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PubMed2006

Theory of mind, neurocognition, and functional status in schizotypy.

The present study is the first to concurrently examine social cognition, neurocognition, and social functioning in psychometric schizotypes. Screening of 2108 undergraduates with the Schizotypal Personality Questionnaire-Brief (SPQ-B) identified 52 persons high in schizotypy and 40 persons low in schizotypy. All participants were administered a test battery designed to assess two elements of neurocognition, verbal secondary memory (California Verbal Learning Test) and executive functioning (Wisconsin Card Sorting Test), two elements of social cognition, emotion perception (The Awareness of Social Inference Test-Part 1) and theory of mind (The Awareness of Social Inference Test-Parts 2 and 3), and social functioning (Social Adjustment Scale-Self Report). Although the persons with high schizotypy were impaired in social functioning relative to the persons with low schizotypy, they were not impaired in theory of mind, emotion perception, verbal secondary memory, or executive functioning. Theory of mind and verbal secondary memory were correlated in persons with high schizotypy. The present findings suggest that psychometric schizotypes are not impaired in the domains of social cognition and neurocognition examined.

Adolescent↗
PubMed1998

Relationship between cognitive and social dysfunction in schizophrenia.

This cross-sectional study examined the relationships between cognitive functioning, social functioning, and social problem solving in a sample of 30 outpatients with schizophrenia. The cognitive battery included measures of verbal ability, memory, executive functioning, visual-spatial ability, and attention. Social functioning was assessed with the Social Dysfunction Index (SDI) and the Social Adjustment Scale-II (SAS-II). Social problem solving was assessed with a video-based test, the Assessment of Interpersonal Problem-solving Skills (AIPSS). No significant association was found between social functioning as assessed by the SDI and the SAS-II and cognitive functioning. In multiple regression analyses, a measure of attention, the auditory Continuous Performance Test was a significant predictor of processing and sending skills, as assessed by the AIPSS. (F = 16.37, 9.23, p < 0.001).

Adult↗
PubMed2003

Quality-of-life assessment of patients after ileal pouch-anal anastomosis for slow-transit constipation with rectal inertia.

PURPOSE: Severe idiopathic constipation with rectal inertia represents a challenging medical problem that, in extremis, might warrant surgery. We studied a group of patients who have undergone proctocolectomy and ileal pouch-anal anastomosis for this problem. The purpose was to assess the functional success of this procedure and its impact on the social function of the patients. METHODS: Patients with functional, intractable constipation have one motion or less per week and are laxative-dependent. The indication for surgery was based on failure of long-term medical therapy. The selection criteria were normal colonoscopy, normal anal manometry and pudendal nerve latency test, and abnormal transit study and abnormal video proctography. The functional outcome after surgery was assessed by anal manometry and stool frequency. Quality of life was analyzed using the Rand health survey 1.0 consisting of a comprehensive questionnaire used preoperatively and postoperatively with emphasis on physical function, role limitation because of functional/emotional problems, social function, pain, and general health. RESULTS: Fifteen patients (14 females) underwent ileal pouch-anal anastomosis over a seven-year period (1993-1999). The mean age was 41 (range, 25-47) years. All had a temporary defunctioning loop ileostomy fashioned, and there were no anastomotic leaks. Two patients required pouch excision within 18 months because of intractable pelvic pain. The mean stool frequency was eight (range, 3-12) per day at the first follow-up. At the second follow-up, this had improved to five (range, 2-6) per day. The mean resting and squeeze anal pressures preoperatively were 82 cm H2O and 104 mmHg, respectively, and were unchanged after surgery. Significant improvement in lifestyle scores were recorded in the categories of physical function, social function, and pain at the first follow-up and in all categories at the second follow-up (P < 0.05). CONCLUSION: Restorative proctocolectomy is an option in selected patients and leads to progressive improvement in quality of life.

Adult↗
PubMed1989

Opiate effects on social behavior of juvenile dogs as a function of social deprivation.

The relationship between opioids and social behavior was examined by administering morphine (an opioid agonist) and naloxone (an opioid antagonist) to juvenile dogs and measuring various social behaviors (e.g., tail wagging) in a large room. Drugs were administered following social deprivation and nondeprivation. It was hypothesized that morphine would ease effects of social deprivation while naloxone would result in behavior typical of untreated socially-deprived dogs. Social deprivation (24 hr) resulted in more contact with the experimenter and increased tail wagging relative to nondeprivation. Morphine (0.25 mg/kg) resulted in more contacts with the experimenter and entrances into the "experimenter's area" relative to vehicle injections. Further, morphine decreased and naloxone increased tail wagging in the dog's area and there was a significant social condition X drug interaction for that measure. Naloxone (0.25 mg/kg) increased wagging following nondeprivation while morphine decreased wagging following deprivation. These data support the hypotheses that social deprivation can increase social behaviors, and that social behavior is regulated by activity in brain opioid systems.

Animals↗
PubMed2002

The unfavorable effects of concomitant asthma and sleeplessness due to the atopic eczema/dermatitis syndrome (AEDS) on quality of life in subjects allergic to house-dust mites.

BACKGROUND: Allergic rhinitis, asthma or the atopic eczema/dermatitis syndrome (AEDS) may independently impair quality of life in patients. However, although many allergic patients may suffer from more than one disorder, the effect of concomitant disease -- in particular, the impact of AEDS -- is largely unknown. As part of a large multicenter clinical trial on the efficacy of mattress casings in house-dust mite (HDM) allergy, generic quality of life in a mixed population of 224 subjects with rhinitis (n = 198) and/or asthma (n = 111) and/or AEDS (n = 64) was studied. The study aimed to estimate quality of life impairment in these atopic patients and to address the question/issue of whether one atopic disorder goes beyond other existing allergic diseases, thereby causing further impairment to quality of life. METHODS: Generic quality of life was assessed by SF-36. Quality of life in the atopic group was compared with a Dutch norm population. Multiple linear regression was used to determine the effects of disease (i.e. the presence of allergic rhinitis, asthma or AEDS) or disease severity, as assessed by visual analog scores (VAS) for asthma, rhinitis, VAS sleeplessness and VAS itching being considered as major symptoms in AEDS on SF-36 domains. RESULTS: Compared to the norm group, atopic patients were impaired in: physical functioning; role physical functioning; general health; vitality; and social functioning. The diagnosis of asthma was negatively associated with the SF-36 subscales for physical functioning (P = 0.02), and general health (P < 0.01). In line with these findings, asthma severity (VAS asthma) was negatively associated with physical functioning (P < 0.01), role physical functioning (P < 0.01), general health (P < 0.0.1), social functioning (P = 0.01), emotional functioning (P = 0.01), and vitality (P = 0.01). VAS sleeplessness had significant negative effect on role physical functioning (P < 0.01), bodily pain (P < 0.01), General health (P = 0.01), mental health (P < 0.01), social functioning (P < 0.01), and vitality (P < 0.01). In contrast, neither the diagnosis of allergic rhinitis or AEDS, nor VAS itching as an outcome parameter of AEDS, exerted additional effects on the SF-36 domains. CONCLUSIONS: Patients with atopic disease based on HDM allergy may have impaired quality of life. The majority of these patients have allergic rhinitis. The (co)existence of asthma, expressed in terms of diagnostic criteria or symptom severity, or the presence of sleep disorders as a consequence of AEDS, may further impair quality of life.

Adolescent↗
PubMed2005

[Health-related quality of life after radical prostatectomy or radiotherapy].

PURPOSE: We compared general and disease specific health related quality of life (QOL) after surgery and radiotherapy for prostate cancer. MATERIALS AND METHODS: We performed a retrospective survey of patients treated between 1992 and 2001. General and disease specific health related QOL were assessed by the SF-36 and the University of California-Los Angels Prostate Cancer Index (UCLA PCI). We mailed questionnaires of QOL survey and obtained from 143 and 73 men who treated surgery and radiotherapy. The median ages of surgery and radiation group were 70.9 and 79.2 years old, and the median periods after treatment were 2.7 and 2.0 years, respectively. RESULTS: Physical function, role physical, social functioning and mental health were higher score in surgery group than radiation group, however, general health perceptions was higher in radiation group among SF-36. Surgery group had worse urinary function and better sexual function compared with radiation group. Multi-variable analysis showed that scores of social functioning, mental health and sexual function were most influenced by each modality, the scores of physical function, role physical, urinary function and sexual bother were most influenced by age, and the score of general health perceptions and body pain was most influenced by the existence of recurrence. CONSIDERATION: This cross-sectional survey cleared the differences of QOL after surgery and radiotherapy, and the influences of each modality. However, because of difference in background of each group, longitudinal investigation will need to aid patients in the decision making process.

Aged↗
PubMedDate not supplied

Quality of life of hearing-impaired older women.

A survey of 66 hearing-impaired older women aged 54 to 96 years interviewed at home examined major influences on quality of life experienced by 27 prevocationally deaf and 39 later onset subjects. A causal model was specified; the predictors of quality of life included age, age at onset of hearing loss, financial adequacy, social hearing handicap, perceived health, and functional social support. The model proposed that health, social support, hearing handicap, and financial adequacy would directly affect quality of life as well as mediate the effect of the demographic variables, age and age at onset of loss, on this outcome. Later onset subjects were hypothesized to have lower quality of life due to increased social hearing handicap, decreased health, and decreased functional social support. Results of the path analysis showed the best predictors of quality of life to be social hearing handicap, functional social support, and perceived health. The later onset group had an overall lower perception of quality of life, this relationship being mediated as predicted. Generally, the hypothesized causal model was supported with 34% of variance explained. Descriptive findings also supported a difference in social hearing handicap between the two groups, yielding several implications for nursing interventions.

Adaptation, Psychological↗
PubMed2002

Cognitive functioning and social problem-solving skills in schizophrenia.

INTRODUCTION: This study examined the relationships between symptoms, cognitive functioning, and social skill deficits in schizophrenia. Few studies have incorporated measures of cognitive functioning and symptoms in predictive models for social problem solving. METHOD: For our study, 44 participants were recruited from consecutive outpatient admissions. Neuropsychological tests were given to assess cognitive function, and social problem solving was assessed using structured vignettes designed to evoke the participant's ability to generate, evaluate, and apply solutions to social problems. A sequential model-fitting method of analysis was used to incorporate social problem solving, symptom presentation, and cognitive impairment into linear regression models. Predictor variables were drawn from demographic, cognitive, and symptom domains. Because this method of analysis was exploratory and not intended as hierarchical modelling, no a priori hypotheses were proposed. RESULTS: Participants with higher scores on tests of cognitive flexibility were better able to generate accurate, appropriate, and relevant responses to the social problem-solving vignettes. CONCLUSIONS: The results suggest that cognitive flexibility is a potentially important mediating factor in social problem-solving competence. While other factors are related to social problem-solving skill, this study supports the importance of cognition and understanding how it relates to the complex and multifaceted nature of social functioning.

Journal Article↗
PubMedDate not supplied

[Validation of the QFS measuring the frequency and satisfaction in social behaviours in psychiatric adult population].

INTRODUCTION: Although everyone working in routine mental health services recognizes the scientific and ethical importance to ensure that treatments being provided are of highest quality, there is a clear lack of consensus regarding what outcome domains to include, what measure of assessment to use and, moreover, who to question when assessing. LITERATURE FINDINGS: Since the fifties, social functioning is considered as an important dimension to take into account for treatment planning and outcome measuring. But for many years, symptoms scales have been considered as sufficient outcome measures and social functioning improvement expected on the basis of symptoms alleviation. As symptoms and social adjustment sometimes appear relatively independent, no accurate conclusion concerning the patient's social functioning can so be driven on the basis of his clinical symptoms. More attention has then been directed toward the development of instruments specifically intended to measure the extent and nature of social functioning impairments observed in most psychiatric syndromes. Many of these instruments are designed to be completed by caregivers or remain time consuming and difficult to use routinely. Presently, in clinical practice, there is a need to rely on simple and brief instruments considering patients'perspective about their social adjustment as a function of time. AIM OF THE STUDY: The aim of this study is to present a new instrument, the QFS, initially developed in order to assess social functioning in patients involved in group psychotherapy programs conducted in a specialist mental health setting, as well as its psychometric characteristics. METHODOLOGY: It was designed to be completed in less than 10 minutes and the questions are phrased in a simple and redundant way, in order to limit problems inherent to illiteracy or language comprehension. The QFS is a 16 items self-report instrument that assesses both the frequency of (8 items) and the satisfaction with (8 items) various social behaviours adopted during the 2 weeks period preceding the assessment. It yields three separate indexes of social functioning, defined a priori and labelled "frequency", "satisfaction" and "global". The higher the scores, the better the social functioning. The QFS was administered to 457 subjects, aged between 18 and 65, including 176 outpatients (99 with anxious or depressive disorders, 25 with personality disorders and 52 with psychotic disorders) and 281 healthy control subjects. RESULTS: No significant difference was found between patients and controls according to age or gender distribution. Acceptance rate was high (>95%). Moreover, the QFS was generally acceptable to the clinicians who used it. Internal consistency calculated for each index ranged from 0.65 to 0.83 (Cronbach alpha). Test-retest reliability, calculated within a 15 days time interval on a sample of 49 healthy controls, ranged from 0.69 to 0.71 (intraclass correlation coefficient). Discriminant validity was calculated on healthy controls and patients divided into sub-groups according to their diagnosis. It showed to be excellent, with significantly higher scores in control subjects than in psychiatric patients and significant differences across diagnostic categories (Kruskal-Wallis ANOVA with post-hoc tests, all p<0.05). The convergent validity of the QFS with other measures of social functioning was calculated, using the Social Adaptation Self-Evaluation Scale (SASS) and the Social Adjustment Scale Self-Report (SAS-SR). With the SASS, the convergent validity was higher among patients (Spearman rS 0.71 to 0.92, p<0.01) than controls (rS from 0.49 to 0.66, p<0.001). In healthy controls, correlation with the SAS-SR was moderate but statistically significant (rS from - 0.21 to - 0.44, p<0.05). When comparing QFS scores with self-rated symptoms severity, lower levels of social functioning were significantly associated with more severe symptoms according to the Brief Symptom Inventory (BSI: rS from - 0.38 to - 0.65, p<0.001). The QFS indexes demonstrated sensitivity to change (Wilcoxon: all p<0.05) on a sample of 27 out-patients suffering from anxious-depressive disorders questioned before and after 4 months of cognitive behavioural group therapy running on a weekly basis during 16 sessions of 2 hours each.The factorial validity of the QFS was measured through 3 separate factor analysis conducted using the data of 457 subjects. The first analysis considered only Frequency items; 7 out of 8 items had loadings above 0.5 on Factor 1 accounting for 30.7% (unrotaded) of the variance. The second analysis considered only Satisfaction items; all items had loadings above 0.6 on Factor 1 explaining 43.4% (unrotaded) of the variance. And finally, in the third factor analysis, all QFS items were included; 15 out of 16 items had loadings above 0.4 on Factor 1 accounting for 30% (unrotated) of the variance. Concerning the factorial validity of the instrument, these results suggest that all QFS items belong to the same underlying dimension. DISCUSSION: Finally, provisional norms for the QFS are provided for healthy controls, in order to characterise individual patients or patient subgroups. In conclusion, the need for assessment in clinical routine, in order to estimate different aspects of patients conditions as well as the quality of the treatment provided, has contributed to the development of a large variety of instruments measuring several domains. Concerning the level of social functioning, many instruments fail to meet chief criterion of feasibility, remaining often too complex or time onsuming. Moreover, only few of them are available in French. CONCLUSION: The QFS presented here is a brief, simple and easy to administer self-rating scale that displays satisfactory psychometric properties. It seems to be a valuable instrument for the monitoring of social functioning in psychiatric patients which, from a therapeutic point of view, may have a clear impact as it sets up expectation of change and allows both to reality test patients and therapists beliefs about the presence of progress or not and to identify if therapy is working on this specific outcome domain. Though, to date, the administration of the QFS to other populations and treatment modalities requires further investigation.

Adolescent↗
PubMedDate not supplied

Social networks and coronary artery disease: a comparison of the structure and function of social relations as predictors of disease.

This study provides the first direct comparison of the relative importance of structural versus functional aspects of social network ties as they relate to susceptibility to coronary artery disease. Data from 119 men and 40 women undergoing coronary angiography provide an opportunity to compare these associations in relation to a direct and continuous measure of atherosclerosis while controlling for age, sex, income, hypertension, serum cholesterol, smoking, angina, diabetes, family history of heart disease, Type A behavior pattern, and hostility. Regression analyses indicate that network instrumental support and feelings of being loved are more important in predicting coronary atherosclerosis than is network size, independent of all covariables (relative extent of atherosclerosis, low/high support = 1.74 and 1.5, respectively). More "problem-oriented" emotional support did not show a similarly strong association (relative extent of atherosclerosis = 1.01). These findings suggest that certain functional aspects of social network ties are more strongly associated with host resistance to coronary atherosclerosis than are structural characteristics like network size.

Adult↗
PubMed2006

The evaluation of quality of life in fibromyalgia syndrome: a comparison with rheumatoid arthritis by using SF-36 Health Survey.

Musculoskeletal disorders are the most common causes of deterioration in quality of life (QOL). We in this study aimed to assess (1) the impact of fibromyalgia syndrome (FS) on QOL comparing with that of rheumatoid arthritis (RA) patients and control subjects and (2) the impact of these two musculoskeletal disorders on various components of QOL using SF-36 Health Survey. Thirty-five patients with RA, 30 patients with FS, and 30 voluntary control subjects were included in the study. The groups were comparable in terms of demographic characteristics. QOL was evaluated by using Short-Form (SF)-36 Health Survey in all study participants, and Fibromyalgia Impact Questionnaire (FIQ), which is a specific health-status instrument for FS, was used in FS patients. Physical functioning, physical role, social functioning, bodily pain, general health, vitality, emotional role, and mental health scores were significantly lower in RA and FS patients than in control subjects (p<0.05). The between-groups comparisons revealed that FS patients had significantly lower mental health scores than RA patients (49.87 vs 62.51, respectively), (p<0.001). Total FIQ score correlated significantly with physical functioning, physical role, and bodily pain in FS patients. All parameters of SF-36 Health Survey except for social functioning correlated significantly with some of the variables of FIQ. FS has a negative impact on QOL, like RA. Furthermore, mental health was more severely affected in FS patients when compared with RA patients.

Adult↗
PubMed1984

Social recovery and therapeutic mission.

Social recovery is defined as restoration to effective social functioning. The Social Recovery Inventory, an instrument derived from role and social exchange theories, is demonstrated as a method of measuring recovery vis-à-vis occupational, familial, and civic functioning. Conditions for social recovery are examined, with discussion of implications for treatment, in-service training, and administration.

Adult↗
PubMed2000

Assessment of health-related quality of life in renal transplant and hemodialysis patients using the SF-36 health survey.

OBJECTIVES: To determine whether the health-related quality of life (HQOL) for renal transplant patients improved using SF-36 survey scores and to examine which clinical measures after renal transplantation are connected to aspects of their HQOL. METHODS: A total of 117 renal transplant patients and 114 hemodialysis patients, including 49 awaiting transplantation and 65 not awaiting transplantation, were included in this study. The scale scores of the SF-36 survey concerning HQOL were compared between the two groups of patients. The relationships of the clinical episode and complications with the scale scores were examined. RESULTS: The renal transplant patients had significantly higher scores in the physical functioning, bodily pain, general health, and social functioning scales than did the hemodialysis patients. The role-physical functioning, bodily pain, and social functioning scales of the transplant patients were significantly higher than those of the hemodialysis patients not awaiting transplantation. In contrast, the scores, except for that of general health, of the transplant patients were not significantly different from those of the hemodialysis patients awaiting transplantation. Multiple regression analysis demonstrated that the scale scores of physical functioning, general health, and vitality were significantly dependent on the serum level of creatinine in the renal transplant patients (P <0.05). The scores of physical functioning and general health of the patients with a creatinine level >2 mg/dL were significantly lower than those of the patients with 1 mg/dL < creatinine level </=1.5 mg/dL or a creatinine level </=1 mg/dL (P <0.05). An episode of hospitalization was not related to the scale scores, but an instance of rejection had an effect on the scores of social functioning and role-emotional functioning. CONCLUSIONS: The SF-36 health survey is a short but comprehensive scale for evaluating a patient's HQOL. The renal transplant patients' HQOL improved compared with that of the hemodialysis patients. The most important factor affecting HQOL was the serum creatinine level at the time of testing with the SF-36 survey.

Adult↗
PubMed1999

The relationship of functional limitations to disability and the moderating effects of psychological attributes in community-dwelling older persons.

This paper examines the moderating effects of three psychological attributes (neuroticism, self-efficacy expectancies and mastery) on the association between functional limitations (motor and cognitive limitation, vision and hearing loss) and disability ((instrumental) activities of daily living, role function and social function) in a sample of 624 community-dwelling older persons. In contrast to our hypothesis, we did not find any evidence for interaction effects. This means that low levels of psychological resources do not exacerbate the effect of functional limitation on disability in community-dwelling older persons. We found significant unique contributions of the psychological attributes to disability. Even when all three psychological attributes were taken into account, neuroticism and mastery had unique effects on social and role function, and self-efficacy expectancies had unique effects on (instrumental) activities of daily living. We conclude that the effects of functional limitation and psychological attributes on disability can be considered as additive. Older persons with less psychological resources are particularly at risk in developing disability.

Activities of Daily Living↗
PubMed1999

Health-related quality of life among renal-transplant recipients in Japan.

BACKGROUND: This study had four goals: (1) to evaluate an index of health-related quality of life (HQOL) among renal-transplant recipients in Japan, (2) to compare HQOL of renal-transplant recipients with that of the Japanese population as a whole, and (3,4) to study associations of HQOL with renal function and with the time since transplantation. METHODS: Questionnaires were distributed to 570 subjects. All were outpatients, were 16 years old or older, and were studied at least 1 year after they had received their latest renal transplant. HQOL was assessed with the Short Form 36-item health survey. Subjects' physicians provided data on renal function. Associations of HQOL with serum creatinine concentration and with the time since transplantation were evaluated by logistic regression. RESULTS: The response rate was 83%. Data from patients with diabetes and from those who had had at least two renal transplants were excluded; data from 395 recipients were analyzed. On the physical functioning, general health perception, vitality, and social functioning scales, the patients' scores were significantly lower than the Japanese national-norm scores. General health perception was particularly low. Serum creatinine concentrations were associated with general health perception, vitality, and social functioning. Longer times since transplantation were associated with better social functioning. CONCLUSIONS: Although social and physical functioning may improve after transplant surgery, a low self-rating of general health seemed to remain. The rarity of renal transplantation in Japan and other psychosocial factors may explain the low self-rating of general health in Japanese renal-transplant recipients.

Adolescent↗
PubMed2001

Measuring health status of people who are wheelchair-dependent: validity of the Sickness Impact Profile 68 and the Nottingham Health Profile.

PURPOSE: Several questionnaires measuring health status are available, but their validity and correspondence between them in people with severe physical disabilities is not well known. In this study, the equivalence of the Nottingham Health Profile (NHP) and the Sickness Impact Profile 68 (SIP68) was examined. METHODS: Patients were 111 people who were wheelchair-bound due to spinal cord injuries (45%), rheumatic diseases (27%) or other causes (28%). Internal consistency, associations between scales of both questionnaires and with criterion variables (reflecting upper and lower extremity function, perceived health, social functioning and well-being) were examined. RESULTS: Both the NHP and the SIP68 were of acceptable clinimetric quality (Cronbach's alpha 0.53-0.85). Agreement between scales of both questionnaires was moderate for scales reflecting emotional health (0.56) and for scales reflecting physical (0.22-0.68) and social functioning (0.28-0.35). CONCLUSION: The NHP reflects perceived health, whereas the SIP68 reflects functional health status. In rehabilitation research, a careful choice between available health status measures must be made.

Persons with Disabilities↗
PubMed2003

Correlates of substance use disorder among psychiatric outpatients: focus on cognition, social role functioning, and psychiatric status.

This study compared psychiatric outpatients who were never, former, and current substance abusers on psychiatric, social, and cognitive functioning. Fifty-six outpatients with schizophrenia spectrum and bipolar disorders volunteered to complete diagnostic and social role function interviews, self-report inventories, and neuropsychological tests. Multinomial logit regression analyses indicated that current and former abusers reported greater subjective feelings of distress than those who never abused. Contrary to expectations, however, both groups of substance abusers performed better on nonverbal cognitive tests compared with those who never abused. Differences in social functioning were also observed: former abusers demonstrated better instrumental role functioning than those who never abused. This pattern of findings challenges assumptions about additive effects of comorbid disorders on cognitive and social functioning.

Adult↗
PubMed1997

Assessment of quality of life in early stage HIV-infected persons: data from the AIDS Time-oriented Health Outcome Study (ATHOS).

The development of new pharmaceutical interventions for persons with human immunodeficiency virus (HIV) infection has resulted in extended survival and a need for valid, reliable and responsive instruments to assess health-related QoL (HRQoL). This paper reviews the reliability and validity of an HRQoL instrument, the AIDS Health Assessment Questionnaire (AIDS-HAQ), among persons participating in an observational database of HIV infection. The AIDS-HAQ includes nine subscales: disability, energy, general health, pain, cognitive functioning, mental health, social functioning, health distress and symptoms. Individuals complete the AIDS-HAQ quarterly. Data are reported for 440 individuals entering the study with early HIV infection. Fifty-nine progressed to symptomatic disease and 109 to AIDS after 1 year. The subscales of the instrument resulted in high internal consistency reliability (range = 0.79-0.88). Concurrent validity data reflected the ability to distinguish between patients with increasing disease severity. In all domains, except cognitive functioning, individuals who progressed to AIDS had significant decrements (p < 0.01) in HRQoL compared with symptomatic and asymptomatic patients. Significant decrements (p < 0.01) were observed for disability, general health, energy and symptoms for patients who progressed to symptomatic disease from an asymptomatic status. Individuals who had decreasing CD4+ counts also had significant declines (p < 0.001) in disability, general health, social functioning, pain and symptoms. The AIDS-HAQ is an instrument that can be used when comparing group differences and within group changes in observational databases, naturalistic studies and clinical trials.

Adult↗