Psychosocial factors affect the occurrence of coronary artery disease (CAD) disease and development of complications. People with depression or anxiety symptoms have the activate hypothalamic-pituitary-adrenal axis. Thyroid hormone changes are also found in patients with CAD. Fatigue and health-related quality of life (HRQoL) depends not only on good physical health, but also on psychoemotional state, especially on the presence of depression and anxiety disorders. Therefore, it is important to evaluate complex of hormonal markers and behavioral factors (depression, anxiety and fatigue) interaction on patients with CAD for quality of life, disease course and outcome. The aim of this study was examine relationship of cortisol and thyroid axis hormones concentrations with NT-pro B type natriuretic peptide (NT-proBNP) concentrations and with patient oriented outcomes such as depressive symptoms, fatigue and HRQoL in CAD patients. Study demonstrates relationship between thyroid axis hormones and cortisol concentrations with depression, anxiety symptoms, fatigue and HRQoL in CAD patients. Low T3, free T4 and higher RT3 concentrations are associated with higher NT-proBNP levels, depression symptoms, higher fatigue and worse HRQoL. Higher morning cortisol concentrations are associated with depression symptoms in women. The data obtained can be used in patients with coronary artery disease and depressive anxiety disorder, disease progression, and prognosis and quality of life... [to full text] / Psichosocialiniai veiksniai turi įtakos išeminės širdies ligos (IŠL) vystymuisi ir komplikacijų atsiradimui. Depresijos ir nerimo patogenezėje dalyvauja pagumburio-hipofizės-antinksčių ašis. Skydliaukės hormonų pokyčiai taip pat dažnai randami sergantiesiems IŠL bei depresija. Nuovargis ir su sveikata susijusi gyvenimo kokybė priklauso ne tik nuo geros fizinės sveikatos, bet ir nuo psichoemocinės būklės, todėl svarbu kompleksiškai įvertinti hormoninių žymenų ir elgesio veiksnių (depresijos, nerimo ir nuovargio) sąveikos įtaką sergančiųjų IŠL gyvenimo kokybei, ligos eigai bei baigtims. Šio tyrimo tikslas buvo išnagrinėti kortizolio ir skydliaukės ašies hormonų koncentracijų ryšį sergantiesiems IŠL su N-galinio smegenų tipo natriuretinio propeptido (NT-proBNP) koncentracija bei subjektyviomis sveikatos būklėmis: depresijos, nerimo simptomais, nuovargiu ir su sveikata susijusia gyvenimo kokybe. Tyrimas parodė skydliaukės hormonų ir kortizolio koncentracijų reikšmingą ryšį su subjektyviu sveikatos vertinimu sergantiesiems IŠL. Mažesnė bendrojo T3, laisvojo T4 ir didesnė reversinio T3 koncentracija susijusi su didesne NT-proBNP koncentracija, depresijos simptomų pasireiškimu, didesniu nuovargiu ir blogesniu su sveikata susijusios gyvenimo kokybės vertinimu. Didesnė rytinio kortizolio koncentracija susijusi su depresijos simptomų pasireiškimu moterims. Gauti duomenys gali būti panaudoti sergančiųjų IŠL depresijos bei nerimo simptomams, ligos eigai, prognozei ir gyvenimo kokybei... [toliau žr. visą tekstą]

Nugaros skausmas gydomas taikant kompleksines reabilitacijos priemones, tačiau ir po jų taikymo kai kuriem pacientams išlieka vidutinio intensyvumo skausmas ir gyvenimo kokybė pagerėja ne visose srityse. Šio darbo tikslas yra nustatyti, kuriose sveikatos srityse po sėkmingo II reabilitacijos etapo įveikimo, išlieka tam tikri apribojimai ir nustatyti individualios kineziterapijos programos poveikį su sveikata susijusiai gyvenimo kokybei ir skausmo intensyvumui. / Back pain is treated through complex rehabilitation measures, however, some of health indicators remains unchanged. The goal of this study is to determine which health indicators remains impaired at the end of 2nd stage of rehabilitation, and to determine the effectiveness of individual physical therapy programme for quality of life and pain intensity.

Malgré un intérêt grandissant pour la question du devenir des survivants de tumeur cérébrale pédiatrique, l’évaluation de leur équilibre est souvent négligée. Les objectifs de nos travaux étaient de 1) examiner les écrits portant sur l’équilibre chez les survivants de tumeur cérébrale pédiatrique; 2) comparer l'équilibre debout et la qualité de vie entre les survivants et un groupe d’enfants témoins; et 3) examiner l'association entre l'équilibre debout et qualité de vie chez les survivants. Notre recension des écrits démontra que les survivants de tumeur cérébrale présentent des troubles de l’équilibre, mais les limites méthodologiques des études nous empêchent de conclure de manière définitive. Ensuite, nous avons recruté un groupe d’enfants survivants d’une tumeur cérébrale de la fosse postérieure et un groupe d’enfants sains. Leur équilibre était évalué à l’aide du Bruininks-Oseretsky Test of Motor Proficiency-2nd edition (BOT-2) et du Pediatric Balance Scale (PBS). Certains participants ont aussi été évalués avec une plate-forme de force où les limites de stabilité étaient documentées. Finalement, tous les enfants et leurs parents remplissaient le Pediatric Quality of Life Inventory (PedsQL4.0). Nos résultats démontrent que les survivants présentent une diminution de l’équilibre mise en évidence par le BOT-2, mais que leur qualité de vie est similaire aux enfants sains. La performance au BOT-2 est associée à la dimension physique du PedsQL4.0, suggérant une relation entre l’équilibre et la qualité de vie. Nos résultats suggèrent qu’une évaluation de l’équilibre pourrait être bénéfique chez cette clientèle afin de mieux cerner ses besoins de réadaptation. / There is growing interest in studying outcomes in survivors of pediatric brain tumours. Physical outcomes, especially balance abilities, are less investigated. Objectives of this thesis are to: 1) examine the literature for balance outcomes in survivors of pediatric brain tumours, 2) compare standing balance and health-related quality of life (HRQOL) between survivors of pediatric posterior fossa brain tumours (PFBT) and typically-developing controls and 3) explore the association between balance and HRQOL. A comprehensive review demonstrated that although the literature suggests that survivors of pediatric brain tumours display ongoing balance deficits, studies have limitations, emphasizing the need for further research. Survivors of pediatric PFBT and typically-developing children were recruited and their balance assessed with the Bruininks-Oseretsky Test of Motor Proficiency-2nd edition (BOT-2) and Pediatric Balance Scale (PBS). Dynamic balance was also evaluated for some participants using a force platform. The Pediatric Quality of Life Inventory measured HRQOL. Statistical analyses included Mann-Whitney U tests to compare results between groups and Spearman's rank correlation coefficient to determine the association between balance and HRQOL. Balance abilities were significantly worse in survivors as measured by the BOT-2. The PBS displayed a ceiling effect. Certain laboratory outcome measures suggested balance difficulties. All participants’ HRQOL scores were within normative values. In survivors, an association was found between BOT-2 scores and the physical dimension of HRQOL. Survivors of PFBT demonstrate persistent balance difficulties, best assessed by the BOT-2; however, they report normal HRQOL. Future research should be collaborative and focus upon the best ways to manage balance deficits.

The purpose of this study was to understand the factors that encourage midlife women to make exercise and dietary changes, the prevalence of those changes, the process by which women make them, the factors that support or impede them, and how we can enhance women’s capacity to make health behaviour changes in midlife. Since the literature highlighted the importance of self-efficacy in changing health behaviour, and of health-related quality of life as a widely recognized measure of women’s mental and physical wellbeing, the study sought to understand the relationship between exercise and dietary self-efficacy, health behaviour change and health-related quality of life (SF-36), by testing a modified version of Bandura’s 1977 and 2002/2004b models of self-efficacy. The methodology involved postal surveys as well as semi-structured interviews with a subsample of the women who completed the survey. Surveys were sent to 866 women aged 51-66 years from rural and urban locations in Queensland, Australia. Five hundred and sixty-four (69%) were completed and returned. Survey data was analysed using descriptive and bivariate statistics and structural equation modeling. Thematic analysis was used to analyse interviews. The results confirmed that midlife is a significant time for women to make positive health behaviour changes. Almost 40% of women made a change to their exercise and around 60% made a dietary change since turning 40. The main exercise change was doing more walking and the most common dietary change was reducing fat intake. Self-efficacy was shown to be a key influence on whether women made positive changes to their health in midlife. In the relationship between health behaviour change and health-related quality of life, making a positive change to exercise was significantly related to physical but not mental health, and making a dietary change was not related to either physical or mental health. Body mass index was shown to be an important influence on both self-efficacy and health-related quality of life (particularly physical health). Interviews were conducted with 29 of the participants. Interview data reinforced that the main motivations to make a positive health behaviour change among midlife women were being overweight, having an injury or being diagnosed with an illness or health condition. Witnessing the hardship experienced by others with a degenerative disease could also prompt a positive behaviour change. Successful changes mainly involved modifying existing practices and repeating new behaviours until they became part of the daily routine. The main facilitators of health behaviour change were having positive role models, having more time due to retirement, and having support from significant others (such as husbands), health professionals and organizations such as Weight Watchers. The main obstacles to making changes were work, care giving, illness and injury. Bandura’s (1977, 2000/2004b) model was partially supported, but the cross-sectional nature of the study may have been a limitation in demonstrating all aspects of the self-efficacy process. In summary, women are willing to make positive health behaviour changes in midlife, but they need education and support to have those changes be effective. It is anticipated that this research will lead to a greater understanding of the significance of midlife as a time for making healthy lifestyle changes that have the potential to improve women’s health and quality of life in later years.

Made available in DSpace on 2015-05-14T12:56:00Z (GMT). No. of bitstreams: 1 Arquivototal.pdf: 12440507 bytes, checksum: 4c602610a4947af78ebd9048d453e0e8 (MD5) Previous issue date: 2004-09-20 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This study had two objectives. The main objective was to evaluate the association of the impact of temporomandibular disorders (TMD) on oral health related quality of life to the psychosocial and psychological factors. The specific objective was to validate the Portuguese version of Axis II questionnaire to Research Diagnostic Criteria for TMD (RDC/TMD) as preconized by Dworkin and LeResche at 1992. The sample was compounded by 156 patients, with TMD, who attempted at Orofacial Pain Control Center School of Dentistry of Pernambuco University, from July 2003 to February 2004. Data collection was done by the author using the following instruments: Simplified Anamnesis Index DMF for screening patients with TMD; RDC/TMD Axis I to evaluated clinically and to classify TMD and Axis II to evaluate psychosocial and psychological factors; the specific questionnaires to evaluated oral health related to quality of life, OIDP and OHIP-14. Two different types of studies were conducted: validation study and cross sectional study. The validation study consisted on the evaluation of internal consistence by alpha Crombach reliability test; reliability and reproducibility estimated by Kappa statistics and by Spearman correlation and also concurrent validity (Spearman). For the transversal study, one has used Kruskall Wallis to test OIDP and ANOVA to test OHIP-14. The Portuguese version for Axis II of RDC/TMD was considered consistent (Crombach a=0,72), reliable (Kappa 0,73-0,91; p<0,01) and valid (p<0,01). According to transversal study, among the variables for sample characterization, the impact on oral health related qualify of life was statistical associated to sex and scholarship, this factor exclusively for OHIP-14. On Axis I, using OIDP, the impact was associated to groups I and II, muscle and joint disorders, respectively. While for OHIP-14, only for group I (muscle disorders) the association was detected. On Axis II, psychological factors, as depression and somatization (inespecific organic symptoms with or without pain) and psychosocial factor of disability and pain were statically associated to the impact of oral health related quality of life, according to evaluation with OIDP and OHIP-14. The validity of Axis II of RDC/TMD followed the methodology proposed at the literature and showed reproducbility and validity for brazilian population. Temporomandibular disorders and psychosocial and psychological factors produced an important impact on oral health related quality of life, associated to psychosocial and psychological factors associated and proportional to their intensity. / O presente estudo teve dois objetivos. O objetivo geral foi avaliar a associação entre o impacto da disfunção temporomandibular (DTM) na qualidade de vida relacionada à saúde bucal, e os fatores psicossocial e psicológicos. O objetivo específico foi realizar a validação da versão em português do questionário Eixo II dos Critérios Diagnósticos de Pesquisa em DTM (RDC/TMD), preconizado por Dworkin e LeResche, em 1992. A amostra foi composta por 155 pacientes portadores de DTM que procuraram atendimento no Centro de Controle da Dor Orofacial da Faculdade de Odontologia da Universidade de Pernambuco no período de Julho de 2003 a Fevereiro de 2004. Para a coleta de dados foram utilizados os seguintes instrumentos: Índice Anamnésico Simplificado DMF para a triagem dos pacientes com DTM; RDC/TMD: Eixo I para avaliação clínica e classificação da DTM, e Eixo II para avaliação psicossocial e psicológica e os questionários específicos para avaliação da qualidade de vida relacionada à saúde bucal OIDP e OHIP-14. Foram realizados dois tipos de estudo: estudo de validação e transversal. O estudo de validação constou da avaliação da consistência interna pelo teste de confiabilidade alfa Crombach; confiabilidade e reprodutibilidade, estimada pela estatística Kappa e correlação de Spearman e validação concorrente (Spearman). No estudo transversal, para o OIDP, utilizouse o teste Kruskal-Wallis e para o OHIP-14 o teste ANOVA. Os resultados revelaram que a versão em português Eixo II do RDC/TMD foi considerada consistente (Crombach=0,72); reprodutível (Kappa 0,73-0,91; p<0,01) e válida (p<0,01). No estudo transversal, dentre as variáveis de caracterização amostral, o impacto da qualidade de vida relacionado à saúde bucal foi estatisticamente associado com gênero e escolaridade, sendo este último fator apenas evidenciado quando da utilização do OHIP-14. No Eixo I, usando o OIDP, o impacto teve associação com os grupos I e III, de desordem muscular e articular, respectivamente; com o OHIP-14, teve associação apenas para o grupo I (desordem muscular). No Eixo II, os fatores psicológicos, como depressão e somatização (sintomas físicos não específicos, com e sem itens de dor), e o fator psicossocial de incapacidade e intensidade da dor, foram estatisticamente associados ao impacto da qualidade de vida relacionado à saúde bucal, quando avaliados pelo OIDP e OHIP-14. Conclui-se que a validação do Eixo II do RDC/TMD seguiu metodologia proposta na literatura e mostrou-se reprodutível e válida para a população brasileira. A disfunção temporomandibular e os fatores psicossocial e psicológicos produzem importante impacto nos portadores de DTM, interferindo negativamente na qualidade de vida relacionada à saúde bucal, e este impacto também foi associado ao grau de severidade dos fatores psicossocial e psicológicos.

Bakgrund: För att halitosis ska tas på större allvar och för att de drabbade individerna ska få rätt sorts stöd är det av stor vikt att identifiera samt uppmärksamma halitosis eventuella effekter på livskvaliteten. Syftet: Syftet med studien var att identifiera och sammanställa kunskap kring halitosis eventuella effekter på upplevd livskvalitet med speciellt avseende på oralhälsorelaterad livskvalitet, social ångest och sociala relationer. Metod:Examensarbetet är en allmän litteraturstudie där systematiska och manuella sökningar användes för att finna artiklar. Resultat: Studiens resultat är baserat på 17 vetenskapliga originalartiklar. Gemensamt visar artiklarna en negativ korrelation mellan halitosis och oralhälsorelaterad livskvalitet, halitosis och social ångest eller halitosis och sociala relationer. Majoriteten av artiklarna visar att individer med halitosis anpassar sina sociala liv efter symptomet. Slutsats: Halitosis kan konstateras vara mer än bara dålig andedräkt. Genom att bland annat ha en negativ påverkan på en individs självförtroende kan halitosis leda till psykisk ohälsa i form av social ångest, försvårade sociala relationer och försämrad oral hälsorelaterad livskvalitet vilket kan påverka livskvaliteten. Det är därför av stor vikt att tandvårdspersonal beaktar den orala hälsan ur ett bredare perspektiv där halitosis kan uppmärksammas. / Background: In order for halitosis to be taken more seriously and for the affected individuals to receive the right kind of support, it is important to identify and pay attention to halitosis's possible effects on the quality of life. Aim:The aim of the study was to identify and compile knowledge about halitosis possible impact on perceived quality of life particulary regarding oral health related quality of life, social anxiety and social relationships. Method: The study was a general literature study where systematic and manual searches, in three different databases, were used to find articles. The selection of articles where made in three steps. Results: The study results is based on 17 scientific original articles. The articles mutually show a negative correlation between halitosis and oral health-related quality of life, halitosis and social anxiety or halitosis and social relationships. Conclusion:By affecting an individual's self- esteem, halitosis can lead to psychological distress in terms of social anxiety, impaired social relationships and impaired oral health related quality of life, which can affect the general quality of life. It is therefore at the utmost importance that dental professionals take oral health into account from a broader perspective where halitosis can be noted.

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Chronic disorders of the locomotion organs belong to serious civilization diseases deteriorating the quality of human life. Medical literature generally accepts the opinion that the way of life is responsible for 50 % of our physical condition. Healthy lifestyle requires that we move regularly. Perceived as a kind of physical exercise, locomotion activities are expected to meet certain criteria - they should be attractive, easy to do, time unlimited, not expensive, and generally available. These criteria seem to be satisfied by what is known as Nordic Walking, an activity recently much promoted. This diploma paper uses a sample of 43 patients / clients suffering locomotion problems to evaluate the effect that Nordic Walking, as applied at the Rehabilitation Spa Sanatorium at Vráž, may have on the Health-Related Quality of Life (HRQoL), and it assesses the NW for its suitability of inclusion into the spa treatment as a part of group physical exercises. The sample of respondents comprised Czech patients having completed full spa treatment no shorter than 21 days, and German clients of the Spa, who paid for 3-week treatments between 1 July 2007 to 30 November 2007. The practical section of the paper relied on a quantitative method applied through the questionnaire technique, specifically the SF-36 HRQoL Questionnaire and the EDUTOOL Questionnaire. The SF-36 Questionnaire was used to investigate the health-related quality of life in eight principle areas, namely the physical functions; physical limitation of roles; emotional limitation of role; physical and emotional limitation of social functions; pain; mental health; vitality; and overall perception of the state of own health. The ninth area of investigation, employed primarily for internal supervision, rested in the changes of own health. The EDUTOOL Questionnaire (its balneology version designed to assess the basic nutritious, regimen and movement habits) was used to review the results of the educational interventions into the health & social sphere, and specify the period of their effectiveness after the balneology procedures were completed. The paper identified the procedure of Nordic Walking as an activity fit to be incorporated into the spa treatment, and proved it to be capable of improving the health-related quality of the patients' lives. Hypotheses formulated: a) Nordic Walking will enhance the health-related quality of life - confirmed b) The results will depend on proper observance of instructions and consistent application of stereotypes and habits instilled by the education - confirmed c) The German-speaking clients will be more consistent in the application of what they were taught than the Czech-speaking patients - confirmed The diploma paper can be a useful tool of social education suitable to enhance the awareness of this topic.

Migraine - with or without aura - is an enervating primary headache disorder that represents a heavy economic and social burden. The health-related quality of life of migraineurs is poor. The aim of this research was to investigate the health-related quality of life of migraine without aura sufferers. As the thesis was approached from a biopsychosocial perspective, potential determinants were chosen for investigation from the molecular, individual, interpersonal and wider societal levels. The research was executed in two phases: Phase 1 data (N = 341) were gathered using a survey of health-related quality of life (Short Form 6), temperament (the Tridimensional Personality Questionnaire), catastrophizing as a pain coping strategy (the four-item Pain Coping Scale) and the amount of perceived social support (the six-item Social Support Questionnaire). For phase 2, participants were requested to provide blood specimens for ELISA serum quantification of glutamate (n = 66) and gene expression analysis of the main glutamate transporter gene SLC1A2 on real-time reverse-transcription polymerase chain reaction (n = 20). Of the 341 adult residents of Gauteng Province, South Africa that participated in the survey, 94 (28%) met the criteria for migraine without aura and a further 60 (18%) suffer from possible migraine without aura, using the International Classification of Headache Diagnosis (2nd edition) criteria. This indicates that migraine without aura is a significant burden for South Africa. Health-related quality of life was significantly poorer for migraineurs versus those without migraine (p < .001), and is in fact comparable to that of liver transplant, cardiac bypass and elderly populations. This raises concerns about the severe burden of the disease on the mental and physical well-being of South African sufferers. Investigation of the predictors of health-related quality of life yielded two significant variables when controlling for sex, head and neck injury and language - Harm Avoidance and vii Catastrophizing. The regression model accounts for 29% of the variance in health-related quality of life. A reciprocal relationship likely exists between Harm Avoidance and Catastrophizing, in which a harm avoidant migraineur interprets the headache pain as a catastrophic event to be avoided – even at high cost to the self. Though there have been calls for more biopsychosocial studies of migraine, this thesis did not find added understanding of health-related quality of life through the combination of biological and psychosocial data. The implication is that the role of glutamate in migraine without aura still requires further investigation. Further study is also required with regard to which biological factors may influence the sufferer’s quality of life. The thesis indicates a key role for psychological intervention in aiding migraineurs to live a life of quality. The inclusion of interventions for the psychological aspects of migraine may yield improved outcomes for patients. However, Gauteng residents suffering from MO are potentially unaware of their diagnosis and therefore of potential management for their disorder. Awareness around migraine needs to be the first step in limiting this disorder’s devastating impact on individuals, their relationships and their potential to contribute meaningfully to society. / Psychology / D.Litt. et Phil. (Psychology)