Narrative review of health‐related quality of life and its predictors among patients with coronary heart disease

This paper summarizes the empirical evidence concerning health‐related quality of life (HRQoL) of patients with coronary heart disease (CHD) and attempts to identify its significant predictors. A systematic search of the literature from 2002 to 2012 was conducted using seven electronic databases (CINAHL, ScienceDirect, Medline, Scopus, PsycINFO, PubMed and Web of Science) using the search terms ‘HRQoL’. ‘CHD’, ‘social support’, ‘depression’, ‘anxiety’, ‘psychosocial factors’, ‘sociodemographic factors’, ‘clinical factors’ and ‘predictors’. A total of 1052 studies were retrieved, of which 24 articles were included in this review. Previous studies have consistently demonstrated the negative impact of CHD on HRQoL, citing three major types of predictive factors: sociodemographic, clinical and psychosocial factors. Studies have also highlighted the advantageous use of HRQoL as a gauge for treatment satisfaction and efficacy. There are, however, few studies that collectively investigate the relationship among concepts such as HRQoL, anxiety and depression, social support, and sociodemographic and clinical factors in relation to CHD. This review highlights the need to conduct further study on HRQoL of patients with CHD in the Asian context. Such research will promote patient‐centric care and improved patient satisfaction through incorporation of the concept of HRQoL into clinical practice.     

Recommendations for measuring health‐related quality of life in children on anticoagulation

Bruce AK, Bauman ME, Jones S, Massicotte MP, Monagle P. Recommendations for measuring health‐related quality of life in children on anticoagulation. J Thromb Haemost 2012; 10: 2596–8.     

Impact of von Willebrand disease on health‐related quality of life in a pediatric population

Summary. Background: Von Willebrand disease (VWD) is the most frequent inherited bleeding disorder. Whether VWD is associated with health‐related quality of life (HR‐QoL) in children is unknown. Objectives: This nationwide cross‐sectional study measured HR‐QoL in children with moderate or severe VWD. Our primary aim was to compare HR‐QoL of VWD patients with that of reference populations. Additionally, we studied the impact of bleeding phenotype and VWD type on HR‐QoL. Methods: HR‐QoL was assessed with the Infant/Toddler QoL Questionnaire (0–5 years) and Child Health Questionnaire (6–15 years), and compared with reference population scores. Multivariate analysis was used to evaluate the influence of type of VWD and bleeding phenotype on HR‐QoL scores. Results: Preschool children (0–5 years, n = 46) with VWD had lower HR‐QoL scores for general health perceptions and parental time than reference populations. School children (6–15 years, n = 87) with VWD had lower scores for physical functioning, role functioning – emotional/behavioral, general health perceptions, and physical summary. Type of VWD was associated with HR‐QoL in school children for bodily pain, general health perceptions, parental emotion, family activities, and physical summary. Scores of children with type 3 VWD were, on average, 15 points lower than those of the reference population on the above‐mentioned scales. A more severe bleeding phenotype was associated with a lower score on 11/15 physical, emotional and social scales. Conclusion: HR‐QoL is lower in VWD children than in reference populations, in particular in school children. The negative impact of VWD is sensitive to type of VWD and bleeding phenotype; as well as physical scales, emotional and social scales are affected.     

Effects of chronic diseases on health‐related quality of life and self‐rated health among three adult age groups

Little is known about whether there is any difference in associations of chronic diseases with health‐related quality of life and self‐rated health across age groups. The purpose of the present study was to examine the associations of one specific and multiple chronic diseases with health‐related quality of life and self‐rated health (measured using the 5‐level EQ‐5D version) in three age groups: young (21–44 years), middle‐aged (45–64 years), and older adults (≥65 years). Secondary data analysis of 1932 participants in the Population Health Index Survey was performed. Linear regression results showed that different chronic diseases had a characteristic effect on health‐related quality of life and self‐rated health among different age groups. The presence of a single chronic disease was associated with lower health‐related quality of life and self‐rated health in young adults. Multi‐morbidity was consistently associated with decreased health‐related quality of life and self‐rated health in all age groups. Our findings suggest that although young adults have a lower prevalence of chronic diseases, their impacts on health‐related quality of life and self‐rated health can be as significant as that in middle‐aged and older adults.     

Health‐related quality of life among adult patients with moderate and severe von Willebrand disease

Summary. Background: von Willebrand Disease (VWD) is the most frequent inherited bleeding disorder. It is unknown how this disorder affects quality of life. Objectives: This nationwide multicenter cross‐sectional study determined health‐related quality of life (HR‐QoL) in adult patients with moderate or severe VWD, and assessed whether bleeding severity and type of VWD are associated with HR‐QoL. Methods: HR‐QoL was assessed using the Short Form (SF)‐36, and bleeding severity was measured using the Bleeding Score (BS). Results: Five hundred and nine patients participated; 192 males and 317 females, median age and range 45 (16–87) and 47 (16–84) years, respectively. Compared with the general population, HR‐QoL in VWD patients was lower in the vitality domain (61 vs. 66 P < 0.001 for females, 67 vs. 72 P < 0.001 for males). Patients with the most severe bleeding phenotype (highest quartile BS, BS > 17) had a lower HR‐QoL in eight domains than patients with a less severe bleeding type (lowest quartile BS, BS < 7) in the univariate analysis. After adjustment for age, gender, co‐morbidity and employment/educational status, a more severe bleeding phenotype was associated with lower scores on the domains of physical functioning, role limitations due to physical functioning, bodily pain, general health, social functioning and physical component summary. Conclusions: HR‐QoL is lower in VWD patients compared with the general population. HR‐QoL is strongly associated with bleeding phenotype.     

Marital relationship and health‐related quality of life after prostate cancer diagnosis

Prostate cancer has an impact on the health‐related quality of life (HRQoL) of patients and their spouses. However, the marital relationship at the time of prostate cancer diagnosis is not well known. The aim of the study was to describe and compare the marital relationship of patients with prostate cancer and their spouses and to identify factors associated with HRQoL at the time of diagnosis. The data of this cross‐sectional study were collected with The Marital Questionnaire and RAND‐36 Item Health Survey scales after the diagnosis of prostate cancer from 232 patients and 229 spouses at five Finnish central hospitals from October 2013 to January 2016. Patients with prostate cancer rated their dyadic satisfaction better than their spouses. Respectively, spouses reported better dyadic cohesion. The marital relationship of the patients or spouses was not associated with demographic variables of the respondents. In patients, energy, emotional well‐being and general health were associated with the marital relationship. In spouses, emotional role functioning, emotional well‐being and social functioning were explained by the marital relationship. At the time of diagnosis, the marital relationship of patients with prostate cancer and their spouses was good. However, there were differences in associations between patients' and their spouses' marital relationship and HRQoL. Based on the results of this study, it is useful to take into account the spouses and the marital relationship in the nursing of patients with prostate cancer. The follow‐up research on this subject is needed.     

The psycho‐social dimension of pain and health‐related quality of life in the oldest old

Background: Chronic pain has an impact on the physical and social functioning of older people which in turn may worsen their health‐related quality of life. Research with focus on prolonged extensive pain in the most elderly and how pain may interfere with their life situation is scarce. Aims: The aims were to describe and investigate pain from a multidimensional point of view (duration, location, psycho‐social) and health‐related quality of life as well as to compare sex and age groups in people aged 80 years and over. Methods: In this cross‐sectional study, a total of 225 of 282 people responded to a questionnaire consisting of two instruments and background questions. The psycho‐social dimension of pain was measured using the Multidimensional Pain Inventory–Swedish language version (MPI‐S) with five scales: Pain Severity, Interference, Life Control, Affective Distress and Social Support. Health‐related quality of life was measured using the Short Form Health Survey‐12 (SF‐12). Results: Median duration of pain was 9.0 years, and the mean number of pain locations was 2.04. The MPI‐S scale Interference with a negative orientation had the highest mean score, while the mean score for Social Support was the highest for the scales with a positive orientation. The duration of pain was significantly greater for women, and those aged 80–85 years had higher pain severity than those aged ≥86. Participants with a lower health‐related quality of life experienced significantly more severe pain, were more troubled with pain and had less control of their life. Conclusions: Older people with prolonged pain suffered from a low health‐related quality of life. Pain interfered with their lives and contributed to diminished control in their daily lives. Nurses are essential for the identification and prevention of pain and should be aware of how pain affects older people’s physical, mental and social health.     

Sleep–wake activity rhythm and health‐related quality of life among patients with coronary artery disease and in a population‐based sample—An actigraphy and questionnaire study

The aim of this study was to explore whether there are gender differences in sleep and health‐related quality of life in patients with coronary artery disease (CAD) and a matched population‐based sample and to see how subjectively rated sleep is associated with actigraphy. Secondly, to explore whether factors that predict patients' sleep quality could be identified. Fifty‐seven patients with stable CAD and 47 participants from a population‐based sample were included. All participants completed the Uppsala Sleep Inventory (USI), the Epworth Sleepiness Scale and the SF‐36. Actigraphy recordings and a sleep diary were performed for seven 24‐h periods. Multiple stepwise regression analysis showed that sleep duration, sleep onset latency, nocturnal awakenings, vitality (SF‐36) and body mass index explained 60% of the sleep quality outcome (USI). Sleep duration, sleep efficiency and fragmentation index assessed with actigraphy and sleep diary accounted for 36% of the sleep quality outcome (diary). The result can form the basis for a non‐pharmacological, self‐care programme supported and led by nurses.