Pasaulinės sveikatos organizacija, rūpindamasi žmonių sveikata, siekia užtikrinti galimybę visiems žmonėms siekti geresnės gyvenimo kokybės. Žmonių gerovė glaudžiai susijusi su jų sveikata. Fizinės, psichinės ir socialinės gerovės būsenos individas turi optimalias galimybes būti visuomenėje, dalyvauti visuomeniniame gyvenime, dirbti ir realizuotis (Juozulynas ir kt. 2005). Gyvenimo kokybė – tai individo savos pozicijos gyvenime suvokimas jo tikslų, lūkeščių, interesų bei kultūros vertybių sistemoje, kurioje jis gyvena (Kalėdienė ir kt. 1999). (Puzaras ir kt.) vieni pirmųjų Lietuvoje ištyrė ir nustatė gyvenimo kokybės, sveikatos ypač dvasinės bei religingumo sąsajas (Puzaras ir kt. 2000). Gyvenimo kokybę nulemia daugybė veiksnių ir aplinkybių : būstas, užimtumas, pajamos, gyvenimas šeimoje, socialinė parama, stresai, sveikata, sveikatos priežiūros galimybės ir kt. (Ašmenskas ir kt. 1997). Tyrimo tikslas – nustatyti ir įvertinti senyvo amžiaus žmonių gyvenimo kokybę. Įgyvendinant šio tyrimo tikslą buvo sprendžiami tokie pagrindiniai darbo uždaviniai : 1. Įvertinti senyvo amžiaus vyrų ir moterų bendrą gyvenimo kokybę lyties aspektu. 2. Įvertinti senyvo amžiaus vyrų ir moterų bendrą gyvenimo kokybę išsilavinimo aspektu. 3. Įvertinti senyvo amžiaus vyrų ir moterų bendrą gyvenimo kokybę šeimyninės padėties aspektu. Tyrimas buvo atliekamas AB Birštono sanatorija ,,Versmė“ 2009 m. lapkričio mėn. tarp tenai atvykusių senyvo amžiaus vyrų ir moterų. Tyrime naudotas... [toliau žr. visą tekstą] / World Health Organization, taking care of human health and to ensure access for all people to seek a better life quality. Human welfare is closely related to their health. Physical, mental and social well – being of the individual states have the optimum opportunity to be in society, participate in social life, work and realized (Juozulynas ir kt. 2005). Quality of life - a life of the individual's perception of their position to achieve its objectives, expectations and cultural values of the system where it resides (Kalėdienė ir kt. 1999). (Puzaras ir kt.) Lithuania were among the first investigated and found the quality of life, especially mental health and religious links (Puzaras ir kt. 2000). Quality of life is determined by many factors and circumstances: housing, employment, income, family life, social support, stress, health, health care facilities etc. (Ašmenskas ir kt. 1997). The study objective - to identify and assess older people's quality of life. Implementation of this study was addressed in the following major tasks : 1. Rate of elderly men and women in the overall quality of life by gender. 2. Rate of elderly men and women in the overall quality of life in educational terms. 3. Rate of elderly men and women in the overall quality of life for the family aspect of the situation. The study was carried out in SC Birštonas sanatorium ,,Versmė” 2009 November. arrived there between older men and women. The survey used to determine the quality of life and evaluate... [to full text]

Bakgrund: Bröstcancer är den vanligaste cancerformen bland kvinnor och i Sverige diagnostiseras cirka 7000 nya fall per år. Behandlingsstrategierna vid bröstcancer är i första hand kirurgi följd av eventuell strålbehandling och läkemedelsbehandling. Efter genomförd mastektomi erbjuds alla svenska kvinnor plastikkirurgisk rekonstruktion. Rekonstruktion är frivilligt men många kvinnor väljer att rekonstruera för att känna sig mer kvinnliga, mer självsäkra i sin kropp och sin sexualitet och som en “hel” människa igen. Det är framför allt yngre och ensamstående kvinnor som tycker det är viktigt med rekonstruktion. Syfte: I denna studie undersöktes livskvalitet hos mastektomerade kvinnor med eller utan efterföljande rekonstruktion, att jämföra uppfattning mellan grupperna och beroende på ålder, och hur de upplevde stödet från vården. Metod: Kvalitativ intervjustudie. 7 kvinnor intervjuades utifrån 8 öppna frågor rörande psykosocial situation relaterad till kroppsbild, sexualitet, beslutsfattande och stödbehov. Intervjuerna spelades in, transkriberades och analyserades med hjälp av innehållsanalys. Resultat: Innehållsanalysen delades in i 2 teman, livskvalitet och bröstcancerkirurgin, som delades in i 5 kategorier, psykisk hälsa, kroppsuppfattning, psykosocial hälsa, upplevelse av vården och valet: rekonstruktion/ej rekonstruktion. Oavsett om kvinnorna genomfört rekonstruktion eller inte så skattade de sin livskvalitet som god. De kvinnor som genomgått rekonstruktion skattade sin livskvalitet högre efter rekonstruktionen än innan. Beslutet om rekonstruktion togs utifrån personliga känslor och tankar. Kvinnorna som inte hade gjort rekonstruktion upplevde ingreppet som riskfyllt och onödigt. De kvinnor som genomförde rekonstruktionen ville inte känna sig stympade och efter operation upplevde att de kände sig mer kvinnliga och som en hel människa igen. Vården uppfattade kvinnorna som bra, men med ökat behov av eftervård och bättre kontinuitet. Slutsats: Oavsett om kvinnorna gjort rekonstruktion eller inte är de nöjda med sitt enskilda val och skattar sin livskvalitet god. Kvinnorna uppfattar bemötandet från vården bra men det finns ett behov av ökad kontakt efter behandlingsslut. / Background: Breast cancer is the most common cancer among women and in Sweden approximately 7000 new cases are diagnosed every year. The primary treatment for breast cancer is surgery with possible subsequent radiation therapy and chemotherapy. Following mastectomy all women in Sweden are offered a surgical breast reconstruction. This is an optional choice, but many women choose reconstruction in order to feel more feminine, more confident in their bodies and their sexuality, and as a more "whole" woman. It is mainly the younger and single women who chose to do a reconstruction. Purpose: This study examines the health related quality of life within women who did or did not undergo breast reconstruction, depending of choice, age and how they experienced the healthcare support. Method: Qualitative interview study with seven women who participated in the study. The interview contained eight open questions concerning psychosocial situation related to body image, sexuality, decision-making and support needs. The interviews were recorded, transcribed and analysed with Graneheim- and Lundmans content analysis. Results: The analysis from the transcript was categorized into 2 groups: Quality of life and the breastcancer surgery. These two groups were divided into psychic health, body image, psychosocial health, and experience of the health care and the choice of reconstruction. Both the women who chose to do the reconstruction and those who do not, rate their health related quality of life as high. The women who underwent reconstruction rated their quality of life higher after the reconstruction than before. The decision regarding reconstruction was based on personal thoughts, and women who did not do reconstruction wished to focus on wining their fight against cancer and that thought that breast reconstruction was a major surgery with a high risk of complications. Decision about reconstruction was based on feeling truncated without breasts and with the new breast they feel feminine and whole again. Conclusion: Whether the women have made a reconstruction or not they are satisfied with their individual choices and rate their quality of life as high. The women also have experienced the communication to health care staff as good, but they even experience a huge need for follow-ups. / Hälsorelaterad livskvalitet och psykosocial situation bland kvinnor från olika kulturer efter bröstcancerkirurgi med eller utan rekonstruktion.

This study assesses generic and disease-specific Health-Related Quality of Life (HRQOL) in children and adolescents with Inflammatory Bowel Disease (IBD). More specifically, the purpose of the study is to address the relationship between disease- specific indicators, both on a symptom-by-symptom basis and as a whole, to overall HRQOL. Self- and proxy-report versions of the Pediatric Quality of Life Inventory™ (PedsQL™) Generic Core Scales and the newly developed Pediatric Quality of Life Inventory™ Gastrointestinal Symptoms Module were administered to 187 parent-child dyads at ten study sites across the United States. Disease-specific indicators included: stomach pain, stomach upset, trouble swallowing, heartburn and reflux, gas and bloating, constipation, and diarrhea. It was hypothesized that caregiver- and child-reported disease-specific HRQOL would be positively correlated with generic HRQOL, and that physical disease-specific indicators would contribute the greatest variance in total generic HRQOL scores, for both self and proxy report. Results confirmed the hypothesis that disease-specific HRQOL would be positively correlated with generic HRQOL for children and caregivers. Multivariate regression results revealed that the Stomach Pain and Hurt, Worry, Medicines, and Communication scales contributed the most variance to overall HRQOL scores for children. The same analysis performed for parent ratings yielded one statistically significant scale: Worry. In essence, intervention efforts aimed at reducing the influence of worry and anxiety may prove more effective in improving HRQOL outcomes than interventions targeting reduction of physical symptoms.

BAKGRUND: Schizofreni är en allvarlig psykiatrisk sjukdom som innebär ett stort lidande för den drabbade. Sjukdomen kan leda till symtom så som hallucinationer, förvrängd verklighetsuppfattning, apati och tillbakadragenhet. Sammantaget innebär detta att patienter med schizofreni skattar sin Quality of Life lägre än genomsnittspopulationen. SYFTE: Syftet med litteraturöversikten var att belysa vilka faktorer som påverkar Quality of Life hos personer med diagnosen schizofreni och som behandlas i öppenvården. METOD: Undersökningen genomfördes som en litteraturöversikt. Tio vetenskapliga artiklar som stämde överens med studiens syfte ingick, de granskades kvalitémässigt och genomgick en strukturerad analys. RESULTAT: De identifierade faktorer som påverkade Quality of Life hos personer med schizofreni delades in i tre huvudkategorier som var synonyma med Anontonvskys KASAMbegrepp: begriplighet, hanterbarhet och meningsfullhet. Som underkategorier till dessa begrepp identifierades följande underkategorier: Positiva symtom, den kognitiva förmågan, den psykosociala situationen, att ha kontroll över vardagen, fysisk hälsa, stöd från vården och livsglädje och optimism. Sammanfattningsvis visar artiklarna att de tre huvudkategorierna identifierar områden där patienterna har en låg funktionsgrad. De sju underkategorierna identifierar i sin tur områden som direkt eller indirekt påverkar patientens Quality of Life. SLUTSATS: Sjuksköterskan kan på egen hand eller tillsammans med andra yrkeskategorier inom vården stärka Quality of Life hos personer med schizofreni, dels genom motiverande samtal men också genom samordnade insatser mellan olika samhällsaktörer. KLINISK BETYDELSE: Personer med schizofreni upplever socialt utanförskap, brist på sysselsättning och isolering som faktorer som påverkar deras livssituation negativt. Som vårdgivare är det av största vikt att möta patienten i dess upplevda problem för att få ett positivt behandlingsresultat. / BACKGROUND: Schizophrenia is a serious psychiatric illness, which entails great suffering for the person afflicted. The illness may cause symptoms such as hallucinations, a distorted sense of reality, apathy and reclusiveness; in effect causing the schizophrenic patient to evaluate his or her Quality of Life as being lower than the average persons. PURPOSE: The purpose of the literature review, was to highlight which factors affect Quality of Life, for schizophrenic patients in outpatient care. METHOD: The study was carried out as a literature review. Ten scientific articles, well suited for the purpose of this paper, were critically reviewed and structurally analyzed. RESULT: The identified factors, influencing Quality of Life for patients suffering from schizophrenia, were divided into three main categories, synonymous with Antonovsky's concept of KASAM: comprehensibility, manageability and meaningfulness. Furthermore, seven concepts were identified as constituting subcategories: positive symptoms, the psychosocial situation, maintaining control of ones everyday life, physical health and support from health facilities and exuberance and optimism. In summary, the articles studied show that the three main categories identify areas, in which the patients are low functioning. The seven sub-categories in their turn identify areas that directly or indirectly affect the patients' Quality of Life. CONCLUSION: The nurse can improve Quality of Life in individuals diagnosed with schizophrenia, either on her own, or in collaboration with other professionals in the health care sector. This can be achieved through motivational talks, but also through coordinated efforts between various social actors. CLINICAL SIGNIFICANCE: Patients suffering from schizophrenia, perceive exclusion in the social arena, a lack of pursuit and/or employment and general isolation as factors negatively affecting their lives. Thus the ability of caregivers, to meet the perceived problems and needs of the patient, is paramount when striving for a positive outcome of treatment.

Background Health-related quality of life (HRQoL) measures have become important when determining health priorities, but only five longitudinal studies limited to older adults and/or to subjects with an oral disadvantage have investigated the association between routine dental care and HRQoL. The aims in this study were to determine if dentist visiting or the volume, complexity and cost of general dental care, and baseline oral HRQoL and treatment need were associated with changes in HRQoL, and/or modify the impact of dental care on changes in HRQoL. Methods The project was an observational prospective cohort study of a sample of randomly selected dentate adult Tasmanians surveyed in 2006 and followed over a one-year period. The collection procedures comprised a computer-assisted telephone interview, an oral epidemiological examination, a baseline mail self-complete questionnaire, a service use log book, and a twelve-month mail self-complete questionnaire. Change in HRQoL was measured by change in the summary measure of the Oral Health Impact Profile (OHIP-14 severity) and change in the EuroQol index (EQ-5D), global oral and general transition statements, and follow-up OHIP-14 severity. Results From 1,745 eligible household numbers, 59.7% were interviewed, of whom 43.7% received epidemiological examinations. Of those, over three-quarters (77.4%) completed the baseline mail questionnaire. Nearly three-quarters of those who completed the baseline self-complete questionnaires completed the twelve-month follow-up questionnaire (73.5%). More than half of the respondents (53.8%) visited a dental practitioner, the vast majority of whom (94.9%) saw a private sector dentist. The most common types of dental care received were diagnostic, preventive and restorative services When the dependent variable was change in mean OHIP-14 severity, visiting a dentist was associated with a statistically significant worsening of oral HRQoL after adjusting for confounders. In contrast, visiting a dentist was associated with a significant improvement in quality of life when the dependent variable was the global oral health transition statement, although that association was not homogeneous. The global general health transition statement showed an unfavourable association of dental visits, although it was not statistically significant. Follow-up OHIP-14 dental attendance was associated with worsening QoL, although the association was not statistically significant. When change in HRQoL was measured by the global general health transition statement, high compared to low volume of dental care had a statistically significant favourable influence on HRQoL, although there was effect modification. With the global oral health transition statement, high complexity dental care was associated with a statistically significant worsening of HRQoL, while high cost dental care was associated with a statistically significant improvement of HRQoL. Across all measures of HRQoL, the survey participant factors most often subject to effect modification where those related to socio-economic status, particularly education and occupation. Conclusions The results varied according to which dependent measure of change in HRQoL was used. Dental care had a differing effect on general health compared to oral health, although the effects on general health varied considerably among some population groups. Researchers need to devise consistent definitions of health, HRQoL, oral health and oral HRQoL. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1375110 / Thesis (Ph.D.) - University of Adelaide, School of Dentistry, 2009

Until recently, long-term effects of a critical illness (CI) have received little attention from intensive care staff, who have traditionally measured outcome from an intensive care unit (ICU) by morbidity and mortality. However, it is now acknowledged that CI is a continuum that begins before ICU and continues to impact on a patient�s quality of life after they have been discharged home. Measuring health related quality of life (HRQOL) is a complex matter due to its multifaceted, subjective and dynamic nature. There has been a lack of consensus in the literature regarding the most appropriate methodological approaches and measuring instruments to use. This disparity has impeded comparison between studies. The aim of this thesis was to review the literature between January 1998 and December 2003 that focused on HRQOL for patients after a CI to identify and summarise themes and key outcomes. There were two main areas of focus - the methods used to measure the effects of the CI, and evaluation of the patient outcomes. An electronic search for relevant articles was conducted using the common clinical research databases and key words such as health related quality of life, outcomes and critical illness. Reference lists from these articles and conference proceedings were reviewed to identify further studies. There were 74 primary papers identified that reflected a number of subcategories including general ICU, Acute Respiratory Distress Syndrome (ARDS), and elderly patients. There were four categories of instruments used in the literature including those that measured acuity of illness, physical functioning, psychological functioning and HRQOL. The majority of studies used more than one measuring instrument, most of which had been previously validated. Results from the studies were diverse, but it is apparent that physical and psychological recovery from a CI may be a slow and varied process. Most studies were observational; only one randomised control study examined the benefits of a physical exercise program for patients post-hospital discharge. In general, there was no evidence of how to translate the study findings into some form of structured program to assist the patient with any identified problems. To enhance continuum of care, integration of ICU, hospital and rehabilitation services could target identified physical and psychological problems to assist patient recovery. However, strong evidence on the benefits of initiatives such as inpatient follow-up, outpatient clinics and use of ICU diaries is yet to be demonstrated.

Background Health-related quality of life (HRQoL) measures have become important when determining health priorities, but only five longitudinal studies limited to older adults and/or to subjects with an oral disadvantage have investigated the association between routine dental care and HRQoL. The aims in this study were to determine if dentist visiting or the volume, complexity and cost of general dental care, and baseline oral HRQoL and treatment need were associated with changes in HRQoL, and/or modify the impact of dental care on changes in HRQoL. Methods The project was an observational prospective cohort study of a sample of randomly selected dentate adult Tasmanians surveyed in 2006 and followed over a one-year period. The collection procedures comprised a computer-assisted telephone interview, an oral epidemiological examination, a baseline mail self-complete questionnaire, a service use log book, and a twelve-month mail self-complete questionnaire. Change in HRQoL was measured by change in the summary measure of the Oral Health Impact Profile (OHIP-14 severity) and change in the EuroQol index (EQ-5D), global oral and general transition statements, and follow-up OHIP-14 severity. Results From 1,745 eligible household numbers, 59.7% were interviewed, of whom 43.7% received epidemiological examinations. Of those, over three-quarters (77.4%) completed the baseline mail questionnaire. Nearly three-quarters of those who completed the baseline self-complete questionnaires completed the twelve-month follow-up questionnaire (73.5%). More than half of the respondents (53.8%) visited a dental practitioner, the vast majority of whom (94.9%) saw a private sector dentist. The most common types of dental care received were diagnostic, preventive and restorative services When the dependent variable was change in mean OHIP-14 severity, visiting a dentist was associated with a statistically significant worsening of oral HRQoL after adjusting for confounders. In contrast, visiting a dentist was associated with a significant improvement in quality of life when the dependent variable was the global oral health transition statement, although that association was not homogeneous. The global general health transition statement showed an unfavourable association of dental visits, although it was not statistically significant. Follow-up OHIP-14 dental attendance was associated with worsening QoL, although the association was not statistically significant. When change in HRQoL was measured by the global general health transition statement, high compared to low volume of dental care had a statistically significant favourable influence on HRQoL, although there was effect modification. With the global oral health transition statement, high complexity dental care was associated with a statistically significant worsening of HRQoL, while high cost dental care was associated with a statistically significant improvement of HRQoL. Across all measures of HRQoL, the survey participant factors most often subject to effect modification where those related to socio-economic status, particularly education and occupation. Conclusions The results varied according to which dependent measure of change in HRQoL was used. Dental care had a differing effect on general health compared to oral health, although the effects on general health varied considerably among some population groups. Researchers need to devise consistent definitions of health, HRQoL, oral health and oral HRQoL. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1375110 / Thesis (Ph.D.) - University of Adelaide, School of Dentistry, 2009

Thesis (D.Phil (Sociology))--University of Pretoria, 2007. / Includes bibliographical references. Available on the internet via the World Wide Web.

Thesis (Ph. D.)--West Virginia University, 2009. / Title from document title page. Document formatted into pages; contains viii, 116 p. : ill. (some col.). Includes abstract. Includes bibliographical references (p. 75-87).

Thesis (Ph. D.)--West Virginia University, 2007. / Title from document title page. Document formatted into pages; contains xvi, 354 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 243-262).