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1.
Front Public Health ; 9: 600330, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33748057

RESUMEN

Background: There is a global disaster since WHO declared Covid-19 as a pandemic. With the increase in cases & mortality rate, various health issues viz., stress, mental disorders and altered health-related quality of life have been noted as a result of pandemic and lockdowns. This study aimed to assess the association of COVID-19 pandemic stress with health-related quality of life in the Kingdom of Saudi Arabia. Methodology: It was a cross-sectional analytical study. Subjects included 878 citizens and residents of Saudi Arabia aged 18 years and above. Convenience, non-probability sampling technique was used. A web-based, self-administered, electronic questionnaire in Arabic language having three sections; Sociodemographic & clinical profile, Standard PSS-10, and Standard SF-12 was used as the study tool and distributed through various social media means. The study period was of 2 months. Data were analyzed using SPS version 25. Descriptive statistics, Pearson's correlation coefficient, independent sample t-test and the one-way analysis of variance (ANOVA) were employed for suitable statistical analysis. Results: Almost two-thirds of the subjects were between the age of 18 to < 40 and majority (74.1%) being females. Majority (83.0%) reported as having no chronic diseases, and 69.5% had no contact history with COVID-19 cases. The mean of MCS & PCS was (32.34 ± 25.30) & (41.65 ± 11.82), respectively. Majority (67.6%) had a moderate level of COVID-19 stress. A significant negative relationship between total stress scores and HRQOL domains was observed. Conclusion: Majority subjects had a moderate level of stress related to COVID-19 lockdown. Stress during COVID-19 has a significant negative association with both physical and mental HRQOL in which MCS was significantly lower than PCS. It is recommended to evaluate the effectiveness of stress management program and follow a holistic approach.


Asunto(s)
Estado de Salud , Calidad de Vida/psicología , Cuarentena/psicología , Estrés Psicológico/psicología , Adulto , Estudios Transversales , Femenino , Humanos , Internet , Masculino , Persona de Mediana Edad , Arabia Saudita , Autoinforme , Medios de Comunicación Sociales , Encuestas y Cuestionarios
2.
Medicine (Baltimore) ; 100(10): e25089, 2021 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-33725900

RESUMEN

ABSTRACT: To investigate the health-related quality of life (HRQoL) and related factors, the symptoms of posttraumatic stress disorder (PTSD) among earthquake survivors in minority area 2 years after Jiuzhaigou earthquake.Two years after the Jiuzhaigou earthquake, a cross-sectional survey was conducted by a multi-stage sampling approach. HRQoL was measured by the short form 12 (SF-12), PTSD was measured by the PTSD Check List-Civilian Version (PCL-C), and social support was measured by the Multidimensional Scale of Perceived Social Support. Descriptive statistics, t-tests, ANOVA and multiple linear regression analysis were used for data analysis.Of the 561 participants, the mean scores on the physical component summary (PCS) and mental component summary (MCS) were 46.36 ±â€Š12.79 and 55.03 ±â€Š8.73, and 5.73% reported the symptoms of PTSD. Lower PCS and MCS after an earthquake were associated with elderly age, physical illness, and low level of social support (P < .05). Meanwhile, PTSD was significantly associated with MCS.These findings showed that physical disease and psychological symptoms can adversely affect the HRQoL of survivors. Moreover, providing higher social support to survivors should be considered as a way to improve the HRQoL outcomes of survivors.


Asunto(s)
Terremotos , Calidad de Vida/psicología , Trastornos por Estrés Postraumático/epidemiología , Sobrevivientes/psicología , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , China/epidemiología , Estudios Transversales , Femenino , Estado de Salud , Humanos , Entrevistas como Asunto , Masculino , Salud Mental , Persona de Mediana Edad , Factores de Riesgo , Factores Sexuales , Apoyo Social , Factores Socioeconómicos , Adulto Joven
3.
Soc Sci Med ; 274: 113748, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33648821

RESUMEN

Understanding the health-related quality of life (HrQoL) of hospitalized COVID-19 survivors is an emerging global challenge arising from the current pandemic. A qualitative study of the experiences of sixteen hospitalized COVID-19 survivors from Nanning City, China, was conducted using semi-structured telephone interviews in May 2020. These first-hand accounts were critically and empirically analysed to identify emerging health and social issues, and provide potential solutions to improve survivors' quality of life. This in-depth, qualitative study of HrQoL for hospitalized COVID-19 survivors provides the first empirical evidence and conceptual framework with eight dimensions (physical symptoms, anxiety, trauma, economic loss, place-based identity, self-stigma, health self-interventions, and changing lifestyle) for understanding the physiological, psychological, socio-economic and health behavioral aspects of their daily lives. We argue that local and global governments should provide integrated healthcare, social and digital infrastructure to support this vulnerable group. More comparative and multi-disciplinary studies in this area are needed to generate academic standards of assessing health-related quality of life and produce good practice guidelines for promoting urban resilience in response to public health disasters.


Asunto(s)
/terapia , Calidad de Vida/psicología , Sobrevivientes/psicología , Adaptación Psicológica , China , Humanos , Entrevistas como Asunto , Investigación Cualitativa
4.
Occup Ther Int ; 2021: 6675680, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33727902

RESUMEN

Objective: Instrumental activities of daily livings are important for independent living and active participation in the community. The present study is aimed at determining factors predicting instrumental activities of daily living performance in patients with stroke. Methods: In this cross-sectional study, a convenient sample of 90 patients with stroke entered from five occupational therapy centers, which were selected based on the cluster randomization method. Lawton IADL scale, Barthel Index, Trail Making Test (A and B), Digit span subtest of Wechsler memory scale, Motorcity index, and Beck Depression Inventory-II were used to investigate the study's aim. Statistical analyses were performed using independent sample t-test, one-way ANOVA, Pearson correlation, and multiple linear regression analysis. Results: Age (r = -0.384, p < 0.001), memory (r = 0.565, p < 0.001), basic activities of daily living (r = 0.818, p < 0.001), depression (r = -0.758, p < 0.001), Trial Making Test (B-A) (r = -0.614, p < 0.001), and motoricity index (r = 0.670, p < 0.001) were significantly associated with instrumental activities of daily living performance. Conclusions: Basic activities of daily living were the strongest predictor of IADL's performance. Age, TMT (B-A), and depression were orderly the next strongest predictors. Stroke patients with more dependency in basic activities of daily living, older age, cognitive impairment, and depression are more opted to be dependent in instrumental activities of daily living and as a result, less participation in home and community affairs.


Asunto(s)
Actividades Cotidianas , Disfunción Cognitiva/complicaciones , Función Ejecutiva/fisiología , Calidad de Vida/psicología , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular/psicología , Anciano , Anciano de 80 o más Años , Estudios Transversales , Depresión/epidemiología , Evaluación de la Discapacidad , Femenino , Humanos , Vida Independiente , Masculino , Persona de Mediana Edad , Terapia Ocupacional , Accidente Cerebrovascular/complicaciones
5.
Front Public Health ; 9: 630620, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33692982

RESUMEN

The outbreak of coronavirus disease-2019 (COVID-19) ineluctably caused social distancing and unemployment, which may bring additional health risks for patients with cancer. To investigate the association of the pandemic-related impacts with the health-related quality of life (HRQoL) among patients with melanoma during the COVID-19 pandemic, we conducted a cross-sectional study among Chinese patients with melanoma. A self-administered online questionnaire was distributed to melanoma patients through social media. Demographic and clinical data, and pandemic-related impacts (unemployment and income loss) were collected. HRQoL was determined by the Functional Assessment of Cancer Therapy-General (FACT-G) and its disease-specific module (the melanoma subscale, MS). A total of 135 patients with melanoma completed the study. The mean age of the patients was 55.8 ± 14.2 years, 48.1% (65/135) were male, and 17.04% (34/135) were unemployed since the epidemic. Unemployment of the patients and their family members and income loss were significantly associated with a lower FACT-G score, while the MS score was associated with the unemployment of the patients' family members. Our findings suggested that unemployment is associated with impaired HRQoL in melanoma patients during the COVID-19 epidemic.


Asunto(s)
Grupo de Ascendencia Continental Asiática/psicología , /psicología , Melanoma/economía , Melanoma/psicología , Calidad de Vida/psicología , Desempleo/psicología , Adulto , Anciano , Grupo de Ascendencia Continental Asiática/estadística & datos numéricos , China/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Melanoma/epidemiología , Persona de Mediana Edad , Pandemias , Encuestas y Cuestionarios , Desempleo/estadística & datos numéricos
7.
Bone Joint J ; 103-B(4): 672-680, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33752468

RESUMEN

AIMS: The aim of this study was to assess the quality of life of patients on the waiting list for a total hip (THA) or knee arthroplasty (KA) during the COVID-19 pandemic. Secondary aims were to assess whether length of time on the waiting list influenced quality of life and rate of deferral of surgery. METHODS: During the study period (August and September 2020) 843 patients (THA n = 394, KA n = 449) from ten centres in the UK reported their EuroQol five dimension (EQ-5D) scores and completed a waiting list questionnaire (2020 group). Patient demographic details, procedure, and date when listed were recorded. Patients scoring less than zero for their EQ-5D score were defined to be in a health state "worse than death" (WTD). Data from a retrospective cohort (January 2014 to September 2017) were used as the control group. RESULTS: The 2020 group had a significantly worse EQ-5D score compared to the control group for both THA (p < 0.001) and KA (p < 0.001). Over one-third (35.0%, n = 138/394) of patients waiting for a THA and nearly a quarter (22.3%, n = 100/449) for KA were in a health state WTD, which was significantly greater than the control group (odds ratio 2.30 (95% confidence interval (CI) 1.83 to 2.93) and 2.08 (95% CI 1.61 to 2.70), respectively; p < 0.001). Over 80% (n = 680/843) of the 2020 group felt that their quality of life had deteriorated while waiting. Each additional month spent on the waiting list was independently associated with a decrease in quality of life (EQ-5D: -0.0135, p = 0.004). There were 117 (13.9%) patients who wished to defer their surgery and the main reason for this was health concerns for themselves and or their family (99.1%, n = 116/117). CONCLUSION: Over one-third of patients waiting for THA and nearly one-quarter waiting for a KA were in a state WTD, which was approaching double that observed prior to the pandemic. Increasing length of time on the waiting list was associated with decreasing quality of life. Level of evidence: Level III retrospective case control study Cite this article: Bone Joint J 2021;103-B(4):672-680.


Asunto(s)
Artroplastia de Reemplazo de Cadera , Artroplastia de Reemplazo de Rodilla , Accesibilidad a los Servicios de Salud , Indicadores de Salud , Calidad de Vida/psicología , Listas de Espera , Adulto , Anciano , Anciano de 80 o más Años , /prevención & control , Estudios Transversales , Femenino , Humanos , Modelos Lineales , Masculino , Auditoría Médica , Persona de Mediana Edad , Análisis Multivariante , Pandemias , Aceptación de la Atención de Salud , Mejoramiento de la Calidad , Factores de Tiempo , Reino Unido/epidemiología
8.
J Rehabil Med ; 53(3): jrm00163, 2021 Mar 17.
Artículo en Inglés | MEDLINE | ID: mdl-33710351

RESUMEN

OBJECTIVE: To evaluate existing evidence from published systematic reviews for the effectiveness of rehabilitation interventions in patients with lymphoma. DATA SOURCES: A comprehensive literature search was conducted using medical/health science databases up to 1 October 2020. Bibliographies of pertinent articles, journals and grey literature were searched. DATA EXTRACTION AND SYNTHESIS: Two reviewers independently selected and reviewed potential reviews for methodological quality and graded the quality of evidence for outcomes using validated tools. Any discrepancies were resolved by final group consensus. RESULTS: Twelve systematic reviews (n = 101 studies, 87,132 patients with lymphoma) evaluated 3 broad categories of rehabilitation interventions (physical modalities, nutrition and complementary medicine). Most reviews were of moderate-to-low methodological quality. The findings suggest: moderate-quality evidence for exercise programmes for improved fatigue and sleep disturbance; low-quality evidence for exercise therapy alone and qigong/tai chi for improved symptoms and overall quality of life, and an inverse association between sunlight/ultraviolet radiation exposure and incidence of non-Hodgkin's lymphoma; and very low-quality evidence for beneficial effects of yoga for sleep disturbances. Association between physical activity and lymphoma risk is indistinct. CONCLUSION: Despite a range of rehabilitation modalities used for patients with lymphoma, high-quality evidence for many is sparse. Beneficial effects of exercise programmes were noted for fatigue, psychological symptoms and quality of life. More research with robust study design is required to determine the effective rehabilitation approaches.


Asunto(s)
Linfoma/rehabilitación , Calidad de Vida/psicología , Humanos
9.
Psicothema (Oviedo) ; 33(1): 28-35, feb. 2021.
Artículo en Inglés | IBECS | ID: ibc-ET5-2639

RESUMEN

BACKGROUND: A new paradigm, which we refer to as The Quality of Life Supports Paradigm, is emerging internationally in the field of intellectual and developmental disabilities. The new paradigm integrates the key concepts of 'quality of life' and 'supports'. This article addresses the question of how one evaluates a new paradigm. METHOD: This is a conceptual work that describes five characteristics of a paradigm. The characteristics are based on the groundbreaking work of relevant authors in the field of intellectual and developmental disabilities, quality of life, supports, and evaluation. RESULTS: The five characteristics are that a paradigm is theory driven, ethical, flexible, adaptable, and measurable. The article especially delves into the fifth characteristic and provides specific examples of how to evaluate the new paradigm. CONCLUSIONS: The new paradigm encompasses core values, accommodates contextual factors, and can be used for multiple purposes to positively impact the development and implementation of value-based policies and practices that enhance the quality of life and personal well-being of people with intellectual and developmental disabilities


ANTECEDENTES: en el ámbito internacional de las discapacidades intelectuales y del desarrollo está surgiendo un nuevo paradigma, el Paradigma de Calidad de Vida-Apoyos, que integra los conceptos clave "calidad de vida" y "apoyos". Este artículo aborda la cuestión de cómo se evalúa un nuevo paradigma como este. MÉTODO: este es un trabajo conceptual que describe cinco características de un paradigma. Estas características están basadas en el trabajo innovador de autores relevante en el ámbito de las discapacidades intelectuales y del desarrollo, la calidad de vida, los apoyos y la evaluación. RESULTADOS: las cinco características de un paradigma son que este es impulsado por la teoría, ético, flexible, adaptable y medible. En el artículo se profundiza especialmente en la quinta característica y se proporcionan ejemplos específicos sobre cómo evaluar el nuevo paradigma. CONCLUSIONES: el nuevo paradigma abarca valores fundamentales, incorpora factores contextuales y se puede utilizar para múltiples propósitos para favorecer el desarrollo y la implementación de políticas y prácticas basadas en valores que mejoran la calidad de vida y el bienestar personal de las personas con discapacidades intelectuales y del desarrollo


Asunto(s)
Humanos , Discapacidad Intelectual , Discapacidades del Desarrollo , Autonomía Personal , Calidad de Vida/psicología , Teoría Psicológica , Calidad de Vida , Personas con Discapacidad Mental/psicología , Adaptación Psicológica , Apoyo Social
10.
Public Health ; 191: 68-77, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33540186

RESUMEN

OBJECTIVES: The goal of care at the end-of-life has changed in recent years to encompass not only the relief of suffering but also improve the quality of death. Palliative care offers a coordinated and multidisciplinary approach to improving the quality of life and quality of care of individuals and their families facing illness at the end-of-life. This manuscript examines the end-of-life of older adults in Mexico and the factors associated with pain in this period of their life. STUDY DESIGN: We used data from the Mexican Health and Aging Study (MHAS), a longitudinal panel study of adults 50 years and older in Mexico that is nationally representative of urban and rural areas and includes a next-of-kin questionnaire that captures the conditions during the last year of life of those who died. We used all four waves of data to construct a group of deceased individuals between 2001 and 2015, including information in the wave immediately before death and a complete next-of-kin questionnaire. We studied factors associated with pain at the end-of-life in this group. METHODS: The dependent variable was pain reported over time among deceased individuals. We constructed pain categories based on whether the pain was reported in one or two waves (occasional and persistent), and the pain intensity reported (mild, moderate, or severe). We included independent variables previously reported to be related to pain, including sociodemographic, functional, and health characteristics. We used descriptive statistics and a multinomial regression model to examine the factors associated with pain in this group. RESULTS: Pain was reported by 71.5% of older adults who died between 2001 and 2015. The prevalence of pain differed significantly by sociodemographic characteristics. Women had 1.69 higher odds of reporting severe pain than men. Compared to those with zero years of education, the odds of reporting severe pain were 0.72 for those with 1-6 years of education (P < 0.05) and 0.55 for those with more than 7 years (P < 0.001). Poor self-reported health, arthritis, taking more medications, depression, and functional limitations in the wave prior to death were associated with higher odds of persistent pain at the end-of-life (P < 0.05). Conversely, older age, more years of education, and diabetes were associated with lower odds of persistent pain (P < 0.001). CONCLUSIONS: The prevalence of pain among older Mexican adults is high at the end-of-life. Sociodemographic factors, some chronic diseases, number of medications, psychosocial factors, and functional status impact the odds of reporting pain in this group at the end-of-life. Providing education to families on psychosocial interventions to improve the quality of care at the end-of-life is a pressing need in Mexico. These findings provide information to help policymakers and healthcare providers in Mexico improve the quality of care at the end-of-life.


Asunto(s)
Envejecimiento , Muerte , Dolor/epidemiología , Calidad de Vida/psicología , Anciano , Enfermedad Crónica , Femenino , Humanos , Estudios Longitudinales , Masculino , México/epidemiología , Persona de Mediana Edad , Dolor/psicología , Prevalencia , Autoinforme
11.
J Laryngol Otol ; 135(2): 130-133, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33531092

RESUMEN

OBJECTIVE: The audiological benefits of a bone conducting hearing implant are well documented; however, there is a paucity of literature comparing pre- and post-operative quality of life benefits. This study assessed the quality of life status before and after the device is implanted. METHODS: A prospective study was conducted of all adult bone conducting hearing implants inserted in a teaching hospital between 2012 and 2017. All patients completed the Glasgow Health Status Inventory, a validated quality of life questionnaire, before and three to six months after implantation. RESULTS: Sixty-two patients received a unilateral bone conducting hearing implant. All scores except the social score improved post-operatively. The paired t-test showed that the differences in the means for the Glasgow Health Status Inventory total, general and physical scores were statistically significant at the 5 per cent level (p < 0.0001). CONCLUSION: This study, one of the few to assess quality of life pre- and post-implantation, showed a vast improvement in patients' perceived quality of life from the pre- to the post-operative phase.


Asunto(s)
Conducción Ósea/fisiología , Implantación Coclear/psicología , Pérdida Auditiva/cirugía , Prótesis e Implantes/efectos adversos , Calidad de Vida/psicología , Adulto , Anciano , Anciano de 80 o más Años , Implantación Coclear/métodos , Femenino , Audífonos/efectos adversos , Audífonos/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Percepción/fisiología , Periodo Posoperatorio , Periodo Preoperatorio , Estudios Prospectivos , Encuestas y Cuestionarios
12.
J Med Internet Res ; 23(2): e21615, 2021 02 17.
Artículo en Inglés | MEDLINE | ID: mdl-33595448

RESUMEN

BACKGROUND: The COVID-19 pandemic has shined a harsh light on a critical deficiency in our health care system: our inability to access important information about patients' values, goals, and preferences in the electronic health record (EHR). At Memorial Sloan Kettering Cancer Center (MSK), we have integrated and systematized health-related values discussions led by oncology nurses for newly diagnosed cancer patients as part of routine comprehensive cancer care. Such conversations include not only the patient's wishes for care at the end of life but also more holistic personal values, including sources of strength, concerns, hopes, and their definition of an acceptable quality of life. In addition, health care providers use a structured template to document their discussions of patient goals of care. OBJECTIVE: To provide ready access to key information about the patient as a person with individual values, goals, and preferences, we undertook the creation of the Patient Values Tab in our center's EHR to display this information in a single, central location. Here, we describe the interprofessional, interdisciplinary, iterative process and user-centered design methodology that we applied to build this novel functionality as well as our initial implementation experience and plans for evaluation. METHODS: We first convened a working group of experts from multiple departments, including medical oncology, health informatics, information systems, nursing informatics, nursing education, and supportive care, and a user experience designer. We conducted in-depth, semistructured, audiorecorded interviews of over 100 key stakeholders. The working group sought consensus on the tab's main content, homing in on high-priority areas identified by the stakeholders. The core content was mapped to various EHR data sources. We established a set of high-level design principles to guide our process. Our user experience designer then created wireframes of the tab design. The designer conducted usability testing with physicians, nurses, and other health professionals. Data validation testing was conducted. RESULTS: We have already deployed the Patient Values Tab to a pilot sample of users in the MSK Gastrointestinal Medical Oncology Service, including physicians, advanced practice providers, nurses, and administrative staff. We have early evidence of the positive impact of this EHR innovation. Audit logs show increasing use. Many of the initial user comments have been enthusiastically positive, while others have provided constructive suggestions for additional tab refinements with respect to format and content. CONCLUSIONS: It is our challenge and obligation to enrich the EHR with information about the patient as a person. Realization of this capability is a pressing public health need requiring the collaboration of technological experts with a broad range of clinical leaders, users, patients, and families to achieve solutions that are both principled and practical. Our new Patient Values Tab represents a step forward in this important direction.


Asunto(s)
/diagnóstico , Registros Electrónicos de Salud/organización & administración , Informática Médica/métodos , Cuidados Paliativos/métodos , Calidad de Vida/psicología , Humanos
13.
Span J Psychol ; 24: e8, 2021 Feb 08.
Artículo en Inglés | MEDLINE | ID: mdl-33551011

RESUMEN

In the midst of the COVID-19 epidemic, Spain was one of the countries with the highest number of infections and a high mortality rate. The threat of the virus and consequences of the pandemic have a discernible impact on the mental health of citizens. This study aims to (a) evaluate the levels of anxiety, depression and well-being in a large Spanish sample during the confinement, (b) identify potential predictor variables associated to experiencing both clinical levels of distress and well-being in a sample of 2,122 Spanish people. By using descriptive analyses and logistic regression results revealed high rates of depression, anxiety and well-being. Specifically, our findings revealed that high levels of anxiety about COVID-19, increased substance use and loneliness as the strongest predictors of distress, while gross annual incomes and loneliness were strongest predictors of well-being. Finding of the present study provide a better insight about psychological adjustment to a pandemic and allows us to identify which population groups are at risk of experiencing higher levels of distress and which factors contribute to greater well-being, which could help in the treatments and prevention in similar stressful and traumatic situations.


Asunto(s)
Adaptación Psicológica , Trastornos de Ansiedad/psicología , Trastorno Depresivo/psicología , Salud Mental , Distrés Psicológico , Trastornos Relacionados con Sustancias/psicología , Adolescente , Adulto , Anciano , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/epidemiología , Estudios Transversales , Trastorno Depresivo/diagnóstico , Trastorno Depresivo/epidemiología , Femenino , Encuestas Epidemiológicas , Humanos , Renta , Internet , Soledad/psicología , Masculino , Persona de Mediana Edad , Embarazo , Calidad de Vida/psicología , Factores de Riesgo , España/epidemiología , Trastornos Relacionados con Sustancias/diagnóstico , Trastornos Relacionados con Sustancias/epidemiología , Adulto Joven
14.
Epidemiol Psychiatr Sci ; 30: e10, 2021 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-33526166

RESUMEN

AIMS: Late-life depression has substantial impacts on individuals, families and society. Knowledge gaps remain in estimating the economic impacts associated with late-life depression by symptom severity, which has implications for resource prioritisation and research design (such as in modelling). This study examined the incremental health and social care expenditure of depressive symptoms by severity. METHODS: We analysed data collected from 2707 older adults aged 60 years and over in Hong Kong. The Patient Health Questionnaire-9 (PHQ-9) and the Client Service Receipt Inventory were used, respectively, to measure depressive symptoms and service utilisation as a basis for calculating care expenditure. Two-part models were used to estimate the incremental expenditure associated with symptom severity over 1 year. RESULTS: The average PHQ-9 score was 6.3 (standard deviation, s.d. = 4.0). The percentages of respondents with mild, moderate and moderately severe symptoms and non-depressed were 51.8%, 13.5%, 3.7% and 31.0%, respectively. Overall, the moderately severe group generated the largest average incremental expenditure (US$5886; 95% CI 1126-10 647 or a 272% increase), followed by the mild group (US$3849; 95% CI 2520-5177 or a 176% increase) and the moderate group (US$1843; 95% CI 854-2831, or 85% increase). Non-psychiatric healthcare was the main cost component in a mild symptom group, after controlling for other chronic conditions and covariates. The average incremental association between PHQ-9 score and overall care expenditure peaked at PHQ-9 score of 4 (US$691; 95% CI 444-939), then gradually fell to negative between scores of 12 (US$ - 35; 95% CI - 530 to 460) and 19 (US$ -171; 95% CI - 417 to 76) and soared to positive and rebounded at the score of 23 (US$601; 95% CI -1652 to 2854). CONCLUSIONS: The association between depressive symptoms and care expenditure is stronger among older adults with mild and moderately severe symptoms. Older adults with the same symptom severity have different care utilisation and expenditure patterns. Non-psychiatric healthcare is the major cost element. These findings inform ways to optimise policy efforts to improve the financial sustainability of health and long-term care systems, including the involvement of primary care physicians and other geriatric healthcare providers in preventing and treating depression among older adults and related budgeting and accounting issues across services.


Asunto(s)
Servicios de Salud Comunitaria/estadística & datos numéricos , Depresión/terapia , Gastos en Salud/estadística & datos numéricos , Calidad de Vida/psicología , Anciano , Anciano de 80 o más Años , Servicios de Salud Comunitaria/economía , Análisis Costo-Beneficio , Estudios Transversales , Trastorno Depresivo Mayor/terapia , Femenino , Geriatría , Investigación sobre Servicios de Salud , Hong Kong , Humanos , Vida Independiente , Masculino , Persona de Mediana Edad , Cuestionario de Salud del Paciente , Apoyo Social
15.
BMC Psychol ; 9(1): 26, 2021 Feb 08.
Artículo en Inglés | MEDLINE | ID: mdl-33557956

RESUMEN

BACKGROUND: Breast cancer is a common tumor in China and has become a public health problem in modern society. Stress plays an important role in the occurrence and progression of cancer. At present, the current situation of stress on breast cancer survivors (BCSs) in China has not been fully understood. This study aims to explore the stress and coping strategies of Chinese BCSs, which provide suggestions to help BCSs reduce stress. METHODS: Sixty-three BCSs from the Shanghai Cancer Rehabilitation Club in China were included in this study and were divided into eight focus groups. These were transcribed verbatim, coded using thematic analysis and analyzed using NVivo 11. RESULTS: Three themes were extracted from the data to address our research objectives: stress, coping strategies and expectations. The stress of BCSs included psychological stress, stress caused by physical pain, economic stress, stress caused by the change of life status, and stress caused by information overload; the coping strategies included self-strategies and help from others; from the perspective of the survivors, they put forward their expectations for both the society and themselves. CONCLUSIONS: This study shows that BCSs face a variety of stress. In the face of stress, BCSs need comprehensive support, including social and family support to cope with stressors. The findings from this study provide evidence for improving the quality of life among BCSs.


Asunto(s)
Adaptación Psicológica , Neoplasias de la Mama/psicología , Supervivientes de Cáncer/psicología , Calidad de Vida/psicología , Estrés Psicológico/psicología , Adulto , Anciano , Neoplasias de la Mama/etnología , China/epidemiología , Femenino , Grupos Focales , Humanos , Entrevistas como Asunto , Persona de Mediana Edad , Motivación , Investigación Cualitativa
16.
Orv Hetil ; 162(7): 269-279, 2021 02 14.
Artículo en Húngaro | MEDLINE | ID: mdl-33582650

RESUMEN

Összefoglaló. Bevezetés: A kutatócsoport 99 fo, cerebralis paresisben (CP) szenvedo gyermek (8-18 éves) önállóan közölt életminoségét értékelte, és az eredményeket összehasonlította egy 237 fos kontrollcsoport adataival, amelyek hasonló életkorú, egészséges általános populációhoz tartozó gyermekektol származtak. Célkituzés: A kutatás célja annak megismerése volt, hogy a CP-ben szenvedo gyermekek hogyan vélekednek egészségi állapotukról és társadalmi helyzetükrol. Módszer: Életminoség-kérdoív alkalmazása. Betegségspecifikus és társadalmi-demográfiai mutatók mérése, kiértékelése. Eredmények: Az CP-ben szenvedo gyermekek és szüleik az egészséggel kapcsolatos életminoséget rosszabbnak ítélték meg, mint társaik. Eredményeink azt mutatják, hogy a noi nem, a rosszabb motoros funkció és a komorbiditások (epilepszia, incontinentia és intellektuális károsodás) negatív hatású. A szüloi vélemény alkalmas volt proxyjelentésként a korreláció mért erossége miatt. Figyelemre méltó, hogy az agyi bénulás típusai közül az egyoldali spasticus CP-ben szenvedo gyermekek életminoség-értéke a legalacsonyabb. A válaszadók valószínuleg a test két oldala között lévo funkcionális különbséget érezték. A szellemi fogyatékosság a betegpopuláció több mint felénél fordult elo. Testvéreik között a mentális betegség 5,7-szer gyakoribb. A CP-s gyerekek családi környezete sokkal hátrányosabb volt, mint az egészséges gyermekeké. A kutatás eredményei alapján megállapítható, hogy a szülo alacsonyabb iskolai végzettsége és munkaeropiaci inaktivitása, valamint az egyszülos család a CP-s gyerekeknél szignifikánsan magasabb arányban fordult elo, és ezek a tényezok negatív hatást gyakoroltak az életminoségre. Következtetés: A fogyatékkal élo gyermekek életminoségét a betegség és a szociodemográfiai környezet egyaránt befolyásolja. Orv Hetil. 2021; 162(7): 269-279. INTRODUCTION: Self-reported health-related quality of life (HRQoL) of 99 children (8-18 years) with cerebral palsy (CP) was assessed and compared with 237, age-matched healthy control children from the general population. OBJECTIVE: The aim was to find out the opinions of children with CP about their health status and social condition. METHOD: Assessment of quality of life questionnaire was carried out. Measurements of disease-specific and sociodemographic variables were done. RESULTS: Children with CP and their parents rated HRQoL poorer than their counterparts. Our results show that female sex, worse gross motor function and comorbidities (epilepsy, incontinence and intellectual impairment) had negative impact. The parental opinion was suitable as proxy report because of the measured strength of the correlation. Among the types of CP, interestingly, children with unilateral spastic CP had the poorest HRQoL. They were likely to feel a functional difference between the two sides of the body. Intellectual disability occurred in more than half of our patient population. Among their siblings, mental illness is 5.7 times more common. The family environment was much more disadvantageous than in the case of healthy children. As our study shows, lower education, inactive status in the labour market and single-parent family occurred at a much higher rate and worsened the quality of life. CONCLUSION: Quality of life of children with disability was influenced by both the sociodemographic background and the disease. Orv Hetil. 2021; 162(7): 269-279.


Asunto(s)
Parálisis Cerebral/psicología , Costo de Enfermedad , Calidad de Vida/psicología , Factores Socioeconómicos , Niño , Femenino , Humanos , Masculino , Perfil de Impacto de Enfermedad , Encuestas y Cuestionarios
17.
BMC Infect Dis ; 21(1): 203, 2021 Feb 23.
Artículo en Inglés | MEDLINE | ID: mdl-33622262

RESUMEN

BACKGROUND: Quality of life (QOL) is one of the major factors to assessing the health and wellbeing of People living with HIV (PLWH). Likewise, improved QOL is among the prominent goals of patient treatment. This study was conducted to investigate the QOL of PLWH in Kermanshah, Iran. METHODS: This cross-sectional study was conducted on 364 PLWH of Kermanshah between 2016 and 2017. Outpatients were selected as the sample through the convenience sampling method from HIV Positive Clients of Kermanshah Behavioral Diseases Counseling Center. The reasons for the selection of outpatients include: (a) some patients were substance users, homeless or did not have a fixed address to follow-up; (b) addresses and personal details that were registered on the first admission were incorrect or incomplete; (c) due to financial issues, some were forced to relocate frequently and were difficult to track; (d) some patients were convicts or prisoners, making it hard to find them after their release; (e) some of them were from other provinces, where managing access was not easy/possible. Data was collected using WHOQOL-HIV BREF questionnaire (Persian Version). Data also analyzed with STATA 14, and SPSS 23 using T-test and multiple regression. RESULTS: This study showed that mean (SD) age of PLWH was 40.21 (10.45) years. Females had better QOL than males except for spirituality, religion and personal beliefs. The gender differences disappeared in multivariate results. A significant association was observed between education and the independence, environment, and spirituality domains of QOL. In addition, being married was correlated with overall QOL, psychological and social relationships domains of QOL of PLWH. Drug use was a behavioral factor with negative influence on the QOL. CONCLUSION: This study found that marital status and drug use were the main predictors of various domains of QOL. Drug use was a behavioral factor with a negative influence on the QOL. Hence, it is recommended that health professionals, planners, and policymakers take effective measures to improve the status quo.


Asunto(s)
Infecciones por VIH/psicología , Calidad de Vida/psicología , Adulto , Instituciones de Atención Ambulatoria/estadística & datos numéricos , Estudios Transversales , Femenino , Infecciones por VIH/epidemiología , Humanos , Irán/epidemiología , Masculino , Persona de Mediana Edad , Psicometría
18.
AIDS Patient Care STDS ; 35(2): 47-55, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33571046

RESUMEN

People living with HIV (PLHW) and other concealable stigmatized identities (CSIs) face continual decisions about the degree of openness they are willing to allow for their identities in different social contexts. Disclosing or concealment of CSIs describes potential stigma management strategies that may have distinct psychosocial consequences. This study aimed to examine disclosure processes in a sample of sexual minority men (SMM) with intersecting CSIs, who use substances and were suboptimally engaged in HIV care. Interviews (N = 33) were initially double coded following thematic analysis, which identified disclosure as a theme. Subsequently, content analysis and additional selective double coding were used to iteratively identify and refine subthemes related to disclosure decisions. Illustrative quotes and frequencies of the invoked subthemes and identities were recorded for each participant. The majority of participants discussed experiences of disclosure and nondisclosure (N = 31, 94%). Among these, a spectrum of related behaviors and preferences emerged, including active disclosure, passive disclosure, passive nondisclosure, and concealment. Across disclosure-related content, in addition to HIV status, the majority of participants also described navigating decisions about disclosure of sexual orientation (71%), substance use (61%), and multiple identities at once (55%). Findings from this study highlight the fluid and multi-dimensional nature of identity-related disclosure processes in SMM with multiple CSIs. Participants in this study possessed interlocking stigmatized identities and described being varying degrees of "out" across identities and time. Moreover, these findings challenge common beliefs that disclosure is a binary construct associated with positive gain.


Asunto(s)
Infecciones por VIH/psicología , Calidad de Vida/psicología , Estigma Social , Estrés Psicológico/etiología , Estrés Psicológico/psicología , Revelación de la Verdad , Adulto , Anciano , Toma de Decisiones , Femenino , Infecciones por VIH/tratamiento farmacológico , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Minorías Sexuales y de Género , Estereotipo
19.
Value Health ; 24(2): 281-290, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33518035

RESUMEN

BACKGROUND: There are increasing concerns about the appropriateness of generic preference-based measures to capture health benefits in the area of mental health. OBJECTIVES: The aim of this study is to estimate preference weights for a new measure, Recovering Quality of Life (ReQoL-10), to better capture the benefits of mental healthcare. METHODS: Psychometric analyses of a larger sample of mental health service users (n = 4266) using confirmatory factor analyses and item response theory were used to derive a health state classification system and inform the selection of health states for utility assessment. A valuation survey with members of the UK public representative in terms of age, sex, and region was conducted using face-to-face interviewer administered time-trade-off with props. A series of regression models were fitted to the data and the best performing model selected for the scoring algorithm. RESULTS: The ReQoL-Utility Index (UI) classification system comprises 6 mental health items and 1 physical health item. Sixty-four health states were valued by 305 participants. The preferred model was a random effects model, with significant and consistent coefficients and best model fit. Estimated utilities modeled for all health states ranged from -0.195 (state worse than dead) to 1 (best possible state). CONCLUSIONS: The development of the ReQoL-UI is based on a novel application of item response theory methods for generating the classification system and selecting health states for valuation. Conventional time-trade-off was used to elicit utility values that are modeled to enable the generation of QALYs for use in cost-utility analysis of mental health interventions.


Asunto(s)
Análisis Costo-Beneficio/métodos , Salud Mental/economía , Calidad de Vida/psicología , Encuestas y Cuestionarios/normas , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Estado de Salud , Esperanza , Humanos , Relaciones Interpersonales , Actividades Recreativas , Masculino , Persona de Mediana Edad , Autonomía Personal , Psicometría , Factores Socioeconómicos , Adulto Joven
20.
Am J Phys Med Rehabil ; 100(4): 313-320, 2021 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-33496442

RESUMEN

BACKGROUND: Patients with COVID-19 can present functional status and disability alterations in the medium- and long-term. On the international level, a multicentered study is being carried out to validate the Post-COVID-19 Functional Status scale for different nations, thus allowing visualizing the needs for a multidisciplinary approach and planning intervention plans. The objective of this study was to perform a linguistic validation and cross-cultural adaptation of the Post-COVID-19 Functional Status scale for people infected with COVID-19 for the Chilean population. METHODS: A cross-sectional study of scale validation was carried out. The study was performed in two phases: (1) forward-translation, reverse-translation and (2) apparent cross-validity adaptation. For the apparent validity analysis, 29 individuals who had been hospitalized in Hospital del Salvador with a COVID-19 infection diagnosis and at the time of the interview were in their homes participated. RESULTS: In phase 1 forward-translation, an item required semantical changes. The reverse-translation versions were similar, and the most relevant doubts were resolved in a consensus meeting. In phase 2, the pilot study confirmed adequate understanding and scale applicability. CONCLUSIONS: Using a systematic and rigorous methodology allowed obtaining a Spanish version of the Post-COVID-19 Functional Status scale for Chile, which is conceptually and linguistically equivalent to the original instrument and adequate to assess the functional status of people infected with COVID-19.


Asunto(s)
Actitud Frente a la Salud , Encuestas y Cuestionarios/normas , Adulto , Chile , Comparación Transcultural , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Psicometría , Calidad de Vida/psicología , Reproducibilidad de los Resultados , Traducciones
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