Measuring health-related quality of life in adolescents and young adults: Swedish normative data for the SF-36 and the HADS, and the influence of age, gender, and method of administration

Sense of coherence and health in adolescents: a longitudinal cohort study

OBJECTIVE

Several studies indicate an association between adolescents' sense of coherence (SOC) and health. However, a few longitudinal studies have been conducted. The aim of the study was to analyze the association between SOC and health among adolescents during secondary education.

METHODS

Participants of longitudinal cohort study were followed by questionnaires at the age of 15 (N = 441), and 17 (N = 354). The data were analyzed using the methods of descriptive and inferential statistics. We used hierarchical regression to examine significant predictors of health.

RESULTS

Adolescents' SOC was stable during the analyzed two-year period (128.84 ± 22.17; 129.24 ± 23.06). A strong significant positive correlation was found between SOC and mental health (r = 0.635, p<.001; r = 0.670, p<.001). A significant difference was found between adolescents with a low SOC and those with a high SOC in physical functioning (p<.018), general health (p<.001), vitality (p<.001), social functioning (p<.001), emotional role functioning (p<.013) and mental health (p<.001). Boys had higher SOC and most of the health dimensions. Having a stronger SOC, being male, and living with both parents were predictors of better mental health.

CONCLUSIONS

Sense of coherence was a significant and stable factor associated with mental health. Thus, salutogenic interventions for improving the sense of coherence during adolescence should be explored.

Quality of life in chiropractic students pre- and post-COVID-19 lockdowns utilizing the Short-Form Health Survey-36

OBJECTIVE

To compare previously recorded quality of life scores of students at the New Zealand College of Chiropractic using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) to those after New Zealand (NZ) COVID lockdowns.

METHODS

Previously recorded students' SF-36 questionnaires were collected before (2019) and after (2022) the lockdowns. Student populations were independent at each time point (pre- and post-lockdown) and were compared between 2019 and 2022 using unpaired Wilcoxon tests and to similarly aged and NZ normative data.

RESULTS

Two hundred seventy-six pre-COVID (51.1% female) and 120 post-COVID (60.8% female) data sets were returned. All pre-COVID years and scores were significantly higher or comparable with reference data (p ≤ .050). Post-COVID scores dropped below pre-COVID and reference data-with the largest drops seen in emotional wellbeing, emotional role limitations, social, and fatigue domains (p < .05 - p < .001). Only post-COVID physical functioning was comparable with pre-COVID or reference data (p > .050).

CONCLUSION

This study suggests that before COVID New Zealand College of Chiropractic perceived their quality of life as the same or better than the average New Zealander or similarly aged person. After COVID, most quality of life scores dropped substantially with emotional, social, and fatigue-related domains showing the greatest decline.

Development of updated population norms for the SF-36 for Hungary and comparison with 1997-1998 norms

BACKGROUND

Hungarian SF-36 population norm data were last collected in 1997-1998 and have not been updated since, reducing their relevance and limiting their usability and comparability. This study aimed to establish contemporary normative data for the SF-36 domain and standardised summary scores in Hungary and compare them to the previous population norms.

METHODS

An online cross-sectional survey, including the SF-36v1, was conducted among 1,700 members of the Hungarian adult general population in 2020. The sample demonstrated good representativeness across key sociodemographic characteristics. Normative data were calculated for domains using raw scores and for summary scores using country-specific factor score coefficients derived from exploratory factor analysis. Multivariate linear regression models were performed to examine the association of domain and summary scores with sociodemographic and health-related characteristics. Raw domain scores were compared with the 1997-1998 norms.

RESULTS

Males reported higher scores (better health) in seven out of eight domains (p < 0.001). Mean standardised PCS scores decreased, whereas MCS scores increased with age (p < 0.001). Compared to the 1997-1998 population norms, the 18-24 and 25-34 age groups reported lower, while the 65 + age group reported higher scores in all eight domains. Higher scores were reported in 2020 from the 35-44 age group onward on the role physical, bodily pain, social functioning, and role emotional domains.

CONCLUSIONS

This study established contemporary population norms for the SF-36 in Hungary. Our results highlight the changes in health status in the general population, particularly in young adults, compared to the 1997-1998 population norms, and provide valuable input to inform decision-makers.

Teenagers and Young Adults with Cochlear Implants: A Multidisciplinary Follow-Up Study Approach and Baseline Characteristics

Background/Objectives: Early pediatric cochlear implantation positively impacts early language outcomes. The Teenager and Young Adults Cochlear Implant (TAYACI) study investigates the long-term outcomes of early implantation and factors influencing variability among cochlear implant (CI) users. This article outlines participants' background, early language outcomes, and multidisciplinary study protocol. Methods and Materials: Individuals aged 12-22 received CIs before 30 months of age, followed-up at the same hearing implant center, and adhered to a standard school curriculum were invited to participate. Out of 109 eligible CI users, 50 participated; 46 agreed to undergo clinical assessments, while four completed questionnaires only. Results: The mean age at the first CI was 15.63 months (SD = 6.0). All but one communicated with spoken language(s). Participants attended mainstream schools and had highly educated parents. Over half (56%) had received Auditory Verbal Therapy in early childhood. Earlier implantation correlated with better language understanding one year post-CI. Conclusions: Earlier implantation was associated with better early language outcomes, with parental education level and early family-centered intervention likely contributing. Future sub-studies will investigate multidisciplinary long-term effects of pediatric cochlear implantation in adolescents.

Gender-specific changes in vision-related quality of life over time - results from the population-based Gutenberg Health Study

PURPOSE

To investigate potential gender- and age-specific changes over time in vision-related quality of life (VRQoL) on a population-based level. Further, factors associated with changes in VRQoL will be explored.

METHODS

The Gutenberg Health Study is a population-based, prospective, observational, single-center cohort study in Germany. VRQoL was quantified at baseline and 5-year follow-up using the visual function scale (VFS) and socio-emotional scale (SES-VRQoL). VFS and SES-VRQoL are calculated using the "National Eye Institute 25-Item Visual Functioning Questionnaire" (NEI-VFQ-25). Both scales range from 0 to 100, 0 corresponds to the sum that would be achieved if a participant had answered all items with the worst performance, and 100 corresponds to the sum of all items answered with the best possible performance. Distance-corrected visual acuity was measured in both eyes. Univariable and multivariable linear regression analyses were conducted to identify ophthalmic and sociodemographic predictors of VRQoL.

RESULTS

A total of 10,152 participants (mean age 54.2 years; 49.2% female) were included in the analysis. The mean visual functioning decreased from 89.6 (IQR: 81.3, 95.1) at baseline to 85.9 (IQR: 79.2, 92.6) at 5-year follow-up in the VFS (p < 0.001). Participants' socio-emotional well-being remained the same from baseline to 5-year follow-up in the SES-VRQoL. In multivariable linear regression analysis, older age (0.03, p = 0.002) and female gender (-1.00, p < 0.001) were associated with a VFS change. Higher baseline socioeconomic status was associated with a slightly positive increase in VFS (0.07, p = 0.001). Deterioration of visual acuity in the better and worse-seeing eye was associated with negative VFS change over 5 years (better-seeing eye: -5.41, p < 0.001, worse-seeing eye: -7.35, p < 0.001). Baseline socioeconomic status was associated with SES-VRQoL change (0.06, p < 0.001). The negative change in visual acuity showed an association with negative SES-VRQoL in the better (-4.15, p < 0.001) and worse-seeing eye (-3.75, p < 0.001). Stratification of the regression models by age and gender showed greater reductions in VFS scores with visual acuity changes in participants aged 65 years or older and a more pronounced decrease in female participants over 5 years.

CONCLUSIONS

This study demonstrated an association between visual acuity change and change in VRQoL over 5 years, with a greater decrease in female participants and participants aged 65 years or older. The better-seeing eye and the worse-seeing eye both had an impact on changes in VRQoL.

KEY MESSAGES

What is known Previous studies have predominantly used cross-sectional designs to investigate the correlation between visual acuity and vision-related quality of life, with limited insights into how visual acuity changes over time affect vision-related quality of life in a large cohort. What is new This study demonstrates that visual acuity changes significantly impact VRQoL over a 5-year period, with a notable decrease observed in female participants and those aged 65 years or older. Analysis reveals both the better-seeing and worse-seeing eye contribute to changes in VRQoL, highlighting the necessity of comprehensive visual assessments in both eyes for a more accurate understanding of VRQoL outcomes.

Psychosocial impact of climatotherapy in young patients with psoriasis: a 3-month cohort study

Ultraviolet rays are known to have positive effect on psoriasis, but the cold climate and latitude in Northern Europe reduce access to the sun. Climatotherapy is a treatment modality where the patient is relocated to a warmer region with a high ultraviolet (UV) index. Young patients with psoriasis can be particularly burdened by the disease, and studies have shown an association between psoriasis and mood disorders. Patients who have undergone climatotherapy often report beneficial psychological effects after treatment, but this has not yet been studied. To explore the psychosocial impact of climatotherapy, an observational study was designed. Thirty-four participants (median age of 24 years) underwent 3 weeks of treatment in Gran Canaria (Spain) and responded to questionnaires assessing the psychosocial aspects of the disease. Climatotherapy was associated with significantly reduced scores of HADS, PSS-10, PSQ, EQ-VAS, DLQI, and itch intensity at the end of and at 3 months after the end of treatment compared to before treatment onset. The results suggest that climatotherapy not only exerts effects on psoriasis skin disease but also improves symptoms of anxiety, depression, perceived stigmatization, stress, quality of life, self-assessed overall health perception, and itch intensity. The results can be of use in the decision-making process when choosing a suitable treatment for young patients with psoriasis.

Perceived Stress Mediates Associations Between Grit and Health-Related Quality of Life

Grit, characterized by passion and perseverance in the pursuit of long-term goals, may be associated with enhanced quality of life and reduced levels of perceived chronic stress. We hypothesized that reduced levels of perceived stress may mediate the association between facets of grit (i.e., Perseverance and Consistency) and healthy functioning. We conducted two studies, one with college students and one with community adults, to test this hypothesis (cumulative N = 600). In both studies, facets of grit were assessed using the Short Grit Scale, levels of perceived chronic stress were assessed via the Perceived Stress Scale, and health-related quality of life was measured using selected questions from the Medical Outcome Study Short Form-36. Consistent with our hypothesis, perceived stress levels significantly mediated the relation between Grit-Perseverance and health-related quality of life in both college students and community adults. Our data suggest that individuals with high Grit-Perseverance experience lower perceived stress, which may result in improved health-related quality of life. Additionally, perceived stress partially mediated the relation between Grit-Consistency and health-related quality of life, but only in community adults. These novel findings suggest that the association between Grit-Perseverance and perceived chronic stress may differ for college students and community adults. Overall, our work indicates that perceived stress may be a key mediator through which facets of grit are related to healthy functioning in college students and community adults.

Health-related quality of life and self-reported health status in adolescents with chronic health conditions before transfer of care to adult health care: an international cohort study

BACKGROUND

Heath-related quality of life (HRQoL) is lower in adolescents with chronic health conditions compared to healthy peers. While there is evidence of some differences according to the underlying condition and gender, differences by measure and country are poorly understood. In this study we focus on the differences in HRQoL in adolescents with various chronic medical conditions in the year before transfer of care to adult health services. We also study the associations of two different HRQoL measurements to each other and to self-reported health.

METHODS

We recruited 538 adolescents from New Children`s Hospital, Helsinki, Finland, and the Royal Children`s Hospital, Melbourne, Australia in 2017-2020. We used two validated HRQoL measurement instruments, Pediatric Quality of Life Inventory (PedsQL) and 16D, and a visual analog scale (VAS) for self-reported health status.

RESULTS

In total, 512 adolescents (50.4% female, mean age 17.8 [SD 1.2] years), completed the survey measures. Higher HRQoL was reported in males than females in both countries (PedsQL 79.4 vs. 74.1; 16D 0.888 vs. 0.846), and in adolescents from Finland than Australia (80.6 vs. 72.2 and 0.905 vs. 0.825, p < 0.001 for all). Adolescents with diabetes, rheumatological, nephrological conditions and/or organ transplants had higher HRQoL than adolescents with neurological conditions or other disease syndromes (p < 0.001). PedsQL and 16D scores showed a strong correlation to each other (Spearman correlation coefficient r = 0.81). Using the 7-point VAS (1-7), 52% (248 of 479) considered their health status to be good (6-7) and 10% (48 of 479) rated it poor (1-2). Better self-reported health was associated with higher HRQoL.

CONCLUSIONS

The HRQoL of transition aged adolescents varies between genders, diagnostic groups, and countries of residence. The association between self-reported health and HRQoL suggests that brief assessment using the VAS could identify adolescents who may benefit from in-depth HRQoL evaluation.

TRIAL REGISTRATION

Trial registration name The Bridge and registration number NCT04631965 ( https://clinicaltrials.gov/ct2/show/NCT04631965 ).

Clinical outcomes measurement in pediatric lower limb prosthetics: A scoping review

OBJECTIVE

This study aimed to identify clinical measures that have been used to evaluate function, health related quality of life (HRQoL), and/or satisfaction in children who use lower limb prostheses (LLP). The data reported on psychometric properties for children who use LLP were collected for each measure.

METHODS

First, PubMed, CINAHL, and Web of Science databases were searched using broad search terms to identify standardized outcome measures of function, HRQoL, and/or satisfaction with treatment used in pediatric LLP research published in 2001 or after. For each of the eligible measures found, a second search was performed to identify psychometric properties (e.g., validity, reliability) assessed with children who use LLP.

RESULTS

Forty-four standardized outcome measures were identified from 41 pediatric LLP research articles. Five measures (i.e., Gait Outcomes Assessment for Lower Limb Differences, Functional Mobility Assessment, Child Amputee Prosthetics Project- Prosthesis Satisfaction Inventory, Child Amputee Prosthetics Project- Functional Scale Index, and Lower Limb Function Questionnaire) had data on psychometric properties for children who use LLP.

CONCLUSIONS

Few studies report psychometric data for assessing the overall HRQoL, function, and/or satisfaction for children who use LLP. Further research is needed to validate or create new outcome measures that assess the HRQoL, satisfaction, and/or function of children who use LLP.

Psychometric Properties of a New Mexican Optimism Scale: Ethnopsychological Approach

BACKGROUND

In this paper, a Mexican Optimism Scale was constructed to investigate and estimate psychometric properties (reliability and validity based on the measurement model). The convergent validity and validity criterion were evaluated for a sample of young Mexicans.

METHODS

The scale was presented to 848 Mexican young people aged between 17 and 30 years from three different regions of Mexico. The scale was reduced to 20 items on the basis of CFA and analyses of internal consistency.

RESULTS

The confirmatory factor analysis (CFA) suggested a three-factor structure of optimism: affective resources, positive vision and hope. The data provided evidence for convergent validity with positive affect, negative affect and coping. Additionally, males scored higher on affective resources and positive vision than females. Finally, the results support the reliability of the instrument.

CONCLUSIONS

The psychometric properties of the Mexican Optimism Scale proved to be highly acceptable and allow for a novel assessment of optimism from an ethnopsychological perspective. Validity, reliability and invariance were determined, as well as percentiles for the practical use of the scale. This scale may be of crucial importance for future research on optimism and health.

Health-related quality of life profiles in adolescents and young adults with chronic conditions

PURPOSE

To assess health-related quality of life (HRQOL) among adolescents and young adults (AYAs) with chronic conditions.

METHODS

AYAs (N = 872) aged 14-20 years completed NIH's Patient-Reported Outcomes Measurement Information System® (PROMIS®) measures of physical function, pain interference, fatigue, social health, depression, anxiety, and anger. Latent profile analysis (LPA) was used to group AYAs into HRQOL profiles using PROMIS T-scores. The optimal number of profiles was determined by model fit statistics, likelihood ratio test, and entropy. Multinomial logistic regression models were used to examine how LPA's HRQOL profile membership was associated with patient demographic and chronic conditions. The model prediction accuracy on profile membership was evaluated using Huberty's I index with a threshold of 0.35 for good effect.

RESULTS

A 4-profile LPA model was selected. A total of 161 (18.5%), 256 (29.4%), 364 (41.7%), and 91 (10.4%) AYAs were classified into Minimal, Mild, Moderate, and Severe HRQOL Impact profiles. AYAs in each profile had distinctive mean scores with over a half standard deviation (5-points in PROMIS T-scores) of difference between profiles across most HRQOL domains. AYAs who were female or had conditions such as mental health condition, hypertension, and self-reported chronic pain were more likely to be in the Severe HRQOL Impact profile. The Huberty's I index was 0.36.

CONCLUSIONS

Approximately half of AYAs with a chronic condition experience moderate to severe HRQOL impact. The availability of risk prediction models for HRQOL impact will help to identify AYAs who are in greatest need of closer clinical care follow-up.

YES, WE COPE: Dyadic Coping as a Mediator Between Perceived Relationship Quality and Emotional Representation of COVID-19

Background

The COVID-19 pandemic has brought about social changes that have impacted the functioning and dynamics of couples in a romantic relationship, arising from the overwhelming amount of added stress they have endured. Specifically, the divorce rate in Portugal has increased after lockdown, which underscores the adverse consequences of COVID-19 on couples. A lower quality of the couple's relationship may worsen the emotional representation of COVID-19; however, the literature suggests that perceived partner dyadic coping responses have a great influence on adverse events. The aim of the present study was to assess the mediating role of partner coping in the association between relationship quality and emotional representation of COVID-19. We also sought to observe whether the length of the relationship moderates this association.

Methods

Participants (N = 528) were adults living in Portugal (84.7% female) currently in a romantic relationship with their current partner for at least 1 year. Online data collection.

Results

We found that relationship quality predicted COVID-19 emotional representation, but this association was fully mediated by total dyadic coping. This association was especially significant in couples with a shorter length of time in the relationship.

Conclusions

We point out the importance of dyadic coping as a protective factor against emotional distress to cope with the ongoing stressors associated with the COVID-19 pandemic. These data suggest the need for relationship education programs that promote positive coping between partners.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10608-023-10379-4.

Exercise as an Airway Clearance Technique in people with Cystic Fibrosis (ExACT-CF): rationale and study protocol for a randomised pilot trial

Background

Chest physiotherapy is an established cornerstone of care for people with cystic fibrosis (pwCF), but is often burdensome. Guidelines recommend at least one chest physiotherapy session daily, using various airway clearance techniques (ACTs). Exercise (with huffs and coughs) may offer an alternative ACT, however the willingness of pwCF to be randomised into a trial needs testing. The 'ExACT-CF: Exercise as an Airway Clearance Technique in people with Cystic Fibrosis' trial will test the feasibility of recruiting pwCF to be randomised to continue usual care (chest physiotherapy) or replace it with exercise ACT (ExACT) for 28-days. Secondary aims include determining the short-term clinical impact (and safety) of stopping routine chest physiotherapy and replacing it with ExACT, and effects on physical activity, sleep, mood, quality of life and treatment burden, alongside preliminary health economic measures and acceptability.

Methods

Multi-centre, two-arm, randomised (1:1 allocation using minimisation), pilot trial at two sites. Fifty pwCF (≥10 years, FEV 1 >40% predicted, stable on Elexacaftor/Tezacaftor/Ivacaftor (ETI)) will be randomised to an individually-customised ExACT programme (≥once daily aerobic exercise of ≥20-minutes duration at an intensity that elicits deep breathing, with huffs and coughs), or usual care. After baseline assessments, secondary outcomes will be assessed after 28-days, with additional home lung function and exacerbation questionnaires at 7, 14 and 21-days, physical activity and sleep monitoring throughout, and embedded qualitative and health-economic components. Feasibility measures include recruitment, retention, measurement completion, adverse events, interviews exploring the acceptability of trial procedures, and a trial satisfaction questionnaire.

Discussion

Co-designed with the UK CF community, the ExACT-CF pilot trial is the first multi-centre RCT to test the feasibility of recruiting pwCF stable on ETI into a trial investigating ExACT. This pilot trial will inform the feasibility, design, management, likely external validity for progression to a main phase randomised controlled trial.

Registration

Clinicaltrials.gov ( NCT05482048).

Influence of Screen Time during COVID-19 on Health-Related Quality of Life of Early Adolescents

This study investigated the influence of screen time during COVID-19 on the physical and mental domains of the health-related quality of life of early adolescents. A total of 860 early adolescents were recruited. The 36-Item Short Form Health Survey was used to measure their health-related quality of life. The early adolescents reported their average daily time spent using smartphones and computers and watching television over the previous week. The results show that most early adolescents, on average, spent less than 1 h to more than 4 h per day during COVID-19 using smartphones (n = 833, 96.9%) and computers (n = 783, 91.0%), and watching television (n = 804, 93.5%), respectively. Though early male and female adolescents spent a similar amount of time daily on average using smartphones, early male adolescents spent more time using computers and watching television than early female adolescents and reported a significantly lower mean score for three out of the eight scales in the physical and mental domains of health-related quality of life. While health-related quality of life of early female adolescents was negatively associated with time spent using smartphones only, early male adolescents were adversely affected by the time spent using smartphones and computers and watching television (p < 0.05). Therefore, early adolescents who spent more time using display devices during COVID-19 had significantly poorer outcomes in their health-related quality of life, and gender difference was found in the influence of screen time on health-related quality of life.

Interviewer Administration Corresponds to Self-Administration of the Vision Impairment in Low Luminance (VILL) Questionnaire

Purpose

To quantify the impact of the mode of administration (MOA) on scores of the Vision Impairment in Low Luminance (VILL) questionnaire.

Methods

The VILL questionnaire was implemented using different MOAs (paper, interview, electronic), in addition to a demographical survey of adult participants recruited at an outpatient eye clinic, with the initial MOA being either paper or interview. Polytomous Rasch models were used to generate person measure scores for the three subscales of the VILL questionnaire (reading, VILL_R; mobility, VILL_M; and emotional, VILL_E). Measures of agreement among the different MOAs were calculated (self-administered paper/interview, self-administered paper/self-administered electronic, and interview/self-administered electronic). An age-matched analysis was performed to control for the impact of the initial MOA, administration interval, visual acuity, and self-reported hearing difficulties.

Results

We included 309 participants (mean age, 63 ± 14 years; 61% female). Intra-class correlation coefficients were 0.930, 0.919, and 0.799 for paper versus interview assessment; 0.951, 0.959, and 0.916 for paper versus electronic; and 0.967, 0.955, and 0.907 for interview versus electronic assessment (VILL_R, VILL_M, and VILL_E, respectively). Mean differences were 0.35, 0.41, and 1.74 logits; 0.32, 0.18, and 0.68 logits; and 0.08, 0.22, and 0.63 logits, respectively. None of the mentioned factors significantly affected the results (corrected P ≥ 0.11).

Conclusions

Paper, interview, and electronic MOAs of the VILL can be considered equivalent. Reporting across the main MOAs of self-administration (paper) and interviewer-administration was unaffected by better eye visual acuity and self-reported hearing difficulties.

Translational Relevance

The results support use of the VILL questionnaire with flexible modes of administration.

Comparing SF-36 Scores Collected Through Web-Based Questionnaire Self-completions and Telephone Interviews: An Ancillary Study of the SENTIPAT Multicenter Randomized Controlled Trial

Background

The 36-Item Short Form Health Survey (SF-36) is a popular questionnaire for measuring the self-perception of quality of life in a given population of interest. Processing the answers of a participant comprises the calculation of 10 scores corresponding to 8 scales measuring several aspects of perceived health and 2 summary components (physical and mental). Surprisingly, no study has compared score values issued from a telephone interview versus those from an internet-based questionnaire self-completion.

Objective

This study aims to compare the SF-36 score values issued from a telephone interview versus those from an internet-based questionnaire self-completion.

Methods

Patients with an internet connection and returning home after hospital discharge were enrolled in the SENTIPAT multicenter randomized trial on the day of discharge. They were randomized to either self-completing a set of questionnaires using a dedicated website (internet group) or providing answers to the same questionnaires administered during a telephone interview (telephone group). This ancillary study of the trial compared SF-36 data related to the posthospitalization period in these 2 groups. To anticipate the potential unbalanced characteristics of the responders in the 2 groups, the impact of the mode of administration of the questionnaire on score differences was investigated using a matched sample of individuals originating from the internet and telephone groups (1:1 ratio), in which the matching procedure was based on a propensity score approach. SF-36 scores observed in the internet and telephone groups were compared using the Wilcoxon-Mann-Whitney test, and the score differences between the 2 groups were also examined according to Cohen effect size.

Results

Overall, 29.2% (245/840) and 75% (630/840) of SF-36 questionnaires were completed in the internet and telephone groups, respectively (P<.001). Globally, the score differences between groups before matching were similar to those observed in the matched sample. Mean scores observed in the telephone group were all above the corresponding values observed in the internet group. After matching, score differences in 6 out of the 8 SF-36 scales were statistically significant, with a mean difference greater than 5 for 4 scales and an associated mild effect size ranging from 0.22 to 0.29, and with a mean difference near this threshold for 2 other scales (4.57 and 4.56) and a low corresponding effect size (0.18 and 0.16, respectively).

Conclusions

The telephone mode of administration of SF-36 involved an interviewer effect, increasing SF-36 scores. Questionnaire self-completion via the internet should be preferred, and surveys combining various administration methods should be avoided.

Trial Registration

ClinicalTrials.gov NCT01769261; https://www.clinicaltrials.gov/ct2/show/record/NCT01769261

Disentangling between- and within-person associations of psychological distress and mental well-being: An experience sampling study examining the dual continua model of mental health among university students

The dual continua model assumes that psychological distress and mental well-being are two related, yet distinct dimensions of mental health. Previous studies did convincingly show the distinctiveness of these two dimensions using mainly cross-sectional research. Despite the importance to distinguish between- and within-person associations in psychological theories, to date, no study specifically distinguished between- and within-person associations for the relationship between distress and well-being. Therefore, the objective of this study was to validate whether the dual continua model actually holds when examined within individuals. Intensive longitudinal data were collected through experience sampling. The sample included 25 university students (mean age = 23.50 years, 56% female), who completed a baseline questionnaire as well as momentary measures of psychological distress and mental well-being three times per day for two weeks. 1,014 timepoints were analyzed using multilevel models and person-mean centering was applied to distinguish between- and within person associations. A significant moderate negative between-person association was found for the relationship between psychological distress and mental well-being (β = -.363, marginal R 2 = 0.15, p < .001). The within-person association was also significant and similar in magnitude (β = -.432, marginal R 2 = 0.18, p < .001) at the group level. Individual within-person associations between distress and well-being varied substantially, but were negative for almost all participants. This study is an important step towards validating the applicability and universality of this widely used model. The current findings provide preliminary evidence that the dual continua model does not only hold between people, but also on the level it is actually used for, namely within individual people.

Influences of Smartphone and Computer Use on Health-Related Quality of Life of Early Adolescents

This study explored the daily amount of time that early adolescents spent using smartphones and computers, and their influences on health-related quality of life of early adolescents. A total of 650 early adolescents were recruited. The 36-Item Short Form Health Survey was used to measure their health-related quality of life. The early adolescents reported their average daily time spent using smartphones and computers over the course of the previous week; the majority of early adolescents (71%) spent approximately 1 h a day or less using computers on average or reported no computer use, and 98.8% indicated that they used smartphones for less than 1 h to more than 4 h per day on average. The results showed that the average daily time spent using smartphones was significantly negatively associated with two scales in the physical domain and four scales in the mental domain of health-related quality of life of early adolescents, whereas the average daily time spent using computers was significantly negatively associated with two scales in the mental domain (p < 0.05). Therefore, early adolescents who spent more time using smartphones and computers have significantly poorer outcomes in the physical and mental domains of their health-related quality of life.

A survey of ovarian reserve and quality of life in female survivors of pediatric cancer

INTRODUCTION

Childhood cancer is rare; the incidence in Sweden is approximately 16 new cases/100 000 children each year. Reduced reproductive function and fertility are well-known side effects of cancer treatment. Anti-Müllerian hormone (AMH) has been shown to correlate well with antral follicle count in healthy women but is currently not recommended as the primary surveillance modality for evaluation of premature ovarian insufficiency in this patient group. Psychological wellbeing related to fertility could affect quality of life and should be included in long-term follow-up. The aim of the study is to present the baseline data from inclusion for a prospective follow-up study of fertility surveillance where both medical and psychological aspects of fertility in female childhood cancer survivors are considered.

MATERIAL AND METHODS

These are the first results from this longitudinal follow-up cohort study. Female adolescent and young adult survivors of pediatric cancer in Western Sweden were included from January 2016 to December 2018, a total of 54 participants. Median age at inclusion was 21 (15-29) years and median age at cancer diagnosis was 10 (1-17) years. AMH levels, antral follicle count, and data on fertility were recorded at inclusion and will be prospectively followed up. The study includes questionnaires and interviews concerning quality of life. This study is planned to continue until the participants reach the age of 40 years.

RESULTS

Eighteen of 54 (33%) participants had AMH levels below 1.0 µg/L and were considered to have high or very high risk of infertility. Median AMH level was 2.50 µg/L. Six women had immediate need of oocyte cryopreservation. Psychological assessment showed that more than one-third of participants (n = 20) had elevated anxiety scores.

CONCLUSIONS

One-third of female survivors of pediatric cancer in the study had high risk of low ovarian reserve, measured by a combination of AMH and antral follicle count, and many had signs of anxiety. The longitudinal study could contribute to better knowledge in the changes of AMH over time for this patient group. Psychological follow-up with questionnaires and interviews evaluating signs of depression and anxiety may serve as a model for future screening programs.

Increased Computer Use is Associated with Trunk Asymmetry That Negatively Impacts Health-Related Quality of Life in Early Adolescents

PURPOSE

This study aimed to investigate the effects of trunk asymmetry on the health-related quality of life of early adolescents and to identify daily activities that were associated with trunk asymmetry in this cohort.

METHODS

This study included 200 early adolescents (52 male and 148 female) aged 10 to 14 years in Hong Kong. Among them, 100 adolescents were considered to have trunk asymmetry with angle of trunk rotation ≥5° and one or more physical signs on visual inspection. The 36-Item Short Form Health Survey was used to measure the eight scales under the physical and mental domains of the health-related quality of life. The adolescents reported their average daily durations spent (1) using a computer; (2) using a smartphone; (3) watching television, videos or DVDs; (4) doing homework; and (5) doing physical exercise. Independent samples t-tests, chi-square (χ 2) tests or Mann-Whitney U-tests were performed to compare the health-related quality of life and the average daily duration of daily activities between early adolescents with and without trunk asymmetry. Logistic regression was performed to investigate the odds ratios of daily activities for trunk asymmetry.

RESULTS

Compared with early adolescents without trunk asymmetry, those with trunk asymmetry had a lower health-related quality of life in some of the physical domains, namely, bodily pain and general health, and all mental domains, namely, vitality (energy/fatigue), social functioning, role limitation due to emotional problems and mental health (p < 0.05). Use of computer was found to be significantly associated with trunk asymmetry in early adolescents (OR = 1.63, 95% CI [1.23, 2.14]).

CONCLUSION

Our results indicate that increased computer use is associated with trunk asymmetry, which negatively impacts the health-related quality of life in early adolescents.

Quality of life and related demographic factors in long-term survivors of childhood non-Hodgkin's lymphoma

OBJECTIVES

To evaluate the quality of life and related demographic factors in long-term survivors of childhood non-Hodgkin's lymphoma (NHL).

METHODS

A retrospective analysis was performed on the medical and demographic data of the NHL patients who received treatment in the Sun Yat-sen University Cancer Center and achieved long-term survival at follow-up, with an age of <18 years at initial diagnosis and a present age of ≥18 years. A questionnaire survey was performed using 36-Item Short-Form Health Survey (SF-36) and the symptom subscale of the Chinese version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (QLQ-C30). The health status of long-term survivors of NHL was evaluated by comparing the scores of various dimensions of the SF-36 scale of general adult population in the United States (American norm) and those of the SF-36 scale of general adult population in Hong Kong, China (Hong Kong norm). The correlation between the score of each dimension of the scale and demographic characteristics was evaluated. The symptoms of long-term NHL survivors were evaluated according to the score of QLQ-C30 scale.

RESULTS

A total of 23 patients with NHL with complete follow-up data were enrolled. The pathological types included diffuse large B-cell lymphoma in 10 patients, Burkitt lymphoma in 4 patients, T-cell lymphoblastoma in 5 patients, B-cell lymphoblastoma in 3 patients, and natural killer/T cell lymphoma in 1 patient. All patients received the chemotherapy regimen containing anthracyclines and alkylating agents. The median present age was 26.2 years (range: 16.9-55.8 years), and the median age at initial diagnosis was 10.4 years (range: 2.4-17.6 years). Among the 23 patients, 6 were married and had children and 2 had chronic diseases. There was no significant difference between the long-term survivors and the US norm in role physical, general health, role-emotional, and mental health (P>0.05), while the long-term survivors had significantly better scores of the other dimensions than the US norm (P<0.05). Similar results were obtained for the comparison between the long-term survivors and the China Hong Kong norm. Age at initial diagnosis was negatively correlated with the scores of social functioning, role physical, and general health in the SF-36 scale (P<0.05), and the present age of patients was positively correlated with the score of physical functioning and was negatively correlated with the score of general health (P<0.05). The urban and rural distribution of patients was related to the general health status (P<0.05). In addition, the long-term survivors of childhood NHL had relatively low scores of the symptom domain of QLQ-C30, and few moderate or severe symptoms were found.

CONCLUSIONS

Long-term survivors of childhood NHL tend to have a good overall health status, with no significant differences compared with the general population. Age at initial diagnosis is the main demographic factor that affects patients' quality of life. Citation.

Self-Perception of Quality of Life and Emotional Well-Being among Students Attending Hospital Classrooms during COVID-19 Pandemic

The COVID-19 pandemic caused disruptions in schooling and the closure of schools worldwide, how this has affected children’s and youth’s health and wellbeing is a current area of research. However, those who suffer a chronic or temporary disease may be attending hospital classrooms, and this scenario has received little attention in comparison to regular schools. The objective of this exploratory quantitative study focuses on exploring the quality of life and emotional well-being of students attending hospital classrooms. For this purpose, four Chilean hospital classrooms from different regions of the country were randomly selected. A total number of 248 students participated in the survey, each of whom filled out two online questionnaires. The findings show similar scores in children with mental illness and those with other health conditions. In comparison with one year before, students rate their general health as the same or somewhat better now, as well as manifesting an optimistic view of the future regarding the pandemic.

What Does the Future Hold? Health-Related Quality of Life 3-12 Years Following a Youth Sport-Related Knee Injury

Knee trauma can lead to poor health-related quality of life (HRQoL) and osteoarthritis. We aimed to assess HRQoL 3–12 years following youth sport-related knee injury considering HRQoL and osteoarthritis determinants. Generic (EQ-5D-5L index, EQ-VAS) and condition-specific (Knee injury and Osteoarthritis Outcome Score quality of life subscale, KOOS QOL) HRQoL were assessed in 124 individuals 3–12 years following youth sport-related knee injury and 129 uninjured controls of similar age, sex, and sport. Linear regression examined differences in HRQoL outcomes by injury group. Multivariable linear regression explored the influence of sex, time-since-injury, injury type, body mass index, knee muscle strength, Intermittent and Constant Osteoarthritis Pain (ICOAP) score, and Godin Leisure-Time Exercise Questionnaire (GLTEQ) moderate-to-strenuous physical activity. Participant median (range) age was 23 years (14–29) and 55% were female. Injury history was associated with poorer KOOS QOL (−8.41; 95%CI −10.76, −6.06) but not EQ-5D-5L (−0.0074; −0.0238, 0.0089) or EQ-VAS (−3.82; −8.77, 1.14). Injury history (−5.14; −6.90, −3.38), worse ICOAP score (−0.40; −0.45, −0.36), and anterior cruciate ligament tear (−1.41; −2.77, −0.06) contributed to poorer KOOS QOL. Worse ICOAP score contributed to poorer EQ-5D-5L (−0.0024; −0.0034, −0.0015) and higher GLTEQ moderate-to-strenuous physical activity to better EQ-VAS (0.10; 0.03, 0.17). Knee trauma is associated with poorer condition-specific but not generic HRQoL 3–12 years post-injury.

A causal model for health-related quality of life among Thai adolescents with congenital heart disease

Purpose

The objective of this study was to examine the causal relationships among sex, social support, disease severity, symptoms, physical activity, general health perception and health-related quality of life (HRQOL) in Thai adolescents with congenital heart disease (CHD).

Design/methodology/approach

A cross-sectional study was conducted using convenience sampling to recruit 200 Thai adolescents with CHD aged between 13 and18 years from four tertiary university hospitals in Bangkok. Interview method and self-administered questionnaires were used for data collection held between November 2018 and February 2019. Data were analyzed using path analysis to test the hypothesized model of the relationships.

Findings

The causal model of HRQOL revealed a good fit with the data. This model of relationship could explain 48% of the variances in HRQOL. Only direct effects of disease severity, symptoms and social support on HRQOL were found while indirect effects were not.

Originality/value

Due to the lack of study focusing on factors influencing HRQOL in Thai adolescents with CHD, this empirical study provides the evidence in Thai literature. The modifiable influencing factors for HRQOL found in this study can be manipulated through psycho-educational intervention given to the adolescents and significant others, especially parents, to help increase quality of life in adolescents with CHD.

Stigma and psychological distress among pediatric participants in the FD/MAS Alliance Patient Registry

Background

Stigma, both enacted and internalized, is part of the illness experience of many chronic conditions / diseases and has been found to increase psychological distress, lower self-esteem, and impact social engagement lowering quality of life (QOL). Stigma among pediatric patients is of particular concern due to its potential impact on identity formation. Using patient data from the online FD/MAS Alliance Patient Registry (FDMASAPR), this study seeks to 1) determine levels of enacted and self-stigma in a pediatric population of fibrous dysplasia (FD) / McCune Albright syndrome (MAS) patients and 2) to explore the relationship between stigma and anxiety and depression.

Methods

This is a cross sectional analysis of deidentified self-report data from 18 pediatric patients. Key analytic variables include the Neuro-QOL stigma short form, the Hospital Anxiety and Depression Scale (HADS), diagnostic category and craniofacial involvement, and select demographics. Sample means and score distributions are examined. Bivariate relationships between stigma, anxiety and depression and patient’s personal and medical characteristics are established through analysis of variance and correlation.

Results

Composite stigma levels for FD/MAS pediatric patients were comparable to those of children with multiple sclerosis, epilepsy, and muscular dystrophy. Self-stigma was more frequently reported than enacted/felt stigma, but few patients indicated complete freedom from either type of stigma. Diagnosis was significantly related to self-stigma. Significant bivariate relationships were found between depression and enacted/felt and self-stigma and between anxiety and self-stigma.

Conclusions

This study establishes the illness experience of pediatric patients with FD / MAS is impacted by stigma and suggests they should be regularly screened for stigma and psychological distress. It supports the integration of clinical psychologists/ therapists in regular patient care, referral of families to advocacy organizations, and indicates that rare disease patient registries can be a useful tool in efforts to improve the QOL of patients.

Assessing quality of life in pediatric fibrous dysplasia and McCune Albright syndrome: PEDS-QL and HADS data from the Fibrous Dysplasia Foundation Patient Registry

PURPOSE

The International FD/MAS Consortium recently encouraged using the Pediatric Quality of Life Inventory (PEDS-QL) and the Hospital Anxiety and Depression scales (HADS) in clinical care. This study examines scores on these measures among pediatric fibrous dysplasia and McCune Albright (FD/MAS) patients to initiate consideration of their use in clinical treatment.

METHODS

This is a retrospective analysis of pediatric data from 39 minors, ages 2-17, entered in the Fibrous Dysplasia Foundation Patient Registry from July 2016 to December 2018. Sample means and score distributions are compared to general population and chronic disease benchmarks. Associations with medical and demographic variables are also explored.

RESULTS

Mean PEDS-QL scores for children 2-7 were inconclusive in determining at risk status for impaired quality of life (QOL). Individual score distributions suggested up to half experienced extensive physical or social impairment. Means and individual score distributions for the physical and psychosocial components of the PEDS-QL for children 8-17 suggested many were at risk of impaired QOL. Over half of 13-17 year-olds met the clinical benchmark for anxiety. Older males scored better than females on the PEDS-QL and HADS. Pain frequency was associated with physical function for older children.

CONCLUSIONS

Older children with FD/MAS may be more compromised in terms of psychosocial QOL than previously reported. Clinicians should be attentive to the influence of gender on QOL in older children. Online patient registries associated with rare diseases have the potential to serve as efficient and cost-effective mechanisms to jumpstart examination of new measures in consideration for clinical use.

Distribution and associations of vision-related quality of life and functional vision of children with visual impairment

BACKGROUND

Patient-reported outcome measures (PROMs) are increasingly used in paediatric ophthalmology. However, little is known about the distribution of PROM scores among children and young people with visual impairment.

AIM

To investigate the distributions and predictors of scores on the VQoL_CYP (measuring vision-related quality of life) and FVQ_CYP (measuring functional vision).

METHODS

Children and young people aged 8-18 years, with visual impairment/blindness (logarithm of the minimum angle of resolution (LogMAR) worse than 0.48 in the better eye, and/or eligible visual field restriction) completed the VQoL_CYP and FVQ_CYP at home or Great Ormond Street Hospital, London, UK. Associations between VQoL_CYP and FVQ_CYP scores and sociodemographic and clinical factors were analysed using multiple linear regression models.

RESULTS

Among 93 participants, VQoL_CYP scores ranged from 36.6 to 78.2 (mean=57.9, SD=8.1). FVQ_CYP scores ranged from 23.5 to 70.3 (mean=48.3, SD=10.1). Only 0.4% of the variation in VQoL_CYP scores was explained, with no associations with the variables of interest. By contrast, 21.6% of the variation in FVQ_CYP scores was explained, with a gradient of worse acuity (p<0.001) and female gender (p=0.04) associated with worse self-rated functional vision. Age, ethnicity, time of onset and stability/progression of visual impairment were not associated.

DISCUSSION

Self-rated vision-related quality of life and functional vision are not readily predicted from sociodemographic or clinical characteristics that ophthalmologists measure/record. Routine use of PROMs in clinical practice can offer important insights. Use in research can provide valuable measures of effectiveness of interventions. The reference values provided will aid interpretation in both settings.

Predictors of Disability Attributed to Symptoms of Increased Interrecti Distance in Women after Childbirth: An Observational Study

OBJECTIVE

The purpose of this study was to investigate how various physical and psychological factors are linked to disability attributed to symptoms from increased interrecti distance (IRD) in women after childbirth.

METHODS

In this cross-sectional observational study, 141 women with an IRD of at least 2 finger-widths and whose youngest child was between the ages of 1 and 8 years participated. A multiple linear regression model was performed, with disability as the outcome variable and fear-avoidance beliefs, emotional distress, body mass index, lumbopelvic pain, IRD, and physical activity level as predictor variables.

RESULTS

The regression model accounted for 60% (R2 = 0.604, adjusted R2 = 0.586) of the variance in disability (F6,132 = 33.5). The 2 strongest predictors were lumbopelvic pain, with a regression coefficient of 1.4 (95% CI = 1.017 to 1.877), and fear avoidance, with a regression coefficient of 0.421 (95% CI = 0.287 to 0.555). The actual IRD, with a regression coefficient of -0.133 (95% CI = -1.154 to 0.888), did not contribute significantly to the variation in disability.

CONCLUSION

Disability attributed to symptoms from an increased IRD is explained primarily by the level of lumbopelvic pain but also by the degree of fear-avoidance beliefs and emotional distress.

IMPACT

This study highlights pain intensity and psychological factors as crucial factors for understanding disability attributed to increased IRD.

Quality of Life in Young Adults after Flatfoot Surgery: A Case-Control Study

The true impact of surgery for flatfoot deformities on patient's quality of life and health status remains poorly defined. The aim of this study is to evaluate the quality of life and the return to daily tasks and sports or physical activities in young adults after surgical correction of flatfoot deformity. Patients treated for bilateral symptomatic flat foot deformity were retrospectively studied. The healthy control group comprised a matched reference population with no history of foot surgery or trauma that was voluntary recruited from the hospital community. All subjects were asked to fill out questionnaires centered on the assessment of the health-related quality of life (Short-form 36; SF-36) and physical activity (International Physical Activity Questionnaire; IPAQ). Most study group SF-36 subscales were lower when compared to the control group. Among the study group, post-operatively, 36.6% of patients managed to resume low levels of sports activity, 40% were sufficiently active and were able to perform moderate sports activity (an activity that requires moderate physical effort and which forces the patient to breathe with a frequency only moderately higher than normal), while 23.3% of them were active or very active and were able to perform intense physical activity. Most IPAQ scores were statistically different from the control group. The present study suggests that patients treated with medializing calcaneal osteotomy and navicular-cuneiform arthrodesis for symptomatic flafoot had lower levels of quality of life and physical activity when compared to healthy subjects. After surgery, patients showed a significant improvement in the clinical scores.

Health-Related Quality of Life in Italian Adolescents During Covid-19 Outbreak

Coronavirus disease 2019 (COVID-19) outbreak represented an experience of social isolation potentially leading to changes in the health quality of life. The aim of this study is to investigate the health-related quality of life during quarantine in early adolescents. Data were collected from 1,289 adolescents (mean age, 12.5; male, 622), at the beginning of the school year (September 2019, Standard Condition, SC) as part of the AVATAR project and during Phase 1 of the Italian lockdown (mid-late April 2020) (COVID-19 Quarantine, CQ) using an online questionnaire. In the CQ period, with respect to SC, adolescents showed lower perception in the dimensions, such as psychological (p = 0.001), physical well-being (p = 0.001), mood/emotion (p = 0.008), autonomy (p = 0.001), and financial resources (p = 0.018). Relationship with the family (p = 0.021) and peers (p = 0.001), as well as the perception of bullying (p = 0.001) were reduced. In lifestyle, adolescents developed higher adherence to the Mediterranean diet (p = 0.001). Adolescents living in the village had greater reduction in both autonomy (p = 0.002) and peer relationships (p = 0.002). Moreover, the perception of physical well-being was lower in those living in the city instead of those living in the countryside (p = 0.03), in an apartment instead of a detached house (p = 0.002), and in those who did not have green space (p = 0.001). Gender effect emerged for the psychological (p = 0.007) and physical well-being (p = 0.001), mood/emotion (p = 0.001), and self-perception (p = 0.001). The study showed that health-related quality of life during quarantine changed in its psychosocial dimensions, from mood and self-esteem to social relationships, helping to define the educational policies at multiple points in the promotion process of health.

Comparing the reliability and validity of the SF-36 and SF-12 in measuring quality of life among adolescents in China: a large sample cross-sectional study

OBJECTIVE

We compare the reliability and validity of the Short Form 36 (version 1, SF-36) and the Short Form 12 (version 1, SF-12) in adolescence, the period of life when a child develops into an adult, i.e., the period from puberty to maturity terminating legally at the age of majority (10-19 years), thus supplying evidence for the selection of instruments measuring the quality of life (QOL) and decision-making processes of adolescents in China.

METHODS

Stratified cluster random sampling was adopted according to geographical location, and the SF-36 was administered to assess QOL. The Pearson correlation coefficient was used to show correlation. Cronbach's alpha and construct reliability (CR) were used to evaluate the reliability of SF-36 and SF-12, while criterion validity and average variance extracted (AVE, convergence validity) were used to evaluate validity. Confirmatory factor analysis was used to calculate the load factors for the items of the SF-36 and SF-12, then to obtain the CR and AVE. The Semejima grade response model (logistic two-parameter module) in item response theory was used to estimate item discrimination, item difficulty, and item average information for the items of the SF-36 and SF-12.

RESULTS

19,428 samples were included in the study. The mean age of respondents was 14.78 years (SD = 1.77). Reliability of each domain of the SF-36 was better than for the corresponding domain of the SF-12. The domains of PF, RP, BP, and GH in SF-36 had good construct reliability (CR > 0.6). The criterion validities of some domains of the SF-36 were a little higher in some corresponding dimensions of the SF-12, except for PCS. The convergence validities of the SF-12 were higher than the SF-36 in PF, RP, BP, and PCS. The items of BP, SF, RP, and VT in the SF-12 had acceptable discrimination of items that were higher than in the SF-36. The items' average amounts of information on BP, VT, SF, RE, and MH in the SF-36 and SF-12 were poor.

CONCLUSION

Two component (PCS and MCS) measurements of the SF-12 appeared to perform at least as well as the SF-36 in cross-sectional settings in adolescence, but the reliability and validity of the 8 domains of the SF-36 were better than those of the SF-12. Some domains, for instance SF and BP, were not suitable for adolescents or need to be studied further.

Poor Psychosocial Well-Being in the First Year-and-a-Half After Losing a Parent to Cancer - A Longitudinal Study Among Young Adults Participating in Support Groups

The purpose of this study was to investigate variations in psychosocial well-being over time among young adults who participated in a support group after the death of a parent from cancer. Fifty-five young adults, aged 16-28 years, completed questionnaires that measured self-esteem, anxiety, depression, and life satisfaction at three time-points during the first year-and-one-half after the loss. Results indicated overall poor psychosocial well-being with few increases in psychological health over the study period, despite access to support and social networks. However, these resources may help to prevent major impairments in the participants' future lives.

Examining Gender Differences, Personality Traits, Academic Performance, and Motivation in Ukrainian and Polish Students of Physical Education: A Cross-Cultural Study

Background: This study examined the relationship of academic performance with the Big Five traits of personality, academic motivation, and gender in a cross-cultural context. Methods: Participants in the study were 424 university students of physical education (PE) departments from Poland (53%) and Ukraine (47%). Undergraduates completed a brief version of the International Personality Item Pool (Mini-IPIP) to assess the Five-Factor model of personality, the Academic Motivations Scale (AMS), and grade point average (GPA). Results: Polish PE students scored higher in emotional stability and extroversion and had a higher GPA than Ukrainian PE undergraduates. Gender differences were found in both personality traits and academic motivation scales. Intrinsic motivation may predict academic performance. Conscientiousness and intellect emerged as mediators of the relationship between intrinsic motivation and academic performance and gender was found as a moderator in the relationship between conscientiousness and academic success. Conclusions: Women are more motivated regarding academic achievements than men. In addition to intrinsic motivation, the most important factors for academic grades are some personality traits, gender, and cultural differences. Openness and conscientiousness in men are mediators between intrinsic motivation and academic performance. The results of this study may be useful for PE academic teachers to improve the motivation of their students.

Health-related quality of life in young people: the importance of education

BACKGROUND

The concept of health-related quality of life and education integrates the bio-psychosocial perspective of health and the multidimensional potentialities of education for wellbeing. This present work is especially relevant to young people because understanding the interaction between health and education can facilitate the design of preventive policies. The research examines the way in which the educational level of young people from an urban district in the city of Zaragoza (Casablanca) has an influence on their health-related quality of life (HRQOL).

METHODS

A cross sectional survey was undertaken in the Casablanca district of Zaragoza (Spain). Participants were not randomly selected; their numbers reflected the areas where they lived with respect to age and sex distribution. It comprised 122 boys and 122 girls, aged between16 and 29, living in the neighbourhood are: Viñedo Viejo, Las Nieves and Fuentes Claras. These three residence zones are markedly different in terms of socioeconomic composition. The questionnaire included the following information: socioeconomic characteristics (sex, age, educational level, employment status, residence zone), an assessment of health (health problems, diagnosis and medication in the last 2 weeks) and HRQOL (WHOQOL-BREF dimensions: mental health; physical health; social relations; and environment). ANOVA and four regression models were used to assess the role, direction and intensity of educational level on HRQOL.

RESULTS

The results show that the higher the level of education, the better the level of HRQOL. The biggest impact of education was on the mental health dimension, but this influence was modulated by sex and residence zone. The value of the interaction of education and residence zone was more significant than educational level alone. HRQOL of girls is more sensitive to education, being a student and residence zone than the HRQOL of boys.

CONCLUSIONS

The dimensions of HRQOL are influenced by educational level. The influence is greatest among girls and the youngest members of the poorest area of the district. Public authorities should contemplate the development of an equitable education system from the beginning of the life cycle as a public health strategy.

The impact of menarche on health-related quality of life in a sample of Italian adolescents: evidence from school-based AVATAR project

Adolescence is a period characterized by rapid physical maturation, involving bodily changes that often necessitate a reorganization of self-perception. The current study investigated the impact of menarche on the determinants of quality of life in healthy female adolescents. Data were collected from 361 healthy female adolescents divided into two groups: pre- and post-menarcheal event. Participants, according the AVATAR project, completed Italian version of KIDSCREEN-52 questionnaires on health-related quality of life. Pre-menarcheal females had the higher score in psychological well-being and mood than post-menarcheal females. As concerns self-perception, post-menarcheal females exhibited lower score compared to pre-menarcheal females. In social context, pre-menarcheal females perceived a better school environment, also when we considered it in terms of social acceptance.Conclusion: Menarche event affects all the components of quality of life, from mood, self-esteem to social relationships, underlining how this hormonal variation is responsible of psychological and emotional changes, opening up the opportunity for preventive approaches aimed not only at traditional risk factors but according a more integrated perspective.What is Known:• Adolescence is a time of increasing behavioural divergence between males and females, probably due to the different hormonal development.• There is a possible link between menarche and the health-related quality of life variables.What is New:• Menarche condition affects all the components of quality of life, from mood to social relationships.• Post-menarcheal condition is associated to psychosocial and emotional changes, with possible multiple pathways to post-pubertal depressive symptoms.

Quality of life and costs of patients prior to colorectal surgery

Objective: To assess the quality of life and societal costs of patients prior to colorectal surgery in the Netherlands.Methods: This study is embedded in a previous randomized controlled trial (SANICS II). The quality of life was measured using EQ-5D-5L questionnaires. The iMTA medical consumption questionnaire (iMCQ) and the iMTA productivity costs questionnaire (iPCQ) were used to identify and measure healthcare and productivity costs. Subgroup analyses were performed based on age and gender.Results: A total of 178 patients were included in the cost analysis and a total of 161 patients in the quality of life analysis. The three-month mean societal cost per patient amounted to €3,211 of which €1,459 was due to productivity losses. The mean utility was 0.88 per patient. Gender was an important predictor in quality of life with men scoring significantly higher than women (0.92 versus 0.82) at p < 0.0001.Conclusion: Colorectal cancer represents a high economic burden in the Netherlands. Further research with repeated cost and quality of life measurements would be needed to explore the change over time and the effects of surgery.

Gastrointestinal symptoms in relation to quality of life after metabolic surgery in adolescents

BACKGROUND

Adolescent obesity is associated with significant co-morbidities, including decreased quality of life (QOL). QOL improves after metabolic and bariatric surgery (MBS), but recent studies have demonstrated that certain gastrointestinal symptoms (GIS) worsen after surgery, including reflux symptoms, nausea, bloating, and diarrhea.

OBJECTIVE

The aim of this study was to evaluate QOL and the effect of these symptoms on QOL after bariatric surgery.

SETTING

Five academic centers that perform adolescent MBS in the United States.

METHODS

We prospectively studied 228 adolescents undergoing MBS using the Teen-Longitudinal Assessment of Bariatric Surgery cohort. GIS and QOL scores were assessed before surgery, at 6 months, and yearly to 5 years after surgery. Analysis involved linear models examining QOL and the association between GIS and QOL adjusting for a priori determined covariates.

RESULTS

Adjusting for body mass index change over time, the physical component score (PCS) of the Short Form-36 (SF-36) increased after surgery from 44.2 at baseline to 54.4 at 5 years (P < .0001). The mental component score did not significantly change over time. The SF-36 domains that showed the biggest increase after surgery were physical functioning, physical role functioning, and general health. The SF-36 PCS decreased significantly over time post surgery in those with GIS of reflux, nausea, and diarrhea but remained higher than baseline SF-36 PCS. There was no statistically significant change in mental component score or impact of weight on quality of life-KIDS scores in those with or without GIS.

CONCLUSION

QOL, specifically the SF-36 PCS, increases after MBS. Reflux symptoms, nausea, and diarrhea reduce the degree of improvement in QOL in adolescents after MBS. Patients should be monitored and treated for these symptoms to address this decreased QOL.

The Impact of a Previous Ankle Injury on Current Health-Related Quality of Life in College Athletes

CONTEXT

There has been an increased interest in understanding how ankle injuries impact patient outcomes; however, it is unknown how the severity of a previous ankle injury influences health-related quality of life (HRQOL).

OBJECTIVE

To determine the impact of a previous ankle injury on current HRQOL in college athletes.

DESIGN

Cross-sectional study.

SETTING

Athletic training clinics.

PARTICIPANTS

A total of 270 participants were grouped by the severity of a previous ankle injury (severe = 62, mild = 65, and no injury = 143).

MAIN OUTCOME MEASURES

Participants completed the Foot and Ankle Ability Measure (FAAM) and the Short Form 12 (SF-12).

METHODS

A 2-way analysis of variance with 2 factors (injury group and sex) was used to identify interaction and main effects for the FAAM and SF-12.

RESULTS

No interactions were identified between injury group and sex. Significant main effects were observed for injury group, where the severe injury group scored lower than athletes with mild and no injuries on the FAAM activities of daily living, FAAM Global, and SF-12 mental health subscale scores. In addition, a main effect was present for sex in the SF-12 general health, social functioning, and mental health subscales in which females reported significantly lower scores than males.

CONCLUSIONS

Our findings suggest that a severe ankle injury impacts HRQOL, even after returning back to full participation. In addition, females tended to report lower scores than males for aspects of the SF-12, suggesting that sex should be considered when evaluating HRQOL postinjury. As a result, clinicians should consider asking athletes about their previous injury history, including how much time was lost due to the injury, and should mindful of returning athletes to play before they are physiologically and psychologically ready, as there could be long-term negative effects on the patients' region-specific function as well as aspects of their HRQOL.

Symptoms of anxiety and depression and risk of atrial fibrillation-The HUNT study

BACKGROUND

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. Anxiety and depression may activate the autonomic nervous system which is likely to play an important role in the etiology of AF. However, little is known about the association between symptoms of anxiety and depression and risk of AF.

OBJECTIVE

This study aimed to assess the association between symptoms of anxiety and depression and risk of AF.

METHODS

In a population-based study, 37,402 adult residents were followed for incident AF from 2006 to 2008 until 2015. Participants were classified according to data on anxiety and depression symptoms. Cox proportional regression models were used to adjust for common AF risk factors.

RESULTS

During a median follow-up of 8.1 years, 1433 (3.8%) participants developed AF. In comparisons with no anxiety symptoms, the multivariable-adjusted hazard ratios (HRs) were 1.1 (95% CI: 0.9-1.5) for mild to moderate anxiety symptoms and 1.0 (95% CI: 0.8-1.4) for severe anxiety symptoms. In comparisons with no depression symptoms, the multivariable-adjusted HRs were 1.5 (95% CI: 1.2-1.8) for mild to moderate depression symptoms and 0.9 (95% CI: 0.6-1.3) for severe depression symptoms. Recurrent anxiety/depression symptoms were not associated with increased AF risk.

CONCLUSIONS

In this large, population-based study, we found no evidence of an association between symptoms of anxiety or severe depression and AF risk, even for recurrent anxiety or depression symptoms. An unexpected association of symptoms of mild to moderate depression with increased AF risk requires confirmation in other studies. Our findings add to the sparse literature on symptoms of anxiety and depression and risk of AF.

Young People Living at Risk of Huntington's Disease: The Lived Experience

BACKGROUND

For young people in families with Huntington's disease (HD) the challenge of having an affected family member (AFM) compounds challenges related to being at risk of HD themselves.

OBJECTIVE

This study aimed to quantitatively examine the experiences of young people in families with HD, adding to existing qualitative studies regarding teenagers and young adults in families with HD.

METHODS

The experiences of young people with living in a family with HD were captured by an online anonymous questionnaire, available worldwide through the Huntington's Disease Youth Organization. The questionnaire contained mostly forced choice questions.

RESULTS

Most participants (n = 84/101, 83.2%) provide assistance to an AFM and 46.4% (n = 39/84) wish they didn't have to look after their AFM. Many participants (n = 64/78, 82.1%) reported feeling anxious about being at risk; 64.9% (n = 50/77) agreed it is a barrier in their life. Over one third (n = 29/76, 38.2%) of participants disagreed that they have support in relation to being at risk, despite 85.5% (n = 65/76) agreeing it is important to have support and ongoing follow up.

CONCLUSIONS

Young people in families with HD endure considerable emotional, social and practical burden secondary to having an AFM and being at risk themselves. Without increased support and services, the effects of being a young caregiver and living at risk are likely to have long term impacts on the well-being of these young people.

Associations of psychosis-risk symptoms with quality of life and self-rated health in the Community

BACKGROUND

Understanding factors related to poor quality of life (QoL) and self-rated health (SRH) in clinical high-risk (CHR) for psychosis is important for both research and clinical applications. We investigated the associations of both constructs with CHR symptoms, axis-I disorders, and sociodemographic variables in a community sample.

METHODS

In total, 2683 (baseline) and 829 (3-year follow-up) individuals of the Swiss Canton of Bern (age-at-baseline: 16-40 years) were interviewed by telephone regarding CHR symptoms, using the Schizophrenia Proneness Instrument for basic symptoms, the Structured Interview for Psychosis-Risk Syndromes for ultra-high risk (UHR) symptoms, the Mini-International Neuropsychiatric Interview for current axis-I disorders, the Brief Multidimensional Life Satisfaction Scale for QoL, and the 3-level EQ-5D for SRH.

RESULTS

In cross-sectional structural equation modelling, lower SRH was exclusively significantly associated with higher age, male gender, lower education, and somatoform disorders. Poor QoL was exclusively associated only with eating disorders. In addition, both strongly interrelated constructs were each associated with affective, and anxiety disorders, UHR and, more strongly, basic symptoms. Prospectively, lower SRH was predicted by lower education and anxiety disorders at baseline, while poorer QoL was predicted by affective disorders at baseline.

CONCLUSIONS

When present, CHR, in particular basic symptoms are already distressful for individuals of the community and associated with poorer subjective QoL and health. Therefore, the symptoms are clinically relevant by themselves, even when criteria for a CHR state are not fulfilled. Yet, unlike affective and anxiety disorders, CHR symptoms seem to have no long-term influence on QoL and SRH.

School Absenteeism, Health-Related Quality of Life [HRQOL] and Happiness among Young Adults Aged 16-26 Years

This study examines the association between school absenteeism, health-related quality of life (HRQOL) and happiness among young adults aged 16-26 years attending vocational education. Cross-sectional data from a survey among 676 young adults were analyzed. School absenteeism was measured by the self-reported number of sick days in the past eight weeks and hours of truancy in the past four weeks. HRQOL was measured by the 12-item Short Form Health Survey; physical and mental component summary scores were calculated. General happiness was assessed on a scale of 0-10, higher scores indicating greater happiness. Linear regression analyses were performed. The study population had a mean age of 18.5 years (SD 2.2); 26.1% were boys. Young adults with ≥5 sick days or ≥6 h of truancy reported lower mental HRQOL compared to young adults without sickness absence or truancy (p < 0.05). Young adults with 1-4 and ≥5 sick days reported lower physical HRQOL compared to young adults who had not reported to be sick (p < 0.05). Young adults with 1-5 h and ≥6 h of truancy reported higher physical HRQOL compared to young adults who were not truant (p < 0.05). No associations were observed between school absence and happiness. Lower self-reported mental HRQOL was observed among young adults with more school absenteeism due to sickness or truancy. Sickness absence was additionally associated with lower physical HRQOL.

Nomophobia and its relationship with depression, anxiety, and quality of life in adolescents

BACKGROUND

Nomophobia is a portmanteau for "no mobile phone" and phobia or mobile phone addiction. Nomophobia refers to discomfort, anxiety, nervousness, or anguish caused by being out of contact with a mobile phone. There is a paucity of literature from India on this emerging mental health condition.

OBJECTIVES

The objectives of this study were to assess the prevalence of nomophobia and its relationship with depression, anxiety, and quality of life among adolescent students.

MATERIALS AND METHODS

A cross-sectional study was carried out in 1386 high school students aged between 14 and 17 years. The Nomophobia Questionnaire (NMP-Q) was used to assess nomophobia. Beck's Depression Inventory (BDI), Beck's Anxiety Inventory (BAI), and Short Form-36 (SF-36) were used to measure depression, anxiety, and quality of life, respectively.

RESULTS

Out of 1386 adolescents, 569 (41.05%), 303 (21.86%), and 82 (5.1%) have mild, moderate, and severe nomophobia, respectively. There were significantly more males with nomophobia. There was a statistically significant relationship between NMP-Q score and BDI, BAI, and SF-36 scores. A significant positive correlation was observed between NMP-Q score and scores on BDI and BAI and a significant negative correlation between SF-36 score.

CONCLUSION

The results of the study indicate that nomophobia is an emerging mental health condition, especially in male adolescents. Nomophobia is significantly associated with depression, anxiety, and poor quality of life. Multicentric studies are needed to better understand this disorder.

Quality of life in persons with hearing loss: a study of patients referred to an audiological service

Objective: To investigate the relationship between hearing loss (HL) and general quality of life (QoL) in adults seeking hearing aids (HAs). Design: The patients completed the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire's general part and a questionnaire measuring self-assessed communication ability (Abbreviated Profile of hearing Aid Benefit-APHAB). These responses were compared with EORTC scores from a general population and patients with former head and neck cancer. Study sample: One-hundred and fifty-eight adults with HL were recruited prior to hearing aid (HA) fitting with one half seeking renewal of their HA. Results: General QoL scores among patients with HL were similar to those in the general population, but higher than in many chronic serious diseases. Patients with unilateral HL reported slightly worse social function and more fatigue than patients with bilateral HL. Self-assessed communication ability correlated with general QoL scores. Also, we found that best ear pure tone average (PTA), cognitive and physical QoL function predicted APHAB scores. Conclusion: In the investigated HL group, general QoL scores seem to be relatively close to those seen in the general population.

Recommendations and Challenges of the Clinical Services Panel of the PhenX Early Psychosis Working Group

Coordinated specialty care (CSC) is a promising multielement treatment for the care of individuals experiencing the onset of schizophrenia. The community mental health block grant program has increased federal support for CSC programs. In order to maximize the number of sites capable of science-to-service or service-to-science translation, the National Institute of Mental Health funded a supplement to the PhenX toolkit consisting of measures for early psychosis. The early psychosis working group included translational research and clinical services panels. The clinical services panel was charged with identifying low-burden and psychometrically sound measures for use in routine clinical settings. The 19 new clinical measures complement existing measures already in the toolkit. Measures cover a range of domains, including symptoms, social and occupational functioning, well-being, medication adherence and side effects, physical activity, and shared decision making and person-centered care. Several challenges are also discussed. The review process underscored the challenges facing nonacademic sites in collecting even low-burden assessments.

Cognitive Behavior Therapy for Persistent Severe Fatigue in Childhood Cancer Survivors: A Pilot Study

OBJECTIVES

Fatigue is a common and disabling late effect in childhood cancer survivors (CCS). In this pilot study, the effectiveness of cognitive behavior therapy (CBT) in CCS with persistent and severe fatigue was retrospectively evaluated.

MATERIALS AND METHODS

In total, 33 consecutively referred CCS with persistent severe fatigue were offered CBT. The primary outcome was fatigue severity (Checklist Individual Strength, Fatigue Severity Subscale). Secondary outcomes were functional impairment, psychologic distress, and quality of life (QoL).

RESULTS

In total, 25 CCS completed CBT (76%). The mean age of CCS was 23.1 years (range, 11 to 42 y), mean age at primary cancer diagnosis was 9.7 years (range, 0 to 17 y), and mean time since primary cancer diagnosis was 13 years (range, 5 to 34 y). Fatigue severity ([INCREMENT] 17.4; confidence interval (CI)=12.7-22.1; P<0.001), functional impairment (SIP8 [INCREMENT] 470.3; CI=312.3-628.4; P<0.001/SF36 [INCREMENT] 11.7; CI=17.2-6.3; P<0.001), and psychologic distress ([INCREMENT] 26.4; CI=15.6-34.9; P<0.001) were significantly decreased at second assessment. QoL ([INCREMENT] 13.5; CI=22.0-4.3; P=0.005) was significantly improved. A total of 23 CCS of the 33 CCS (70%) met the criteria for clinically significant improvement of fatigue.

CONCLUSIONS

In this pilot study, the majority of severely fatigued CCS showed a clinically significant reduction in fatigue following CBT. Moreover, daily function and QoL improved, and psychologic distress decreased.

Differences in illness perception between children with cancer and other chronic diseases and their parents

BACKGROUND

The purpose of this study was to explore the differences in illness perception between children with cancer and other chronic diseases. A secondary aim was to examine the similarities and differences between the illness perception of these children and their parents.

METHODS

The Revised Illness Perception Questionnaire (IPQ-R) was used to measure the children's and parents' illness perceptions. In this study, 184 children (ages 8-18 years) and their caregivers completed the questionnaires.

RESULTS

This study shows that children with cancer feel that they have greater control over their treatment compared to the other two groups. The children's parents have more pessimistic views of the illness than their children.

CONCLUSION

Examinations of illness perceptions among paediatric cancer patients and their families are essential in designing psychosocial interventions for these families. The clinical value of our results can help better understand the cancer-specific features of illness perceptions.

Cognition, health-related quality of life, and mood in children and young adults diagnosed with a glioneuronal tumor in childhood

AIMS

The aim of this study was to investigate long-term cognitive outcome, health-related quality of life (HRQoL), and psychiatric symptoms in children and young adults diagnosed with a glioneuronal tumor in childhood.

METHODS

Twenty-eight children and adolescents (0-17.99years) with a minimum postoperative follow-up time of five years were eligible for the study; four persons declined participation. A cross-sectional long-term follow-up evaluation was performed using the following study measures: Wechsler Intelligence Scale for Children (WISC-IV) or Wechsler Adult Intelligence Scale (WAIS-IV), Reys Complex Figure Test (RCFT), Short Form 36 version 2 (SF-36v2), Short Form 10 (SF-10), Quality of Life in Epilepsy 31 (QOLIE-31), Hospital Anxiety Depression Scale (HADS) or Beck Youth Inventory Scales (BYI), and Rosenberg Self-Esteem Scale. Historical WISC-III and RCFT data were used to compare cognitive longitudinal data.

RESULTS

Mean follow-up time after surgery was 12.1years. Sixty-three percent (15/24) were seizure-free. Despite a successive postoperative gain in cognitive function, a significant reduction relative to norms was seen in the seizure-free group with respect to perceptual reasoning index (PRI), working memory index (WMI), and full-scale intelligence quotient (FSIQ). Seizure freedom resulted in acceptable HRQoL. Thirty-two percent and 16% exceeded the threshold level of possible anxiety and depression, respectively, despite seizure freedom.

CONCLUSION

Although lower than in corresponding reference groups, cognitive outcome and HRQoL are good provided that seizure freedom or at least a low seizure severity can be achieved. There is a risk of elevated levels of psychiatric symptoms. Long-term clinical follow-up is advisable.