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PubMed2000

Long-term health-related quality of life in survivors of sepsis. Short Form 36: a valid and reliable measure of health-related quality of life.

OBJECTIVE: To describe the long-term health-related quality of life (HRQL) of survivors of sepsis and to evaluate the reliability and validity of the medical outcomes study Short Form-36 (SF-36) in this population. STUDY DESIGN: Cross-sectional survey. SETTING: University intensive care unit. PATIENTS: Surviving patients over the age of 17 yrs who met the criteria for the Society of Critical Care Medicine/American College of Chest Physicians definition of sepsis identified through a review of patients admitted to the intensive care unit from 1994 to 1998. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Baseline demographics and clinical characteristics were abstracted from the medical chart. After hospital discharge, the SF-36 and Patrick's Perceived Quality of Life scale were administered by telephone. The SF-36 was readministered 2 wks later. We screened the charts of 109 patients; 78 had a diagnosis of sepsis. Of these, 31 had died, 3 had severe communication problems, 9 refused to participate, and 5 patients could not be located. A total of 30 patients completed the first interview; 26 completed the second. Compared with established norms for the U.S. general population, survivors of sepsis scored significantly lower on the physical functioning, role physical, general health, vitality, and social functioning domains, as well as on the Physical Health Summary Scale. Mean scores on the Mental Health Summary Scale were very similar between the survivors of sepsis and U.S. norms. The SF-36 demonstrated high internal consistency (Cronbach's alpha ranged from 0.65 to 0.94) and excellent test-retest stability (intraclass correlation coefficient ranged from 0.75 to 0.97). Both the Physical Health Summary Scale and the Mental Health Summary Scale correlated well with overall Perceived Quality of Life scores (Pearson correlation coefficients 0.45 and 0.56, respectively). CONCLUSIONS: The long-term HRQL of survivors of sepsis is significantly lower than that of the general U.S. population. The SF-36 demonstrated good reliability and validity when used to measure HRQL in survivors of sepsis.

Activities of Daily Living↗

PubMedDate not supplied

Ethical and legal issues in end-of-life care: content of the End-of-Life Nursing Education Consortium curriculum and teaching strategies.

The End-of-Life Nursing Education Consortium (ELNEC) is a train-the-trainer educational program to help nursing faculty integrate care of dying patients and their families in the nursing curriculum. This article presents techniques derived from the ELNEC project regarding teaching the ethics module and the key content areas for developing ethical decision-making skills in end-of-life care. Competent end-of-life nursing care begins with an understanding of ethics and the potential affect on care of dying patients and their families.

Curriculum↗

PubMed2003

Quality of life philosophy III. Towards a new biology: understanding the biological connection between quality of life, disease, and healing.

This paper addresses (in a philosophical way) the complex and enigmatic interface between matter, life, and consciousness in modern medical science. The problem today in understanding living matter is not at the molecular level, but at the macro level where all molecular activities in the individual cell are coordinated, and especially at a higher level, where the activities of all the organism"s cells are coordinated. Although we understand very much of the body"s chemistry, we have only just started to get the gist of the tremendous organization of living matter. We are just beginning to acknowledge the enormous flow of information that is needed to make everything function in a healthy organism, including consciousness, where every cell does exactly what it has to do to make the organs function. A concept that seems to be able to bridge the scientifically very different domains of matter, life, and consciousness seems to be "biological information". If a cell is seen as a liquid crystal in which the cell"s molecules constantly connect in firm mutual relationships only to dissolve again and become fluid and free, whenever the cell needs it, the backbone of the cell seems to be the information that organizes the cell. For example, in cell motion a cell is able to crawl with the help of a skeleton of fibers that can be created guided by biological information, whenever the cell needs the solidity provided by the fibers. The moment it has finished crawling or intends to crawl in another direction, these fibers will dissolve again. The fibers are made of millions of molecules that connect in an arranged pattern, and they dissolve when these molecules again let go of each other. How the cell precisely regulates such processes is today a complete mystery. How cells cocreate consciousness is also an enigma. All we can do is describe the cell and the organisms arising from its cells as filled with energy and information as well as an unbeatable ability to organize itself way down to the molecular level, where apparently the cell is in control of almost every single molecule. Our understanding today of how the information is stored and how it flows through living matter is still very limited. The source of the qualities (the qualia) characterizing the human being as a whole--like joy, love, motivation, consciousness, free will, wisdom, intuitive competence--is still practically unknown and scientifically unexplained, more than 50 years after science has turned itself towards these fundamental problems. We believe that we need a radically new biology and medicine to give the scientific explanations of the structure, dynamics, and quality of life, and of its consciousness.

Animals↗

PubMed2004

Quality of life: information and learning resources in supporting people with severe life-changing injuries to return to independence.

This paper reports the first stages of the development of an integrated care model for people with massive sudden change in their lives with special reference to spinal cord injuries. The model aims to be holistic by placing the patient at the centre of the service. In addition to providing medical care for physical injuries, the model emphasises at the outset that regaining a good quality of life postinjury is expected. There is quality of life after change if individuals and their support network are provided with access to quality information and evidence for them to make informed choices. In New Zealand, this has been referred to as "life beyond bugger"!

Climacteric↗

PubMed2004

A new instrument for assessing quality of life in atopic dermatitis: international development of the Quality of Life Index for Atopic Dermatitis (QoLIAD).

BACKGROUND: Atopic dermatitis (AD) is a chronic or chronically relapsing inflammatory skin condition that can have a considerable impact on those affected. There are a number of instruments available to measure outcome in dermatological conditions but none have been developed specifically for AD. In addition, most measure symptoms and/or daily functioning, which are potential influences on quality of life (QoL) rather than assessments of the construct itself. OBJECTIVES: The aim of the current study was to develop a new instrument specifically designed to measure QoL in adults with AD-the Quality of Life Index for Atopic Dermatitis (QoLIAD). METHODS: The instrument was developed based on the needs-based model of QoL and was produced in several different countries simultaneously. Its content was derived from 65 in-depth interviews with relevant patients in the U.K., Italy and the Netherlands. The initial version of the measure was produced in U.K. English and translations were produced for the Netherlands, Italy, Germany, France and the U.S.A. using a dual translation panel methodology. A Spanish version was developed using the same adaptation process after the instrument was finalized. Field-test interviews were conducted with approximately 20 patients in each country to assess face and content validity. The instrument [in addition to the Dermatology Life Quality Index (DLQI) and the Psychological General Well-Being Schedule (PGWB)] was then administered to up to 300 AD patients in each country at two time points to finalize the instrument and test its psychometric properties. RESULTS: The initial version of the QoLIAD had 56 items that reflected the areas of need fulfillment identified in the qualitative interviews as having been affected by AD: mental and emotional stimulation, physical and emotional stability, security, sharing and belonging, self-esteem, personal development and fulfillment. Comments from patients in field-test interviews resulted in the removal of 14 items, to leave a 42-item instrument that was considered relevant and acceptable. The number of patients participating in the survey were 286 in the U.K., 46 in the Netherlands, 213 in France, 187 in Germany, 178 in the U.S.A. and 83 in Spain. Application of the Rasch model to these data identified the final 25-item QoLIAD. Unidimensionality was confirmed, with deviation of the total scale from the Rasch model evident at a single time point in one country only (the U.K.). All language versions, with the exception of the Dutch measure, had test-retest reliability coefficients in excess of 0.85. The test-retest in the Netherlands was 0.80. However, this country had the smallest sample size and the corresponding reliability for the DLQI was only 0.40. The QoLIAD had adequate internal consistency and the initial indications of construct validity were good. The levels of association with the DLQI indicated that the two instruments measure related but distinct constructs. CONCLUSIONS: The QoLIAD is a practical, reliable, valid and culturally applicable instrument for measuring the impact of AD and its treatment on QoL in clinical trials or in routine clinical practice.

Adolescent↗

PubMed2006

Quality of life in adults with an intellectual disability: the Evaluation of Quality of Life Instrument.

BACKGROUND: The construct of quality of life (QoL) has been the focus of a great deal of recent research and has been operationalized in the assessment of the effectiveness of biomedical and rehabilitative interventions. Consequently, the effective measurement of QoL has become a relevant issue. QoL assessment should take account of both objective life conditions and reported satisfaction with those conditions, and should recognize that QoL has multiple domains. There is also evidence to suggest that it is useful to supplement such assessments with the evaluations of significant others within a multidimensional assessment perspective. METHODS: The current study describes a further stage of testing and refinement of the Evaluation of Quality of Life Instrument (EQLI), which was designed to elicit from staff of health and social care services assessments of the level of satisfaction experienced by adults with an intellectual disability. Specifically, the EQLI's internal consistency, and construct, convergent and discriminant validity were analysed. RESULTS: The EQLI appears to be a psychometrically valid measure for collecting data on the levels of satisfaction which, according to health and social services staff, might be experienced by individuals with an intellectual disability who attend residential institutions and community-based day centres. The factor analyses supported a three-factor structure for the EQLI and reliability estimates of scores on the three factors were in the moderate to high range. The data collected supported convergent and discriminant validity. CONCLUSIONS: The results indicate that the EQLI is an effective measure for gaining staff perceptions of individuals who may be at risk of dissatisfaction with various QoL domains. The EQLI is as an instrument which, within a multidimensional assessment, could contribute to the identification of areas of user dissatisfaction with services.

Adolescent↗

PubMed2006

Developing a quality of life instrument in patients with psoriasis: the Psoriasis Quality of Life Questionnaire (PQLQ).

BACKGROUND AND DESIGN: Psoriasis is a chronic skin disease which causes psychological, social and physical problems and affects quality of life. The aim of this study was to develop a quality of life instrument for patients with psoriasis which is suitable for Islamic populations. MATERIALS AND METHODS: The psychosocial and daily life problems defined by 75 patients with psoriasis, their relatives and physicians were used to construct a questionnaire, the reliability and validity of which were determined in a group of 156 patients with psoriasis. RESULTS: For reliability, Chronbach's alpha coefficient was 0.87, and item-total correlations were between 0.37 and 0.60 for internal consistency. There was high test-retest reliability (r = 0.98, P < 0.001). For validity, three factors were extracted in the principal components method for construct validity. The maximum factor loadings of each item were between 0.456 and 0.681. For convergent validity, all patients' self-ratings and Psoriasis Area and Severity Index (PASI) were correlated with the questionnaire score (P < 0.001). CONCLUSION: The questionnaire consisting of 17 items was found to be suitable for both epidemiologic and clinical trials.

Adolescent↗

PubMed2006

Quality of life and acne in Scottish adolescent schoolchildren: use of the Children's Dermatology Life Quality Index (CDLQI) and the Cardiff Acne Disability Index (CADI).

BACKGROUND: Acne vulgaris is known to adversely affect all aspects of quality of life. However, although acne is thought to occur in the majority of adolescents, there are few data currently available on the impact of acne in this age group. OBJECTIVES: Measurement of the impairment of health-related quality of life (HRQoL) in teenage Scottish schoolchildren in a comparative study using two HRQoL questionnaires. A secondary objective was to collect data on the use and perceived efficacy of medical and over-the-counter (OTC) preparations. STUDY DESIGN: An anonymous cross-sectional survey of 200 adolescent (15-18 years) Dundee schoolchildren was conducted by means of two self-reported questionnaires: the Children's Dermatology Life Quality Index (CDLQI) and the Cardiff Acne Disability Index (CADI). Data on demographics and therapeutic modalities and their perceived efficacy were also collected. ANALYSIS: Statistical analysis was performed using the package Stata 7.0. RESULTS: Self-reported acne was present in 83% of teenagers (147/178), with similar sex distribution (54% male, 46% female). The overall mean CDLQI score (max. 30) was low 1.7 {6% impairment} (CI -1 to 0), range 0-19. Nine pupils scored between 5 and 9 {17-30% impairment} suggesting moderate HRQoL impairment and three scored > 10 {> 33% impairment} indicating severe impairment. The overall mean CADI score (max. 15) of 1.9 {13% impairment}, CI 0 to 1 (range 0-15) was also low, but 12 pupils scored between 5 and 9 {33-60% impairment}, one scoring 10 + {> 67% impairment} and one scoring the maximum, 15 {100% impairment}. There was no significant difference in mean scores between the sexes in either questionnaire (P = 0.5). There was good correlation between the results from the two questionnaires (Spearman's rho = 0.62). Three-quarters (75%) had used OTC products, of which only a third (33%) felt they helped 'a lot'. Fifteen per cent were receiving prescribed treatment from their doctors of which 66% found it helpful. CONCLUSIONS: Self-reported acne occurred in 83% (147/178) of the Scottish teenagers involved in this study, which confirms previous reports of a high prevalence of acne in teenagers. Cross-validation of the CLDQI and CADI demonstrated good correlation and both scales were easy to administer and identified 11% (16/147) of teenagers who perceive their lives to be significantly affected by their acne (8% moderately to severely, 3% severely). It is important to identify and treat such teenagers early to reduce the future socio-economic burden of their acne.

Acne Vulgaris↗

PubMed1999

Health-related quality-of-life assessment of patients with life-threatening ventricular arrhythmias.

The purpose of this study was to determine whether treatments for life-threatening ventricular arrhythmias are associated with quality-of-life (QOL) and psychological distress. Multidimensional measures of QOL and psychological distress were used to cross-sectionally compare patients with ICDs to patients treated with antiarrhythmic drugs and patients without serious cardiac conditions. The sample consisted of 157 patients: 35 patients treated with antiarrhythmic medication only, 24 patients treated with ICD only, 25 patients treated with ICD and antiarrhythmic medication, and 73 controls. Patients completed the Medical Outcomes Study SF-36 health survey, the Brief Symptom Inventory, and background questionnaires. There were no significant differences in self-reported QOL and psychological distress between patients with or without ICD, and the occurrence of defibrillator shocks was unrelated to QOL and psychological distress. However, patients treated with antiarrhythmic drugs reported greater QOL impairment in physical functioning, vitality, emotional role limitations, and sleep, as well as greater psychological distress than patients not treated with antiarrhythmics. These limitations may be attributed to adverse effects arising from antiarrhythmic pharmacotherapy. Results of the present investigation suggest that QOL and psychological distress are maintained among ICD patients, whereas treatment with antiarrhythmic drugs are associated with a diminished QOL and greater psychological distress. These findings may assist cardiologists to select the optimal treatment for life-threatening ventricular arrhythmias that minimizes disturbances in health-related QOL and psychological distress and increases patient compliance.

Activities of Daily Living↗

PubMed1992

Adding years to life: effect of avoidable mortality on life expectancy at birth.

STUDY OBJECTIVE: The aim was to determine the number of years that could be gained by preventing avoidable deaths. DESIGN: The study arose from the concept of avoidable causes of death and life expectancy at birth. Four abbreviated life tables were computed. The first included all causes of death; the second excluded all avoidable causes of death; the third and fourth excluded respectively primary and secondary avoidable causes of death. SETTING: Mortality and population data were taken from Mortality Statistics Offices in Valencia Region, Spain. MAIN RESULTS: Life expectancy at birth (LEB) was 75.7 years. After removing all avoidable deaths, LEB increased by 1.74 years. This improvement is attributed to avoidable deaths by primary prevention (1.09 years) and avoidable death by secondary prevention (0.37 year). CONCLUSIONS: According to these results the greatest improvement in LEB would be gained by primary prevention.

Cause of Death↗

PubMed2006

Determinants of the quality of life in Alzheimer's disease patients as assessed by the Japanese version of the Quality of Life-Alzheimer's disease scale.

BACKGROUND: Although QOL is an important indicator to assess multiple facets of life, the QOL of Alzheimer's disease (AD) subjects with impaired cognitive ability due to dementia has not yet been fully investigated. In this study, we developed the Japanese version of the Quality of Life-Alzheimer's disease (QOL-AD) scale by means of back-translation, and ascertained its reliability and validity for evaluating the quality of life in AD subjects. We also hypothesized that the presence of neuropsychiatric symptoms may determine the characteristics and determinants of both the patients' and the caregivers' responses to the patients' QOL questionnaire. METHODS: We administered the QOL-AD questionnaire to subjects with mild or moderate AD (n = 140). The test-retest reliability was evaluated by the same interviewer after a month's interval. Data from the following tests were also collected to ascertain the validity of the questionnaire: Short Memory Questionnaire (SMQ), Neuropsychiatry Inventory (NPI), Hyogo Activities of Daily Living Scale (HADL) and Mini-Mental State Examination (MMSE). RESULTS: The Japanese version of the QOL-AD questionnaire demonstrated good internal reliability for both the patients' (Cronbach's alpha = 0.84) and the caregivers' responses (Cronbach's alpha = 0.82) and good test-retest reliability for both the patients' (intraclass correlation coefficient = 0.84) and caregivers' reports (intraclass correlation coefficient = 0.91). The concordance between the patients' self-report and the caregivers' observation was moderate (Pearson correlation coefficient = 0.60). The score for the 'mood factor' (apathy, depression/dysphoria) in NPI predicted the overall QOL score as determined from both the patients' and the caregivers' responses for subjects with mild (MMSE>or=21, n = 88) and moderate (MMSE< 21, n = 52) AD. The score for the 'psychosis factor' (delusions, hallucinations, anxiety, agitation, disinhibition, irritability, aberrant motor activity) in NPI predicted the total QOL score as determined by the patients and the caregivers among subjects with moderate AD only. CONCLUSIONS: As hypothesized, the presence of neuropsychiatric symptoms may be an important predictor of both the patients' and caregivers' responses to the patients' QOL questionnaire. QOL-AD appears to be a promising measure of the QOL of subjects with mild to moderate AD in Japan.

Activities of Daily Living↗

PubMed1997

Clinical findings, status of care, comprehensive quality of life, daily life therapy and treatment at home in patients with Parkinson's disease.

We analyzed patients with Parkinson's disease from various aspects such as clinical findings, the degree of independence in daily life, care environment, quality of life (QOL) and treatment at home. The subjects were 104 in- and outpatients (47 males and 57 females) seen at our hospital. The mean age was 69.85 years in the males and 70.35 years in the females. The disease most frequently developed at the age of 60-69 years and the disease duration was 5 years or more in 52 patients. Rigidity was the most common symptom (91 patients), followed by gait disturbance (n = 87) and tremor (n = 86). Levodopa/carbidopa was the drug most frequently used (77 patients). The number of patients treated by combination drug therapy increased with the duration of disease. Concerning the degree of independence in daily life, assistance was often necessary in bathing, dressing and undressing, toileting and walking. In particular, total assistance was necessary in patients with Hoehn-Yahr stage-IV and V disease. The comprehensive QOL was the lowest in terms of social activities, hobbies and leisure activities, followed in order by work and subjective QOL. QOL decreased in each item with the severity of the disease. Treatment at home was performed for 19 patients, of whom 11 are still being treated by our staff. Treatment at home combined with persons who care for the patient and in cooperation with other welfare resources may improve the patient's QOL. In diseases that require long-term care such as Parkinson's disease, a comprehensive care management system should be established from the aspect of the patient's QOL.

Activities of Daily Living↗

PubMed2004

The value of the qualitative method for adaptation of a disease-specific quality of life assessment instrument: the case of the Rheumatoid Arthritis Quality of Life Scale (RAQoL) in Estonia.

BACKGROUND: Due to differences in current socio-economical situation and historically shaped values, different societies have their own concepts of high-quality life. This diversity of concepts interferes with quality of life (Qol) research in health sciences. Before deciding to apply a Qol assessment tool designed in and for another society, a researcher should answer the question: how will this instrument work under the specific circumstances of my research. Our study represents an example of the utilization of qualitative research methods to investigate the appropriateness of the Rheumatoid Arthritis Quality of Life Scale (RAQol) for the assessment of Qol in Estonian patients. METHODS: Semi-structured interviews were conducted with the rheumatoid arthritis (RA) patients of Tartu University Hospital and these were analyzed using the principles of the grounded theory. RESULTS: We described the significance of the questionnaire's items for our patients and also identified topics that were important for the Qol of Estonian RA patients, but that were not assessed by the RAQol. We concluded that the RAQol can be successfully adapted for Estonia; the aspects of Qol not captured by the questionnaire but revealed during our study should be taken into account in future research. CONCLUSIONS: Our results show that qualitative research can successfully be used for pre-adaptation assessment of a Qol instrument's appropriateness.

Activities of Daily Living↗

PubMed2005

Individualized quality of life, standardized quality of life, and distress in patients undergoing a phase I trial of the novel therapeutic Reolysin (reovirus).

BACKGROUND: The purpose of this study was to evaluate the individualized and standardized quality of life (QL) and psychological distress of patients participating in a Phase I trial of the novel therapeutic reovirus (Reolysin). METHODS: 16 patients with incurable metastatic cancer were interviewed prior to being accepted into the phase I trial with a semi-structured expectations interview, the Schedule for the Evaluation of Individual Quality of Life--Direct Weighting (SEIQoL-DW), the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the Brief Symptom Inventory (BSI), the Beck Depression Inventory (BDI), and the Spiritual Health Inventory (SHI). RESULTS: Patients were able to complete all measures. They felt hopeful and excited about the trial, with about two thirds hoping for disease regression and one third hoping for a cure. The most commonly spontaneously nominated areas of QL were family relationships, activities and friends, and the overall SEIQoL mean index score was 69. Health was nominated by only 38% of the sample. Scores on the SEIQoL were correlated with global QL on the EORTC QLQ C-30. Scores on the BDI and BSI were lower than reported for similar populations, and on the SHI scores were similar to other samples. Global QL on the EORTC QLQ C-30 and depression scores were associated with time to death in the nine patients who had died at the time of writing. CONCLUSIONS: Individualized QL is easy to assess in seriously ill cancer patients, provides useful information relative to each individual, and is related to standard QL measures. Repeated assessment of individualized QL of patients in Phase I trials would be a useful addition to the research.

Adult↗

PubMed2001

On becoming depressed or anxious in late life: similar vulnerability factors but different effects of stressful life events.

BACKGROUND: Little research has been done on the uniqueness of risk profiles for depression and anxiety in late life. AIMS: Delineating risk factors for the decline of mental health in older persons, comparing risk profiles for developing symptoms of pure depression, pure anxiety and both anxiety and depression in a prospective design. METHOD: Self-report data on depression and anxiety were collected from community-dwelling older respondents (> or = 55 years) on two occasions, 3 years apart. Data from emotionally healthy respondents (n=1810) were used to investigate the effects of long-standing vulnerability factors and stressful life events. RESULTS: After 3 years 9% of the subjects had scored beyond the thresholds for symptoms. Vulnerability for depression and anxiety was quite similar, but life events differed: onset of depression was predicted by death of a partner or other relatives; onset of anxiety was best predicted by having a partner who developed a major illness. No support for moderator effects between vulnerability factors and stress was found; the effects were purely additive. CONCLUSIONS: Depression and anxiety have many risk factors in common, but specific risk factors also were found, especially in subjects developing both depression and anxiety.

Aged↗

PubMed1999

Quality of life in head and neck cancer patients: validation of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-H&N35.

PURPOSE: The aim of this study was to define the scales and test the validity, reliability, and sensitivity of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ)-H&N35, a questionnaire designed to assess the quality of life of head and neck (H&N) cancer patients in conjunction with the general cancer-specific EORTC QLQ-C30. PATIENTS AND METHODS: Questionnaires were given to 500 H&N cancer patients from Norway, Sweden, and the Netherlands as part of two prospective studies. The patients completed the questionnaires before, during (Norway and Sweden only), and after treatment, yielding a total of 2070 completed questionnaires. RESULTS: The compliance rate was high, and the questionnaires were well accepted by the patients. Seven scales were constructed (pain, swallowing, senses, speech, social eating, social contact, sexuality). Scales and single items were sensitive to differences between patient subgroups with relation to site, stage, or performance status. Most scales and single items were sensitive to changes, with differences of various magnitudes according to the site in question. The internal consistency, as assessed by Cronbach's alpha coefficient, varied according to assessment point and within subsamples of patients. A low overall alpha value was found for the speech and the senses scales, but values were higher in assessments of patients with laryngeal cancer and in patients with nose, sinus, and salivary gland tumors. Scales and single items in the QLQ-H&N35 seem to be more sensitive to differences between groups and changes over time than do the scales and single items in the core questionnaire. CONCLUSION: The QLQ-H&N35, in conjunction with the QLQ-C30, provides a valuable tool for the assessment of health-related quality of life in clinical studies of H&N cancer patients before, during, and after treatment with radiotherapy, surgery, or chemotherapy.

Aged↗

PubMed2003

Decreased quality of life in adult patients with growth hormone deficiency compared with general populations using the new, validated, self-weighted questionnaire, questions on life satisfaction hypopituitarism module.

To develop reference ranges for the Questions on Life Satisfaction Hypopituitarism Module (QLS-H), a new quality of life questionnaire for patients with hypopituitarism, data from 8177 adults were collected in France, Germany, Italy, The Netherlands, Spain, the United Kingdom, and the United States QLS-H scores declined with age, were lower in females than males, and differed significantly among countries. From these reference ranges we derived equations for z-scores, which adjust for age, gender, and country. QLS-H results from 957 adults with GH deficiency (GHD) participating in clinical trials were analyzed. At baseline, QLS-H scores were lower in females and differed significantly among countries. QLS-H scores significantly increased after GH treatment (6-8 months), but differences by country persisted. Calculating z-scores for patients eliminated all gender and most country differences. Pooled z-scores (mean +/- SD) from all patients increased from -0.99 +/- 1.39 at baseline to -0.14 +/- 1.30 after GH treatment. Quality of life assessment in adults with GHD requires the use of z-scores to correct for age, gender, and country differences. This approach allows pooling of data from different cohorts and comparison with general populations. QLS-H scores in adults with GHD were significantly decreased at baseline and were almost normalized after 6-8 months of GH therapy.

Adult↗

PubMed2002

Assessment of life stress in gay and bisexual men with the gay affect and life events scale.

The Gay Affect and Life Events Scale (GALES) was administered to a sample of gay-identified and non-gay-identified behaviourally bisexual married men (n = 186) and a comparative sample of never-married gay-identified men (n = 33). All participants in the study reported moderate levels of life stress in the preceding six months. No significant differences were found between the ever-married and never-married groups on the Overall Stress Value Score (OSV) of the GALES. Among the ever-married, those who identified as gay/homosexual reported significantly higher life stress than those who identified as bisexual. No differences were found within the ever-married between those who remained with their heterosexual partner and those who had separated. Difficulties in the use of the Nott and Vedhara (1995) version of the GALES with both gay men and populations of behaviourally bisexual men are reported.

Bisexuality↗