Purpose
Quality of life (QOL) is an important concept in the field of health and medicine. QOL is a complex concept that is interpreted and defined differently within and between disciplines, ...including the fields of health and medicine. The aims of this study were to systematically review the literature on QOL in medicine and health research and to describe the country of origin, target groups, instruments, design, and conceptual issues.
Methods
A systematic review was conducted to identify research studies on QOL and health-related quality of life (HRQOL). The databases Scopus, which includes Embase and MEDLINE, CINAHL, and PsycINFO were searched for articles published during one random week in November 2016. The ten predefined criteria of Gill and Feinstein were used to evaluate the conceptual and methodological rigor.
Results
QOL research is international and involves a variety of target groups, research designs, and QOL measures. According to the criteria of Gill and Feinstein, the results show that only 13% provided a definition of QOL, 6% distinguished QOL from HRQOL. The most frequently fulfilled criteria were: (i) stating the domains of QOL to be measured; (ii) giving a reason for choosing the instruments used; and (iii) aggregating the results from multiple items.
Conclusion
QOL is an important endpoint in medical and health research, and QOL research involves a variety of patient groups and different research designs. Based on the current evaluation of the methodological and conceptual clarity of QOL research, we conclude that the majority QOL studies in health and medicine have conceptual and methodological challenges.
The aim of this study was to investigate factors related to insomnia in a cohort of people with asthma.
This secondary analysis utilized cross-sectional data from the Norwegian Nord-Trøndelag Health ...Study, a population-based health survey (n=50,807).
We used self-reported data from 1,342 men and women with a physician-confirmed asthma diagnosis ranging in age from 19.5 to 91 years.
Data on sleep, lifestyle variables (smoking and exercise), anxiety, and depression were included. An insomnia scale and asthma impact scale were constructed using factor analysis. Hierarchical series of multiple regression models were used to investigate direct and mediational relationships between the study variables and insomnia.
The hierarchical models revealed significant independent contributions of female sex, higher age, not exercising, asthma impact, anxiety, and depression on insomnia (R (2)=25.2%). Further, these models suggested that the impact of smoking on insomnia was mediated by anxiety, and that the beneficial impact of exercise was mitigated by depression symptoms.
Smokers with asthma have more insomnia, and this relationship may be mediated by anxiety. Further, people with asthma who experience depression symptoms are less likely to benefit from physical exercise as a method to enhance sleep quality. Our findings would suggest that helping smokers to manage their anxiety and depression through behavioral methods may reduce their insomnia symptoms, and enable them to engage in other health-enhancing pursuits, such as physical exercise.
Although chronic obstructive pulmonary disease (COPD) primarily affects the lungs, it is regarded as a systemic disorder associated with comorbidity and physical deterioration, which often results in ...reduced levels of health-related quality of life (HRQoL). Self-efficacy is an important concept in self-management, which is vital for improving HRQoL in patients with COPD. The purpose of this study was to examine how general self-efficacy, leisure time physical activity, and sociodemographic variables such as employment status are related to the physical and mental health components of HRQoL in patients with COPD.
In this cross-sectional study, 97 COPD patients (54.6% male, mean age 64.6 years, standard deviation SD 9.5) beginning a pulmonary rehabilitation program completed three self-report questionnaires: the short form (SF)-12v2 Health Survey as a measure of HRQoL; the General Self-Efficacy Scale; and a standardized instrument measuring regular leisure time physical activity.
The physical health component median score was 31.3 (interquartile range IQR 16.3) and the mental health component median score was 45.9 (IQR 21.5). Two sets of linear regression analyses were performed, one predicting physical health and the other predicting mental health. The first analysis showed that better physical health was directly related to being in paid work (P-value <0.001), but was not significantly related to age, sex, marital status, education, work status, physical activity, or self-efficacy. In the second analysis, better mental health was directly related to living with a partner, being physically active, and having higher self-efficacy (P-value <0.001).
The findings suggest that general self-efficacy has differential relationships to the two dimensions of HRQoL. Our results indicate that general self-efficacy, physical activity, and paid work might be important factors for improving HRQoL of persons with COPD, and should be taken into consideration in pulmonary rehabilitation.
The aim of this study was to examine how neuroticism, stressful life events, self-rated health, life satisfaction, and selected lifestyle factors were related to insomnia both by sex and among users ...and nonusers of prescribed sleep medication (PSM).
Cross-sectional data from the Norwegian Nord-Trøndelag Health Study (HUNT3, 2006-2008), a population-based health survey, were linked to individual data from the Norwegian Prescription Database.
Logistic regression analyses were used to investigate the associations between the selected variables and insomnia in both males and females and among subjects using and not using PSM. Individuals were considered to have a presumptive diagnosis of insomnia disorder if they reported difficulty with sleep initiation, sleep maintenance, or early morning awakening several days per week for the last 3 months. PSMs were categorized as anxiolytics or hypnotics; the dose was estimated according to defined daily dose (DDD).
Of the total 50,805 participants, 6,701 (13.2%) used PSM. The proportions of PSM users were larger among elderly participants. Increased risk of insomnia was strongly associated with poor self-rated health and higher level of neuroticism. These associations were evident for both sexes and were similar among both users and nonusers of PSM. Low satisfaction with life was strongly related to insomnia, but only among nonusers of PSM. Increased doses of PSM were not associated with reduced likelihood of insomnia.
Insomnia is a problem among both users and nonusers of PSM and is associated with psychosocial factors. Our findings suggest that successful treatment for sleep problems should take individual variation into account, such as age, sex, personality traits, satisfaction with life, and health perception.
The purpose of this paper was to describe quality of life (QoL) following an acute exacerbation of chronic obstructive pulmonary disease (COPD), and to examine possible relationships between QoL, ...health status, psychological distress and QoL. This prospective longitudinal study examined data from hospitalization and two subsequent phases, collected over a 9-month period. The sample consisted of 51 COPD patients aged 48-87 years. Health status was assessed with the St George's Respiratory Questionnaire (SGRQ); psychological distress with the Hopkins Symptom Checklist (HSCL); and quality of life using the World Health Organization Quality of Life - Bref (WHOQOL - Bref). Health status improved significantly over the 9 months; from 65.95 to 59.40 (p=0.001) in the SGRQ total score. Psychological distress improved significantly from hospitalization to the 1-month assessment (T2) (p=0.001). QoL remained stable except for a significant increase in the physical domain from hospitalization to T2, and in the environmental domain from hospitalization to T2 and T3. Test-retest correlations of the WHOQOL - Bref were high. The results suggest an improvement in the health status over a 9-month period from being discharged after an exacerbation of COPD in spite of high levels of psychological distress and reduced QoL.
Background. Knowledge of what may influence patients’ perceptions of quality of life is essential for improving nursing interventions, but there has been little research on the influence of ...psychological distress on health status and quality of life among patients with chronic obstructive pulmonary disease.
Aim. This paper reports a study whose aim was to examine how disease factors and health status affect psychological distress and subjectively perceived quality of life in patients admitted for an acute exacerbation of chronic obstructive pulmonary disease.
Method. A convenience sample of 92 inpatients (mean age 69 years) were interviewed using the St George's Respiratory Questionnaire, Hopkins Symptoms Check List (23 item version), and World Health Organization Quality of Life Assessment. Disease variables (disease duration and pulmonary function) and health status were entered in blockwise multivariate regression analyses to examine the relationships between disease variables, psychological distress, and a single item assessment of overall quality of life.
Results. The St George's Respiratory Questionnaire Total and Impact subscores showed statistically significant associations with psychological distress. Pulmonary function showed a moderately significant association with subjective perceived quality of life. Pulmonary function and disease duration explained a minor part of the variance in quality of life. Psychological distress had a statistically significant association with quality of life and accounted for 34% of the total 39% variance explained by our model.
Conclusions. The influence of psychological distress on quality of life implies that bringing about change in psychological distress factors may have important consequences for quality of life. The findings should be taken seriously in developing future nursing interventions for this group of patients.
Objectives: To investigate the prevalence of psychological distress in hospitalized patients with chronic obstructive pulmonary disease (COPD), and to examine possible associations between ...psychological distress and several sociodemographic variables. Methods: The Hopkins Symptom Checklist was used to gather data from 92 hospitalized COPD patients. These data were compared with 3,319 respondents aged 45 or over drawn from the 1998 Norwegian Statistics Health Survey. The latter were divided into four groups: respondents with COPD, respondents with other respiratory diseases, respondents with mixed chronic diseases, and a healthy group. Results: The prevalence of psychological distress was found to be 58.7% in the hospitalized COPD patients and 42.9% in the community-based COPD sample. After controlling for sociodemographic variables and current smoking, the results showed a higher risk of psychological distress among hospitalized COPD patients (OR = 23.69; 95% CI: 13.37-41.98) and the community-based COPD sample (OR = 18.16; 95% CI: 8.31-39.68), and with sub-samples with other respiratory diseases (OR = 5.87; 95% CI: 3.82-9.02), and mixed chronic diseases (OR = 3.51; 95% CI: 2.39-5.18). Conclusions: COPD is associated with a high prevalence of psychological distress in both hospital and community settings. Furthermore, it appears that age, gender, education, marital status, and current smoking status do not substantially mediate the association between the severity of psychological distress and COPD status. The results provide additional evidence of the importance of screening for psychological distress symptoms in both hospitalized and community-based patients with COPD.
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