scholarly journals The effect of obesity upon Health Related Quality of Life (HRQoL): A comparison of the AQoL-8D and SF-36 instruments

2012 ◽  
Vol 13 (2) ◽  
pp. 69-82 ◽  
Author(s):  
Munir Ahmed Khan ◽  
Jeff Richardson ◽  
Paul O'Brien

OBJECTIVES: The objective of this study was to describe and measure the loss of health related quality of life (HRQoL) associated with obesity using two generic instruments. The first of these, the SF-36, is the most widely used and validated HRQoL instrument worldwide. However, it does not provide utility weights and cannot be used to measure quality adjusted life years (QALYs), an increasingly common unit for comparing the effect of health states in economic evaluation studies. The second, the AQoL-8D, is a multi-attribute utility (MAU) instrument which was developed to increase sensitivity of previous MAU instruments to psycho-social dimensions of a health state and to allow the calculation of QALYs. Since the two instruments differ, an important additional objective of the study was to determine the validity of the AQoL-8D as judged by the SF-36, and therefore the confidence which might be placed upon its use in the context of obesity.METHODS: Data were obtained from patients waiting for bariatric surgery who had completed both the SF-36 and AQoL-8D quality of life instruments and a general questionnaire including height, weight, demographic and socio-economic information. For comparative purposes, scores were standardized using results from a representative sample of the general population. The content validity of the AQoL-8D was assessed by comparing it with the dimension scores from the SF-36 and the summary component (physical and mental) scores. Overall scores from the SF-36 and AQoL-8D instruments were regressed upon patient BMI and the results from the AQoL-8D used to estimate the effect of overweight and obesity upon utility and lost QALYs.RESULTS: The comparison of the instruments indicated that the AQoL-8D has good convergent, concurrent and content validity. Using both instruments, obesity was significantly associated with lower scores for 14 of their 16 dimensions. AQoL-8D, in particular, identified a significant decrease in psychological and social health with happiness, self-worth, coping and mental health, all being poorer than in the control group. Regression results implied that a change in BMI from 30 to 50 decreases utility by 0.12 or by 13.8 percent of the average utility for a 25-35 year old.CONCLUSION: AQoL-8D is a valid measure of utility in the context of obesity. Its inclusion of psycho-social effects significantly increases the measured adverse effects of obesity.

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Eui Geum Oh ◽  
Soo Hyun Kim ◽  
So Yeon Bang ◽  
Sa Saeng Hyun ◽  
Yong Kwan Jeon ◽  
...  

Background: The metabolic syndrome (MetS), with associated increased CHD risk, is highly prevalent among postmenopausal women in Korea. Although therapeutic lifestyle modification (TLM) has been recommended as a cornerstone therapy, studies investigating the effects of TLM on health related quality of life (HRQOL) are limited. Purpose : This study was to evaluate HRQOL outcomes of a six-month TLM in Korean women with Mets. Methods: A randomized controlled design was used. Fifty four women (mean age of 63.2 y) with Mets were recruited from community health centers and randomly assigned to the intervention (N=31) or control (N=23) groups. The subjects in the intervention group participated in a supervised weekly TLM session for six months. The TLM program was consisted of health monitoring, education, aerobic exercise (40-min/session, 200 Kcal/day), and a low calorie diet with low carbohydrate (≈1300Kcal/d). Those in the control group received a booklet about MetS and were instructed to maintain their usual diet and activities. HRQOL was measured using the MOS SF-36 at before, during (month 3), completion (month 6), and after completion of the TLM program (month 12). Mixed-model repeated measures ANCOVA was used to evaluate HRQOL outcomes. Results : There were significant group by time interactions for general health ( P = .043) and vitality ( P = .012). Both general health (mean 23-point change) and vitality scores (mean 16-point change) greatly improved in the treatment group over 6 months of TLM, compared with control group. However, the improvement of the general health and vitality in the experimental group was not sustained at month 12. There were significant treatment main effects (all P < .05) for the remaining SF-36 subscale scores. Conclusion : A systematic TLM program may be effective strategy for improving HRQOL in postmenopausal women with MetS.


2012 ◽  
Vol 20 (2) ◽  
pp. 346-353 ◽  
Author(s):  
Lígia da Silva Leroy ◽  
Maria Helena Baena de Moraes Lopes

This case-control study evaluated whether UI in the puerperium compromises the health-related quality of life (HRQoL) and if so, in which aspects. The study included 344 women (77 case group and 267 control group) up to 90 days postpartum, who were attended the Obstetrics Outpatient Clinic of a public teaching hospital, for the postpartum follow up consultation. A socio-demographic and clinical data questionnaire formulated and validated for the study, the International Consultation on Incontinence Questionnaire - Short-Form (ICIQ-SF), the King's Health Questionnaire (KHQ) and the Medical Outcomes Study 36 - Item Short Form Health Survey (SF-36), were applied. The mean score of the ICIQ-SF was 13.9 (SD: 3.7). The case group presented high mean scores in the domains Impact of the Incontinence, Emotions, Daily Activity Limitations and Physical Limitations, of the KHQ. The groups differed significantly in the domains Physical Aspects, Pain, General Health Status, Vitality, Social Aspects and Mental Health of the SF-36. It is concluded that UI significantly affects the physical and mental health of puerperae.


Rheumatology ◽  
2020 ◽  
Author(s):  
Alvaro Gomez ◽  
Fawz Hani Butrus ◽  
Petter Johansson ◽  
Emil Åkerström ◽  
Sofia Soukka ◽  
...  

Abstract Objectives Associations between BMI and health-related quality of life (HRQoL) in SLE have been implied, but data are scarce. We determined the impact of overweight and obesity on HRQoL in a large SLE population. Methods We pooled cross-sectional baseline data from the BLISS-52 (NCT00424476) and BLISS-76 (NCT00410384) trials (N = 1684). HRQoL was evaluated using the 36-item Short Form Health Survey (SF-36), Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue scale and the European Quality of Life 5-dimension questionnaire (EQ-5D). Comparisons between BMI groups were conducted using the Mann–Whitney U test and adjustments using linear regression. Clinical relevance was determined by minimal clinically important differences (MCIDs). Results In total, 43.2% of the patients had BMI above normal and 17.4% were obese. Overweight and obese patients reported worse SF-36 physical component summary (PCS), physical functioning, role physical, bodily pain and FACIT-Fatigue scores than normal weight patients. Divergences were greater than corresponding MCIDs and more prominent with increasing BMI. Despite no clinically important difference in SF-36 mental component summary scores across BMI categories, patients experienced progressively diminished vitality and social functioning with increasing BMI. In linear regression analysis, BMI above normal and obesity were associated with worse PCS (standardized coefficient β = −0.10, P &lt; 0.001 and β = −0.17, P &lt; 0.001, respectively), FACIT-Fatigue (β = −0.11, P &lt; 0.001 and β = −0.16, P &lt; 0.001) and EQ-5D (β = −0.08, P = 0.001 and β = −0.12, P &lt; 0.001) scores, independently of demographic and disease-related factors. The impact of BMI on the PCS and FACIT-Fatigue was more pronounced than that of SLE activity. Conclusion Patients with SLE and BMI above normal experienced clinically important HRQoL diminutions in physical aspects, fatigue and social functioning. A survey of potential causality underlying this association is warranted.


2016 ◽  
Vol 28 (12) ◽  
pp. 2045-2054 ◽  
Author(s):  
G. Pusswald ◽  
D. Moser ◽  
M. Pflüger ◽  
A. Gleiss ◽  
E. Auff ◽  
...  

ABSTRACTBackground:Health-related quality of life (HRQOL) is an important issue in the context of dementia care. The purpose of this study was to investigate the association between HRQOL and depressive symptoms in patients with subjective cognitive decline (SCD) and subtypes of mild cognitive impairment (MCI) and Alzheimer´s disease (AD).Methods:In this cross-sectional, observational study, a control group and four experimental groups (SCD, non-amnestic MCI, amnesticMCI, AD) were compared. Neuropsychological measurers (NTBV) and psychological questionnaires were used for data collection.Results:The control group scored higher than patients with SCD, naMCI, aMCI, or AD for the Mental Health Component Score (MHCS) of the Short Form of the Health Survey (SF-36). The Physical Health Component Score (PHCS) of the SF-36 differed only between some groups. Furthermore, cognitive variables were more strongly associated with the physical aspects of HRQOL, whereas depressive symptoms were more strongly related with the mental aspects of HRQOL.Conclusions:HRQOL and depressive symptoms are closely related in patients with cognitive impairments. Therefore, it is of great importance to assess patients with subjective impairment carefully in terms of depressive symptoms.


2021 ◽  
pp. 105566562098769
Author(s):  
Mecheala Abbas Ali ◽  
Alwaleed Fadul Nasir ◽  
Shaza K. Abass

Objective: This study compared the oral health-related quality of life (OHRQoL) among children with a cleft lip with or without a cleft palate (CL±P) and a group of their peers. The reliability of the Arabic version of the Child Oral Health Impact Profile Questionnaire (COHIP) was also assessed. Design: A cross-sectional study. Settings: Cleft clinic in a private dental college in Omdurman City, Sudan. Patients: In all, 75 children (mean age 11.3 ± 2.5 years) with a history of CL±P and a group of 150 school children without CL±P (mean age 11.4 ± 2.6 years). Main Outcome Measures: Overall and subscale scores on the Arabic version of the COHIP. Results: Test–retest reliability of COHIP in Arabic was high with an interclass correlation coefficient >0.8. Cronbach α value internal consistency was 0.8 for the total scale and between 0.7 and 0.8 for the subscales. The COHIP score was 89.41 ± 19.97 in children with CL±P and 122.82 ± 9.45 for the control group. Children with CL±P had significantly lower scores on the overall and all subscales when compared to children without CL±P ( P ≤ .001). Among the children with CL±P, there were no statistically significant differences on the COHIP based on age and/or gender ( P ≥ .05). Conclusions: Children with CL±P had a relatively high OHRQoL, which was lower than that of their peers without CL±P in both the overall scale and all subscales. Gender and age differences had no significant impact on the OHRQoL. The COHIP Arabic version showed appropriate reliability.


2021 ◽  
pp. 1-24
Author(s):  
Daniela Viramontes-Hörner ◽  
Zoe Pittman ◽  
Nicholas M Selby ◽  
Maarten W Taal

Abstract Health-related quality of life (HRQoL) is severely impaired in persons receiving dialysis. Malnutrition has been associated with some measures of poor HRQoL in cross-sectional analyses in dialysis populations, but no studies have assessed the impact of malnutrition and dietary intake on change in multiple measures of HRQoL over time. We investigated the most important determinants of poor HRQoL and the predictors of change in HRQoL over time using several measures of HRQoL. We enrolled 119 haemodialysis and 31 peritoneal dialysis patients in this prospective study. Nutritional assessments (Subjective Global Assessment [SGA], anthropometry and 24-hour dietary recalls) and HRQoL questionnaires (Short Form-36 [SF-36] mental [MCS] and physical component scores [PCS] and European QoL-5 Dimensions [EQ5D] health state [HSS] and visual analogue scores [VAS]) were performed at baseline, 6 and 12 months. Mean age was 64(14) years. Malnutrition was present in 37% of the population. At baseline, malnutrition assessed by SGA was the only factor independently (and negatively) associated with all four measures of HRQoL. No single factor was independently associated with decrease in all measures of HRQoL over 1 year. However, prevalence/development of malnutrition over one year was an independent predictor of 1-year decrease in EQ5D HSS and 1-year decrease in fat intake independently predicted the 1-year decline in SF-36 MCS and PCS, and EQ5D VAS. These findings strengthen the importance of monitoring for malnutrition and providing nutritional advice to all persons on dialysis. Future studies are needed to evaluate the impact of nutritional interventions on HRQoL and other long-term outcomes.


BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e047812
Author(s):  
Takuya Aoki ◽  
Shunichi Fukuhara ◽  
Yasuki Fujinuma ◽  
Yosuke Yamamoto

ObjectivesLongitudinal studies, which consider multimorbidity patterns, are useful for better clarifying the effect of multimorbidity on health-related quality of life (HRQoL) and for identifying the target population with poorer clinical outcomes among patients with multimorbidity. This study aimed to examine the effects of different multimorbidity patterns on the decline in HRQoL.DesignNationwide prospective cohort study.SettingJapanese adult residents.ParticipantsResidents aged ≥50 years selected by the quota sampling method.Primary outcome measureClinically relevant decline in HRQoL was defined as a 0.50 SD (5-point) decrease in the 36-Item Short Form Health Survey (SF-36) component summary scores for 1 year.ResultsIn total, 1211 participants completed the follow-up survey. Among the multimorbidity patterns identified using confirmatory factor analysis, multivariable logistic regression analyses revealed that high cardiovascular/renal/metabolic and malignant/digestive/urologic pattern scores were significantly associated with the clinically relevant decline in SF-36 physical component summary score (adjusted OR (aOR)=1.25, 95% CI: 1.08 to 1.44 and aOR=1.28, 95% CI: 1.04 to 1.58, respectively). High cardiovascular/renal/metabolic pattern score was also significantly associated with the clinically relevant decline in SF-36 role/social component summary score (aOR=1.23, 95% CI: 1.06 to 1.42).ConclusionsOur study revealed that multimorbidity patterns have different effects on the clinically relevant decline in HRQoL for 1 year. These findings can be useful in identifying populations at high risk and with poor clinical outcomes among patients with chronic diseases and multimorbidity for efficient resource allocation.


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