Health-related quality of life in systemic lupus erythematosus: a longitudinal study on the impact of problematic support and self-efficacy.

OBJECTIVES: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease which can affect any organ in the body, reducing patients' health-related quality of life (HR-QOL). Psychosocial research on SLE is quite recent and is mostly based on qualitative and cross-sectional evidence. Some studies suggest that a protective role is played by perceived self-efficacy in the management of the disease, while a detrimental role is played by problematic social interactions. METHODS: In a longitudinal study, we tested the independent contribution of self-efficacy and problematic social support, in predicting patients' HR-QOL after 11 months. An online questionnaire was completed by 162 participants with SLE, the second questionnaire after 11 months. RESULTS: Controlling for corticosteroids and hydroxychloroquine use, self-efficacy in the management of the disease at Time 1 showed a significant and positive effect on HR-QOL at Time 2, while problematic social support (denying/uninformed) showed a negative effect. CONCLUSIONS: HR-QOL of SLE patients is influenced by self-efficacy in the management of the disease and problematic support. Specific attention should be paid to the quality of patients' social relationships and their perceived efficacy in the management of the disease in focused interventions as in daily clinical practice.

Sport activity and health-related quality of life after kidney transplantation.

OBJECTIVE: Considering the importance of sport activity for enhancing quality of life, the aim of this study was to investigate the effects of regular sport activity on quality of life of kidney transplant recipients. METHODS: Health-related quality of life (HRQoL) was assessed with the use of the SF-36 questionnaire on a group of 118 active kidney transplant patients (AKTPs) practicing different sports at low to moderate intensity (5±4 h/wk). Scores were compared with those of 79 sedentary kidney transplant patients (SKTPs) and with 120 active healthy control subjects (AHCs). RESULTS: AKTPs reported higher scores than SKTPs in the SF-36 scales of Physical Functioning (P<.05), Role Limitations due to Physical Problems (P<.05), General Health (P<.01), Vitality (P<.05), Social Functioning (P<.05), Role Limitations due to Emotional Problems (P<.05), and Mental Health (P<.01). AKTPs obtained higher scores than AHCs on the Mental Health (P<.01) and Social Functioning scales (P<.01) and similar scores (P>.05) on all the other scales. The effect of quantity of sport activity was significant on the General Health (P<.01; η2=0.05), and Role Physical scales (P=.04; η2=0.03), with higher sport activity associated with higher HRQoL. The effect of sex was significant for Bodily Pain (P=.05; η2=0.02), Vitality (P=.08; η2=0.06), Social Functioning (P=.08; η2=0.05), and Mental Health (P=.05; η2=0.02), with male participants scoring higher than female participants. CONCLUSIONS: This study indicates that regular sport activity significantly improves different dimensions of HRQoL among kidney transplant recipients. The benefits of sport activity go beyond its impact on physical health to involve psychologic and social components of quality of life. Spontaneous and low to moderate sport activity may play an important role after kidney transplantation that has been largely underestimated in the literature.

Social support and health in patients with systemic lupus erythematosus: a literature review.

In the last decades, with the improvement of life expectancies for systemic lupus erythematosus (SLE) patients, the relationship between social support and health in this population has received a considerable amount of attention in behavioural medicine and health psychology. This paper is the first to review research studies which specifically investigated perceived social support in relation to SLE patients' health outcomes (quality of life, disease activity and damage). Starting with a descriptive approach to social support perceived by patients with SLE, the research evidence on the impact of social support on health is presented. These studies demonstrate that the consideration of social support is critical in predicting disease activity, damage and quality of life (both physical and psychological components) although the precise ways in which social support contributes to health are not yet completely understood. Discussing the results, the authors offer some suggestions which could guide further research in this field. Finally, clinical and non-clinical implications of the findings are discussed.

Surviving a serious traffic accident: adaptation processes and quality of life.

Research on the consequences of motor vehicle accidents centres mainly on the assessment and treatment of post-traumatic psychological-behavioural reactions of the people involved. Few studies have explored the experience of surviving a serious accident and its impact on different dimensions of individuals' lives. This qualitative study aims at investigating adaptation strategies and quality of life of 20 severely injured accident survivors who spent several months in an intensive care unit of a hospital, and who still suffer permanent injuries of varying extent. Participants completed individual in-depth interviews which were subsequently analysed according to the grounded theory method. The findings indicate that the adaptation process follows a sequence of temporal phases ('past-present', 'present', 'future' and 'being'), characterized by different emotional and behavioural reactions, perceived needs, and by the adoption of specific coping strategies. The duration of the adaptation process is influenced by the severity of the injury suffered, participants' age at the time of the trauma, the occurrence of coma and the availability of social support in participants' life environment.

Who has the final say? Decisions on adolescent behaviour within the family

The transition to adolescence involves significant changes for the family. To date, research on these changes and how they occur has been restricted by lack of suitable measures. An instrument-the Perspectives on Adolescent Decision-Making Questionnaire-was designed for such research. It examines 21 issues which can lead to conflict. The instrument was completed by 500 Italian adolescents aged 13 and 15. Sensitivity to age and sex differences was examined, and perceptions of personal choice, parental feelings, conflict and normal patterns for adolescents were analysed. The instrument offers promising possibilities for more effective study of parent/offspring relationships during the adolescent period.