The purpose of this report is to examine health-related quality of life (HRQoL) as measured by the Medical Outcomes Study Short Form-36, across patient populations with chronic disorders and to compare quality of life (QoL) in these subjects with normative data on healthy persons. Six studies, within the Center for Research in Chronic Disorders at the University of Pittsburgh School of Nursing, in patients with urinary incontinence, prostate cancer, chronic obstructive pulmonary disease (COPD), acquired immune deficiency syndrome (AIDS), fibromyalgia and hyperlipidaemia provided the data for analysis. The results demonstrated that not only did the prostate cancer and hyperlipidaemia patients have the highest QoL across the chronic disorders, but their QoL was comparable to normative data on healthy persons. Homebound, elderly, incontinent patients had the lowest QoL for physical functioning, whereas patients hospitalized with AIDS had the lowest QoL in general health and social functioning. Patients with COPD had the lowest QoL in role-physical, role-emotional and mental health. Patients with fibromyalgia had the lowest QoL in bodily pain and vitality. Compared to normative data, patients with urinary incontinence, COPD, AIDS and fibromyalgia generally had lower QoL. Prostate cancer and hyperlipidaemia patients had QoL comparable to normative data. Compared to normative data, patients with urinary incontinence, COPD, AIDS and fibromyalgia had more variability for role-emotional. AIDS patients had more variability on physical functioning, bodily pain and social functioning compared to the normative data. These data suggest that patients with various chronic disorders may have QoL that is lower in most domains compared to a healthy population. However, there may be differences in the domains affected as well as the extent of variation across specific chronic disorders.

Health-related quality of life in chronic disorders: a comparison across studies using the MOS SF-36.

Reliability and validity of the Flanagan Quality of Life Scale (QOLS) were tested in four chronic illness groups. Open-ended questions and four instruments, the QOLS, Duke-UNC Health Profile (DUHP), Life Satisfaction Index (LSI-Z), and either the Arthritis Impact Measurement Scales (AIMS) or the Ostomy Adjustment Scale (OAS) were administered by telephone interview and mailed questionnaires to 227 adults three times over 6 weeks. Subjects generated verbal responses that substantiated the content validity of the QOLS. Stability reliability estimates for all instruments ranged from .53 to .90. Cronbach's alpha coefficients averaged .87 for the QOLS. Appropriate validity coefficients indicated both convergent and discriminant construct validity.

Quality of life of adults with chronic illness: a psychometric study.

Quality of life is a critically important concept for health care that has been developed predominantly in the past three decades. Conceptual clarity is extremely important, because differences in meaning can lead to profound differences in outcomes for research, clinical practice, and allocation of health care resources. This paper describes the development of the Ferrans conceptual model of quality of life. The model was developed based on the adoption of an individualistic ideology, which recognizes that quality of life depends on the unique experience of life for each person. Individuals are the only proper judge of their quality of life, because people differ in what they value. Consistent with this ideology, quality of life was defined in terms of satisfaction with the aspects of life that are important to the individual. The model was developed using qualitative methodology. Factor analysis of patient data was used to cluster related elements into domains of quality of life. The resulting model identifies four domains of quality of life: health and functioning, psychological/spiritual, social and economic, and family. Subsequent cross-cultural work with African Americans and Mexican Americans has provided evidence that the elements of the model appropriately reflect quality of life for segments of the population not sampled in the original work. The Ferrans and Powers Quality of Life Index was developed based on this model.

Development of a conceptual model of quality of life.

Quality of life bibliography and indexes.

Functional status outcomes of patients with a coronary artery bypass graft over time.

Information available for nurses on counseling cardiac patients about the outcomes of bypass surgery has focused on the time following the first postoperative year. In order to assess earlier impact, two groups of bypass patients--alike in terms of preoperative physical activity, angina level, and type of revascularization--were compared in terms of quality of life and related areas. Seventeen patients were 3 to 5 months (88-141 days) postoperative and 17 patients were 6 to 8 months (161-222 days) post-operative. They were asked to rate themselves on Cantril's Self-Anchoring Scale in relation to past, present, and future life satisfaction. An analysis of variance (ANOVA) indicated that both groups of patients viewed their future life satisfaction to be better than their life satisfaction prior to open heart surgery. Furthermore, the patients 6 to 8 months postoperative viewed their present life satisfaction to be significantly better than their past (p less than .05). Both groups reported a decrease in the level of angina and an increase in the level of physical activity after surgery (p less than .001). They also reported greater satisfaction with family life (p less than .05), social life (p less than .001), and sexual life (p less than .01) following surgery. Overall, there were significant improvements in the quality of life early in the recovery period following surgery. Residual incisional pain may have contributed to any differences between groups.

Sue Hastings Penckofer

Papers

Early appraisal of coronary revascularization on quality of life.

What you should know about women and heart disease.