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PubMed1978

Social adjustment by self-report in a community sample and in psychiatric outpatients.

Data are presented on social functioning derived from a self-report social adjustment scale (SAS-SR) administered to 774 subjects including a community sample and three psychiatric outpatient populations: acute depressives, alcoholics, and schizophrenics. This self-report scale derives from an interview form and was developed and tested on depressed outpatients. Since its publication, it has been used in populations other than depressives including other psychiatric patients, nonpsychiatric patients, and nonpatients. The purpose of this paper is to make data available to other investigators on results of this self-report social adjustment scale in a broad range of subjects and to describe further the psychometric properties, limitations, and utility of the scale. Findings show that the scale has wide applicability in a range of subjects but that certain cautions should be followed in using it with chronically impaired psychiatric populations who may not be involved in the major roles assessed by the scale.

Acute Disease↗
PubMed2002

Functional outcome and radiographic correction after spinal osteotomy.

STUDY DESIGN: A prospective clinical trial to study the radiographic parameters and functional outcome in patients undergoing spinal osteotomy. OBJECTIVES: To determine whether correction of specific radiographic parameters is associated with improved functional outcome. SUMMARY OF BACKGROUND DATA: Although vertebral osteotomies have been shown to improve functional outcome in patients with spinal deformity, no prospective reports have studied whether correction of specific radiographic parameters is associated with improvement in functional outcome. METHODS: Eighty-three patients with fixed sagittal and/or coronal deformity were followed over a 7-year period. Patients were evaluated clinically and radiographically and completed a SF-36 Health Survey and American Academy of Orthopedic Surgeons Modems Instrument questionnaire. Spearman correlation analysis was used to determine the association between correction of radiographic parameters and functional outcome. RESULTS: Mean preoperative lumbar lordosis measured -14.2 degrees (i.e., kyphosis) with an average postoperative correction of 27.9 degrees. Mean preoperative lumbar scoliosis measured 40.1 degrees with an average postoperative correction of 15.1 degrees. Mean preoperative plumb sagittal and coronal plane alignment was 8.37 cm and 4.22 cm, respectively; after surgery they improved to 3.33 cm and 2.31 cm, respectively. A significant association was found between sagittal angular correction and physical function (P = 0.034) and role-physical (P = 0.01) when postoperative lumbar lordosis was >25 degrees. A significant association was also found between plumb coronal correction and physical function (P = 0.041), vitality (P = 0.05), and social function (P = 0.047) when postoperative plumb coronal alignment was <2.5 cm. CONCLUSIONS: Correction of sagittal and coronal deformity is important in the treatment of spinal deformity. A significant association was found between outcomes and radiographic correction of coronal and/or sagittal deformity if postoperative sagittal lordosis was >25 degrees and if postoperative plumb coronal alignment was <2.5 cm. Therefore, these radiographic parameters should be the goal of a spinal osteotomy. The surgery has a relatively high complication rate.

Adult↗
PubMedDate not supplied

Are fitness, activity, and fatness associated with health-related quality of life and mood in older persons?

PURPOSE: This study sought to determine whether levels of fitness, habitual physical activity, and fatness are associated health-related quality of life and mood in older persons. METHODS: The subjects were men (n = 38) and women (n = 44), ages 55 to 75 years, who had milder forms of hypertension, but who were otherwise healthy and not engaged in a regular exercise or diet program. Aerobic fitness was assessed by maximal oxygen uptake during treadmill testing, muscle strength by a one-repetition maximum, habitual activity by questionnaire, fatness by dual-energy x-ray absorptiometry, and body mass index. Health-related quality of life was assessed by the Medical Outcomes Study SF-36, and mood by the Profile of Mood States (POMS). Correlations were determined by bivariate and multivariate regression. RESULTS: Higher aerobic fitness was associated with more desirable outcomes, as indicated by the POMS anger and total mood disturbance scores and by the SF-36 bodily pain, physical functioning, vitality, and physical component scores. Increased fatness was associated with less desirable outcomes, as indicated by the POMS anger, depression, and total mood disturbance scores and by the SF-36 bodily pain, physical functioning, role-emotional, role-physical, social functioning, vitality, and physical component scores. Higher physical activity was associated with an increased POMS score for vigor and a decreased SF-36 score for bodily pain. Strength was not related to health-related quality of life or mood. Aerobic fitness was the strongest predictor of the SF-36 score for vitality and the POMS score for total mood disturbance, whereas fatness was the strongest predictor of the POMS anger score and the SF-36 bodily pain, physical functioning, and physical component scores. CONCLUSIONS: Even in the absence of regular exercise and a weight-loss diet, relatively small amounts of routine physical activity within a normal lifestyle, slight increases in fitness, and less body fatness are associated with a better health-related quality of life and mood.

Affect↗
PubMed2004

Markers of Resilience and Risk: Adult Lives in a Vulnerable Population.

In this report, we drew on data from an ongoing longitudinal study that began in 1978 (Hauser, Powers, Noam, Jacobson, Weiss, & Folansbee, 1984). Focusing on late, young-adult life among individuals who were psychiatrically hospitalized during adolescence, we examined markers of resilience empirically defined in terms of adult success and well-being. The study includes a demographically similar group recruited from a public high school. Major goals were to (a) develop preliminary models of adaptive functioning among adults in their 30s, (b) examine the extent to which adults with histories of serious mental disorders can be characterized by these models, and (c) explore predictors of successful adult lives from indicators of individuals' psychosocial adjustment at age 25.Results showed significant cohort effects on indexes of adaptive functioning, especially for men. Findings suggest that social relations as well as self-views of competence and relatedness play important roles in characterizing adjustment during the adult years. In addition, indexes of psychosocial adjustment as well as symptoms of psychiatric distress and hard drug use at age 25 made a difference in adult social functioning and well-being, providing hints of possible mechanisms likely to facilitate the ability to "bounce back" after a difficult adolescence.

Journal Article↗
PubMed2000

Evaluation of the short-form 36-item questionnaire to measure health-related quality of life in patients with idiopathic pulmonary fibrosis.

OBJECTIVE: To validate the use of the 36-item short-form questionnaire (SF-36) for measuring health-related quality of life (HRQL) in patients with idiopathic pulmonary fibrosis (IPF). DESIGN: : Observational data at a single point in time. SETTING: : A specialized outpatient respiratory clinic. PARTICIPANTS: Thirty-four patients (mean +/- SE age, 58.29 +/- 1.87 years) with IPF and no significant comorbidity. A matched control group for HRQL measurements was composed of 34 normal subjects (mean age, 58.00 +/- 1.89 years). MEASUREMENTS AND RESULTS: Dyspnea was measured by the baseline dyspnea index (BDI). Respiratory function evaluation included FVC, FEV(1), and resting arterial blood gases. IPF patients showed a mean BDI score of 5.21 +/- 0.46. The mean FVC and FEV(1) values were 62.41 +/- 2.96% and 66.41 +/- 3.33%, respectively. The mean PaO(2) was 67 +/- 2.51 mm Hg, and the mean PaCO(2) was 37 +/- 1. 05 mm Hg. Patients scored significantly worse than control subjects with respect to the SF-36 domains of physical functioning, physical role, general health perceptions, vitality, social functioning, emotional role, and mental health index. BDI scores were significantly correlated with five SF-36 components, and FVC and FEV(1) were significantly correlated with two SF-36 components. Significant negative correlations were found between arterial pH and four SF-36 domains. CONCLUSIONS: Patients with IPF have a significant impairment of HRQL in both physical and psychological functioning. Dyspnea is the most important factor influencing the quality of life in these subjects. The SF-36 questionnaire is a valid instrument to evaluate HRQL in IPF patients.

Adaptation, Psychological↗
PubMed2004

Etanercept: in ankylosing spondylitis.

Etanercept is a dimeric fusion protein based on the p75 tumor necrosis factor (TNF) receptor. It binds to TNFalpha and blocks its biological activity. Subcutaneous etanercept is effective in the treatment of rheumatoid arthritis, psoriatic arthritis, and polyarticular-course juvenile rheumatoid arthritis. More recently, etanercept has shown efficacy in the treatment of adults with ankylosing spondylitis. In randomized, double-blind, placebo-controlled trials, subcutaneous etanercept 25mg twice weekly for 6-24 weeks significantly reduced disease activity in patients with active ankylosing spondylitis. In the largest trial, etanercept produced a response rate of 57% compared with 22% for placebo after 24 weeks (response was determined via the validated ASAS 20 response criteria developed by the Assessments in Ankylosing Spondylitis [ASAS] Working Group). Etanercept therapy significantly improved health-related quality of life in patients with ankylosing spondylitis compared with placebo. The greatest improvements in a 16-week study were seen in the domains of physical functioning, physical role, bodily pain, vitality, and social functioning. Etanercept was generally well tolerated, with few serious adverse events or treatment withdrawals. The most common adverse events were injection-site reactions and minor upper respiratory tract infections.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2003

interACTION: case managers and social skills teaching.

There is good evidence that social skills are important to the community adjustment of persons with serious and persistent mental health problems. There is also conjecture that inattention to the development of social skills may explain the lack of impact that case management services are having on social functioning. This paper describes a series of social skills education groups provided by case managers over several years. Ways that assisted people in maintaining regular attendance at the groups are also described.

Adult↗
PubMed1989

Improving patient function: a randomized trial of functional disability screening.

STUDY OBJECTIVES: To test whether a 34-item functional status questionnaire measuring physical, psychological, and social function can be used by physicians in practice to help improve their patients' outcomes. DESIGN: Prospective randomized trial. SETTING: Community internal medicine practices. PATIENTS: Five hundred and ten continuing patients with functional disabilities who saw their physicians at least four times a year. PHYSICIANS: Seventy-six UCLA clinical volunteer faculty who are internists in community office practices. INTERVENTIONS: Physicians and their patients were randomly assigned to the experimental or the control group. Experimental group physicians attended a 2-hour multimedia educational session and received four functional status reports on each of their study patients over a 1-year period. Control group physicians received no education and no functional status feedback. Control group and experimental group patients were tested for functional status with the functional status questionnaire every 4 months for 1 year. Both groups also completed monthly diaries that measured use of health services. Experimental group physicians answered an anonymous evaluation questionnaire at 6 months after study entry. MEASUREMENTS AND MAIN RESULTS: Forty-three percent of experimental group physicians reported that they had used the functional status questionnaire to change therapy. Ninety-five percent reported that it was useful and accurate. Patient diaries did not show any difference between experimental group patients and control group patients in number of medications used, visits to physicians or other health professionals, equipment purchased, diet, or exercise programs. There were no significant differences between experimental and control group patients at exit from the study on any functional status or health outcome measure. CONCLUSION: A more powerful intervention than a 2-hour educational session and the regular provision of functional status information is needed to help office-based internists improve patient outcomes.

Activities of Daily Living↗
PubMed2004

Development and validation of the BSP-BPH (Bononian Satisfaction Profile--Benign Prostatic Hyperplasia) a "disease-specific" questionnaire for the evaluation of health related quality of life in patients with benign prostatic hyperplasia.

OBJECTIVES: Lower Urinary Tract Symptoms (LUTS) associated to Benign Prostatic Hyperplasia (BPH) are very common in middle aged and older men. Since BPH, and the related therapies have a significant impact on a patient's Quality of Life (QoL), the health related quality of life (HQoL) evaluation is becoming an important aspect to be considered. The present study deals with the development and validation of a BPH disease specific questionnaire (Bononian Satisfaction Profile - BSP-BPH), considering HQoL in patients seeking medical help for BPH. The innovation of this questionnaire is that the patients' scores achieved are related to their subjective satisfaction. MATERIALS AND METHODS: Questionnaire development: On the base of our previous experience with BSP-PC (a disease specific questionnaire assessing HQoL in prostate Cancer patients), of a careful review of other available instruments (SAT-P, SF-36, ICS-QoL, BPH-HqoL) and of three subsequent meetings with experts (10) and patients (20), we defined the ten life aspects mostly impaired by BPH. We created a first 72-item version of the BSP-BPH. Ten patients cross matched for age end education to our study population were asked to fill in the questionnaire. A 31 item questionnaire version, together with EuroQoL, an already generic validated instrument, was administered to 121 patients as well. Further meetings and statistical analysis defined the 18 items of the BSP- BPH. Questionnaire validation: the BSP-BPH was filled in by 435 patients enrolled in a campaign for detection of prostatic diseases held among the male population of Bologna. RESULTS: Questionnaire development: the participants' mean age was 63 years (N = 121); 47.1% had BPH. The 18 items were selected on the basis of the following criteria: a) r > 0.50, p < 0.05 (correlation test re-test); b) p < 0.05 (ANOVA presence vs absence of BPH); c) r > 0.50, p < 0.05 (correlation with EuroQol). Questionnaire validation: the participants' mean age was 63 years (N = 436). 16 patients with a history of neoplasia were excluded from our study. 21 were missing data. 45% of the sample had BPH. Principal component analysis identified 5 components: 1) satisfaction about sexual functionality (Cronbach alpha = 0.94); 2) satisfaction about social functionality (alpha = 0.80); 3) satisfaction about cognitive/emotional functionality (alpha = 0.82); 4) satisfaction about urinary functionality (alpha = 0.87); 5) satisfaction about physical functionality (alpha = 0.66); total Cronbach alpha was 0.88. CONCLUSIONS: The 18 items version of BSP-BPH questionnaire can be used as an instrument for HQoL evaluation in patients with BPH focusing on patients' subjective satisfaction. At the moment only the Italian version is available.

Humans↗
PubMedDate not supplied

Quantity of dialysis: quality of life--what is the relationship?

Health related quality of life (HRQOL) is increasingly being used to evaluate physical and psychosocial parameters in patients receiving dialysis. In patients with chronic illness, these indices are important adjuncts to biochemical measurements. Inadequate dialysis with low urea clearance (Kt/Vurea) has been linked to adverse outcomes in dialysis patients. Little is known about the relationship between dialysis adequacy and patient reported HRQOL. We evaluated HRQOL in 55 hemodialysis and 60 peritoneal dialysis patients using the RAND 36 Item Health Survey 1.0, measuring the following: physical functioning; role limitations (physical); role limitations (emotional); social functioning; emotional well being; pain; energy; and general health perceptions. Kt/V was also calculated for each patient. Mean HD Kt/V was 1.44 +/- 0.31 (range, 0.5-2.0); mean weekly PD Kt/V was 2.28 +/- 0.90 (range, 1.13-6.02). The relationship between Kt/V and HRQOL was tested using Pearson's correlation. No significant association was found for either treatment group between Kt/V and any of the domains of HRQOL. Thus, HRQOL seems to be influenced by factors other than dialysis adequacy, enhancing its role as an independent measure of patient problems otherwise undetected by traditional objective parameters.

Adult↗
PubMed2003

Patterns of premorbid functioning in first-episode psychosis: initial presentation.

Premorbid functioning in first-episode psychosis has been reported to be associated with poorer outcome. We assessed premorbid functioning in a sample of 306 subjects newly admitted to an early-psychosis program. Using cluster analyses, we identified four patterns: stable-good, stable-moderate, deteriorating and poor-deteriorating. Results were that relative to the stable-good group, the deteriorating and the poor-deteriorating groups had more negative symptoms, poorer social functioning and some evidence of poorer cognitive functioning. The deteriorating group had increased positive symptoms compared to the stable-good group. These results suggest that prior to the onset of the acute psychosis those who have poor social and interpersonal functioning premorbidly present initially with increased social impairment and negative symptoms compared to those who have better premorbid functioning.

Adolescent↗
PubMed2000

Association between psychosocial work characteristics and health functioning in American women: prospective study.

OBJECTIVE: To examine prospectively the relation between psychosocial work characteristics and changes in health related quality of life over four years in a cohort of working women in the United States. DESIGN: Longitudinal cohort study. SETTING: United States. PARTICIPANTS: 21 290 female registered nurses who completed the Karasek's job content questionnaire and a modified version of the short form 36 questionnaire (SF-36) as used for a survey of health status by the medical outcomes study. MAIN OUTCOME MEASURES: Seven dimensions of health status: physical functioning, role limitations due to physical health problems, bodily pain, vitality, social functioning, role limitations due to emotional problems, and mental health. RESULTS: Examined separately low job control, high job demands, and low work related social support were associated with poor health status at baseline as well as greater functional declines over the four year follow up period. Examined in combination, women with low job control, high job demands, and low work related social support ("iso-strain" jobs) had the greatest functional declines. These associations could not be explained by age, body mass index, comorbid disease status, alcohol consumption, smoking status, education level, exercise level, employment status, marital status, or presence of a confidant. CONCLUSIONS: Adverse psychosocial work conditions are important predictors of poor functional status and its decline over time.

Adult↗
PubMed1987

[Assessment of functional status in children with brain tumors].

Thirty children treated for brain tumors between 1978-1985 at Kurume university hospital were evaluated for alternation in intellectual, emotional, and social function. They were 15 males and 15 females, aged 3 to 16 years, on the averaged 1.7 years after treatment. Twenty-eight children had no neurological deficits and 2 children had slight neurological deficits. It was possible for twenty-eight children to be evaluated for intelligence quotient by Wechsler Intelligence Scale for Children-revised and Tanaka-Binet. The median score and standard deviation of intelligence quotient (IQ) test in children with brain tumors were as follows; verbal IQ: 84 +/- 16, performance IQ: 77 +/- 20, full scale IQ: 80 +/- 20. There children with brain tumors obtained significant low IQ scores than children (t-test, P less than 0.01). Twenty-one (72%) children showed subnormal IQ scores (IQ less than 90) and 7 children showed normal IQ scores (IQ greater than or equal to 90). Concerning social and emotional function, twelve children (45.7%) showed abnormal behaviour. The median scores and standard deviation of IQ scores in cranial irradiated patients were as follows; verbal IQ: 79 +/- 13, performance IQ: 71 +/- 15, full scale IQ: 71 +/- 14. Especially, ten of twelve cranial irradiated patients showed subnormal IQ scores. Also, cranial irradiated patients obtained significant low IQ scores than non-cranial irradiated patients (t-test, P less than 0.05). Serial evaluation of three cranial irradiated patients revealed further deterioration without recurrence of tumor and hydrocephalus, The results are discussed to: (1) the effects and mechanism of cranial irradiation on cognitive development.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

Hip fractures in primary health care. Evaluation of a rehabilitation programme.

The routine follow-up of hip fracture patients was transferred from the Orthopaedic Department, Lund University Hospital, to the primary health care districts in 1985. The medical state and social functions of all 298 patients during the first 12 months of the follow-up rehabilitation programme were registered. Before fracture, 61% lived in their own homes, 22% in old people's homes, and 14% in geriatric hospitals or nursing homes. Four months after fracture, 13% were dead, 47% were living in their own homes, 14% were in old people's homes, 25% in geriatric hospitals or nursing homes, while the rest were in other types of institutional residence. Of patients coming from their own homes, 75% were back at home four months after fracture and their social and functional status were as good as before fracture. The study has shown that routine check-ups at the orthopaedic department can be omitted. Follow-up in primary health care without radiography and orthopaedic expertise gives equally good functional results as in previous studies, provided that patients with pain and walking problems from the hip are guaranteed rapid specialist treatment.

Aged↗
PubMed2004

Psychometric validation of the French version of the quality of life in epilepsy inventory (QOLIE-31): comparison with a generic health-related quality of life questionnaire.

A psychometric evaluation of a French transcultural version of the quality of life in epilepsy inventory-31 (QOLIE-31) was carried out. QOLIE-31 was compared to a generic health-related quality of life questionnaire, the Nottingham health profile (NHP). The psychometric properties of QOLIE-31, assessed in 190 adults with epilepsy, included: acceptability, test-retest reliability and validity (multi-trait analysis including internal consistency and item-to-scale correlations, construct validity using factor analysis, discriminative validity using relationship with disease characteristics, treatment effects, divergent and convergent validity using correlations with NHP scores). Both acceptability and reproducibility were good and internal consistency was high (Cronbach's alpha coefficient = 0.86). Factor analysis with varimax rotation identified seven factors with eigenvalues > 1, with two factors, related to cognitive function and mood, accounting for 46.5% of the variance. However, goodness of fit indices revealed that a model with four factors best fitted the data. The first factor corresponds to a generic mental dimension, the second is equivalent to the cognitive functioning dimension, the third to medication effects including social functioning, and the fourth to seizure worry. Discriminative validity was good for seizure control and treatment tolerability. High correlations between QOLIE-31 and pertinent NHP scales (emotional reactions, energy and social isolation) were observed. The French version of QOLIE-31 thus meets established psychometric criteria for reliability and validity.

Activities of Daily Living↗
PubMed1989

Comparison of the physical characteristics of grooming in two species of macaques (Macaca nemestrina and M. radiata).

Examined social grooming in groups of bonnet and pigtail macaques to test hypothesis that the physical aspects of grooming (body sites, postures, methods) evolved in more aggressive species of primates to serve social functions (proximity maintenance and tension reduction). Both species used social presents to direct grooming to particular sites, and used grooming to other sites to terminate interactions, thus regulating proximity with grooming to certain body sites. The 2 species differed in method of grooming. Pigtails primarily stroked (method used for tension reduction); bonnets picked or pick-stroked (method used for hygiene). Pigtail but not bonnet grooming method regulates tension reduction. Pigtails groomed in a social context, whereas bonnets groomed in solitary context. The pigtail results are similar to those found with rhesus monkeys. Different aspects of grooming serve different functions.

Aggression↗
PubMed2004

Neuroimaging in disorders of social and emotional functioning: what is the question?

Social and emotional processing uses neural systems involving structures ranging from the brain stem to the associational cortex. Neuroimaging research has attempted to identify abnormalities in components of these systems that would underlie the behavioral abnormalities seen in disorders of social and emotional processing, notably autism spectrum disorders, the focus of this review. However, the findings have been variable. The most replicated anatomic finding (a tendency toward large brains) is not modular, and metabolic imaging and functional imaging (although showing substantial atypicality in activation) are not consistent regarding specific anatomic sites. Moreover, autism spectrum disorder demonstrates substantial heterogeneity on multiple levels. Here evidence is marshaled from a review of neuroimaging data to support the claim that abnormalities in social and emotional processing on the autism spectrum are a consequence of systems disruptions in which the behaviors are a final common pathway and the focal findings can be variable, downstream of other pathogenetic mechanisms, and downstream of more pervasive abnormalities.

Adolescent↗
PubMed1987

Medical-social intervention in a 70-year-old Swedish population. A general presentation of methodological experience.

The possibilities of improving physical, mental and social functioning or retarding the development of handicap and reducing the need for medical and social services were investigated in an interdisciplinary intervention study in a representative population sample of 1206 70-year-olds. The assessments concerned cognitive function and mental health, earlier and current social interaction and living conditions, state of health including dental status, muscular strength and performance, pulmonary and cardiovascular function, bone mineral content, ADL and dietary habits. The intervention (response rate 76.8%) concerned social, psychological, environmental and medical aspects in 400 and medical aspects only in 406 probands. 400 register controls were sampled for comparison. The intervention period was 2 years, and a follow-up study will be performed at the age of 75. The interventions were guided by the life-style and the activity hypotheses within the resource perspective to promote everyday activities. The study allows comparisons with two previous 70-year-old cohorts investigated with similar methods in Gothenburg.

Activities of Daily Living↗