Quality of life related to the health and socio-economic resources of the elderly

2017 ◽  
Vol 41 (S1) ◽  
pp. S694-S695
Author(s):  
F. Daniel ◽  
A. Ferreira ◽  
H. Espírito-Santo ◽  
R. Monteiro ◽  
I. Massano-Cardoso ◽  
...  

IntroductionAging is a very heterogeneous and dissimilar process, full of asymmetries. There is evidence that socio-economic differences determine disadvantages and inequalities in old ages. Older people face particular inequalities in healthiness especially with more complex and vulnerable long-term conditions, being more likely to need support from social care services.AimTo evaluate the quality of life (well-being) related to the health of the elderly according to socio-economic indicators.MethodCross-sectional quantitative study was performed. A total of 316 elderly people (M = 74.78; SD = 9.78 years of age) was interviewed with the Portuguese version of the EQ-5D-3L scale for health-related quality of life.ResultsThe interaction between income and the type of residential follow-up (alone vs. accompanied) was not statistically significant [F (2.310) = .910, P < .407; Ƞp2 = .006]. Differences in health status index were statistically significant for income [F (2.310) = 5.518, P < .004; Ƞp2 = .034]. Post-hoc comparisons indicated that the mean score for those with insufficient income for their expenses (M = .39, SD = .27) was significantly different from those with income reaching their expenses (M = .50, SD = .25) as well as those with income covering their expenses sufficiently (M = .60, SD = .21). The main effect for the type of follow-up (alone vs. accompanied) did not reach statistical significance [F (2.310) = .224, P < .636, Ƞp2 = .672].ConclusionsIncome has an impact on health-related quality of life. Health in aging as a social phenomenon is not neutral to economic differences and is exposed to these structural disadvantages.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Author(s):  
Jocelito TONDOLO JUNIOR ◽  
Jessica Klöckner KNORST ◽  
Gabriele Rissotto MENEGAZZO ◽  
Bruno EMMANUELLI ◽  
Thiago Machado ARDENGHI

ABSTRACT Objective: To assess the influence of early childhood malocclusion on oral health-related quality of life (OHRQoL). Methods: 7-year cohort study involving 639 preschoolers (1 to 5 years) who had been evaluated initially with a survey conduced in 2010. Children completed the Brazilian version of the Child Perception Questionnaire (CPQ8-10) to assess OHRQoL during the follow-up period. Exploratory variables were collected at baseline, including the presence and severity of malocclusion (overjet and lip coverage). Socioeconomic characteristics, oral health behavior, and patterns of dental attendance were also investigated. A multilevel Poisson regression model was used to fit the association between malocclusion and OHRQoL. With this approach, incidence rate ratio (IRR) and 95% confidence intervals (95% CI) were calculated. Results: A total of 449 children were re-evaluated (follow-up rate, 70.3%). The prevalence of accentuated overjet and inadequate lip coverage was 13.5% and 11.9%, respectively. The mean (±SD) CPQ8-10 score was 10.57±10.32. The presence of inadequate lip coverage was associated with higher overall mean CPQ8-10 scores (IRR 1.51; 95% CI 1.29-1.77), and social well-being, emotional well-being, and functional limitation domains. Children with accentuated overjet (>3mm) also demonstrated higher overall scores on the CPQ8-10 than their normal counterparts. The presence of this condition also influenced the oral symptom (IRR 1.29; 95% CI 1.08-1.53) and emotional well-being (IRR 1.30; 95% CI 1.02-1.66) domains. Conclusion: Results of the present study suggest that early childhood malocclusion is a risk factor for low OHRQoL in future.


1996 ◽  
Vol 7 (5) ◽  
pp. 763-773 ◽  
Author(s):  
K M Beusterien ◽  
A R Nissenson ◽  
F K Port ◽  
M Kelly ◽  
B Steinwald ◽  
...  

As a component of the open-label, multicenter National Cooperative Recombinant Human Erythropoietin (Epo) Study, the health-related quality-of-life effects of Epo therapy were assessed in 484 dialysis patients who had not previously been treated with Epo therapy (New-to-Epo) and 520 dialysis patients who were already receiving Epo therapy at the time of study enrollment (Old-to-Epo). Using scales from the Medical Outcomes Study 36-item Short Form Health Survey (SF-36), health-related quality of life was assessed on study enrollment (baseline) and at an average of 99 days follow-up. At baseline, SF-36 scores for Old- and New-to-Epo patients were well below those observed in the general population, reflecting substantial impairments in functional status and well-being among patients with chronic renal failure. Significant improvements from baseline to follow-up were observed among New-to-Epo patients in vitality, physical functioning, social functioning, mental health, looking after the home, social life, hobbies, and satisfaction with sexual activity (P < 0.05 for each). The mean improvements in hematocrit values among New-to-Epo and Old-to Epo patients were 4.6 and 0.3, respectively. At the time of follow-up, SF-36 scores for New-to-Epo patients were comparable with those observed among Old-to-Epo patients, whose scores did not change significantly from baseline to follow-up. Analysis of the relationship between Epo therapy, hematocrit values, and health-related quality of life suggest that some of the beneficial quality-of-life effects of Epo are mediated through a change in hematocrit level.


2020 ◽  
Author(s):  
James John ◽  
Kathy Tannous ◽  
Amanda Jones

Abstract Purpose: Evidence suggests that Patient-centred Medical Home (PCMH) model facilitates person-centred care and improves health-related quality of life for patients with chronic illness. This study aims to evaluate changes in health-related quality of life (HRQoL), before and after enrolment into a 12-month integrated care program called ‘WellNet’. Methods: This study includes 616 eligible consented patients aged 40 years and above with one or more chronic conditions from six general practices across Sydney, Australia. The WellNet program included a team of general practitioners (GPs) and clinical coordinators (CCs) providing patient-tailored care plans configured to individual risk and complexity. HRQoL was recorded using the validated EuroQol EQ-5D-5L instrument at baseline and 12 months. Additionally, patients diagnosed with osteoarthritis also reported HRQoL using short versions of Knee and/or Hip disability and osteoarthritis outcome scores (KOOSjr and HOOSjr). A case-series study design with repeated measures analysis of covariance (ANCOVA) was used to assess changes in mean differences of EQ-5D index scores after controlling for baseline covariates. Per-protocol (Model 1) and multiple imputation models (Model 2), the latter using a fully conditional specification (FCS) of Markov Chain Monte Carlo (MCMC) algorithm was analysed. Additionally, backward stepwise multivariable linear regression models were conducted to determine significant predictors of EQ-5D index scores at follow-up. Results: Out of 616 patients, 417 (69%) reported EQ-5D scores at follow-up. Almost half (48%) of the WellNet patients reported improved EQ-5D index scores at follow-up. After controlling for baseline covariates, the adjusted mean difference was statistically significant whilst also meeting the bare minimal clinically important difference (MCID) with a change of 0.03 (95% CI 0.01, 0.05). However, the imputed model failed to meet statistical significance. The multivariable regression models determined that baseline EQ-5D scores, positive diagnosis of a respiratory illness, and private health insurance status were significant predictors of HRQoL at follow-up. There were significant improvements across both KOOS and HOOS assessments, specifically, the pain and symptom scores in both scales met statistical significance in addition to meeting the MCID.Conclusion: Patient-tailored CDM plans designed by team of GPs and CDM clinical coordinators could lead to better HRQoL among primary care patients.


2013 ◽  
Vol 12 (3) ◽  
pp. 8-16
Author(s):  
Matthew R. Scherer, PT, PhD, NCS ◽  
Daniel M. Gade, PhD ◽  
Kathleen E. Yancosek, PhD, OTR/L, CHT

Adaptive sports are popular within military and civilian rehabilitation communities as a means to promote fitness, independence, self-efficacy, and return to participation in life roles. Although widely prescribed, there is little evidence to demonstrate the efficacy of such interventions. This study surveyed 40 wounded, ill, and injured active duty and veteran service members (SMs) who participated in a week-long adaptive kayaking program. Validated health-related quality of life instruments assessing physical and behavioral health domains following trauma were administered before and after participation in a week-long adaptive kayaking trip. Postintervention analysis of these measures revealed clinically significant improvements in depression (+7 percent), anxiety (+5 percent), posttraumatic stress disorder (+4 percent), and social interaction (+7 percent) subscales on the Trauma Outcome Profile (TOP) which trended toward, but did not achieve, statistical significance. Analysis of Veterans RAND (VR-12) data revealed a mean four-point improvement in participant mental health component summary (MCS) scores (p _ 0.05) following intervention indicating clinically and statistically significant improvement in behavioral health symptoms. No improvement was observed on the mean postintervention physical health component summary (PCS) score suggesting minimal short-term effects of kayaking on self-assessment of physical well-being. In aggregate, findings from this study suggest that adaptive kayaking may be an effective intervention to remediate behavioral health sequelae commonly experienced by SM following trauma. Future research should explore the effectiveness of adaptive kayaking relative to standard of care clinical rehabilitation strategies to optimize physical as well as mental health outcomes.


2020 ◽  
Author(s):  
James John ◽  
Kathy Tannous ◽  
Amanda Jones

Abstract Purpose: Evidence suggests that Patient-centred Medical Home (PCMH) model facilitates person-centred care and improves health-related quality of life for patients with chronic illness. This study aims to evaluate changes in health-related quality of life (HRQoL), before and after enrolment into a 12-month integrated care program called ‘WellNet’. Methods: This study includes 616 eligible consented patients aged 40 years and above with one or more chronic conditions from six general practices in Sydney, Australia. The WellNet program included a team of general practitioners (GPs) and specially trained chronic disease management (CDM) clinical coordinators (CCs) providing patient-tailored CDM plans configured to individual risk and complexity. HRQoL was recorded using the validated EuroQol EQ-5D-5L instrument. A case-series study design with repeated measures ANCOVA was used to assess changes in EQ-5D index scores after controlling for baseline covariates. Per-protocol analysis and imputed model, the latter using Markov Chain Monte Carlo (MCMC) algorithm of multiple imputation were analysed. A backward stepwise multivariate linear regression models were conducted to determine predictors of EQ-5D index scores at follow-up. In addition to EQ-5D instrument, a supplementary analysis was carried out with use of the short versions of Knee and/or Hip disability and osteoarthritis outcome scores (KOOS and HOOS) reported by patients diagnosed with osteoarthritis. Results: Out of 616 patients, 417 (69%) reported EQ-5D scores at follow-up. Almost half (48%) of the WellNet patients reported improved EQ-5D index scores at follow-up. After controlling for baseline covariates, the adjusted mean difference was statistically significant whilst also meeting the bare minimal clinically important difference (MCID) with a change of 0.03 (95% CI 0.01, 0.05). However, the imputed model failed to meet statistical significance. The multivariate regression models determined that baseline EQ-5D scores, positive diagnosis of a respiratory illness, and private health insurance status were significant predictors of HRQoL at follow-up. There were significant improvements across both KOOS and HOOS assessments, specifically, the pain and symptom scores in both scales met statistical significance in addition to meeting the MCID.Conclusion: Patient-tailored CDM plans designed by team of GPs and CDM clinical coordinators could lead to better HRQoL among primary care patients.


2021 ◽  
Vol 8 (2) ◽  
pp. 205510292110528
Author(s):  
Tehila Eilam-Stock ◽  
Jon Links ◽  
Nabil Z. Khan ◽  
Tamar E. Bacon ◽  
Guadalupe Zuniga ◽  
...  

Objective At the time of multiple sclerosis (MS) diagnosis, identifying those at risk for poorer health-related quality of life and emotional well-being can be a critical consideration for treatment planning. This study aimed to test whether adverse childhood experiences predict MS patients’ health-related quality of life and emotional functioning at time of diagnosis and initial course of disease. Methods We recruited patients at the time of new MS diagnosis to complete self-report surveys at baseline and a one-year follow-up. Questionnaires included the Adverse Childhood Experiences (ACEs), as well as the MS Knowledge Questionnaire (MSKQ), the 36-Item Short Form Health Survey (SF-36), and Self-Management Screening (SeMaS). Results A total of n = 31 participants recently diagnosed with relapsing remitting MS (median EDSS = 1.0, age M = 33.84 ± 8.4 years) completed the study measures. The ACEs significantly predicted health-related quality of life (SF-36) at baseline (Adjusted R 2 = 0.18, p = 0.011) and follow-up (Adjusted R 2 = 0.12, p = 0.03), baseline scores on the SeMaS Depression scale (Adjusted R 2 = 0.19, p = 0.008), as well as follow-up scores on the SeMaS Anxiety (Adjusted R 2 = 0.19, p = 0.014) and SeMaS Depression (Adjusted R 2 = 0.14, p = 0.036) scales. Importantly, increased ACEs scores were predictive of increased anxiety at the one-year follow-up assessment, compared to baseline. Conclusions Childhood adversity predicts health-related quality of life and emotional well-being at time of MS diagnosis and over the initial course of the disease. Measured using a brief screening inventory (ACEs), routine administration may be useful for identifying patients in need of increased supportive services.


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