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.

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

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).

Thesis (D.P.H.)--University of Michigan.

Thesis (M.S.)--University of Michigan, 1990.

Thesis (M.S.)--University of Michigan, 2000. / Running title: Measurement of quality-of-life in heart failure. Includes bibliographical references.

Thesis (doctoral)--Lund University, 1997. / Added t.p. with thesis statement inserted. Includes bibliographical references.