No description available.

No description available.

The objective of this study was to contribute evidence regarding the use of the SF6D and HUI3 in persons with neurological conditions. The data of 776 individuals from the LINC Study was analyzed. The mean utility score of the HUI3 was 0.47 (95% CI 0.45, 0.49) and SF6D was 0.62 (95% CI 0.62, 0.63). Even though the SF6D and HUI3 were sensitive to a variety of HRQoL domains relevant to persons with neurological conditions, they showed only marginal agreement (ICC of 0.41) with a mean utility difference of 0.15 (95% CI 0.13, 0.17). Discordance varied systematically with HRQoL status and was consistent regardless of the participant or impairment characteristics present. Despite sharing a common purpose, the substantial and clinically important differences found between the SF6D and HUI3 cast doubt on whether the utility estimates produced by these instruments are directly comparable or universally valid.

Bakgrund: Många personer med psykisk funktionsnedsättning har en upplevelse av låg livskvalitet. De har också en sämre utgångspunkt materiellt, ekonomiskt, socialt och hälsomässigt. Att beviljas insatsen särskilt boende innebär att få stöd, service och omsorg i sin vardagstillvaro. Tidigare studier har visat att för att ett stöd ska upplevas stödjande behöver personalen ha både kunskap och vissa egenskaper, lyssnande, medkännande och lyhördhet. Syfte: Att beskriva vårdpersonals erfarenheter och tankar kring hur man utformar vardagligt stöd till livskvalitet för personer som bor i särskilt boende. Metod: Halvstrukturerade intervjuer gjordes där sammantaget tio personal deltog från fem särskilda boenden. Som analysmetod användes kvalitativ innehållsanalys med induktiv ansats. Resultat: Personalens erfarenheter av att ge stöd till livskvalitet rörde sig inom tre olika områden. Hur dessa områden, vårdrelation, organisation och miljö var beskaffade och upplevdes påverkade stödets insats och kvalitet. Det framkom att en viktig komponent i det vardagliga stödet utgjordes av ett omfattande motivationsarbete. Det fanns en bristande överensstämmelse mellan de boendes uppfattning om stöd behov och det som personalen ansåg att de behövde. Ett samband som visade sig var personalens uttryckta maktlöshet i vissa stödjande situationer och samtidig frånvaro eller bristande kontinuitet av handledning. Diskussion: Det särskilda boendet har som konstruktion stora utmaningar i att göra anspråk på att vara ett hem och inte en institution. Redan språkbruket etiketterar; man bor inte i en lägenhet utan på ett gruppboende och man är inte hyresgäst utan boende. De yttre strukturerna kan förstärka ett vi och dom tänkande där behov och svårigheter riskerar att bli beskrivna utifrån grupptillhörighet. / Background: Many people with psychiatric disabilities have a perception of low quality of life. They also have lower standard, materially, economically, socially and health-wise. To be granted supportive housing means getting daily support, service and care. Previous studies have shown that the supporting staff have to be knowledgeable and have special features, compassionate, responsive and attentive. Aim: To describe a health care professional experiences and thoughts on how to style casual support to the quality of life for people living in sheltered housing. Methods: Semi-structured interviews were conducted as with ten staff members from five supportive housing. The method of analysis was qualitative content analysis with an inductive approach. Results: The staffs’ experiences of providing support for quality of life was categorized into three different areas. How these areas, care relationship, organization and environment was constituted and perceived made impact on support effort and quality. It emerged that a key component of the everyday support consisted of a comprehensive motivational work. There was a mismatch between the residents' perception of support needs and what the staff felt that they needed. A relationship that turned out was the staff expressed powerlessness in some supportive situations and the absence or lack of continuity of supervision. Discussions: Supportive housing has as major challenges in claiming to be a home and not an institution. The language used; you do not live in your own apartment, but in a group home and you are not a tenant, but a person living there. The outer structures can reinforce an “us” and “them” thinking where the needs and difficulties might be described on the basis of group membership.

Thesis (MNutr (Interdisciplinary Health Sciences. Human Nutrition))--Stellenbosch University, 2008. / OBJECTIVES: To determine perceived Quality of Life (QOL) of the diabetic patient and to assess whether QOL is associated with diabetes-related markers. DESIGN: This was a descriptive cross sectional study. SETTING: A multiethnic group of type 1 and 2 diabetic patients (n= 68) attending a diabetic clinic in Alberton, South Africa, were evaluated. SUBJECTS OUTCOME MEASURES: QOL was assessed by means of the Audit of Diabetes-Dependant Quality of Life (ADDQoL) questionnaire. Glycaemic control, duration of Diabetes Mellitus (DM), type of DM, diabetic complications, level of education and nutritional status were evaluated. RESULTS: Ninety eight percent of diabetic patients perceived their DM to impact negatively on their QOL (p=0.03). QOL and glycaemic control were significantly (p=0.03) related. QOL and the duration (p=0.80) or type (p=0.77) of DM were not significantly related. QOL ratings were lower in participants who had hypertension and hyperlipidaemia, whereas this trend was not present in those with microvascular complications. There was a trend towards a negative relationship between QOL and weight (p=0.10), BMI (p=0.10) and WC (p=0.41). All 13 individual life domains were significantly related (p < 0.05) to QOL for the group as a whole. Rankings of individual life domains differed between type 1 and type 2 diabetics (p<0.05) as well as between black and white subjects (p<0.05). CONCLUSIONS: These results show that DM impacts on various aspects of QOL and that various population sub-groups perceive their DM to impact differently on their QOL. QOL assessments should therefore form part of DM management and should be culturally sensitive.

A crescente importância da QV enquanto desfecho em saúde fez o grupo WHOQOL, da OMS, elaborar medidas de avaliação de QV para utilização internacional. Com a necessidade de instrumentos menores que demandassem pouco tempo para o preenchimento, foi desenvolvido o EUROHIS-QOL 8-ITEM, originado dos itens do WHOQOL- BREF. Objetivos: Testar as propriedades psicométricas do EUROHIS-QOL 8-ITEM em uma amostra brasileira. Métodos: A amostra foi constituída de 325 indivíduos. Eles foram divididos em dois grupos, 151 indivíduos constituiram o grupo dos doentes do Hospital de Clínicas de Porto Alegre, RS, e 174 o grupo dos saudáveis. Para a avaliação das propriedades psicométricas do índice EUROHIS-QOL 8-ITEM, foram realizadas algumas análises. A Consistência Interna, foi avaliada usando o Alpha de Cronbach. A validade discriminante foi avaliada comparando o grupo de doentes e saudáveis e também o de deprimidos e não-deprimidos. A análise da validade convergente ocorreu através da correlação do EUROHIS-QOL 8-ITEM com diferentes medidas de QV já validadas e reconhecidas, o SF-36 e o WHOQOL-BREF. A análise fatorial foi avaliada usando o modelo de equação estrutural (SEM). Avaliou-se a unidimensionalidade usando as propriedades do modelo de Rasch. Resultados: A consistência interna avaliada pelo Alpha de Cronbach (com valor de 0,81) monstrou-se boa. O índice EURO-HIS–QOL 8-ITEM também mostrou boa capacidade discriminativa entre os grupos de doentes e saudáveis (média1=3,32; DP1=0,70; média2=3,77; DP2=0,63 t =6,12, p < 0,001) e também entre os grupos de deprimidos e não deprimidos (média3=3,14; DP3=0,69; média4=3,72; DP4=0,61 t = 7,25 p <0,001). O instrumento demonstrou boa validade convergente, através de correlações significativas (p < 0,001) entre o EUROHIS-QOL 8-ITEM e todos os domínidos do WHOQOL- BREF (QV Geral r = 0,47; Saúde Geral r= 0,54; Físico r = 0,69; Psicológico r = 0,62; Relações Sociais r = 0,55; Meio Ambiente r = 0,55) e entre o EUROHIS-QOL 8-ITEM e os domínios do SF-36 (QV Geral r = 0,36; Capacidade Funcional r =0,49; Limitação Física r = 0,45; Dor r = 0,43; Saúde Geral r = 0,52; Vitalidade r = 0,21; Aspectos Sociais r = 0,45; Aspectos Emocionais r = 0,38 e Saúde Mental r = 0,17), com exceção do domínio social (p = 0,38). Na análise de Rasch, as medidas de ajuste geral do modelo apresentaram adequado desempenho estatístico e foi considerado um bom ajuste logo na primeira avaliação (Ajuste de resíduo Interação Item pessoa: M= 0,01 e DP= 1,51; ajuste de resíduo de pessoa: M = -0,38 e DP= 1,19 e Item traço: Item total X²=69,60 p=0,00. Personal Separation Index = 0,82), ou seja, os resíduos foram aceitáveis, não foi preciso excluir itens. O EUROHIS-QOL 8-ITEM, apresentou bom ajuste aos dados na análise fatorial confirmatória (X²= 18,46; DF= 15; CFI= 0,99; RMSEA= 0,03; GFI = 0,99; RMR=0,03; P = p,24). Conclusão: O EURHIS-QOL 8-ITEM, validado em amostras europeias apresentou adequadas propriedades psicométricas neste estudo, mostrando-se uma medida confiável de QV para ser usada em amostras brasileiras. / In the 70s, quality of life began to be considered a health outcome. With the growing importance of this assessment in different areas of medicine, there were no instruments developed in the cross-cultural perspective for international use. In this context, quality of life assessement outcome measures were developed by the WHOQOL group from WHO. With the need of shorter instruments which demanded less time to be filled in, the EUROHIS-QOL 8 ITEM was developed, originated from WHOQOL-BREF items. Objectives: Test the psychometric properties of EUROHIS-QOL 8-ITEM in a Brazilian sample. Methods: The sample consisted of 325 individuals. They were divided in to two groups, 151 subjects constituted the group of patients from the Hospital de Clinicas de Porto Alegre, RS, and 174 subjects the group of healthy controls. Some analyses were performed for the assessment of the psychometric properties of EUROHIS-QOL 8-ITEM index. Internal consistency was measured by using Cronbach’s alpha. Discriminant validity was assessed by comparing the group of patients and healthy controls and also the depressed and nondepressed. Analysis of convergent validity was through the correlation of EUROHIS-QOL 8-ITEM with different quality of life measures already validated and recognized as the SF-36 and WHOQO-BREF. Factor analysis was assessed using structural equation model (SEM). Unidimensionality was assessed using the properties of the Rasch model. Results: The Cronbach's alpha showed good internal consistency (with a value of 0.81). The measure also showed good discriminative ability between the groups of patients and healthy controls (mean1=3.32; SD1=0.70; mean2=3.77; SD2=0.63 t =6.12, p = 0,00) and between the depressed and nondepressed groups (mean3=3.14; SD3=0.69; mean4=3.72; SD4=0.61 t = 7.25 p =0.00). The instrument showed good convergent validity through significant correlations ( p < 0.001 ) between the EUROHIS–QOL 8-ITEM and all domains of WHOQOL-BREF (QV Overall r = 0.47; General Health r= 0.54; Physical Health r = 0.69; Psychological Health r = 0.62; Social Relationship r = 0.55; Meio Environment r = 0.55) and between EUROHIS-QOL 8-ITEM and the domains of the SF-36 (QV Overall r = 0.36; Functioning Physical r =0.49; Role Physical r = 0.45; Bodily Pain r = 0.43; General Health r = 0.52; Vitality r = 0.21; Social Functioning r = 0.45; Role Emotional r = 0.38 and Mental Health r = 0.17) , except for the social domain ( p = 0.38). In the Rasch analysis, general fit measures of the model had adequate statistical performance and were considered a good fit at the first assessment (residual fit Item-person Interaction: M = 0.01, SD = 1.51; person residual fit: M = -0.38, SD = 1.19 and Item-trait: Total Item X² = 69.60 p = 0.00. Personal Separation Index = 0.82), that is, the residuals were acceptable, it was not necessary to exclude items. The EUROHIS-QOL 8-ITEM showed a good fit to the data in the confirmatory factor analysis (X² = 18.46, DF = 15; CFI = 0.99; RMSEA = 0.03; GFI = 0.99; RMR = 0.03; P = 24). Conclusion: EUROHIS-QOL 8-ITEM, validated in European samples, showed adequate psychometric properties in this study showing to be a reliable quality of life measure to be used in Brazilian samples.

A crescente importância da QV enquanto desfecho em saúde fez o grupo WHOQOL, da OMS, elaborar medidas de avaliação de QV para utilização internacional. Com a necessidade de instrumentos menores que demandassem pouco tempo para o preenchimento, foi desenvolvido o EUROHIS-QOL 8-ITEM, originado dos itens do WHOQOL- BREF. Objetivos: Testar as propriedades psicométricas do EUROHIS-QOL 8-ITEM em uma amostra brasileira. Métodos: A amostra foi constituída de 325 indivíduos. Eles foram divididos em dois grupos, 151 indivíduos constituiram o grupo dos doentes do Hospital de Clínicas de Porto Alegre, RS, e 174 o grupo dos saudáveis. Para a avaliação das propriedades psicométricas do índice EUROHIS-QOL 8-ITEM, foram realizadas algumas análises. A Consistência Interna, foi avaliada usando o Alpha de Cronbach. A validade discriminante foi avaliada comparando o grupo de doentes e saudáveis e também o de deprimidos e não-deprimidos. A análise da validade convergente ocorreu através da correlação do EUROHIS-QOL 8-ITEM com diferentes medidas de QV já validadas e reconhecidas, o SF-36 e o WHOQOL-BREF. A análise fatorial foi avaliada usando o modelo de equação estrutural (SEM). Avaliou-se a unidimensionalidade usando as propriedades do modelo de Rasch. Resultados: A consistência interna avaliada pelo Alpha de Cronbach (com valor de 0,81) monstrou-se boa. O índice EURO-HIS–QOL 8-ITEM também mostrou boa capacidade discriminativa entre os grupos de doentes e saudáveis (média1=3,32; DP1=0,70; média2=3,77; DP2=0,63 t =6,12, p < 0,001) e também entre os grupos de deprimidos e não deprimidos (média3=3,14; DP3=0,69; média4=3,72; DP4=0,61 t = 7,25 p <0,001). O instrumento demonstrou boa validade convergente, através de correlações significativas (p < 0,001) entre o EUROHIS-QOL 8-ITEM e todos os domínidos do WHOQOL- BREF (QV Geral r = 0,47; Saúde Geral r= 0,54; Físico r = 0,69; Psicológico r = 0,62; Relações Sociais r = 0,55; Meio Ambiente r = 0,55) e entre o EUROHIS-QOL 8-ITEM e os domínios do SF-36 (QV Geral r = 0,36; Capacidade Funcional r =0,49; Limitação Física r = 0,45; Dor r = 0,43; Saúde Geral r = 0,52; Vitalidade r = 0,21; Aspectos Sociais r = 0,45; Aspectos Emocionais r = 0,38 e Saúde Mental r = 0,17), com exceção do domínio social (p = 0,38). Na análise de Rasch, as medidas de ajuste geral do modelo apresentaram adequado desempenho estatístico e foi considerado um bom ajuste logo na primeira avaliação (Ajuste de resíduo Interação Item pessoa: M= 0,01 e DP= 1,51; ajuste de resíduo de pessoa: M = -0,38 e DP= 1,19 e Item traço: Item total X²=69,60 p=0,00. Personal Separation Index = 0,82), ou seja, os resíduos foram aceitáveis, não foi preciso excluir itens. O EUROHIS-QOL 8-ITEM, apresentou bom ajuste aos dados na análise fatorial confirmatória (X²= 18,46; DF= 15; CFI= 0,99; RMSEA= 0,03; GFI = 0,99; RMR=0,03; P = p,24). Conclusão: O EURHIS-QOL 8-ITEM, validado em amostras europeias apresentou adequadas propriedades psicométricas neste estudo, mostrando-se uma medida confiável de QV para ser usada em amostras brasileiras. / In the 70s, quality of life began to be considered a health outcome. With the growing importance of this assessment in different areas of medicine, there were no instruments developed in the cross-cultural perspective for international use. In this context, quality of life assessement outcome measures were developed by the WHOQOL group from WHO. With the need of shorter instruments which demanded less time to be filled in, the EUROHIS-QOL 8 ITEM was developed, originated from WHOQOL-BREF items. Objectives: Test the psychometric properties of EUROHIS-QOL 8-ITEM in a Brazilian sample. Methods: The sample consisted of 325 individuals. They were divided in to two groups, 151 subjects constituted the group of patients from the Hospital de Clinicas de Porto Alegre, RS, and 174 subjects the group of healthy controls. Some analyses were performed for the assessment of the psychometric properties of EUROHIS-QOL 8-ITEM index. Internal consistency was measured by using Cronbach’s alpha. Discriminant validity was assessed by comparing the group of patients and healthy controls and also the depressed and nondepressed. Analysis of convergent validity was through the correlation of EUROHIS-QOL 8-ITEM with different quality of life measures already validated and recognized as the SF-36 and WHOQO-BREF. Factor analysis was assessed using structural equation model (SEM). Unidimensionality was assessed using the properties of the Rasch model. Results: The Cronbach's alpha showed good internal consistency (with a value of 0.81). The measure also showed good discriminative ability between the groups of patients and healthy controls (mean1=3.32; SD1=0.70; mean2=3.77; SD2=0.63 t =6.12, p = 0,00) and between the depressed and nondepressed groups (mean3=3.14; SD3=0.69; mean4=3.72; SD4=0.61 t = 7.25 p =0.00). The instrument showed good convergent validity through significant correlations ( p < 0.001 ) between the EUROHIS–QOL 8-ITEM and all domains of WHOQOL-BREF (QV Overall r = 0.47; General Health r= 0.54; Physical Health r = 0.69; Psychological Health r = 0.62; Social Relationship r = 0.55; Meio Environment r = 0.55) and between EUROHIS-QOL 8-ITEM and the domains of the SF-36 (QV Overall r = 0.36; Functioning Physical r =0.49; Role Physical r = 0.45; Bodily Pain r = 0.43; General Health r = 0.52; Vitality r = 0.21; Social Functioning r = 0.45; Role Emotional r = 0.38 and Mental Health r = 0.17) , except for the social domain ( p = 0.38). In the Rasch analysis, general fit measures of the model had adequate statistical performance and were considered a good fit at the first assessment (residual fit Item-person Interaction: M = 0.01, SD = 1.51; person residual fit: M = -0.38, SD = 1.19 and Item-trait: Total Item X² = 69.60 p = 0.00. Personal Separation Index = 0.82), that is, the residuals were acceptable, it was not necessary to exclude items. The EUROHIS-QOL 8-ITEM showed a good fit to the data in the confirmatory factor analysis (X² = 18.46, DF = 15; CFI = 0.99; RMSEA = 0.03; GFI = 0.99; RMR = 0.03; P = 24). Conclusion: EUROHIS-QOL 8-ITEM, validated in European samples, showed adequate psychometric properties in this study showing to be a reliable quality of life measure to be used in Brazilian samples.

En la presente investigación se adaptó y se determinaron las propiedades psicométricas (validez, fiabilidad) y la utilidad diagnóstica del cuestionario Quality of life Bipolar Disorder [QoL. BD] en pacientes bipolares chilenos atendidos en centros de salud públicos y privados de Santiago. Se entrevistaron a 63 sujetos (grupo clínico n=32 y grupo no clínico n=31) a los cuales se le administró el QoL. BD, SF-36, MINI, YMRS, HAM-D y el respectivo consentimiento informado. Se obtuvo una elevada fiabilidad (α =0.95) y alta validez referida a criterio externo (r= entre 0.453 y 0,819; p<0,001). En términos de utilidad diagnóstica, se estimó un punto de corte de 170 puntos (sensibilidad de 87,9% y especificidad de 80%). Se concluye que el QoL. BD muestra propiedades psicométricas adecuadas, hallándose evidencia de confiabilidad y validez, además de una adecuada sensibilidad y especificidad para distinguir entre una percepción negativa y positiva de calidad de vida en pacientes bipolares chilenos

Polycystic Ovary Syndrome (PCOS) is one of the most common endocrine disorders amongst women, estimated to affect one out of 10 women. Symptoms include infertility, obesity, alopecia, acne, hirsutism and menstrual irregularities. Women with the syndrome are also more likely to experience co-morbid physical and psychological conditions such as diabetes, heart disease, endometrial cancer and also depression and anxiety. PCOS has also been found to have a negative impact on quality of life. This thesis aimed to further understanding, and improve quality of life of women with PCOS in the UK. To achieve this, the thesis aimed to investigate and identify how women with PCOS in the UK perceive and define their quality of life and to further understanding of the day-to-day experience of living with PCOS. Moreover, in order to measure quality of life, it aimed to develop and validate a UK disease-specific quality of life measure for women with PCOS. It also aimed to identify, develop and test a pilot intervention to increase quality of life in women with PCOS. To achieve these aims a mixed-methods approach was taken employing a variety of data generation and collection methods including: photovoice, online Skype™ interviews; LimeSurvey and Qualtrics. The findings of this thesis emphasise that PCOS has a negative impact on quality of life; encompassing psychological, social, environmental, and physical domains of quality of life. Women with PCOS who experienced the symptoms of infertility, hirsutism, weight, alopecia, skin discolouration, skin tags and mood swings had significantly lower scores of overall quality of life than those women who did not experience the symptoms. In addition, those women with PCOS who had a diagnosis of anxiety and/or depression had reduced quality of life. The dissemination of these findings will enable health care professionals to better understand the experience of living with PCOS and its impact on quality of life. Moreover, this thesis identifies many areas for future research which will enable a better understanding of the impact of PCOS on quality of life. Finally, this thesis makes recommendations for clinical practice which include improvement of support from health care professionals for women with PCOS in order to help them better manage their symptoms, and therefore improve their overall quality of life.

Depression är idag en av de vanligaste orsakerna till sjukskrivning i Sverige. WHO räknar med att det kommer vara den näst vanligaste orsaken till sjukskrivning, världen över, år 2020. Det finns flera behandlingsalternativ för att behandla depression, läkemedelsbehandling och psykoterapi är det vanligaste behandlingsformerna. Det har kommit mycket forskning om den fysiska aktivitetens positiva påverkan på depression. Trots kunskapen kring träningens positiva effekter kan de depressiva besvären upplevas som en barriär för att utföra den fysiska aktiviteten, som till exempel trötthet eller dålig självkänsla. Vi har därför valt att skriva om deprimerade patienters upplevelse av fysisk aktivitet. Studien är gjord utifrån Åsa Axelssons (2012) modell för litteraturstudier. Tio artiklar, med både kvalitativ och kvantitativ ansats, har använts för resultatet. Resultatet är presenterat i fyra huvudteman och 13 subteman. De fyra huvudteman är upplevda kroppsliga förändringar, upplevda emotionella förändringar, upplevd motivation och upplevda hinder. Den fysiska aktiviteten skapade en god spiral där många deltagare upplevde bland annat en ökad energi, en förbättrad sömn, bättre humör, ökad motivation till förändring och ett ökat självförtroende. I diskussionen diskuteras depressionens påverkan på jaget, och trygghetens betydelse. Även livskraftens och livsrytmens roll diskuteras.