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PubMed2005

Adolescent health-related quality of life and perceived satisfaction with life.

PURPOSE: To explore the relationship between perceived satisfaction with life and health-related quality of life (HRQOL) in a state-wide sample of 13-18-year-old adolescents (n = 4914) in South Carolina, USA. METHODS: Questions were added to the self-report Centers for Disease Control (CDC) Youth Risk Behavior Survey (YRBS) asking about perceived life satisfaction in six domains (self, family, friends, living environment, school, and overall) and HRQOL (self-rated health; and the number of poor physical health days, poor mental days, and activity limitation days during the past 30 days). RESULTS: Adjusted logistic regression analyses and multivariate models constructed separately revealed that self-rated health, poor physical days (past 30 days), poor mental health days (past 30 days), and activity limitation days (past 30 days) were significantly related (p < 0.05) to reduced life satisfaction, regardless of race or gender. Moreover, as the number of reported poor health days increased, the greater the odds of reporting life dissatisfaction. CONCLUSIONS: This is the first study to document the relationship between poor physical health and perceived life satisfaction. This adds to the mounting evidence that life satisfaction is related to a variety of adolescent health behaviors and that life satisfaction may add additional information in longitudinal databases that track adolescent health because it appears to be related to HRQOL.

Adolescent↗
PubMed1984

Life events or life processes as determinants of mental strain? A 5-year follow-up study.

In a study among Finnish metal industry employees (n = 748) mental strain was measured at the beginning and at the end of a 5-year follow-up. Life event data for the follow-up period were gathered retrospectively through a questionnaire and a later interview. Mental strain was substantially higher among blue-collar than white-collar workers. In contrast, no differences in the occurrence or in the rating of life events was observed between these groups. Self-rated undesirable events were associated with high levels and desirable events with low levels of mental strain. Similar associations were observed in three objectively defined live events, viz. divorce, promotion in the job and change in housing conditions. Life events were, however, also related with the mental strain measured prior to the life events. Both the self-rated and objectively defined desirable events had usually a favourable impact on mental well-being, whereas undesirable events in most cases slightly increased mental strain. The differences in mental strain between occupational status groups seem to be caused by differences in the life processes rather than life events. Furthermore, many life events, e.g. divorce, are actually only discrete moments in long-lasting processes, which have an impact on mental well-being. And last, desirable life events can be seen rather as a preventive than a risk factor of mental strain.

Adult↗
PubMed2005

Patterns of proopiomelanotropin and proopiocortin gene expression and of immunohistochemistry for gonadotropin-releasing hormones (lGnRH-I and III) during the life cycle of a nonparasitic lamprey: relationship to this adult life history type.

There are two adult life history types among lamprey species, nonparasitic and parasitic, with the former commencing the final interval of sexual maturation immediately after metamorphosis. There are no extensive studies that directly compare hormone profiles during the life cycles of nonparasitic and parasitic lamprey species, yet such data may explain differences in development, reproductive maturation, and feeding status. The present study uses immunohistochemistry to show the life cycle profiles for gonadotropin-releasing hormones (GnRH-I and -III) in the brain of the nonparasitic species, the American brook lamprey, Lampetra appendix, for comparison with the extensive, published, immunohistochemical data on these hormones in the parasitic species, the sea lamprey, Petromyzon marinus. The complete cDNAs for the two lamprey prohormones, proopiocortin (POC), and proopiomelanotropin (POM), were cloned for L. appendix and both nucleotide and deduced amino acid sequences were compared with those previously published for P. marinus. The POC and POM cDNAs for both species were used in expression studies, with Northern blotting, throughout their life cycles. Although GnRH-I and -III immunohistochemistry revealed a similar distribution of immunoreactive cells and fibers in the two species during the life cycles, a qualitative evaluation of staining intensity in L. appendix, implied early activity in the brains of metamorphosis of this species, particularly in GnRH-I. GnRH-III seems to be important in larval life and early metamorphosis in both species. A novel feature of this immunohistochemical study is the monthly observations of the distribution and relative intensity of the two GnRHs during the critical period of final sexual maturation that lead to spawning and then the spent animal. L. appendix POC and POM nucleotide sequences had 92.9 and 94.6% identity, respectively, with P. marinus POC and POM and there was an earlier increase in their expression during metamorphosis and postmetamorphic life. Since there was some correlation between the timing of metamorphic development, gonad maturation, and brain irGnRH intensity with POC and POM expression in L. appendix, it was concluded that these prohormones yield posttranslational products that likely play a substantial role in development and maturation events that lead to the nonparasitic adult life history of this species.

Amino Acid Sequence↗
PubMedDate not supplied

[A new patient focused scale for measuring quality of life in schizophrenic patients: the Schizophrenia Quality of Life Scale (SOL)].

UNLABELLED: RATIONALE/OBJECTIVE: Quality of Life (QOL) has been recognized as an important measure of the outcome of patients by clinicians and policy makers in Mental Health. The emerging consensus in the health field that personal values and the patient's preferences are important in monitoring the quality of medical care outcomes makes it even more important to assess the patient's perspectives. Unfortunately, there is little consensus about what constitutes QOL or how to measure it, particularly in psychotic patients. The objective of this study is to report the stages of development and validation of a QOL questionnaire based on issues pertinent to patients with schizophrenia. METHOD: During a first phase, identical pattern were identified among interviews (conducted by psychologists) of schizophrenic patients (DSM IV, n = 100), mental health staff (n = 20) and families (n = 20). The data gathered in the first phase were discussed and organized, by 25 experts, into a structure that made up the skeleton of the scale (133 items, 17 factors). Based on a prospective epidemiological study conducted with 337 French psychiatrists, a validation analysis of structural and psychometric proprieties was performed. Finally reliability of the scale was assessed by a second test/retest (D0, D7) study (n = 100). RESULTS: A total of 686 schizophrenic, schizophreniform or schizoaffective patients (DSM IV) were included. Internal consistency analysis identified 14 factors (74 items), all with a Cronbach's alpha of at least 0.75: professional life (0.95), affective and sexual life (0.92), illness knowledge (0.90), relationship (0.92), life satisfaction, (0.87), coping with drugs (0.79), drugs impact on the body (0.87), daily life (0.83), family relationship (0.81), future (0.88), security feeling (0.84), leisure (0.87), money management (0.76) and autonomy (0.75). Construct validity was confirmed (Pearson test) using established clinical (Brief Psychiatry Rating Scale and Clinical Global Improvement), social (Psychological Aptitude Rating Scale) and generic quality of life (Functional Status questionnaire) measures, correlation coefficient was significant for all factors but 2 in the BPRS (illness knowledge and coping with drugs) and 3 in the CGI (illness knowledge, coping with drugs and life satisfaction). Lastly, test/retest indicated high reliability for each factor (p < 0.001), the lower correlation coefficient (r) was 0.526. CONCLUSIONS: The Schizophrenia Quality Of Life-scale (SOL), based on a patient's point of view approach, is an efficient, multidimensional instrument designed for the measurement of the consequences of schizophrenia on individuals' lives.

Adolescent↗
PubMed1997

Assessment of major life events for Hong Kong adolescents: the Chinese Adolescent Life Event Scale.

Previous Chinese research on adolescent life stress adopted life event scales that were directly translated from Western measures. To address the methodological and cultural issues overlooked by the "import" approach, the present research aimed at constructing a life event scale for Hong Kong adolescents. Study 1 was conducted to congregate items for the Chinese Adolescent Life Event Scale (CALES). The CALES contains 44 items derived from 618 Hong Kong adolescents. Study 2 revealed adequate test-retest reliability and criterion-related validity for the CALES. Moreover, the CALES yielded stronger relationships with depression than did the translated life event measures. Results suggest that the CALES is appropriate for assessing life events for Hong Kong adolescents. Both unique features of the CALES and life events found only in the translated measures are examined. Implications for Chinese research on life stress are discussed.

Adolescent↗
PubMed2000

Getting a life: the emergence of the life story in adolescence.

In the life story, autobiographical remembering and self-understanding are combined to create a coherent account of one's past. A gap is demonstrated between developmental research on the story-organization of autobiographical remembering of events in childhood and of life narratives in adulthood. This gap is bridged by substantiating D.P. McAdams's (1985) claim that the life story develops in adolescence. Two manifestations of the life story, life narratives and autobiographical reasoning, are delineated in terms of 4 types of global coherence (temporal, biographical, causal, and thematic). A review of research shows that the cognitive tools necessary for constructing global coherence in a life story and the social-motivational demands to construct a life story develop during adolescence. The authors delineate the implications of the life story framework for other research areas such as coping, attachment, psychotherapeutic process, and the organization of autobiographical memory.

Adolescent↗
PubMed1997

Experiences of daily life and life quality in men with prostate cancer. An explorative study. Part I.

Eleven men with prostate cancer were randomly chosen and interviewed during an in-patient period at a southern Swedish hospital. The interview focused on functional health status in relation to daily life and life quality. In addition the sense of coherence scale was used, as well as the European Organization or Research and Treatment of Cancer (EORTC) QLQ C-30 questionnaire. The interview findings were analysed from a phenomenological-hermeneutic perspective and interpreted within the concept of transition. The entry to transition was marked by the men when experiencing an altered life continuum in terms of physical and existential fatigue, pain, micturition problems and an altered sex life. The passage phase was marked by descriptions of a new lifestyle where hope was a central internal resource, creating a positive illusion of life in order to endure. Their external resources were wives and family who supported physically (household matters, gardening) and psycho-logically (comfort, encouragement). The exit phase meant continuously adapting to a new life style, living with a slowly deteriorating functional health status, a new sense of dependency on others, daily life routine broken by in-patient hospital periods and contacts with primary health care. Thus the findings pointed more at continuously facing new passages than a stable exit, i.e. an ongoing transition. The areas of life imbalance described may serve as a basis for care assessment and intervention as well as supplying support of the transitional process.

Activities of Daily Living↗
PubMed1996

Why do physicians prefer to withdraw some forms of life support over others? Intrinsic attributes of life-sustaining treatments are associated with physicians' preferences.

Some physicians caring for critically ill patients have preferences for withdrawing some forms of life support over others, even after the decision to withdraw life support has already been made. Past research has attempted to explain these preferences by variations in clinical circumstances. The authors wondered whether differences in the forms of life support themselves might be important, and whether these differences would reveal implicit goals that physicians attempt to achieve. Four hundred fifty-six university-affiliated internists were surveyed and their rank-ordered preferences for withdrawing eight different forms of life support were assessed. The authors then sought to explain these preferences on the basis of intrinsic characteristics of the eight forms of life support determined by an expert panel of critical care physicians. In general, the physicians studied prefer to withdraw forms of life support that are scarce, expensive, invasive, artificial, unnatural, emotionally taxing, high technology, and rapidly fatal when withdrawn. They prefer not to withdraw forms of therapy that require continuous rather than intermittent administration, and forms of therapy that cause pain when withdrawn. Even when a decision has been made to withdraw life-sustaining treatment from a patient, many physicians have preferences for the manner in which this is accomplished. These preferences may reflect perceived intrinsic characteristics of different forms of life support that are consistent across physicians.

Adult↗
PubMedDate not supplied

[An approach to "quality-adjusted life years" quality of life weights from self-assessed health status].

OBJECTIVES: To estimate quality of life weights in Spain for 1987, 1993 and 2001, based on self-assessed health status reported in the National Health Survey. MATERIAL AND METHODS: Quality of life weights were estimated using an ordered probit model. In this model, self-assessed health status was related to the presence of chronic diseases, demographic characteristics, and a random error. Quality of life weights were derived by normalizing the regressors obtained. RESULTS: Quality of life values related to chronic diseases varied depending on the diseases. Pain, limitations, and diseases in the previous 12 months had a greater negative impact on quality of life than did chronic diseases. Quality of life decreased as age increased, and increased as educational level increased. For the same disease and adjusted for age, sex, and educational level, quality of life weights were greater for 1993 and 2001 than for 1987. CONCLUSIONS: The proposed methodology allows quality of life weights to be calculated from health survey data, which has direct application in economic assessment, analysis of socioeconomic health inequalities, and health capital estimation.

Adult↗
PubMed2005

Spiritual struggle: effect on quality of life and life satisfaction in women with breast cancer.

BACKGROUND: Women with breast cancer experience stressors affecting quality of life (QOL) and life satisfaction. Little is known about effects of spiritual struggle as a coping strategy on QOL and life satisfaction. PURPOSE: Examine relationships between spiritual struggle, QOL, and life satisfaction. METHOD: Nonprobablility sample of 100 participants recruited from an Internet Web site with mailed questionnaires. Three instruments were used: breast cancer-specific version of Functional Assessment of Cancer Therapy Scale (FACT-B), Functional Assessment of Chronic Illness Therapy-Spiritual (FACIT-Sp-12) combined for QOL, Negative Coping subscale of Religious Coping (RCOPE) for spiritual struggle, and a single-item measuring life satisfaction. FINDINGS: Small inverse relationships between spiritual struggle, QOL (r = -.36, p < .001), and life satisfaction (r = -.31, p < .001) existed. CONCLUSIONS: Spiritual struggle gives voice to women's questionings implying lower QOL and life satisfaction. IMPLICATIONS: Assessment of and assistance with managing spiritual struggle are necessary to promote QOL and life satisfaction among those facing difficult health problems.

Adaptation, Psychological↗
PubMed1990

[Life style and the right to clean air in public places (RCA). Part 1. The relationship between life style and legal consciousness on smoking regulations].

The right to clean air in public places (RCA) could be a good indicator of health consciousness. We surveyed the consciousness of RCA among residents (20 years of age or older; n = 1500) in city D, a satellite town of Osaka, and examined the relationship between life style and the knowledge aspect of RCA, one of the three aspects of the consciousness concerning RCA. Knowledge of laws concerning the smoking regulations in public places are divided into two categories. One is knowledge of laws concerning general matters, and the other is knowledge of laws concerning concrete matters. Therefore, we get two kinds of relationships. These are the relationship between life style and knowledge of laws concerning general matters, and the relationship between life style and knowledge of laws concerning concrete matters. We examined these two relationships by using Student's t test, and tried to determine the individual life style closely related to the scores for knowledge of laws with the chi-square test. We got following results. (1) The relationship between life style and knowledge of laws concerning general matters Knowledge scores got higher as the life style scores (HPI) became higher. This trend could be detected in all four subgroups. The scores of male subgroups were generally higher than those of female subgroups. This could be construed as follows: those who take care of their physical health have a lot of knowledge of laws concerning smoking regulations. (2) The relationship between life style and knowledge of laws concerning concrete matters Knowledge scores got lower as the life style scores became higher. This trend was almost the same in all four subgroups. The scores of male groups were generally higher than those of female subgroups. This trend could be construed as follows: men and women whose HPI is lower get more opportunities to be in the public places where smoking is totally allowed (e. g., bars) irrespective of their smoking status.

Adult↗
PubMed2002

Quality of life of Do-Not-Resuscitate (DNR) patients: how good are physicians in assessing DNR patients' quality of life?

QUESTIONS UNDER STUDY: To assess 1) the impact of quality of life evaluation on the implementation of Do-Not-Resuscitate (DNR) orders by physicians, 2) the accuracy of physicians' estimation of DNR patients' quality of life. METHODS: A 10-month prospective clinical study in a community hospital including 255 DNR patients and 9 physicians in postgraduate training. Outcomes of interest were the influence of quality of life on the DNR decision and the assessment from patients and physicians of five different components related directly or indirectly to quality of life: mental (the Mini Mental State Examination), physical (the Activities of Daily Living) and social (Framingham Disability), degree of pain (visual analogical scale of pain) and of depression (Geriatric Depression Scale). RESULTS: Quality of life intervened in more than 70% of the DNR decisions. However, physicians underestimated quality of life components of DNR patients (Kappa <0.4 for each functionality). Severe depression, social isolation and physical dependence influenced negatively patients' perception of their quality of life (p <0.01). CONCLUSION: Physicians often (71%) rely on the assumed quality of life of their patients in their DNR decision but unfortunately tend to underestimate it. Greater involvement of patients in the DNR decision could improve quality of care.

Decision Making↗
PubMed2002

The effect of erectile dysfunction on quality of life: psychometric testing of a new quality of life measure for patients with erectile dysfunction.

PURPOSE: We assessed the psychometric properties of the newly developed Erectile Dysfunction Effect on Quality of Life (ED-EQoL) instrument for quantifying the effect of erectile dysfunction on quality of life. MATERIALS AND METHODS: The questionnaire was assessed in a cohort of 283 men recruited from 11 centers in the United Kingdom. Internal consistency was examined by Cronbach's alpha, test-retest reliability was determined by administering the instrument on 2 occasions 2 weeks apart without treatment in the interim, construct validity was assessed by comparison with other quality of life measures and responsiveness was evaluated by comparing the change in the ED-EQoL after treatment with change in other measures. RESULTS: The ED-EQoL was simple to complete and captured wide variation in quality of life. It demonstrated good internal consistency and reliability, and generally correlated in an expected manner with other quality of life measures. Correlation with initial erectile function was relatively low but the change in function after treatment was reflected by the change in quality of life. CONCLUSIONS: When assessing erectile dysfunction in clinical practice or research, it is important to consider the effect on quality of life in addition to function. To our knowledge the ED-EQoL is the first erectile dysfunction specific quality of life instrument developed and extensively validated according to accepted principles of questionnaire design. Combined with a measure of erectile function its use is recommended in routine clinical practice and in research to provide a holistic approach to the assessment of erectile dysfunction and its treatment.

Erectile Dysfunction↗
PubMed1976

Calendar life-span versus fission life-span of Paramecium aurelia.

The hypothesis that paramecia use fissions, not days, to measure length of cell life-span was investigated. Parallel cell lines were grown at 27 C and at 24 C. The daily fission rate of the cells at 24 C was lower than at 27 C. If the cells count fissions, not days, the life-span in fissions should remain unchanged, whereas the cell life-span in days should increase in the lines with reduced daily fission rate. The results showed a significant increase in cell life-span in days when the cells were cultivated for 70-100% of their life cycle at 24 C. The life-span as measured by fissions, however, remained unchanged regardless of the time of the life cycle when cells were shifted to 24 C. The data indicate that, as a model system for cellular aging, paramecia are comparable to cells which use cell doublings to measure life-span.

Animals↗
PubMed2002

Measurement of quality of care and quality of life at the end of life.

PURPOSE: Consumers and providers demand better indicators for quality of care and quality of life at the end of life. This article presents recommendations for advancing the science of measurement at end of life. DESIGN AND METHODS: The authors reviewed the extant literature and applied the Institute of Medicine's conceptual framework for national health care quality to end-of-life care and research. RESULTS: Ten recommendations were developed, charting a course for research that will improve the quality of care delivered and, consequently, the quality of life experienced at life's end. IMPLICATIONS: Measurement bridges the conceptual and operational levels of scientific research, clinical care, and quality improvement. Although a large amount of psychometric groundwork has been laid in the field of end-of-life research, the next wave of studies will ideally take measurement at end of life to a higher level of rigor and precision.

Data Collection↗
PubMed1997

[End of life and termination of life: opinions of elderly persons with health problems].

OBJECTIVE: To determine the views of elderly persons with physical limitations about a number of aspects of the end stage of life and termination of life. DESIGN: Enquiry. SETTING: University of Groningen, the Netherlands. METHOD: An enquiry was conducted in 1995 among 575 elderly (429 females, 146 males; age 57-99 years; 281 living alone) with physical restrictions (mostly heart disease, hypertension, rheumatism or other articular diseases). The group had been selected from the 'Groningen longitudinal aging study'. The respondents were asked (a) what they thought about euthanasia, (b) whether they worried about the end stage of life, (c) whether they were afraid of death and how much they were 'preoccupied with death'. For the last-mentioned two questions a visual analogue scale was used. RESULTS: Almost one-third of the elderly were not preoccupied with death and over half were not afraid of death. Very few scored high on these scales. Respondents' views about the acceptability of active termination of life varied greatly: almost half were of the opinion that their life had to be terminated once they themselves had developed complete dementia. Regarding the end stage of life, respondents mostly worried about being a burden to others, being completely dependent on others, having to say goodbye to their loved ones and having to suffer greatly. Elderly persons with poorer health were more preoccupied with death and worried more about the problems of the end stage of life. CONCLUSION: Most of those interviewed were not greatly preoccupied with or afraid of death. They did worry, however, about the problems that might be associated with the end stage of life.

Aged↗
PubMed2000

Uncertain lifetime, life protection, and the value of life saving.

The analytic innovation is treating life's end as uncertain, and life expectancy as partly the product of individuals' efforts to self-protect against mortality and morbidity risks. The demand for self-protection is modeled in a stochastic, life-cycle framework under alternative insurance options. The model helps explain the trend and systematic diversity in life expectancies across different population groups, as well as the wide variability in reported "value of life saving" estimates. The analysis yields a closed-form solution for individuals' value of life saving that is estimable empirically. It reflects the impacts of specific personal characteristics and alternative insurance options on both life expectancy and its valuation.

Humans↗
PubMed1993

Life activities and life quality of heroin addicts in and out of methadone treatment.

The focus of the present study was the daily life activities and self-perceived health and life quality of heroin addicts both in and out of methadone treatment, based on 219 addicts followed for 8 months after treatment entry. The majority of outcome evaluations of methadone treatment have focused on the "hard" outcome criteria of drug use levels, criminal activities, and employment. The present study, in contrast, addressed how heroin addicts live on a daily basis, and whether being chemically supported on methadone was associated with changes in daily life activities and perceived quality of life. A six-dimensional measurement model of daily life activities, perceived health, and life quality was established. Substantial changes on the dimensions in a positive direction were found in the 2 months just following treatment entry. Changes in daily life activities (e.g., spending more time with the family, attending to the home) may be early indicators of the impact of methadone treatment that precede changes on the usual "hard" criteria (e.g., obtaining legal employment).

Activities of Daily Living↗