Thesis (M. Nurs.)--University of Hong Kong, 2006.

Purpose: The relationship between severity of voiding dysfunction and quality of life in children with daytime wetting was analyzed. Materials and Methods: The relationship between age, gender, severity of voiding dysfunction (measured by DVSS) and quality of life (measured by PinQ) in the child with daytime wetting was analyzed. Twenty-four children (4 males, 20 females) aged 5-10 years (x 8.17 years, SD 1.37) and their parents completed the DVSS and PinQ. Results: Parent and child total DVSS and total PinQ Scores had similar results with only a significant mean difference between the parent total DVSS scores based on gender. Only Gender with Parental Total DVSS Score (r = 0.462, p = 0.023) and Child Total DVSS Score with Parent Total DVSS Scores (r = 0.472, p = 0.020) were significant correlations. Conclusions: Results illustrate the importance of early recognition and intervention to minimize the impact daytime wetting has on the child.

Women who are post surgery for breast cancer (BCa) experience distressing side effects that negatively influence Quality of Life (QoL). Physical activity (PA) following a BCa diagnosis is associated with decreased mortality, reduced recurrence, increased functional capacity, less fatigue, and may improve depression and QoL. Furthermore, evidence suggests that a combined PA and psychotherapy intervention may reduce physically and emotionally distressing side effects associated with diagnosis and treatment. The purpose of the study is to examine relationships among PA, fatigue, clinician-rated depression, depressed mood, and QoL in women after undergoing surgery for BCa and to assess the continuity of these relationships as they move through adjuvant treatment. In addition, the study investigates whether fatigue is an underlying psychosocial mechanism accounting for the effects of PA on study outcomes. Finally, given prior evidence that participation in a Cognitive-Behavioral Stress Management (CBSM) intervention was associated with reduced fatigue, the study assesses whether women who were physically active showed less fatigue above and beyond the effects of CBSM. Women (N=240) with non-metastatic stage 0-III BCa were recruited 2-10 weeks post-surgery and randomized to either a CBSM intervention group or a psycho-educational control group. Physical activity, fatigue, functional QoL, rated depression, and depressed mood were assessed at the baseline and 3-month post intervention time points. Structural equation modeling was used to test hypotheses. At baseline, results revealed that greater PA was associated with less fatigue-related daily interference (FRDI), and that less FRDI was associated with greater functional QoL, lower rated depression, and less depressed mood. Furthermore, lower FRDI was a pathway by which greater PA was associated with greater functional QoL, less rated depression, and less depressed mood. These relationships were similar at the 3-month post intervention time point and when difference scores were used in the model. Finally, PA contributed significantly to the change in FRDI above and beyond the effects of participation in CBSM. A combined PA and CBSM intervention may be effective in reducing FRDI, and improving depressive symptoms and QoL for women after surgery for BCa and during adjuvant treatment, and should be investigated in future studies.

This study examined the relationship between spirituality/religiousness and quality of life and the moderating effect of comorbid illness in a sample of 308 long-term cancer survivors who had received an initial primary cancer diagnosis of breast, prostate, colorectal, and Hodgkin's disease at least 5 prior to the beginning of the study. In addition to the self-report measures assessing the variable of interest, participants completed a set of socio-demographic items and several questions related to their cancer treatment at entry into the study (T1) and at a second assessment 12 months later (T2). Results showed that each spirituality/religiousness and comorbidity was significantly related to various aspects of quality of life at both time points of assessment. More specifically, spirituality/religiousness was significantly associated with greater cancer benefits, enhanced general quality of life, lower sexual dysfunction, but unexpectedly, greater family-related distress at T1. Similarly, comorbidity significantly related to more financial problems, worries about appearance, and pain at both time points. Greater comorbidity was also significantly associated with more sexual dysfunction and lower general quality of life at T1. Findings also provided supported for the moderating role of comorbidity on various domains of quality of life both concurrently (i.e., family-related distress and appearance concerns) and prospectively (i.e., family-related distress and pain). In some cases, the direction of the interaction effect was in the predicted direction such that greater spirituality/religiousness related to lower family-related distress (prospectively) and more appearance concerns (concurrently at T2) among survivors with a new comorbidity, for example. In other cases, the direction of the interaction was contrary to expectations, such that higher spirituality/religiousness was associated with greater family-related distress (concurrently at T1) and more pain (prospectively) among the group of survivors with greater comorbidity. Possible explanations for the apparently inconsistent findings are offered as well as recommendations for future research.

Thesis (M.S.)--University of Florida, 2003. / Title from title page of source document. Includes vita. Includes bibliographical references.

Thesis (Ph. D.)--Ohio State University, 2006. / Title from first page of PDF file. Includes bibliographical references (p. 71-87).

Thesis (M.S.N.)--University of North Carolina at Greensboro, 2006. / Title from PDF title page screen. Advisor: Donald Kautz; submitted to the School of Nursing. Includes bibliographical references (p. 32-34).

Older adults represent a growing part of the population of the United States. Due to decreased physical activity, dietary changes, and alterations in metabolic rate this population is susceptible to an increased rate of diseases. The generation entering older adulthood is one which welcomed fast food and meal replacement foods allowing them to adapt to a more sedentary lifestyle and to need programs of preventative health. The Nutrition and Life Satisfaction Survey was used to investigate gardening as a preventative health intervention for older adults. This instrument was used to compare older (age 50+) gardeners and nongardeners on their perceptions of personal life satisfaction, nutrition, health, and gardening habits. The instrument was posted online at the Aggie Horticulture website in spring 2005. Respondents differentiated themselves as gardeners or nongardeners by responding positively or negatively to the question “Do you garden?” Then, they completed the questionnaire about their quality of life andhealth status and, for gardeners, their gardening habits. Results indicated that gardeners had more desirable responses: Overall quality of life scores were higher for gardeners compared to nongardeners, and four individual quality of life statements yielded more positive answers by gardeners. Additionally, gardeners reported a higher consumption of total fruits and vegetables, including herbs, and of vegetables only including herbs. Personal reports of physical activity and of perceived health were higher among gardeners. Females were more likely than males to garden and spend a higher percentage of their budget on fruits and vegetables. Higher consumption of fruits and vegetables and higher levels of physical activity result in healthier lifestyles and, in turn, can increase quality of life.

Les cancers des voies aéro-digestives supérieures sont connus pour entraîner, par eux-mêmes et par leur traitement, une altération significative de la qualité de vie. Depuis le milieu des années septante, un grand nombre dauteurs ont étudié cette qualité de vie. De nombreux outils de mesure ont été fabriqués et le sujet occupe de plus en plus de place tant dans la littérature que dans les congrès scientifiques. Pourtant, jusquà présent, aucune étude importante ne sest penchée sur la perception quont les médecins de la qualité de vie de leurs malades souffrant dun cancer de la tête et du cou ainsi que sur les implications de cette « représentation» médicale. Nous proposons donc ici dessayer de pallier à ce manque et de présenter un travail sur une large population médicale. Lensemble de la population ORL belge ainsi que 3000 médecins traitants belges ont été contactés. Chacun dentre eux a reçu un questionnaire par la poste. Ce questionnaire, totalement anonyme, formulé dans la langue maternelle de chaque médecin (français ou néerlandais) avait pour but de recueillir de manière la plus précise possible des indications sur la perception des soignants. Ces questions portaient aussi bien sur la perception générale de la qualité de vie que sur les symptômes importants et sur les différents traitements habituellement utilisés en oncologie cervico-faciale. Une étude statistique sérieuse de ces réponses nous a conduits à appréhender de manière nettement plus scientifique cette problématique. Par ailleurs, nous nous sommes attachés à comparer dans la mesure du possible cette perception médicale avec ce que le patient pense vraiment de sa propre qualité de vie (sur base de la littérature scientifique existante). 245 ORL ont répondu à létude tandis que 506 généralistes faisaient de même. Lanalyse des réponses démontre que le monde médical accorde énormément dimportance à la qualité de vie. Cette attention portée à la qualité de vie paraît plus importante que chez les patients eux-mêmes. Les médecins sont très majoritairement prêts à sacrifier le pronostic en terme de survie pour maintenir une qualité de vie quils jugeraient plus acceptable. Sur base de la littérature, ceci va à lencontre de la volonté première du malade. Une moitié des médecins répondeurs reconnaissent ne pas présenter dempathie pour leur malade cancéreux. Il transparaît que les soignants perçoivent la qualité de vie liée à un cancer des voies aéro-digestives supérieures comme étant moins bonne que pour dautres localisations néoplasiques. Probablement pour cette raison, ils pensent très majoritairement quune prise en charge psychologique est indispensable pour de tels patients. Ils pensent également de manière générale que leur façon daborder le patient peut indirectement influencer sa qualité de vie. Pour les médecins, tous les symptômes nont pas la même importance en terme de qualité de vie. La douleur joue, pour eux, un rôle prépondérant. Elle est suivie dans lordre par la respiration, lalimentation, la voix et finalement lapparence physique. Des différences interculturelles ont été retrouvées notamment pour la voix et lalimentation. Les médecins perçoivent également différemment les traitements habituellement utilisés en oncologie cervico-faciale sur base de la qualité de vie quils peuvent offrir aux patients traités. La radiothérapie est clairement mieux perçue que la chirurgie. La chimiothérapie offre la moins bonne qualité de vie post-thérapeutique aux yeux de nos confrères. Ces différences ne semblent pas sappuyer sur des éléments cliniques solides quand on se place du côté des patients (sur base de la littérature). Il est important de remarquer également que bien que le médecin traitant souhaite participer à la décision thérapeutique, il se sent sous informé quant aux cancers des voies aéro-digestives et à la qualité de vie résiduelle. En conclusion, nous pouvons affirmer que le médecin considère la qualité de vie du malade comme un point essentiel dans sa prise en charge et est prêt à sacrifier partiellement la survie pour préserver la qualité de vie. Ceci doit ouvrir un débat éthique important et doit nous amener à une question fondamentale : « Sachant que notre représentation de soignant diffère autant de celle du patient tant du point de vue de la qualité de vie que du but principal du traitement, sommes-nous autorisés à imposer notre perception de la maladie et de ses effets dans le choix thérapeutique? ». Par ailleurs, sur base de nos résultats, il serait judicieux que les spécialistes cervico-faciaux puissent mieux informer leurs collègues sur le cancer de la tête et du cou ainsi que sur la qualité de vie résiduelle.

This thesis focuses on the role of different psychosocial factors in the course of pain over time in a general population sample of women in Sweden. The main aim was to identify and quantify such factors as predictors of pain, pain-related disability and quality of life within a biopsychosocial framework for the understanding of the pain experience over time.  The studies were based on baseline (BL) and follow-up (FU) measures with 12 months apart among 2,300 women living in Sweden, and included physical and psychological health and socio-economic status. Study I investigated associations between socio-economic status (SES) at baseline and pain and pain-related disability at follow-up, and additionally a possible mediating role of depressive symptoms in such associations. The results indicated that educational level, financial strain and occupational level were associated with pain over time. Symptoms of depression were related to all pain-and SES factors, and might be understood as a mediating factor within this context. The results of Study II showed a link between symptoms of burnout at baseline and several pain-locations. Additionally, among women with pain, the characteristics of the pain experience and pain-related disability were associated with level of burnout over time. Study III focused on the sub sample of women reporting pain at follow-up, and examined possible predictors of their perceptions of quality of life (QOL). Several psychosocial factors were associated with QOL, and seemed to be more important predictors than the characteristics of pain in terms of intensity and frequency. These factors were burnout, emotional distress, and social support. Study IV was an attempt to sum up the results of the previous studies by analysing predictors of the course of pain, i.e. by comparing women that developed pain from BL to FU with those that remained pain-free and to compare women with sustained pain with those who recovered from pain during the assessment period. These analyses showed symptoms of posttraumatic stress (PTSD) to be associated with reporting emerging pain, while pain variables, educational level and social support were related to sustained pain. The results of the four studies in this thesis indicate that psychosocial factors and their interplay with the characteristics of pain can be identified and described in a female sample, with a broad definition of pain, and that these factors play a central role in the experience of pain and its impact on the everyday life of these women. There may be several possible paths leading to the development of persistent pain among women and the identification of risk factors is complicated by never-ending interactions between biological, psychological and social processes. At an early stage, prior to pain development, several risk factors may cluster together (e.g. SES, depression), and work as indicators of, e.g. dysfunctional coping in relation to pain. In the first contact with health care and among primary care personnel the identification of such indicators is crucial so as to find women at risk for prolonged pain conditions. General indicators might then be more easily distinguishable than certain individual behaviour characteristics widely accepted as risk factors for pain and disability (e.g. fear-avoidance). To spread the knowledge of general factors in the first line of health care is therefore of great importance in preventive work. Finally, the results demonstrated that many women report pain with characteristics that to a great extent affect their lives and through interactions with psychological and social health might have grave consequences for perceptions of quality of life.