Affective disorders and Health-Related Quality of Life (HRQoL) in adolescents and young adults with Multiple Sclerosis (MS): the moderating role of resilience

Purpose

To investigate the moderating role of resilience in the relationship between affective disorders and Health-Related Quality of Life (HRQoL) for adolescents and young adults with multiple sclerosis (MS).

Methods

A quantitative methodology was adopted. Fifty-three adolescents and young adults were interviewed to assess resilience as a personality trait (Ego-Resiliency Scale) and resilience as an interactive competence (CYRM-28), Health-Related Quality of Life (PedsQL 4.0), depression and anxiety (BDI-II and STAI-Y).

Results

Affective disorders, both depression (β = ?.38, p < .001) and anxiety (State β = –.35, p < .001; Trait β = ?.41, p < .001), were negatively associated with HRQoL. Data also showed that the resilience competencies using Individual (β = .22, p < .001) and relational resources (β = .12, p < .05) are significantly associated HRQoL. According to the regression analyses, we tested the moderating role of resilience competence using individual resources on the relationship between the Depression Cognitive Factor and Emotional Functioning. Data show that in step 2 of the regression analysis, we obtained a variation of β = ?.45 (p < .001) to β = ?.30 (p < .001) in the dimension for the Depression Cognitive Factor. The Sobel test showed that the moderating effect of resilience was significant regarding the increase in R² (p < .01).

Conclusions

Resilience competence using individual resources moderates the relationship between the Depression Cognitive Factor and Emotional Functioning in adolescents with MS. Our study suggests that to improve well-being for adolescents with MS resilience could play a key role.

     

Neonatal treatment philosophy in Dutch and German NICUs: health-related quality of life in adulthood of VP/VLBW infants

Purpose

Although survival after very preterm birth (VP)/very low birth weight (VLBW) has improved, a significant number of VP/VLBW individuals develop physical and cognitive problems during their life course that may affect their health-related quality of life (HRQoL). We compared HRQoL in VP/VLBW cohorts from two countries: The Netherlands (n = 314) versus Germany (n = 260) and examined whether different neonatal treatment and rates of disability affect HRQoL in adulthood.

Method

To analyse whether cohorts differed in adult HRQoL, linear regression analyses were performed for three HRQoL outcomes assessed with the Health Utilities Index 3 (HUI3), the London Handicap Scale (LHS), and the WHO Quality of Life instrument (WHOQOL-BREF). Stepwise hierarchical linear regression was used to test whether neonatal physical health and treatment, social environment, and intelligence (IQ) were related to VP/VLBW adults’ HRQoL and cohort differences.

Results

Dutch VP/VLBW adults reported a significantly higher HRQoL on all three general HRQoL measures than German VP/VLBW adults (HUI3: .86 vs .83, p = .036; LHS: .93 vs. .90, p = .018; WHOQOL-BREF: 82.8 vs. 78.3, p < .001). Main predictor of cohort differences in all three HRQoL measures was adult IQ (p < .001).

Conclusions

Lower HRQoL in German versus Dutch adults was related to more cognitive impairment in German adults. Due to different policies, German VP/VLBW infants received more intensive treatment that may have affected their cognitive development. Our findings stress the importance of examining effects of different neonatal treatment policies for VP/VLBW adults’ life.

     

Correlates of health-related quality of life in young-old and old–old community-dwelling older adults

Purpose

This study aimed (1) to examine the role of potential correlates of HRQoL in a large representative sample of older adults, and (2) to investigate whether the relationships between HRQoL and potential factors differ as a function of HRQoL component (physical vs. mental) and/or age cohort (young-old vs. old–old).

Methods

This cross-sectional study included 802 older adults aged 60–79 years old. HRQoL was assessed using the SF-36 questionnaire. Functional fitness was assessed using the Senior Fitness Test. Physical activity was measured via the Baecke questionnaire. Demographic information, mental and health features were obtained through questionnaires.

Results

A multiple regression analysis showed that BMI (β = ?0.15, p?=?0.001), body strength (β =?0.21, p?<?0.001), aerobic endurance (β =?0.29, p?<?0.001), physical activity (β =?0.11, p?=?0.007), depressive symptoms (β = ?0.19, p?<?0.001), falls (β = ?0.19, p?<?0.001), and living alone (β = ?0.16, p?<?0.001) were all significantly related to HRQoL-SF-36 total score. The positive relation with aerobic endurance was significantly higher for the physical component of HRQoL, while the negative relation with living alone was significantly higher for the mental component. The positive relation of HRQoL with physical activity was significantly higher in old–old compared to young-old adults.

Conclusion

This data suggest that body composition, functional fitness, psycho-social factors, and falls are important correlates of HRQoL in old age. There are HRQoL-component and age-cohort differences regarding these correlates, underlying the need for specific strategies at the community level to promote HRQoL in older adults.

     

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.

     

Gender differences in the effect of social support on health-related quality of life: results of a population-based prospective cohort study in old age in Germany

Purpose

The causality between social predictors and HRQoL in old age remains almost unclear as only a few studies have examined the influence of social support on HRQoL in a longitudinal setting. Moreover, available studies investigating gender differences in the effect of social support on HRQoL in old age have been solely cross-sectional. Consequently, the aim of this study was to examine whether social support affects health-related quality of life (HRQoL) in old age and whether this effect is moderated by gender.

Methods

In a population-based cohort (N = 2443) of people aged 75 years and older in Germany, the development of HRQoL was prospectively observed over a 3-year period. Quality of life was quantified by using the visual analogue scale of the EQ-5D instrument. Social support was assessed by using the 14-item form of the questionnaire for social support (F-SozU K-14). In order to control for unobserved heterogeneity, fixed-effects regression analysis was used.

Results

In the total sample (β = 0.55, p < 0.05) and in men (β = 1.39, p < 0.001), a strong positive impact of social support on HRQoL was found. There was no significant effect of social support on HRQoL in women. The effect of social support on HRQoL was significantly moderated by gender (p < 0.05).

Conclusions

Findings accentuate the fundamental role of social support in HRQoL in old age. Particularly in men, it is therefore crucial to strengthen the social ties in old age.

     

Quality of life in patients with a permanent stoma after rectal cancer surgery

Aim

Health-related quality of life (HRQoL) assessment is important in understanding the patient’s perspective and for decision-making in health care. HRQoL is often impaired in patients with stoma. The aim was to evaluate HRQoL in rectal cancer patients with permanent stoma compared to patients without stoma.

Methods

711 patients operated for rectal cancer with abdomino-perineal resection or Hartman’s procedure and a control group (n = 275) operated with anterior resection were eligible. Four QoL questionnaires were sent by mail. Comparisons of mean values between groups were made by Student´s independent t test. Comparison was made to a Swedish background population.

Results

336 patients with a stoma and 117 without stoma replied (453/986; 46 %). A bulging or a hernia around the stoma was present in 31.5 %. Operation due to parastomal hernia had been performed in 11.7 % in the stoma group. Mental health (p = 0.007), body image (p < 0.001), and physical (p = 0.016) and emotional function (p = 0.003) were inferior in patients with stoma. Fatigue (p = 0.019) and loss of appetite (p = 0.027) were also more prominent in the stoma group. Sexual function was impaired in the non-stoma group (p = 0.034). However in the stoma group, patients with a bulge/hernia had more sexual problems (p = 0.004). Pain was associated with bulge/hernia (p < 0.001) and fear for leakage decreased QoL (p < 0.001). HRQoL was impaired compared to the Swedish background population.

Conclusion

Overall HRQoL in patients operated for rectal cancer with permanent stoma was inferior compared to patients without stoma. In the stoma group, a bulge or a hernia around the stoma further impaired HRQoL.

     

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.

     

Stigma as a key determinant of health-related quality of life in Parkinson’s disease

Purpose

People with Parkinson’s disease (PD) may experience stigma due to their visible features of movement and communication difficulties. This paper aimed to examine the role of experienced stigma in health-related quality of life (QOL), after controlling for personal and clinical characteristics.

Methods

This is a preliminary analysis of a subset of baseline data from the Social Self-Management of Parkinson’s Disease Study (SocM-PD), an ongoing 3-year prospective cohort study. Seventy-three people with PD (M _age = 65.72, 29 women) participated in this study. Hierarchical multiple regression analyses were used to determine the role of stigma in QOL, after controlling for gender, disease severity, depression, and motor difficulties of daily living.

Results

Significant correlations were found between QOL with gender (r = .26), disease severity (r = .38), depression (r = .65), motor difficulties of daily living (r = .71), and stigma (r = .83). After controlling for the significant covariates, stigma made a significant and unique contribution to the explanation of QOL by 13.7 % (p < 0.001). A final hierarchical multiple regression with stigma and the 4 covariates revealed an overall model that explained 77.8 % of the total variance of QOL (F [5, 63] = 48.79, p < 0.001).

Conclusions

Experienced stigma appears to be a key determinant of QOL in people with PD. The results suggest the importance of further understanding stigma in PD to develop possible intervention strategies. Future work is also needed to verify the results with a larger and longitudinal dataset of the SocM-PD.

     

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.

     

Relationship between cyberbullying and health-related quality of life in a sample of children and adolescents

Purpose

Health-related quality of life (HRQoL) is a well-known construct that refers to a state of complete physical, mental, and social well-being. Its relationship with multiple forms of violence, including bullying, has been widely explored, but this is not the case for cyberbullying. The main objective is to analyze how HRQoL varies depending on the role played in cyberbullying, its temporal stability, and gender and age differences.

Method

An analytical and longitudinal study was conducted at two temporal moments. At Time 1 (December 2015), 920 Spanish students aged between 11 and 18 years participated (M_age?=?13.36, SD?=?1.83: 48.9% boys and 51.1% girls). At Time 2 (April 2016), there were 313 participants (M_age 12.81 years, SD?=?1.59: 53.4% boys and 46.6% girls). We used the Cyberbullying Test (technological scale) and the Spanish version of the KIDSCREEN-52.

Results

Cybervictims and cyberbully–victims present worse scores in all dimensions of the KIDSCREEN-52 (p?<?.001), compared to cyberbystanders or uninvolved individuals. There are gender differences only in cyberaggression and cyberbystanding. There are significant inverse correlations between all the dimensions of the KIDSCREEN-52 and cybervictimization, with Bullying (r?=???.603, p?<?.001), Mood (r?=???.329, p?<?.001), and School environment (r?=???.327, p?<?.001) being particularly relevant. There were statistically significant differences between T1 and T2 for cyberbystanding (lower scores at T2).

Conclusion

Cybervictims and cyberbully–victims have worse quality of life in all the dimensions than uninvolved individuals, especially in Psychological well-being, School environment, and Bullying.

     

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.

     

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.

     

Impact of a community-based lifestyle intervention program on health-related quality of life

Background

The presence of risk factors for type 2 diabetes and cardiovascular disease, or the conditions themselves, contributes to lower health-related quality of life (HRQoL) among adults. Although community-based lifestyle intervention programs have been shown to be effective for improving risk factors for these diseases, the impact of these interventions on HRQoL has rarely been described.

Purpose

To examine changes in HRQoL following participation in the Group Lifestyle Balance program, a community translation of the Diabetes Prevention Program lifestyle intervention for adults with prediabetes and/or the metabolic syndrome.

Methods

Participants enrolled in the 12-month, 22-session intervention program (N = 223) completed the EuroQol Health Questionnaire (EQ-5D-3L) at baseline, 6, and 12 months. Linear mixed-effects regression models determined change in EQ-5D-visual analog scale (VAS) and Index scores post-intervention.

Results

Mean EQ-5D-VAS was improved by +7.38 (SE = 1.03) at 6 months and by +6.73 (SE = 1.06) at 12 months post-intervention (both; p < 0.0001). Mean changes in EQ-5D index values were +0.00 (SE = 0.01; NS) and +0.01 (SE = 0.01; p < 0.05), respectively. Adjusted for age, baseline score, and achieving intervention goals, mean change in EQ-5D-VAS was +11.83 (SE = 1.61) at 6 months and +11.23 (SE = 1.54) at 12 months (both; p < 0.0001). Adjusted mean change in EQ-5D index value was +0.04 (SE = 0.01) at 6 months and +0.05 (SE = 0.01) at 12 months (both; p < 0.01).

Conclusion

Participation in a community lifestyle intervention program resulted in improved HRQoL among adults with prediabetes and/or the metabolic syndrome. These benefits to HRQoL, together with improved clinical and behavioral outcomes, should increase the appeal of such programs for improving health.

     

Longitudinal assessment of health related quality of life of HIV infected patients treated for tuberculosis and HIV in a high burden setting

Introduction

Assessment of patients receiving treatment for human immunodeficiency virus (HIV) and tuberculosis (TB) using a Health Related Quality of Life (HRQoL) instrument is important to get the subjective view of the patients’ wellbeing.

Methods

We used the Functional Assessment of HIV Infection (FAHI) HRQoL instrument to collect perceived wellness information at baseline, month 3, 6 and 12 from patients enrolled in a pharmacokinetic study between March 2007 and April 2008. Composite domain scores at each time point and their relationship with the rate of adverse events (AEs) and serious adverse events were compared between treatment arms.

Results

Out of the 82 patients enrolled, 76 were analysed. There was a significant increase in total score in all groups between baseline, month 3, 6 and 12 (all p values < 0.0001), and over time (p < 0.001). Adjusting for baseline total score, baseline CD4 count had a significant effect on the total score over time (p = 0.002) and the rate of change in total score over time, that is; interaction effect (p < 0.001). There was no difference in each domain scores between participants that received ART with TB treatment and those that received TB treatment only. Respiratory AEs had a significant effect on HRQoL.

Conclusion

We found that assessment of HRQoL of participants in TB–HIV treatment using the FAHI instrument was useful in evaluating treatment responses. It showed improvement consistent with decrease in adverse events and signs and symptoms of TB. Number and type of AEs was related to lower HRQoL in spite of TB cure.

     

Physical training following gastric bypass: effects on physical activity and quality of life—a randomized controlled trial

Background

Obesity is associated with physical inactivity and impaired health-related quality of life (HRQoL). We aim to test the hypothesis that Roux-en-Y gastric bypass (RYGB) followed by supervised physical training improves physical activity (PA) levels and HRQoL.

Methods

Sixty patients, qualified for RYGB, were at 6 months post-surgery randomized to 26 weeks of a supervised physical training intervention (INT) or to a control (CON) group. PA was assessed by accelerometry and using the questionnaire RPAQ. HRQoL was measured by the SF-36 questionnaire. All assessments were performed pre-surgery and 6, 12, and 24 months post-surgery.

Results

RYGB did not improve objectively or self-reported PA, but improved all domains of SF-36 (all p?<?0.01). Objectively measured light PA, moderate to vigorous PA, and step counts tended to increase in INT compared to CON 12 months after RYGB (0.05?<?p?<?0.09), but the effects failed to persist. The SF-36 domain “general health” increased in INT compared to CON 24 months after RYGB (p?=?0.041).

Conclusion

RYGB improves HRQoL, but does not increase PA. Supervised physical training intervention improves general health 24 months after RYGB and tends to improve certain domains of PA right after the intervention period, but fails to increase the patients’ overall PA level over time. Clinical Trial Registration Registered at ClinicalTrials.gov—no. NCT01690728.

     

Depression treatment and health-related quality of life among adults with diabetes and depression

Background

Previous findings regarding depression treatment and its consequences on health-related quality of life (HRQoL) of adults with diabetes were inconsistent and targeted certain groups of population. Therefore, there is a critical need to conduct a population-based study that focuses on a general population with diabetes and depression.

Objective

The primary aim of this study was to examine the physical and mental HRQoL associated with depression treatment during the follow-up year.

Methods

We adopted a longitudinal design using multiple panels (2005–2011) of the Medical Expenditure Panel Survey to create a baseline year and follow-up year. We included adults with diabetes and depression. We categorized the baseline depression treatment into: (1) antidepressant use only; (2) psychotherapy with or without antidepressants; and (3) no treatment. HRQOL was measured using SF-12 version 2 physical component summary (PCS) and SF-12 mental component summary (MCS) scores during both baseline year and follow-up year. Ordinary least squares (OLS) were used to estimate the association between depression treatment and the HRQoL measures. The OLS regression controlled for predisposing, enabling, need, external environment factors, personal health practices, and baseline HRQoL measures.

Results

After controlling for all the independent variables and the baseline PCS, individuals who received psychotherapy with or without antidepressants had higher PCS scores as compared to those without any treatment for depression (beta = 1.28, p < 0.001). Individuals who reported using only antidepressants had lower PCS scores (beta = ?0.54, p < 0.001) as compared to those without depression treatment. On the contrary, individuals who reported receiving psychotherapy with or without antidepressants had lower MCS scores as compared to those without depression treatment (beta = ?1.43, p < 0.001). Those using only antidepressants had higher MCS scores as compared to those without depression treatment (beta = 0.56, p < 0.001).

Conclusion

The associations between depression treatment and the HRQoL varied by the type of depression treatment and the component of the HRQoL measures.

     

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.

     

Preference-based health-related quality of life among victims of bullying

Purpose

No previous study has estimated the association between bullying and preference-based health-related quality of life (HRQoL) (“utility”), knowledge of which may be used for cost-effectiveness studies of interventions designed to prevent bullying. Therefore, the aim of the study was to estimate preference-based HRQoL among victims of bullying compared to non-victims.

Methods

A cross-sectional survey data collection among Swedish adolescents aged 15–17 years in the first year of upper secondary school was conducted in the city of Gothenburg in Sweden (N = 758). Preference-based HRQoL was estimated with the SF-6D. Regression analyses were conducted to adjust for some individual-level background variable.

Results

Mean preference-based health-related quality of life scores were 0.77 and 0.71 for non-victims and victims of bullying, respectively. The difference of 0.06 points was statistically significant (p < 0.05) and robust to inclusion of gender, age, and parental immigrant status.

Conclusions

The preference-based HRQoL estimates in this study may be used as an upper bound in economic evaluations of bullying prevention interventions, facilitating a comparison between costs and quality-adjusted life-years.

     

The impact of living arrangements on quality of life among Korean elderly: findings from the Korean Longitudinal Study of Aging (2006–2012)

Purpose

To investigate the impact of different living arrangements on quality of life (QoL) and health-related quality of life (HRQoL) in the elderly.

Methods

We used data from the first to fourth wave of the Korean Longitudinal Study of Aging. Using the first wave as a baseline, the data included 5050 individuals aged 60 years and older with at least one living child. QoL and HRQoL were measured using a visual analogue scale developed by the Korean Labor Institute that bears similarity to the EQ-VAS. Living arrangements were categorized based on household composition (single household, one-generation household, two-generation household, and three-generation household) and the marital status of a cohabiting adult child. A generalized estimating equation was used to examine the association between living arrangements and QoL/HRQoL.

Results

Compared to elderly individuals living in three-generation families with a married child, those in a single household (QoL: β = ?2.67 [P = 0.001]; HRQoL: β = ?2.24 [P = 0.007]), those living in a three-generation family with an unmarried adult child (QoL: β = ?5.19 [P < 0.0001]; HRQoL: β = ?3.41 [P < 0.0001]), and those living in a two-generation family with an unmarried adult child (QoL: β = ?2.88 [P < 0.0001]; HRQoL: β = ?2.80 [P < 0.0001]) were more likely to have lower QoL and HRQoL. These associations were particularly strong for women and individuals in the lowest equivalent household income group.

Conclusion

It is necessary to devise government programs not only for elderly individuals living alone, but also for those living with an unmarried adult child; elderly persons who are female and part of the lowest equivalent household income group must receive particular attention.

     

Test–retest reliability of <Emphasis Type="Italic">HeartQoL</Emphasis> and its comparability to the <Emphasis Type="Italic">MacNew</Emphasis> heart disease health-related quality of life questionnaire

Objectives

Heart Quality of Life (HeartQoL) is a new “hybrid” developed from the MacNew and two condition-specific questionnaires measuring health-related quality of life (HRQoL) in patients with ischemic heart disease (IHD). This study investigates test–retest reliability of HeartQoL (English version) according to international criteria (e.g., COSMIN, GRRAS). Findings on HeartQoL are compared to the published data on MacNew in view that both serve as the core IHD-specific HRQoL instrument.

Methods

Out of 105 patients with IHD, 76 completed self-administration of HeartQoL at the clinic followed by at home within a 2-week interval. In retest, patients responded using non-interview methods (phone messaging, email, fax, and post). Phone interviewing was reserved for non-respondents to reminder.

Results

Reliability of HeartQoL was good (intraclass correlation coefficients = 0.78–0.82), was supported in the Bland–Altman plot, and was comparable to five studies on MacNew of similar retest interval (MacNew-English = 0.70–0.75; translated MacNew = 0.72–0.91). Applicability of its standard error of measurement (0.20–0.25) and smallest detectable change (0.55–0.70) will depend on availability of normative data in future.

Conclusion

The reliability of HeartQoL is comparable to its parent instrument, the MacNew. The HeartQoL is a potentially reliable core IHD-specific HRQoL instrument in measuring group change.