A new instrument for measuring anticoagulation-related quality of life: development and preliminary validation.

BACKGROUND: Anticoagulation can reduce quality of life, and different models of anticoagulation management might have different impacts on satisfaction with this component of medical care. Yet, to our knowledge, there are no scales measuring quality of life and satisfaction with anticoagulation that can be generalized across different models of anticoagulation management. We describe the development and preliminary validation of such an instrument - the Duke Anticoagulation Satisfaction Scale (DASS). METHODS: The DASS is a 25-item scale addressing the (a) negative impacts of anticoagulation (limitations, hassles and burdens); and (b) positive impacts of anticoagulation (confidence, reassurance, satisfaction). Each item has 7 possible responses. The DASS was administered to 262 patients currently receiving oral anticoagulation. Scales measuring generic quality of life, satisfaction with medical care, and tendency to provide socially desirable responses were also administered. Statistical analysis included assessment of item variability, internal consistency (Cronbach's alpha), scale structure (factor analysis), and correlations between the DASS and demographic variables, clinical characteristics, and scores on the above scales. A follow-up study of 105 additional patients assessed test-retest reliability. RESULTS: 220 subjects answered all items. Ceiling and floor effects were modest, and 25 of the 27 proposed items grouped into 2 factors (positive impacts, negative impacts, this latter factor being potentially subdivided into limitations versus hassles and burdens). Each factor had a high degree of internal consistency (Cronbach's alpha 0.78-0.91). The limitations and hassles factors consistently correlated with the SF-36 scales measuring generic quality of life, while the positive psychological impact scale correlated with age and time on anticoagulation. The intra-class correlation coefficient for test-retest reliability was 0.80. CONCLUSIONS: The DASS has demonstrated reasonable psychometric properties to date. Further validation is ongoing. To the degree that dissatisfaction with anticoagulation leads to decreased adherence, poorer INR control, and poor clinical outcomes, the DASS has the potential to help identify reasons for dissatisfaction (and positive satisfaction), and thus help to develop interventions to break this cycle. As an instrument designed to be applicable across multiple models of anticoagulation management, the DASS could be crucial in the scientific comparison between those models of care.

Saúde e bem-estar na transição para o ensino superior: influência dos estilos de vida nos processos de adaptação

Dissertação mest., Psicologia da saúde, Universidade do Algarve, 2008

The quality of life in the Master of Education program, Brock University

This study addressed the problem of the quality of life in the Brock Master of Education program. Survey and interview data were used to gain an understanding of satisfaction with the learning achieved and student life experienced. Eighty-seven percent of the study sample reported satisfaction with the program overall. Results suggested the higher the overall satisfaction with a program, the greater the likelihood learning and student life satisfaction were also more positive. Student reflections suggested satisfaction with the quality of life in the program was associated with the program's focus on the student, the use of self-directed learning, and the support of professors to meet student needs. Comparison of the Brock Master of Education survey with the Brock Pre-Service Teacher Education program showed both student groups shared a similar satisfaction with student life in the Faculty. Comparison of Master of Education programs suggested the difference between two programs, a difference which may be influenced by time in the program. The results from the three programs suggested that students beyond the first undergraduate degree favored the school domains of learning acquisition. Supplementary data on the relationship between cognitive and affective opinions suggested the more positive the affective dimension of learning, the greater the likelihood the cognitive dimensions of student life were also more positive. It was concluded that time was a chief factor influencing part-time student satisfaction with both learning and student life in the program. Part-time students, as. the majority in the survey, expressed comments about the need for clarity of communication between the organization and student to promote the effective use of limited time.

Relation entre la satisfaction et la qualité de vie reliée à la santé bucco-dentaire chez les patients totalement édentés

Problématique : La satisfaction des patients et la qualité de vie reliée à la santé bucco-dentaire (OHRQoL) sont deux mesures de résultats fréquemment utilisées durant les études cliniques. Néanmoins, chez les patients totalement édentés, les évidences scientifiques relatives au niveau de relation entre ces deux mesures sont faibles. De plus, on ignore toujours quels éléments de la satisfaction des patients relativement à leurs prothèses partagent la meilleure relation avec la OHRQoL. Objectifs : Déterminer, chez les patients totalement édentés, s’il existe un lien entre leur satisfaction de leurs prothèses et leur OHRQoL et identifier les déterminants de satisfaction qui démontrent le meilleur niveau de relation avec la OHRQoL. Méthodologie : Les données provenant de 255 patients totalement édentés qui ont participé à une étude randomisée et contrôlée ont été utilisées. La OHRQoL a été évaluée à l’aide du questionnaire Oral Health Impact Profile (OHIP-20). Le McGill Denture Satisfaction Instrument a été utilisé pour estimer la satisfaction des patients. Ces mesures ont été prises au temps initial, à 6 mois et à 12 mois suivants la mise en bouche des prothèses. Des analyses statistiques de régression linéaire simples et multiples ont été utilisées afin d’évaluer la relation entre les deux mesures. Résultats : Une relation positive et considérable existe entre la satisfaction des patients totalement édentés et leur OHRQoL. La difficulté masticatoire (P = .005) et la condition buccale (P = .002) sont les éléments de la satisfaction qui possèdent le meilleur lien avec la OHRQoL. Ces deux facteurs expliquent 46.4% (P = .0001) de la variance dans l’amélioration d’OHIP suivant un traitement prosthodontique. La relation décrite est dépendante du temps, mais pas du type de traitement ni des variables sociodémographiques. Conclusions : Dans les limites de l’étude, il est conclu qu’une relation positive existe entre la satisfaction des patients et leur OHRQoL. La difficulté masticatoire et la condition buccale sont les deux éléments de la satisfaction les plus importants.

Los horarios laborales y su influencia en la percepción del equilibro trabajo-familia

Conciliar el trabajo y la familia es una lucha cotidiana que cada persona realiza para satisfacer las exigencias de ambas dimensiones de su vida. El no tener consciencia del problema que surge en el empleado para lograr esta conciliación y la ausencia de soluciones eficaces a éste, no sólo afecta a la organización a través de la baja productividad, el absentismo, el aumento del estrés, entre otros efectos; sino también a la vida familiar, social, física y psicológica del trabajador. Es por ello, que este proyecto de grado busca a partir de la revisión de la literatura mostrar cómo la percepción que tienen los trabajadores de su equilibrio trabajo-familia, se ve influenciada por un factor organizativo, como lo son los turnos laborales; además evidenciar las soluciones que se han implementado en las diferentes empresas de manera exitósa, para finalmente plantear estrategias que se puedan aplicar en las organizaciones facilitando el equilibrio trabajo-familia de los trabajadores.

Educar las emociones: una reflexión sobre los programas de educación emocional en la primera infancia a través de la lente de la Psicología Positiva

La primera infancia es la etapa comprendida entre los 0 y los 6 años, y es el momento en el cual el cerebro tiene mayor plasticidad, por lo que en la actualidad se cree que la educación debe iniciar en este momento de la vida. La educación inicial ha venido dejando de lado el interés por los procesos cognitivos y ha puesto su foco de atención en el desarrollo social y emocional de los niños. El objetivo del presente trabajo es describir las características de los programas de educación emocional en la primera infancia a través de la lente de la Psicología Positiva utilizando una metodología cualitativa documental y específicamente el estado del arte. Los resultados obtenidos se dividen en corte empírico y corte teórico; para los de corte empírico se encontró que si bien el target que se pretende impactar son los niños en la primera infancia, varios programas le apuntan a trabajar como primera instancia con los cuidadores de los niños. Por otro lado como variables más comunes se manejaban las habilidades interpersonales y la resolución de problemas. Para los de corte teórico se encontró que los programas se orientan bajo una pedagogía dinámica y que muchos se centran en enfoques orientados a la promoción de habilidades sociales.

Demarcación teórica del optimismo y la resiliencia en el contexto de capital psicológico.

En este estudio se describe el constructo del Capital Psicológico y se hace el análisis de sus respectivos componentes; enfocándose en los conceptos de Optimismo y Resiliencia, con el fin de encontrar y demarcar teóricamente las diferencias que existen entre estos dos componentes. A consecuencia de la frecuente confusión entre estos dos términos en el ámbito académico, surge el interés de encontrar y analizar diferentes estudios e investigaciones que se hayan hecho hasta el momento, las cuales logren resaltar dichas diferencias, para aplicar este conocimiento a las personas con el fin de brindarles una mejor calidad de vida en el ámbito personal y profesional. La autoeficacia, en contextos organizacionales, hace referencia a la convicción y confianza con la que cuenta un trabajador, sobre sus habilidades para trabajar su motivación, teniendo en cuenta recursos cognitivos y/o cursos de acción necesarios para proyectar y completar exitosamente una prueba específica de su vida. El optimismo, se estudia como aquel estilo de pensamiento explicativo, que carga los eventos positivos a causas internas, continuas y penetrantes, y los eventos negativos a razones externas. Por otro lado, la esperanza es la capacidad de todo ser humano para llevar a cabo acciones que lo orienten a una meta deseada, a través de la propia motivación y el pensamiento seguro y positivo. Por último, la Resiliencia es tener la capacidad de recobrar frente a la adversidad, el fracaso, o incluso cambios efectivos que pueden parecer opresores.

Preditores da satisfação no trabalho dos professores do ensino básico e secundário português : remuneração, valores de trabalho e stress

O papel do professor é crucial numa sociedade, e o sucesso da sua missão depende da sua satisfação no trabalho. Este estudo tem como objectivo avaliar a satisfação no trabalho dos professores do ensino público português não superior. Uma amostra de 637 professores respondeu a um questionário online sobre satisfação no trabalho, valores de trabalho, e stress. Verificou-se que os professores, em média, se encontram insatisfeitos com o seu trabalho; que os do sexo masculino se encontram mais insatisfeitos que os do sexo feminino; que a variação da remuneração dentro da profissão não tem impacto sobre a satisfação no trabalho nos professores; que o stress é o principal preditor da satisfação, tendo um claro impacto negativo; e que tanto os valores intrínsecos de locus de controlo interno como os valores sociais influenciam (positivamente) a satisfação de modo independente.

The influence of perceived control on subjective wellbeing in later life

It has been proposed that a sense of control (primary control) is critical to maintaining positive and stable subjective wellbeing (SWB). As people age and control capacity presumably declines (due to physical and cognitive deterioration and increased sociocultural challenges), it is argued that the influence of secondary perceived control (or acceptance) increases to help maintain normative levels of SWB. While previous studies have typically investigated the relationship between perceived control and global estimates of satisfaction (i.e., overall life satisfaction), the present study evaluated the link between perceived control and seven key domains of satisfaction in order to obtain a more comprehensive understanding of the control-satisfaction relationship. A community-based sample of 1,317 individuals (age range: 17–92 years) was utilised to examine potential age-related differences in perceived control (primary and secondary) and satisfaction. Findings revealed that primary and secondary perceived control both increased across age, with secondary perceived control increasing at a higher rate. Primary perceived control had predictive primacy for satisfaction over secondary perceived control (consistent with theory). A moderated mediation effect was also found, suggesting that, in later life, secondary perceived control influences primary perceived control and, in turn, influences satisfaction with various domains. Therefore, while primary control is important to wellbeing, it should be acknowledged that secondary perceived control may have unique significance to the wellbeing of older adults.

Life quality and wealth : a qualitative and quantitative comparison of affluent and poor people

It is well-documented that auent people, on average, have higher subjective wellbeing (SWB) than do poor people. is phenomenon has been explained using SWB homeostasis theory. However, a more precise understanding of the dierences in personal experience that lead to homeostatic failure remains to be documented. We sought such understanding through qualitative interviews and a quantitative examination of SWB domains. Twenty auent people and 20 people dependent on social welfare completed an interview and the Personal Wellbeing Index. As expected, the two groups diered signicantly in SWB. Moreover, the poor group reported a preponderance of negative life experiences while the auent group concentrated on the positive events in their lives. Most telling was the nding that both the qualitative and quantitative methods identied the area of ‘relationships’ as representing the greatest degree of divergence between the two groups. is life domain is especially relevant in the maintenance of normative levels of SWB.

The contribution of job and partner satisfaction to the homeostatic defense of subjective wellbeing

Two studies investigate subjective wellbeing (SWB) homeostasis. The first investigates the contribution of job satisfaction (JS) and partner satisfaction (PS) to the homeostatic defense of SWB. The extant model of homeostasis does not include either variable. The second study investigates the relationship between Homeostatically Protected Mood (HPMood) and other factors involved in the homeostatic model. It has been proposed that HPMood is the basic, biologically determined, positive mood that saturates SWB and other related variables, and forms the basis of the SWB set-point. Thus, if HPMood is an individual difference and it perfuses other homeostatic variables, then HPMood should be responsible for much of the shared variance between such variables. Two comparative samples are involved. One is a group of 171 Hong Kong Chinese recruited through convenience sampling. The other is a group of 343 Australians recruited via a general population survey. Results indicate that both JS and PS predict significant variance in Global Life Satisfaction beyond the existing factors in the homeostatic model. It is also found that, after controlling for the effect of HPMood, the strength of correlations between SWB and other homeostatic variables is significantly diminished. The implications of these findings are discussed.

Exploring the effects of perceived service provider sincerity on consumers' emotional state and satisfaction during service consumption

A holistic approach to satisfaction and its effects seems to be particularly important in high-affect, high-involvement, and extended duration services such as those offered by many travel and tourism providers. This means understanding the complexities of service provision and its processes. Consumers value service interaction that appears sincere. For this reason, organizations expect service providers to manage their service "performance" to reflect a genuine display of positive emotions towards the customer, which has a direct impact on customer satisfaction and possibly overall life satisfaction. This study explores consumers' perception of sincerity and tests its effects on positive emotions and satisfaction in an extended duration service. The findings indicate that perceived service sincerity positively influences consumers' emotions during a service and has important direct and indirect effects on life satisfaction, service satisfaction, and intention to repurchase. Implications for managers and opportunities for further research are discussed.

Understanding quality of life in medicine : a new approach

This article introduces the subjective side of quality of life as it has evolved within the discipline of psychology. Subjective well-being is also of special interest within medicine due to its links to pathology and the fact that it is managed by a homeostatic system. This form of management offers an explanation for the unusual properties of subjective well-being, including its normal positivity, stability, and nonlinear relationship to objective variables, such as physical health. Central to understanding is the proposition that subjective well-being mainly consists of a specific form of trait mood. This homeostatically protected mood has a genetic set point and it is the experience of this set-point mood that homeostasis is defending. The resources required to maintain normal homeostatic control are described. If these resources are inadequate to protect the experience of set-point mood, mood positivity falls, and there is a high probability of depression. In this article, the process of homeostasis is shown to assist understanding of intervention effectiveness within both psychology and medicine. This concerns matters of resilience, the nonlinear relationship between levels of subjective well-being, and the strength of challenging agents, and the important understanding that interventions designed to raise subjective well-being are critically dependent on its level at baseline. Key teaching points: • The physiological process of homeostasis has a parallel in psychology in the homeostatic management of subjective well-being. • Subjective well-being is a more globally informative construct than health-related quality of life. • How people feel about themselves and their lives cannot be simply predicted through measures of health. • When subjective well-being homeostasis is defeated, there is a high probability of depression.

QFD aplicado em uma metodologia para avaliação da satisfação de clientes em uma cadeia logística

Este trabalho apresenta uma metodologia para avaliação da satisfação de clientes em uma cadeia logística, que visa buscar a melhoria dos serviços logísticos. A metodologia utiliza técnicas estatísticas, técnicas de pesquisa de mercado e técnica de análise de decisão. A técnica de análise de decisão utilizada nesta metodologia é o Desdobramento da Função Qualidade (QFD) aplicada para planejar melhorias no serviço logístico, priorizando as características do serviço demandadas pelos clientes e os indicadores de desempenho para o mesmo. A aplicação desta metodologia em uma empresa do ramo alimentício resultou na confirmação da metodologia proposta como instrumento de apoio na elaboração de planos de melhorias para sistemas logísticos.

Life expectancy, educational attainment, and fertility choice

This paper explores the role of mortality as a determinant of educational attainment and fertility, both during the demographic transition and after its completion. Two main points distinguish our analysis from the previous ones. Together with the investments of parents in the human capital of children, traditional in the fertility literature, we introduce investments of adult individuals (parents) in their own education, which ultimately determines productivity in both the goods and household sectors. Second, we let adult longevity affect the way parents value each individual child. Increases in adult longevity or reductions in child mortality eventually raise the investments in adult education. Together with the higher utility derived from each child, this tilts the quality-quantity trade off towards less and better educated children, and increases the growth rate of the economy. This setup can explain both the demographic transition and the recent behavior of fertility in “post-transition” countries. Evidence from historical experiences of demographic transition, and from the recent behavior of fertility, education, and growth generally supports the predictions of the model.