Quality of life of people who inject drugs: characteristics and comparisons with other population samples.

PURPOSE: To assess the quality of life (QOL) of persons who inject drugs. METHODS: Some 483 current injecting drug users visiting a large NSP over a 2-week period in October 2009 were interviewed using a structured questionnaire. QOL was measured using the WHOQOL-BREF. Data were collected on age, gender, injecting patterns, current drug treatment status and hepatitis C status. Participant QOL profiles were compared to published domain scores for a range of other population groups. RESULTS: People who inject drugs (PWID) experience a very poor QOL irrespective of socio-demographic characteristics, injecting patterns, hepatitis C sero-status and drug treatment status. Sample participants (PWID) experience a QOL below that experienced by many population groups in the community affected by disabling chronic illnesses. CONCLUSIONS: Injecting drug use is associated with a poor QOL. Some PWID may be self-medicating for chronic non-malignant pain, and it is likely that these people had a low QOL prior to the decision to inject. Despite this caveat, it remains likely that injecting drug use does little to enhance the QOL of the user.

Mental health promotion and non-profit health organisations.

Health related non-profit organisations (NPOs) provide a potentially important but largely untapped role in mental health promotion in communities. This paper reports on a study investigating the activities and contributions made by NPOs to mental health and well-being. One hundred and eight NPOs based in the metropolitan area of Brisbane, Queensland, Australia, participated in a survey exploring agency activities that contribute to promoting mental well-being; factors that helped or hindered the organisation in engaging in mental health promotion activities and evaluation methods and processes. An index of key themes was developed and frequencies derived from categorical data. NPOs undertook five key types of activities to promote mental health and well-being: support provision (81%); service provision (59%); information sharing (52%); activities to promote well-being (24%); and advocacy (6%). Systematic evaluation of longer-term outcomes was rare, with most NPOs (72%) relying on informal feedback from clients. Human resources in the form of paid or volunteer workers were most frequently (58%) identified as contributing to the capacity of agencies to carry out mental health promotion activities. Training and education emerged as a substantive need (34%). NPOs are well placed to enhance resiliency in the context of ongoing health problems, disability or other adverse psychosocial circumstances that place people at risk of mental health problems. As such they constitute a significant resource for advancing mental health promotion goals. What is needed to extend the practice and evidence base in this area is training and skill development for NPO workers, along with larger-scale research conducted in collaboration with NPOs to assess the contributions and cost-effectiveness of the sector.

Symptom prevalence and clustering of symptoms in people living with chronic hepatitis C infection.

Quality of life has been shown to be poor among people living with chronic hepatitis C. However, it is not clear how this relates to the presence of symptoms and their severity. The aim of this study was to describe the typology of a broad array of symptoms that were attributed to hepatitis C virus (HCV) infection. Phase 1 used qualitative methods to identify symptoms. In Phase 2, 188 treatment-naïve people living with HCV participated in a quantitative survey. The most prevalent symptom was physical tiredness (86%) followed by irritability (75%), depression (70%), mental tiredness (70%), and abdominal pain (68%). Temporal clustering of symptoms was reported in 62% of participants. Principal components analysis identified four symptom clusters: neuropsychiatric (mental tiredness, poor concentration, forgetfulness, depression, irritability, physical tiredness, and sleep problems); gastrointestinal (day sweats, nausea, food intolerance, night sweats, abdominal pain, poor appetite, and diarrhea); algesic (joint pain, muscle pain, and general body pain); and dysesthetic (noise sensitivity, light sensitivity, skin problems, and headaches). These data demonstrate that symptoms are prevalent in treatment-naïve people with HCV and support the hypothesis that symptom clustering occurs.