Thesis (M. Med. Sc.)--University of Hong Kong, 2001. / Includes bibliographical references (leaves 45-47).

Thesis (M.Med.Sc.)--University of Hong Kong, 2001. / Includes bibliographical references (leaves 45-47). Also available in print.

Quality of life (QoL) questionnaires have been suggested as the most appropriate way to measure the effectiveness of low vision rehabilitation. However, several research studies have not been able to detect differences in effectiveness between rehabilitation strategies. The hypothesis of this study is that there are other factors, unrelated to vision, influencing the scores obtained in these questionnaires and masking the changes achieved by rehabilitation. The suggestion is that patients' realistic acceptance of, and successful adaptation to, their visual loss is influenced by psychosocial factors such as; personality, religious beliefs, social support, general health (i.e. mental and physical), understanding of their eye condition, level of education, and financial status. Concurrently, a parallel study was conducted with children. As with the adult arm, the aim of the study was to understand whether quality of life, and social behaviour and relationships in children with a visual impairment were related to the vision loss, vision rehabilitation, or non-visual factors. Patients attending the Manchester Royal Eye Hospital low vision clinic between May 2009 and August 2010, were recruited: 448 patients between 18 and 96 years old, with best-corrected binocular visual acuity smaller or equal to6/18, and 62 children between 5 and 16 years old. Telephone delivery of previously validated questionnaires was used with adult patients and parents of child patients; face-to-face interviews were completed by children. Both studies showed how psychosocial factors were stronger determinants of quality of life in people with low vision, than traditional low vision rehabilitation using optical aids. In the case of adults, physical and mental health appeared to be major predictors of quality of life, adaptation to the vision loss and participation restriction. In the case of children, visual acuity at distance and near, contrast sensitivity (CS), age, and parents' coping strategies appeared to determine quality of life and children behaviours. The final element of this work was a pilot study to attempt to address issues causing poor quality of life. Seventy-one participants who scored low in the Low Vision Quality of Life Questionnaire (LVQOL-25) (i.e. below 62.5) were given the opportunity to enrol for the Expert Patient Programme, which is a self-management programme aimed at adults with chronic health problems or disabilities. Only 2 participants expressed an interest in the programme, and none of them actually took part.

Diss. (sammanfattning) Linköping : Univ., 2003. / Härtill 6 uppsatser.

Diss. (sammanfattning) Umeå : Univ., 2007. / Härtill 5 uppsatser.

Thesis (D.P.H.)--University of Alabama at Birmingham, 2008. / Title from first page of PDF file (viewed Sept. 16, 2008). Includes bibliographical references (p. 89-99).

Thesis (M.S.)--University of South Florida, 2009. / Title from PDF of title page. Document formatted into pages; contains 56 pages. Includes bibliographical references.

Diss. (sammanfattning) Uppsala : Uppsala universitet, 2008. / Härtill 4 uppsatser.

Orientador: Maria Jose D'Elboux Diogo / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Educação / Made available in DSpace on 2018-08-06T22:25:47Z (GMT). No. of bitstreams: 1 Falcao_FabianaConceicaodeOliveiraSantos_M.pdf: 1241878 bytes, checksum: 98a929778d4ecdf11274945217f53e3f (MD5) Previous issue date: 2006 / Resumo: Este estudo teve como objetivo geral investigar a qualidade de vida relacionada à saúde (QVRS) e incapacidade em idosos com dor lombar crônica. Fizeram parte deste estudo 92 idosos com dor lombar crônica atendidos em um centro de reabilitação. Os dados foram obtidos por meio da aplicação dos instrumentos de caracterização sociodemográfica e clínica; de avaliação da QVRS ¿ Medical Outcomes Study 36-item short-form healthy survey (SF-36); Brasil ROLAND-MORRIS (Brasil-RM) para avaliação da incapacidade; Escala Qualitativa de Dor (EQD) e Escala de Depressão Geriátrica (EDG-15). Foram realizadas as seguintes análises: descritiva; coeficientes de confiabilidade; análise de variância univariada (ANOVA) e multivariada (MANOVA); coeficientes de correlação de Pearson (r) e Sperman (rs); análise de regressão linear univariada e múltipla (stepwise); e Teste de Mann-Whitney. De acordo com a ANOVA, as variáveis que influenciaram diferentes dimensões do SF-36 foram: sexo, escolaridade, distúrbios do sono, duração do episódio atual da dor lombar, intensidade da dor e sintomas depressivos. Enquanto que na MANOVA somente as variáveis intensidade da dor e sintomas depressivos afetaram a QVRS dos idosos como um todo. As variáveis que tiveram significância na análise de regressão univariada foram faixa de idade, presença de distúrbios do sono, atividade física, duração do episódio atual há mais de um ano, parestesia, fraqueza muscular, rigidez matinal, intensidade da dor e sintomas depressivos. Destas variáveis as que juntas explicaram 36,5% da variabilidade dos escores do Brasil-RM, na análise de regressão múltipla foram: intensidade da dor; rigidez matinal; distúrbios do sono e sintomas depressivos. Houve correlação negativa significante de forte magnitude entre as dimensões capacidade funcional, aspectos físicos, aspecto emocional e Brasil-RM; estado geral de saúde, vitalidade, aspecto emocional, saúde mental e sintomas depressivos. Os resultados evidenciam que a QVRS e a incapacidade funcional dos idosos com dor lombar crônica estão correlacionados e são influenciados, principalmente, pela intensidade da dor e sintomas depressivos. Portanto, recomenda-se que sejam elaboradas intervenções voltadas para minimizar a dor lombar referida por estes idosos, bem como melhorar as outras variáveis relacionadas ao aumento da dor lombar destes sujeitos, visando otimizar a capacidade funcional e, conseqüentemente, a QVRS / Abstract: This study had the objective to investigate the health related quality of life (HRQL), and disabilities in elderly people with chronic low back pain. The participants were 92 elderly people with chronic low back pain who attended a rehabilitation center. The data were gathered through the administration of sociodemographic and clinical outcome measures; the evaluation of HRQL ¿ The Medical Outcomes Study 36-item short-form healthy survey (SF-36); Brazil ROLAND-MORRIS (Brazil-RM) for the evaluation of the disabilities; numerical pain rating scale (PS) and Geriatric Depression Scale (GDS). The following analyses were made: descriptive; coefficients of reliability; univariate (ANOVA) and multivariate (MANOVA); Pearson¿s correlation and Spearman¿s correlation coefficients; univariate and stepwise linear multiple regression analysis; and the Mann-Whitney test. According to ANOVA, the variables which influenced different dimensions of SF-36 were: gender, level of education, sleep disorders, duration of the current episode of low back pain, intensity of pain, and depressive symptoms. While in MANOVA only the variables intensity of pain and depressive symptoms affected the HRQL of the elderly people as a whole. The variables which were significant in univariate linear regression were age range, presence of sleep disorders, physical activity, duration of the current episode for more than one year, paresthesia, muscle weakness, morning stiffness, intensity of pain and depressive symptoms. The variables which explained 36.5% of the score variability of Brazil-RM, in the stepwise multiple linear regression were: intensity of pain; morning stiffness; sleep disorders and depressive symptoms. There was a significant negative correlation of high magnitude among the dimensions physical functioning, role-physical, role-emotional and Brazil-RM; general health, vitality, role-emotional, mental health and depressive symptoms. The correlation among Brazil-RM and intensity of pain and depressive symptoms, although significant, has a moderate magnitude. The results make evident that HRQL and the disabilities of the elderly people with chronic low back pain are correlated and are influenced mainly by intensity of pain and depressive symptoms. Therefore, it is recommended to elaborate interventions oriented to minimize the low back pain referred by these elderly people, as well as to improve the other variables related with the increasing of the low back pain of these subjects, aiming the optimization of functional capability and hence, the HRQL / Mestrado / Mestre em Gerontologia

En cancérologie, la qualité de vie relative à la santé (QdV) est considérée comme second critère de jugement principal dans les essais cliniques en l’absence d’effet sur la survie globale. L’interprétation des scores de QdV et d’une différence de scores cliniquement pertinente entre deux temps de mesure est un problème majeur en QdV. Cette différence peut être significative d’un point de vue statistique sans être cliniquement significative du point de vue du patient. La différence minimale cliniquement importante (DMCI) a ainsi été définie comme la plus petite différence de score de QdV qui serait considérée comme ayant un sens clinique pour le patient. L’analyse longitudinale de la QdV est complexe, en particulier en raison de l’occurrence de l’effet « Response Shift » qui est susceptible de biaiser les résultats d’analyse longitudinal et en particulier les résultats de la DMCI. Dans ce contexte, le premier objectif de ce travail de thèse est une revue de la littérature concernant la détermination de la DMCI selon les méthodes les plus couramment utilisées : les méthodes basées sur l’ancre et les méthodes basées sur la distribution. Deuxièmement, calculer la DMCI par les méthodes basées sur l’ancre et la distribution en appliquant différents critères de distribution et plusieurs ancres différentes. L’objectif est de comparer les résultats obtenus par les différentes méthodes et de les comparer également avec les résultats obtenus par les études antérieures. Enfin, étudier l’impact de l’occurrence de l’effet Response Shift sur la détermination de la DMCI pour les questionnaires de QdV en cancérologie. / In oncology, the health-related quality of life (HRQOL) is generally considered as a second endpoint in the clinical trials. The interpretation of the results of the longitudinal analysis of such data must be made in both statistical and clinical point of view in order to produce meaningful results for both patients and clinicians. The main objective is to assess the impact of the treatment on patient’s HRQOL level over time. The minimal clinically important difference (MCID) was defined as the smallest change between two scores in a treatment outcome that a patient would identify as important. Indeed, the longitudinal analysis of HRQOL remains complex, particularly due to the potential occurrence of a Response Shift effect characterizing the process of adaptation of the patient in relation to the illness and its treatment. Hence, the first objective of this work is a literature review concerning the determination of the MCID by the most commonly used methods: anchor-based and distribution-based methods. Secondly, calculating the MCID using anchor-based and distribution-based methods by applying different distribution criteria and several different anchors. The objective is to compare the results obtained by the different methods and to compare them to others obtained by previous studies. Finally, studying the impact of the Response Shift effect on the determination of MCID for the HRQOL questionnaires in cancer research using several data corresponding to different therapeutic situations and cancer locations.