scholarly journals 372Social Isolation, Social Support and Loneliness as independent interconnected concepts

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Rosanne Freak-Poli ◽  
Joanne Ryan ◽  
Thach Tran ◽  
Alice Owen ◽  
Joanna McHugh Power ◽  
...  

Abstract Background Social isolation, lack of social support and loneliness have historically been assessed as overlapping or even interchangeable terms. We aimed to assess whether these three social constructs are independently associated with health-related quality of life (HRQoL). Methods This analysis included 10,517 women aged 70-75 years from the Australian Longitudinal Study on Women's Health (ALSWH). Social isolation (Duke Social Support Index: DSSI), social support (DSSI), and loneliness (one-item) were investigated for their association with HRQoL (physical [PCS] and mental [MCS] component scores of the SF-36® questionnaire). Multivariable analyses adjusted for age, demographics, socio-economic position and medical conditions. Results Social isolation, social support and loneliness were not strongly correlated with one another. However, all were independently associated with HRQoL (PCS: isolation -0.97, low support -2.24, loneliness -2.70; MCS: isolation -1.96, low support -4.78, loneliness -10.31; p-value<0.001 for each). Compared to those with low social isolation, high social support and lack of loneliness, women highly isolated, with low social support and lonely reported the lowest HRQoL (MCS: -18 to -17; PCS: -8 to -6). Other combinations of isolation, support and loneliness varied in their associations with HRQoL. Conclusions Social isolation, social support and loneliness are distinct, yet interconnected concepts that may coexist and are each adversely associated with HRQoL. Key messages Ageing populations present the challenge of supporting older people to maintain a longer, healthy, meaningful and community-dwelling lives. Social isolation, low social support and loneliness have adverse associations with HRQoL.

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4234-4234
Author(s):  
Fabio Efficace ◽  
Michele Baccarani ◽  
Massimo Breccia ◽  
Francesco Cottone ◽  
Gianantonio Rosti ◽  
...  

Abstract Abstract 4234 Background: Whilst recent data indicates that survival of chronic myeloid leukemia (CML) patients, who are in complete cytogenetic response (CCyR) with Imatinib therapy, is not statistically significantly different from that of the general population, health-related quality of life (HRQOL) differences do exist. However, to date no study has investigated the predictive factors of long-term HRQOL outcomes of CML patients treated with TKIs. Aim: The main objective of this study was to investigate potential key factors associated with long-term HRQOL outcomes of CML patients in CCyR treated with first line Imatinib therapy. A secondary objective was to investigate the relationships between fatigue and other treatment related symptoms and describe how fatigue relates to socio-demographic and clinical data. Patients and Methods: Analysis was performed on 422 CML patients recruited in an observational multicenter study. Median time in treatment with Imatinib was five years (range: 3 to 9.3 years). HRQOL was assessed with the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). This questionnaire consists of 36 items covering eight generic HRQOL domains: physical functioning (PF), role limitations due to physical health (RP), bodily pain (BP), general health perceptions (GH), vitality (VT), social functioning (SF), role limitations due to emotional problems (RE), and mental health (MH). Predictor variables investigated included, fatigue and social support, measured with two psychometrically robust questionnaires, that is the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue scale and the multidimensional scale of perceived social support (MSPSS) scale. Other CML treatment related symptoms were measures with an ad hoc CML symptom checklist. Key socio-demographic and clinical data including, age, gender, education, Sokal risk, response to therapy and duration of treatment, were also considered. Univariate and multivariate regression analyses were used to identify a set of independent predictors for each SF-36 scale, via a stepwise selection procedure. Results: In the multivariate analysis the following factors independently predicted a better PF: younger age (P<0.001), being male (P<0.001), higher education (P=0.002), and less fatigue(P<0.001). Together, this set of variables explained 56% of the variance in the PF scale. Fatigue was the only variable showing an independent and consistent association across all HRQOL domains measured by the SF-36. Role physical (RP) and role emotional (RE) scales (SF-36) were found to be the two mostly compromised aspects by fatigue severity. As fatigue was found to be the main predictor variable, for descriptive purposes in figure 1 we report mean scores of the SF-36 scales by levels of fatigue. Mean score differences, between patients reporting low versus high fatigue levels, were respectively 70 and 63 points for the RP and RE scales. Higher perceived social support independently predicted better social functioning (P<.001) and mental health (P<.001). Hb levels, measured at the most recent follow-up visit (mean time 2.9 weeks), showed a weak correlation (r=.187) with fatigue. Higher levels of fatigue were more common in those patients who already had comorbidity at diagnosis and in female patients. Patients who reported higher levels of fatigue also reported a higher severity of other CML symptoms. Conclusion: To our knowledge, this was the first investigation to date of factors associated with long-term HRQOL in CML patients being treated with an oral anticancer-targeted therapy. Our findings suggest that although responding to Imatinib therapy, long-term patient's HRQOL is greatly affected by fatigue levels. Also, our results suggest that symptom management is crucial to the possible improvement of HRQOL outcomes. Legend: Low, Low-Medium, Medium-High and High correspond respectively to the 4th (75th to 100th percentile), 3rd, 2nd and 1st (0th to 25th percentile) quartile of FACIT-Fatigue scale. On this scale, the higher the score the lower is the level of fatigue. Disclosures: Efficace: Bristol Myers Squibb: Consultancy; Novartis: Research Funding. Baccarani:Novartis : Consultancy, Honoraria; Bristol Myers Squibb: Consultancy, Honoraria; Pfizer and Ariad: Honoraria. Breccia:Bristol Myers Squibb: Consultancy; Novartis: Consultancy. Rosti:Novartis: Consultancy, Honoraria, Research Funding; Bristol Myers Squibb: Consultancy, Honoraria. Alimena:Novartis: Honoraria; Bristol Myers Squibb: Honoraria. Turri:Novartis: Consultancy, Novartis Other; Bristol Myers Squibb: Bristol Myers Squibb, Bristol Myers Squibb Other, Consultancy.


2016 ◽  
Vol 11 (1) ◽  
pp. 90-96 ◽  
Author(s):  
Katie E. Cherry ◽  
Laura Sampson ◽  
Sandro Galea ◽  
Loren D. Marks ◽  
Kayla H. Baudoin ◽  
...  

AbstractObjectiveExposure to multiple disasters, both natural and technological, is associated with extreme stress and long-term consequences for older adults that are not well understood. In this article, we address age differences in health-related quality of life in older disaster survivors exposed to the 2005 Hurricanes Katrina and Rita and the 2010 BP Deepwater Horizon oil spill and the role played by social engagement in influencing these differences.MethodsParticipants were noncoastal residents, current coastal residents, and current coastal fishers who were economically affected by the BP oil spill. Social engagement was estimated on the basis of disruptions in charitable work and social support after the 2005 hurricanes relative to a typical year before the storms. Criterion measures were participants’ responses to the SF-36 Health Survey which includes composite indexes of physical (PCS) and mental (MCS) health.ResultsThe results of logistic regressions indicated that age was inversely associated with SF-36 PCS scores. A reduction in perceived social support after Hurricane Katrina was also inversely associated with SF-36 MCS scores.ConclusionsThese results illuminate risk factors that impact well-being among older adults after multiple disasters. Implications of these data for psychological adjustment after multiple disasters are considered. (Disaster Med Public Health Preparedness. 2017;11:90–96)


2020 ◽  
Author(s):  
Xinye Qi ◽  
Jiao Xu ◽  
Linghan Shan ◽  
Ye Li ◽  
Yu Cui ◽  
...  

Abstract BackgroundThe diagnosis and health care of patients with rare diseases present a tremendous challenge worldwide. This study estimated the health service utilization, cost of illness, and patients with Gaucher disease (GD)’s/caregivers’ health-related quality of life in China.MethodAn online retrospective survey of patients with GD and their caregivers was conducted during May-June 2018. Socio-demographic, health service utilization, disease-related expenses, social support, sleep quality (Pittsburgh Sleep Quality Index [PSQI]), and the Short Form Health Survey (SF-36) were investigated. Using self-reported information, we estimated the annual cost of illness, including direct medical, direct non-medical, and indirect medical costs. ResultsForty patients and their 49 caregivers were surveyed. The patients’ onset age of GD was 9.3±10.9; their disease course was 3.5±3.1 years. 21 (42.9%) patients had ≥2 caregivers, but 35 (71.4%) caregivers reported have no experience as a caregiver. 79.6% caregivers have stopped working, and 87.8% changed weekly working schedule. Before final diagnosis, patients visited 3.9±3.1 (max=20) hospitals and took 1.2±1.7 (max=6.6) years for confirmed diagnosis. On average, 5.0±9.6 misdiagnoses occurred, and the per-patient diagnoses cost was USD ($) 7,576. After GD confirmation, 8 (16.3%) patients received no treatment, 40 (81.6%) received pharmacotherapy, 10 (20.4%) received surgery, 38 (77.6%) received outpatient service (8.8±9.1 times/annually), and 37 (77.5%) received inpatient service (4.0±3.5 times/annually). Annual per-patient cost was USD ($) 49,925 (95% confidence interval: 29,178, 70,672). Average direct medical cost was $41,816, including pharmaceutical ($29,908), inpatient ($7,451), and outpatient ($1,838). Productivity loss per-caregiver was $1,980, and their Zarit Burden Inventory score was moderate-severe (48.6±19.6). Both patients/caregivers reported lower social support (32.4±7.4, 34.9±7.6), two times higher PSQI (7.9±2.9, 8.7±3.6), and half lower SF-36 (41.3±18.6, 46.5±19.3) than those reported for healthy Chinese individuals.ConclusionThis study finds out that fill the unmet need for extremely rare diseases is very challenging. The high misdiagnosis rate, together with delayed diagnosis, substantial costs, and deteriorated health-related quality of life of GD patients as well as their heavy care burden, calls for extreme attention from policymakers in China. Further efforts of government and society are urgently demanded, including pharmaceutical reimbursement, screening newborns, developing precise diagnostic tools, and training doctors.


2015 ◽  
Vol 69 (Suppl. 1) ◽  
pp. 6911510212p1
Author(s):  
Kylie Watts ◽  
Hillary Henke ◽  
Rachel Chambers ◽  
Ahn Tran ◽  
Lynne Clarke

Author(s):  
Raquel Fábrega-Cuadros ◽  
Fidel Hita-Contreras ◽  
Antonio Martínez-Amat ◽  
José Daniel Jiménez-García ◽  
Alexander Achalandabaso-Ochoa ◽  
...  

(1) Background: The aim of this study was to analyze the associations between severity of sarcopenia and health-related quality of life (HRQoL) among community-dwelling middle-aged and older adults. (2) Methods: A cross-sectional study involving 304 older-adult participants was used to assess the severity of sarcopenia by measuring muscle strength (handgrip dynamometer), muscle mass (bioelectrical impedance analysis), and physical performance (Timed Up-and-Go test). The generic 36-item Short-Form Health Survey (SF-36) was used to evaluate HRQoL. Anxiety and depression (Hospital Anxiety and Depression Scale) as well as age were considered as possible confounders. Probable sarcopenia was determined by low muscle strength; confirmed sarcopenia was defined by the presence of both low muscle strength and muscle mass; and severe sarcopenia was defined by low muscle strength and mass along with poor physical performance. (3) Results: The linear regression analysis showed that the presence of probable sarcopenia was associated with the SF-36 domains physical role (adjusted R2 = 0.183), general health (adjusted R2 = 0.290), and social functioning (adjusted R2 = 0.299). As for the SF-36 mental (MCS) and physical (PCS) component summary scores, probable sarcopenia, as well as depression and anxiety, remained associated with MCS (adjusted R2 = 0.518), and these three variables, together with age, were linked to PCS (adjusted R2 = 0.340). (4) Conclusion: Probable sarcopenia, but not confirmed or severe sarcopenia, was independently associated with poor HRQoL. More precisely, it was related to PCS and MCS, as well as to the physical role, general health, and social functioning of SF-36 domains.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xinye Qi ◽  
Jiao Xu ◽  
Linghan Shan ◽  
Ye Li ◽  
Yu Cui ◽  
...  

Abstract Background The diagnosis and health care of patients with rare diseases present a tremendous challenge worldwide. This study described the health care service utilization through participants’ perspective and estimated the cost of illness (COI), and patients with Gaucher disease (GD)’s/caregivers’ health-related quality of life in China. Method An online retrospective survey of patients with GD and their caregivers was conducted during May–June 2018. Socio-demographic, health service utilization, disease-related expenses, social support, sleep quality (Pittsburgh Sleep Quality Index [PSQI]), and the Short Form Health Survey (SF-36) were investigated. Using self-reported information, we estimated the annual COI, including direct healthcare, direct non-healthcare, and indirect costs. Results Forty patients and their 49 caregivers were surveyed. The patients’ onset age of GD was 9.3 ± 10.9; their disease course was 3.5 ± 3.1 years. 21 (42.9%) patients had ≥ 2 caregivers, but 35 (71.4%) caregivers reported have no experience as a caregiver. 79.6% caregivers have stopped working, and 87.8% changed weekly working schedule. Before final diagnosis, patients visited 3.9 ± 3.1 (max = 20) hospitals and took 1.2 ± 1.7 (max = 6.6) years for confirmed diagnosis. On average, 5.0 ± 9.6 misdiagnoses occurred, and the per-patient diagnoses cost was USD ($) 7576. After GD confirmation, 8 (16.3%) patients received no treatment, 40 (81.6%) received pharmacotherapy, 10 (20.4%) received surgery, 38 (77.6%) received outpatient service (8.8 ± 9.1 times/annually), and 37 (77.5%) received inpatient service (4.0 ± 3.5 times/annually). Annual per-patient COI was USD ($) 49,925 (95% confidence interval: 29,178, 70,672). Average direct healthcare cost was $41,816, including pharmaceutical ($29,908), inpatient ($7,451), and outpatient ($1,838). Productivity loss per-caregiver was $1,980, and their Zarit Burden Inventory score was moderate-severe (48.6 ± 19.6). Both patients/caregivers reported lower social support (32.4 ± 7.4, 34.9 ± 7.6), two times higher PSQI (7.9 ± 2.9, 8.7 ± 3.6), and half lower SF-36 (41.3 ± 18.6, 46.5 ± 19.3) than those reported for healthy Chinese individuals. Conclusions The high misdiagnosis rate, together with delayed diagnosis, substantial costs, and deteriorated health-related quality of life of GD patients as well as their heavy care burden, calls for extreme attention from policymakers in China. Further efforts of government and society are urgently demanded, including pharmaceutical reimbursement, screening newborns, developing precise diagnostic tools, and training doctors.


PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e3968 ◽  
Author(s):  
Andreas Baranyi ◽  
Omid Amouzadeh-Ghadikolai ◽  
Dirk von Lewinski ◽  
Robert J. Breitenecker ◽  
Hans-Bernd Rothenhäusler ◽  
...  

Background The aim of this cross-sectional study was to identify important biopsychosocial correlates of major depression. Biological mechanisms, including the inflammatory and the tryptophan-serotonin deficiency hypotheses of major depression, were investigated alongside health-related quality of life, life satisfaction, and social support. Methods The concentrations of plasma tryptophan, plasma kynurenine, plasma kynurenic acid, serum quinolinic acid, and the tryptophan breakdown to kynurenine were determined alongside health-related quality of life (Medical Outcome Study Form, SF-36), life satisfaction (Life Satisfaction Questionnaire, FLZ), and social support (Social Support Survey, SSS) in 71 depressive patients at the time of their in-patient admittance and 48 healthy controls. Results Corresponding with the inflammatory hypothesis of major depression, our study results suggest a tryptophan breakdown to kynurenine in patients with major depression, and depressive patients had a lower concentration of neuroprotective kynurenic acid in comparison to the healthy controls (Mann–Whitney-U: 1315.0; p = 0.046). Contradicting the inflammatory theory, the concentrations of kynurenine (t: −0.945; df = 116; p = 0.347) and quinolinic acid (Mann-Whitney-U: 1376.5; p = 0.076) in depressive patients were not significantly different between depressed and healthy controls. Our findings tend to support the tryptophan-serotonin deficiency hypothesis of major depression, as the deficiency of the serotonin precursor tryptophan in depressive patients (t: −3.931; df = 116; p < 0.001) suggests dysfunction of serotonin neurotransmission. A two-step hierarchical linear regression model showed that low tryptophan concentrations, low social support (SSS), occupational requirements (FLZ), personality traits (FLZ), impaired physical role (SF-36), and impaired vitality (SF-36) predict higher Beck Depression Inventory (BDI-II) scores. Discussion Our study results argue for the validity of a biopsychosocial model of major depression with multiple pathophysiological mechanisms involved.


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