous bowel movements per week tended to be higher in the active group when compared to placebo after 6 weeks (T2 = 1.8; p _value = 0.036; one-sided). The mean number of spontaneous bowel movements significantly increased over the course of the study, with significant differences between study arms considering the whole study time (F test = 4.743; p _{time × group} = 0.010, 2-sided). Stool consistency of spontaneous bowel movements (p < 0.001) and the subjectively perceived symptoms concerning constipation (p = 0.005) improved significantly with the natural mineral water as compared to placebo.

Conclusions

The daily consumption of a natural mineral water rich in magnesium sulphate and sodium sulphate improved bowel movement frequency and stool consistency in subjects with functional constipation. Moreover, the subjects’ health-related quality of life improved.

Clinical Trial Registration

EudraCT No 2012-005130-11.

     

Ten-year follow-up of health-related quality of life among ambulatory persons with multiple sclerosis at baseline

Purpose

The aim of this 10-year follow-up study was to determine changes in health-related quality of life (HRQoL) over time among ambulatory persons with MS (PwMS) at the baseline using generic and disease-specific instruments.

Methods

Of 109 independently walking PwMS included in a population-based study in 2002, 77 (70.6 %) were re-assessed in 2012. HRQoL was captured using the 36-Item Short Form Survey Instrument (RAND-36), 15D instrument (15D), and the Multiple Sclerosis Quality of Life-54 (MSQOL-54). Repeated-measures ANOVA and effect size (ES) calculations (Cohen’s d) were used in the statistical analysis.

Results

The RAND-36 physical health composite score (p = 0.003, ES = 0.26) and 15D total score (p = 0.012, ES = 0.25) declined from the baseline levels. In particular, lower scores were observed on the RAND-36 scales of physical functioning (p = 0.001, ES = 0.27), pain (p = 0.020, ES = 0.25), and general health perceptions (p = 0.002, ES = 0.36), on the MSQOL-54 scales of physical functioning (p = 0.001, ES = 0.27), pain (p = 0.040, ES = 0.21), sexual functioning (p = 0.003, ES = 0.43), and satisfaction with sexual functioning (p = 0.012, ES = 0.38), and in the 15D dimensions of mobility (p = 0.004, ES = 0.31) and sexual functioning (p ≤ 0.001, ES = 0.59). Improvement was observed on the RAND-36 scale of social functioning (p = 0.049, ES = 0.25). The other composite scores, scales, and dimensions remained unchanged.

Conclusion

The results of this study suggest that ambulatory PwMS at baseline reported reduced HRQoL in physical functioning after a 10-year follow-up period, while emotional well-being was maintained and social functioning improved. The scores in the other HRQoL dimensions and scales remained unchanged. More long-term population-based studies are needed to precisely determine the development of HRQoL among PwMS.