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PubMed2005

Predictors of quality of life in oncology outpatients with pain from bone metastasis.

The relationship between pain and quality of life (QOL) in cancer patients is complex due to the number and the diversity of factors that can influence pain and QOL. The aims of this study of oncology outpatients with pain from bone metastasis were: 1) to determine the extent to which pain characteristics (i.e., severity, duration, meaning of pain, and perceived availability and efficacy of pain relief), psychological distress (i.e., depression), physical functioning, social functioning and QOL are intercorrelated, and 2) to determine which of these variables are important predictors of QOL. A total of 157 oncology outpatients completed questionnaires that evaluated pain, QOL, depression, physical functioning, and social functioning at the time of enrollment into a randomized clinical trial that evaluated the effectiveness of a psychoeducational intervention to improve cancer pain management. Pearson product moment correlation coefficients were calculated to examine the relationships among the study variables. A blockwise, hierarchical multiple regression analysis was performed to determine which variables were the most important predictors of QOL. Meaning of pain was significantly correlated with all the other variables, in particular pain intensity and duration. The most important factors that predicted QOL were depression, social functioning, and physical functioning. Depression proved to be the most important predictor of QOL.

Adult↗
PubMed2002

Health-related quality of life in urban African Americans with type 2 diabetes.

OBJECTIVE: To examine the association of socioeconomic barriers, familial barriers, and clinical variables with health-related quality of life (HRQL). METHODS: A cross-sectional study was conducted of 186 African Americans with type 2 diabetes recruited from 2 primary care clinics in East Baltimore, Maryland. Physical functioning, social functioning, mental health, and general health were measured using the Medical Outcomes Study 36-item short form. Socioeconomic (money, housing, street crime) and familial (family problems, caretaker responsibilities) barriers were assessed by standardized interview. Insulin use, comorbid disease, and measured abnormalities in body mass index, hemoglobin A1c (HbA1c), blood pressure, lipids, and renal function were investigated. RESULTS: Mean HRQL scores were: physical functioning, 61 +/- 29; social functioning, 76 +/- 26; mental health, 69 +/- 21; and general health, 48 +/- 21. Linear regression analyses revealed that each barrier to care was significantly associated with lower scores in 1 or more HRQL domain. As number of socioeconomic and familial barriers increased from 0 to 5, HRQL scores decreased by 18 for social functioning, 21 for general health, 23 for physical functioning, and 28 for mental health (all P for trend <.01). Clinical variables significantly associated with reduced HRQL were obesity, impaired renal function, insulin use, and comorbid disease. Blood pressure, lipids, and HbA1c were not significantly associated with HRQL. CONCLUSIONS: An independent, graded relationship was found between socioeconomic and familial barriers to care and HRQL. This relationship was at least as strong as the association between HRQL and the clinical variables more likely to be perceived by participants as causing symptomatic distress or impacting lifestyle.

Adult↗
PubMedDate not supplied

Predictors of depressive symptomatology of geriatric patients with lung cancer-a longitudinal analysis.

BACKGROUND: Lung cancer is a major health problem throughout the world. It is the leading cause of cancer-related death in men and women in the USA, with a 5-year survival rate of only 14%. It has been hypothesized that variables such as physical and social functioning, cancer-related symptomatology, comorbid conditions, cell type, and treatment are valid predictors of the psychological response to a diagnosis of lung cancer. METHODS: As part of a larger longitudinal study, 211 patients, 65 years of age or older, with an incident diagnosis of lung cancer, were recruited from 23 sites within a midwestern state. Repeated measures analysis of variance techniques were used to analyse how age, gender, comorbid conditions, stage of disease, cell type, as well as the time-dependent variables symptoms, physical functioning, social functioning, and treatment predict depressive symptomatology at four assessments over the first year following diagnosis. RESULTS: Social functioning (p<0.0001), symptoms severity (p<0.0001) and radiation treatment (p=0.017) were significant predictors of depressive symptomatology, with more symptoms and more restricted social functioning generally corresponding to higher levels of depressive symptomatology. Patients who had not received radiation treatment were more depressed than those who had received treatment at least 40 days prior to the interview. CONCLUSIONS: At a clinical level of patient care, these findings mandate early identification of psychosocial difficulties experienced, an individualized symptom management plan and the application of other interventions, such as information giving, reassurance and referral to other resources.

Activities of Daily Living↗
PubMed1995

A controlled study of the long-term prognosis of adult Still's disease.

PURPOSE: To assess the long-term prognosis of patients with adult Still's disease for physical and psychological disability, pain, social functioning, social support, medication use, formal education, occupation, time lost from work, and family income, and to contrast these results with those of same-sex sibling controls. PATIENTS AND METHODS: Patients were recruited from medical center-based cohorts in Pittsburgh and Eastern Canada and from a national survey of rheumatologists. Patients and same-sex sibling controls completed the Health Assessment Questionnaire for physical disability, the psychological and social function domains of the Arthritis Impact Measurement Scales, and the Interpersonal Skills Evaluation List questionnaire for social support, and replied to questions on medication use, formal education, occupation, time lost from work, and family income. RESULTS: One hundred four of 111 eligible adult Still's patients (94%) provided data. They identified 86 same-sex sibling controls, of whom 60 (70%) participated. The mean duration of adult Still's disease was 10 years. Approximately half of patients continued to require medication even 10 years after diagnosis. Patients had significantly higher levels of pain, physical disability, and psychological disability when compared with the controls. However, the levels of pain and physical disability were low compared to patients with other rheumatic diseases. Educational achievement, occupational prestige, social functioning and support, time lost from work, and family income were similar for both patients and controls. CONCLUSIONS: Despite causing disability, pain, and, in many, the need for long-term medication, patients with adult Still's disease are resilient. The disease did not interfere with educational attainment, occupational prestige, social functioning and support, time lost from work, or family income.

Adolescent↗
PubMed2006

Testicular cancer: a longitudinal pilot study on stress response symptoms and quality of life in couples before and after chemotherapy.

GOALS OF WORK: The current study was designed to longitudinally examine stress response symptoms (SRS) and quality of life (QoL) in couples confronted with disseminated testicular cancer. The objectives were to examine couples' patterns of adjustment over time and possible differences in adjustment between the patient and his partner. MATERIALS AND METHODS: Couples completed the Impact of Event Scale and the QoL subscales physical functioning, social functioning, and mental health of the RAND-36 before chemotherapy (T1), after completion of chemotherapy (T2), and 1 year later (T3). RESULTS: Before chemotherapy 26% of the patients and 50% of partners reported clinically elevated levels of SRS. Patients reported lower physical and social functioning at T2 compared to T1 and T3. Partners reported an improvement in social functioning over the year and no changes in physical functioning or mental health. No relationships between patients and partners' functioning were found. One year after diagnosis, QoL of patients and partners was similar to that of reference groups, and patients even reported better physical functioning than the reference group. SRS of patients and partners were negatively related at T1, and patients and partners' social functioning were positively related at T2. CONCLUSIONS: According to stress response levels, the period before the start of chemotherapy was most stressful for couples. Adjustment patterns differ between testicular cancer patients and their partners with patients reporting lowered QoL after completion of chemotherapy. QoL of couples returned to normal levels 1 year after diagnosis. The effect of disseminated testicular cancer on the QoL of patients and their partners seems to be temporary. A minority may need clinical attention for severe SRS.

Activities of Daily Living↗
PubMed1994

Influence of major depression on 1-year outcome in patients with traumatic brain injury.

The authors examine those factors that contributed to deterioration in social functioning, activities of daily living, or intellectual functioning during a 1-year period after traumatic brain injury (TBI). Fifty-two patients suffering an acute TBI were evaluated for existence and severity of mood disorders and impairment during their hospital stays and at 3-, 6-, and 12-month follow-up examinations. Patients whose scores on intellectual function, social function, or daily activities deteriorated during the 1-year period after trauma were considered to have a poor outcome. Eleven of 52 patients had a poor outcome in social function, which was associated with race, right-hemisphere lesions, intellectual impairment, and prolonged major depression. Seven of 52 patients had a poor outcome in daily activities, which was associated with a major depression of more than 6 months' duration and severity of Hamilton Depression Rating Scale scores. Eleven of these patients had a poor outcome in cognitive function, which was associated with cognitive impairment immediately after TBI. A major depression lasting more than 6 months was associated with deterioration of social functioning and activities of daily living during the 1-year period after TBI.

Activities of Daily Living↗
PubMed2002

[Quality of life following laryngectomy].

OBJECTIVE: To assess the quality of life and relevant factors following laryngectomy. METHODS: Quality of life was evaluated in 42 laryngeal cancer and hypopharyngeal cancer patients following laryngectomy and in 38 controls. The assessment included General Quality of Life Inventory, University of Washington Quality of Life Head and Neck Questionnaire and a study specific questionnaire. RESULTS: The laryngectomized patients reported significant lower scores of quality of life than the controls in many aspects of physical health, psychological health and social function dimensions. For patients, the most important dimension affecting quality of life was psychological condition, and the others were physical function, social function, and economic condition in turn; while for the controls, they were of opposite order. The significant factors affecting quality of life in patients following total laryngectomy were their concern about prognosis, disfigurement, decannulation, employment, speech and breathing conditions. The most important factor affecting psychological condition was physical function, while psychological condition was the most important factor affecting social function. Items ranked in the top five included those related to physical function, economic condition, psychological condition, social situation and social communication. CONCLUSION: More attention should be paid to research about quality of life. The quality of life of patients undergone laryngectomy is affected by many factors. Through the integration of psychological, clinical and social interventions, the quality of life of patients may have an overall improvement.

Adult↗
PubMed1987

Comparison of depressed patients with and without suicide attempts in their past history.

Forty-eight inpatients with the diagnosis of a Brief or Prolonged Depressive Reaction according to ICD-9 who had attempted suicide just before the admission were compared to 24 inpatients with the same diagnosis but no history of previous suicide attempts. The variables investigated included sociodemographic characteristics, family history, life events within the year prior to admission, social functioning, social support, and personality factors. The comparison of these two groups revealed that alcoholism and suicide attempts in first degree relatives, and divorce or separation of the patients' parents predispose for a depressive reaction associated with the suicidal behavior. No differences between the two patient groups were found for personality factors, number and quality of life events in the year before index admission, social functioning, and social support during the last 4 weeks. Due to the small number of patients in both groups the conclusions drawn are preliminary.

Adult↗
PubMed1998

Effect of prior lumbar discectomy on outcome of lumbar fusion: a prospective analysis using the SF-36 measure.

This study prospectively measured patient-reported quality-of-life outcome in patients undergoing fusion for recurrent symptoms after prior discectomy. Analysis of SF-36 data revealed statistically significant improvement in physical function, social function, and bodily pain 1 year postoperatively. Analysis of variance revealed significant interactions based on worker's compensation, litigation status, educational level, and age. The results support the conclusion that the SF-36 is a useful and applicable tool for measuring patient perception and quality-of-life parameters after spinal surgery. SF-36 outcomes demonstrated a reasonable level of success for lumbar fusion in revision spine surgery, with the most significant improvements noted in the categories of pain, physical function, and social function.

Adult↗
PubMed2005

Health-related quality of life improves in children and adolescents with inflammatory bowel disease after attending a camp sponsored by the Crohn's and Colitis Foundation of America.

PURPOSE: To describe the reported health-related quality of life (HRQOL) in children and adolescents with inflammatory bowel disease (IBD) after attending an IBD summer camp. METHODS: A prospective analysis of quality of life was completed at an overnight camp that was exclusively for patients with IBD, which was sponsored by the Crohn's and Colitis Foundation of America. The IMPACT-II questionnaire (Canada and United States) and the State-Trait Anxiety Inventory for Children were administered to the campers at the beginning and at the end of a 1-week camp to assess HRQOL and anxiety. The IMPACT-II questionnaire consists of 35 questions measuring 6 quality-of-life domains (i.e., bowel domain, systemic symptoms, emotional functioning, social functioning, body image, and treatment/interventions). The State-Trait Anxiety Inventory for Children consists of 2 different 20-item sets of questions. One set assesses state anxiety, and the other, trait anxiety. A repeated-measures multivariate analysis of variance was performed to determine the differences between scores attained before and after camp on the IMPACT-II questionnaire and in each of its domains. Paired sample t tests were performed on state and trait anxiety before and after camp. RESULTS: A total of 125 individuals consented to participate, but 61 patients (50 girls and 11 boys; age range, 9 to 16 y) completed the IMPACT-II questionnaire in full. Of those 61 patients, 47 had Crohn's disease and 14 had ulcerative colitis. There was statistically significant improvement between the mean (+/-SD) precamp total score (172.95 +/- 36.61) and the mean postcamp total score (178.71 +/- 40.97; P = 0.035), bowel symptoms scores (P = 0.036), social functioning scores (P = 0.022), and treatment interventions scores (P = 0.012). No difference was found between anxiety scores before and after camp on either the state or trait anxiety inventories (n = 55; P > 0.05). CONCLUSIONS: Overall, HRQOL improved in children after attending IBD summer camp. This exploratory study suggests that contributing factors for these improvements may be an increase in social functioning, a better acceptance of IBD symptoms, and less distress regarding treatment interventions, suggesting that a camp that is specifically designed for children with IBD may normalize the chronic illness experience. However, future research using a multimodal measurement approach is warranted to support these conclusions.

Adolescent↗
PubMed1997

Use of the MQoL-HIV with asymptomatic HIV-positive patients.

The purpose of this study was to determine the appropriateness of the recently developed Multidimensional Quality of Life Questionnaire for HIV/AIDS (MQoL-HIV) as a measure of quality of life (QoL) in cases of asymptomatic human immunodeficiency virus (HIV) infection. The MQoL-HIV is a 40-item instrument measuring ten domains (mental health, physical health, physical functioning, social functioning, social support, cognitive functioning, financial status, partner intimacy, sexual functioning and medical care) relevant to HIV infection. An overall QoL score, the MQoL-HIV Index, is a weighted composite of two domain scores. In a sample of 216 HIV-infected men and women, the MQoL-HIV distinguished acquired immune deficiency syndrome (AIDS), symptomatic and asymptomatic cases in overall QoL and in seven individual QoL domains. The index was responsive to perceived QoL changes over 5.5 months (r = 0.52). We also found the MQoL-HIV was less susceptible to ceiling effects in asymptomatic cases than was the Medical Outcomes Study (MOS) SF-20. These results suggest that the MQoL-HIV is a valid and reliable measure of QoL for both asymptomatic and symptomatic HIV infection.

Adult↗
PubMed2002

The significance of correlation of radiographic variables and MOS short-form health survey for clinical decision in symptomatic low back pain patients.

OBJECTIVES: To assess any correlation between SF-36 scores and several lateral roentgenographic variables of the lumbar spine, both in low back pain patients and asymptomatic volunteers. The clinical relevance of the method proposed in this study to make a surgical strategy on the basis of distinct lateral roentgenographic parameters and conversely was assessed by independent radiologists and physicians. METHODS: One hundred asymptomatic male volunteers, used as controls and an equal number of age-, height- and weight- comparable consecutive patients with chronic low back pain were examined both roentgenographically and with the SF-36 questionnaire. The roentgenographic variables measured were: lumbar lordosis, sacral inclination, L1 to S1 vertebral inclination, L4-S1 distal lordosis, disc index, and L1 to L5 vertebral index. These variables were correlated with the eight SF-36 items both in patients and controls. Both sensitivity and specificity of the method were calculated to assess the impact of subjectivity on the clinical decision. RESULTS: Low back patients showed significantly lower scores than their asymptomatic counterparts, in physical role limitations (P<0.01), severity of bodily pain (P<0.01), interference of bodily pain (P<0.01) and mental health (P<0.001). In the controls, general health, physical functioning, social functioning, and role limitations displayed a statistically significant correlation with age, height, weight, lumbar lordosis, sacral inclination, inclination of L1,L3 & L5-vertebra, L1 to L5-vertebral index and L1-L2, L3-L4, L4-L5 and L5-S1 disc index. In LBP-patients previous general health, physical functioning, role limitations, social functioning, bodily pain were significantly correlated with age, height, L1-and L2-inclination, distal lordosis, L5-index, and disc index L4-L5, and L5-S1. Although the consensus between either radiologists suggesting a strategy on the basis of roentgenographic data only or between physicians based on only SF-36 data was significant (P<0.001), there was no consensus in clinical decision between physicians and radiologists. Clinical decision based on matched SF-36 and roentgenographic data made either by radiologists or surgeons showed significant correlations (P<0.001). However, both sensitivity and specificity of our method to make a clinical decision on the basis of radiology were low: 0.48 and 0.36 respectively. CONCLUSIONS: SF-36 scores were correlated with distinct lateral roentgenographic variables of the lowermost lumbar spine (L4-S1) in low back patients, and of the whole lumbar spine in asymptomatic individuals. Clinical decision should not be taken on the basis of radiological evidence of pathology because clinical decision seems to be more accurate when is taken on the basis of combined SF-36 and roentgenographic data. However, clinical examination is mandatory to SF-36 questionnaire and radiographic analysis.

Activities of Daily Living↗
PubMed2004

Correlation between Karnofsky Performance Status Scale and Short-Form Health Survey in patients on maintenance hemodialysis.

BACKGROUND: Assessment of quality of life is vital inmonitoring response to various treatment measures. Various instruments, which include both generic and disease-specific instruments, are used in the assessment of health-related quality of life (HRQOL). In this study, we compare two commonly used generic instruments. OBJECTIVES: The objective of this study was to compare two generic instruments, the Karnofsky Performance Status Scale and the SF-36 Health Survey in hemodialysis (HD) patients. The study also aims to find out the association (if any) between HRQOL scores using these two scales and various clinical and biochemical parameters. MATERIALS AND METHODS: Sixty-two maintenance HD patients were recruited after informed consents were obtained. Detailed sociodemographic data was obtained. They were assessed during their regular HD sessions. Serum chemistry (which included serum urea, creatinine, Na+, K+, HCO3-, Ca2+, Po4(2-)), albumin, globulin, total protein and hemoglobin (g/dl) were assessed in all the patients. Adequacy of HD was assessed using second-generation Daugirdais formula. HRQOL was assessed using the Karnofsky and SSF-36 instruments and the scores collated and compared. Data was analyzed using SPSS version 10. RESULTS: Fifty-five patients completed the study (27 males and 28 females, mean age 40.76 +/- 11.05 years and age range of 20-65 years). There was a significant positive correlation between Karnofsky scores and all eight SF-36 domains, but only physical functioning, social functioning and role limitation due to emotional problems maintained the significance on multiple regression analysis. The serum creatinine and hemoglobin postively correlated with physical function, bodily pain, social functioning and Karnofsky scores. Age of the patients correlated negatively with two SF-36 dimensions (physical functioning and role limitation due to physical fitness) and Karnofsky scores. CONCLUSION: This study revealed a good correlation between Karnofsky performance status scale and the short-form (SF36) health survey in this Egyptian population. Age, serum creatinine and hemoglobin significantly influence quality of life in this HD patient population.

Adult↗
PubMed2002

Correlative analysis of lateral vertebral radiographic variables and medical outcomes study short-form health survey: a comparative study in asymptomatic volunteers versus patients with low back pain.

This prospective comparative study was designed to investigate the possible link between SF-36 functional status and lateral roentgenographic variables of the standing lumbar spine in patients with low back pain (LBP) versus asymptomatic volunteers. To the authors' knowledge, no previous studies have correlated SF-36 scores and sagittal roentgenographic variables in patients with LBP versus asymptomatic individuals. A total of 100 male volunteers, used as controls, and an equal number of age-, height-, and weight-comparable patients of the same ethnicity with chronic LBP were compared on the basis of roentgenographic and SF-36 data. The roentgenographic variables that were measured included the following: lumbar lordosis, sacral inclination, L1-S1 vertebral inclination, L4-S1 distal lordosis, disc index, and L1-L5 vertebral index. These variables were correlated with the eight SF-36 scales both in patients and controls. As the patients with LBP get older, they show lower functional scores in Role-Emotional (p < 0.01) and Physical Functioning (p < 0.01). Body height was not found to be a predisposition favoring LBP, but tall patients with LBP showed less Bodily Pain than patients of short stature (p < 0.001). This study showed that patients with LBP had significantly lower scores than their asymptomatic counterparts in the following SF-36 scales: Role-Physical (p < 0.01), Bodily Pain (p < 0.01), Role-Emotional (p = 0.058), and Mental Health (p < 0.001). In the controls General Health, Physical Functioning, Social Functioning, and Role-Emotional, Bodily Pain, Mental Health, and Vitality correlated statistically significantly with individuals' age, height, weight, lumbar lordosis, sacral inclination, inclination of L1, L3, and L5 vertebra, L1-L5 vertebral index, and L1-L2, L2-L3, L3-L4, L4-L5, and L5-S1 disc index. For the patients with LBP this study showed that General health, Physical Functioning, Role-Emotional, Social Functioning, and Bodily Pain were significantly correlated with age, height, L1-L2 inclination, distal lordosis, L2-L5 index, and L4-L5 and L5-S1 disc index. This comparative study showed that the functional status of hard-working patients with chronic LBP is associated with degenerative changes on the lateral radiographs of the lumbosacral spine. Spine surgeons should take into consideration the results of this study in reconstruction of painful degenerative lumbosacral spine.

Adult↗
PubMed2006

Assessing the effect of HAART on change in quality of life among HIV-infected women.

BACKGROUND: The impact of highly active antiretroviral therapy (HAART) on health-related quality of life (QOL) of HIV-1 infected individuals in large prospective cohorts has not been well studied. OBJECTIVE: To assess the effect of HAART on QOL by comparing HIV-infected women using HAART with HIV-infected women remaining HAART naïve in the Women's Interagency HIV Study (WIHS), a multicenter prospective cohort study begun in 1994 in the US. METHODS: A 1:1 matching with equivalent (<or= 0.1%) propensity scores for predicting HAART initiation was implemented and 458 pairs were obtained. HAART effects were assessed using pattern mixture models. The changes of nine QOL domain scores and one summary score derived from a shortened version of the MOS-HIV from initial values were used as study outcomes. RESULTS: The background covariates of the treatment groups were well-balanced after propensity score matching. The 916 matched subjects had a mean age of 38.5 years and 42% had a history of AIDS diagnosis. The participants contributed a total of 4,292 person visits with a median follow-up time of 4 years. In the bivariate analyses with only HAART use and time as covariates, HAART was associated with short-term improvements of 4 QOL domains: role functioning, social functioning, pain and perceived health index. After adjusting for demographic, socioeconomic, biological and clinical variables, HAART had small but significant short-term improvements on changes in summary QOL (mean change: 3.25; P = 0.02), role functioning (6.99; P < 0.01), social functioning (5.74; P < 0.01), cognitive functioning (3.59; P = 0.03), pain (6.73; P < 0.01), health perception (3.67; P = 0.03) and perceived health index (4.87; P < 0.01). These QOL scores typically remained stable or declined over additional follow-up and there was no indication that HAART modified these trends. CONCLUSION: Our study demonstrated significant short-term HAART effects on most QOL domains, but additional use of HAART did not modify long-term trends. These changes could be attributed to the direct effect of HAART and indirect HAART effect mediated through clinical changes.

Journal Article↗
PubMed1990

Trial of brief intermittent neuroleptic prophylaxis for selected schizophrenic outpatients: clinical and social outcome at two years.

OBJECTIVE: To evaluate a novel approach to the prophylaxis of schizophrenic relapse characterised by administration of brief courses of neuroleptic for the earliest non-psychotic signs of relapse (prodromal symptoms). DESIGN: Two year follow up of subjects randomised, double blind, to receive either active (control group) or placebo (intermittent group) depot neuroleptic medication. Both groups received brief courses of oral neuroleptic when prodromal symptoms or relapse occurred. SETTING: Psychiatric outpatient department, Charing Cross Hospital, London. SUBJECTS: 54 Stable patients in remission who met the American Psychiatric Association's DSM-III criteria for schizophrenia on the basis of case notes. MAIN OUTCOME MEASURES: Survival without relapse, survival without hospitalisation, point prevalence of extrapyramidal side effects and tardive dyskinesia, structured assessment of social functioning (social adjustment scale II), and frequency of prodromal symptoms. RESULTS: Of 19 relapses recorded over two years, 10 (53%) were preceded by non-psychotic prodromal signs. Survival rates for both relapse and hospitalisation were worse with intermittent treatment than continuous treatment over the two year follow up: 92% of controls and only 54% of patients given intermittent treatment survived the two year period without hospitalisation. Prolonged or frequent relapses as well as episodes of prodromal symptoms were more frequent with intermittent treatment. Lower scores for extrapyramidal side effects were recorded in the intermittent treatment group, but periodic assessments of social functioning failed to show any social advantages from this. CONCLUSION: The findings are at variance with a previous report of one year follow up in this cohort and attest to the superiority of continuous depot neuroleptic prophylaxis in preventing both psychotic and neurotic or dysphoric morbidity in schizophrenia.

Administration, Oral↗
PubMedDate not supplied

The effect of total shoulder arthroplasty on self-assessed health status is comparable to that of total hip arthroplasty and coronary artery bypass grafting.

The purpose of this study was to assess the impact of total shoulder arthroplasty on the self-assessed health status of a large series of patients with glenohumeral osteoarthritis. In 91 patients we were able to compare the 8 quantitative domains of Short Form-36 (SF-36) before surgery and at 30 to 60 months after surgery. These preoperative and postoperative scores were compared with data from an age- and gender-matched control population. These results were also compared with those reported for patients who underwent other common, effective surgical procedures. Preoperative SF-36 values were significantly lower than population controls for 6 of 8 SF-36 domains (physical function, social function, physical role function, emotional role function, vitality, and comfort). Patients improved significantly in 4 of 8 SF-36 domains at 30 to 60 months after total shoulder arthroplasty: physical role function (P <.01), comfort (P <.01), social function (P <.01), and mental health (P <.05). Although the improvements were significant and similar to the postoperative scores reported for total hip arthroplasty and coronary bypass procedures, the scores did not reach those of the general population.

Aged↗
PubMed1995

Social skills in schizophrenia: assessing the relationship between social skills, psychopathology and community functioning.

Social skills training (SST) has been widely used in attempts to rehabilitate chronic schizophrenic patients. The key assumption underlying SST is that social skills deficits are important determinants of the social isolation, poor social role functioning, and low quality of life characteristic of schizophrenic patients. To test this assumption, 89 patients meeting DSM-III-R criteria for schizophrenia were assessed on behavioural and self-report measures of social skills. A structured clinical interview, a self-report inventory of distress during social interaction, and self-monitoring of time in social interaction were used to assess social functioning. Positive psychotic symptoms were assessed in a standardised clinical interview. A structural equation modelling analysis showed that observed social skills predicted social functioning, and that this association was statistically independent of severity of psychotic symptoms. This finding is consistent with the hypothesis that social skills are important in the social functioning of patients with schizophrenia.

Activities of Daily Living↗