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Guillain-Barré syndrome ( GBS) encompasses a broad spectrum of health-related quality of life ( HRQL) determinants, including mobility, fatigue, pain, and depression. We systematically reviewed the literature on functional outcome domains in which GBS patients experience limitations in the short and long terms and evaluated determinants of HRQL in GBS patients. MEDLINE and EMBASE were systematically searched by two independent reviewers for articles covering HRQL data of GBS patients. Of 730 abstracts screened, 17 articles covering data of 14 studies matched the selection criteria. The included articles showed that many GBS patients experienced physical limitations, even years after the acute phase of the disease, while results were inconsistent for perceived levels of pain, fatigue, and general mental well-being. Only three papers covered HRQL assessments at more than one time point, generally showing large improvements in HRQL in the first year after GBS onset, but not thereafter. We appraised the methodological quality of included studies using a 13-item checklist; none of the articles fulfilled all items and only seven articles presented data on correlations between HRQL and determinants. In conclusion, the majority of studies on HRQL in GBS patients are cross-sectional and of low methodological quality. This paper provides guidance for much needed high-quality studies on patterns of patient-perceived recovery after GBS onset. [ABSTRACT FROM AUTHOR]

Copyright of Developmental Medicine & Child Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Developmental Medicine & Child Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Developmental Medicine & Child Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Developmental Medicine & Child Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To explore the association between bullying and HRQoL among Chinese school‐aged children and adolescents utilizing a cross‐sectional survey design. Bivariate associations were used to determine the correlation between the experience of bullying and lower HRQoL, and multivariate logistic regressions were evaluated. A total of 2,155 participants, 32.57%, reported experiencing bullying: traditional bullying, 27.80% (n = 599) (β = −3.55, p <.001, SE = 0.41), and cyberbullying, 7.47% (n = 161) (β = −2.50, p <.001, SE = 0.71). The degree of traditional bullying (β = −10.28, p <.001, SE = 1.19) was negatively significantly associated with HRQoL. Other determinants of the impact of the bullying in this cohort were the children's school performance and their relationship with parents, teachers and classmates. [ABSTRACT FROM AUTHOR]

Objective: This study aims to investigate the psychometric properties (component structure, reliability, and construct validity) of the Headache‐Specific Locus of Control scale in several clinical migraine populations. Background: Headache‐specific locus of control beliefs may impact a person's behavioral decisions that affect the likelihood of migraine attack onset, emotional responses to migraine attacks, coping strategies used, and treatment adherence. The 33‐item Headache‐Specific Locus of Control scale is the most widely used measure of locus of control specific to headache yet psychometric evaluations remain limited. Methods: Six hundred and ninety‐five adults with a diagnosis of migraine from 5 different research studies completed cross‐sectional self‐report measures including the Headache‐Specific Locus of Control scale and measures of quality of life and disability (Migraine‐Specific Quality of Life Questionnaire and Migraine Disability Assessment). Results: Five Headache‐Specific Locus of Control components emerged from Horn's Parallel Analysis, Minimum Average Partial test, and Principal Component Analysis (eigenvalues: Presence of Internal = 5.7, Lack of Internal = 4.0, Luck = 2.9, Doctor = 2.0, and Treatment = 1.5). The 33 Headache‐Specific Locus of Control items demonstrated adequate internal consistency for total (α = 0.79) and subscale scores (α's = 0.69 to 0.88). This study found preliminary evidence of convergent validity. For example, Lack of Internal (r = −0.12, P = 0.004), Doctor (r = −0.20, P <.001), and Treatment (r = −0.12, P = .004) beliefs were associated with higher overall migraine‐specific quality of life impairments. Conclusions: The Headache‐Specific Locus of Control scale is a reliable and valid measure of headache‐specific locus of control. Findings suggest that headache‐specific locus of control is more multidimensional than previous conceptualizations and contribute to our understanding of control beliefs as a potential mechanism for migraine treatment. [ABSTRACT FROM AUTHOR]

Objective: Prior studies investigated objective somatic consequences of eating disorders whereas research on subjective somatic symptom severity, that is, profiles of subjective burden of somatic symptoms in patients with anorexia (AN) and bulimia nervosa (BN), is sparse. Methods: Somatic symptom severity (Patient Health Questionnaire‐15) was investigated in a cross‐sectional consecutive sample of outpatients with AN or BN. Using regression and mediation analyses, effects of somatic symptom severity on days of sick leave during the last 2 weeks and quality of life were examined. Results: Compared with AN‐outpatients (n = 90, MBMI = 17.2, Mage = 27.9 years, 95% female), BN‐outpatients (n = 63, MBMI = 21.8, Mage = 29.0 years, 93% female) reported a significantly higher somatic symptom severity (p = 0.016). Increased somatic symptom severity predicted days of sick leave during the last 2 weeks (p = 0.036) and physical quality of life (p = <0.001). However, after controlling for depression and anxiety as mediators, somatic symptom severity did no longer predict psychological quality of life (p = n.s.). Conclusions: Somatic symptom severity is high in both eating disorders. As it is associated with increased sick leave during the last 2 weeks and decreased quality of life, it adds to the psychological burden of AN and BN. Future research should investigate predictors of subjective somatic symptom severity and whether direct somatic symptom management enhances treatment of AN and BN. [ABSTRACT FROM AUTHOR]

Background: There is increasing recognition that dysphagia has significant implications for a person's psychological well‐being, social participation and quality of life (QOL). However, a paucity of research exists regarding the clinical management of this area. To inform future research and the development of appropriate and beneficial resources and guidelines, a better understanding of the current practice of speech and language therapists (SLTs) in this area would be useful. This information will highlight current challenges to clinical practice and the ongoing development needs of the profession, which are, as of yet, undocumented. Aims: To determine the practices of SLTs when addressing QOL issues in individuals with dysphagia, the beliefs of SLTs regarding the impact of dysphagia on QOL, the current trends in assessing and managing QOL in dysphagia, and if variations in beliefs and practices in this area exist. Methods & Procedures: An anonymous cross‐sectional, non‐experimental survey study was used. The survey consisted of 18 questions exploring participants' beliefs and opinions regarding dysphagia and QOL, current clinical practice in the area, perceived facilitators and barriers, and education, training and development needs. The survey was created on Survey Monkey and disseminated by e‐mail link to SLT professional bodies. Purposive and snowball sampling were used and participants self‐selected based on the information provided alongside the e‐mail link. Inclusion criteria for the study were a qualification in speech and language therapy, proficiency in the English language, and access to a computer with the internet. Outcomes & Results: A total of 148 SLTs working across the UK, Ireland and South Africa completed the survey. Over 90% of respondents believe that dysphagia has a negative impact on QOL, but only 25% are currently satisfied with the amount of clinical time they can dedicate to this area. Staffing, resources, a lack of best‐practice guidelines and disease‐specific QOL assessment tools were cited as contributing factors. A number of facilitators and barriers to best practice were also highlighted. Based on these findings, professional development actions for the future are suggested. Conclusions & Implications: SLTs believe they have an important role to play in supporting QOL issues in dysphagia. However, it is reported that the area is currently under‐developed, under‐resourced and under‐supported. Increased awareness raising of the role of SLT, alongside the development of best‐practice guidelines and disease‐specific QOL assessment tools, will enhance the quality of care that can be offered in this area. [ABSTRACT FROM AUTHOR]

Background and Objectives: Migraine headache is the seventh leading cause of disability worldwide causing adverse outcomes in many aspects of an individual's life. Many psychological aspects affect chronic migraine (CM): illness perception, anxiety, depressive symptoms, and job satisfaction. This observational study aimed to examine the association among illness perception, anxiety, depressive symptoms, and job satisfaction, connected to migraine and its features. Methods: Ninety‐eight individuals with CM treated with OnabotulinumtoxinA were recruited from the Regional Referral Headache Centre of Sant'Andrea Hospital in Rome. They completed 4 questionnaires (Brief Illness Perception Quality of Life, Enjoyment and Satisfaction Questionnaire, State‐Trait Anxiety Inventory, Beck Depression Inventory‐II) and a socio‐anamnestic form. Results: This cross‐sectional study examined 2 mediational models. The first one demonstrated an indirect mediating effect of trait anxiety on the association between illness perception and job satisfaction (ab = −0.217, 95% CI [−0.37, −0.09]). In the second model, depressive symptoms mediated the association between illness perception and job satisfaction (ab = −0.186, 95% CI [−0.33, −0.04]). Conclusions: In our study, levels of anxiety and depressive symptoms showed a mediational effect on the association between illness perception and job fulfillment. It is important to develop interventions aimed at improving the quality of life of individuals with CM and to increase knowledge about headache and psychological consequences. [ABSTRACT FROM AUTHOR]

Aim: Families of children and adolescents with Type 1 diabetes experience self‐management challenges that negatively impact diabetes control. This study assesses whether self‐management challenges are also associated with quality of life (QOL) for children and adolescents with Type 1 diabetes and their parents. Methods: Children aged 8–12 years (n = 135), adolescents aged 13–16 years (n = 132) and their parents completed QOL assessments (diabetes‐specific QOL from the PedsQL Diabetes Module or the Family Impact Module, both scaled 0–100) and a validated survey of up to six self‐management barriers [PRISM; scaled 1 (low) to 5 (high)]. Regression coefficients were calculated to assess the association of self‐management barriers with child and adolescent diabetes‐specific QOL or parent QOL, including interaction effects to assess the stability of the associations. Results: Mean duration of diabetes was 4.7 years for children and 6.1 years for adolescents. The majority of children and adolescents did not meet target values for glycaemic control. All barriers but one (Healthcare Team Interactions) were associated with lower diabetes‐specific QOL for children and adolescents, as well as lower QOL for parents (all P < 0.05). Barrier scores that were 1 unit higher were associated with diabetes‐specific QOL that was 3.7–5.1 points lower for children and 5.8–8.8 points lower for adolescents, as well as QOL that was 6.0–12.6 points lower for parents. Diabetes‐specific QOL was most strongly associated with 'Denial of Disease and Its Consequences' for children and with 'Regimen Pain and Bother' for adolescents. Parent QOL was most strongly associated with 'Understanding and Organizing Care'. Associations were stable across numerous demographic and disease factors. Conclusions: Single‐unit differences in self‐management barrier scores are associated with clinically meaningful differences in QOL for children and parents. Interventions specifically tailored to address individual self‐management barriers may improve both diabetes control and QOL. What's new?: Type 1 diabetes self‐management barriers have a potential impact on diabetes‐specific quality of life (QOL) for children and adolescents, as well as QOL for their parents.This study highlights the relationship between six specific, actionable and common self‐management barriers and diabetes‐specific QOL for children (8–12 years) and adolescents (13–17 years) with Type 1 diabetes, as well as QOL for their parents.Findings point to the potential utility of identifying and addressing self‐management barriers in clinical settings as a potential pathway to improve both diabetes self‐management and QOL. [ABSTRACT FROM AUTHOR]

Background. The assessment of oral health should consider clinical and biopsychosocial aspects. Aim. To evaluate the impact of untreated dental caries on the quality of life of children. Design. A cross-sectional study was conducted with 647 Brazilian children. The Child Perceptions Questionnaire (CPQ8-10) and the 'oral health' global indicator were administered to the children and used as the outcomes. Parents answered a general questionnaire, and oral clinical examinations were performed. Data analysis involved descriptive statistics, chi-squared test, Mann-Whitney test, and Poisson's regression analysis (a = 5%). The psychometric properties of the CPQ8-10 were tested for younger age group (6/7 years). Results. Untreated caries was a predictor of impact on quality of life for the following items: 'pain in teeth/mouth' (PR = 1.69; 95% CI: 1.41-2.04), 'difficulty biting/chewing hard foods' (PR = 1.28; 95% CI: 1.05-1.56), 'difficulty eating what you wanted to eat' (PR = 1.61; 95% CI: 1.29-2.02), 'trouble sleeping' (PR = 1.64; 95% CI: 1.27-2.13), 'missed school' (PR = 1.62; 95% CI: 1.24-2.12), 'trouble doing homework' (PR = 1.61; 95% CI: 1.12-2.31), and 'difficulty paying attention in class' (PR = 1.41; 95% CI: 1.01-1.96). Conclusion. Children with untreated dental caries feel greater negative impacts on quality of life than children without untreated caries. [ABSTRACT FROM AUTHOR]

Introduction: Lymphoedema may cause complex problems that can strongly influence patients' health‐related quality of life (HRQoL). The main purpose of this study was to investigate the impact of lymphoedema on HRQoL in patients with varying forms of lymphoedema. Methods: The Lymphoedema Quality of Life Inventory (LyQLI), measuring three domains, physical, psychosocial and practical, and the Short Form 36 Health Survey Questionnaire (SF‐36), measuring eight health domains, were sent to 200 lymphoedema patients. Out of those who answered both questionnaires, 88 patients had lymphoedema secondary to cancer treatment and they additionally received the Functional Assessment of Cancer Therapy Scale‐General (FACT‐G). The relation between continuous variables and the three domains were analysed by Spearman's correlation coefficients, and Kruskal–Wallis test was used to analyse categorical variables. Results: Altogether 129 patients completed the LyQLI and SF‐36 and 79 of them also completed FACT‐G. Twenty per cent had a high mean score (≥2.0) in at least one domain of the LyQLI, thus having a low HRQoL. Lower HRQoL was found in the practical domain of LyQLI in patients with lower limb lymphoedema compared to patient with lymphoedema in upper limb or head/neck (p = 0.002) and in patients working part‐time compared to patients working full‐time (p = 0.005). The impact on HRQoL tended to decrease with age, with a significant correlation in the psychosocial domain (rs = 0.194, p = 0.028). Compared with the general Swedish population, patients with lymphoedema scored significantly lower in general health (p = 0.006), vitality (p = 0.002) and social functioning (p = 0.025) assessed by the SF‐36. From a cancer‐specific view, HRQoL was similar to other Swedish studies using the FACT‐G. Conclusions: This study indicates that about 20% of the patients with lymphoedema had major impact on their HRQoL. More effort and research is needed to identify, understand and support groups of patients with severe lymphoedema‐related problems. [ABSTRACT FROM AUTHOR]

Background: Alcohol and other drug (AOD) treatment and recovery research typically have focused narrowly on changes in alcohol/drug use (e.g., “percent days abstinent”) with little attention on changes in functioning or well‐being. Furthermore, little is known about whether and when such changes may occur, and for whom, as people progress in recovery. Greater knowledge would improve understanding of recovery milestones and points of vulnerability and growth. Methods: National, probability‐based, cross‐sectional sample of U.S. adults who screened positive to the question, “Did you used to have a problem with alcohol or drugs but no longer do?” (Response = 63.4% from 39,809; final weighted sample n = 2,002). Linear, spline, and quadratic regressions tested relationships between time in recovery and 5 measures of well‐being: quality of life, happiness, self‐esteem, recovery capital, and psychological distress, over 2 temporal horizons: the first 40 years and the first 5 years, after resolving an AOD problem and tested moderators (sex, race, primary substance) of effects. Locally Weighted Scatterplot Smoothing regression was used to explore turning points. Results: In general, in the 40‐year horizon there were initially steep increases in indices of well‐being (and steep drops in distress), during the first 6 years, followed by shallower increases. In the 5‐year horizon, significant drops in self‐esteem and happiness were observed initially during the first year followed by increases. Moderator analyses examining primary substance found that compared to alcohol and cannabis, those with opioid or other drugs (e.g., stimulants) had substantially lower recovery capital in the early years; mixed race/native Americans tended to exhibit poorer well‐being compared to White people; and women consistently reported lower indices of well‐being over time than men. Conclusions: Recovery from AOD problems is associated with dynamic monotonic improvements in indices of well‐being with the exception of the first year where self‐esteem and happiness initially decrease, before improving. In early recovery, women, certain racial/ethnic groups, and those suffering from opioid and stimulant‐related problems appear to face ongoing challenges that suggest a need for greater assistance. [ABSTRACT FROM AUTHOR]

Background: Although outcomes for acute myeloid leukemia (AML) have improved over time, they remain poor overall, and toxicity from both the disease and its treatment can affect quality of life (QOL). One barrier to including QOL endpoints in clinical trials is the lack of a disease-specific QOL instrument that can efficiently capture the major QOL deficits in this population.Methods: A cross-sectional study was performed to elicit concepts for inclusion in a new AML-specific QOL instrument called the AML-QOL. Eighty-two patients at various stages of disease were interviewed about sources of support (positive concepts) and problems and symptoms (negative concepts) experienced over the past week, and they were asked to grade how much each affected their QOL. In addition, patients were asked to complete 2 validated instruments: the Functional Assessment of Cancer Therapy with the leukemia and transplant modules and the 29-item Patient-Reported Outcomes Measurement Information System questionnaire.Results: With data from the open-ended and questionnaire-based portions of the interview, 7 positive concepts and 64 negative concepts were elicited. From these, 5 positive concepts and 21 negative concepts were selected for inclusion in the preliminary AML-QOL on the basis of concept prevalence and the impact on QOL.Conclusions: These concepts will form the basis of a new QOL instrument specific to AML. Cancer 2018;124:145-52. © 2017 American Cancer Society. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to understand how hope and motivation of patients considering phase I trial participation are affected by psychological factors such as coping strategies and locus of control (LoC) and general well-being as measured by the quality of life (QoL).Methods: An exploratory cross-sectional study was performed in patients with incurable cancer (N = 135) referred to our phase I unit for the first time. Patients were potentially eligible for phase I trial participation and participated in our study while deliberating phase I trial participation. We used questionnaires on hope, motivation to participate, coping, LoC, and QoL. To investigate the nature and magnitude of the relationships between the scales, a structural equation modeling (SEM) was fitted to the data.Results: Hope significantly predicted the motivation to participate in phase I trials. Predictors of hope were a combination of flexible and tenacious goal pursuit (both P < .01), internal LoC (P < .01), and QoL (P < .01). The SEM showed an exact fit to the data, using a null hypothesis significance test: chi-square (8) = 9.30, P = .32.Conclusions: Patients considering phase I trial participation seem to use a pact of tenacious and flexible coping and control to stay hopeful. Furthermore, hope and QoL positively affected each other. The psychological pact may promote an adaptation enabling them to adjust to difficult circumstances by unconsciously ignoring information, called dissonance reduction. This mechanism may impair their ability to provide a valid informed consent. We suggest including a systematic exploration of patients' social context and values before proposing a phase I trial. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether there are differences in fertility quality of life (FertiQoL) and socio-demographic characteristics between immigrants and non-immigrant patients attending a government-funded fertility program.Design: Cross-sectional study.Setting: McGill University Reproductive Center in Montreal, Canada, at a time when governmental funding for in vitro fertilisation (IVF) was provided to all residents.Population: All infertile patients, males and females, attending the center between March and July 2015.Methods: Patients were invited to complete anonymous questionnaires which included socio-demographic items and the validated FertiQoL questionnaire.Main Outcome Measures: Socio-demographic characteristics (age, gender, marital state, infertility type & duration, previous IVF attempts; education, employment, income, ethnicity, spoken languages) and FertiQoL scores.Results: In all, 1020 patients completed the questionnaires; of these, 752 (77.7%) non-immigrant Canadian citizens and 215 (22.3%) resident immigrants were included in the analysis. Median duration in Canada for immigrants was 4 years. Immigrants were more likely to have university/graduate degrees (75% versus 64%), to be unemployed (37% versus 13.1%) and to have lower annual household incomes (72.8% versus 39.5%, all P < 0.05). They also reported poorer QoL and achieved significantly lower scores in the emotional, mind/body, social, treatment and total FertiQoL domains. Multivariate analysis showed male gender, lower education level and Caucasian/European ethnicity to be significantly associated with higher QoL.Conclusions: Despite governmental funding of IVF, immigrants experience reduced fertility QoL, implying cost is not the only barrier to IVF use. The reduced QoL may stem from cross-cultural differences in infertility perception. This population may be at greater risk for depression and anxiety and should be flagged accordingly.Tweetable Abstract: Immigrants' fertility QoL is lower despite publicly funded IVF implying cost is not the only barrier to IVF use. [ABSTRACT FROM AUTHOR]

Objective: Extensive studies on health-related quality of life (HRQoL) in idiopathic inflammatory myopathies (IIMs) are lacking. Our objective was to document HRQoL and to identify factors associated with a reduced HRQoL in patients with IIM.Methods: A total of 1,715 patients (median age 49.9 years, 70% female, 87% white) who met probable or definite Bohan and Peter criteria or Griggs criteria for myositis were included from the Myovision registry. HRQoL was ascertained using the Short Form 12 (SF-12) health survey questionnaire. HRQoL physical component summary (PCS) and mental component summary (MCS) scores in relation to different patient and disease characteristics were compared to scores from matched normative data from the US general population and rheumatoid arthritis (RA) patients. Bivariate and multiple linear regression analyses were performed to assess the association between HRQoL and patient and disease parameters.Results: The mean SF-12 summary scores were significantly lower in IIM patients than in the normative and RA populations. A diagnosis of inclusion body myositis, older age, patient-reported negative effect of disease on work, presence of another co-occurring autoimmune disease, polypharmacy, and IIM-associated lung disease and joint involvement were significantly associated with lower PCS scores. Lower MCS scores were associated with joint involvement and a negative effect of disease on work.Conclusion: In this large study of patient-reported outcomes in IIM, an association was found between multiple disease characteristics and reduced HRQoL, mostly in the physical domain. In the US, the HRQoL of IIM patients was found to be lower than that of the general population and RA patients. [ABSTRACT FROM AUTHOR]

Aim: To identify the associated factors of quality of life (QOL) among the family caregivers of patients with terminal cancer at home. Methods: The design was an epidemiological study with self-administered questionnaires by mail. Date collection was carried out in the Tokyo Metropolitan, Tochigi, Ibaraki, Saitama, Chiba, Kanagawa, Nara, Hyogo, Kagawa, Ehime, and Saga prefectures in Japan. The participants who met the criteria for the present study were 262 family caregivers. Their QOL was assessed by the Japanese version of the Caregiver Quality of Life Index-Cancer. The potential factors that are associated with family caregivers' QOL included three factors: patient factors, including demographic characteristics and disease-related factors, family caregiver factors, including demographic characteristics, health conditions, and self-efficacy of family caregiving, and environmental factors, including instrumental, emotional, informational support, and satisfaction with the home care service. A multiple regression analysis was conducted in order to identify the associated factors with family caregivers' QOL. Results: A total of 74 family caregivers participated in this study (response rate: 33.2%). The mean age of the family caregivers was 63.6 years and 79.7% was female. The multiple regression analysis indicated that depression, self-efficacy of family caregiving, the subcaregiver, and satisfaction with the home care service were associated with family caregivers' QOL. Conclusion: It is recommended that health practitioners should develop interventions for family caregivers in order to enhance the competence of the individual and home care system in order to achieve the sustainability of high-quality home care for patients with terminal cancer and the family caregivers' QOL. [ABSTRACT FROM AUTHOR]

Purpose The Minnesota Living With Heart Failure Questionnaire (MLHFQ) is the leading method for assessing quality of life in patients with heart failure (HF) around the world. However, unique, culture-specific variations in factorial structure have been identified. The current study examined the cross-cultural equivalence of an Italian version of the MLHFQ. Design Cross-sectional assessment as part of an HF study in Italy. Patients ( n = 1,192; mean age = 72 years, SD = 11) completed demographics, the MLHFQ, and the Short-Form 12 (SF-12). Methods A series of exploratory and confirmatory factor analyses were used to develop an appropriate factor model in the current sample. Findings We initially fit a confirmatory factor analysis based on published psychometric work validating the MLHFQ. This did not provide adequate fit, and the sample was then randomly split into equivalent subsets to conduct factor analyses with cross-validation. In the first subsample, an exploratory factor analysis uncovered slight modifications to the proposed factor structure that resulted in much improved model fit. The final model included a higher order factor and three subscales: physical, emotional, and social. A cross-validation confirmatory factor analysis using this structure was conducted in the remaining subset to ensure broader applicability of the results. Correlations with the SF-12 were consistent with previous work using these measures. Conclusions Some items of the MLHFQ are sensitive to differences across cultures, and factor structures vary based on where the scale is administered. In spite of these differences, the total score remains a valid and reliable indicator of quality of life in HF patients across cultures. Clinical Relevance Cultural influences on quality of life are important to consider when assessing patients' well-being in HF. [ABSTRACT FROM AUTHOR]

Background There is a need for studies on the biopsychosocial factors that influence the use of dental services by preschoolers. Aim To evaluate the influence of the perceptions of parents/caretakers and children regarding oral health-related quality of life ( OHRQo L) as well as the sense of coherence ( SOC) of parents/caretakers on the use of dental services among Brazilian preschoolers. Design A school-based, cross-sectional study was conducted with 768 preschoolers. Parents/caretakers answered a questionnaire addressing socio-demographic characteristics. The OHRQo L of the children was measured using the Scale of Oral Health Outcomes for Five-Year-Old Children. SOC among the parents/caretakers was evaluated using the Sense of Coherence scale. Clinical examinations were performed by examiners who had previously undergone a training exercise. Descriptive analysis was conducted, followed by Poisson's regression analysis ( α = 5%). Results A total of 56.5% of the preschoolers had never used dental services. The following variables exerted a significant influence on the use of services: higher monthly household income ( PR = 1.27; 95% CI: 1.07-1.51), toothache ( PR = 1.59; 95% CI: 1.34-1.89), the absence of traumatic dental injury ( TDI; PR = 1.18; 95% CI: 1.01-1.40), and a strong SOC ( PR = 1.19; 95% CI: 1.01-1.42). Conclusions A higher monthly household income, history of toothache, the absence of TDI, and strong SOC of the parents/caretakers influence the use of dental services by preschoolers. [ABSTRACT FROM AUTHOR]

Copyright of Developmental Medicine & Child Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Overactive bladder (OAB) has been found to have a number of psychological consequences, including anxiety, depression and shame. However, there is little research on how drug treatment, which has been found to be effective at reducing physical symptoms, impacts on these psychological effects. This study aimed to examine patients' experiences of anticholinergic treatment for OAB, and the impact of both OAB and its treatment on psychological well‐being. A cross‐sectional, qualitative interview design with a secondary care outpatient sample was used. The approach was idiographic and sought to understand the detailed complexities and nuances of patient experiences. This small‐scale qualitative study found that, even where there had been symptom reduction, patients did not feel ‘better’, and found it difficult to let go of worries and fears around OAB. These findings suggest that a person with OAB may need support even after a ‘successful’ treatment, as OAB continues to be at the centre of patients' lives. [ABSTRACT FROM AUTHOR]

Background Oral health-related quality of life may be influenced by a series of characteristics. Considering the multidimensional character of quality of life, these impacts should be evaluated in the context of the physical, psychological, and social domains. Aim To evaluate the impact of clinical and perceived oral health problems on oral health-related quality of life in its different domains. Design Clinical exams were conducted on a representative cross-sectional sample of 12-year-old children in Brazil. The instrument Oral Impacts on Daily Performance ( OIDP) was used to evaluate the quality of life in relation to oral health. Descriptive, bivariate, and multiple hierarchical analyses were conducted. Results Of the 7328 children studied, 2577 (33.5%) presented oral health-related impacts on quality of life. Clinical and perceived conditions of oral health were associated with the presence of overall impacts in the physical, psychological, and social dimensions of oral health-related quality of life. Furthermore, Family income was associated with overall impacts and the level of motivation to use dental health services was associated with the physical dimension. Conclusions The clinical and perceived conditions of oral health in Brazilian 12-year-olds were associated with a negative impact on oral health-related quality of life. [ABSTRACT FROM AUTHOR]

Background and Objectives: Comorbid attention deficit hyperactivity disorder (ADHD) symptoms are highly prevalent among heroin-dependent patients. We aim to investigate differences in dependence severity, depression, and quality of life between heroin-dependent patients with and without ADHD-screened positive.Methods: Heroin-dependent participants (n = 447) entering methadone maintenance treatment were divided into ADHD-screened positive (ADHD-P) and ADHD-screened negative (ADHD-N) groups according to scores of Adult ADHD Self-Report Scale (ASRS). Mini-International Neuropsychiatric Interview was used to identify current and lifetime depressive episodes and suicidality. Substance use disorder, depression, family support, and quality of life in two groups were also assessed.Results: About 7.8% (n = 35) scored 24 or higher of ASRS indicating highly likely Adult ADHD. More heroin-dependent patients of ADHD-P had a current depressive episode (p = .02). They had higher Center for Epidemiological Studies Depression (CESD) scores (p = .003), and more severe heroin dependence (p = .006). Poorer family support and quality of life in physical, and psychological domains were found in patients of ADHD-P compared to ADHD-N.Discussion and Conclusions: Heroin-dependent patients of ADHD-P represent a vulnerable minority. They were comorbid with regard to depression, greater substance dependence severity, and poorer quality of life.Scientific Significance: Assessment for ADHD symptoms in heroin-dependent patients may be indicated for the effective management of the complex problems of these patients. (Am J Addict 2017;26:26-33). [ABSTRACT FROM AUTHOR]

Objectives To assess the association between gingival recession ( GR) and oral health-related quality of life ( OHRQoL) in a Brazilian population of adults. Methods A representative sample from Porto Alegre city was drawn in 2011 using a multistage probability sampling strategy. For this study, 740 individuals, 35-59 years of age and with ≥6 teeth, were included. GR was assessed by two calibrated examiners at four sites in all present teeth. The Oral Health Impact Profile ( OHIP-14) was used to assess OHRQoL. OHIP-14 was dichotomized using 'fairly often' as the cutoff point for a negative impact. Multiple logistic regression models were fitted to define which descriptors of GR were associated with the dichotomous outcome of OHIP-14, including dentine hypersensitivity in separate models, adjusting for age, gender, socioeconomic status, smoking, dental care, and missing teeth. Results Mean OHIP was significantly higher for individuals with ≥1 tooth with GR ≥2, ≥3, ≥4, and ≥5 mm. Individuals with ≥1 tooth with GR ≥2 mm had approximately two times higher chance of having a negative impact than individuals without GR of this threshold [odds ratio ( OR) = 1.99, 95% confidence interval ( CI) 1.05-3.78]. When buccal and proximal sites were analyzed separately, the presence of GR was significantly associated with worst quality of life only in anterior and not in posterior teeth. GR in the lower arch had no impact on OHRQoL. GR ≥2 mm affected only physical pain ( OR = 2.61; 95% CI 1.06-6.42), whereas GR ≥4 mm affected functional limitation, physical pain, psychological discomfort, physical and psychological disabilities, with ORs ranging from 1.43 to 1.91. Dentine hypersensitivity alone was not associated with OHRQoL, but it modified the association between GR and OHIP when present concomitantly with GR, mainly in buccal sites. Conclusions OHRQoL is poorer in this adult population in the presence of GR, mainly in upper and anterior teeth. Dentine hypersensitivity and esthetics were found to be factors linking GR to OHRQoL. [ABSTRACT FROM AUTHOR]

Objective: To determine the satisfaction with information received by prostate cancer survivors and associations with health-related quality of life (HRQoL) and illness perception.Methods: A cross-sectional study was performed among 999 patients diagnosed between 2006 and 2009. All patients received a questionnaire on HRQoL (EORTC QLQ-C30), illness perception (B-IPQ) and satisfaction with information provision (EORTC QLQ-INFO-25). Multivariate regression analyses were performed to assess the association between satisfaction with information provision and HRQoL as well as illness perception.Results: Response rate was 70% (N = 697), 34% (N = 222) indicated to be dissatisfied with the information received. Multivariate linear regression analyses showed a significant positive association between satisfaction with information provision and global health (P = <0.001), emotional functioning (P = 0.004), social functioning (P = 0.027), physical functioning (P = 0.002) and role functioning (P = 0.001). Satisfaction was negatively associated with illness perception subscales on consequences (P = 0.020), timeline (P = 0.031), personal control (P = 0.013), treatment control (P < 0.001), illness concern (P < 0.001), coherence (P = 0.001) and emotional representation (P = 0.004). Hence, more satisfied patients reported fewer consequences of disease, illness concern and emotional representation, but higher personal and treatment control and coherence.Conclusions: A third of all prostate cancer survivors reported to be dissatisfied with the information received and scored worse on HRQoL and illness perception. A prospective randomized study is needed to study the effect of an intervention that improves information provision on HRQoL and illness perception outcomes. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Aim: To estimate health-related quality of life (HRQOL) in patients with Duchenne muscular dystrophy (DMD).Method: HRQOL was assessed using the Health Utilities Index Questionnaire (HUI) and the Pediatric Quality of Life Inventory (PedsQL) neuromuscular module version 3.0 online. Results were stratified by disease stage (early/late ambulatory/non-ambulatory) and caregivers' perceptions of patients' health and mental status.Results: A total of 770 patient-caregiver pairs (173 German, 122 Italian, 191 UK, and 284 USA) participated. Most caregivers (>84%) perceived their patients as happy/somewhat happy and in excellent/very good/good health, irrespective of current ambulatory class. In contrast, mean patient utility (reflecting public preferences: 0, dead; 1, perfect health) deteriorated with disease course, from 0.75 in early ambulatory males to 0.15 in the most severely affected patients. Mean patient PedsQL scores (0-100, higher score indicating better HRQOL) decreased from 80 to 57 across ambulatory classes.Interpretation: HRQOL in DMD, measured through public preferences, is substantially impaired in relation to the general population and significantly associated with disease progression. Still, most patients are perceived as happy and in good health by their caregivers, indicating that influential domains of HRQOL remain intact through the disease progression. Our findings emphasize the challenges in measuring HRQOL in a rare, progressive childhood condition such as DMD. [ABSTRACT FROM AUTHOR]

Objective: Our aim was to identify risk factors for lower quality of life (QOL) in non-metastatic breast cancer patients.Methods: Our study included 120 patients from the University Hospital Centers of Tours and Poitiers. This cross-sectional study was conducted 7 months after patients' breast cancer diagnosis and assessed QOL (Quality of Life Questionnaire Core 30 = QLQ-C30), socio-demographic characteristics, coping strategies (Brief-COPE), physiological and biological variables (e.g., initial tumor severity and types of treatment received), the existence of major depressive disorder (Mini International Neuropsychiatric Interview), and pain severity (Questionnaire de Douleur Saint Antoine). We assessed personality disorders 3 months after diagnosis (Vragenlijst voor Kenmerken van de Persoonlijkheid questionnaire). We used multiple linear regression models to determine which factors were associated with physical, emotional, and global QOL.Results: Lower physical QOL was associated with major depressive disorder, younger age, a more severe initial tumor stage, and the use of the behavioral disengagement coping. Lower emotional QOL was associated with major depressive disorder, the existence of a personality disorder, a more severe pain level, higher use of self-blame, and lower use of acceptance coping strategies. Lower global QOL was associated with major depressive disorder, the existence of a personality disorder, a more severe pain level, higher use of self-blame, lower use of positive reframing coping strategies, and an absence of hormone therapy.Conclusions: Lower QOL scores were more strongly associated with variables related to the individual's premorbid psychological characteristics and the manner in which this individual copes with the cancer (e.g., depression, personality, and coping) than to cancer-related variables (e.g., treatment types and cancer severity). Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective: Our aim is to examine whether provider screening for physical and emotional symptoms, as reported by medical oncology outpatients, varies across medical oncology treatment centres.Methods: A cross-sectional sample of 716 patients attending the outpatient medical oncology department of six public cancer treatment centres across five Australian states participated. Four patient-report survey items explored how often patients were specifically asked by clinical staff at the treatment centre about their (i) emotional distress (anxiety, distress and depression), (ii) pain, (iii) fatigue and (iv) other physical symptoms (e.g. nausea and constipation). Asking at less than half of all appointments was classified as infrequent screening.Results: No significant associations were found between treatment centre and symptom screening for emotional distress (p = 0.65), pain (p = 0.21), fatigue (p = 0.95) and other physical symptoms (p = 0.40). The proportion of patients who were regularly screened versus infrequently screened was significantly higher for physical symptoms than emotional symptoms (p < 0.001): 36% infrequently screened for emotional distress (range: 33-45%), 15% infrequently screened for pain (range: 9-21%), 16% infrequently screened for fatigue (range: 15-19%) and 11% infrequently screened for other physical symptoms (range: 5-17%).Conclusions: No significant variation in symptom screening was found across treatment centres. While the majority of patients received recommended care, treatment centres must continue to improve symptom screening rates, particularly for emotional distress. However, screening is only the first step and must be accompanied by the offer of help and provision of help to relieve patient suffering. [ABSTRACT FROM AUTHOR]

Background Oral diseases can negatively influence the quality of life causing harm in the development of routine activities, child development and their well-being. Aim To investigate the impact of dental caries, malocclusion and developmental defects of enamel ( DDE) on the oral health-related quality of life of preschool children and their parents. Design A cross-sectional study was carried out with 646 children aged 2-6 years in Diamantina, Brazil. Calibrated dental examiners performed the oral examinations. Parents answered the Brazilian version of the Early Childhood Oral Health Impact Scale ( B- ECOHIS) and a questionnaire on socio-economic indicators. Statistical analyses involved the chi-square test and Poisson regression. Results Malocclusion and DDE did not cause a negative impact on the children's quality of life. Children with dental caries ( PR: 1.92; 95% CI: 1.56-2.35) and those aged 5 ( PR: 1.51; 95% CI: 1.13-2.02) and 6 years ( PR: 1.51; 95% CI: 1.02-2.23) were more likely to have a negative quality of life impact on the total B- ECOHIS. Conclusions Dental caries was associated with a negative impact on the quality of life of children. Malocclusion and DDE did not cause a negative impact on the children's quality of life. Older children had higher frequency of negative impact on OHRQo L. [ABSTRACT FROM AUTHOR]

Objectives: To determine the prevalence of psychological distress (PD) among parents of Lebanese children with cancer and to investigate the associated stressors and coping strategies.Methods: A cross-sectional study conducted at the American University of Beirut Medical Center-Children Cancer Center of Lebanon in 2012. Parents of all children with cancer admitted for treatment were eligible participants. The General Health Questionnaire (GHQ-12) was used to estimate the prevalence of PD. Coping strategies were measured via the Coping Health Inventory for Parents (CHIP). Bivariate and multiple regression analyses were conducted to evaluate the relationship between GHQ-12 (scores 0-36), stressors, family/social support, and coping strategies.Results: One hundred fourteen parents (68.2%) completed the anonymous questionnaire. Based on GHQ-12, significant PD was considered among 56.0% of the parents. It was found to be significantly positively associated with the degree of family financial problems and significantly negatively associated with the child's disease duration. A significant negative relationship was also found between PD and Coping (CHIP) scale, coping pattern I (Maintaining Family Integration and an Optimistic Outlook for the Situation), pattern II (Seeking Social Support), yet not with pattern III (Seeking Information).Conclusions: PD is prevalent among parents of Lebanese children hospitalized because of cancer. Screening for PD in the latter population is feasible, would identify those who are at risk for disruptive PD, and facilitate the provision of support towards better adjustment and coping. Alleviating parental PD may facilitate the realization of optimal health outcomes. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to describe the patterns of therapy service use for a sample of children and adolescents with cerebral palsy over a 1 year period and to identify factors associated with frequency of therapy and parental satisfaction with therapy frequency.Methods: Parents of 83 children completed a survey on their child's use of occupational therapy, physiotherapy and speech and language pathology services over the previous year. Participants were randomly selected from a sample stratified by age and Gross Motor Function Classification System (GMFCS) level.Results: During the year prior to survey completion, 83% of children had received occupational therapy, 88% had received physiotherapy and 60% had received speech and language pathology services. Frequency of therapy was higher for younger children (P < 0.01), those classified at GMFCS levels IV-V (P < 0.05) and those attending schools specifically for children with disabilities.Conclusions: Current structures for therapy service delivery for children with cerebral palsy are systems-based, and age-based funding systems and the organisation of services around the education system are preventing the delivery of needs-based therapy. Paediatricians that care for children and young people with cerebral palsy need to pay particular attention to those that may miss out on therapy due to age or school type, and support these families in accessing appropriate therapy. [ABSTRACT FROM AUTHOR]

Aim. To assess the impact of caries and its treatment on quality of life (QoL) in 12- to 15-yearold children in Benin, Nigeria. Design. This was a cross-sectional study involving 1790 children. Clinical examinations were conducted using the WHO criteria for diagnosis and coding of caries. The Decayed Missing Filled Teeth score of each child was calculated. The child Oral Impact on Daily Performance questionnaire was used to assess the QoL of children with caries preand post-treatment. Associations between age, sex, and socio-economic status and caries were analysed using bivariate and multivariate logistic regression analysis. Results. The prevalence of caries in the study population was 21.9%. Approximately 57% of children with caries reported negative impact on their QoL pre-treatment. Eating (47.6%) was the most affected domain. The mean pre-treatment QoL score was 8.40 ± 10.34. Four weeks posttreatment, only 1.12% of participants reported negative impact of caries treatment on their QoL. The mean post-treatment QoL score was 0.22 ± 0.91 There was a significant difference between pre- and post-treatment QoL scores (P = 0.0001) with significant changes in all the eight domains studied. Age, sex, and socio-economic status had no significant impact on QoL pre- and post-treatment. Conclusions. Caries had a significant impact on the QoL of adolescents. Its treatment resulted in marked improvement in QoL. [ABSTRACT FROM AUTHOR]

Objective: Depression and reduced quality of life are often reported in patients with upper-extremity lymphedema secondary to breast cancer treatment. Little is known about how pain and body image influence depression in patients with lymphedema. The current study examined the association of pain intensity and body integrity beliefs with depressive symptoms and the extent to which body image dissatisfaction mediated these associations.Methods: A cross-sectional sample of patients with lymphedema secondary to breast cancer treatment completed self-report questionnaires of pain, body image, and depressive symptoms. Hierarchical regression analyses and tests of mediation were conducted to examine the associations among the variables of interest.Results: Pain intensity and body integrity beliefs were positively associated with depressive symptoms. Further, body image dissatisfaction mediated the relationship between pain and depressive symptoms, indicating that higher levels of pain led to higher states of body image dissatisfaction, which, in turn, led to greater depressive symptoms. Body image dissatisfaction also mediated the relationship between body integrity beliefs and depressive symptoms, suggesting that greater body integrity beliefs led to higher dissatisfaction with one's body and subsequently to greater depressive symptoms.Conclusions: Our findings provide preliminary evidence that pain intensity and body image are important factors in understanding depressive symptoms in patients with lymphedema. Clinical implications include screening for pain and body image concerns in this population to identify patients who are in distress. Counseling interventions targeting body image dissatisfaction can also be potentially helpful for patients with lymphedema. [ABSTRACT FROM AUTHOR]

Background Besides the clinical aspects, the patient's perspective of oral health-related quality of life ( OHRQoL) may be influenced by a series of individual characteristics. Aim The aim was to investigate the impact of clinical and psychosocial variables on the OHRQoL of Brazilian schoolchildren. Design A school-based cross-sectional study was conducted with children of 8-10 year old attending public (15) and private (5) schools ( n = 749). Questionnaires were applied to parents to obtain socioeconomic characteristics, and children were interviewed. Assessment of OHRQoL was performed using the Child Perceptions Questionnaire 8-10 ( CPQ). Oral health examinations included periodontal condition, dental caries, dental trauma, and malocclusion assessment. Unadjusted analyses were undertaken using t-tests and one-way analysis of variance. Multiple linear regression was used to assess the effects of independent variables on CPQ scores. Results Factors associated with higher CPQ scores in the linear regression analysis after adjustments were family income, presence of decayed teeth, self-reported dental trauma, dental fear, and dental pain. Conclusion Oral health-related quality of life was influenced by psychosocial and clinical variables. [ABSTRACT FROM AUTHOR]

ABSTRACT Surgical outcomes due to cystectomy continue to improve, but this is not enough to eliminate all physical, psychological and social problems that patients experience after discharge and that continue to impact their quality of life (QOL). The aim of this study is to determine the QOL and problems experienced by urostomy patients. The data of this cross-sectional and descriptive study were gathered from 17 patients who underwent first and elective radical cystectomy and ileal conduit in one university hospital in Turkey between March 9, 2009, and September 5, 2010. Data were collected by using two forms and the 'Short Form-36 Quality of Life Scale ( SF-36)'. Number, percentage, mean, standard deviation, the Kolmogorov-Smirnov test, t-test and anova were used for data analysis. The mean age of patients was 64·76 ± 8·81. The majority of the patients in the study were male (94·1%). It was found that many patients experienced constipation (82·4%), problems related to incision site (64·7%), fatigue (58·8%), myalgia, limitation of movement and difficulties with changing stoma pouch (52·9%). The patients who experienced problems generated lower mean QOL scores than patients who did not experience any post-discharge problems. In conclusion, urostomy patients experienced many physical and psychological problems after discharge which affected the patients' QOL. It is recommended that specialist stoma care nurse services are established in each hospital in Turkey to give comprehensive discharge training pre-operatively and post-operatively in order to prepare the patient for post-operative recovery and adjustment to an ostomy, to continue counselling during home follow-ups for decreasing psychologically and physically problems related to stoma and for improving patients' physical, psychological and social well-being, and the QOL. [ABSTRACT FROM AUTHOR]

Background Quality of life (QoL) is an important construct when assessing treatment outcomes. Aims To examine the relative contributions of functioning, psychological well-being and self-efficacy on self-perceived QoL with a sample of total laryngectomy patients in Australia who had surgery for advanced laryngeal cancer. Methods & Procedures In a cross-sectional study, 113 members of the Laryngectomy Associations of New South Wales and of Victoria, Australia, were recruited, and each was sent a series of questionnaires for postal return. Four psychometrically validated measures were used for participants to document their QoL, functioning (speech, swallowing), psychological well-being and general self-efficacy. Outcomes & Results Eighty-six (77%) questionnaires were returned and 83 were analysed. The cohort consists of 70 men and 13 women aged between 46 and 88 years. Overall, this sample of total laryngectomy survivors demonstrated significantly reduced physical health QoL ( p < 0.001) and social relationship QoL ( p = 0.011) and higher levels of depression ( p = 0.008) and anxiety ( p = 0.001) when compared with normative samples. This was in the context of them having higher than normal self-efficacy scores and, at worst, mild (self-rated) impairment of speech and of swallowing. Psychological well-being ( sr2 = 0.43, p < 0.001) had a stronger association than functioning (speech, swallowing, sr2 = 0.08, p < 0.05) for their psychological QoL. Psychological well-being ( sr2 = 0.17, p < 0.001) and not functioning ( sr2 = 0.05, p > 0.05) were significantly associated with social relationship QoL. Self-efficacy scores were significantly higher than norms in this cohort, but were not associated with either their psychological QoL or social relationship QoL, after controlling for psychological well-being and functioning. Conclusions & Implications For survivors of laryngeal cancer treated by total laryngectomy, it is important to be aware of the impact of psychological well-being (depression, anxiety, stress) on self-perceived QoL. In addition to rehabilitating function (speech, swallowing), specific interventions to assist these individuals better manage their psychological well-being will likely improve their perceived life satisfaction/QoL. [ABSTRACT FROM AUTHOR]

Background Chronic migraine with medication overuse ( CM-MO) impairs quality of life ( QoL) and causes disability. Psychosocial variables such as depressive symptomatology, self-efficacy, and social support have been sparingly investigated, and their impact on disability and QoL is unknown. Methods Patients with CM-MO under withdrawal were consecutively enrolled. Standardized measures of disability and QoL were used as outcomes; psychosocial (ie, mood state, self-efficacy, social support) and clinical (ie, headache frequency and intensity) variables were considered as associated variables. Associations between these variables, disability, and QoL were tested with Pearson's correlations. Hierarchical multiple regression was used to assess the cumulative contribution of psychosocial variables on disability and QoL variation when added to clinical variables. Results One hundred ninety-four patients were enrolled; 82.5% were females and mean age was 43.9. Disability and QoL were moderately or little correlated to clinical and psychosocial variables. Models based on clinical variables explained 7.5-14.3% of disability and QoL variation, with pain intensity being the only significant predictor; when psychosocial variables were added, the explained variation increased to 21.5-35.2%, with depressive symptomatology always having independent predictive power and perceived social support having independent predictive power in the regression model over role-prevention component of QoL. Conclusions Adding information on psychosocial variables to headache features improved our ability to understand disability and QoL of CM-MO patients. We deem that the inclusion of psychosocial variables in standard evaluation protocols may contribute to the global assessment of CM-MO patients, and eventually to their success in reducing the personal and social impact of this condition. Future longitudinal studies are needed to confirm this hypothesis. [ABSTRACT FROM AUTHOR]

Aims A population-based cross-sectional study design was used to study the effects of symptoms of various gynecological morbidities ( GM) on health-related quality of life ( HRQo L) of women, residents of squatter settlements of Karachi, Pakistan. Material and Methods This cross-sectional study was conducted in squatter settlements of Karachi from September 2012 to August 2013, with 1002 married, non-pregnant women. After obtaining written informed consent from every participant, a structured questionnaire was used to collect information about symptoms of GM and their effect on four domains of HRQo L (physical, social, functional and financial domains). Results Of 1002 women who participated in the study, 578 reported suffering from one or more symptoms of GM. The most commonly reported symptoms were foul-smelling vaginal discharge, dysmenorrhea and uterovaginal prolapse while the least reported symptom was post-coital bleeding. Symptoms of GM were found to have a negative impact on HRQo L. Approximately one-third of women with the symptoms of GM reported having negative influences on the physical, financial and functional domains of HRQo L with social domain being comparatively less affected. Compared to other symptoms, dysmenorrhea and uterovaginal prolapse were reported to be mostly associated with poor HRQo L of women. Conclusion The concept of HRQo L has been kept marginal and inconspicuous by clinicians. In order to achieve the psychosocial satisfaction of the patient, the focus needs to be diverted to all domains of HRQo L. [ABSTRACT FROM AUTHOR]

Objectives The purpose of this study was to investigate quality of life ( QOL) and attitudes to ageing in Turkish older adults at two old people's homes (nursing homes) and to explain relationship between QOL and attitudes to ageing. Methods This study is a quantitative and descriptive exploratory study of QOL and attitudes to ageing of older adults in nursing homes in a developing country. Instruments Two international data measurement tools were used for data collection. Data measurement instruments in this study are The World Health Organization Quality of Life Instrument- Older Adults Module ( WHOQOL- OLD) and the WHO - Attitudes to Ageing Questionnaire ( AAQ). The WHOQOL- OLD module consists of 24 items assigned to six facets (sensory abilities, autonomy, past, present and future activities, social participation, death and dying and intimacy) AAQ consists of 24 items classified in three domains (psychosocial loss, physical change and psychological growth) with eight items each. Participants The Turkish version of the WHOQOL- OLD and AAQ was administered to 120 older (>65 years) adults living in two old people's homes in Samsun Province, Turkey. This study was conducted and planned between on 1 November 2011 and on 31 November, 2011. Results The results indicated that there was significant relationship between QOL and attitudes to ageing of older adults. In this study, the highest significant relationship is between psychological growth subscale of attitudes to ageing and sensory abilities subscale of QOL ( r = 0.579; P < 0.01). Overall QOL and overall attitudes to ageing had a significant and positive relationship ( r = 0.408; P < 0.01). The dimensions of attitudes to ageing (psychosocial loss, physical change and psychological growth) were significant predictors for QOL in older adults in Turkey. It was found that the gender does not affect overall QOL in older adults. However, happiness is significant variable for overall QOL in this study. Conclusion The results suggest that QOL is a complex, multidimensional concept that should be studied at different levels of analysis in Turkey and other developing countries. The results of this study emphasize the importance of QOL in older adults in older people's homes in Turkey and attitudes to ageing of nursing home residents in Turkey. [ABSTRACT FROM AUTHOR]

ABSTRACT Overactive bladder ( OAB) is condition, characterized by urinary urgency, frequency and incontinence, which has the potential to disrupt everyday life considerably. Although there is evidence that antimuscarinic treatment is effective at treating physical symptoms, there is currently no systematic exploration of psychological factors associated with OAB after treatment. This study aimed to examine the quality of life, relationships, sexual functioning, psychological wellbeing and illness perceptions of individuals with OAB after they have received treatment. And to determine whether an individual's psychological wellbeing is directly related to the severity of their symptoms, or whether their illness perceptions mediate this relationship. This study used a cross-sectional, questionnaire-based quantitative design with a secondary care outpatient sample who were diagnosed with OAB and had been either previously or currently prescribed drug treatment. Patients reported moderately severe OAB symptoms, with approximately a third reporting moderate/severe anxiety and 12% reporting severe depression. There was no direct relationship between symptom severity and psychological wellbeing ( β = −0·03, t(31) = −0·96, p = 0·34; β = −0·02, t(31) = −0·41, p = 0·68) - this relationship was mediated by the patient's sense of personal control over their OAB ( β = 0·03 ( SE = 0·02), 95% CI [0·004, 0·09]; β = 0·02 ( SE = 0·02), 95% CI [0·0008, 0·08]). Including interventions to improve personal control alongside drug treatment may improve treatment adherence and outcomes. [ABSTRACT FROM AUTHOR]

Aim To evaluate the impact of traumatic dental injury ( TDI) among Brazilian adolescents on their families' quality of life (QoL). Design A cross-sectional study was carried out with a population-based sample of 1122 schoolchildren aged 11-14 years selected using a multistage sampling procedure. Parents/caregivers answered the Brazilian version of the 14-item Family Impact Scale (B- FIS) to assess the impact on family's QoL. The main independent variable was TDI, which was diagnosed using the Andreasen classification. Malocclusion, dental caries, gender and socio-economic classification were the other independent variables. Poisson regression analyses were carried out ( P < 0.05). Results The prevalence of TDI was 14.8%. The multivariate model demonstrated that families of adolescents diagnosed with fracture involving the dentine or dentine/pulp were more likely to report a negative impact on the overall B- FIS score [rate ratio ( RR) = 1.44; 95% confidence interval ( CI): 1.10-1.88] as well on the Parental/Family Activity ( RR = 1.45; 95% CI: 1.09-1.94), Parental Emotions ( RR=1.45; 95% CI: 1.03-2.04) and Family Conflict ( RR = 1.46; 95% CI: 1.01-2.11) subscales in comparison with those who had no signs of TDI. Conclusions Families of adolescents with more severe TDI were more likely to report a negative impact on QoL, affecting family activities and emotions, which can result in family conflicts. [ABSTRACT FROM AUTHOR]

ABSTRACT Overactive bladder ( OAB) is a common medical condition. A number of health-related quality of life ( HRQOL) measurements for OAB have been developed during recent years, including the linguistic validation of the traditional Chinese version of the Kings' Health Questionnaire ( KHQ). However, limited studies are available for this version of KHQ. Hence, the aim of this study was to examine the reliability and discriminant validity of this traditional Chinese version within the communities of Taiwanese. A cross-sectional and case-control study was designed. On the basis of a convenience sampling, participants were recruited at a community health center in Pingtung County, Taiwan from March to July 2010. The collected data included OAB symptoms assessed by the Overactive Bladder Symptom Score ( OABSS), the HRQOL assessed by the traditional Chinese version of the KHQ and demographic characteristics. Subjects with urinary urgency at least once a week and a total score of OABSS ≥ 3 were assigned to the OAB group. Participants without OAB but with matched age and gender were selected as the control group. Internal consistency reliability was assessed using Cronbach's α, and discriminant validity was examined by Student's independent t-test. A total of 173 pairs of observations were matched and analysed. The Cronbach's α value was above 0·80 for the traditional Chinese version of KHQ and all its subscales, suggesting a good internal consistency reliability for this measurement. The participants in OAB group showed poor quality of life than the controls (all p < 0·001), which display a good discriminant validity of traditional Chinese version of KHQ. Only 39·9% ( n = 69) participants with OAB had discussed their symptoms with a doctor during the past year. As the HRQOL could be improved by medical help, health care providers should educate the public about OAB and encourage patients to seek medical attention. [ABSTRACT FROM AUTHOR]

Objectives The long and demanding course of medical education may be accompanied by distress with serious consequences. This study was conducted to assess the multidimensional health-related quality of life ( HR- QoL) in medical students in different stages of medical education and its associations with behavioural and social factors. Methods A cross-sectional study was conducted in medical students at three medical schools at, respectively, Tehran University of Medical Sciences, Aja University of Medical Sciences and Baghiyatalah Medical School, in November and December 2011 using stratified sampling. Data were obtained on participants' characteristics, including gender, current education stage, living situation, smoking status, physical activity, and membership of associations or teams. Health-related QoL was measured using the Persian version of the 36-item Short Form Health Survey ( SF-36), which generates a physical component score ( PCS) and a mental component score ( MCS). Logistic regression was applied to measure the adjusted associations between variables. Results Of the 1350 students invited, 1086 individuals completed the survey to give a response rate of 80.4%. Logistic regression showed male gender (odds ratio [ OR] = 2.88, p < 0.001), living with family versus in a dormitory ( OR = 2.72, p < 0.001) and participation in daily physical activity ( OR = 16.96, p < 0.001) to be significantly associated with a higher PCS. Being in an internship versus in the basic sciences stage of medical education showed a significant association with a lower PCS ( OR = 0.12, p < 0.001). Similarly, male gender ( OR = 1.67, p < 0.05), living with family rather than in a dormitory ( OR = 16.91, p < 0.001), daily physical activity ( OR = 25.36, p < 0.001), and membership of associations or teams ( OR = 3.67, p < 0.001) were associated with a higher MCS. Likewise, studying in internship rather than in the basic sciences stage was accompanied by a lower MCS ( OR = 0.12, p < 0.001). Conclusions This large, multi-institution study, despite its limitations, indicates that medical students in internships show lower scores in all domains of QoL. Social engagement is an important associate of higher HR-QoL. Further studies should address the efficacy of interventions, such as self-awareness programmes and initiatives to encourage students to be more physically and socially active, in improving students' health. [ABSTRACT FROM AUTHOR]

Objectives To determine the prevalence of nonmotor symptoms ( NMS) in nursing home ( NH) residents with Parkinson's disease ( PD) and to establish the association with quality of life. Design Cross-sectional. Setting Nursing homes in the southeast of the Netherlands. Participants Nursing home residents with PD and a Mini- Mental State Examination score of 18 or greater (N = 73; mean age 78.7, disease duration 10 years, mainly Hoehn and Yahr Stages 4 (38%) and 5 (49%)) underwent detailed examination to determine the prevalence of NMS. Measurements Validated instruments for PD-related NMS were used to examine the NH residents with PD. The overall burden of NMS, and autonomic problems in particular, were measured using the Non- Motor Symptoms Scale ( NMSS). Depression, neuropsychiatric symptoms, sleep problems, cognitive dysfunction, and motor impairments were focused on in further detail using established clinimetric tests. Linear regression analysis was used to examine the relationship between these symptoms and quality of life, which was measured using the Parkinson's Disease Questionnaire ( PDQ-8). Results The NMSS revealed a mean of nearly 13 different NMS per resident. Autonomic problems (constipation, urinary urgency) were particularly prevalent (48-75% of residents). Depressive symptoms were present in 45%. The most prevalent neuropsychiatric symptoms other than depression were irritability and apathy. The most common sleep problems were overall poor nighttime sleep quality, daytime sleepiness, and nocturia. Cognitive problems were highly prevalent, and 77% of the residents met the criteria for PD-related dementia. High scores were also obtained for motor impairments. Mean PDQ-8 score was high, indicating poor quality of life. Poor quality of life was most strongly associated with the prevalence and severity of overall NMS burden (coefficient of determination = 0.45). Conclusion Nonmotor symptoms were highly prevalent in NH residents with PD. Quality of life was poor, largely because of NMS. Because many NMS are potentially treatable, diagnosis and treatment of these severely affected individuals deserve more attention. [ABSTRACT FROM AUTHOR]

Objectives To evaluate the effect of urinary incontinence ( UI) on elderly nursing home ( NH) residents' self-reported quality of life ( QOL), especially on the specific QOL domains most closely associated with UI. Design Retrospective cross-sectional study using the Minimum Data Set ( MDS) and Minnesota Nursing Home Report Card data in 2010 to compare overall QOL and its domains of residents with and without UI using propensity scores and inverse probability weighting ( IPW) adjustments to reduce selection bias. Setting All Medicare- or Medicaid-licensed NHs in Minnesota. Participants All residents aged 65 and older except those with conditions that could readily overwhelm the effect of UI on QOL, such as coma and cerebral palsy. Measurements Urinary incontinence ( UI) was defined as leakage two or more times a week (score ≥2 on MDS 5-point scale), and continence was defined as continent or usually continent (score 0 or 1 on MDS 5-point scale). QOL was assessed using a self-reported QOL questionnaire that measured general QOL, not QOL specific to UI symptoms. Results Urinary incontinence ( UI) prevalence was 65.8% in 10,683 older NH residents. Self-reported QOL was good (>0.7 on a scale from 0 to 1) in 8,620 eligible residents in 371 NHs. Mood and meaningful activity domains had lower scores; dignity had the highest score. UI was associated with being older and female, ADL dependence, impaired cognitive ability, Alzheimer's disease, non- Alzheimer's dementia, bowel incontinence, diabetes mellitus, and long-term NH stay. Bivariate analysis found that residents with UI had lower QOL than those without. Using IPW to reduce selection bias, it was found that, although UI was not associated with overall QOL, it decreased the QOL domains of dignity, autonomy, and mood. Conclusion To improve the QOL of residents with UI, attention should be paid to dignity, autonomy, and mood. [ABSTRACT FROM AUTHOR]

SUMMARY Health-related quality of life (HRQOL) and depression in chronic dialysis patients, accepted (n = 122) or rejected (n = 93) for renal transplantation (Tx), were compared, whereas dialysis patients with pending acceptance status (n = 86) were followed for a median time of 3.6 years to assess whether HRQOL or depression predicted the likelihood of receiving a transplant. Clinical significant depression was present in 30% of the study patients. Less depression and better HRQOL were associated with being on the waiting list for Tx after adjusting for comorbidity, age, gender and dialysis vintage. During follow-up, 55% of the dialysis patients in the group with pending acceptance were transplanted. The likelihood of receiving a renal graft was based on comorbidity and not on impaired HRQOL or depression. Follow-up studies should investigate whether improved renal health after Tx translates into further improvement of HRQOL and less depression. Whether clinical depression and impaired HRQOL will impact graft survival needs to be explored. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate the prevalence and effect of overactive bladder (OAB) on healthcare-seeking behavior, mental health, and generic and condition-specific health-related quality of life (HRQL) in older adults. DESIGN: Secondary analysis of the U.S. sample of the Epidemiology of Lower Urinary Tract Symptoms (EpiLUTS) study-a population-based, cross-sectional, Internet-based survey. SETTING: Community. PARTICIPANTS: Two thousand four hundred eighty-five men and 2,877 women aged 65 and older. MEASUREMENTS: Prevalence and effect on HRQL of urinary symptoms, including OAB. OAB was defined as the presence of urinary urgency and/or urinary urgency incontinence. Descriptive analyses and subgroup comparisons were conducted to evaluate the prevalence of OAB in men and women aged 65 and older and the effect of OAB on various aspects of HRQL. RESULTS: The survey response rate was 46.9% of men and 61.0% of women. Prevalence rates of OAB at least 'sometimes' were 40.4% in men and 46.9% in women. OAB was associated with significant impairments across all domains of patient-reported outcomes, including general HRQL (Medical Outcomes Study 12-item Short-Form Survey), ratings of anxiety and depression (Hospital Anxiety and Depression Scale), and urinary condition-specific outcomes (Overactive Bladder Questionnaire Short Form and Patient Perception of Bladder Condition) ( P<.001). CONCLUSION: OAB is common in older adults in the United States and is associated with substantial impairment in mental health and HRQL, but rates of treatment seeking behavior are low. Older patients should be assessed for OAB. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the predictive value of various coping processes for the psychological and disease specific aspects of health-related quality of life (HRQoL) in Parkinson’s disease (PD). Method: Cross-sectional study of 85 participants with PD using the Ways of Coping Questionnaire (WCQ), Depression, Anxiety, and Stress Scale (DASS-21), quality of life (PDQ-39), and sociodemographic and clinical variables. Results: Greater use of planful problem solving coping was found to be significantly associated with better HRQoL in relation to cognitive impairment, communication and bodily discomfort. In addition to greater disease duration, greater use of escape-avoidance coping processes were identified as significant predictors of poorer HRQoL outcomes in the domains of mood and emotional well-being. Conclusion: Psychological interventions such as mindfulness training, aimed at reducing the use of escape-avoidance copying, may help to improve HRQoL in PD. [ABSTRACT FROM AUTHOR]