Role of contextual factors in health-related quality of life in ankylosing spondylitis

2009 ◽  
Vol 69 (01) ◽  
pp. 108-112 ◽  
Author(s):  
V S Gordeev ◽  
W P Maksymowych ◽  
S M A A Evers ◽  
A Ament ◽  
L Schachna ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Contextual Factors ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Impact

Background:In the bio-psycho-social model of health, the role of contextual factors, either environmental or personal, is recognised.Objective:To assess the impact of a number of contextual factors on self-reported disease-specific and generic health-related quality of life in patients with ankylosing spondylitis (AS).Methods:522 patients with AS from Canada and Australia completed a postal questionnaire including sociodemographic variables, disease activity (Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)) function (Bath Ankylosing Spondylitis Functional Index (BASFI)) health-related quality of life (ASQoL and EQ-5D) and Rheumatoid Attitudes Index Helplessness Subscale. The contribution of contextual factors (nationality, ethnicity, marital status, education, employment and helplessness) in addition to functioning and disability (BASDAI and BASFI) to health-related quality of life was analysed using multivariate regression analyses. Interactions between contextual variables were explored.Results:Contextual factors explained 37% and 47% of the variance in EQ-5D and ASQoL, respectively. Helplessness and employment were the most important contextual factors. Their role was independent of the strong effect of disease activity (BASDAI) and functional limitations (BASFI). When ASQoL was the outcome, an interaction was seen between employment and education and when EQ-5D was the outcome, an interaction was seen between helplessness and education.Conclusions:Of the contextual factors explored in this study, helplessness and employment had an important and independent contribution to health-related quality of life. In patients with lower education, the effect of not being employed on ASQoL and the effect of helplessness on EQ-5D were stronger. Contextual factors, especially helplessness and employment, should receive more attention when interpreting data on health-related quality of life.

Health-Related Quality of Life in the Aftermath of the L’Aquila Earthquake in Italy

2015 ◽  
Vol 10 (1) ◽  
pp. 11-15 ◽  
Author(s):  
Antonella Gigantesco ◽  
Paolo D’Argenio ◽  
Vincenza Cofini ◽  
Cristiana Mancini ◽  
Valentina Minardi
Keyword(s):  
Quality Of Life ◽  
Suicide Rate ◽  
L’Aquila Earthquake ◽  
Health Related Quality ◽  
Cross Sectional ◽  
Related Quality ◽  
Health Related ◽  
The Impact

AbstractObjectiveA recent article reported a reduction in the suicide rate in the inhabitants of L’Aquila (Italy) in 2009, when on the night of April 6, a devastating earthquake struck the city. The potential implications of the role of resilience in the aftermath of natural disasters, together with the limitations of existing evidence on this topic, suggest a need for more research. We aimed to retrospectively investigate the impact of the L’Aquila earthquake on a standardized self-reported measure of health-related quality of life (HRQoL).MethodsHRQoL data were collected through 2 separate cross-sectional surveys conducted during 2008 and 2010, before and after the earthquake that occurred in 2009, on 2 random samples of adults living in L’Aquila.ResultsThe data seemed to suggest no decrease in the inhabitants’ HRQoL level after the disaster, which may suggest the role of resilience in supporting survivors’ HRQoL. The findings were also consistent with previous observations of a reduction in the suicide rate in the same inhabitants after the earthquake.ConclusionsAfter a natural disaster, people likely activate personal resources and protective social factors that result in better subjective outcomes. (Disaster Med Public Health Preparedness. 2016;10:11-15)

What is the role of prophylaxis in the improvement of health-related quality of life of patients with hemophilia?

Hematology ◽  
2013 ◽  
Vol 2013 (1) ◽  
pp. 52-55 ◽  
Author(s):  
David Buchbinder ◽  
Margaret V. Ragni
Keyword(s):  
Quality Of Life ◽  
Health Related Quality ◽  
The Past ◽  
Related Quality ◽  
Health Related ◽  
History Of ◽  
Lost Time ◽  
The Impact

Abstract A 32-year-old male with severe hemophilia presents for his annual evaluation. He has a history of multiple joint bleeds that he has always treated on-demand, that is, after they occur. You have recommended prophylaxis, that is, preventively, before they occur, to decrease his episodes of bleeding; however, he had been reluctant to comply in the past. He is having difficulty keeping up at work because of interruptions, pain, and lost time at work. He is willing to consider a trial of prophylaxis. You discuss the impact of hemophilia on his health-related quality of life (HRQOL) and consider measuring his HRQOL over time using a generic measure of HRQOL to determine whether prophylaxis will reduce interruptions, pain, and lost time from work and improve his HRQOL.

The association between duration of remission, fatigue, depression and health-related quality of life in Italian patients with systemic lupus erythematosus

Lupus ◽  
2019 ◽  
Vol 28 (14) ◽  
pp. 1705-1711 ◽  
Author(s):  
D P E Margiotta ◽  
S Fasano ◽  
F Basta ◽  
L Pierro ◽  
A Riccardi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Health Related Quality ◽  
Systemic Lupus ◽  
Related Quality ◽  
Health Related ◽  
The Impact

Objective To evaluate the impact of duration of remission on the health-related quality of life (HRQoL) of patients with systemic lupus erythematosus (SLE). Methods We conducted a 5-year retrospective study on two Italian cohorts. Remission was defined as a continuative period of no clinical disease activity, according to the Systemic Lupus Erythematosus Disease Activity Index 2 K, and a permitted maximum prednisone dose of 5 mg/day. HRQoL was measured using the 36-Item Short-Form Health Survey (SF36) during the last visit. Results We enrolled 136 female SLE patients. During observation, 15 (11%) patients had been in remission for ≥1 and <2 years, 15 (11%) for ≥2 and <3 years, 19 (14%) for ≥3 and <4 years, 9 (7%) for ≥4 and <5 years, and 53 (39%) had been in prolonged remission for ≥5 years. In the multivariate model, considering depression and fatigue as covariates, patients in prolonged remission showed significantly better scores in the physical functioning ( p = 0.039), role physical ( p = 0.029), bodily pain ( p = 0.0057), general health ( p = 0.0033) and social functioning ( p = 0.0085) components of the SF36, compared with those in remission <5 years or unremitted. Subsequent mediation analyses found that these effects were partly influenced by depression. Conclusion Lupus remission could improve the HRQoL of SLE patients, particularly when associated with appropriate management of depression and fatigue.

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