With the increase of students with disabilities attending post secondary education, it is important to have an understanding of how satisfied a student with a disability is with college. At present, the research on college satisfaction focuses on specific variables and how the specific variables moderate or mediate college satisfaction; however, there is limited research in the area of college satisfaction and students with disabilities. To address the current gap in research, the purpose of the current study was to address if there was a difference in overall satisfaction in students with a disability compared to students without a disability. Further, analysis of group differences in relation to domain scores was conducted, and how variables such as entrance status, gender, ethnicity, ACT scores, and grade point average mediate college satisfaction for students with disabilities. Additionally, it was important to examine the relationship between disability status and overall satisfaction, as well as examine the relationship of the 4 domains (e.g. Instruction and Life Skills, Quality of Student Services, and Quality of Undergraduate Experience) and overall satisfaction. Survey data were collected from 2009-2014 Undergraduate Survey from the Office of Institutional Research and Effectiveness at a university in the southeastern United States. The results indicated a statistically significant difference between students with disabilities and students without disabilities in regards to perceptions of services provided, and undergraduate experience. Specifically, individual with disabilities are more satisfied in the area of services provided compared to students without disabilities, while students without disabilities are more satisfied with their undergraduate experience compared to students with disabilities. Further, numerous relationships were found between variables such as gender, ethnicity, entrance status, academic proficiency, and overall satisfaction. Lastly, instructional and life skills, quality of student services, quality of academic advising, and quality of undergraduate experience scores load onto the latent variable of overall satisfaction as hypothesized.

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Introduction The Breatheasy© Tracheostomy Program based at the Red Cross War Memorial Children's Hospital, Cape Town, manages children mostly from poor socio-economic backgrounds. In our resource-limited setting, it is unclear how these families cope with the demands of a tracheostomised child. We aim to assess the quality of life (QOL) of tracheostomised children and their families as the first study of its kind in a low-resource setting. Methods A descriptive, observational study was done to assess the QOL of tracheostomised children managed by the Breatheasy© Program over 10 months. Children with tracheostomies for longer than 6 months, complex syndromic children, and home ventilated children were included. The validated Paediatric Tracheotomy Health Status Instrument (PTHSI) was utilised, where a higher score, implied a better outcome. Results A total of 68 families were recruited. In 57 (85.1%) of the carers, the highest level of education achieved was primary or high school. Twenty-seven (42%) families reported having an annual household income of less than $675 US Dollars (ZAR10,000). Sixteen (24%) resided within informal housing. The mean scores for the 4 PTHSI domains were: physical symptoms 24.8/35 (70.9%), frequency/financial impact of medical visits 14.2/15 (94.7%), QOL of child 8.8/15 (58.7%), QOL of carer 62.3/85 (73.3%); the overall score was 110.2/150 (73.5%). There was no significant correlation between total PTHSI and annual household income, carer's educational status or type of housing. Children with a concomitant major medical condition had a significantly poorer total PTHSI scores (p-value 0.024). Conclusion Tracheostomy care compounds challenging socio-economic circumstances. In our experience, with adequate training, home-care nursing is not necessary. Despite difficult living conditions, the Breatheasy© Program empowers children and their families to live independently of the hospital system and appear to be thriving. The decision to perform a paediatric tracheostomy should not be influenced by the carer's education level, socioeconomic status, or on the basis of formal or informal housing. Children with major medical comorbidities represent a group that requires more support.

Work-life balance goes hand-in-hand with the quality of life and the quality of working life and the level of satisfaction with thereof. Recent survey that took place in the Czech Republic in 2018 attempted at measuring the quality using the index of the quality of life and the index of the working life quality. The questionnaire developed by the World Health Organization and the set of questions proposed by Vinopal aiming at measuring the subjectively perceived quality of working life. The aim of this work is firstly to test the functionality of the two indices, the quality of life index and the quality of working life index, and then examine the existence and potential strength of the relationship between them within the selected subgroups of population. The work builds up on two basic pillows. The first pillow deals with the defitions of the explored phenomena. The concept of quality of life is explored at different levels: philosophical, sociological, subjective and objective. Then the rationale for developing a tool that measures the quality of life is described, including the variations of the Czech adaptation of the questionnaire. In the following chapters, the phenomenon of the quality of working life is introduced with special focus on the explanation of the dual nature of the concept and...

We hypothesized that HIV-related stigma would be related to poorer HIV-related quality of life (HIV-QOL) in people living with HIV (PLWH), and that this relationship would be stronger in women living with HIV (WLWH) than in men living with HIV (MLWH). 105 PLWH completed an online survey including measures of demographics, HIV-related stigma, and HIV-QOL. Results suggest that higher levels of HIV-stigma were associated with poorer HIV-QOL, and that in some cases, this relationship was stronger for WLWH than for MLWH. It is possible that WLWH have unique HIV-related experiences affecting their quality of life that are not shared by MLWH.

Nursing home resident choice in daily life is recognized as vital to resident quality of life and quality of care. Advocacy and policy activities to promote resident choice abound, yet little research exists to guide nursing home staff in how to enable resident choice on a moment to moment basis. Our three studies developed conceptual and practical tools to elucidate the factors, challenges, and behaviors involved in enabling resident choice. We first crafted a conceptual model, the “REAlizing Resident CHoice (REACH)” model, as described in the first paper. The REACH model identifies the factors influencing staff efforts to enable resident choice and the broader contextual dimensions within which the resident-staff member relationship exists. The REACH model was developed through a literature review of 1,969 abstracts and expert opinion. The second study assessed 1) tensions nursing home staff members encounter when trying to enable resident choice and 2) resolutions employed in the face of these tensions. We conducted semi-structured, qualitative interviews with 26 staff participants in two Veterans Health Administration (VHA) Community Living Centers (i.e., nursing homes). Participants highlighted intra-personal, inter-personal, and organizational tensions that affected their resident choice enabling efforts. Resolutions to these tensions focused on preventive practices, education, reinforcement, deliberation, collaboration, and leadership. A formative assessment tool, the “Supporting Choice Observational Tool (SCOT),” was developed in the third study. The SCOT provides nursing home staff with detailed, non-graded feedback on how to offer and enable resident choice in-the-moment. We created the SCOT using the following methodologies, in order: ethnographic observation, tool piloting, expert panel consultation, and a representational algorithm. SCOT results can inform discussion amongst co-workers and supervisors on how to advance their resident choice enabling efforts. These three studies address an important research gap. They provide scientifically grounded concepts and tools to assist nursing home staff, researchers, and policy makers in advocating for and instituting resident choice. The REACH model can be used to frame future research, and future studies can be undertaken to validate the SCOT. Findings from the second study could improve quality improvement initiatives targeting tensions and resolutions in enabling resident choice. / 2018-02-17T00:00:00Z

The purpose of this thesis is to examine how rehabilitation interventions, specifically physiotherapy (PT), occupational therapy (OT), and speech and language pathology (SLP) or a combination of these interventions affect quality of life (QoL) in people with amyotrophic lateral sclerosis (ALS). The purpose of the first study (Chapter 2) was to synthesize qualitative research through a qualitative meta-synthesis on the potential of rehabilitation interventions to maintain and/or improve QoL from the perspective of people with ALS. The literature search for this study was conducted using the SPIDER strategy and five articles were included. Four themes emerged: 1) the concept of control; 2) adapting interventions to disease stage; 3) struggles with interventions; and 4) barriers between healthcare providers and patients. The evidence suggests that from the perspective of people with ALS, PT, OT, and SLP interventions, or a combination of these interventions have the potential to be beneficial in the management of people with ALS and to optimize QoL. The systematic review (Chapter 3) aimed to determine the effectiveness of rehabilitation interventions, in particular PT, OT and SLP interventions or a combination of these interventions, on QoL in people with ALS. The PICO search strategy was used and six studies were included: three RCTs, two cohort studies, and one cross-sectional study. A narrative synthesis of interventions was conducted as the included studies were not sufficiently similar thus data extracted were not adequate for conducting meta-analyses. Need to briefly discuss interventions, which outcomes you included and inconsistency in results across studies. Due to the limited evidence, it was difficult to determine the exact effects of the interventions from each rehabilitation field to affect QoL for people with ALS. The evidence suggests that more research is required; currently therapists need to rely on their clinical expertise, expert opinions, and theoretical models to select the most effective interventions to sustain or improve QoL in people with ALS. Future research needs to take into consideration the needs of people with ALS to evaluate the impact of rehabilitation interventions on QoL. / Thesis / Master of Science (MSc)

The objective of this dissertation was to examine the relation between shyness and quality of life (QoL) among adults with schizophrenia in a series of three studies. I first began by understanding whether commonly used measures of shyness and sociability were reliable in this population (Study 1). Next, I examined two moderating variables related to stress-responses subserved by the central (Study 2) and peripheral (Study 3) nervous systems. Study 1, used self-report questionnaires of shyness and sociability to determine whether individuals with schizophrenia responded to these questionnaires in the same way as healthy controls. Studies 2 and 3 used linear regression analyses to determine whether passive neural responses (ERP’s) to social stimuli (emotional faces) and hormonal levels (baseline salivary cortisol and testosterone), respectively, moderated the relation between shyness and QoL. I found that individuals with schizophrenia responded to self-reported shyness and sociability items in a similar way as their nonclinical peers, suggesting that self-reported shyness and sociability are equivalent across populations (Study 1). Study 2, found that individuals who were shy and displayed a hyposensitivity to the processing of fearful faces displayed the lowest QoL. Those who were shy and took longer to process happy faces also demonstrated hindered QoL. Finally, individuals who were shy and had relatively lower baseline salivary cortisol levels also had the lowest QoL. In all circumstances, individuals who were relatively less shy were not susceptible to factors relating to the central and peripheral nervous system. The results of these three studies show that interpretations of findings using self-reported measures of shyness and sociability can be made with confidence in this population. The results also provide support that factors related to processing stressful stimuli can influence the relation between shyness and QoL, thereby further increasing our understanding of this nuanced relation. Theoretical and practical implications of these findings are discussed. / Dissertation / Candidate in Philosophy / Individuals with schizophrenia have been shown to experience reduced quality of life (QoL). Many studies have tried to understand what factors lead to reduced QoL, with one of them being individual differences in personality. This dissertation focused on the personality trait of shyness and addressed two main questions: 1. Are we correctly measuring shyness in people with schizophrenia? 2. What other factors influence the relation between shyness and QoL among individuals with schizophrenia? I first examined whether the meaning of shyness was equivalent between adults with schizophrenia and nonclinical controls. I then examined two different biological factors (i.e., neural and hormonal) related to stress responses to see if they influenced the relation between shyness and QoL in adults with schizophrenia. The answers to these questions have theoretical and practical implications for helping us understand who is at increased and decreased risk for experiencing hindered QoL, and possible targets for intervention.

Cancer is the second leading cause of death in the United States and a leading cause of death worldwide. The rate of mortality is currently approximately 171.2 out of every 100,000 individuals with a terminal cancer diagnosis annually. Individuals with terminal cancer diagnoses facing probable mortality utilize various coping mechanisms or internal resources in an attempt to maintain an internal sense of well-being, commonly referred to as quality of life (QOL). The purpose of this literature review was to investigate themes prevalent in the literature pertaining to internal coping mechanisms and analyze any correlation or causation linking these resources to a change in QOL in individuals with a terminal cancer diagnosis. The secondary purpose of this review was to interpret and define the healthcare provider’s role in supporting this relationship. A systematic review of the literature was conducted from multiple online databases. Multiple studies related to the overarching themes of internal resources and QOL for individuals with a terminal cancer diagnosis were selected for the review. Results revealed major themes pertaining to correlation between hope and QOL. Studies which analyzed the relationship between hope and QOL found a positive correlation. The literature suggests that healthcare providers are capable of facilitating this relationship between hope and QOL. Healthcare provider facilitation of the relationship between hope and QOL is valuable in the clinical setting, and can aid an individual in achieving a desirable QOL.

Introduction: Dementia is a debilitating health condition affecting all aspects of an individual’s well-being. Quality of life (QOL) and health related quality of life (HRQOL) assessments play a large role in understanding the limitations within the patients’ lifestyle and helping care providers manage their needs better. Therefore, our aims for this thesis were twofold: 1. Explore the symptoms, behaviors, or activities deemed as priorities by caregivers for monitoring dementia progression, impact of treatment, or exploring alternative care, and 2. Examine the measurement properties of QOL and HRQOL measures used for people with dementia living in the community. Methods: For the first aim, a qualitative descriptive study was performed with caregivers of individuals living with dementia. Caregivers from various regions in Canada were enlisted, and virtual listening sessions took place between November 2022 and January 2023. Open-ended questions were employed to prompt participants to express their viewpoints. For the second aim, a systematic review guided by COsensus-based Standards for the selection of health Measurement Instruments (COSMIN) was performed to identify literature surrounding measurement properties of QOL and HRQOL measures used in community-dwelling adults with a diagnosis of dementia. A search was performed through four databases (Ovid MEDLINE, EMBASE, CINAHL, and PsychInfo) to identify literature published up until June 2022, followed by abstract and title screening and full-text review, which was performed in duplicate. Measurement properties extracted included structural validity, internal consistency, reliability (test-retest and inter-rater reliability), construct validity, and responsiveness. Risk of bias assessments and quality assessments were also performed for all identified QOL and HRQOL measures. Results: Through the listening sessions, we identified that mobility limitations, social interactions, emotions, feeding behaviors, cognitive difficulties and extrinsic factors were priority topics that caregivers wanted to highlight when assessing QOL for people with dementia. There were 13 dementia-specific and generic QOL and HRQOL measures included in the systematic review. Results showed varying quality of evidence for each of the measures with many having a moderate to very low score for some of the measurement properties. Conclusion: The first study showed dementia caregivers’ perspectives on how routine activities, mobility, social interactions, and behaviors, are important pillars of QOL and should be assessed in clinical and research settings for individuals living with dementia. The second study highlighted the importance of rigorously testing QOL instruments in order to provide accurate measurements when evaluating health concerns and impact of therapy. QOL measures can help researchers and healthcare providers obtain a comprehensive assessment of the individual they are treating. / Thesis / Master of Science (MSc) / Dementia is a disease that affects an individual’s thinking and memory and can affect one’s quality of life (QOL). Family caregivers have firsthand knowledge of their loved ones’ dementia progression and their needs. QOL questionnaires can be used to better understand the health and well-being of an individual who is living with dementia. For individuals with dementia these measures tell us how dementia is changing an individuals QOL over time and how effective the treatment is on their QOL. In this thesis, we explored caregivers’ perspectives on the behaviours and activities of the person living with dementia that should be assessed when monitoring symptom progression and impact of treatment on QOL. We found that domains related to difficulty with everyday activities, changes in mood and behaviour, cognitive difficulties and extrinsic factors are all important to assess when evaluating the impact of treatment on the individual living with dementia. We also reviewed studies that evaluated the measurement properties of QOL questionnaires in individuals living with dementia in the community. QOL questionnaires can be used to measure these outcomes, but there is mixed quality of evidence on the reliability and validity of QOL questionnaires in people living with dementia.