Measurement limit of quality-of-life questionnaires in psychiatric settings

The Office Work and Stretch Training (OST) Study: An Individualized and Standardized Approach to Improve the Quality of Life in Office Workers

In the context of workplace health promotion, physical activity programs have been shown to reduce musculoskeletal diseases and stress, and to improve the quality of life. The aim of this study was to examine the effects of using the “five-Business” stretch training device for office workers on their quality of life. A total of 313 office workers (173m/137f) participated voluntarily in this intervention–control study with an average age of 43.37 ± 11.24 (SD) years, 175.37 ± 9.35 cm in height and 75.76 ± 15.23 kg in weight, with an average BMI of 24.5 ± 3.81 kg/m². The participants completed the stretch training twice a week for approximately 10 min for a duration of 12 weeks. The SF-36 questionnaire was used to evaluate the effectiveness of the intervention at baseline and after 12 weeks. Significantly improved outcomes in mental sum score (p = 0.008), physical functioning (p < 0.001), bodily pain (p = 0.01), vitality (p = 0.025), role limitations due to physical problems (p = 0.018) and mental health (p = 0.012) were shown after the stretching training. The results suggest that a 12-week stretching program for office desk workers is suitable to improve significantly their health-related quality of life.

Measuring life satisfaction among psychiatric patients: Measurement invariance and validity of the Satisfaction with Life Scale

The main aim of the present study was to evaluate the measurement invariance and the convergent validity of the Satisfaction with Life Scale (SWLS) across clinical and nonclinical samples. A total of 216 psychiatric patients (47.7% females; M_age = 44.56) and 235 participants from the general population (54.5% females; M_age = 43.11 years) were recruited. The measurement invariance was tested by a multi-group confirmatory factor analysis. Full scalar invariance of the SWLS was supported. Psychiatric patients reported substantially lower life satisfaction than participants from the general population. The SWLS demonstrated good convergent validity in both samples. The present study supported the use of the SWLS as a measure of life satisfaction among psychiatric patients.

Correlation between chronic skin ulcers dimension and burden of suffering evaluated with PRISM test

BACKGROUND

In the practice of dermatology, many tools are available to help the physician measure the patient's quality of life. The Pictorial Representation of Illness and Self Measure (PRISM) is a novel and simple method to measure personal suffering. The aim of our study was to evaluate, using PRISM, whether the reduction of the ulcers' size positively correlated with an improvement of the patients' suffering.

METHODS

This was a multicenter national prospective study. 143 patients from five dermatological centers were enrolled in the study. At times T0 and T1 (after 1 month), the size of the ulcers was collected for each patient. At the same time, the PRISM test was also administered, in order to calculate the Self-Illness-Separation (SIS).

RESULTS

First, a substantial decrement of the size of the ulcer seemed to correlate with a significant difference between the SIS score obtained at T0 and T1. On the contrary, the duration of the wound did not seem to influence the SIS value. No relationship between the age of the patient and the SIS value was found either.

CONCLUSIONS

Our study showed that the decrease in the wound dimension positively affects the patient's suffering. In fact, ulcer's size reduction is correlated with an improvement in the patient's disease perception.

The Use of PRISM (Pictorial Representation of Illness and Self Measure) in Patients Affected by Chronic Cutaneous Ulcers

OBJECTIVE

PRISM (Pictorial Representation of Illness and Self Measure) is a nonverbal visualization instrument. The authors chose to use this tool to avoid the limitation of the other tests for the assessment of quality of life by using interview methods that depend on the cognitive and cultural level of the patient. The aim of the study was to assess the impact on the quality of life of different types of chronic wounds using the PRISM test.

SETTING

The PRISM test was administered by the same medical student to each patient visiting the dermatology department for a routine visit and medication.

PARTICIPANTS

The PRISM test was administered to 77 patients with chronic cutaneous ulcers referred to the Dermatology Department of the Spedali Civili of Brescia, Italy.

MATERIALS AND METHODS

The authors analyzed the "Self-llness-Separation"' (SIS) value, which resulted from the PRISM test, and related it to sex, age, and ulcer etiology.

RESULTS

Considering all categories, the mean SIS was 9.58 cm; a different perception of the disease between the sexes was noted and also in the subgroups based on the ulcer's different etiology. In addition, the age of the affected patients influenced the SIS value.

CONCLUSIONS

PRISM is an easy and sensitive instrument to record information about the patient's expectations and suffering in order to improve the overall physician-patient relationship.

Quantification of relevance of quality of life assessment for patients with cognitive impairment: the suitability indices

Background

The extent to which MS patients with cognitive dysfunction can accurately self-report outcomes has been a crucial issue. The aim of this study was to quantify and compare the relevance of the quality of life (QoL) assessment between two populations with a high occurrence of cognitive dysfunction, specifically in individuals with multiple sclerosis (MS) and in individuals suffering from schizophrenia (SCZ).

Methods

Design: A cross-sectional study was performed using the following inclusion criteria: MS and SCZ patients were diagnosed according to the McDonald criteria and DSM-IV criteria, respectively. Data on sociodemographic (age, gender, education level) and clinical (disease severity, disease duration) factors, QoL (disease-specific questionnaires, MusiQoL and SQoL) and cognitive performance (executive, memory, and attention functions) were collected. Non-impaired and impaired populations were defined according to the French norms. Psychometric properties were compared to those reported in reference populations, which were assessed in the respective validation studies. Suitability indices were provided used to quantitatively compare how the structures in the different populations matched with the initial structure of the questionnaires (reference populations).

Results

One hundred and twenty-four MS patients and 113 SCZ patients were enrolled. Factor analysis was performed on the impaired populations and revealed that the questionnaire structure adequately matched the initial structure of the disease-specific QoL questionnaires. All of the suitability indices of construct and external validity in the non-impaired populations ranged from 70 to 100%.

Conclusions

Our study suggested that cognitive dysfunction did not compromise the reliability or validity of the self-reported QoL questionnaires among subjects with cognitive dysfunction, such as MS and SCZ. Thus, this report may clarify the relevance of using self-reported QoL assessments in clinical practice.

Measuring quality of life in patients with schizophrenia:an overview

Quality of life (QoL) is of great importance to patients with schizophrenia and their families. Although the use of QoL measures may contribute to better adherence to therapeutic interventions, more satisfaction with care, improved health outcomes and reduction of health costs, QoL assessment remains underutilized in clinical practice. In this review, the authors propose a reflection on the limitations and lack of impact of QoL measures in clinical care. Our argument is based on three challenges regarding conceptual aspects and metrics, use and limits and the usefulness of measuring QoL. For each challenge, the authors have suggested pragmatic proposals and new research directions to promote the use of QoL measures in the future. These avenues of research involve a shared responsibility between QoL researchers, the medical community and decision makers. Close collaboration between all parties is necessary to promote the use of QoL measures in schizophrenia.

Self-reported quality of life measure is reliable and valid in adult patients suffering from schizophrenia with executive impairment

BACKGROUND

Impaired executive functions are among the most widely observed in patients suffering from schizophrenia. The use of self-reported outcomes for evaluating treatment and managing care of these patients has been questioned. The aim of this study was to provide new evidence about the suitability of self-reported outcome for use in this specific population by exploring the internal structure, reliability and external validity of a specific quality of life (QoL) instrument, the Schizophrenia Quality of Life questionnaire (SQoL18).

DESIGN

cross-sectional study.

INCLUSION CRITERIA

age over 18 years, diagnosis of schizophrenia according to the DSM-IV criteria.

DATA COLLECTION

sociodemographic (age, gender, and education level) and clinical data (duration of illness, Positive and Negative Syndrome Scale, Calgary Depression Scale for Schizophrenia); QoL (SQoL18); and executive performance (Stroop test, lexical and verbal fluency, and trail-making test). Non-impaired and impaired populations were defined for each of the three tests. For the six groups, psychometric properties were compared to those reported from the reference population assessed in the validation study.

RESULTS

One hundred and thirteen consecutive patients were enrolled. The factor analysis performed in the impaired groups showed that the questionnaire structure adequately matched the initial structure of the SQoL18. The unidimensionality of the dimensions was preserved, and the internal/external validity indices were close to those of the non-impaired groups and the reference population.

CONCLUSIONS

Our study suggests that executive dysfunction did not compromise the reliability or validity of self-reported disease-specific QoL questionnaire.

A review of the measurement properties of the 36-item short-form health survey (SF-36) to determine its suitability for use in an alcohol-dependent population

A psychometric evaluation of the 36-item short-form health survey (SF-36) was undertaken in contemporary studies to assess its suitability for use in an alcohol-dependent population. Three criteria were used to try and determine this: factor analysis, internal consistency reliability and test-retest reliability. Factor analysis revealed that it is mainly consistent with a bidimensional model, internal consistency reliability showed that it consistently provided scores above the recommended threshold and test-retest reliability of the SF-36 highlights that it too provided higher than suggested scores. A conclusion was reached recommending the SF-36 as a reliable screening tool in an alcohol-dependent population, but this is given in caution as no studies were found analysing the instrument in this population.

Relevance of quality of life assessment for multiple sclerosis patients with memory impairment

Background

Memory disturbances, in particular episodic verbal memory dysfunction, are the most frequent cognitive impairment observed in multiple sclerosis (MS) patients. The use of self-reported outcomes for evaluating treatment and managing care of these subjects has been questioned. The aim of this study was to provide new evidence about the suitability of self-reported outcomes for use in this impaired population by exploring the internal structure, reliability and external validity of a specific quality of life (QoL) instrument, the Multiple Sclerosis International Quality of Life questionnaire (MusiQoL).

Methods

Design: cross-sectional study. Inclusion criteria: MS patients of any disease subtype. Data collection: sociodemographic (age, gender, marital status, education level, and occupational activity) and clinical data (MS subtype, Expanded Disability Status Scale, disease duration); QoL (MusiQoL and SF36); and memory performance (Grober and Buschke test). In accordance with the French norms of the memory test, non-impaired and impaired populations were defined for short- and long-delay free composites and for short- and long-delay total composites. For the 8 populations, psychometric properties were compared to those reported from the reference population assessed in the validation study.

Principal Findings

One hundred and twenty-four consecutive patients were enrolled. The analysis performed in the impaired populations showed that the questionnaire structure adequately matched the initial structure of the MusiQoL. The unidimensionality of the dimensions was preserved, and the internal/external validity indices were close to those of the reference population.

Conclusions/Significance

Our study suggests that memory dysfunction did not compromise the reliability or validity of the self-reported QoL questionnaires.

Is the concept of quality of life relevant for multiple sclerosis patients with cognitive impairment? Preliminary results of a cross-sectional study

Background

Cognitive impairment occurs in about 50% of multiple sclerosis (MS) patients, and the use of self-reported outcomes for evaluating treatment and managing care among subjects with cognitive dysfunction has been questioned. The aim of this study was to provide new evidence about the suitability of self-reported outcomes for use in this specific population by exploring the internal structure, reliability and external validity of a specific quality of life (QoL) instrument, the Multiple Sclerosis International Quality of Life questionnaire (MusiQoL).

Methods

Design: cross-sectional study. Inclusion criteria: MS patients of any disease subtype. Data collection: sociodemographic (age, gender, marital status, education level, and occupational activity) and clinical data (MS subtype, Expanded Disability Status Scale, disease duration); QoL (MusiQoL and SF36); and neuropsychological performance (Stroop color-word test). Statistical analysis: confirmatory factor analysis, item-dimension correlations, Cronbach's alpha coefficients, Rasch statistics, relationships between MusiQoL dimensions and other parameters.

Principal Findings

One hundred and twenty-four consecutive patients were enrolled. QoL scores did not differ between the 69 cognitively non-impaired patients and the 55 cognitively impaired patients, except for the symptoms dimension. The confirmatory factor analysis performed among the impaired subjects showed that the structure of the questionnaire matched with the initial structure of the MusiQoL. The unidimensionality of the MusiQoL dimensions was preserved, and the internal validity indices were satisfactory and close to those of the reference population.

Conclusions/Significance

Our study suggests that executive dysfunction did not compromise the reliability and the validity of the self-reported QoL questionnaires.

Impact of the life review program on elders with dementia: a preliminary study at a day care center in southern Taiwan

BACKGROUND

: Life review, a type of reminiscence therapy, assists participants to seek personal value in order to enhance social status and maintain a high quality of life (QOL).

PURPOSE

: This study aimed to examine the impact of an adaptive life review program (LRP) on perceived QOL in elders with mild to moderate dementia at a day care center and assess the effect, if any, of different cognitive impairment levels on intervention outcome.

METHODS

: This pre-experimental design used a single group of seven subjects for pretest and posttest and purposive sampling at a 2-week interval. Researchers administered to each subject a 10-day therapeutic recreation program modified from Tabourne's (1991) LRP.

RESULTS

: Posttest results found no statistically significant improvements. However, subjects reported higher mean scores of perceived QOL as measured by the 36-Item Short Form Health Survey. This finding indicated a trend of improving physical and mental health after the intervention. In addition, subjects with moderate cognitive impairment reported a higher improvement in physical health perception than did subjects with mild cognitive impairment.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

: Future research should include a larger sample size and a longer period of intervention and adopt multiple dimensions of QOL measurements to increase research rigor. Suggestions from this study can be used to improve the LRP.