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Rogers P. Best practices for your confirmatory factor analysis: A JASP and lavaan tutorial. Behav Res Methods 2024; 56:6634-6654. [PMID: 38480677 DOI: 10.3758/s13428-024-02375-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2024] [Indexed: 08/30/2024]
Abstract
Confirmatory factor analysis (CFA) is a fundamental method for evaluating the internal structural validity of measurement instruments. In most CFA applications, the measurement model serves as a means to an end rather than an end in itself. To select the appropriate model, prior validity evidence is crucial, and items are typically assessed on an ordinal scale, which has been used in the applied social sciences. However, textbooks on structural equation modeling (SEM) often overlook this specific case, focusing on applications estimable using maximum likelihood (ML) instead. Unfortunately, several popular commercial SEM software packages lack suitable solutions for handling this 'typical CFA', leading to confusion and suboptimal decision-making when conducting CFA in this context. This article conceptually contributes to this ongoing discussion by presenting a set of guidelines for conducting a typical CFA, drawing from recent empirical research. We provide a practical contribution by introducing and developing a tutorial example within the JASP and lavaan software platforms. Supplementary materials such as videos, files, and scripts are freely available.
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Affiliation(s)
- Pablo Rogers
- Federal University of Uberlândia, João Naves de Ávila 2121, 38.408-100, Uberlândia, Minas Gerais, Brazil.
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2
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Farias IF, Trajman A, Nadanovsky P, Ribeiro M, Faerstein E. Quality of life of Venezuelan migrants in Brazil during the COVID-19 pandemic. CAD SAUDE PUBLICA 2024; 40:e00147423. [PMID: 38922224 PMCID: PMC11192570 DOI: 10.1590/0102-311xen147423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 03/05/2024] [Accepted: 03/19/2024] [Indexed: 06/27/2024] Open
Abstract
The economic, social, and health crisis in Venezuela has resulted in the largest forced migration in recent Latin American history. The general scenario in host countries influence migrants' self-perception of quality of life, which can be understood as an indicator of their level of integration. The COVID-19 pandemic has exacerbated socioeconomic and health vulnerabilities, especially for forced migrants. We hypothesized that the adverse circumstances faced by Venezuelan migrants during the pandemic have deepened their vulnerability, which may have influenced their perception of quality of life. This study aims to evaluate the quality of life of Venezuelan migrants in Brazil during the COVID-19 pandemic. We assessed the quality of life of 312 adult Venezuelan migrants living in Brazil using the World Health Organization WHOQOL-BREF quality of life assessment, which was self-administered online from October 20, 2020, to May 10, 2021. The associations of quality of life and its domains with participants' characteristics were analyzed via multiple linear regression models. Mean quality of life score was 44.7 (±21.8) on a scale of 0 to 100. The best recorded mean was in the physical domain (66.2±17.8) and the worst in the environmental domain (51.1±14.6). The worst quality of life was associated with being a woman, not living with a partner, lower household income, and discrimination based on nationality. Factors associated with overall quality of life and respective domains, especially income and discrimination, were also observed in other studies as obstacles to Venezuelan migrants. The unsatisfactory quality of life among Venezuelans living in Brazil may have been worsened by the pandemic during the study period.
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Affiliation(s)
- Iaralyz Fernandes Farias
- Instituto de Medicina Social Hesio Cordeiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Anete Trajman
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
- McGill University, Montreal, Canada
| | - Paulo Nadanovsky
- Instituto de Medicina Social Hesio Cordeiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Manuel Ribeiro
- Instituto de Medicina Social Hesio Cordeiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Eduardo Faerstein
- Instituto de Medicina Social Hesio Cordeiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
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Bombardier CH, Fann JR, Ehde DM, Reyes MR, Burns SP, Barber JK, Temkin NR. Collaborative Care Versus Usual Care to Improve Quality of Life, Pain, Depression, and Physical Activity in Outpatients With Spinal Cord Injury: The SCI-CARE Randomized Controlled Clinical Trial. J Neurotrauma 2023; 40:2667-2679. [PMID: 37597201 DOI: 10.1089/neu.2023.0200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/21/2023] Open
Abstract
Our goal was to test the effectiveness of collaborative care (CC) versus usual care (UC) to improve treatment of pain, depression, physical inactivity, and quality of life in outpatients with spinal cord injury (SCI). We conducted a single blind parallel group randomized controlled trial. The setting was two outpatient SCI rehabilitation clinics within a large academic medical center. Participants were 174 outpatients who were on average 47.7 years old, 76% male, 76% white, 8% Hispanic, 47% tetraplegic, 95% more than 1 year post-SCI, and 45% on Medicare. The intervention consisted of a mental health-trained collaborative care manager (CM) integrated into two SCI rehabilitation medicine clinics and supervised by content experts in pain and mental health treatment. The CM provided assessment, medical care coordination, adherence support, outcome monitoring, and decision support along with brief psychological interventions to the patients via up to 12 in-person or telephone sessions. Among all participants, 61% chose to focus on pain; 31% on physical activity and 8% on depression. The primary outcome was quality of life as measured by the World Health Organization Quality of Life-BREF at the end of treatment (4 months). Secondary outcomes were quality of life at 8 months and pain intensity and interference, depression severity, and minutes per week of moderate to vigorous physical activity at 4 and 8 months. A total of 174 participants were randomized 1:1 to CC (n = 89) versus UC (n = 85). The primary analysis, a mixed-effects linear regression adjusting for time since injury and sex, revealed a non-significant trend for greater improvement in quality of life in CC versus UC at 4 months (p = 0.083). Secondary analyses showed that those receiving CC reported significantly greater improvement in pain interference at 4- and 8-months and in depression at 4-months, but no significant effect on physical activity. We conclude that in an outpatient SCI care setting, CC is a promising model for delivering integrated medical and psychological care and improving management of common, chronic, disabling conditions such and pain and depression.
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Affiliation(s)
- Charles H Bombardier
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Jesse R Fann
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Dawn M Ehde
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Maria R Reyes
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Stephen P Burns
- Department of Veterans Affairs, Puget Sound Health Care System, Seattle, Washington, USA
| | - Jason K Barber
- Department of Neurological Surgery, University of Washington, Seattle, Washington, USA
| | - Nancy R Temkin
- Department of Neurological Surgery, University of Washington, Seattle, Washington, USA
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Zhang B, Wang Q, Wang Y, Tong R. Measuring the Health Related Quality of Life and Economic Burden of Illness Among Migrant Workers With Pneumoconiosis. J Occup Environ Med 2023; 65:e105-e112. [PMID: 36868863 DOI: 10.1097/jom.0000000000002766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
OBJECTIVE The aim of the study is to evaluate the living status of migrant workers with pneumoconiosis (MWP) in China with regard to health-related quality of life (QOL) and economic burden of illness. METHODS An on-site investigation of 685 respondents in 7 provinces is conducted. Quality of life scores are derived using the self-made scale, and human capital method and disability-adjusted life year are applied to value the economic loss. Multiple linear regression and K-means clustering analysis are performed for further investigation. RESULTS Respondents have an overall lower QOL of 64.85 ± 7.04 and significant average loss of Ұ344.5 thousand per capita, where age and provincial heterogeneity generally exist. Pneumoconiosis stage and assistance condition are 2 significant predictors affecting MWP's living conditions. CONCLUSIONS The evaluation of QOL and economic loss would contribute to the formulation of targeted countermeasures for MWP to enhance their well-being.
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Affiliation(s)
- Boling Zhang
- From the School of Emergency Management and Safety Engineering, China University of Mining and Technology-Beijing, Beijing, China
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5
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Vasconcelos P, Paúl C, Serruya SJ, Ponce de León RG, Nobre P. A systematic review of sexual health and subjective well-being in older age groups. Rev Panam Salud Publica 2022; 46:e179. [PMID: 36320206 PMCID: PMC9595221 DOI: 10.26633/rpsp.2022.179] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/28/2022] [Indexed: 11/24/2022] Open
Abstract
Objectives. This systematic review aimed at assessing the associations between sexual health and subjective well-being in older age groups (i.e. people aged between 40 and ≥90 years). Methods. A systematic search was conducted of the Web of Science, MEDLINE, EBSCO, Scopus, SciELO and LILACS (Latin American and Caribbean Health Sciences Literature) databases for studies published until September 2021. Search strings included a combination of terms such as “sexual health” or “sexuality” and “well-being” and terms related to the measures that assess the constructs of interest. This systematic review followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results were grouped into four categories that assess the interplay between sexual health and subjective well-being: cognitive and attitudinal factors, sexual behavior, sexual function and sexual satisfaction. The subjective well-being domains that were analyzed were life satisfaction, positive and negative affect, and psychological well-being. Results. A total of 15 quantitative studies were reviewed, of which 14 were articles and 1 was a doctoral dissertation. Findings suggest that living a fulfilling sexual life is an essential part of subjective well-being. Conclusions. This review suggests that programs aiming to promote well-being in older age groups should also encourage a fulfilling sexual life.
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Affiliation(s)
- Priscila Vasconcelos
- Center for Psychology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Constança Paúl
- School of Medicine and Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal
| | - Suzanne J. Serruya
- Latin American Center of Perinatology, Women and Reproductive Health (CLAP/WR), Montevideo, Uruguay
| | | | - Pedro Nobre
- Center for Psychology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
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Murphy O, Looney K, McNulty M, O’Reilly G. Exploring the factors that predict quality of life, and the relationship between recovery orientation and quality of life in adults with severe mental health difficulties. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03296-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AbstractIntegration of intrapersonal, interpersonal and environmental factors has been proposed to enhance understanding of psychological quality of life (QOL) in adults with severe and enduring mental illness (SMI). This study examined the contribution of factors such as self-stigma, coping style and personal recovery orientation to psychological QOL in SMI; compared QOL outcomes to norms from the general population; and examined the association between personal recovery orientation and overall QOL. 70 participants with SMI completed measures of QOL (including psychological QOL), personal recovery orientation, coping, perceived stigma, psychological distress and demographic variables. Regression analysis found that only adaptive coping and psychological distress contributed significantly to psychological QOL. Personal recovery orientation was significantly associated with overall subjective QOL. Participants had lower QOL in the psychological and social relationships domains compared to the general population. Findings support the positive contribution of adaptive coping to psychological QOL, and the positive association between personal recovery orientation and overall QOL.
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Hegedüs L, Bianco AC, Jonklaas J, Pearce SH, Weetman AP, Perros P. Primary hypothyroidism and quality of life. Nat Rev Endocrinol 2022; 18:230-242. [PMID: 35042968 PMCID: PMC8930682 DOI: 10.1038/s41574-021-00625-8] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/17/2021] [Indexed: 12/15/2022]
Abstract
In the 1970s, treatment with thyroid extract was superseded by levothyroxine, a synthetic L form of tetraiodothyronine. Since then, no major innovation has emerged for the treatment of hypothyroidism. The biochemical definition of subclinical hypothyroidism is a matter of debate. Indiscriminate screening for hypothyroidism has led to overdiagnosis and treatment initiation at lower serum levels of thyroid-stimulating hormone (TSH) than previously. Adverse health effects have been documented in individuals with hypothyroidism or hyperthyroidism, and these adverse effects can affect health-related quality of life (QOL). Levothyroxine substitution improves, but does not always normalize, QOL, especially for individuals with mild hypothyroidism. However, neither studies combining levothyroxine and liothyronine (the synthetic form of tri-iodothyronine) nor the use of desiccated thyroid extract have shown robust improvements in patient satisfaction. Future studies should focus not only on a better understanding of an individual's TSH set point (the innate narrow physiological range of serum concentration of TSH in an individual, before the onset of hypothyroidism) and alternative thyroid hormone combinations and formulations, but also on autoimmunity and comorbidities unrelated to hypothyroidism as drivers of patient dissatisfaction. Attention to the long-term health consequences of hypothyroidism, beyond QOL, and the risks of overtreatment is imperative.
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Affiliation(s)
- Laszlo Hegedüs
- Department of Endocrinology, Odense University Hospital, Odense, Denmark.
| | - Antonio C Bianco
- Section of Adult and Paediatric Endocrinology, Diabetes & Metabolism, Department of Medicine, University of Chicago, Chicago, IL, USA
| | | | - Simon H Pearce
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Department of Endocrinology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Anthony P Weetman
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Petros Perros
- Department of Endocrinology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
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Oladele RO, Gbajabimiala T, Irurhe N, Skevington SM, Denning DW. Prospective Evaluation of Positivity Rates of Aspergillus-Specific IgG and Quality of Life in HIV-Negative Tuberculosis Patients in Lagos, Nigeria. Front Cell Infect Microbiol 2022; 12:790134. [PMID: 35186788 PMCID: PMC8851390 DOI: 10.3389/fcimb.2022.790134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
Background Pulmonary tuberculosis (PTB) often results in residual anatomical and functional changes despite microbiological cure and may be complicated by chronic pulmonary aspergillosis (CPA). In this study, we determined the perceived health-related quality of life (HRQoL) of patients during and after PTB therapy and compared it with their quantitative Aspergillus-specific IgG positivity rates. Methodology We conducted a longitudinal study among TB patients attending two directly observed therapy short-course (DOTS) clinics in Lagos, Nigeria. Two hundred and four confirmed TB patients were recruited over 9 months, with five visits at baseline and 3, 6, 9, and 12 months. They were all acid-fast bacilli smear, GeneXpert, or culture positive for Mycobacterium tuberculosis. Two HRQoL questionnaires translated into Yoruba were self-administered. Chest X-ray and Aspergillus IgG were collected at each visit. Results A total of 204 participants were recruited into this study. Most (70.6%) were age 18–39 years, and only 3.9% were above 60 years; 66.7% of all participants were males. A total of 189 (92.6%) participated in the 3-month assessment, 174 (85.3%) at 6 months, 139 (68.1%) at 9 months, and 99 (48.5%) at 12 months. At baseline, only 60.9% scored “good” or “very good” QoL and health on the WHOQOL-Bref, which improved to 77% at 6 months. At baseline, 10.4% had positive Aspergillus IgG levels, 15.1% at 3 months, 11.5% at 6 months, 16.7% at 9 months, and 19.3% at 12 months. Those with a positive Aspergillus IgG at 6 months had worse physical health (p = 0.001), psychological state (p = 0.002), social relationships (p = 0.006), and environmental QoL (p = 0.001) domains of the WHOQOL-Bref. Probable CPA was 10.4% at baseline and 19.3% at 6 months post-PTB therapy. Thirty-eight (18.6%) relocated after 6 months of treatment, 16 (7.8%) were lost to follow-up, and 11 (5.4%) died. Conclusion Our findings reveal a significant relationship between the QoL and Aspergillus IgG levels of TB patients. Further follow-up studies and additional imaging are required to determine when patients develop CPA and its clinical impact.
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Affiliation(s)
- Rita O. Oladele
- Department of Medical Microbiology & Parasitology, College of Medicine, University of Lagos, Lagos, Nigeria
- *Correspondence: Rita O. Oladele,
| | - Titi Gbajabimiala
- Clinical Sciences Department, National Institute for Medical Research, Lagos, Nigeria
| | - Nicholas Irurhe
- Department of Radiology, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Suzanne M. Skevington
- Manchester Centre for Health Psychology, Division of Psychological Science and Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - David W. Denning
- Manchester Fungal Infection Group, Core Technology Facility, The University of Manchester, Manchester, United Kingdom
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Siette J, Knaggs GT, Zurynski Y, Ratcliffe J, Dodds L, Westbrook J. Systematic review of 29 self-report instruments for assessing quality of life in older adults receiving aged care services. BMJ Open 2021; 11:e050892. [PMID: 34794991 PMCID: PMC8603300 DOI: 10.1136/bmjopen-2021-050892] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Quality of life (QoL) outcomes are used to monitor quality of care for older adults accessing aged care services, yet it remains unclear which QoL instruments best meet older adults', providers' and policymakers' needs. This review aimed to (1) identify QoL instruments used in aged care and describe them in terms of QoL domains measured and logistical details; (2) summarise in which aged care settings the instruments have been used and (3) discuss factors to consider in deciding on the suitability of QoL instruments for use in aged care services. DESIGN Systematic review. DATA SOURCES MEDLINE, EMBASE, PsycINFO, Cochrane Library and CINAHL from inception to 2021. ELIGIBILITY CRITERIA Instruments were included if they were designed for adults (>18 years), available in English, been applied in a peer-reviewed research study examining QoL outcomes in adults >65 years accessing aged care (including home/social care, residential/long-term care) and had reported psychometrics. DATA EXTRACTION AND SYNTHESIS Two researchers independently reviewed the measures and extracted the data. Data synthesis was performed via narrative review of eligible instruments. RESULTS 292 articles reporting on 29 QoL instruments were included. Eight domains of QoL were addressed: physical health, mental health, emotional state, social connection, environment, autonomy and overall QoL. The period between 1990 and 2000 produced the greatest number of newly developed instruments. The EuroQoL-5 Dimensions (EQ-5D) and Short Form-series were used across multiple aged care contexts including home and residential care. More recent instruments (eg, ICEpop CAPability measure for Older people (ICECAP-O) and Adult Social Care Outcomes Toolkit (ASCOT)) tend to capture emotional sentiment towards personal circumstances and higher order care needs, in comparison with more established instruments (eg, EQ-5D) which are largely focused on health status. CONCLUSIONS A comprehensive list of QoL instruments and their characteristics is provided to inform instrument choice for use in research or for care quality assurance in aged care settings, depending on needs and interests of users.
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Affiliation(s)
- Joyce Siette
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
- Centre for Ageing, Cognition and Wellbeing, Macquarie University, Sydney, New South Wales, Australia
| | - Gilbert Thomas Knaggs
- NHMRC Partnership Centre for Health Systems Sustainability, Macquarie University, Sydney, New South Wales, Australia
| | - Yvonne Zurynski
- NHMRC Partnership Centre for Health Systems Sustainability, Macquarie University, Sydney, New South Wales, Australia
| | - Julie Ratcliffe
- Health and Social Care Economics Group, Caring Futures Institute, Flinders University of South Australia, Adelaide, South Australia, Australia
| | - Laura Dodds
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Johanna Westbrook
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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Lima-Castro S, Arias-Medina P, Bueno-Pacheco A, Peña-Contreras E, Aguilar-Sizer M, Cabrera-Vélez M. Factor structure, measurement invariance and psychometric properties of the Quality of Life Scale WHOQOL-BREF in the Ecuadorian context. PSICOLOGIA-REFLEXAO E CRITICA 2021; 34:29. [PMID: 34622355 PMCID: PMC8497657 DOI: 10.1186/s41155-021-00194-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 09/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The short version of the World Health Organization Quality of Life questionnaire (WHOQOL-BREF) is a popular instrument used to assess quality of life. The objective of this study was to evaluate the following psychometric properties: structural validity, convergent validity, internal consistency, and measurement invariance across sex of the WHOQOL-BREF in a sample of Ecuadorian adults. METHODS We used a sample of undergraduates (n = 987) to assess the WHOQOL-BREF original four-factor structure, a model with correlated factors, a hierarchical model, and two models resulting from the exploratory factor analysis and exploratory graph analysis. All the models were evaluated using confirmatory factor analysis. RESULTS The results of the exploratory factor analysis and exploratory graph analysis suggest that the items are organized into four factors, although differently from the original version and the orthogonality assumption is not maintained. The confirmatory factor analysis shows that the original WHOQOL-BREF structure with correlated factors presents adequate psychometric properties. However, we propose a four-factor structure that has the best psychometric properties and adequate internal consistency. The results of the measurement invariance show that strict and strong invariance is achieved between men and women. Convergent validity analysis reveals moderate correlations with self-esteem, resilience, and social support. CONCLUSIONS Despite the original version of the WHOQOL-BREF with correlated factors has acceptable psychometric properties in the Ecuadorian context, we propose a version with a different organization of its items, which is consistent with the findings of other investigations.
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Affiliation(s)
- Sandra Lima-Castro
- Faculty of Psychology, University of Cuenca, Av. 12 de abril y Agustín Cueva, Cueca, Ecuador
| | - Paúl Arias-Medina
- Faculty of Psychology, University of Cuenca, Av. 12 de abril y Agustín Cueva, Cueca, Ecuador.
| | - Alexandra Bueno-Pacheco
- Faculty of Philosophy, Letters and Educational Sciences, Universidad del Azuay, Av. 24 de mayo 7-77 and Hernán Malo. Section: 01.01.981, Cuenca, Ecuador
| | - Eva Peña-Contreras
- Faculty of Psychology, University of Cuenca, Av. 12 de abril y Agustín Cueva, Cueca, Ecuador
| | - Mónica Aguilar-Sizer
- Faculty of Psychology, University of Cuenca, Av. 12 de abril y Agustín Cueva, Cueca, Ecuador.
| | - Marcela Cabrera-Vélez
- Faculty of Psychology, University of Cuenca, Av. 12 de abril y Agustín Cueva, Cueca, Ecuador
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Chen M, Jeronen E, Wang A. Toward Environmental Sustainability, Health, and Equity: How the Psychological Characteristics of College Students Are Reflected in Understanding Sustainable Development Goals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8217. [PMID: 34360510 PMCID: PMC8346037 DOI: 10.3390/ijerph18158217] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 07/27/2021] [Accepted: 07/31/2021] [Indexed: 01/02/2023]
Abstract
This study aimed to identify how the psychological characteristics of college students are reflected in understanding sustainable development goals (SDGs) by examining college students' psychological characteristics, including attitude, interests, motivations, and self-efficacy, through the Sustainable Development Goals Psychological Inventory (SDGPI). The relationships among SDGs attitude, SDGs interest, SDGs motivation, and SDGs self-efficacy were analyzed by Pearson product-moment correlation coefficients. In addition, the Mann-Whitney U test and Kruskal-Wallis one-way analysis of variance were used to explore the differences among the college student groups in terms of gender, grade, and major in relation to attitude and personal characteristics. Attitude scores based on regression analysis were used to predict college students' interest, motivation, and self-efficacy in relation to the SDGs. According to the results, (a) the college students considered the three most important SDGs to be good health and well-being (SDG 3) (49.72%), quality education (SDG 4) (41.39%), and no poverty (SDG 1) (32.22%), while the three least important SDGs were decent work and economic growth (SDG 8) (41.11%), partnerships for the goals (SDG 17) (38.06%), and response consumption and institutions (SDG 12) (30.83%); (b) the SDGPI had a high reliability, with a Cronbach's alpha of 0.942; (c) there was a significant positive correlation between attitude and the variables of interest, motivation, and self-efficacy; (d) differences in attitudes, interest, and motivation between men and women were distinct and women scored much higher in these three subscales than men; (e) attitude could explain significant variance in interest, motivation and self-efficacy. In addition, attitude, interest, and motivation could account for self-efficacy. This study supports the development of sustainability education (SE) at the college level by providing new insights into college students' psychological characteristics in relation to the SDGs.
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Affiliation(s)
- Meiai Chen
- School of Landscape Architecture, Zhejiang A & F University, Hangzhou 311300, China
| | - Eila Jeronen
- Department of Educational Sciences and Teacher Education, University of Oulu, FI-90014 Oulu, Finland;
| | - Anming Wang
- College of Materials, Chemistry and Chemical Engineering, Hangzhou Normal University, Hangzhou 311121, China
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Gagliardi J, Brettschneider C, König HH. Health-related quality of life of refugees: a systematic review of studies using the WHOQOL-Bref instrument in general and clinical refugee populations in the community setting. Confl Health 2021; 15:44. [PMID: 34078413 PMCID: PMC8173726 DOI: 10.1186/s13031-021-00378-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 05/11/2021] [Indexed: 11/21/2022] Open
Abstract
Purpose To systematically review studies on HRQOL, measured by the WHOQOL-Bref instrument, of refugees in general and clinical populations who are settled in the community of the hosting country, and outline the differences in scores among the two population groups and across the four domains of WHOQOL-Bref (physical, psychological, social relationships and environment domain) as well as factors impacting those outcomes. Methods Several databases were systematically searched by using a broad search strategy. Additionally, a hand search for grey literature was performed. Studies had to comply with the following inclusion criteria: (a) population of refugees; (b) living in the community of the country of destination; (c) assessing HRQOL through the WHOQOL-Bref instrument. Results 15 studies were identified and divided into two subgroups: (a) general population of refugees (b) clinical population of refugees, who were specifically selected for their mental status or because they had experienced relevant past traumas. Although we can outline common patterns among the two groups, in terms of domains scoring the highest and the lowest, heterogeneous values of HRQOL are observed across the studies included. Conclusions Individuals who were included in the clinical refugee group have a lower quality of life in respect to the general population of refugees. However, among the two groups different patterns can be outlined considering each domain of HRQOL: higher scores for the Physical and lower for the Environment domain when considering the general population of refugees and higher scores for the Environment and lower for the Psychological domain when referring to the clinical one. These lower scores are probably due to having a higher rate of mental distress and being more exposed to somatization, stigmatization and barriers to access the healthcare system of the hosting country. Supplementary Information The online version contains supplementary material available at 10.1186/s13031-021-00378-1.
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Affiliation(s)
- Juliette Gagliardi
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.,Department of Economics, University of Bologna, Via Zamboni 33, Bologna, 40126, Italy
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
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13
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Mayer RCF, Alves MR, Yamauti SM, Silva MT, Lopes LC. Quality of Life and Functioning of People With Mental Disorders Who Underwent Deinstitutionalization Using Assisted Living Facilities: A Cross-Sectional Study. Front Psychol 2021; 12:622973. [PMID: 34113278 PMCID: PMC8185360 DOI: 10.3389/fpsyg.2021.622973] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 04/19/2021] [Indexed: 11/13/2022] Open
Abstract
Context People with mental disorders can acquire long-term disabilities, which could impair their functioning and quality of life (QoL), requiring permanent care and social support. Systematic data on QoL and functioning, which could support a better management of these people, were not available. Objective To analyze the QoL, level of functioning and their association with sociodemographic and clinical factors of people with mental disorders who underwent deinstitutionalization using assisted living facilities. Methods A Cross-sectional study was conducted between July 2018 and July 2019, through interviews using the World Health Organization Quality of Life (WHOQOL-BREF) to determine the QoL scores, and the World Health Organization Disability Assessment Schedule (WHODAS 2.0) to determine the level of functioning. All adults (≥18 years old) with mental disorders, who underwent deinstitutionalization, users of assisted living facilities and assisted by the Psychosocial Assistance Centers III, in a city in the state of São Paulo, Brazil, were selected. For statistical analysis of the associated factors, Student’s t-test was used for dichotomous variables and ANOVA for polynomial variables. Pearson correlation coefficient was used to measure the association between QoL and functioning scores. Results Out of 359 people who underwent deinstitutionalization with mental disorders, 147 met the eligibility criteria. The mean total score for the WHOQOL-BREF was 66.5 ± 13.4 and the mean score for WHODAS 2.0 was 10.4 ± 7.6. An association was found between people who were studying (n = 65.8; 95%CI, 63.5–68.1 vs. n = 73.9; 95%CI, 67.5–80.3; p = 0.04) and better WHOQOL-BREF QoL scores or WHODAS 2.0 levels of functioning (n = 10.9; 95%CI, 9.6–12.2 vs. n = 5.1; 95%CI, 2.5–7.7; p = 0.01). A weak negative correlation (r = 0.41) emerged between higher QoL scores and functioning improvement. Conclusion This study indicates that the QoL of the sample is associated by their functioning levels, which, in turn, may reflect on their social interactions. Public policies that favor interventions increasing socialization of this population can result in better health outcomes. The QoL and functioning scores provide valuable insights to develop public policies more suited to this population profile.
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Affiliation(s)
| | - Maíra Ramos Alves
- Graduate Program in Pharmaceutical Sciences, University of Sorocaba, Sorocaba, Brazil
| | - Sueli Miyuki Yamauti
- Graduate Program in Pharmaceutical Sciences, University of Sorocaba, Sorocaba, Brazil
| | | | - Luciane Cruz Lopes
- Graduate Program in Pharmaceutical Sciences, University of Sorocaba, Sorocaba, Brazil
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14
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Shaffer SM, Emerson AJ, Burr M, Einhorn L, Naze GS. Quality of life in painful temporomandibular disorders onset: a systematic review of outcome measure clinimetrics and predictive properties. PHYSICAL THERAPY REVIEWS 2021. [DOI: 10.1080/10833196.2021.1914955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | - Alicia J. Emerson
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, High Point, NC, USA
| | - Meghan Burr
- Exercise Science Department, Congdon School of Health Sciences, High Point University, High Point, NC, USA
| | | | - Garrett S. Naze
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, High Point, NC, USA
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15
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Skevington SM, Rowland C, Panagioti M, Bower P, Krägeloh C. Enhancing the multi-dimensional assessment of quality of life: introducing the WHOQOL-Combi. Qual Life Res 2021; 30:891-903. [PMID: 33331967 PMCID: PMC7952286 DOI: 10.1007/s11136-020-02661-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION We revisited the global concept of subjective quality of life (QoL) as assessed by the WHOQOL-BREF to investigate whether it could be elaborated into a conceptually more comprehensive instrument with good psychometric properties. Responding to a growing need for shorter QoL measures with broader social, spiritual and environmental contents, facets from WHOQOL international modules were examined for potential integration into the new WHOQOL-Combi. METHOD Adults over 65 years, diagnosed with one or more chronic diseases (n = 2833), completed 41 WHOQOL items during the CLASSIC survey; each item represented a WHOQOL facet. This pool of specific QoL facets contained 24 from the WHOQOL-BREF (excluding general items), and 17 from recent international WHOQOL short-form modules, selected for their generic properties. Rasch modelling reduced the final item pool when assessing the WHOQOL-Combi's conceptual structure. Comparisons are made with the WHOQOL-BREF. RESULTS Modelling confirmed the tenability of a 36-item solution scored as a five-domain profile, comprised of 24 WHOQOL-BREF facets and 12 new facets from modules. Social and psychological domains were strengthened by three facets, spiritual QoL by five, and physical QoL by one. The WHOQOL-Combi showed sound model fit, excellent internal consistency (α = .95), and scores discriminated between socio-demographic categories. Concurrent validity with the EQ-5D-5L was confirmed for physical and psychological domains. Performance was similar to the WHOQOL-BREF. CONCLUSION The WHOQOL-Combi offers a contemporary, comprehensive, integrated, multi-dimensional subjective QoL instrument with enhanced evaluations of social, spiritual, psychological and physical QoL. Acceptable to older people, future research should evaluate younger age groups and other cultures.
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Affiliation(s)
- Suzanne M Skevington
- International Hub for Quality of Life Research, Manchester Centre for Health Psychology, Division of Psychological Science and Mental Health, University of Manchester, Manchester, M13 9PL, UK.
| | - Christine Rowland
- International Hub for Quality of Life Research, Manchester Centre for Health Psychology, Division of Psychological Science and Mental Health, University of Manchester, Manchester, M13 9PL, UK
| | - Maria Panagioti
- NIHR School for Primary Care Research, NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester Academic Health Science Centre, University of Manchester, Manchester, M13 9PL, UK
| | - Peter Bower
- NIHR School for Primary Care Research, Centre for Primary Care, Division of Population of Health, Health Services Research and Primary Care, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Christian Krägeloh
- Centre for Person Centred Research, Auckland University of Technology, Auckland, New Zealand
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16
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Georgiadou I, Vlachou A, Stavroussi P. Quality of life and vocational education service quality in students with intellectual disability. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2021; 68:681-691. [PMID: 36210900 PMCID: PMC9542618 DOI: 10.1080/20473869.2021.1887435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 01/30/2021] [Accepted: 01/31/2021] [Indexed: 06/16/2023]
Abstract
The aim of the study was to investigate the relation between subjective quality of life and quality of vocational education services from the view of students with intellectual disability who participate in public special vocational education schools in Greece. The level of quality of life and quality of special vocational education services was explored. The article presents a functional description of service quality in special vocational education and operationalizes quality of life for students with disability. Instruments were developed and adapted in line with the participatory research paradigm. Convenience sampling was used. Data was gathered from 131 students with intellectual disability. All measures showed good evidence of internal consistency and construct validity. The findings suggest relationship between quality of life and quality of special vocational education services received by students with intellectual disability. Low levels of self-determination are highlighted. Practical implications concerning the application of the instruments in special education settings as measures for the quality assessment and the evaluation of educational interventions are discussed.
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Affiliation(s)
- Ioanna Georgiadou
- Department of Special Education, University of Thessaly, Volos, Greece
| | - Anastasia Vlachou
- Department of Special Education, University of Thessaly, Volos, Greece
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Kalfoss MH, Reidunsdatter RJ, Klöckner CA, Nilsen M. Validation of the WHOQOL-Bref: psychometric properties and normative data for the Norwegian general population. Health Qual Life Outcomes 2021; 19:13. [PMID: 33413455 PMCID: PMC7792093 DOI: 10.1186/s12955-020-01656-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 12/17/2020] [Indexed: 12/05/2022] Open
Abstract
Background The World Health Organization’s Quality of Life Questionnaire (WHOQOL-Bref) is a frequently used instrument to assess the quality of life in both healthy and ill populations. Inquiries of the psychometric properties of the WHOQOL-Bref report that the validity and reliability is generally satisfactory. However, some studies fail to support a four-factor dimensionality; others report poor reliability of the social and environmental domain; and there may be some challenges of supporting construct validity across age. This paper evaluates the psychometric properties of the Norwegian WHOQOL-Bref and extends previous research by testing for measurement invariance across age, gender and education level. In addition, we provide updated normative data for the Norwegian population. Methods We selected a random sample of the Norwegian population (n = 654) aged 18–75 years. Participants filled out the WHOQOL-Bref, the Utrecht Work Engagement Scale and various sociodemographic variables. Results We found an acceptable convergent and discriminate validity and internal consistency of the physical, psychological and environmental domains, but a marginal reliability was found for the social domain. The factor loadings were invariant across gender, education and age. Some items had low factor loadings and explained variance, and the model fit for the age group 60–75 years were less satisfactory. Conclusions The original four-factor dimensionality of the WHOQOL-Bref displayed a better fit to the data compared to the one-factor solution and is recommended for use in the Norwegian population. The WHOQOL-Bref is suitable to use across gender, education and age, but for assessment in the oldest age group, the WHOQOL-Old module could be a good supplementary, but further studies are needed.
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Affiliation(s)
- Mary H Kalfoss
- Faculty of Health Studies, VID Specialized University, Campus Diakonova, Pb 184, Videren, 0319, Oslo, Norway
| | - Randi J Reidunsdatter
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Christian A Klöckner
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Marianne Nilsen
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway. .,Department of Social Work, Norwegian University of Science and Technology, Trondheim, Norway.
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Thangiah G, Said MA, Majid HA, Reidpath D, Su TT. Income Inequality in Quality of Life among Rural Communities in Malaysia: A Case for Immediate Policy Consideration. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238731. [PMID: 33255397 PMCID: PMC7727827 DOI: 10.3390/ijerph17238731] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/13/2020] [Accepted: 11/18/2020] [Indexed: 11/24/2022]
Abstract
Quality of life (QOL) is a proxy of health and social well-being. Hence, it is vital to assess QOL as it informs the strategies of policymakers to enhance the living conditions in communities. Rural areas in emerging economies are underserved in terms of modern facilities and technologies, which impact QOL. To address this, this study investigated whether income played a role in the QOL of rural residents within emerging economies using a large survey of Malaysian adults above 18 years old. The study extracted data from a sample of 18,607 respondents of a health and demographic surveillance system survey. A generalized linear model was used to estimate the impact of three income groups, the bottom 40%, middle 40% and top 20%, on perceived QOL, controlling for sociodemographic, chronic disease co-morbidities and mental health status. Results of the study showed a statistically significant association between income and the physical, psychological, social and environmental QOL domains. Using the bottom 40% as a reference category, the middle 40% and top 20% income groups showed a significant and positive association across the four domains of QOL. Hence, intervention programs are necessary to escalate the income levels of rural communities, especially the bottom 40%, to uplift perceived QOL among rural residents.
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Affiliation(s)
- Govindamal Thangiah
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia; (G.T.); (M.A.S.); (H.A.M.)
- South East Asia Community Observatory (SEACO) & Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya 47500, Malaysia;
| | - Mas Ayu Said
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia; (G.T.); (M.A.S.); (H.A.M.)
| | - Hazreen Abdul Majid
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia; (G.T.); (M.A.S.); (H.A.M.)
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Jawa Timur 60115, Indonesia
| | - Daniel Reidpath
- South East Asia Community Observatory (SEACO) & Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya 47500, Malaysia;
- International Centre for Diarrhoeal Disease Research, Dhaka 1212, Bangladesh
| | - Tin Tin Su
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia; (G.T.); (M.A.S.); (H.A.M.)
- South East Asia Community Observatory (SEACO) & Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya 47500, Malaysia;
- Correspondence: or
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Cresswell JA, Barbour KD, Chou D, McCaw-Binns A, Filippi V, Cecatti JG, Barreix M, Petzold M, Kostanjsek N, Cottler-Casanova S, Say L. Measurement of maternal functioning during pregnancy and postpartum: findings from the cross-sectional WHO pilot study in Jamaica, Kenya, and Malawi. BMC Pregnancy Childbirth 2020; 20:518. [PMID: 32894081 PMCID: PMC7487910 DOI: 10.1186/s12884-020-03216-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 08/27/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The World Health Organization's definition of maternal morbidity refers to "a negative impact on the woman's wellbeing and/or functioning". Many studies have documented the, mostly negative, effects of maternal ill-health on functioning. Although conceptually important, measurement of functioning remains underdeveloped, and the best way to measure functioning in pregnant and postpartum populations is unknown. METHODS A cross-sectional study among women presenting for antenatal (N = 750) and postpartum (N = 740) care in Jamaica, Kenya and Malawi took place in 2015-2016. Functioning was measured through the World Health Organization Disability Assessment Schedule (WHODAS-12). Data on health conditions and socio-demographic characteristics were collected through structured interview, medical record review, and clinical examination. This paper presents descriptive data on the distribution of functioning status among pregnant and postpartum women and examines the relationship between functioning and health conditions. RESULTS Women attending antenatal care had a lower level of functioning than those attending postpartum care. Women with a health condition or associated demographic risk factor were more likely to have a lower level of functioning than those with no health condition. However, the absolute difference in functioning scores typically remained modest. CONCLUSIONS Functioning is an important concept which integrates a woman-centered approach to examining how a health condition affects her life, and ultimately her return to functioning after delivery. However, the WHODAS-12 may not be the optimal tool for use in this population and additional components to capture pregnancy-specific issues may be needed. Challenges remain in how to integrate functioning outcomes into routine maternal healthcare at-scale and across diverse settings.
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Affiliation(s)
- Jenny A Cresswell
- Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, UNDP UNFPA UNICEF WHO World Bank Special Programme of Research, World Health Organization, Geneva, Switzerland.
| | - Kelli D Barbour
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA
| | - Doris Chou
- Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, UNDP UNFPA UNICEF WHO World Bank Special Programme of Research, World Health Organization, Geneva, Switzerland
| | - Affette McCaw-Binns
- Department of Community Health and Psychiatry, University of the West Indies, Mona, Kingston, Jamaica
| | - Veronique Filippi
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Jose Guilherme Cecatti
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Maria Barreix
- Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, UNDP UNFPA UNICEF WHO World Bank Special Programme of Research, World Health Organization, Geneva, Switzerland
| | - Max Petzold
- School of Public Health, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Nenad Kostanjsek
- Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland
| | - Sara Cottler-Casanova
- Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Lale Say
- Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, UNDP UNFPA UNICEF WHO World Bank Special Programme of Research, World Health Organization, Geneva, Switzerland
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20
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Walshe C, Roberts D, Calman L, Appleton L, Croft R, Skevington S, Lloyd-Williams M, Grande G, Perez Algorta G. Peer support to maintain psychological wellbeing in people with advanced cancer: findings from a feasibility study for a randomised controlled trial. BMC Palliat Care 2020; 19:129. [PMID: 32807157 PMCID: PMC7433175 DOI: 10.1186/s12904-020-00631-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 08/07/2020] [Indexed: 12/12/2022] Open
Abstract
Background Advanced cancer affects people’s lives, often causing stress, anxiety and depression. Peer mentor interventions are used to address psychosocial concerns, but their outcomes and effect are not known. Our objective was to determine the feasibility of delivering and investigating a novel peer mentor intervention to promote and maintain psychological wellbeing in people with advanced cancer. Methods A mixed methods design incorporating a two-armed controlled trial (random allocation ratio 1:1) of a proactive peer mentor intervention plus usual care, vs. usual care alone, and a qualitative process evaluation. Peer mentors were recruited, trained, and matched with people with advanced cancer. Quantitative data assessed quality of life, coping styles, depression, social support and use of healthcare and other supports. Qualitative interviews probed experiences of the study and intervention. Results Peer mentor training and numbers (n = 12) met feasibility targets. Patient participants (n = 12, from 181 eligible who received an information pack) were not recruited to feasibility targets. Those who entered the study demonstrated that intervention delivery and data collection were feasible. Outcome data must be treated with extreme caution due to small numbers, but indicate that the intervention may have a positive effect on quality of life. Conclusions Peer mentor interventions are worthy of further study and researchers can learn from these feasibility data in planning participant recruitment and data collection strategies. Pragmatic trials, where the effectiveness of an intervention is tested in real-world routine practice, may be most appropriate. Peer mentor interventions may have merit in enabling survivors with advanced cancer cope with their disease. Trial Registration The trial was prospectively registered 13.6.2016: ISRCTN10276684.
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Affiliation(s)
- Catherine Walshe
- International Observatory on End of Life Care, Division of Health Research, Lancaster University, Bailrigg, Lancaster, UK.
| | - Diane Roberts
- Division of Nursing, Midwifery and Social Work, Manchester University, Manchester, UK
| | - Lynn Calman
- Macmillan Survivorship Research Group, School of Health Sciences, Southampton University, Southampton, UK
| | - Lynda Appleton
- Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, UK
| | | | - Suzanne Skevington
- Manchester Centre for Health Psychology, School of Psychological Sciences, Manchester University, Manchester, UK
| | | | - Gunn Grande
- Division of Nursing, Midwifery and Social Work, Manchester University, Manchester, UK
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21
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Berghöfer A, Martin L, Hense S, Weinmann S, Roll S. Quality of life in patients with severe mental illness: a cross-sectional survey in an integrated outpatient health care model. Qual Life Res 2020; 29:2073-2087. [PMID: 32170584 PMCID: PMC7363717 DOI: 10.1007/s11136-020-02470-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/29/2020] [Indexed: 12/29/2022]
Abstract
PURPOSE This study (a) assessed quality of life (QoL) in a patient sample with severe mental illness in an integrated psychiatric care (IC) programme in selected regions in Germany, (b) compared QoL among diagnostic groups and (c) identified socio-demographic, psychiatric anamnestic and clinical characteristics associated with QoL. METHODS This cross-sectional study included severely mentally ill outpatients with substantial impairments in social functioning. Separate dimensions of QoL were assessed with the World Health Organisation's generic 26-item quality of life (WHOQOL-BREF) instrument. Descriptive analyses and analyses of variance (ANOVAs) were conducted for the overall sample as well as for diagnostic group. RESULTS A total of 953 patients fully completed the WHOQOL-BREF questionnaire. QoL in this sample was lower than in the general population (mean 34.1; 95% confidence interval (CI) 32.8 to 35.5), with the lowest QoL in unipolar depression patients (mean 30.5; 95% CI 28.9 to 32.2) and the highest in dementia patients (mean 53.0; 95% CI 47.5 to 58.5). Main psychiatric diagnosis, living situation (alone, partner/relatives, assisted), number of disease episodes, source of income, age and clinical global impression (CGI) scores were identified as potential predictors of QoL, but explained only a small part of the variation. CONCLUSION Aspects of health care that increase QoL despite the presence of a mental disorder are essential for severely mentally ill patients, as complete freedom from the disorder cannot be expected. QoL as a patient-centred outcome should be used as only one component among the recovery measures evaluating treatment outcomes in mental health care.
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Affiliation(s)
- Anne Berghöfer
- Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Luisenstr. 57, 10117, Berlin, Germany.
| | - Luise Martin
- Klinik f. Pädiatrie m.S. Pneumologie, Immunologie und Intensivmedizin, Otto-Heubner-Centrum für Kinder- und Jugendmedizin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Sabrina Hense
- Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Luisenstr. 57, 10117, Berlin, Germany
| | - Stefan Weinmann
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Vivantes Klinikum Am Urban, Berlin, Germany
| | - Stephanie Roll
- Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Luisenstr. 57, 10117, Berlin, Germany
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22
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Skevington SM. Is Culture Important to the Relationship Between Quality of Life and Resilience? Global Implications for Preparing Communities for Environmental and Health Disasters. Front Psychol 2020; 11:1492. [PMID: 32852482 PMCID: PMC7406707 DOI: 10.3389/fpsyg.2020.01492] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 06/04/2020] [Indexed: 01/15/2023] Open
Abstract
Background Using a preventative approach, we investigated whether international subjective qualities of life are associated with resilience to adversity when culture is taken into account. Although resilience has been previously associated with good QoL, cross-cultural studies are scarce. Methods Sequential linear multiple regression models of WHOQOL SRPB data from 15 countries worldwide (N = 3,019) examined which qualities are most closely associated with resilience, when adjusting for culture and selected demographics. We also examined whether all cultures confirmed this positive association. Of 13 QoL facets identified from a literature summary, seven were associated with defining resilience and six reflected strategies for building resilience; these were tested together. Principal components analysis provided a dependent variable for resilience, covering inner strength and hope. Results The final model explained 52% of resilience overall, of which QoL explained 37% and culture explained 12% (p < 0.0001). Being older than 45 years was a significant covariate. Spiritual QoL from meaning in life, awe and wonder, wholeness and integration, and being kind to others was linked with strategies for building resilience (28%). Better psychological QoL from high levels of positive feelings and low negative feelings was associated with defining resilience (9%). Larger significant positive β’s were found for 10 cultures, so model “universality” was not confirmed. Conclusion A new cross-cultural psycho-spiritual model of resilience is presented. Assessing individual QoL profiles could identify suitable community members to build resilience locally in culturally acceptable styles. The WHOQOL SRPB evidence could inform international policy designed to prepare vulnerable cultures that are threatened with environmental and health disasters.
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Affiliation(s)
- Suzanne M Skevington
- Manchester Centre for Health Psychology, Division of Psychological Science and Mental Health, The University of Manchester, Manchester, United Kingdom
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23
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Garner RM, Aldridge JB, Wolfe SQ, Fargen KM. Quality of life, need for retreatment, and the re-equilibration phenomenon after venous sinus stenting for idiopathic intracranial hypertension. J Neurointerv Surg 2020; 13:79-85. [PMID: 32611623 DOI: 10.1136/neurintsurg-2020-016124] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND Long term failure rates after venous sinus stenting (VSS) for idiopathic intracranial hypertension (IIH) are poorly understood. METHODS Retrospective analysis was performed on a prospectively-maintained single center database to identify patients with medically refractory IIH who underwent VSS. Patients with persistent or severe recurrent symptoms after VSS undergo lumbar puncture (LP), therefore LP serves as a marker for treatment failure. RESULTS 81 patients underwent VSS with a mean follow-up of 10 months; 44 (54.3%) patients underwent LP after VSS due to persistent or recurrent symptoms at a mean of 12 months (median 7, range 2-43). There was a mean decrease in opening pressure (OP) on LP from pre- to post-VSS of 9.1 cm H2O (median 9.5). Overall, a total of 21 (25.9%) patients underwent further surgical intervention following VSS, including five who underwent repeat VSS (6.2% of total) and 18 who underwent cerebrospinal fluid shunting (22.2% of total). There was a non-significant (p=0.18) but overall increase in quality of life scores from pre-stenting (61.2) to last follow-up (71.2), and a significant decrease in Headache Impact Test-6 (HIT-6) scores (p=0.03) with mean pre-stenting and last follow-up scores of 62.7 and 55.8, respectively. CONCLUSIONS VSS is an effective treatment for venous sinus stenosis in IIH; however, this study found higher rates of symptomatic recurrence and need for further surgical intervention (26%) than previously reported in the literature. Recurrence of symptoms occurred at a median of 7 months, even though OP remained lower at follow-up LP, suggestive of a re-equilibration phenomenon.
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Affiliation(s)
- Rebecca M Garner
- Neurological Surgery, Wake Forest University, Winston-Salem, North Carolina, USA
| | | | - Stacey Q Wolfe
- Neurological Surgery, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Kyle M Fargen
- Neurological Surgery, Wake Forest University, Winston-Salem, North Carolina, USA
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Community asset participation and social medicine increases qualities of life. Soc Sci Med 2020; 259:113149. [PMID: 32603958 PMCID: PMC7397510 DOI: 10.1016/j.socscimed.2020.113149] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/11/2020] [Accepted: 06/13/2020] [Indexed: 11/22/2022]
Abstract
Rationale Social prescribing to community assets, like social groups, is a current policy goal. As aging adults lead longer, healthier lives, the effects of participating in community assets raises questions about whether subjective quality of life (QoL) improves during participation and on what dimensions. Objective The study's goal was to examine the effectiveness of community assets at improving QoL among older people living in the community. Method Examining longitudinal survey data which tracked health and wellbeing in older adults living in Salford, UK over 12 months, we first used regressions on community assets to compare the World Health Organization's QoL Assessment (WHOQOL-BREF) domains at baseline for those who already participated in community assets (54%) and with non-participants (46%). Second, we used propensity score matching to compare QoL in an ‘uptake’ group (no initial participation but who participated at 12 months), to those who never participated, and to a ‘cessation’ group who participated initially, but ceased within one year, to those who always participated. Results Group comparisons confirmed that participants reported significantly higher QoL on all domains – environmental, psychological, physical, and social QoL – and on 16 predicted facets. After affirming group matching reliability, the strongest results were for the uptake group, with significant improvements in all domains, and in 18 facets. All QoL domains decreased in the cessation group, but overall, the effect was weaker. As predicted from the context, QoL relating to ‘opportunities for recreation and leisure’ showed the greatest effect. Furthermore, QoL increased with uptake, and decreased with cessation. Conclusion Policies to improve QoL in later life should be designed not just to promote community assets, but also maintain participation once initiated. Social prescribing to community assets such as social groups is now a policy goal. Little is known about their effect on participants' quality of life (QoL). Community asset participants reported higher QoL on all four domains. Participation uptake strongly led to increased QoL. Cessation was detrimental to QoL.
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Moore C, Carter LA, Mitra S, Skevington S, Wearden A. Quality of life improved for patients after starting dialysis but is impaired, initially, for their partners: a multi-centre, longitudinal study. BMC Nephrol 2020; 21:185. [PMID: 32423378 PMCID: PMC7236460 DOI: 10.1186/s12882-020-01819-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 04/19/2020] [Indexed: 02/07/2023] Open
Abstract
Background Quality of life (QOL) is important to patients with end stage renal disease and their partners. Despite the first 12 weeks being a critical time in the treatment pathway, limited research exists which examines how the transition onto dialysis impacts QOL. In this study we measured QOL in patients and their partners at pre-dialysis and over the first 12 weeks on dialysis to investigate QOL during this crucial period. Methods Patients and their partners, recruited from 10 renal units in England, completed questionnaires at pre-dialysis (n = 166 participants, 83 couples), 6 weeks (n = 90 participants, 45 couples) and 12 weeks (n = 78, 39 couples) after starting dialysis. On each occasion participants completed a QOL questionnaire (WHOQOL-BREF). Multilevel modelling accommodated the nested structure of couples with repeated measures within participants. Three-level random intercept models estimated changes in WHOQOL general QOL and its four domains (Physical, Psychological, Social and Environment). Two-level random intercept models assessed the relationship between baseline clinical and socio-demographic variables with changes in general QOL. Results Patients reported positive changes in general QOL from pre-dialysis to 6 weeks (β = 0.42, p < 0.001, 95% CI 0.19, 0.65) and from pre-dialysis to 12 weeks (β = 0.47, p < 0.001, 95% CI 0.24, 0.71). Partners’ general QOL decreased significantly from pre-dialysis to 6 weeks (β = − 0.24, p = 0.04, 95% CI -0.47, − 0.01) but returned to its original level at 12 weeks. Patients reported improvements in the physical domain between pre-dialysis and 12 weeks (β = 6.56, p < 0.004, 95% CI 2.10, 11.03). No other domains changed significantly in patients or partners. Only in patients were there significant associations between moderator variables and general QOL. High comorbidity risk level and diabetes were associated with poorer QOL at pre-dialysis whereas being female and having an arteriovenous fistula were linked with improvements in general QOL. Conclusions Patients reported significant improvements in their general and physical QOL after starting dialysis. Partners’ general QOL worsened after patients started dialysis but improved by 12 weeks. Both patients and partners may benefit from additional educational and counselling services in the lead up to, and immediately after starting dialysis, which could facilitate the transition onto dialysis and improve QOL in both. Study registration This study was adopted on the NIHR Clinical Research Network (UK). The details of this study are registered on the Research Registry website (www.researchregistry.com). The identifier for this study is researchregistry2574.
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Affiliation(s)
- Currie Moore
- School of Health Sciences, Division of Psychology and Mental Health, Manchester Centre for Health Psychology, University of Manchester, Manchester, UK. .,Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
| | - Lesley-Anne Carter
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, Manchester, UK
| | - Sandip Mitra
- Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.,Manchester University NHS Foundation Trust, Manchester, UK.,NIHR Devices for Dignity MedTech Cooperative, Sheffield, UK
| | - Suzanne Skevington
- School of Health Sciences, Division of Psychology and Mental Health, Manchester Centre for Health Psychology, University of Manchester, Manchester, UK.,Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Alison Wearden
- School of Health Sciences, Division of Psychology and Mental Health, Manchester Centre for Health Psychology, University of Manchester, Manchester, UK.,Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
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Abstract
PURPOSE Diagnosing cancer early is an imperative, as help-seeking delays affect survival. Quality of life (QoL) deteriorates after diagnosis, but decline may start when cancer is suspected at the earliest stage of the pathway to treatment. This study examined whether offering guided feedback about personal QoL to adults with potential cancer symptoms, living in deprived communities, changes QoL and promotes help-seeking in primary care. METHODS Visitors to a CRUK mobile cancer roadshow were recruited in 43 sites. A prospective longitudinal (2 × 2) repeated-measures design was applied. Where they presented a potential cancer symptom, and were 'signposted' to a GP, they were allocated to a symptom condition, or a lifestyle condition, if seeking cancer risk advice. Randomisation was to an Intervention group, who received feedback about personal QoL results (WHOQOL-BREF and WHOQOL importance measures), or a Control group who assessed QoL without feedback. Depression was screened. RESULTS Of 107 participants, the mean age was 53; 50% were women, 57% were without tertiary education, 66% were unemployed and 45% were currently ill. Over 10 weeks, 54% of all those with symptoms sought help from a medical source and 42% specifically from a GP. Thirty-one completed all three assessments. With symptoms present, psychological, social and environmental QoL were poor, becoming poorer over time. When the symptoms group received feedback, psychological QoL increased, but GP visits were unaffected. However, feedback increased help-seeking from informal social contacts. Lifestyle groups reported consistently good psychological and social QoL. CONCLUSION This early cancer research offers practical and theoretical implications for QoL interventions in deprived communities.
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McConachie H, Wilson C, Mason D, Garland D, Parr JR, Rattazzi A, Rodgers J, Skevington S, Uljarevic M, Magiati I. What Is Important in Measuring Quality of Life? Reflections by Autistic Adults in Four Countries. AUTISM IN ADULTHOOD 2020; 2:4-12. [PMID: 36600984 PMCID: PMC8992842 DOI: 10.1089/aut.2019.0008] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Relevant and valid measurement is crucial in determining whether interventions and supports have improved the quality of life (QoL) of autistic people. However, it is possible that researchers' and services' use of general population QoL tools may overlook issues of specific importance. To advance methodology, we conducted a preliminary exploration of the need and basis for cross-cultural development of additional autism-specific QoL questions. Nine consultation groups with autistic adults (n = 38) were held in Argentina, Australia, Singapore, and the United Kingdom to examine the items of the World Health Organization QoL questionnaire (WHOQOL-BREF) and the WHOQOL Disabilities add-on module. Each group discussion was transcribed and analyzed thematically to identify missing issues and nuances of particular significance to autistic people. Themes seen as important and particularly relevant to QoL of autistic people included a positive autistic identity, other people's lack of understanding of autism, sensory issues, and autistic people's contributions to society. There were notable similarities across sites indicating that creation of cross-cultural autism-specific items is likely to be possible; the themes identified could inform the focus of items for measurement of QoL. This project represents an initial step toward fuller international consultation, and subsequent development of an autism-specific module for addition to the core WHOQOL model. Lay summary Why was this project done?: Quality of life (QoL) refers to how satisfied a person is with their life now, taking into account their experiences and the conditions in which they live. There are questionnaires for the general public to rate their QoL, but these may ask questions in ways that are not important or relevant for autistic people; for example, some autistic people have few or no friends, but are fine with this. Also questionnaires miss out topics such as sensory overload that impact on QoL for autistic people.What was the purpose?: We wanted to try to understand whether the questions in the World Health Organization Questionnaire (WHOQOL-BREF for short), and in the optional add-on Disabilities questionnaire, were important and relevant to autistic people from different countries and cultures. We also wanted to find out whether autistic people thought there were other important topics missing from these questionnaires.What did the researchers do?: We held 9 consultation groups about the WHO questionnaire items, with 38 autistic people in 4 countries: the United Kingdom, Singapore, Australia, and Argentina. Researchers, including members of the autism community, read the typed out discussions a number of times to find common themes, especially what was particularly relevant, or topics and experiences that were missing. First we analyzed the four United Kingdom groups, and then the other five groups.What did the researchers find?: Autistic people we consulted thought that most of the existing items of the WHOQOL questionnaires were important. From the discussions, we found 13 themes that were identified as particularly relevant to QoL, including being positive about one's autistic identity, other people's (lack of) knowledge of autism, sensory issues, mental health difficulties, the nature of friendships, and supporting other people as carers or volunteers.What do these findings add to what was already known?: The discussions from the four countries were quite similar. The items from the WHO QoL questionnaires were mostly viewed as important and relevant by autistic people, but a number of issues are missing, which seem different in autism and should be included in any improved measurement of QoL.What are potential weaknesses?: The project was a first step in consultation about measuring autistic adults' QoL, involving only four countries, and all except one group conducted in English. Only one group included people with intellectual disability.How will these findings help autistic adults now or in the future?: Having good QoL is central for everyone. Our consultation found that some topics highly relevant for autistic people are not included in QoL questionnaires developed for the general population. Our findings suggest that it will be both important and possible to develop a set of internationally appropriate items for autistic people to add to the existing WHO QoL questionnaires. This would allow researchers and health workers to measure accurately the QoL of autistic adults and to be able to judge how helpful supports and services are in improving QoL.
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Affiliation(s)
- Helen McConachie
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom
| | | | - David Mason
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Deborah Garland
- National Autistic Society North East Resource Centre, Newcastle upon Tyne, United Kingdom
| | - Jeremy R. Parr
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom
- Northumberland Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Alexia Rattazzi
- Programa Argentino para Niños, Adolescentes y Adultos con Condiciones del Espectro Autista (PANAACEA), Buenos Aires, Argentina
| | - Jacqui Rodgers
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Suzanne Skevington
- Manchester Centre for Health Psychology, University of Manchester, Manchester, United Kingdom
| | - Mirko Uljarevic
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Stanford Autism Center, School of Medicine, Stanford University, Stanford, California, USA
- Olga Tennison Autism Research Centre, School of Psychological Science, La Trobe University, Bundoora, Australia
| | - Iliana Magiati
- Department of Psychology, National University of Singapore, Singapore, Singapore
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Chao ICI, Nicpon K, Roduta Roberts M. Effect of Cognitive Stimulation Therapy on Quality of Life: A Critical Review. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2020. [DOI: 10.1080/02703181.2020.1716915] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Iris C. I. Chao
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Katarzyna Nicpon
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
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Jack SM, Boyle M, McKee C, Ford-Gilboe M, Wathen CN, Scribano P, Davidov D, McNaughton D, O’Brien R, Johnston C, Gasbarro M, Tanaka M, Kimber M, Coben J, Olds DL, MacMillan HL. Effect of Addition of an Intimate Partner Violence Intervention to a Nurse Home Visitation Program on Maternal Quality of Life: A Randomized Clinical Trial. JAMA 2019; 321:1576-1585. [PMID: 31012933 PMCID: PMC6487547 DOI: 10.1001/jama.2019.3211] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
IMPORTANCE Intimate partner violence (IPV) is a public health problem with significant adverse consequences for women and children. Past evaluations of a nurse home visitation program for pregnant women and first-time mothers experiencing social and economic disadvantage have not consistently shown reductions in IPV. OBJECTIVE To determine the effect on maternal quality of life of a nurse home visitation program augmented by an IPV intervention, compared with the nurse home visitation program alone. DESIGN, SETTING, AND PARTICIPANTS Cluster-based, single-blind, randomized clinical trial at 15 sites in 8 US states (May 2011-May 2015) enrolling 492 socially disadvantaged pregnant women (≥16 years) participating in a 2.5-year nurse home visitation program. INTERVENTIONS In augmented program sites (n = 229 participants across 7 sites), nurses received intensive IPV education and delivered an IPV intervention that included a clinical pathway to guide assessment and tailor care focused on safety planning, violence awareness, self-efficacy, and referral to social supports. The standard program (n = 263 participants across 8 sites) included limited questions about violence exposure and information for abused women but no standardized IPV training for nurses. MAIN OUTCOMES AND MEASURES The primary outcome was quality of life (WHOQOL-BREF; range, 0-400; higher score indicates better quality of life) obtained through interviews at baseline and every 6 months until 24 months after delivery. From 17 prespecified secondary outcomes, 7 secondary end points are reported, including scores on the Composite Abuse Scale, SPAN (Startle, Physiological Arousal, Anger, and Numbness), Prime-MD Patient Health Questionnaire, TWEAK (Tolerance/Worry About Drinking/Eye-Opener/Amnesia/C[K]ut Down on Drinking), Drug Abuse Severity Test, and the 12-Item Short-Form Health Survey (physical and mental health), version 2. RESULTS Among 492 participants enrolled (mean age, 20.4 years), 421 (86%) completed the trial. Quality of life improved from baseline to 24 months in both groups (change in WHOQOL-BREF scores from 299.5 [SD, 54.4] to 308.2 [SD, 52.6] in the augmented program group vs from 293.6 [SD, 56.4] to 316.4 [SD, 57.5] in the standard program group). Based on multilevel growth curve analysis, there was no statistically significant difference between groups (modeled score difference, -4.9 [95% CI, -16.5 to 6.7]). There were no statistically significant differences between study groups in any of the secondary participant end points. There were no adverse events recorded in either group. CONCLUSIONS AND RELEVANCE Among pregnant women experiencing social and economic disadvantage and preparing to parent for the first time, augmentation of a nurse home visitation program with a comprehensive IPV intervention, compared with the home visitation program alone, did not significantly improve quality of life at 24 months after delivery. These findings do not support the use of this intervention. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01372098.
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Affiliation(s)
- Susan M. Jack
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - Michael Boyle
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Christine McKee
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - Marilyn Ford-Gilboe
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
| | - C. Nadine Wathen
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
- Faculty of Information and Media Studies, Western University, London, Ontario, Canada
| | - Philip Scribano
- The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Clinical Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Danielle Davidov
- Department of Emergency Medicine, West Virginia University, Morgantown
- School of Public Health, West Virginia University, Morgantown
| | - Diane McNaughton
- Department of Community, Systems, and Mental Health Nursing, Rush University Medical Center, Chicago, Illinois
| | - Ruth O’Brien
- College of Nursing, University of Colorado Anschutz Medical Campus, Denver
| | - Carolyn Johnston
- Nurse-Family Partnership National Service Office, Denver, Colorado
| | - Mariarosa Gasbarro
- Department of Pediatrics, University of Colorado School of Medicine, Denver
| | - Masako Tanaka
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Melissa Kimber
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Jeffrey Coben
- School of Public Health, West Virginia University, Morgantown
| | - David L. Olds
- Department of Pediatrics, University of Colorado School of Medicine, Denver
| | - Harriet L. MacMillan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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Zimpel RR, Panzini RG, Bandeira DR, Fleck MP, da Rocha NS. Psychometric properties of the WHOQOL-SRPB BREF, Brazilian Portuguese version. ACTA ACUST UNITED AC 2019; 41:411-418. [PMID: 30994853 PMCID: PMC6796811 DOI: 10.1590/1516-4446-2018-0083] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 10/16/2018] [Indexed: 11/22/2022]
Abstract
Objective: To test the reliability and the discriminant and convergent validity of the abbreviated Brazilian Portuguese World Health Organization’s Quality of Life Instrument – Spirituality, Religion, and Personal Beliefs module (WHOQOL-SRPB BREF). Methods: In a sample of 404 individuals, we applied a general questionnaire, the WHOQOL-BREF, the long-form SRPB, the Brief Religious-Spiritual Coping Scale (RCOPE), and the Beck Depression Inventory (BDI). Priority was given to the 9-item SRPB assessment: its unidimensionality was tested through confirmatory factor analysis and Rasch analysis. Results: Confirmatory factor analysis of the 9-item SRPB assessment indicated an adjusted model with acceptable fit to data. In the Rasch analysis, general fit measures showed adequate performance. The 9-item SRPB assessment showed good internal consistency (alpha = 0.85), and could differentiate (discriminant validity) between religious and atheist/agnostic respondents (mean = 74.7±14.1 and 56.8±15.5, respectively; t = 6.37; degrees of freedom [df] = 402; p < 0.01) and between non-depressed and depressed respondents (mean = 76.5±12.9 and 67.1±16.5; t = 5.57; df = 190.5; p < 0.01). Correlations (convergent validity) were significant with the positive-RCOPE subscale (r = 0.58, p < 0.01) and the WHOQOL-BREF domains (Pearson coefficient ranging between 0.24 and 0.49; p < 0.01), but were in the negative direction with the negative-RCOPE subscale (r = -0.10, p < 0.05). Correlation with the long-form SRPB domain (r = 0.934) was almost perfect. Conclusion: The Brazilian Portuguese 9-item SRPB has good psychometric properties and confirmed the findings of the long-form Brazilian Portuguese version and the abbreviated English version.
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Affiliation(s)
- Rogério R Zimpel
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Raquel G Panzini
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Secretaria da Saúde do Estado do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Denise R Bandeira
- Programa de Pós-Graduação em Psicologia, UFRGS, Porto Alegre, RS, Brazil
| | - Marcelo P Fleck
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Neusa S da Rocha
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
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Flores-García L, Lensing MB, Ytterstad E, Eisemann M. Quality of life in substance use disorder patients with and without attention deficit hyperactivity disorder 12 months after treatment: a naturalistic follow-up study. ACTA ACUST UNITED AC 2019; 11:299-310. [PMID: 30903585 DOI: 10.1007/s12402-019-00297-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 03/01/2019] [Indexed: 12/15/2022]
Abstract
There is sparse research on quality of life (QoL) as an outcome measure in patients with substance use disorders (SUD), with or without attention deficit hyperactivity disorder (ADHD). We aimed to investigate whether SUD patients with and without ADHD (SUD + ADHD vs. SUD - ADHD) differed in QoL at baseline and at a 12-month follow-up after SUD treatment. The groups were additionally compared with data from a national population sample (NPS). From a sample of 16 SUD + ADHD and 87 SUD - ADHD patients originally recruited between 2010 and 2012, eight SUD + ADHD (50.0%) and 28 SUD - ADHD (32.2%) patients were reached at follow-up. QoL was measured with the short version of the World Health Organization QoL instrument (WHOQOL-BREF). Cross-sectional data on QoL from NPS was utilized. Compared to NPS, SUD patients reported significantly lower QoL at baseline and follow-up. Furthermore, QoL was similar at baseline in SUD + ADHD and SUD - ADHD patients. At a 12-month follow-up after SUD treatment, SUD + ADHD patients 'QoL had improved, however, not significantly differing from SUD - ADHD patients or the NPS. SUD - ADHD patients' QoL remained significantly lower. At follow-up, SUD + ADHD patients' QoL improved nominally compared to SUD - ADHD patients, but not the NPS. The clinical and functional relevance of these findings should be investigated further.
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Affiliation(s)
- Lizbett Flores-García
- Division of Mental Health and Substance Abuse, Section for Substance Use Disorders, University Hospital of Northern Norway, Postbox 6124, 9291, Tromsø, Norway.
- Department of Psychology, Faculty of Health Sciences, UiT, The Arctic University of Norway, 9037, Tromsø, Norway.
| | - Michael B Lensing
- Division of Pediatric and Adolescent Medicine, NevSom- Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias, Oslo University Hospital, Postboks 4956, 0424, Nydalen, Oslo, Norway
| | - Elinor Ytterstad
- Department of Mathematics and Statistics, Faculty of Science and Technology, UiT, The Arctic University of Norway, 9037, Tromsø, Norway
| | - Martin Eisemann
- Department of Psychology, Faculty of Health Sciences, UiT, The Arctic University of Norway, 9037, Tromsø, Norway
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Gartland N, Long H, Skevington SM. Undiagnosed cancer symptoms in the community: does poor quality of life influence the decision to seek help? Qual Life Res 2019; 28:1327-1335. [PMID: 30671707 PMCID: PMC6470111 DOI: 10.1007/s11136-018-2088-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE Although a cancer diagnosis is linked with decrements to quality of life (QoL), it is unknown exactly when QoL starts to deteriorate, and whether this occurs during the pre-diagnostic pathway. This study aimed to examine QoL during this phase, and in addition investigate whether QoL levels influence decisions about seeking professional help. This is important, because early diagnosis is linked to lower cancer mortality rates. METHODS Working alongside a Cancer Research UK Roadshow in socially deprived communities, the recent QoL of adult visitors was assessed, before attending primary care. Using a cross-sectional design, we compared QoL in those presenting a potential cancer symptom/sign, with others seeking lifestyle advice to reduce cancer risk. Self-reported QoL (WHOQOL-BREF), and intention to seek help, were measured. RESULTS Of 107 recruited, 50% were men. The potential cancer symptom group reported significantly poorer general QoL and psychological QoL, than lifestyle controls. Prior poorer physical QoL predicted stronger intentions to consult a general practitioner (GP) in the next 2 weeks, when controlling for symptom presence. CONCLUSIONS QoL is poorer for those with potential cancer symptoms, before they first seek advice from primary care. Poorer physical QoL is associated with stronger intentions to make a GP appointment. An implication for longer term health is that if public awareness about the impact of symptoms on QoL was raised, this could provide an impetus to seek help.
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Affiliation(s)
- Nicola Gartland
- Manchester Centre for Health Psychology and International Hub for Quality of Life Research (IHQoLR), Faculty of Biology, Medicine and Health, University of Manchester, Manchester, MP13 9PL, UK.
| | - Hannah Long
- Manchester Centre for Health Psychology and International Hub for Quality of Life Research (IHQoLR), Faculty of Biology, Medicine and Health, University of Manchester, Manchester, MP13 9PL, UK
| | - Suzanne M Skevington
- Manchester Centre for Health Psychology and International Hub for Quality of Life Research (IHQoLR), Faculty of Biology, Medicine and Health, University of Manchester, Manchester, MP13 9PL, UK
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