Factors associated with health-related quality of life among hemodialysis patients in the DOPPS

Objective To identify modifiable factors associated with health-related quality of life (HRQOL) among chronic hemodialysis patients. Methods Analysis of baseline data of 9,526 hemodialysis patients from seven countries enrolled in phase I of the Dialysis Outcomes and Practice Patterns Study (DOPPS). Using the Kidney Disease Quality of Life Short Form (KDQOL-SF^TM), we determined scores for 8 generic scale summaries derived from these scales, i.e., the physical component summary [PCS] and mental component summary [MCS], and 11 kidney disease- targeted scales. Regression models were used to adjust for differences in comorbidities and sociodemographic and treatment factors. The Benjamini–Hochberg procedure was used to correct P-values for multiple comparisons. Results Unemployment and psychiatric disease were independently and significantly associated with lower scores for all generic and several kidney disease-targeted HRQOL measures. Several other comorbidities, lower educational level, lower income, and hypoalbuminemia were also independently and significantly associated with lower scores of PCS and/or MCS and several generic and kidney disease-targeted scales. Hemodialysis by catheter was associated with significantly lower PCS scores, partially explained by the correlation with covariates. Conclusion Associations of poorer HRQOL with preventable or controllable factors support a greater focus on psychosocial and medical interventions to improve the well-being of hemodialysis patients. An erratum to this article can be found at     

Factors associated with health-related quality of life among Belgrade University students

Purpose  

The aims of the study were to evaluate health-related quality of life (HRQoL) among students of University of Belgrade (Serbia) and to identify factors that might have associated with their HRQoL including relationship with depression.     

Factors associated with health-related quality of life among pulmonary tuberculosis patients in Manila,the Philippines

Purpose

Health-related quality of life (HRQOL) among pulmonary tuberculosis (PTB) patients has not been investigated in the Philippines. This study aimed to describe HRQOL among PTB patients and to determine factors that are associated with HRQOL.

Methods

A cross-sectional survey was conducted at 10 public health centers and 2 non-government organization clinics in District I, Tondo, Manila. Face-to-face interviews using a structured questionnaire including Short Form-8, Duke-UNC Functional Social Support Questionnaire, and Medical Research Council (MRC) dyspnea scale were performed with 561 PTB patients from September to November 2012.

Results

HRQOL among PTB patients was generally impaired. Factors associated with lower physical component summary were exposure to secondhand smoke (SHS) (P = 0.038), positive sputum smear result (P = 0.027), not working (P = 0.038), lower education level (P < 0.01), number of symptoms (P < 0.01), number of adverse drug reactions (ADRs) (P < 0.01), higher score on the MRC dyspnea scale (P < 0.01), and low perceived social support (P = 0.027). Lower body mass index (P = 0.016), non-SHS exposure (P = 0.033), number of symptoms (P < 0.01), number of ADRs (P < 0.01), low perceived social support (P < 0.01), and negative perception for waiting time in the clinic (P = 0.026) were identified to be factors significantly associated with lower mental component summary.

Conclusion

Socioeconomic status including SHS exposure and low perceived social support, in addition to clinical factors, may be associated with poor HRQOL. Further study would be needed to assess our findings.     

Factors associated with general and health-related quality of life in menopausal transition among women from Serbia

ABSTRACT

This study assessed factors associated with quality of life (QOL) among Serbian peri- and postmenopausal women using two menopause-specific scales. This cross-sectional study included 500 women aged 40–65 years who had a gynecologic check-up in one of two Community Health Centers in Belgrade during February 2014 to January 2015. Women completed: a questionnaire about socio-demographics, habits, and health status; a menopause-specific questionnaire, Utian’s Quality of Life Scale (UQOL); and a Women’s Health Questionnaire (WHQ) and Beck’s Depression Inventory (BDI). Higher education was associated with better occupational UQOL and memory/concentration, but with lower emotional UQOL and more anxiety/fears. City center residency was associated with better occupational and sexual UQOL. Being employed was associated with better occupational UQOL and lower anxiety/fears. Higher income was associated with better emotional UQOL. Not having uterine prolapse, insomnia, or tachycardia was associated with better occupational UQOL and fewer sleep problems. Higher parity was associated with better sexual UQOL. Having regular recreation was associated with better health and sexual UQOL but with more frequent vasomotor symptoms. Leaner women felt more attractive. QOL during the menopausal transition does not entail only somatic symptoms and therefore requires a more comprehensive approach that includes psychosocial underpinnings.     

Factors associated with low health-related quality of life among younger and older Thai patients with non-valvular atrial fibrillation

Purpose

The aim of this study was to investigate the factors associated with low health-related quality of life (HRQoL) compared between younger and older Thai patients with non-valvular atrial fibrillation (NVAF).

Methods

This is a cross-sectional analysis of baseline data from a prospective NVAF registry from 24 hospitals located across Thailand. Patient demographic, clinical, lifestyle, and medication data were collected at baseline. EuroQOL/EQ-5D-3L was used to assess HRQoL. Health utility was calculated for the entire study population, and low HRQoL was defined as the lowest quartile. Multivariate logistic regression was used to identify factors that significantly predict low HRQoL among younger and older (≥?65 years) patients with NVAF.

Results

Among the 3218 participants that were enrolled, 61.0% were aged older than 65 years. Mean HRQoL was lower in older than in younger patients (0.72?±?0.26 vs. 0.84?±?0.20; p?<?0.001). Factors associated with low HRQoL among younger NVAF patients were the treatment-related factors bleeding history (p?=?0.006) and taking warfarin (p?=?0.001). Among older patients, the NVAF-related complications ischemic stroke or TIA, heart failure (HF), and dementia (all p?<?0.001) were all significantly associated with low HRQoL. Dementia is the factor that most adversely influences low HRQoL among older NVAF. Interestingly, symptomatic NVAF was found to be a protective factor for low HRQoL (p?<?0.001).

Conclusions

Bleeding history and taking warfarin among younger patients, and ischemic stroke/TIA, HF, and dementia among older patients are significant predictors of low HRQoL. These factors should be taken into consideration when selecting treatment options for patients with NVAF.

     

Factors associated with health-related quality of life in chronic leg ulceration

Background

Individuals with chronic leg ulceration may have significantly impaired health-related quality of life (HRQOL) due to pain, impaired mobility, poor sleep, depression, restricted work capacity, and social isolation. The study purpose was to examine the associations among sociodemographic and clinical factors and HRQOL in a large sample of community-dwelling adults being treated for leg ulcers.

Methods

Data are from the cross-sectional baseline assessment of the Canadian Bandaging Trial, a multi-center, randomized controlled trial conducted to assess time to healing with two forms of high-compression bandaging. All participants received a comprehensive, standardized clinical assessment, and completed the 12-item Short Form (SF-12) and McGill Pain Questionnaire. SF-12 data were compared to age- and sex-adjusted norms, and multivariable logistic regression was used to identify factors associated with whether individuals were below, or at/above their normative values on the physical and mental component summary (PCS, MCS).

Results

Of 424 individuals enrolled over a 50-month period, 407 (96 %) completed the SF-12. Mean age was 65 ± 17 years, and 55 % were women. Mean PCS was 39.1 ± 9.9 with 91 (22.4 %) scoring at/above the mean value for their age and sex; equivalent values for the MCS were 51.4 ± 9.9 and 209 (51.4 %). Higher levels of pain, younger age, larger size and longer duration of ulcer, and limited mobility were associated with poorer HRQOL.

Conclusions

Findings confirm the considerable burden of illness associated with leg ulcers. Given the chronic and recurring nature of the condition, strategies focused on improving HRQOL and healing are needed for this vulnerable population.     

Factors influencing health-related quality of life of thalassaemic Jordanian children

Purpose To assess the health‐related quality of life (HRQoL) of Jordanian children with thalassaemia, identify differences in HRQoL according to socio‐demographic and clinical characteristics of participants, and identify factors influencing HRQoL of thalassaemic children in Jordan. Methods The Pediatric Quality of Life Inventory and socio‐demographic and clinical data forms were used to collect data from a convenience sample of 128 thalassaemic children and 83 healthy children between the ages of 8 to 18 years. Thalassaemic children were recruited from two thalassaemia units during their blood transfusion and treatment visits. Healthy children were recruited from four public schools. Results Thalassaemic children had significantly lower HRQoL mean scores in all dimensions compared with their healthy counterparts. The lowest mean scores for thalassaemic children were reported for the school functioning and the physical functioning domains (46.71 ± 21.14 and 54.19 ± 15.10), respectively. Regression analysis showed that disease complications and family history of thalassaemia explained 8.5% of the variance in the total HRQoL. Conclusion This study highlights the negative impact of thalassaemia on the quality of life of children, especially in terms of physical well‐being and school achievement. Healthcare providers, counsellors and school teachers have very important roles in helping these children to overcome these problems and enhance their quality of life.     

Factors associated with caregiver burden among caregivers of patients with cancer in a hospice setting

Purpose: Previous research has examined caregiver burden in the context of chronic illness, but little is known about this problem in hospice settings. The objective of this project was to identify factors associated with caregiver perceptions of burden among those caring for the terminally ill, with a long-term goal of better understanding the links between the level of burden and the risk of adverse medical and psychological outcomes. Our expectation was that certain groups (e.g., older women) would experience greater burden.Methods: We conducted a cross-sectional survey of primary caregivers in a hospice setting. Among 388 caregivers of patients with cancer admitted between October 1999 and September 2000, 200 (52%) agreed to participate. In-person interviews were conducted to ascertain data on the caregivers' socio-demographic characteristics, self-reported health status, support systems, religiosity, and amount of assistance they provided to their patients. Using this information, we also calculated a composite social network index, incorporating marital status, religious activities, contact with friends, and participation in community groups. Caregiver burden was measured using a 9-item subset of the Zarit burden inventory, and the summary scores were dichotomized at the upper quartile. Using logistic regression, unadjusted and adjusted analyses identified factors significantly associated with increased burden scores.Results: We found that increased caregiver burden was related to younger age (OR 1.49, CI 1.12–1.99), a worse score on the social network index (OR 1.43, CI 1.05–1.95), and the number of activities in which the caregivers themselves were restricted due to their caregiving responsibilities (OR 1.32, CI 1.11–1.58).Conclusions: Although several factors were associated with caregiver feelings of burden, the specific results we found were not anticipated. Future research should examine these factors, as well as others that might be more easily modifiable, when evaluating increased risk among caregivers.     

Health- and oral health-related quality of life among preschool children with cerebral palsy

Objectives  

To assess the health- and oral health-related quality of life of preschool children with cerebral palsy (CP) and to determine their inter-relationship between the two quality of life measures.     

Predictors of health-related quality of life in patients with colorectal cancer

Background  

Most studies that have identified variables associated with the health-related quality of life (HRQL) of patients with colorectal cancer have been cross-sectional or included patients with other diagnoses. The objectives of this study were to identify predictors of HRQL in patients with colorectal cancer and interpret the clinical importance of the results.     

Factors associated with health-related quality of life: the role of social relationships among the elderly in an Italian region

OBJECTIVES: This study examines the association between social relationships and health-related quality of life (HRQL) in the elderly in Lazio Region, Italy, a Mediterranean country where the shape and role of social links has dramatically changed. METHODS: Data were extracted from a national cross-sectional survey in Italy, representative of the non-institutionalised population aged 60 years and over resident in Lazio Region during 1999--2000. HRQL was measured with the Short Health Survey Questionnaire (SF-12). Data analysis was performed using multiple linear regression models using adjustment for the main confounders. RESULTS: Among the sample, 40.4% of the elderly were not married and 27.1 % were living alone. While being married and not living alone were associated with higher scores in the physical and mental quality-of-life components (P-value<0.001), more frequent visiting/seeing friends was likely to be associated with higher scores in both the physical and the mental health components (P-value<0.05). Multiple logistic regression analysis demonstrated that low physical health scores were associated with a low frequency of meeting with relatives and with living far from relatives. CONCLUSIONS: In a region covering 9.2% of the whole Italian population, only a small proportion of the elderly lack frequent social ties, yet low frequency of relationships with friends is associated with a decline in quality of life measured through mental and physical scores. Our findings will be useful for drawing up welfare strategies both at the national and at the Mediterranean level, in countries, like Italy, where the primacy of family support of the elderly has been decreasing in recent years.     

Factors influencing self- and parent-reporting health-related quality of life in children with brain tumors

Purpose

Health-related quality of life (HRQOL) is not only a degree of health but also reflects patient perceptions and expectations of health. For children with brain tumors, better understanding of HRQOL requires the use of complementary reports from parents and interviewer-administered reports for children. Here, we aimed to test whether or not the trait anxiety of children and the psychological distress of their parents influence children’s and parents’ responses to HRQOL questionnaires, and whether or not the report-administration method for children influences children’s responses to HRQOL questionnaires.

Methods

One hundred and thirty-four children aged 5–18 with brain tumors and one of their parents completed the Pediatric Quality of Life Inventory^? (PedsQL^?) Brain Tumor Module questionnaires. In addition, the children also completed the State-Trait Anxiety Inventory for Children (STAIC), and the parents also completed the Kessler-10 (K10) and health and sociodemographic characteristics questionnaires. The child questionnaires were administered either by the child (self-administered) or an interviewer. Rater-dependent perceptions about HRQOL were derived from the subscales scores of the PedsQL^? Brain Tumor Module using structural equation modeling based on a multitrait-multimethod model. The STAIC trait-anxiety score, K10 score, report-administration method, and other health and sociodemographic factors related to each child’s or parent’s perceptions were identified through multiple linear regression analyses of the questionnaire responses. We used a path analysis to estimate the change in a PedsQL^? child-reported score that occurs when interviewer-administration changes the child’s perception about HRQOL.

Results

Surveys for 89 children were self-administered while those for 45 were interviewer-administered. The perceptions of the children and parents were calculated by fitting data to the model (chi-squared P = 0.087, normed fit index = 0.932, comparative fit index = 0.978, standardized root mean squared residual = 0.053, and root mean square error of approximation = 0.054). The children’s perception of HRQOL was affected by their STAIC trait-anxiety score (b = ?0.43, 95% CI [?0.60, ?0.25]). The parent’s perception was affected by their child’s treatment status (b = 0.26, 95% CI [0.09, 0.43]), the parent’s K10 score (b = ?0.21, 95% CI [?0.37, ?0.04]), and by education level (b = 0.17, 95% CI [0.00, 0.34]). The change in the child-reported PedsQL^? score in relation to the method of administration ranged from ?1.1 (95% CI: ?3.5, 1.3) on the procedural anxiety subscale to ?2.5 (95% CI: ?7.6, 2.6) on the movement and balance subscale.

Conclusion

Child-reporting of HRQOL is little influenced by the method of administration. Children’s perception about HRQOL tended to be influenced by their trait anxiety, while parents’ perception was influenced by their psychological distress, academic background, and their child’s treatment status.     

Determinants of health-related quality of life among Omanis hospitalized patients with cancer: a cross-sectional study

Quality of Life Research - This study aimed to examine the difference in HRQoL by participants’ characteristics and to investigate the determinants of health-related quality of life HRQoL...     

Health-related quality of life profiles among family caregivers of patients with schizophrenia

This cross-sectional study aims to determine and compare health-related quality of life profiles of schizophrenia family caregivers on the basis of their sociodemographic characteristics. Thirty outpatient family caregivers completed the generic 36-Item Short Form Health Survey instrument (male = 53.5%; mean age = 51 years; married = 76.7%). The highest mean score was reported for social functioning while role limitation-emotional was rated the worst. Significantly better health-related quality of life profiles were demonstrated by caregivers who were male, younger than 50 years, adequately educated, employed, and without health problems and were receiving monthly income. Understanding of on health-related quality of life matters for family caregivers is crucial to improve the quality of care for schizophrenia patients.     

Clinical correlates of health-related quality of life among opioid-dependent patients

Purpose  

Previous work suggests that opioid users have lower health-related quality of life (HRQOL) than patients with more prevalent chronic illnesses such as hypertension or diabetes. Although comparisons with population norms are informative, studies of the correlates of HRQOL for opioid users are needed to plan clinical services.     

Perception of health-related quality of life in children with chronic kidney disease by the patients and their caregivers: Multicentre national study results

Objective

The aim of the study was to analyse the health-related quality of life (HRQoL) in Polish children with chronic kidney disease (CKD) dependant on the CKD stage, treatment modality and selected social life elements in families of the patients. Furthermore, potential differences between self-report and parent/proxy reports and the factors influencing them were assessed.

Methods

A total of 203 CKD children (on haemodialysis (HD), peritoneal dialysis (PD) and conservative treatment (CT)) and their 388 parent/proxies were enrolled into a cross-sectional national study. The demographic and social data were evaluated. We used the Paediatric Quality of Life Inventory 4.0 Generic Core Scales to assess the HRQoL in children.

Results

Health-related quality of life scores for all CKD groups were significantly lower in all domains compared with population norms, the lowest one being in the HD group. In CT children, HRQoL did not depend on the CKD stage. Both parents assessed the HRQoL of their children differently depending on their involvement in the care. There are differences between the HRQoL scores of the children and their parents.

Conclusion

The HRQoL in children with CKD is lower than in healthy children. This is already observed in the early stages of the disease. The disease itself influences the child’s mental state. Children on HD require special support on account of the lowest demonstrated overall HRQoL. Children’s lower rating of the quality of life observed by their parents may render the patients unmotivated and adversely affect their adjustment to life in later years. It may also create conflicts between the parents and the children.     

411例肠易激综合征患者生活质量状况调查

目的探讨肠易激综合征（IBS）患者的生活质量状况。方法在西安市2所综合医院选取连续的411例IBS患者，其SF-36量表中8个维度的得分以及生理功能总分和心理功能总分与430名健康对照者的得分相比较。结果IBS患者在SF-36量表所有8项维度的得分比健康对照者显著降低（P〈0．001），得分最低的维度是总体健康和情感职能，分别为33．5±16．9、40．8±25．1。IBS患者生理功能总分和心理功能总分也显著降低（P〈0．001）。结论IBS患者生活质量明显受损。分析结果有助于更好了解IBS对患者功能和健康的影响。     

Resilience is associated with health-related quality of life in caregivers of service members and veterans following traumatic brain injury

Quality of Life Research - To examine factors related to resilience in military caregivers across caregiver health-related quality of life (HRQOL), caregiver sociodemographic variables, and service...