Quality of life

About: Quality of life is a research topic. Over the lifetime, 42912 publications have been published within this topic receiving 1198363 citations. The topic is also known as: life quality.

Sleep and quality of life in the Austrian population

Abstract: Purpose– To compare the self-reported estimation of sleep quality evaluated by the Pittsburgh Sleep Quality Index (PSQI) and life quality assessed by the Quality of Life Index (QLI) Background– The PSQI comprised 19 questions and assessed a wide variety of factors relating to sleep quality The QLI consisted of 10 items for self assessment of different dimensions of life quality Subjects– A representative Austrian sample (n=1049) aged above 15 years Procedure– Interviews in the homes of the participants Results– 321% could be classified as poor sleepers (37% females, 265% males) Sleep quality decreased with increasing age, especially in women Overall quality of life was highest in younger (15–29 years) and lowest in elderly subjects (over 50 years) Life quality decreased with increasing age Between subjective sleep quality and quality of life a moderate, significant correlation was found (r2=06721) Conclusions– Complaints about a bad quality of sleep could be used as a screening method in the exploration of patients' quality of life (QoL)

Rehabilitation after myocardial infarction trial (RAMIT): multi-centre randomised controlled trial of comprehensive cardiac rehabilitation in patients following acute myocardial infarction

Abstract: Background It is widely believed that cardiac rehabilitation following acute myocardial infarction (MI) reduces mortality by approximately 20%. This belief is based on systematic reviews and meta-analyses of mostly small trials undertaken many years ago. Clinical management has been transformed in the past 30–40 years and the findings of historical trials may have little relevance now. Objectives The principal objective was to determine the effect of cardiac rehabilitation, as currently provided, on mortality, morbidity and health-related quality of life in patients following MI. The secondary objectives included seeking programmes that may be more effective and characteristics of patients who may benefit more. Design, setting, patients, outcome measures A multi-centre randomised controlled trial in representative hospitals in England and Wales compared 1813 patients referred to comprehensive cardiac rehabilitation programmes or discharged to ‘usual care’ (without referral to rehabilitation). The primary outcome measure was all-cause mortality at 2 years. The secondary measures were morbidity, health service use, health-related quality of life, psychological general well-being and lifestyle cardiovascular risk factors at 1 year. Patient entry ran from 1997 to 2000, follow-up of secondary outcomes to 2001 and of vital status to 2006. A parallel study compared 331 patients in matched ‘elective’ rehabilitation and ‘elective’ usual care (without rehabilitation) hospitals. Results There were no significant differences between patients referred to rehabilitation and controls in mortality at 2 years (RR 0.98, 95% CI 0.74 to 1.30) or after 7–9 years (0.99, 95% CI 0.85 to 1.15), cardiac events, seven of eight domains of the health-related quality of life scale (‘Short Form 36’, SF36) or the psychological general well-being scale. Rehabilitation patients reported slightly less physical activity. No differences between groups were reported in perceived overall quality of cardiac aftercare. Data from the ‘elective’ hospitals comparison concurred with these findings. Conclusion In this trial, comprehensive rehabilitation following MI had no important effect on mortality, cardiac or psychological morbidity, risk factors, health-related quality of life or activity. This finding is consistent with systematic reviews of all trials reported since 1983. The value of cardiac rehabilitation as practised in the UK is open to question.

Positive and negative psychosocial sequelae of bone marrow transplantation: implications for quality of life assessment.

Abstract: Life-threatening disease can trigger positive effects such as greater appreciation for life and enhanced interpersonal relationships. Little research has examined these salutary effects or their association with quality of life (QOL). Adult bone marrow transplantation (BMT) survivors (n=90) were interviewed regarding psychosocial sequelae of BMT and completed indices of QOL and psychological adjustment. Thematic analysis was used to code interview responses into discrete categories of negative and positive sequelae. Multiple regression analyses indicated POSTOTAL scores were inversely associated with time post-BMT and positively associated with negative prognostic factors at BMT. Scores on indices of QOL and psychological adjustment were significantly correlated with reports of negative post-BMT sequelae but unrelated to positive sequelae. It was concluded that life-threatening disease can trigger positive sequelae that can contribute to QOL. However, standard QOL indices may not measure this positive QOL dimension, thus yielding a potentially incomplete picture of current QOL.

Effect of Esthetic Outcome After Breast-Conserving Surgery on Psychosocial Functioning and Quality of Life

Abstract: Purpose Although breast-conserving surgery (BCS) is often assumed to result in minimal deformity, many patients report postoperative breast asymmetry. Understanding the effect of asymmetry on psychosocial functioning is essential for patients to make an informed choice for surgery. Patients and Methods All women who underwent BCS at the University of Michigan Medical Center (Ann Arbor, MI) during a 4-year period were surveyed using a mailed questionnaire (N 714; response rate 79.5%). Women were queried regarding five aspects of psychosocial functioning: quality of life (QOL), depression, fear of recurrence, stigmatization, and perceived change in health status. Postoperative breast asymmetry was assessed using items from the Breast Cancer Treatment and Outcomes Survey. Multiple regression was used to examine the relationship between breast asymmetry and each outcome, controlling for age, time from surgery in years, race, education level, disease stage, surgical treatment, and the occurrence of postoperative complications. Results Women with pronounced breast asymmetry were significantly more likely to feel stigmatized as a result of their breast cancer treatment (odds ratio [OR] 4.58; 95% CI, 2.77 to 7.55) and less likely to report unchanged or improved health after treatment (OR 0.43; 95% CI, 0.27 to 0.66). Minimal breast asymmetry was associated with higher QOL scores (86.3 v 82.4, P .001). Finally, women with pronounced breast asymmetry were more likely to exhibit depressive symptoms (minimal asymmetry, 16.2%; moderate asymmetry, 18.0%; pronounced asymmetry, 33.7%, Wald test 16.6; P .002).

Increased Hospital-Based Physical Rehabilitation and Information Provision After Intensive Care Unit Discharge: The RECOVER Randomized Clinical Trial

Abstract: Importance Critical illness results in disability and reduced health-related quality of life (HRQOL), but the optimum timing and components of rehabilitation are uncertain. Objective To evaluate the effect of increasing physical and nutritional rehabilitation plus information delivered during the post–intensive care unit (ICU) acute hospital stay by dedicated rehabilitation assistants on subsequent mobility, HRQOL, and prevalent disabilities. Design, Setting, and Participants A parallel group, randomized clinical trial with blinded outcome assessment at 2 hospitals in Edinburgh, Scotland, of 240 patients discharged from the ICU between December 1, 2010, and January 31, 2013, who required at least 48 hours of mechanical ventilation. Analysis for the primary outcome and other 3-month outcomes was performed between June and August 2013; for the 6- and 12-month outcomes and the health economic evaluation, between March and April 2014. Interventions During the post-ICU hospital stay, both groups received physiotherapy and dietetic, occupational, and speech/language therapy, but patients in the intervention group received rehabilitation that typically increased the frequency of mobility and exercise therapies 2- to 3-fold, increased dietetic assessment and treatment, used individualized goal setting, and provided greater illness-specific information. Intervention group therapy was coordinated and delivered by a dedicated rehabilitation practitioner. Main Outcomes and Measures The Rivermead Mobility Index (RMI) (range 0-15) at 3 months; higher scores indicate greater mobility. Secondary outcomes included HRQOL, psychological outcomes, self-reported symptoms, patient experience, and cost-effectiveness during a 12-month follow-up (completed in February 2014). Results Median RMI at randomization was 3 (interquartile range [IQR], 1-6) and at 3 months was 13 (IQR, 10-14) for the intervention and usual care groups (mean difference, −0.2 [95% CI, −1.3 to 0.9; P = .71]). The HRQOL scores were unchanged by the intervention (mean difference in the Physical Component Summary score, −0.1 [95% CI, −3.3 to 3.1; P = .96]; and in the Mental Component Summary score, 0.2 [95% CI, −3.4 to 3.8; P = .91]). No differences were found for self-reported symptoms of fatigue, pain, appetite, joint stiffness, or breathlessness. Levels of anxiety, depression, and posttraumatic stress were similar, as were hand grip strength and the timed Up & Go test. No differences were found at the 6- or 12-month follow-up for any outcome measures. However, patients in the intervention group reported greater satisfaction with physiotherapy, nutritional support, coordination of care, and information provision. Conclusions and Relevance Post-ICU hospital-based rehabilitation, including increased physical and nutritional therapy plus information provision, did not improve physical recovery or HRQOL, but improved patient satisfaction with many aspects of recovery. Trial Registration isrctn.com Identifier:ISRCTN09412438