Current Issue : October - December Volume : 2015 Issue Number : 4 Articles : 5 Articles
Aim: To study health related quality of life (HRQOL) and depressive symptoms in adolescents with chronic fatigue\nsyndrome (CFS) and to investigate in which domains their HRQOL and depressive symptoms differ from those of\nhealthy adolescents.\nBackground and objective: Several symptoms such as disabling fatigue, pain and depressive symptoms affect\ndifferent life domains of adolescents with CFS. Compared to adolescents with other chronic diseases, young people\nwith CFS are reported to be severely impaired, both physiologically and mentally. Despite this, few have\ninvestigated the HRQOL in this group.\nMethod: This is a cross-sectional study on HRQOL including 120 adolescents with CFS and 39 healthy controls (HC),\nbetween 12 and 18 years. The Pediatric Quality of Life Inventoryââ??¢, 4.0 (PedsQL) was used to assess HRQOL. The\nMood and Feelings Questionnaire assessed depressive symptoms. Data were collected between March 2010 and\nOctober 2012 as part of the NorCAPITAL project (Norwegian Study of Chronic Fatigue Syndrome in Adolescents:\nPathophysiology and Intervention Trial). Linear and logistic regression models were used in analysis, and all tests\nwere two-sided.\nResults: Adolescents with CFS reported significantly lower overall HRQOL compared to HCs. When controlling for\ngender differences, CFS patients scored 44 points lower overall HRQOL on a scale from 0ââ?¬â??100 compared to HCs.\nThe domains with the largest differences were interference with physical health (B = ?59, 95 % CI ?54 to ?65) and\nschool functioning (B = ?52, 95 % CI ?45 to ?58). Both depressive symptoms and being a patient were\nindependently associated with lower levels of HRQOL\nConclusion: The difference in HRQOL between CFS patients and healthy adolescents was even larger than we\nexpected. The large sample of adolescents with CFS in our study confirms previous findings from smaller studies,\nand emphasizes that CFS is a seriously disabling condition that has a strong impact on their HRQOL. Even though\ndepressive symptoms were found in the group of patients, they could not statistically explain the poor HRQOL...
Background: Self-rated health (SRH) has been demonstrated as a valid and appropriate predictor of incident\nmortality and chronic morbidity. Associations between lifestyle, chronic diseases, and SRH have been reported by\nvarious population studies but few have included data from developing countries. The aim of this study was to\ndetermine the prevalence of poor SRH in Malaysia and its association with lifestyle factors and chronic diseases\namong Malaysian adults.\nMethods: This study was based on 18,184 adults aged 18 and above who participated in the 2011 National Health\nand Morbidity Survey (NHMS). The NHMS was a cross-sectional survey (two-stage stratified sample) designed to\ncollect health information on a nationally representative sample of the Malaysian adult population. Data were\nobtained via face-to-face interviews using validated questionnaires. Two categories were used to measure SRH:\nââ?¬Å?goodââ?¬Â (very good and good) and ââ?¬Å?poorââ?¬Â (moderate, not good and very bad). The association of lifestyle factors and\nchronic diseases with poor SRH was examined using univariate and multivariate logistic regression.\nResults: Approximately one-fifth of the Malaysian adult population (20.1 %) rated their health as poor (men: 18.4 %\nand women: 21.7 %). Prevalence increases with age from 16.2 % (aged 18ââ?¬â??29) to 32.0 % (aged ?60). In the\nmultivariate logistic regression analysis, lifestyle factors associated with poor SRH included: underweight (OR = 1.29;\n95 % CI: 1.05ââ?¬â??1.57), physical inactivity (OR = 1.25; 95 % CI: 1.11ââ?¬â??1.39), former smoker (OR = 1.38; 95 % CI: 1.12ââ?¬â??1.70),\nformer drinker (OR = 1.27; 95 % CI: 1.01ââ?¬â??1.62), and current drinker (OR = 1.35; 95 % CI: 1.08ââ?¬â??1.68). Chronic diseases\nassociated with poor SRH included: asthma (OR = 1.66; 95 % CI: 1.36ââ?¬â??2.03), arthritis (OR = 1.87; 95 % CI: 1.52ââ?¬â??2.29),\nhypertension (OR = 1.39; 95 % CI: 1.18ââ?¬â??1.64), hypercholesterolemia (OR = 1.43; 95 % CI: 1.18ââ?¬â??1.74), and heart disease\n(OR = 1.85; 95 % CI: 1.43ââ?¬â??2.39).\nConclusions: This study indicates that several unhealthy lifestyle behaviours and chronic diseases are significantly\nassociated with poor SRH among Malaysian adults. Effective public health strategies are needed to promote healthy\nlifestyles, and disease prevention interventions should be enhanced at the community level to improve overall\nhealth....
Background: Older adults with mobility impairments are prone to reduced health related quality of life (HRQoL) is\nhighly associated with mobility impairments. The consequences of falls have detrimental impact on mobility.\nHence, ascertaining factors explaining variation among individuals� quality of life is critical for promoting healthy\nageing, particularly among older fallers. Hence, the primary objective of our study was to identify key factors that\nexplain variation in HRQoL among community dwelling older adults at risk of falls.\nMethods: We conducted a longitudinal analysis of a 12-month prospective cohort study at the Vancouver Falls\nPrevention Clinic (n = 148 to 286 depending on the analysis). We constructed linear mixed models where\nassessment month (0, 6, 12) was entered as a within-subjects repeated measure, the intercept was specified as a\nrandom effect, and predictors and covariates were entered as between-subjects fixed effects. We also included the\npredictors by sex and predictor by sex by time interaction terms in order to investigate sex differences in the relations\nbetween the predictor variable and the outcome variable, the EQ-5D.\nResults: Our primary analysis demonstrated a significant mobility (assessed using the Short Performance Physical\nBattery and the Timed Up and Go) by time interaction (p < 0.05) and mobility by time by sex interaction\n(p < 0.05). The sensitivity analyses demonstrated some heterogeneity of these findings using an imputed and a\ncomplete case analysis.\nConclusions: Mobility may be an important predictor of changes in HRQoL over time. As such, mobility is a\ncritical factor to target for future intervention strategies aimed at maintaining or improving HRQoL in late life....
Background: Africa is facing a nutritional transition where underweight and overweight coexist. Although the\nmajority of programs for orphan and vulnerable children (OVC) focus on undernourishment, the association between\nOVC primary caregiving and the caregiversââ?¬â?¢ overweight status remains unclear. We investigated the association\nbetween OVC primary caregiving status with womenââ?¬â?¢s overweight status in Namibia, Swaziland and Zambia.\nMethods: Demographic Health Survey (DHS) cross-sectional data collected during 2006ââ?¬â??2007 were analyzed using\nweighted marginal means and logistic regressions. We analyzed data from 20ââ?¬â??49 year old women in Namibia\n(N 6638), Swaziland (N 2875), and Zambia (N 4497.)\nResults: The overweight prevalence of the primary caregivers of OVC ranged from 27.0 % (Namibia) to 61.3 %\n(Swaziland). In Namibia, OVC primary caregivers were just as likely or even less likely to be overweight than other\nprimary caregivers. In Swaziland and Zambia, OVC primary caregivers were just as likely or more likely to be overweight\nthan other primary caregivers. In Swaziland and Zambia, OVC primary caregivers were more likely to be overweight\nthan non-primary caregivers living with OVC (Swaziland AOR = 1.56, Zambia AOR = 2.62) and non-primary caregivers\nnot living with OVC (Swaziland AOR = 1.92, Zambia AOR = 1.94). Namibian OVC caregivers were less likely to be\noverweight than non-caregivers not living with an OVC only in certain age groups (21ââ?¬â??29 and 41ââ?¬â??49 years old).\nConclusions: African public health systems/OVC programs may face an overweight epidemic alongside existing\nHIV/AIDS, tuberculosis and malaria epidemics. Future studies/interventions to curb overweight should consider OVC\ncaregiving status and address country-level differences...
While optimizing quality of life (QOL) is a key goal of rehabilitation care, no\nprevious study has reported on what ââ?¬Ë?QOLââ?¬â?¢ means to youth with chronic health\nconditions. In addition, no qualitative studies have explored the relationship between\nQOL and self-determination (SD). Objectives of this qualitative study were to examine:\nwhat the terms ââ?¬Ë?quality of lifeââ?¬â?¢ and ââ?¬Ë?self-determinationââ?¬â?¢ mean to youth with chronic\nconditions; the factors these youth think are linked with these concepts; the relationship\nthey see between concepts, the types of future goals youth have and how they view the\nconnection between their SD and these goals. A descriptive methodology was used. A\npurposive sample of 15 youth aged 15 to 20 years was obtained. Youth had cerebral\npalsy, a central nervous system disorder, or autism spectrum disorder. Semi-structured\ninterviews were conducted first, followed by a focus group. Line-by-line coding of\ntranscripts was completed, codes were collapsed into categories, and themes identified.\nParticipants viewed QOL as an overarching personal evaluation of their life, and used\nterms such as satisfaction and happiness to describe the concept. Factors related to\nQOL included: ââ?¬Ë?relationshipsââ?¬â?¢, ââ?¬Ë?supportive environmentsââ?¬â?¢, ââ?¬Ë?doing thingsââ?¬â?¢, ââ?¬Ë?personal\ngrowth and moving forwardââ?¬â?¢, and ââ?¬Ë?understanding of self/acceptance of disabilityââ?¬â?¢.\nParticipants described SD in such terms as confidence and motivation. Contributors\nto SD were: ââ?¬Ë?personal strengthsââ?¬â?¢, ââ?¬Ë?interdependenceââ?¬â?¢, and ââ?¬Ë?functional independenceââ?¬â?¢. SD\nwas considered important to QOL. Youth goals were reflective of the goals of most\nadolescents. They identified the importance of having key goals that were of personal\ninterest to them. This study adds consumer-based information to the debate over the\nmeaning of QOL. Service providers and decision makers should be aware of the factors\nthat youth feel impact their QOL and SD, the importance of SD to youth QOL, and of\nSD to future goals, and consider this information when tailoring therapeutic\ninterventions....
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