Recent changes in health care policy, which mandate the monitoring of illness symptoms and improving the satisfaction of medical patients, may shed light on possible points of intervention to improve patient-centered outcomes. Health-related quality of life (HRQL), or one’s appraisal of their mental and physical functioning, is a frequently-used metric relevant to improved health care outcomes. HRQL may be impacted by multiple inter- and intra-personal factors, whether an adaptive (e.g., social problem solving ability) or maladaptive effect (e.g., thwarted interpersonal needs, depression). We examined the association between social problem solving ability and mental and physical HRQL, and the potential mediating roles of thwarted interpersonal needs and depressive symptoms. Participants (N=223) were middle-aged and recruited from a primary care clinic. Our hypotheses that thwarted interpersonal needs and depressive symptoms would sequentially mediate the association between independent scales of social problem solving (negative problem orientation, positive problem orientation, rational problem solving, impulsive/careless style, avoidant style) and HRQL (mental and physical), were largely supported. Our findings highlight the importance of social problem solving ability as a potential point of intervention to improve mood, interpersonal functioning, and mental and physical health in an integrated care setting. Strategies such as Social Problem Solving Therapy might be particularly effective in bolstering social problem solving, with consequent beneficial effects on interpersonal functioning and mood, thereby improving overall health-related quality of life.

The present study used a mixed methodology approach to understand factors that predict and promote health related quality of life (HRQOL) for parents of youth with Autism Spectrum Disorders (ASD). The first component of the study used quantitative analyses to determine the extent to which study variables predict HRQOL for parents of youth with ASD (N = 365). Findings show that HRQOL is positively impacted by increased total annual household income, increased age of the child with ASD, male gender, and tangible support. HRQOL was negatively impacted by increased age of the parent, increased parental perceptions of burden, and use of maladaptive coping strategies. The second phase of the study incorporated qualitative methodology to describe the lived experience of parents (N = 8). Qualitative interviews solicited perceptions of parents regarding HRQOL. Further, qualitative analyses identified sources of parental support, how parents feel about support from varying professionals, and potential supportive interventions toward which they are amenable but cannot currently access. Directions for future research and implications for improving HRQOL for parents of youth with ASD are discussed. The results of the current study can be used to guide and inform supportive services targeted at parents of youth with ASD to improve their HRQOL.

Hyperpigmentation is a common dermatological complaint that can have profound effect on appearance and quality of life.  Disorders of hyperpigmentation comprise a large group of skin conditions characterized by an increase of melanin production, increase in density of active melanocytes, abnormal melanin distribution, and/or deposition of exogenous pigments. This cross-sectional study was conducted to evaluate the impact hyperpigmentation disorders on health-related quality of life and to better understand patient knowledge, approaches, and experiences. The study was conducted on 298 consenting adult patients with a skin related disorder of hyperpigmentation who sought dermatological care at Boston Medical Center (BMC) or East Boston Neighborhood Health Center (EBNHC) from February of 2015 to March of 2016. Patients were anonymously surveyed in order to collect an assortment of information including demographic characteristics, skin condition, health practices, knowledge base, and health-related quality of life (HRQoL) measured with the Dermatology Life Quality Index (DLQI) (Finlay and Khan 1994) and SDIEQ, a five-item , non-validated, brief health-related quality of life questionnaire (A. Taylor et al. 2008). Disease severity was assessed by Melasma Area Severity Index (MASI), Post Acne Hyperpigmentation Index (PAHPI) and body surface area when appropriate. The mean overall DLQI was 6.56 (SD 5.35). In sub-analysis, the mean DLQI in those diagnosed with post-inflammatory hyperpigmentation was 7.89 (SD 0.61), melasma 6.75 (SD 0.45), and other hyperpigmentation disorders 4.5 (SD 0.55). The disease type and duration were both factors associated with a change in DLQI scores. The factors associated with a higher likelihood of patients’ knowledge of their diagnosis included a higher level of formal education, younger age, longer duration of having the condition, and current use of sunscreen, which were found to have 2.4, 2, 3.7, and 2.4 significantly higher odds of knowing their diagnosis, respectively. This study found that the overall impact of hyperpigmentation on health-related quality of life (HRQoL) was small to moderate; however, about 22% reported a very large affect on quality of life. Patients with post-inflammatory hyperpigmentation (PIH) and melasma have significantly lower quality of life when compared with other hyperpigmentation disorders. MASI had a significantly weak correlation with DLQI and SDIEQ, demonstrating that disease severity does not predict patient perception and impact on quality of life.

Purpose: The relationship between racial disparities and the health-related quality of life (HRQoL) of lung cancer patients is not well understood. The purpose of this study was to quantify the overall HRQoL of lung cancer patients and compare differences in HRQoL among racial groups in the United States. Methods: We analyzed data from the Behavioral Risk Factors Surveillance System (BRFSS), a population-based national cross-sectional study conducted by the Centers for Disease Control and Prevention. The BRFSS is conducted annually in all 50 states and collects information on demographics, health behaviors, health-related experiences, health conditions, use of medications, and use of preventive services. Three HRQoL scores (unhealthy days per month, frequent mental distress, fair/poor health) were generated using the four Healthy Days Measures questions that have been validated as HRQoL measures by previous research. Results: We found that the HRQoL measures of the Non-Hispanic Black group were not statistically different from those of the Non-Hispanic White group for any of the three measures examined. However, the Hispanic group (OR = 3.14, 95%CI=1.40 – 7.02) and Other races (OR = 1.85, 95%CI=1.04-3.27) had significantly higher odds of frequent mental distress when compared to the Non-Hispanic White group. Conclusions: Quality of life among lung cancer patients is a heavily under-researched area of the cancer survivorship experience. Rarer, is data examining specifically how racial disparities affect the quality of life of lung cancer survivors. More research is needed to examine this important topic to create a foundation for more beneficial lung cancer interventions in the future.

Bakgrund: Allergisk rinit (AR) är en vanlig kronisk sjukdom. AR innebär allergi mot luftburna allergener vilket kan yttra sig med långvariga eller återkommande symtom från näsa och/eller ögon med varierande svårighetsgrad. Hälsorelaterad livskvalitet (HRQoL) är de delar av livet som påverkas av hälsa, sjukdom och behandling. Personer med AR som söker vård kan ha svårare symtom och behöver stöd i primärvården. Syfte: Att belysa hälsorelaterad livskvalitet hos personer med allergisk rinit. Metod: Designen var en litteraturstudie bestående av 16 kvantitativa artiklar. Resultat: Samtliga studier fann att personer med svårare AR skattade sin HRQoL sämre än personer med mildare AR. De områden av HRQoL som var påverkade vid svårare AR var dagliga aktiviteter (arbete/skola, hem och hushåll, socialt liv och fritidsaktiviteter), sömn och psykisk hälsa. Gällande psykisk hälsa påvisades sänkt sinnesstämning i form av nedstämdhet, depressiva symtom, ångest och andra känslolägen. Slutsats: Resultatet är entydigt, personer med svårare AR skattar sämre HRQoL än de med mildare sjukdom inom olika områden såsom dagliga aktiviteter, sömn och psykisk hälsa. Resultatet kan bidra med större förståelse om patienter med AR och vara av värde för hälsooch sjukvården där distriktssköterskor med sin specialistkunskap och förskrivningsrätt kan spela en betydelsefull roll. Genom ökad förståelse kan omhändertagandet av patienter med AR förbättras med mål att ge stöd för bättre HRQoL och att patienten ska må bra i sin sjukdom. / Background: Allergic rhinitis (AR) is a common chronic disease. AR means allergy to airborne allergens, which can manifest itself with long-term or recurring symptoms from the nose and/or eyes with varying degrees of severity. Health-related quality of life (HRQoL) is areas of life that are affected by health, disease and treatment. People with AR that seek medical care may have more severe symptoms and need support from primary care. Aim: To highlight health-related quality of life in people with allergic rhinitis. Method: The design was a general literature review of 16 quantitative articles. Results: All studies found that people with more severe AR rated their HRQoL worse than people with mild AR. The areas of health-related quality of life that were affected in more severe AR were daily activities (work/school, home and household, social life and leisure activities), sleep and mental health. In the area mental health associations were seen with affected mood such as sadness, depressive symptoms, anxiety and other emotional states. Conclusion: The result is unanimously, people with more severe AR rated worse HRQoL than people with mild disease in various areas such as daily activities, sleep and mental health. The result can contribute to a greater understanding of patients with AR and be of value to the healthcare system, where district nurses with their specialist knowledge and right to prescribe medication can play an important role. Through increased understanding, the care of patients with AR can be improved with the aim of providing support for better HRQoL and better wellbeing.

Bakgrund: Hälsorelaterad livskvalitet är av stor betydelse för välbefinnandet hos den åldrande befolkningen, och styrketräning kan vara en potentiell metod att förbättra den hälsorelaterade livskvaliteten hos äldre individer. Syfte: Syftet med denna litteraturöversikt är att sammanställa effekterna av regelbunden styrketräning på hälsorelaterad livskvalitet hos personer över 60 år. Metod: En systematisk litteraturöversikt genomfördes i den medicinska databasen PubMed, innehållande randomiserade kontrollerade studier publicerade på engelska under de senaste 10 åren. Studierna inkluderade äldre individer (minst 60 år) och jämförde styrketräning med en kontrollgrupp utan intervention. Studiernas enskilda kvalitet granskades med TESTEX och studiernas sammanlagda evidens bedömdes med GRADEstud. Resultat: Åtta studier med ett totalt deltagarantal på 542 inkluderades. Kvaliteten på studierna varierade från 7-14 av 15 poäng på TESTEX-skalan varav 12 poäng ansågs visa på hög tillförlitlighet. Endast 4 av studierna ansågs vara av hög tillförlitlighet och inkluderades i det sammanlagda resultatet. Evidensstyrkan av de sammanlagda studierna blev i sin tur låg ++, då det förekom bristande samstämmighet och precision i studierna. Tre av 4 studier som inkluderades i det sammanlagda resultatet visade på en positiv effekt av styrketräning på hälsorelaterad livskvalitet, den fjärde studien visade inte några statistiskt signifikanta mellangruppsskillnader. Slutsats: Regelbunden styrketräning kan ha en positiv effekt på hälsorelaterad livskvalitet hos äldre individer, men mer forskning krävs för att dra definitiva slutsatser. Ytterligare högkvalitativa randomiserade studier behövs för att stärka evidensen och fastställa rekommendationer för styrketräning hos äldre. / Background: Health-related quality of life is essential for the well-being of the agingpopulation, and resistance training is a potential approach to enhance the health-relatedquality of life in older individuals. Aim: This literature review aims to summarize the effects of resistance training onhealth-related quality of life in individuals aged 60 and above. Method: A systematic literature review was conducted in the medical database PubMed,including randomized controlled trials published in English within the past 10 years. Theincluded studies involved older individuals (at least 60 years) and compared resistancetraining to a non intervention control group. The quality of the individual studies wereexamined using TESTEX and the evidence of the combined studies results was determinedusing GRADEstud. Results: Eight studies were included with a total of 542 participants. The quality of theindividual studies varied from 7-14 out of 15 points on the TESTEX-scale wherein 12 pointswas considered to show high reliability.Only four of them were considered to be of high quality and were included in the summarizedresult. The combined evidence was deemed as low ++, due to the studies lack of consensusand precision. Three out of four studies included in the summarization found a positive effectof resistance training on health-related quality of life, while the fourth one did not show anystatistically significant differences. Conclusion: Consistent resistance training may have a positive effect on health-relatedquality of life in older individuals, but more research is needed to draw definitiveconclusions. Additional high-quality randomized trials are needed to strengthen the evidenceand establish recommendations for resistance training in the elderly.

The adverse effects of cancer treatment on health-related quality of life (HRQL) are the primary concern of elderly women diagnosed with breast cancer. The interplay of transient and progressive functional impairments caused by cancer therapies, alongside the accelerated physical declines associated with the normal aging process, are all negatively correlated to HRQL. This study compared the HRQL trajectories between cases and controls for ten years after diagnosis. The cancer group included 1467 women (age ≥ 65), diagnosed with primary breast cancer, registered in the Surveillance Epidemiology and End Results (SEER) cancer registry, and completed the Medicare Health Outcomes Survey (MHOS) before and after diagnosis. Controls were frequency-matched to cases with a 1:1 ratio on age and socio-economic variables. Participants reported their HRQL using SF-36/VR12 questionnaire, which was summarized into two summary scores (physical component summary (PCS) and mental component summary (MCS) and eight domain scores: physical functioning (PF), general health (GH), bodily pain (BP), role-limitation physical (RP), social functioning (SF), mental health (MH), role-limitation emotional (RE), and vitality (VT). Hierarchical Linear Modelling was utilized to assess the fixed effects of time, group, and the interaction between time and group (Time*Group) on HRQL trajectories. At the time of cancer diagnosis, cases fared worse than controls in all of the HRQL domains and summary scores. Group and time were majorly significant for PCS, PF, GH, BP, and RP, while only group was predominantly significant for mental domains (MCS, SF, MH, RE, VT). Time was also significant for SF and VT, while Time*Group was only significant for RE. Cases showed remarkable gains over controls across time in MCS, RE, MH, VT, SF, and PF. The need for intervention in improving physical health iii HRQL among older women is validated. On the other hand, the remarkable gains of cases over controls on mental domains of HRQL provoke future research to explore further patient perception on benefit-finding caused by the diagnosis and experience of cancer.

Bakgrund: Att vara född med blåsextrofi innebär upprepade kirurgiska ingrepp, med risk förurininkontinens och ett något annorlunda genitalt utseende. Personer som opererats förblåsextrofi har en del utmaningar i livet där bl.a. egenvård gällande urinvägar är viktigt ipatientens dagliga liv. Det vore därför intressant att beskriva hälsorelaterade livskvalitet,HRQoL, för patientgruppen.Syfte: Att redovisa hur personer som opererats för blåsextrofi beskriver sin HRQoL medavseende på fysiskt, psykiskt och socialt välbefinnande. Detta för att kunna belysa patientensomvårdnadsbehov utifrån sjuksköterskans perspektiv.Metod: En deskriptiv litteraturstudie gjordes på 20 originalartiklar.Resultat: Fysiskt välbefinnande påverkades negativt av framförallt urininkontinens och genitalt utseende. Omvårdnadsbehov var att optimera miktionssituationen, hittacopingstrategier för att acceptera hur kroppen fungerade, samt oro för sexuell funktion.Psykiskt välbefinnande påverkades till viss del av negativ kroppsuppfattning.Omvårdnadsbehov var acceptans av kroppsligt utseende samt oro för att omgivningen skullefå reda på sjukdomstillståndet. Socialt välbefinnande visade att patientgruppen lyckades väl isociala sammanhang. Omvårdnadsbehov var att träffa andra som opererats för blåsextrofi,samt att känna trygghet i social kontext.Slutsats: Flera omvårdnadsbehov framkom i studien. Omvårdnadsåtgärder som hjälp fördetta är t.ex. kompetent rådgivning gällande miktionssituation, möjlighet att träffakontaktsjuksköterska med erfarenhet av patientgruppen, stöd från sjuksköterskan angåendeatt berätta för omgivningen om blåsextrofi på ett bra sätt, möjliggöra för patienter födda medblåsextrofi att få träffa varandra genom t.ex. temadagar samt att lyfta frågan om sexualitet vidbesök inom sjukvården.

This purpose of the study is to examine the difference in the health-related quality of life (HRQOL) between individuals who suffer from physician-diagnosed arthritis compared with individuals who do not suffer from physician-diagnosed arthritis in a population of university students, faculty, and staff. The study sampled from a population of students, faculty, and staff at the University of Central Florida. Through the implantation of a cross-sectional ecological design, differences between the two groups were measured with a survey that measures health-related quality of life, such as the 36-Item Short Form Health Survey (SF-36). The SF-36 questionnaire was distributed to subjects through a campus-wide email system and was administered through Qualtrics, an online survey program. Literature suggests lower SF-36 scores for individuals suffering from arthritis, but is lacking in investigating the effect of arthritis on college-aged students, particularly within the 18-24 age group. The study aims to close this gap in the literature. SPSS software was used to analyze results through tests of association, like ANOVA, which measured differences in the SF-36 scores of subjects with physician-diagnosed arthritis and subjects without physician-diagnosed arthritis. Results showed a significant difference in the HR-QOL scores between individuals with arthritis and individuals without arthritis, as well as age, gender, ethnicity, and the presence of joint pain.

The objective of this research study is to explore trajectories of health-related quality of life (HRQoL) in older breast cancer survivors, along with their predictors. HRQoL is important because patients who show severe symptoms may wish to consider therapies or treatment plans that lead to better HRQoL. Older people are more vulnerable to low HRQoL scores since old age is associated with deteriorating health, multiple comorbidities, and low-socioeconomic status. To examine the HRQoL trajectory among older women with breast cancer, we used the data queried from the Surveillance, Epidemiology and End Results Medicare Health Outcomes Survey database. A total of 1,089 older (≥ 65 years) women who were diagnosed with breast cancer in 1998-2012 and participated in the survey before and after the cancer diagnosis were identified. HRQoL was measured using SF-36/VR-12 questionnaire and summarized as Physical Component Summary (PCS) Score and Mental Component Summary (MCS) Score. Latent Class Growth Mixture Modeling was conducted to identify distinct groups of women with a similar trajectory of HRQoL. The results showed that there were three latent classes of HRQoL trajectories for PCS: the high-declining (46.5% of the sample), mid-declining (36.0%), and the low-improving (17.5%). Two latent classes of HRQoL trajectories were identified for MCS: high-stable (76.5%) and low-declining (23.5%). The results showed that age at diagnosis, BMI, level of education, geographic region, tumor grade, tumor size, and number of comorbidities were some of the major predictors of health-related quality of life. These predictors were further explored using multinomial logistic regression analysis which identified number of comorbidities as the most significant predictor for HRQoL-PCS scores and level of education as the most significant predictor for HRQoL-MCS scores. This suggests that future research needs to be conducted, identifying the most common comorbidities in older breast cancer survivors to develop interventions that better the physical HRQoL in patients, in addition to the development of mental HRQoL interventions for patients that are less educated.