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PubMedDate not supplied

Effect of smoking, alcohol, and depression on the quality of life of head and neck cancer patients.

This pilot study examined the relationship between smoking, alcohol intake, depressive symptoms and quality of life (QoL) in head and neck cancer patients. A questionnaire on smoking, alcohol, depressive symptoms and QoL was distributed to head and neck cancer patients (N=81). Over one-third (35%) of the respondents had smoked within the last 6 months, 46% had drunk alcohol within the last 6 months and 44% screened positive for significant depressive symptoms. About one-third (32%) of smokers were interested in smoking cessation services and 37% of patients with depressive symptoms were interested in depression services. However, only 9% of those who drank alcohol expressed interest in alcohol services. Smoking was negatively associated with five scales of the SF-36V including Physical Functioning, General Health, Vitality, Social Functioning, and Role-Emotional Health. Depressive symptoms were negatively associated with all eight scales on the SF-36V and all four scales of the Head and Neck Quality of Life instrument. Surprisingly, alcohol was not found to be associated with any of the QoL scales. While smoking, alcohol intake and depression may be episodically treated, standardized protocols and aggressive intervention strategies for systematically addressing these highly prevalent disorders are needed in this population.

Adult↗
PubMed1998

Serotonergic function in social phobia: comparison to normal control and obsessive-compulsive disorder subjects.

Eighteen patients with social phobia, 21 normal control subjects, and 42 obsessive-compulsive disorder (OCD) control subjects were challenged with single doses of the partial serotonin agonist oral m-chlorophenylpiperazine (m-CPP) and placebo. Social phobics did not significantly differ from normal or OCD control subjects in prolactin response to m-CPP. There was a significant difference across groups in cortisol response to m-CPP, such that female social phobics had more robust cortisol responses to the m-CPP challenge. Pairwise comparisons only reached trend significance, perhaps due to the relatively small sample sizes. This study offers preliminary evidence for serotonin dysfunction in social phobia, particularly in female social phobics, but needs to be replicated in a larger sample size.

Adult↗
PubMedDate not supplied

[Health indicators in urban areas. Variations in function of social coherence of the geographic areas used].

The detection of health inequalities in the urban environment and their magnitude depends to a great extent on the internal social coherence of the geographical division used. Using an existing social map of Alicante which divides the city into Basic Units for Social Intervention (BUSI), we have compared the distribution of an indicator with wellknown relationship with the socio-economic level such as Low Birth Weight, using both the BUSI and the municipal districts as analysis units. The data of the newborn were obtained from the records of the Hospital of Alicante corresponding to the years 1985, 1986 and 1987, analysing the 177 Low Birth Weights of the 7,728 born within the period. Using the BUSI we found a dose-response relationship between the socio-economic level and the LBW frequency with a range varying from 86.3 to 123.2. Using the municipal districts, the range varied from 62.5 to 159.6. We conclude that, although the geographical divisions with internal social coherence are better to detect health inequalities, municipal districts can be an analysis unit of easy access and useful for describing inequalities in the cities.

Health Status Indicators↗
PubMed2003

A review of psychosocial interventions in infertility.

Counselling has been strongly recommended by numerous governmental, medical and community associations to help infertile people. The purpose of this review was to determine whether psychosocial interventions improved well-being and pregnancy rates, and to identify the kinds of interventions that were most effective. A systematic search identified all published and unpublished papers in any language and any source that (1) described a psychosocial intervention and (2) evaluated its effect on at least one outcome measure in an infertile population. A total of 380 studies met the first criteria but only 6.6% (n=25) of these were independent evaluation studies. Analysis of these studies showed that psychosocial interventions were more effective in reducing negative affect than in changing interpersonal functioning (e.g., marital and social functioning). Pregnancy rates were unlikely to be affected by psychosocial interventions. It was also found that group interventions which had emphasised education and skills training (e.g., relaxation training) were significantly more effective in producing positive change across a range of outcomes than counselling interventions which emphasised emotional expression and support and/or discussion about thoughts and feelings related to infertility. Men and women were found to benefit equally from psychosocial interventions. Directions for future research on the evaluation of psychosocial interventions are discussed.

Counseling↗
PubMed1998

Tests of data quality, scaling assumptions, and reliability of the SF-36 in eleven countries: results from the IQOLA Project. International Quality of Life Assessment.

Data from general population samples in 11 countries (n = 1483 to 9151) were used to assess data quality and test the assumptions underlying the construction and scoring of multi-item scales from the SF-36 Health Survey. Across all countries, the rate of item-level missing data generally was low, although slightly higher for items printed in the grid format. In each country, item means generally were clustered as hypothesized within scales. Correlations between items and hypothesized scales were greater than 0.40 with one exception, supporting item internal consistency. Items generally correlated significantly higher with their own scale than with competing scales, supporting item discriminant validity. Scales could be constructed for 93-100% of respondents. Internal consistency reliability of the eight SF-36 scales was above 0.70 for all scales, with two exceptions. Floor effects were low for all except the two role functioning scales; ceiling effects were high for both role functioning scales and also were noteworthy for the Physical Functioning, Bodily Pain, and Social Functioning scales in some countries. These results support the construction and scoring of the SF-36 translations in these 11 countries using the method of summated ratings.

Cross-Cultural Comparison↗
PubMed1999

Rehabilitation of schizophrenic and other long-term mentally ill patients. Results from a prospective study of a comprehensive inpatient treatment program based on cognitive therapy.

A total of 28 long-term mentally ill patients, the majority schizophrenic, treated with cognitive therapy in the context of milieu-therapy and group therapy, were investigated at admission and discharge with regard to changes in symptomatology, quality of life, global functioning, need for medication, and perceived target complaints. The results showed a significant relief in perceived burden of illness and an improvement in quality of life. A better pre-admission functioning with regard to social functioning, occupational function, and symptoms predicted a more favourable outcome.

Adult↗
PubMed1997

Relation between academic achievement and social adjustment: evidence from Chinese children.

A sample of children in Shanghai, P.R. China, initially aged 10 and 12 years, participated in this 2-year longitudinal project. Information on academic achievement and indexes of social adjustment, including social competence, aggression, social inhibition, leadership, and peer acceptance, was collected from multiple sources. It was found that academic achievement predicted children's social competence and peer acceptance. In turn, children's social functioning and adjustment, including social competence, aggression-disruption, leadership, and peer acceptance, uniquely contributed to academic achievement. These results generally supported the "reciprocal effects" model concerning the relations between academic achievement and social adjustment (S. P. Hinshaw, 1992).

Achievement↗
PubMed1985

On the self-serving function of social anxiety: shyness as a self-handicapping strategy.

We tested the hypothesis that socially anxious or shy individuals use their anxiety symptoms as a strategy to control attributions made about their performances in social-evaluative settings (i.e., self-handicapping strategies). Specifically, we predicted that trait-socially anxious or shy persons would report more symptoms of social anxiety in an evaluative setting in which anxiety or shyness could serve as an excuse for poor performance than would individuals in (a) an evaluative setting in which shyness was precluded as an excuse or (b) a nonevaluative setting. Furthermore, we predicted that this self-protective pattern of symptom reporting would not occur for individuals who were not trait-socially anxious because these persons would not commonly use such symptoms as a self-handicapping strategy. Results supported these predictions for male subjects, but not for female subjects. Sex differences in the strategic use of shyness are discussed in relation to other research on sex differences in the etiology and correlates of social anxiety.

Anxiety↗
PubMed2005

Exploring age differences in the stress-buffering function of social support.

The purpose of this study is to see if there are age differences in the relationship between chronic financial strain, emotional support, and life satisfaction among people aged 65 and older. Data from a nationwide survey of older people (N = 1,518) indicate that emotional support tends to reduce the noxious effects of economic problems on life satisfaction for the sample as a whole. However, the findings further reveal that the potential benefits of emotional support arise primarily among the oldest-old. In contrast, emotional support does not offset the negative effects of financial strain on life satisfaction among the young-old.

Affect↗
PubMed1996

Substitute child care at different ages: relationship to social-emotional functioning in preschool.

In a pilot study based on parent and teacher ratings, the number of hours spent in substitute care during the first three years of life correlated with children's levels of behavior problems in preschool. The developmental period from 18 to 24 months was the most sensitive to the use of substitute care, and boys were more negatively affected than girls. The child-adult ratio and setting were not significant factors. Results suggest reconsideration of parental leave policies and direction for future research.

Age Factors↗
PubMed1997

Quality of life following bone marrow transplantation for breast cancer: a comparative study.

As more women are treated with bone marrow transplantation (BMT) for breast cancer, there is growing interest in quality of life (QOL) following treatment. Although there have been some clinical studies of QOL following BMT, this area has received little systematic attention. In particular, it is unclear how QOL for women treated with BMT for breast cancer differs from that which might be expected for 'healthy' women of about the same age. To address this issue, we compared QOL reported by women treated with autologous BMT for breast cancer with that of a group of women of similar age with no history of cancer. In addition, we examined the relationship of demographic factors, medical factors, and self-reported symptom prevalence, severity, and distress to QOL in post-BMT patients. All participants completed the SF-36 Health Survey developed from the Medical Outcomes Study (SF-36). Post-BMT patients also completed the ECOG Performance Status Rating Scale (PSR) and the Memorial Symptom Assessment Scale (MSAS). Results indicated that, compared to the women with no cancer history, post-BMT patients reported significantly impaired physical functioning, physical role functioning, general health, vitality, social functioning, and emotional role functioning. Impaired QOL following BMT was significantly associated with lower income, a longer time to engraftment, longer hospital stay, poor performance status, and greater symptom prevalence, severity, and distress. The problems identified in this study may be important targets for intervention when trying to improve QOL following BMT.

Adult↗
PubMed1998

Quality of life in adult patients with acute myeloid leukemia receiving intensive and prolonged chemotherapy -- a longitudinal study.

Intensification of treatment for acute myeloid leukemia (AML) in adult patients resulted in a substantial improvement in long-term prognosis. Therefore, the assessment of quality of life (QL) of patients undergoing treatment is of growing interest. This study was designed to evaluate QL in patients with AML treated according to the protocol of the German AML-Cooperative Group (Münster, Germany). The EORTC QLQ-C 30 questionnaire was used to analyze QL throughout therapy, evaluating defined specific parameters at 12 different time-points. Sixty-one patients were recruited within the first 30 months of the study. Those 28 patients who have completed the course of inpatient treatment (n=28) are evaluated for changes in the conceptually distinct QL domains: Physical Functioning (P<0.001), Role Functioning (P=0.001), Emotional Functioning (P < 0.001) and Social Functioning (P=0.007) improve significantly from beginning of chemotherapy to the end of inpatient treatment. Individual assessment of Global Health Status and Subjective QL improves significantly over the same time (P< 0.001). At the end of inpatient treatment patients suffer significantly less from fatigue, nausea/emesis, loss of appetite and sleep disturbance (P < 0.001). Although most patients with AML eventually relapse, the evaluation of QL in patients undergoing treatment shows that subjective benefit outweighs the adverse effects of antileukemic therapy.

Acute Disease↗
PubMed1998

Prospective analysis of quality of life in patients following infrainguinal reconstruction for chronic critical ischaemia.

BACKGROUND: The aims of this prospective study were to analyse the health-related quality of life (QOL) changes associated with infrainguinal arterial reconstruction for chronic critical limb ischaemia (CLI) and to assess the impact of graft patency and limb salvage. METHODS: Fifty-five consecutive patients, 28 women and 27 men of median age 71 (range 41-86) years, undergoing infrainguinal arterial reconstruction for CLI, consented to participate in the study. QOL was assessed using the Short Form 36 (SF36) health survey questionnaire, which was completed before and at 1, 3, 6 and 12 months following surgery. Graft patency was assessed by duplex imaging at the same postoperative intervals. RESULTS: CLI severely impaired QOL. Cumulative graft patency at 1, 3, 6 and 12 months after surgery was 82, 78, 76 and 64 per cent respectively. Reconstruction resulted in significant improvements in the SF36 domains Physical Functioning, Pain, Vitality and Social Functioning (P< 0.01). With a patent graft these improvements began soon after surgery and were maintained for the 12 months studied. Following irredeemable graft occlusion, patients who had secondary amputation also described some QOL improvements. CONCLUSION: A patent graft following infrainguinal arterial reconstruction for critical ischaemia results in an immediate and lasting improvement in health-related QOL.

Activities of Daily Living↗
PubMed2004

Development and validation of a measure of disease-specific quality of life in young children with haemophilia.

No disease-specific tool for measuring health-related quality of life (HRQL), an important outcome when assessing medical treatment, has been developed for children with haemophilia. The goal of this study was to develop a parent-administered questionnaire for evaluating quality of life (QOL) in paediatric haemophilia patients between 2 and 6 years of age. After interviewing physicians (5), nurses (5) and parents (10) of children with haemophilia aged between 2 and 6 years, 92 questions were developed and pilot-tested with parents (44) of children with haemophilia to create a 39-question instrument that assessed somatic symptoms, physical functioning, sleep disturbance, stigma, social functioning, fear/resentment, mood/behaviour, restrictions, treatment upset, haemophilia concern and energy level. Reliability and validity were evaluated with 103 parents of children with haemophilia and parents of 249 age- and gender-matched healthy children. Estimates of scale reliability (internal consistency) for eight multi-item scales ranged from 0.73 to 0.94. Results showed construct validity (correlations with age, severity of haemophilia, treatment type, days absent and days confined to bed) and correlated with two general, paediatric quality-of-life instruments (Impact on Family Scale and Functional Status II). Discriminant validity was demonstrated by comparing scores between patients receiving/not receiving prophylactic therapy and between haemophilia patients and healthy controls. This disease-specific HRQL measure should be of use in clinical trials and general practice to better understand disease and treatment impacts in young children with haemophilia.

Child↗