scholarly journals The Impact of Health behavior, Health status and Healthcare utilization on the Quality of Life of the Baby Boom Generation

2013 ◽  
Vol 7 (1) ◽  
pp. 1-12
Author(s):  
김기향 ◽  
정태영 ◽  
김용민
2019 ◽  
Author(s):  
Austyn Snowden ◽  
Jenny Young ◽  
Jan Savinc

Abstract Background Cancer impacts on patients and their families across a range of different domains. For that reason, optimal cancer care has moved away from a disease-centric focus to a more holistic approach in order to proactively support people with their individual needs and concerns. While international policy clearly advocates this agenda, implementation into routine care is limited. Therefore, relevant interventions that measurably improve patient outcomes are essential to understand if this ideal is to become routine multidisciplinary practice. The aim of this study was to analyse the impact of a proactive, holistic, community-based intervention on health-related quality of life in a cohort of people diagnosed with cancer. Secondary aim was to explore the relationship between changes in health status and: cancer type, cancer stage, number of concerns expressed and change in severity of concerns pre and post intervention. Method Prospective observational cohort study. A convenience sample of 437 individuals were referred to the service ‘Improving the Cancer Journey (ICJ) in the UK. Each completed the Euroqol EQ-5D-3L and visual analogue scale (VAS) and a Holistic Needs Assessment (HNA) during initial visit to the service and again at follow-up review, approximately 4 months later. Change between scores was tested with paired t-tests and relationships between variables with multiple regression models. Results Participants were White British with median age between 50-64 years. Cancer type and stage were varied. There was a statistically significant improvement in EQ-5D scores over time (t(330)=7.48, p<.001). The strongest predictor of change was a decrease in severity of concerns. Cancer stage ‘palliative care’ contributed to a reduction in health status. Conclusion This study is the first to show that a holistic community intervention dedicated to supporting the individual concerns of participants has a statistically and meaningful impact on participants’ health-related quality of life. The mean change in EQ-5D scores was more than the ‘minimally important clinical difference’ described in the literature. This is important because while quality of life has multiple determinants this study has reported that it is possible to capture a meaningful improvement as a function of reducing someone’s personally identified concerns.


Author(s):  
Shah Khalid ◽  
Sayed Zulfiqar Ali Shah ◽  
Abid Ali Khalil ◽  
Ihsan Ullah

Abstract Objective: To determine the impact of musculoskeletal disorders on quality of life of patients visiting Khyber Teaching Hospital, Peshawar. Method and Material: A cross sectional survey conducted in Khyber Teaching Hospital, Peshawar from September 2018 to March 2019 using a validated EQ-5D quality of life scale. The survey questionnaire was attended by 377 respondents having variety of musculoskeletal disorders (MSDs). EQ-5D can be effectively used for assessing the quality of life and health status using the VAS pain scale. Results: There were total 377 respondents. Mean age of the participants was 35.9 ± 12.5 years. Out of 377 participants, 204 (54.1%) were male, while 173 (45.9%) were female. Muscular weakness was the most commonly encountered problem (40.6%), followed by muscle stiffness (13.0%) and adhesive capsulitis (10.3%). The remaining respondents were having different kinds of MSDs. Patients with MSDs were having significantly moderately low score on EQ-5D. Conclusion: The finding of this study suggests that MSDs have negative impact on quality of life and health status of the sufferers. Individuals having any sort of MSDs should seek proper care in order to improve their quality of life, health status and work performance. Key words: Musculoskeletal Diseases, Health, Quality of Life, visual analog scales, Cross Sectional Studies. Continuou....


2018 ◽  
Vol 36 (25) ◽  
pp. 2578-2584 ◽  
Author(s):  
Jonathan Strosberg ◽  
Edward Wolin ◽  
Beth Chasen ◽  
Matthew Kulke ◽  
David Bushnell ◽  
...  

Purpose Neuroendocrine tumor (NET) progression is associated with deterioration in quality of life (QoL). We assessed the impact of 177Lu-Dotatate treatment on time to deterioration in health-related QoL. Methods The NETTER-1 trial is an international phase III study in patients with midgut NETs. Patients were randomly assigned to treatment with 177Lu-Dotatate versus high-dose octreotide. European Organisation for Research and Treatment of Cancer quality-of-life questionnaires QLQ C-30 and G.I.NET-21 were assessed during the trial to determine the impact of treatment on health-related QoL. Patients completed the questionnaires at baseline and every 12 weeks until tumor progression. QoL scores were converted to a 100-point scale according to European Organisation for Research and Treatment of Cancer instructions, and individual changes from baseline scores were assessed. Time to QoL deterioration (TTD) was defined as the time from random assignment to the first QoL deterioration ≥ 10 points for each patient in the corresponding domain scale. All analyses were conducted on the intention-to-treat population. Patients with no deterioration were censored at the last QoL assessment date. Results TTD was significantly longer in the 177Lu-Dotatate arm (n = 117) versus the control arm (n = 114) for the following domains: global health status (hazard ratio [HR], 0.406), physical functioning (HR, 0.518), role functioning (HR, 0.580), fatigue (HR, 0.621), pain (HR, 0.566), diarrhea (HR, 0.473), disease-related worries (HR, 0.572), and body image (HR, 0.425). Differences in median TTD were clinically significant in several domains: 28.8 months versus 6.1 months for global health status, and 25.2 months versus 11.5 months for physical functioning. Conclusion This analysis from the NETTER-1 phase III study demonstrates that, in addition to improving progression-free survival, 177Lu-Dotatate provides a significant QoL benefit for patients with progressive midgut NETs compared with high-dose octreotide.


2020 ◽  
Vol 29 (8) ◽  
pp. 587-597
Author(s):  
Charmaine A. McKie ◽  
Adeyinka O. Laiyemo

A cross-section correlational study was conducted to evaluate the overall quality of life in young adults (AYAs) diagnosed with cancer, and the impact of health-related and non-health-related factors on their quality of life. Fifty-six AYA cancer survivors were recruited to elicit the impact of biological function (cancer type and comorbidity), symptoms, functional status, general perception of health status, gender, and characteristics of the environment on quality of life. Participants experienced higher than average quality of life. Symptoms, functional status, and general perception of health status were significant predictors of quality of life in this group of AYAs diagnosed with cancer. In delivering quality cancer care, nurses must be able to thoroughly assess symptom status, AYA cancer survivors’ perception of their health status, and functioning in order to implement supportive measures to help improve their quality of life.


Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3786-3786
Author(s):  
Zahra Pakbaz ◽  
Marsha Treadwell ◽  
Robert Yamashita2 ◽  
Drucilla Foote ◽  
Elliott Vichinsky

Abstract Introduction: Thalassemia patients have experienced a dramatic increase in lifespan secondary to improved and more complicated therapy. The impact of the disease and its treatment on quality of life is largely unknown. Determining the degree of health impairment as perceived by the patient is essential information needed to recommend suitable therapy. Factors that affect the quality of life of thalassemia major patients may differ from thalassemia intermedia patients. Identifying the specific causes for negative patient assessment of overall health status can result in successful intervention. The objective of this study is to determine the factors that affect quality of life in both transfused and non-transfused thalassemia patients. Methods: The Dartmouth Care Cooperative Chart System (COOP) questionnaire is a standardized, validated, visual screening tool that screens the major domains affecting quality of life. Patients rate quality of life from excellent (1) to poor (5). Scores of 1 and 2 are normal. A Score of 3 are mild to moderate impairment, and 4 and 5 are severe abnormalities. 50 patients were randomly selected during a comprehensive visit to complete a COOP questionnaire. These results were augmented by a brief medical history and chart review. Results: Forty-eight thalassemia patients, including 25 transfusion dependent (Tx) and 23 non-transfused (Non-Tx) patients (50% female) were randomly selected and completed the COOP questionnaire. The mean age of the total population was 19 years (0.9–37.9 yrs) and was similar in both groups. Half of both groups had scores of 3 or less indicating no severe impairment. However, 56% of patients had ratings of 3 indicating mild to moderate impairment of major domains. Four patients (2 Tx, 2 Non-Tx) had repeated 4–5 ratings in multiple domains indicating severe impairment of quality of life. The most commonly reported affected domains were feelings, such as anxiety, depression, and concern of overall health status or indications of recent deterioration in health. Conclusion: At least 50% of transfusion and non-transfusion dependent thalassemia patients demonstrate some impairment in quality of life. Forty-four percent of the population had a severe impairment in at least one domain. In particular, mental health issues are widespread. In contrast to previous beliefs, non-transfusion dependent patients also suffer serious impairment in quality of life. This data suggests all patients should undergo quality of life assessments and intervention, which focuses on affected domains. Studies to determine if quality of life affects patients’ adherence to chelation therapy are needed.


1991 ◽  
Vol 8 (3) ◽  
pp. 258-271 ◽  
Author(s):  
Jeremy Howell

As part of their “Revolution in Motion” advertising campaign in 1987, Nike introduced the controversial television commericial that featured, as a sound track, the 1968 Beatles song Revolution. Located within a contemporary framework of time and place, emotion and message, politics and consumption, and capitalism and pleasure, the commercial can be articulated to a critical debate that has increasingly come to determine our political and affective lives. This paper focuses on the nature of this debate as it has emerged over the last decade and addresses, among other things, the legacy of the 1960s, the rise of the fitness movement, the insertion of the Baby Boom generation into the marketplace, the definition of American quality of life, and the rise of the political New Right.


2004 ◽  
Vol 22 (5) ◽  
pp. 943-952 ◽  
Author(s):  
Jennifer Cullen ◽  
Marc D. Schwartz ◽  
William F. Lawrence ◽  
Joe V. Selby ◽  
Jeanne S. Mandelblatt

Purpose There are few data on the short-term effects of participating in cancer prevention activities, undergoing genetic risk assessment, or having routine screening. The objective of this article is to systematically review existing research on short-term effects of prevention, genetic counseling and testing, and screening activities on quality of life. Methods We conducted a MEDLINE search for original research studies that were published between January 1, 1985, and December 31, 2002, and conducted in North America or Western Europe. Data were abstracted and summarized using a standardized format. Results We reviewed 210 publications. Most studies focused on psychological states (anxiety, depression), symptoms, or general health status. One hundred thirty-one studies used 51 previously validated noncancer instruments. Many researchers (12.6%) also added cancer-specific measures, such as perceived cancer risk or symptom indices. Only one study measured satisfaction or quality of provider-client communication. While one report examined lost workdays, no other economic consequences of short-term outcomes were evaluated. Among seven studies that assessed short-term outcomes preferences, only four specifically used time trade-off or linear rating scale methods. No study used standard gamble or willingness-to-pay methods. The overwhelming majority of research indicated that short-term effects were transient. Only two studies linked short-term effects to long-term cancer-related health behaviors such as repeat screening. Conclusion There is considerable heterogeneity in short-term outcome measurement. Clinicians need to be aware of potential for short-term, transient adverse effects. The impact of short-term experiences should to be linked to long-term health status and use of services.


2020 ◽  
Vol 50 (9) ◽  
pp. 990-998
Author(s):  
Shigeko Umezaki ◽  
Yusuke Shinoda ◽  
Akitake Mukasa ◽  
Shota Tanaka ◽  
Shunsaku Takayanagi ◽  
...  

Abstract Objective The factors associated with health-related quality of life in patients with glioma remain unclear; particularly, the impact of symptoms on quality of life has not been studied comprehensively. This study aims to document the quality of life of patients with glioma and clarify the impact of symptoms. Methods In this cross-sectional study, participants were recruited from patients at The University of Tokyo Hospital and from patients who were registered at the Japan Brain Tumor Alliance. We included adult patients with World Health Organization grade II–IV glioma and excluded those with disturbances of consciousness or aphasia. We used the European Organization for Research and Treatment of Cancer QLQ-C30 and BN20 to evaluate quality of life and the symptoms. Multiple regression analyses were performed to investigate the impact of symptoms on European Organization for Research and Treatment of Cancer global health status and QLQ-C30 social functioning. In addition, we performed univariate subgroup analyses classified by World Health Organization grade and history of chemotherapy. Results This study included 76 patients. Seven symptoms occurred in more than 50% of the patients: fatigue, future uncertainty, drowsiness, communication deficit, financial difficulties, motor dysfunction and weakness of legs. Multiple regression analyses showed that insomnia affected their global health status, and appetite loss, financial difficulties and motor dysfunction were significantly related to their social functioning. In subgroup analysis, the number of symptom subscales that were significantly related to global health status and social functioning was larger in World Health Organization grade II patients compared with grade III/IV patients. Conclusions In addition to neurological deficits, symptoms were associated with poor quality of life in patients with glioma. This study provided the basis on further investigation of usefulness of symptom evaluation on quality of life improvement.


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