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At least 577 records · Page 32Linked to original sources
PubMed1997

Measuring the quality of life of severely mentally ill people using the Lancashire Quality of Life Profile.

Quality of life (QOL) has become an important outcome measure for many disorders, including mental illness. The Lancashire Quality of Life Profile (LQOLP) was developed for use in operational contexts, and has been translated into several languages. It is in use in several European and North American community psychiatric services. The present paper addresses the questions: how easy is it to use?; how reliable is it?; do the results of the LQOLP vary by setting in a meaningful way?; how do the results co-vary with measures of clinical symptoms and social functioning?; how well does it measure change?; is it clinically useful? While most of the answers to these questions are favourable, there is a need for further research and development of the profile, in particular with reference to the consequences of the use of the profile as a routine monitoring instrument and the most appropriate form of statistical analysis in longitudinal data-sets.

Bias↗
PubMed1984

Positive life events and social support and the relationship between life stress and psychological disorder.

This study investigated the relationship between negative life events and psychological disorder and the roles of positive life events and received and perceived social support in moderating this relationship. A prospective design was used and statistical analyses were based on a hierarchical regression model. College undergraduates served as subjects. Negative events were significantly related to psychological disorder at each of two measurement periods. This relationship was found even when initial disorder was statistically controlled. The cross-sectional analyses, but not the prospective analyses, provided some support for the stress-buffering (interaction) effects of positive events. There was no support for the stress-buffering effects of received social support, but the cross-sectional and prospective regression analyses provided strong support for the stress-buffering effects of perceived social support.

Female↗
PubMed1985

Measurement of adolescents' life events: the junior high life experiences survey.

The first of these two studies examined the relationship between adolescents' scores on a social desirability questionnaire and scores of negative, positive, and total life events. Only number of positive events was significantly related to social desirability. The second study compared various scoring strategies with respect to their intercorrelation and their ability to predict adolescents' maladjustment (depression, anxiety, and number of missed school days). The results demonstrated that (a) total number of events and readjustment-weighted life change scores were equally predictive of the maladjustment criteria; (b) negative events, but not positive events, however scored, were significantly related to the maladjustment criteria; (c) indices based on psychologist-judges' ratings of event desirability were not more predictive of the maladjustment criteria than were indices based on the adolescents' self-reports; and (d) uncontrollable negative events and controllable negative events were equally predictive of the maladjustment criteria.

Absenteeism↗
PubMed2002

Origins of gene, genetic code, protein and life: comprehensive view of life systems from a GNC-SNS primitive genetic code hypothesis.

We have investigated the origin of genes, the genetic code, proteins and life using six indices (hydropathy, alpha-helix, beta-sheet and beta-turn formabilities, acidic amino acid content and basic amino acid content) necessary for appropriate three-dimensional structure formation of globular proteins. From the analysis of microbial genes, we have concluded that newly-born genes are products of nonstop frames (NSF) on antisense strands of microbial GC-rich genes [GC-NSF(a)] and from SNS repeating sequences [(SNS)n] similar to the GC-NSF(a) (S and N mean G or C and either of four bases, respectively). We have also proposed that the universal genetic code used by most organisms on the earth presently could be derived from a GNC-SNS primitive genetic code. We have further presented the [GADV]-protein world hypothesis of the origin of life as well as a hypothesis of protein production, suggesting that proteins were originally produced by random peptide formation of amino acids restricted in specific amino acid compositions termed as GNC-, SNS- and GC-NSF(a)-0th order structures of proteins. The [GADV]-protein world hypothesis is primarily derived from the GNC-primitive genetic code hypothesis. It is also expected that basic properties of extant genes and proteins could be revealed by considerations based on the scenario with four stages.

Amino Acids↗
PubMed2006

Extracorporeal life support in a case of acute carbamazepine poisoning with life-threatening refractory myocardial failure.

OBJECTIVE: To report the efficacy of extracorporeal life support (ECLS) in acute carbamazepine poisoning with sustained refractory myocardial failure and a high degree of conductance disturbances. DESIGN AND SETTING: Case report from the toxicological and medical intensive care unit in a university hospital. PATIENT: A 26-year-old man with severe myocardial failure unresponsive to 1.7 microg kg(-1) min(-1) epinephrine and 1.9 microg kg(-1) min(-1) norepinephrine (SvO2, 17.8% and cardiac index, 0.8 l min(-1) m(-2)) following a suicidal ingestion of 32 g slow-release carbamazepine. INTERVENTIONS: ECLS (Jostra-Maquet centrifugal pump (Rotaflow) connected to a hollow-fiber membrane oxygenator). MEASUREMENTS AND RESULTS: ECLS device allowed inotropic drug weaning while maintaining end-organ function and supported the patient until myocardial recovery. The plasma carbamazepine level was 224 micromol/l on admission and peaked at 338 micromol/l 101 h after admission with a prolonged gastrointestinal absorption phase despite multiple doses of activated charcoal. The patient survived and was successfully explanted on day 6. An extensive and regressive thrombosis of the inferior vena cava was noted. Cardiac function totally recovered and at 2-year follow-up. There were no significant sequelae. CONCLUSIONS: We report a case of life-threatening myocardial failure with conductance disturbances secondary to an acute carbamazepine poisoning, demonstrating the efficacy of ECLS to assist recovery.

Adult↗
PubMedDate not supplied

Time after bone marrow transplantation as an important variable for quality of life: results of a cross-sectional investigation using two different instruments for quality-of-life assessment.

Quality of life (QoL) was investigated in 56 BMT recipients. The objective was to compare QoL in terms of physical, emotional, and social functioning between patients within the first year after BMT (n = 15) and patients who were alive more than 1 year after BMT (n=41). The Functional Assessment of Cancer Therapy Scale (FACT-BMT) and the EORTC-Quality of Life Questionnaire (EORTC-QLQ C30) were used to evaluate QoL as perceived by the patients. Results show a significantly reduced general QoL in patients within the first year after BMT. Specific differences were identified on the dimensions of physical and emotional well-being and the symptom scales of appetite loss, fatigue, pain, dyspnea, and nausea and vomiting. QoL improves significantly with time after BMT. We suggest that there should be more integration of QoL expectancy into the pre-BMT information process. Patients should be informed about potential deficits in physical and emotional well-being within the first year after BMT. This could enhance insight and compliance in the critical period early after BMT.

Adult↗
PubMed1993

Withholding and withdrawal of life support from surgical neonates with life-threatening congenital anomalies.

We evaluated why and how life support was withheld or withdrawn in surgical neonates. During the study period, January 1988 through December 1991, 529 neonates were admitted, 52 of whom died (10%). Twenty-eight deaths were due to the underlying disease. The other 24 patients died because treatment was withheld or withdrawn. In 15 of 24 (group A, mean stay 9.2 +/- 9.1 days) treatment was initially started but later withdrawn (13/15) because of the severity of congenital anomalies alone (7/12) or congenital anomalies associated with chromosomal anomalies (5/12). In 9 of 24 (group B, mean stay 20.3 +/- 17.3 days) treatment was withdrawn because of serious complications. In all cases often lengthy discussions have led the doctors and nurses together with the parents to chose unanimously for withdrawal of treatment. Mechanical ventilation was the intervention most frequently withdrawn (10/15 group A, 9/9 group B). Vasoactive and other drugs were withheld in 5 patients of group A. Sedatives and analgetics were administrated as supportive care permitting the child to die in a humane way, 17 in the lap of a parent and 7 in the lap of a nurse. We conclude that life-sustaining care is withheld or withdrawn relatively frequently from patients at our ICU. Such decisions are ethical ones, taken in the light of professional and technical expertise. Evaluation of withholding or withdrawal of treatment is difficult but necessary to evolve appropriate decision-making procedures and to formulate humane standards of intensive care.(ABSTRACT TRUNCATED AT 250 WORDS)

Abnormalities, Multiple↗
PubMed1996

A comparison of two quality-of-life questionnaires for cancer clinical trials: the functional living index--cancer (FLIC) and the quality of life questionnaire core module (QLQ-C30).

Choosing a measure instrument for a study raises the question of whether instruments designed for the same purpose produce the same results. We investigated this question for two instruments designed to measure subjective quality of life (QOL) in cancer clinical trials: the Functional Living Index-Cancer (FLIC) and the Quality of Life Questionnaire Core module (QLQ-C30). These were administered concurrently to 98 cancer patients. Four patient groups were defined: (1) well, no chemotherapy (n = 23); (2) adjuvant chemotherapy (n = 24); (3) stable disease, active chemotherapy (n = 24); (4) progressive disease (n = 27). Both instruments have global, role, social, emotional, pain, and nausea scales; QLQ-C30 also assesses physical function, cognitive function, and fatigue, while FLIC assesses hardship. Correlation analysis indicated convergent validity for the global, role, emotional, pain and nausea dimensions, but not the social dimension. Both instruments indicated that groups 1 and 2 had better QOL than group 4 in at least one dimension. However, different dimension-specific results meant that qualitatively different conclusions would have been drawn if either instrument had been used singly: FLIC indicated that group 1 had better role function that group 4 and suffered less hardship and that group 1 suffered less nausea than group 3, while the QLQ-C30 data indicated that group 2 had better physical function than group 4. The only consistent result was for pain: both instruments indicated group 4 had more pain than either groups 1 or 2. Thus the choice of QOL instrument for use in a particular trial will affect both the results and conclusions. It is important, therefore, to consider carefully which instrument is most likely to detect important differences relevant to the patients' lives in that setting.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2005

Head and neck cancer: to what extent can psychological factors explain differences between health-related quality of life and individual quality of life?

AIMS: To assess the extent to which individualised quality of life (QoL) was related to standardised health-related quality of life (HR-QoL), and to assess how much of the variation in each of these measures could be explained by psychological variables. METHODS: Fifty-five patients with newly diagnosed head and neck cancer completed the following outcome measures: the Patient Generated Index (PGI), the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and the Short Form 12 version 2 (SF-12v2). Explanatory factors were measured with the following: the Illness Perceptions Questionnaire-Revised (IPQ-R), the Beliefs about Medicines Questionnaire (BMQ), the Hospital Anxiety and Depression Scale (HADS), and the Brief COPE (a shortened version of the COPE). MAIN FINDINGS: Standardised and individualised QoL measures were correlated only partly. The PGI correlated only with EORTC QLQ-C30 domains of emotional and cognitive functioning and SF-12 domains of mental health, emotional role, social, and physical role. The underlying psychological factors explaining each of the three outcome measures were different. CONCLUSIONS: Respondent-generated measures such as the PGI could be used as an adjunct to more standardised measures of HR-QoL clinically. This has implications for assessing the impact of head and neck cancer on individualised QoL and also for improving patients' outcome through interventions aimed at targeting underlying psychological factors.

Activities of Daily Living↗
PubMed2006

Patient-reported assessment of quality care at end of life: development and validation of Quality Care Questionnaire-End of Life (QCQ-EOL).

Our goal was to validate an instrument with which terminally ill patients could evaluate the quality of care they receive at the end of life (EOL). Questionnaire development followed a four-phase process: item generation and reduction, construction, pilot testing, and field-testing. Using relevance and priority criteria and pilot testing, we developed a 16-item questionnaire. Factor analyses of data from 235 patients resulted in the Quality Care Questionnaire-End of Life (QCQ-EOL) covering dignity-conserving care, care by health care professionals, individualised care, and family relationships. All subscales and total scores showed high internal consistency (Cronbach alpha range, 0.73-0.89). The ability of total score and selective subscale scores clearly differentiated patients on the basis of clinical situation, sense of dignity, and general rating of care quality. Correlations of scores between patients and caregivers were substantial. The QCQ-EOL can be adopted to assess the quality of care received by terminally ill patients.

Adult↗
PubMedDate not supplied

Libraries of life: using life history books with depressed care home residents.

Depression is a common, and often undetected, psychiatric disorder in geriatric care home residents. Reminiscence, an independent nursing therapy used by a variety of health and social care professionals, can prevent or reduce depression. This practice development project explored the use of reminiscence life history books as an interpersonal therapeutic tool with 3 depressed care-home residents living in residential care and skilled nursing facilities. The process of choosing to produce a book, assessment of capabilities, and methods of construction are described using 3 illustrative case studies. Three themes emerged: reviewing the past, accepting the present, and dreaming of an alternative future. This project demonstrated that life history books, tailored to individual needs and abilities, can facilitate reminiscence and reduce depression by increasing social interaction. The benefits to residents, their families, and care staff are discussed and the relevance to nursing practice highlighted.

Aged↗
PubMed2006

Development and testing of a specific quality-of-life questionnaire for knee and hip osteoarthritis: OAKHQOL (OsteoArthritis of Knee Hip Quality Of Life).

OBJECTIVE: To design a quality-of-life (QOL) instrument specific for patients with knee or hip osteoarthritis and to assess its validity and reproducibility. METHODS: One-on-one or group interviews were conducted with 79 patients and 28 healthcare professionals. Of the 80 potential items identified from the results, 46 were selected based on their content and were used to develop version 1 of the OsteoArthritis of Knee and Hip Quality of Life Scale (OAKHQOL). The psychometric characteristics of the scale were evaluated in patients who met Altman's criteria for knee or hip osteoarthritis. RESULTS: Based on the results of psychometric analyses in 263 patients, three items were excluded, leaving 43 items in the final version (2.3) of the OAKHQOL. Principal components analysis identified four domains: physical activities, mental health, social functioning, and social support. A pain domain was individualized later. Construct validity, reproducibility, and discriminating power of the domains were satisfactory. Standardized response means after joint replacement surgery were close to 1 for the pain and physical functioning domains and equal to 0.7 for the mental health domain, indicating good sensitivity to change. CONCLUSIONS: The OAKHQOL is the first QOL tool specifically dedicated to lower-limb osteoarthritis. It captures specific aspects of QOL in patients with knee or hip osteoarthritis and exhibits psychometric properties consistent with use in longitudinal studies.

Aged↗
PubMed2004

Performance of valued life activities reflected asthma-specific quality of life more than general physical function.

OBJECTIVE: We examined the prevalence of disability in valued life activities (VLAs) among a group of adults with asthma and the impact of general physical function and performance of VLAs on asthma-specific quality of life (QOL). STUDY DESIGN AND SETTING: Interview data collected from two waves of a longitudinal cohort study were used to examine the prevalence of disability in VLAs, the cross-sectional association of general function and performance of VLAs with QOL, and the longitudinal association of changes in general function and changes in performance of VLAs with changes in QOL. General function was assessed with the SF-12; VLAs were assessed with a newly developed measure. RESULTS: A substantial portion of subjects reported disability in VLAs. VLA function was a stronger predictor of QOL than general physical function in cross-sectional and longitudinal analyses. CONCLUSION: Performance of VLAs is more closely tied to asthma-specific QOL than is general physical function.

Activities of Daily Living↗
PubMed2006

Caregiving at the end of life: Perceptions of health care quality and quality of life among patients and caregivers.

This study explored the association between perceptions of health care quality and quality of life in patients with advanced metastatic cancer and their informal caregivers (n=39). Patients' and caregivers' perceptions of health care quality, mental health, health-related quality of life, symptoms, and burden were measured. The key findings included the following: 1) patients' mental health and depression scores correlated with those of caregivers, suggesting that the mental health of patients and their caregivers are associated; 2) patients and caregivers shared similar perceptions regarding health care quality; 3) the presence of depression in caregivers correlated with caregivers being less satisfied with the health care being given to their patients (this correlation did not exist for patients, a finding that may be due in part to the protective buffering effect that caregivers provide their patients as illness progresses); and 4) a modified Primary Care Assessment Survey, originally designed for primary care patients, was a useful measure of health care assessment for both patients and caregivers. These data suggest that patients with advanced disease and their caregivers share similar perceptions and evolve as a "unit of care," and caregivers, as unique and important members of the patient's health care team, are also in need of care. When depressed, caregivers may unilaterally lose trust by becoming less satisfied with the quality of health care being provided to their patients.

Adult↗
PubMed2006

Symptom distress and quality-of-life assessment at the end of life: the role of proxy response.

This study sought to advance understanding of the relationships among proxy and patient reports of symptom distress and quality of life (QOL). English-speaking adults (n=86), their nurses (n=86), and family caregivers (n=49) from 11 hospice/palliative care organizations completed the Memorial Symptom Assessment Scale (MSAS) and McGill Quality of Life Questionnaire (MQOL) at hospice/palliative care enrollment, at 1 week, 2 weeks, then monthly until death or discharge. Patients and proxies provided similar average reports of symptom distress, both physical and psychological, but MSAS correlations were generally poor. MQOL correlations were higher for nurse-patient than for patient-caregiver dyads. Based on small differences between ratings but only moderate levels of correlation, proxy response appears to be a fair substitute for patient response, suggesting that symptom and QOL reports should be obtained from all available respondents throughout the course of clinical care or research in the hospice/palliative care setting.

Caregivers↗
PubMed2005

The origins of life -- the 'protein interaction world' hypothesis: protein interactions were the first form of self-reproducing life and nucleic acids evolved later as memory molecules.

The 'protein interaction world' (PIW) hypothesis of the origins of life assumes that life emerged as a self-reproducing and expanding system of protein interactions. In mainstream molecular biology, 'replication' refers to the material copying of molecules such as nucleic acids. However, PIW is conceptualized as an abstract communication system constituted by the interactions between proteins, in which 'replication' happens at the level of self-reproduction of these interactions between proteins. Densely concentrated peptide interaction systems may have reproduced and expanded as 'protocell' vesicles surrounded by lipid bi-layer membranes. Protocells led to the emergence of proto-RNA molecules of greater chemical stability which served as chemically differentiated 'memories' of peptide interaction states, thereby facilitating the reproduction and expansion of protocells. Simplification-driven expansion led to the selection of biotic amino acids and the reduction of the typical RNA alphabet to the four usual bases (A, C, G and U). Dense interactions between RNA molecules led to the emergence of the RNA interaction subsystem of the cell, and to the emergence of 'memories' of RNA interactions in the form of DNA molecules with greater chemical stability. The expansion of DNA molecule interactions led to the dense clustering and encapsulation of DNA molecules within the cell nucleus. RNA molecules therefore serve as memories of protein interactions and DNA molecules are memories of RNA interactions. We believe that the PIW hypothesis is more evolutionarily plausible than the mainstream RNA world hypothesis, and has greater explanatory power.

Evolution, Molecular↗
PubMed2006

The association between vision quality of life and academics as measured by the College of Optometrists in Vision Development Quality of Life questionnaire.

BACKGROUND: Undetected visual problems are one of the causes of academic difficulties in the classroom. An easily administered screening device that identifies children who are likely to do poorly in school because of vision problems would be a valuable tool. The screening should be able to be performed by a classroom teacher or aide. The objective of this study was to determine if there was an association between vision-related quality-of-life factors (19-item College of Optometrists in Vision Development Quality of Life [COVD-QOL] questionnaire checklist) and academic performance. A secondary objective was to determine whether student and parent responses to the questionnaire would be similar. METHODS: Ninety-one parents or guardians and their children, attending the third, fifth, and seventh grades in a public school participated in this study. Both the parent or guardian and student independently completed the checklist. The scores of both groups were compared with the Stanford IX test scores for total reading, total math, total spelling, and total battery scores of the Stanford IX. The parent or guardian and student scores were compared to evaluate the agreement (intergroup reliability). RESULTS: Parent or guardian and student checklist scores were compared. The Wilcoxon Signed Rank test showed that the mean scores for the parent or guardian were significantly lower than for third grade students and also for the total sample. Visual symptoms were found to be inversely correlated to academic performance; the lower the academic score, the more symptoms were reported. Symptoms reported by third grade students and their parents tended to be more highly correlated with academic scores. In general, symptoms reported by the parent were more highly correlated with academic score than the symptoms reported by the student. CONCLUSION: The COVD-QOL questionnaire is a cost-effective, quick, and easy tool that may be used in school screening to identify possible visual symptoms that are correlated to academic performance.

Child↗
PubMed2005

How education, income, control over life and life style contribute to risk factors for cardiovascular disease among adults in a post-communist country.

OBJECTIVES: To examine the effect of education, income, food habits and control over life on risk factors for cardiovascular diseases in Poland, a former communist country with ongoing transformations of the political and economic system, where cardiovascular disease is an important health problem. METHODS: The data were collected by questionnaire, as part of the CINDI Programme, from 2001 to 2002 in Lodz, an industrial city in Poland. The surveys were directed at random samples of 2000 men and 2000 women; 1847 participants aged 18-64 years responded. As detailed in the ATP III report, participants with three or more of abdominal obesity, hypertriglyceridaemia, low high-density-lipoprotein cholesterol, high blood pressure or high fasting glucose were defined as having the metabolic syndrome. RESULTS: We have found that education is more strongly associated with the metabolic syndrome. Our study suggests that higher education may be a strong and consistent predictor of good health. Also, low control over life (unfulfilled daily needs, unfulfilling work, little or no reward for effort at work) and lack of physical activity have been shown to be predictors for the metabolic syndrome. CONCLUSIONS: Our findings suggest that interventions to improve the health of the Polish population need to be specific for the social environment.

Adult↗