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PubMed1993

Effect of cisapride therapy for severe dyspepsia on gastrointestinal symptoms and quality of life.

Quality of life measures have received little attention in evaluation of therapy for dyspepsia. To examine the effect of cisapride on gastrointestinal symptoms and quality of life measures, we studied eight patients with chronic, severe dyspepsia, before and after therapy with cisapride (20 mg three times daily) for 12 months. Gastrointestinal (GI) Total Symptom Score (TSS), Overall Patient Assessment (OPA), and quality of life by both trait (Minnesota Multiphasic Personality Inventory (MMPI)) and physical function (Sickness Impact Profile (SIP)) were measured at base line and at month 12 of cisapride therapy. Results showed significant improvement in TSS, OPA, and the MMPI Depression and Anxiety scales (all, p < 0.05). Improvement in the SIP physical dimension score approached significance (p = 0.065). We conclude that, in this group of patients with severe dyspepsia, both GI symptoms and quality of life measures improved with 12 months of cisapride therapy. These quality of life measures may prove useful in evaluating the efficacy of drug treatment for dyspepsia.

Adult↗
PubMedDate not supplied

[Impact of therapeutics on sex. Value of measurements of quality of life].

Quality of Life is a new clinical dimension with the objective of evaluating the impact of a disease or of a treatment on patients well being. Quality of life is a measure of increasing interest. It is a global and cumulative measure, relevant for the evaluation of the therapeutic benefit of a treatment. It can be measured through "specific" or "generic" tools. Very few experimental literature exploring the impact of pathologies over the sexual sphere exists today. Only generic scales have been used, because no specific scale has been developed up to now. The impact of certain pathologies such as depression or diabetes has been documented, but very little objective information exists concerning the sexual repercussion of the chronic use of drugs (anti depressive, anxiolytics). Sexual quality or life as a risk factor for disease development is also dimension that has been explored, but only superficially. In a general way, no evidence exists concerning a reel correlation link between pathologies, treatments and sexual quality of life and this specific dimension of the quality of life still remains to be explored further.

Drug Therapy↗
PubMed2003

An assessment of the importance of pad testing in stress urinary incontinence and the effects of incontinence on the life quality of women.

Our objectives in this study were to determine the severity of incontinence using pad testing and the effects of incontinence on the life quality of women with stress incontinence. Fifty women with a diagnosis of stress urinary incontinence were selected for the study. The Symptom Severity Index (SSI) and Symptom Impact Index (SII) were used to determine the severity and impact of incontinence. Afterwards the women were given a 1-h pad test. According to the pad tests 38% of women suffered severe to very severe incontinence. Women who showed severe incontinence on pad testing scored high in the SSI; on the other hand, no relationship was found between SII and pad test indicators. It was also observed that both SSI and SII scores increased with increasing age of the women (SSI: r=0.29, P<0.05; SII: r=0.30 P<0.05). It may therefore be concluded that the severity of incontinence makes no difference in the effects of incontinence on the life quality of women.

Age Factors↗
PubMed2005

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

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

Adult↗
PubMed2005

Psychometric properties of the Dermatology Life Quality Index (DLQI) in 900 Italian patients with psoriasis.

The Dermatology Life Quality Index (DLQI) is one of the most frequently used questionnaires to evaluate the impact of dermatological diseases on patients' lives. This study aimed to assess the reliability and validity of the instrument and to test its unidimensionality in a large sample of patients with psoriasis (n=976) hospitalized at IDI-IRCCS, Rome, Italy. Nine hundred patients completed the DLQI, the Psoriasis Disability Index (PDI) and the Skindex-29 (response rate 92%). The internal consistency of the DLQI was high (Cronbach's alpha=0.83). Evidence of convergent validity was provided by high (r=0.64-0.81) correlations between the DLQI, the PDI, and the functioning and emotions scales of Skindex-29. Exploratory factor analysis indicated the presence of four different principal common factors. Confirmatory factor analysis showed a clear second-order factor structure, with a homogeneous second-order factor underlying the four primary-surface factors. This study confirms that the DLQI is a reliable and valid instrument to assess patient-perceived impact of skin disease. Also, it supports the unidimensionality of the DLQI and hence corroborates the common practice of using the total score.

Adolescent↗
PubMed1987

Utility approach to measuring health-related quality of life.

Quality of life is a broad concept that incorporates all aspects of an individual's existence. Health-related quality of life is a subset relating only to the health domain of that existence. The utility approach can be used to measure a single cardinal value, usually between 0 and 1, that reflects the health-related quality of life of the individual at a particular point in time. The utility approach is founded in modern utility theory, a normative rational model of decision-making under uncertainty. The measurement techniques that have been used include standard gamble, time trade-off, and rating scales. The techniques are described in the paper and compared in terms of their acceptability to subjects, reliability, precision, validity, and ease of use. It is concluded that the utility approach is beyond the experimental stage, and is now a viable alternative for investigators to use in measuring health-related quality of life.

Decision Making↗
PubMedDate not supplied

Looking into the factors affecting renal patients' quality of life.

Quality of life, according to Horquist is "the extent to which one's needs are satisfied, in the context of physical, psychological, social and environmental conditions" (I). Self-esteem is the basic element of a good quality of life. Health-related quality of life consists of a number of components; including family relationships, friendships, finances, physical and psychological status, adjustment to therapy and feeling of security during the treatment.

Adaptation, Psychological↗
PubMed1998

Methods of assessing the impact of climacteric complaints on quality of life.

Quality of life is an important outcome that reflects the way patients feel and function. Assessing the impact of a condition on quality of life is particularly relevant in symptomatic conditions such as the menopause. A range of measurement tools are available for monitoring how symptoms, typical of the climacteric period, affect patients with regard to their well-being, sleep disturbance, other somatic symptoms, cognitive function and sexual functioning. However, to gain a valid assessment of quality of life and the effects of treatment in the menopause, only standard and well-validated measurement tools should be used. The appropriateness of relying on the use of psychiatric rating scales to assess mood is questionable. Results obtained from an increasing number of controlled clinical studies indicate that treatment with oestrogen, in addition to alleviating vasomotor symptoms, can substantially improve patients' quality of life.

Female↗
PubMed2004

Swedish mothers and fathers of a child diagnosed with cancer--a look at their quality of life.

Quality of life was investigated among Swedish mothers (n = 118) and fathers (n = 83) of children on (n = 57) and off (n = 68) cancer treatment. Parents completed the Göteborg Quality of Life Instrument, measuring (a) burden of 30 symptoms organized as follows: depression, tension, head, heart-lung, metabolic, musculo-skeletal, and gastrointestinal-urinary symptoms, and (b) experience of well-being with regard to 18 items organized as follows: physical, social, and mental well-being. Fathers reported higher mental well-being than mothers and more mothers than fathers reported symptoms of depression. Within the same family (n = 70), mothers reported lower mental well-being and more symptoms than fathers. Parents of children on treatment (n = 92) reported lower social and mental well-being and more symptoms of depression than parents with children off treatment (n = 101). The findings suggest that fathers experience a better quality of life than mothers and that parents of children off treatment enjoy a better quality of life than parents of children on treatment.

Adaptation, Psychological↗
PubMed2004

Evaluation of the Asthma Life Quality test for the screening and severity assessment of asthma.

BACKGROUND: Asthma Life Quality (ALQ) test, a 20-question questionnaire developed by the American College of Allergy, Asthma and Immunology, has been shown to be useful for asthma diagnosis. We aimed to determine the relation between ALQ scores and (a) diagnosis of asthma; (b) physician's classification of asthma severity according to National Institutes of Health/Global Initiative for Asthma (GINA). METHODS: Standard translation and cultural adaptation to Portuguese was performed. Patients self-administered the ALQ in the waiting room; the attending allergist classified them, blindly for the test. The scores of nonasthmatics were compared with those of asthma patients. Asthma patients were analyzed in two severity groups: intermittent and mild persistent asthma (IMPA), and moderate and severe persistent asthma (MSPA); sensitivity, specificity, positive and negative predictive values were calculated and receiver operating characteristic curve plotted. Logistic regression analysis models were computed. RESULTS: From 283 patients, 237 tests were analyzed. Non-asthmatic patients ALQ scores (mean +/- SD) were 6 +/- 4 and, for asthmatics, 10 +/- 5 [mean difference 4.6 (95%CI 3.3-5.9)]. The odds of positive diagnosis increased 1.27 times (95%CI 1.17-1.38) for each one-unit increase in the test. For asthma severity ALQ scores were 9 +/- 4 for IMPA, 15 +/- 3 for MSPA [difference 6.0 (95%CI 4.8-7.1)]; with a sensitivity of 88% and specificity of 74% for a score of 12. The odds of MSPA increased 1.49 times (95%CI 1.28-1.74) per unit increase in ALQ. CONCLUSIONS: ALQ can help both to identify patients with asthma and to differentiate those more likely to have moderate/severe asthma. These are relevant characteristics for the possible use of this simple, self-administered questionnaire in the assessment of asthma patients needing additional medical management.

Adolescent↗
PubMedDate not supplied

Life quality assessment of breast cancer patients receiving adjuvant therapy using incomplete data.

Previous research on the effects of adjuvant treatment for women with operable breast cancer focused exclusively on disease-free and overall survival. In this study we evaluate life quality of premenopausal node-positive breast cancer patients receiving adjuvant chemotherapy for at least three months. For the first time, a modified latent variable model is used to assess treatment outcome in a prospective clinical trial. This poses a number of econometric problems which did not occur in the preceding studies. One of them is how to deal with patients whose records are incomplete. The data are provided by the International Breast Cancer Study Group (study VI). The results indicate that the lowest dose treatment improves life quality faster than the remaining three alternatives. At the end of the 24 months observation period no significant differences between the four treatment options remain. Although the lowest dose treatment is also the least costly no definite conclusion regarding cost-effectiveness can be drawn at this stage since survival data is not yet available.

Adult↗
PubMed2004

[Impact of special treatment methods on life quality and lifespan of patients with widespread forms of ovarian cancer].

The experience of the treatment of 138 patients with widespread forms of ovarian cancer within the period of 1998 to 2002 is described. The efficacies of the palliative treatment methods in improvement of the life quality and increase of the lifespan of the patients were compared. The results showed that combination of the chemotherapy with the subsequent citoreductive surgical interventions was advantageous. Such a treatment provided not only increase of the average lifespan of the patients from 13 to 23 months but also improvement of the life quality in 77.8% of the cases.

Combined Modality Therapy↗
PubMed1991

Long-term sick-listing, medical rehabilitation and life quality change: a patient evaluation.

This evaluation of the health service at one of the hospitals of the National Insurance Board in Sweden is primarily based on the perspective of the patient. One interview group of 32 patients (I-group) made life quality ratings before-after their hospital stay. In responding to a postal questionnaire one year after discharge from hospital, another group of 93 former patients (Q-group) made parallel self-ratings. Due to prolonged sick-listing, the patients had been admitted to the hospital for rehabilitation/examination according to paragraph 2:11 in the general insurance law. The basis for their sick-listing was hereby critically reviewed. Within the framework of additional examinations (interview and structured general questions), more than 40% of the respondents stated that the hospital stay was mainly satisfying and a great majority appreciated the nursing care. However, the self-ratings showed that the patients did not ascribe any particularly great significance to the hospital stay. In the short term, it even seemed to have a certain negative impact on the life quality of the patients. No obvious positive bias seems to be built into the ratings. Thus, the assessment package applied may also work well in similar evaluative settings.

Adult↗
PubMed1991

Palliation and life quality in lung cancer; how good are clinicians at judging treatment outcome?

A recent trial by the MRC Lung Cancer Working Party used physician assessments to compare two palliative schedules of radiotherapy in lung cancer. A prospective study has been undertaken on a subset of these trial patients to see how physician assessments of symptomatic relief and general condition correlate with patient perception of therapeutic response. In 40 patients followed up monthly from presentation until close to death, good agreement was found between doctors and patients on change in specific physical symptoms and overall physical condition. Doctors were poor judges of life quality at presentation but appeared able to identify relative improvement or deterioration in overall quality of life. In conclusion, physician assessments may constitute valid end-points for radiotherapy trials comparing palliative schedules in lung cancer.

Aged↗
PubMed2003

Dermatology Life Quality Index: influence of an illustrated version.

BACKGROUND: An illustrated version of the Dermatology Life Quality Index (DLQI) was developed in order to improve the ease with which this standard questionnaire is answered. OBJECTIVES: To compare the illustrated version with the text-only version of the DLQI. METHODS: The two versions were administered to 206 patients attending Dermatology outpatient clinics. The time taken to complete either the illustrated or the text-only version was noted in 52 additional patients. RESULTS: One hundred and ninety-one of 206 patients completed both questionnaires satisfactorily. Their mean DLQI scores were 6.4 (median 4.0, lower quartile 1.0, upper quartile 11.0) for the illustrated version and 6.3 (median 4.0, lower quartile 1.0, upper quartile 10.0) for the text-only version. For the 98 patients who answered the illustrated version first, the mean DLQI scores were 6.9 (median 4.0, lower quartile 1.9, upper quartile 11.9) for the illustrated version and 6.4 (median 4.0, lower quartile 1.8, upper quartile 11.0) for the text-only version. For the 93 patients who answered the text-only version first, the mean DLQI scores were 5.9 (median 4.0, lower quartile 1.7, upper quartile 10.2) for the illustrated version and 6.2 (median 5.0, lower quartile 0.5, upper quartile 9.5) for the text-only version. The median time taken to complete the text-only version was 124 s (mean +/- SD 126 +/- 65, n = 27) and 88 s (mean +/- SD 101 +/- 52, n = 25) for the illustrated version (P = 0.08). There was a very close correlation (r = 0.98) between the scores of the text-only and the illustrated versions; 82.2% of patients either scored the same or had a DLQI score difference of only 1. One hundred and seven (59.8%) patients preferred using the illustrated version and 66 (36.9%) preferred the text-only version. One hundred and four (57.5%) found the illustrated version easier to use. CONCLUSIONS: The illustrated version was superior to the text-only version in terms of patient preference and ease of use, but it was not possible to demonstrate exact equivalence between the two versions.

Adolescent↗
PubMedDate not supplied

[Tendencies of life quality in the scientific nursing production].

This study is characterized by bibliographical research of life quality, undertaken the BDENF and LILACS databases, at the BIREME Virtual Library. Nursing magazines rated as B and C international and B national were also researched by QUALIS/CAPES. The results obtained indicated that the production of knowledge on the topic being discussed is limited to situations of health problems, especially in specific groups. The production is still restricted to graduate courses, which limits the circulation among its peers.

Bibliometrics↗
PubMed1994

How can we measure individual quality of life?

Quality of life is widely discussed today as an important outcome variable in health care. The scientific interest focussing during most of the 20th century on illness enlarges its scope and includes well-being as an important goal and concept. Hence, quality of life (QoL) as a measure of well-being was included in many studies, but mostly determined by the purpose of the study and the external investigators. In order to weigh subjective needs and desires adequately, the Schedule for Evaluation of Individual Quality of Life (SEIQoL) was developed. This analysis is obtained from parameters chosen by the explored subject or patient himself. With the help of structured questions, the relevant dimensions of well-being for a given person are identified and put into context to the actually experienced situation. This method allows the sensitive detection of changes over time, and as a consequence of changes in life circumstances. It goes beyond the simple determination of health status and rather reflects the current state of the person as a whole.

Female↗
PubMed1997

Defining and applying the concept of quality of life.

Quality of life has been increasingly used as a scientific concept in literature embracing a wide range of target groups and populations as a whole. Conceptualizations vary, but there is much common ground concerning the domain content embraced by the term. Commentators are also clear that account needs to be taken of both objective life conditions and subjective personal appraisals, and the fact that what is important to each person varies. A synthesis of these perspectives provides a model of quality of life which integrates objective and subjective indicators and individual values across a broad range of life domains. Life domain issues may be categorized within six areas: physical, material, social, productive, emotional and civic well-being. Whatever its precise specification, the model is put forward as a framework for organizing measurement relevant to the quality of life concept rather than as a blueprint for deriving the ultimate single instrument. There is still a need for methodological flexibility. The pre-eminent aim is to relate the fine grain of the experience of individuals with disability to that of the wider world.

Humans↗