702 resultados para quality-adjusted life year
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Objective: To determine which socio-demographic, exposure, morbidity and symptom variables are associated with health-related quality of life among former and current heavy smokers. Methods: Cross sectional data from 2537 participants were studied. All participants were at ≥2% risk of developing lung cancer within 6 years. Linear and logistic regression models utilizing a multivariable fractional polynomial selection process identified variables associated with health-related quality of life, measured by the EQ-5D. Results: Upstream and downstream associations between smoking cessation and higher health-related quality of life were evident. Significant upstream associations, such as education level and current working status and were explained by the addition of morbidities and symptoms to regression models. Having arthritis, decreased forced expiratory volume in one second, fatigue, poor appetite or dyspnea were most highly and commonly associated with decreased HRQoL. Discussion: Upstream factors such as educational attainment, employment status and smoking cessation should be targeted to prevent decreased health-related quality of life. Practitioners should focus treatment on downstream factors, especially symptoms, to improve health-related quality of life.
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Affiliation: Louise Lafortune: Faculté de médecine, Université de Montréal
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Aux soins intensifs néonataux, les professionnels et les parents évaluent le pronostic du développement et de la qualité de vie (QdV). Le but de cette thèse est de comprendre comment les parents prédisent la QdV future de leurs enfants. Cette étude qualitative basée sur la théorisation ancrée comprend dix entrevues avec des parents. Les résultats indiquent que le pronostic développemental influence les prédictions parentales de QdV, mais il n’est pas suffisant, car la QdV est multidimensionnelle. Les parents utilisent des mécanismes d’adaptation pour gérer la maladie et l’hospitalisation de leur enfant. Ceux qui pensent qu’ils, et leur enfant, seront capables de s’adapter à un mauvais état développemental, prévoient une QdV réévaluée. Le pronostic neuro-développemental et la QdV future ne sont pas facilement estimés et les professionnels doivent en être conscients. Aider les parents à identifier des mécanismes d’adaptation peut les amener à estimer un meilleur pronostic de la QdV.
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School of Management Studies, CUSAT
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Introducción: La hemofilia es una enfermedad poco frecuente; no obstante, los avances en los tratamientos de pacientes hemofílicos en las últimas décadas han generado cambios en su calidad de vida. Esto ha motivado el desarrollo de múltiples investigaciones al respecto. Objetivo: Revisar la literatura sobre la calidad de vida en el paciente hemofílico, producida en el periodo 2008-2012. Método: Se consultaron algunas bases de datos científicas utilizando como palabras clave “hemofilia” y “calidad de vida”. Se recopiló la información encontrada y se organizó según los objetivos propuestos en “factores negativos” y “factores protectores” de la calidad de vida a nivel fisiológico, psicosocial y cultural; “instrumentos para la evaluación de la calidad de vida” a nivel específico y general; y antecedentes empíricos de los últimos cinco años en los que se evaluara la calidad de vida o se realizara alguna intervención en la misma. Resultados: En general la información disponible sobre el comportamiento epidemiológico de la hemofilia es limitada. El interés por factores protectores y negativos es principalmente de tipo fisiológico, aunque se encontraron factores de tipo psicosocial y cultural, lo que indica la importancia de profundizar en esta temática. Existen pocos instrumentos especializados para la evaluación de la calidad de vida en hemofílicos. La evidencia empírica se centra en la evaluación. Conclusión: El estudio de la calidad de vida en pacientes hemofílicos amerita ser abordado de manera interdisciplinaria.
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The goal of this research was to identify predic- tive psychosocial factors of the subjective quality of life in a group of 60 people, with ages between 19 and 57, from both sexes, included in the program of demobilization and social inclusion of the Pro- grama de la Alta Consejería para la Reintegración Social y Económica de Personas y Grupos Alzados en Armas en Colombia. this research was a predic- tive correlational descriptive study. the Question- naire of optimism/Pessimism was used to assess the optimist or pessimist trend, and, for assess the quality of life, these strategies were combined: a home visit to value the objective quality of life, the Analogous scale of subjective Quality of Life to value satisfaction and well-being, and a general format to collect socio-demographic and juridical information. Results show that some variables as perceived health, optimism, educational level, re- ligious believes, objective quality of life, type of demobilization and years spent in the armed group operating outside the law, are associated to better levels of perceived quality of life. The findings and limitations of the study are discussed.
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Aim: Examine the relationship between the functional capacity and the quality of life related to health in university workers. Methodology: Cross-sectional study in 146 subjects, divided in two groups: Low functional Capacity (< 9 METs) and High functional Capacity (> 9.1 METs). We evaluated quality of life related to health (HRQOL-Health Questionnaire SF-12) and functional capacity (Questionnaire PAR/PAF) as indicators of health status. Results: 47.3% (69 men) and 52.7% (78 women). The average age of the groups was 35.0 ± 9.7 years (range 19,0-60,0 years). For HRQOL, the average found in the population assessed was 45.2 ± 4.42 (range 33,0-58,1) and 43.8 ± 6.87 (range 19,8-43,8) in components Physical Component Summary (PCS-12) and Mental Component Summary (MCS-12), respectively p = NS. Significant differences were found when comparing functional ability and sex, p<0,001 in both groups. Similarly, sex and mental component MCS-12 (group of Lower Functional) p = 0,049 as well as women and the physical component PCS-12, p = 0,05 between groups. Finally, a better score in HRQL observed in the group of High Capacity and functional components in both sex OR 0.59 (0.25-1.38). Conclusions: The results of this study demonstrate the relationship between High functional Capacity and a better HRQOL in this population.
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The Chronic Obstructive Pulmonary Disease (COPD) has a progressive and irreversible character and it’s associated to the triad of dyspnea, exercise limitation and the evident deterioration of quality of life. In the United States the prevalence of COPD in adult population is approximately of 6% in men, and 1 to 3% in women and it’s the fourth cause of mortality by no transmissible chronic diseases. In 1993, the National Health Interview Surgery considered that 12 millions of Americans suffer from chronic bronchitis and 2 million had emphysema. These two affections are responsible for more than 13% of the hospitalizations. As this affection progresses, patients experience a diminution in quality of life related to health (CVRS), their capacity to work get worse and their participation in physical and social activities reduces. Nevertheless, it has been confirmed that the isolated evaluation of COPD seriousness, defined by the reduction of the Forced Expiratory Volume in the First Second (FEV1), does not provide enough information to know the health state perceived by the patients. The fact that the CVRS is the result of the interaction of multiple physical, psychological and social factors, unique for each individual, can explain this finding. This paper is a general and updated approach to the integral handling of patients with COPD, and it discusses the concept of quality of life, related to health improvement.
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Introducción: el lupus eritematoso sistémico (LES) es considerado una enfermedad de alto costo. La expresión clínica de la enfermedad depende de la ubicación geografía y la etnicidad. El objetivo de este estudio fue el calcular los costos ambulatorios relacionado al LES en una cohorte colombiana, identificar los predictores de costos y comparar nuestro resultados con otras poblaciones. Métodos: Se realizó una aproximación de tipo prevalencia en 100 pacientes LES en quienes se evaluaron los costos directos médicos, directos no médicos, indirectos e intangibles. Todos los costos médicos fueron evaluados usando una metodología abajo hacia arriba. Los costos directos fueron valorados desde una perspectiva social usando una metodología de micro-costeo. Los costos indirectos se evaluaron mediante una aproximación de capital humano, y los costos intangibles calculados a partir de los años de vida ajustados por calidad (AVAC). Se analizaron los datos por medio de un análisis multivariado. Para comparaciones con otras poblaciones todos los costos fueron expresados como la razón entre los costos y producto interno bruto nacional per cápita. Resultados: La media de costos totales fue 13.031±9.215 USD (ajustados por el factor de conversión de paridad del poder adquisitivo), lo cual representa el 1,66 del PIB per capita de Colombia. Los costos directos son el 64% de los costos totales. Los costos médicos representan el 80% de los costos directos,. Los costos indirectos fueron el 10% y los costos intangibles el 25% de los costos totales. Los medicamentos representaron el 45% de los costos directos. Mayores costos se relacionaron con el estrato socioeconómico, seguro médico privado, AVAC, alopecia, micofenolato mofetilo, y terapia anticoagulante. Los costos directos ajustados de los pacientes con LES en Colombia fueron mayores que en Norte América y en Europa. Conclusiones: el LES impone una carga económica importante para la sociedad. Los costos relacionados con la atención médica y AVAC fueron los principales contribuyentes al alto costo de la enfermedad. Estos resultados pueden ser referencia para determinar políticas en salud pública así como comparar el gasto en salud de forma internacional.
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Objective:To identify aspects that affect the quality of life of nursing caregivers and their relationship with care in an Intensive Care Unit for Adults (A-ICU). Methods:This was a descriptive study with qualitative approach, taking as subjects 21 professionals who constitute the nursing staff of the A-ICU of a school hospital in Maringá-PR. Unstructured interview was used as a strategy to collect data, conducted between May and June 2009. Data analysis was based on the method of content analysis. The categories identified were: overlooking improvement in quality of life related to the resources in an A-ICU; the quality of life influencing the form of care; interpersonal relationships into the health team reflecting on the quality of life and care. Results:The analysis of caregivers’ speech and the results of the observation showed that there is correlation between the aspects they consider influential in their quality of life and the way of caring for patients in an A-ICU.Conclusion: The findings indicate that, among the influential aspects, the stressful factors overlap the enhancing ones. From this perspective, dealing with caregiver’s suffering might be the starting point for the improvement in quality of care in an A-ICU.
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The purpose of this investigation was to determine the impact of hearing loss on the quality of life of adolescents and children. Focus group sessions were held for parents and children or adolescents with hearing loss to discuss their perceptions. Quality of life questionnaires were developed for adolescents and children with hearing loss.
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The purpose of this investigation was to determine the impact of unilateral hearing loss on the quality of life of children. Focus group sessions were held for parents and children or adolescents with unilateral hearing loss to discuss their perceptions. Parents and children or adolescents completed the Pediatric Quality of Life Inventory. Findings were presented depicting which domains of quality of life are most affected.
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This paper forms part of research that is investigating the migration of young Bajan-Brits to Barbados. Specifically, it explores the role of quality of life issues in the decision-making processes of young Bajan-Brits as they negotiate their 'return' to Barbados. The research, based on 51 in-depth qualitative interviews conducted with an under-researched cohort of young Bajan-Brits living in Barbados, argues from a 'lure of home' conceptualisation that the return of young Bajan-Brits to Barbados can best be understood from the context of a search for a better quality of life in the face of social and economic disenfranchisement in the UK context. Subsequently, the paper examines the extent to which the quality of life factors which formed the basis of return to Barbados have in fact been realised on the part of young Bajan-Brits in their adjustment to life in Barbados. The paper ultimately argues that despite problems of adjustment, young Bajan-Brits have generally been successful in actualising a better quality of life in Barbados. Copyright (C) 2009 John Wiley & Sons, Ltd.