Disease-specific (e.g. urinary) and generic problems (e.g. fatigue) impact health-related quality of life (HRQOL) of patients with bladder cancer (BC). A questionnaire addressing both sets of problems and generating utilities, a measure of overall HRQOL, is needed for this population. In consultation with 47 BC patients and 12 BC experts we created a novel HRQOL questionnaire for BC in a stepwise, iterative fashion with conceptual framework development, item generation, item reduction, question design and pilot testing. Patients and experts identified urinary problems, bowel problems, sexual problems, body image, pain, and decreased vigor as domains, which impact daily activities and impair HRQOL. Support from patients’ family and friends and their medical team were also paramount to HRQOL. The Bladder Utility Symptom Scale is a comprehensible instrument that was created to facilitate patient-oriented care and guide clinical policy by grounding guidelines, health resource allocation, and policy decisions in the expressed preferences of BC patients.

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No description available.

Disease-specific (e.g. urinary) and generic problems (e.g. fatigue) impact health-related quality of life (HRQOL) of patients with bladder cancer (BC). A questionnaire addressing both sets of problems and generating utilities, a measure of overall HRQOL, is needed for this population. In consultation with 47 BC patients and 12 BC experts we created a novel HRQOL questionnaire for BC in a stepwise, iterative fashion with conceptual framework development, item generation, item reduction, question design and pilot testing. Patients and experts identified urinary problems, bowel problems, sexual problems, body image, pain, and decreased vigor as domains, which impact daily activities and impair HRQOL. Support from patients’ family and friends and their medical team were also paramount to HRQOL. The Bladder Utility Symptom Scale is a comprehensible instrument that was created to facilitate patient-oriented care and guide clinical policy by grounding guidelines, health resource allocation, and policy decisions in the expressed preferences of BC patients.

Introduction: The proportion of individuals aged 65 and over is increasing and mental health services need to recognise the resources of these individuals and meet their needs. Quality of life is a widely used outcome variable in mental health policy and clinical research. Subjective factors are consistently found to be more significant than objective factors in determining quality of life. This gives clinicians areas to consider when working to improve an individual’s quality of life. The current research looks at the relationship between successful psychosocial development and quality of life in older people with mental health difficulties. A secondary aim is to consider the impact of chronic mental health difficulties on quality of life. Method: Twenty-four older people (mean age 72) who were living in the community and supported by Community Mental Health Teams opted in to the study. Questionnaires, which included the WHOQOL-Old and MEPSI, were administered by the researcher. Results: Strong and significant correlations were found between quality of life and successful psychosocial development. A regression analysis found that successful resolution of the final stage of psychosocial development was the most significant predictor of quality of life over other psychological and demographic variables. No impact of chronicity was found. Discussion: The results of the study suggest that psychosocial development is an important factor to consider when working with older people and that a sense of ego-integrity is important to an individual’s perception of quality of life.

This study looked at people's self-reports of satisfaction with various aspects of life and personal happiness. The sample was divided into three categories regarding the size of the community of the respondent: rural, urban and large urban. Similarly to other studies of this nature, we found that rural people expressed higher levels of subjective psychological wellbeing than did people who live in urban and large urban communities. The concept of social desirability was incorporated into this paper. A rather large percentage of all three categories (rural, urban and large urban) of respondents, across a wide range of demographic characteristics (such as age, sex, race, etc.), indicated substantial amounts of satisfaction and happiness. This seems partially due to the fact that people have a tendency to give very positive answers to questions regarding subjective psychological well-being. In other words, it is socially desirable to indicate that one is satisfied and happy with various aspects of one's life; while it is socially undesirable to indicate that one is dissatisfied or unhappy.

Regular physical activity is significant for overall health and can reduce the risk of chronic disease and health related conditions. Individuals with central nervous system CNS lesions experience impairments that limit their participation in physical activity and reduce quality of life; therefore it is even more important to understand the relationship between the barriers and affordances to engaging in physical activity for this cohort. The current study has uniquely identified a population (n= 11) based on the common experience of spasticity in the lower limb resulting from an CNS lesion across multiple diagnostic categories and used the International Classification of Functioning, Disability and Health model (ICF) (WHO, 2001) to characterize the impairments in body structure and functions, activities and contextual factors to better understand their influence on physical activity levels in this cohort. The findings showed that each individual experienced physical impairments for multiple body functions and structures comprising reduced ankle range of motion (M= 9.98 PlantarFlexion), spasticity as measured by the Ankle Plantar Flexor Tone Scale (middle ankle range resistance M= 1.56, stretch reflex M= 1.64) as well as some reports of pain on a Visual Analog Scale (Usual, M =1.10, and Worst pain, M= 1.64). On average the cohort presented with mild to moderate impairments in their mobility as measured by Timed Up and Go (M= 28.28 seconds), walking velocity (M= 74.94cm/sec Gaitrite mat) and falls (M= .91). Findings from both the Physical Survey for Individuals with Physical Disabilities (PASIPD) and semi-structured interviews suggest that participation in physical activity was low across life roles including areas of work and employment, recreation and leisure, domestic life and selfcare. The physical component summary (PCS) scores of the Short-Form 36 Version 2 Quality of life Survey were lower than average norms (M=38.12, SD=7.53), while the mental components summary (MCS) scores were on par with average ranges (M=50.61, SD=10.02); however the overall MCS score was slightly higher than the trend reflected in the mental health sub-scores which ranged from between slightly below average to average. Clearly aligning with the ICF model, the volume and intensity of physical activity was hampered by physical impairments, fear of falling, cost of activities, poor weather, a lack of transportation, and cut backs to services as reported in the semi-structured interviews. However, the quantitative relationships between the domains of the ICF were less obvious. Through qualitative interviews the participants’ positive outlook toward participating in life roles was strongly expressed. Despite barriers, individuals were finding ways to be somewhat active and were motivated to do more and overcome their functional limitations. / Graduate

The present study used phenomenology to inquire about the quality of life experiences of six adults who had undergone an amputation. This study also explored how the adults perceive their lives. All participants resided in Western Canada and had undergone an upper limb amputation several years prior to the study. Each participant was interviewed twice. Some of the interview questions were from Roberts and Cairns’ (1999) adaptation of Keith and Schalock’s (1994) QOL model. Interviews were conducted, transcribed, and thematically analyzed. Results indicated that some participants experienced a change whereas others reported stability in quality of life. The data analysis revealed specific categories, clusters, and themes of participants’ quality of life experiences. Quality of life categories related to empowerment, satisfaction and well-being, and the social realm. Participants described their lives as being significantly changed as a result of an amputation. The data analysis also revealed specific categories, clusters, and themes of participants’ perceptions of their lives. Psychological attributes and health care were two categories. The present study offers implications for several groups of people. / Graduate

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Stroke is the second most common cause of death worldwide. However stroke is not invariably fatal and survivors may experience major physical, social and psychological problems. The United Kingdom government identified the improvement of the quality of life of stroke survivors as a key objective in the recent "Health of the Nation" consultative document. The concept of health related quality of life has developed over the past few years. Although there is no one universally agreed definition, there are several instruments which claim to measure at least some aspects of health related quality of life. These instruments have not been extensively tested in stroke patients, so the hypothesis which I shall test in this thesis is as follows: that a simple instrument can prove a feasible, valid, reliable, and clinically useful measure of health related quality of life in stroke survivors. I selected a simple measure of health related quality of life (the EuroQol questionnaire) and evaluated its validity in a sample of patients with stroke. A small, but important proportion of patients were unable to complete EuroQol questionnaires either by themselves or by interview, so I investigated whether a proxy (e. g. a spouse or carer) could assess the patient's health status after stroke accurately and without bias. Previous studies comparing one or more different health status instruments did not involve strictly random allocation, so could not provide reliable information on the "best" measure of quality of life to use in stroke patients. I therefore performed a study in a sample of survivors of stroke which directly compared the EuroQol and SF- 36 by using a strict random allocation of questionnaires. It was not possible to compare quantitatively the reliability and validity of the EuroQol and SF-36; however, a qualitative comparison suggested their reliability was similar and they appeared to be sampling broadly the same areas of health. I finally investigated patients' perception of their own quality of life after stroke. The data suggested that many disabled stroke survivors might not view survival in a dependent state as badly as one might expect. This somewhat surprising finding will inform decisions about whether to accept the high risks associated with certain treatments (e. g. thrombolysis) in order to reduce the chances of survival in a dependent state. Assessments of health related quality of life may therefore provide a more comprehensive and relevant view of the patients' outcome than simple measures of disability or impairment.