Journal articles on the topic 'Home-based care; mental health; health-related quality of life'
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Dempster, Martin, and Michael Donnelly. "Selecting a Measure of Health Related Quality of Life." Social Work in Health Care 32, no. 1 (February 28, 2001): 45–56. http://dx.doi.org/10.1300/j010v32n01_04.
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Shieu, Bianca, Todd Schwartz, Matthias Hoben, Mark Toles, Anna Beeber, and Ruth Anderson. "AGE-RELATED DIFFERENCES IN HEALTH-RELATED QUALITY OF LIFE AMONG WESTERN CANADIAN NURSING HOME RESIDENTS." Innovation in Aging 6, Supplement_1 (November 1, 2022): 703. http://dx.doi.org/10.1093/geroni/igac059.2572.
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Abstract Nursing homes (NHs) typically focus on health-related quality of life (HRQoL) among residents aged 65 and over despite approximately 7% of NH residents are younger (aged 18-64). Research suggests that the needs of younger NH residents are not being met and they may have low HRQoL. However, differences in HRQoL of younger and older NH residents may not be apparent in studies that use HRQoL measures designed for research with older NH residents. We hypothesized that the younger residents would have lower HRQoL mean scores than the older (aged ≥ 65) residents using a HRQoL measure based on the HRQoL score derived from Resident Assessment Instrument – Minimum Data Set 2.0 items. The measure uses items that emphasize physical aspects of quality of life rather than social aspects. In a sample of 21,129 residents from 94 NHs in Western Canada, we performed descriptive analyses, t-test, chi-square test, and an adjusted propensity score (PS) analysis through retrospective cohort study from years 2016 to 2017. The HRQoL index score ranged from -.351 to .996 (Mean= 0.693, SD=0.265). In the PS model, the adjusted mean score for younger was higher than for older adults with a mean difference at 0.061 (95% CI 0.031, 0.091) (p<.001). Other domains such as mental health condition of quality of life must be examined in younger NH residents because it is a crucial factor influencing their daily lives, thereby we can explore a more complete set of HRQoL domains of them and redesign care for their unique needs.
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Pan, Yuqin, Patricia S. Jones, and Patricia Pothier. "The Relationship Between Mutuality and Health-Related Quality of Life in Adult Child Caregivers in China." Journal of Family Nursing 23, no. 3 (July 24, 2017): 366–91. http://dx.doi.org/10.1177/1074840717718540.
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The strain inherent in caregiving relationships between adult children and aging parents is a prominent issue in contemporary China due to a combination of demographic and socioeconomic changes. The purpose of this study was to explore how mutuality, a positive quality of caregiving relationships, contributes to the physical health and mental health (health-related quality of life [HRQoL]) of adult child caregivers [ACCs] of parent stroke survivors. A cross-sectional correlational study was conducted on a nonproportional quota sample of 126 ACCs, using questionnaires of demographics, the 15-item Mutuality Scale, and the Second Version of the Standard 12-Item Health Survey (SF-12v2). Higher mutuality was found to be correlated with better caregiver physical health and mental health. However, after adjusting for the covariates, mutuality significantly explained 4.6% of the variance of caregiver physical health (β = .22, ΔR2 = .046, p < .01) but it did not significantly explain the variance of caregiver mental health. Although multiple factors correlate with Chinese family caregivers’ HRQoL, this was the first study exploring the impact of caregiver–care receiver dyadic relationships on caregiver HRQoL in mainland China by using a mutuality scale with SF-12v2. Despite the fact that the Chinese tradition of filial piety can facilitate mutuality, socioeconomic changes and legislation that require adult children to care for aging parents appear to create high stress among family caregivers. Higher levels of mutuality contribute to better physical health in Chinese family caregivers. Therefore, culturally appropriate family nursing strategies and social policies in China could enhance caregiver mutuality and potentially promote their HRQoL, in particular physical health.
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Vatter, Sabina, Kathryn R. McDonald, Emma Stanmore, Linda Clare, and Iracema Leroi. "Multidimensional Care Burden in Parkinson-Related Dementia." Journal of Geriatric Psychiatry and Neurology 31, no. 6 (September 24, 2018): 319–28. http://dx.doi.org/10.1177/0891988718802104.
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Background and Objective: Providing care to people with Parkinson-related dementia (PwPRD) may result in significant stress, strain, and burden for life partners. A common measurement of life partner burden is the Zarit Burden Interview (ZBI), which considers “burden” as a unitary concept; however, burden is highly complex and most likely comprises several dimensions. This study aimed to explore the factor structure of the ZBI in life partners of PwPRD and to examine the relationships among the emerging factors and the demographic and clinical features. Methods: Life partners of PwPRD participated in home-based quantitative assessments and self-completed postal questionnaires. The assessment battery included ZBI, measures of relationship satisfaction, mood, stress, resilience, health, quality of life, feelings related to care provision, and sociodemographic questions. Data on PwPRDs’ motor and neuropsychiatric symptom severity were also elicited in home-based assessments. Results: An exploratory factor analysis (principal axis factoring) of ZBI, conducted with 127 life partners, revealed five burden dimensions: social and psychological constraints, personal strain, interference with personal life, concerns about future, and guilt. These burden factors were associated with lower relationship satisfaction, mental health, and resilience, and higher stress, anxiety, depression, resentment, negative strain, and PwPRD motor severity. In multiple linear regression analyses, where each factor score was the dependent variable, stress, negative strain, and resentment emerged as significant predictors of specific burden dimensions. Conclusions: Burden is a complex and multidimensional construct. Interventions should address specific types of burden among life partners of PwPRD to support couples’ relationships and maintain quality of life.
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Nikmat, Azlina Wati, Graeme Hawthorne, and S. Hassan Al-Mashoor. "Quality of life in dementia patients: nursing home versus home care." International Psychogeriatrics 23, no. 10 (June 24, 2011): 1692–700. http://dx.doi.org/10.1017/s1041610211001050.
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ABSTRACTBackground: Care management providing a high quality of life (QoL) is a crucial issue in dealing with increasing numbers of dementia patients. Although the transition from informal (home-based) care to formal (institutional) care is often a function of dementia stage, for those with early dementia there is currently no definitive evidence showing that informal or formal care provides a higher QoL, particularly where informal care is favored for local cultural reasons. This paper outlines the research protocol for a study comparing formal and informal care in Malaysia. It seeks to provide evidence regarding which is more appropriate and results in higher QoL in early dementia.Methods: This is a quasi-experimental study design involving 224 early dementia patients from both nursing home and community settings. Participants will be assessed for cognitive severity, QoL, needs, activities of daily living, depression and social isolation/connectedness by using the Mini-Mental State Examination (MMSE), Cognitive Impairment Scale – 4 items (CIS-4), EUROPE Health Interview Survey-Quality of Life (WHO8), Assessment of Quality of Life (AQoL8), Camberwell Assessment of Need for the Elderly – Short Version (CANE-S), Barthel Index (BI), Cornell Scale for Depression (CSDD), Geriatric Depression Scale – 15 items (GDS-15), and Friendship Scale (FS) respectively.Conclusion: This study aims to provide a better understanding of care needs in early dementia. Given population aging, the study findings will provide evidence assisting decision-making for policies aimed at reducing the burden of caregiving and preserving the QoL of dementia patients.
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Borah, Anamita. "Mental health implications of COVID-19 outbreak on children." IP Journal of Paediatrics and Nursing Science 4, no. 2 (July 15, 2021): 39–44. http://dx.doi.org/10.18231/j.ijpns.2021.008.
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The COVID-19 pandemic is equally effecting the adult population and the children’s in terms of mental health. Children’s are more susceptible to develop mental health problems as they are in the developmental stage of life. Anxiety, frustrations, impairment of sleep, feeling of helplessness is the common presentations of children during this pandemic outbreak. The health related quality of life has also been deteriorated owing to home confinement and less physical activities. The ongoing situation is quite incongruent with their developmental stage. Children’s are unable to go to school, isolated from their peer group, affecting their healthy development of the brain. It is also evident that the screen time is also gradually increasing which also contributes the brain development in a negative way. It is an important task to monitor the children’s mental and emotional health in this crucial period. Parents and care takers should understand this challenging environmental situation, which may have a devastating effect on their children’s mental health if not handled with utmost care.
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Stojanov, J., and A. Stojanov. "Quality of sleep and health-related quality of life among health care professionals treating patients with coronavirus disease-19." European Psychiatry 65, S1 (June 2022): S380—S381. http://dx.doi.org/10.1192/j.eurpsy.2022.965.
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Introduction Health care professionals exposed to coronavirus disease 2019 (COVID-19) are facing high levels of stress. Objectives The aim was to evaluate the quality of sleep (QoS) and health-related quality of life (HRQoL), among health care professionals treating patients with COVID-19, as well as quantifying the magnitude of symptoms of depression and levels of anxiety. Methods We included 201 health care professionals in a cross-sectional, web-based study by applying 7-item Generalized Anxiety Disorder (GAD-7) Scale, Zung Self-rating Depression Scale, 36-item Health Survey of the Medical Outcomes Study Short Form (SF36), Pittsburgh Sleep Quality Index (PSQI) and additional survey constructed for the purpose of the study. Results Poor QoS and HRQoL correlated with high health anxiety and severe depressive symptoms and several demographic characteristics. Multiple linear regression analysis showed that higher scores on GAD-7 (beta = .71, p < .01) and lower scores on mental health (MH) subscale on SF36 questionnaire (beta = –.69; p < .01) were independent predictors of the higher PSQI score (adjusted R2 = .61, p < .01 for overall model). Higher scores on GAD-7 (beta = .68, p < .01) and worse self-perceived mental status (beta = .25; p < .05) were independent predictors of the lower SF36 scores (adjusted R2 = .73, p < .01 for overall model). Conclusions The major MH burden of health care professionals treating infected patients during the COVID-19 pandemic indicates that they need psychological support. Disclosure No significant relationships.
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Millard, Jack. "The health of older adults in community activities." Working with Older People 21, no. 2 (June 12, 2017): 90–99. http://dx.doi.org/10.1108/wwop-09-2016-0024.
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Purpose The purpose of this paper is to establish whether the inclusion of physical activity (PA) in a community programme setting is more beneficial than the benefit obtained from social participation for older adults. Design/methodology/approach A cross-sectional study conducted with a sample of 105 adults age 65+ and older that take part in community activities organised by the Bristol based charity LinkAge. Participants took part in either solely social groups or social groups with a PA component. A self-report questionnaire was composed of measures assessing functional health and well-being, health-related quality of life, functional ability, outcome expectation for exercise, and social support. Findings A significantly different and higher score on physical health measures was reported by the physically active group for role physical, physical function, bodily pain, and the physical capacity score. No significant difference was found for health measures that include a mental component. The physically active group reported higher outcome expectations for exercise. Research limitations/implications Social activity in community programmes may provide a method to maintain a healthy mental state in older adults, but participation in PA in the same environment is associated with better scores for physical health measures. Originality/value Providing greater support for older people to engage in physical and social activities may enable them to maintain a higher quality of life.
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Stinga, M., E. Moti, E. Papageorgiou, T. Ioannou, V. Paraskevopoulou, K. Papanikolaou, N. Voura, and G. F. Angelidis. "Quality of life of patients residing in long-term care psychiatric community settings." European Psychiatry 26, S2 (March 2011): 584. http://dx.doi.org/10.1016/s0924-9338(11)72291-x.
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IntroductionIn the context of psychiatric reformation, the long-term mentally ill have moved from institutionalized care to outpatient-based mental health services and community-based rehabilitation settings.ObjectiveQuality of Life (QoL) constitutes a critical outcome of mental health programs and services and is a multidimensional subjective construct.AimExploring the perceived QoL of long-term psychiatric residents and, identifying possible associations between sociodemographic variables, psychiatric history, cognitive function (MMSE), physical comorbidity and type of residential care.Method104 patients residing for over six months, to community based rehabilitation settings subjected to the PHPO (5 sheltered apartments, 7 hostels, 2 boarding houses) were encountered. QoL of participants was assessed using the self-fulfilling, 36 item Short-Form Health Survey (SF-36) at a given point of time.ResultsThe majority of the residents expressed good levels of satisfaction in all subscales of the SF-36, with mean values of Physical Component Summary (PCS): 34.90 ± 13.92 (range: 0–50) and Mental Component Summary (MCS): 67.89 ± 20.09 (range: 25-100). Statistical significant differences were recorded concerning the PCS and age (p = 0.000), MMSE scores (p = 0.000), educational level (p = 0.017), marital status (p = 0.049) and type of residential home (p = 0.012). MCS was statistically significant associated with age (p = 0.032), MMSE scores (p = 0.007), socioeconomic status (p = 0.008) and type of residential home, too (p = 0.040). No differences were found concerning psychiatric diagnosis or physical comorbidity.ConclusionsCommunity care models provide subjective positive life satisfactions to the majority of the chronically mentally ill. Thus, besides the care giver's management, independent variables play an important role to perceived QoL.
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Lee, Jeongim. "The Influencing Factors on Health-Related Quality of Life in Childbearing Women Based on the Korea National Health and Nutrition Examination Survey (KNHANES) 2019 Data." Journal of The Korean Society of Maternal and Child Health 25, no. 4 (October 31, 2021): 282–91. http://dx.doi.org/10.21896/jksmch.2021.25.4.282.
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Purpose: This study was conducted to identify the influencing factors on health-related quality of life in childbearing women.Methods: This study used data from the 2019 Korea National Health and Nutrition Examination Survey. The participants were 1,348 women aged 19–49 years.Results: Health-related quality of life in childbearing women affecting factors are stress level, depression recognition, self-related health, and current smoking, having 40.1% explaining power (F=59.94, p=0.05).Conclusion: Personal mental health care programs and nonsmoking programs should be developed to improve health-related quality of life in childbearing women. There is a need to establish a section dedicated to women's health promotion, and the section makes a policy for women's health care according to the life cycle dedicated to women's health promotion.
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Nikmat, Azlina Wati, S. Hassan Al-Mashoor, and Nurul Azreen Hashim. "Quality of life in people with cognitive impairment: nursing homes versus home care." International Psychogeriatrics 27, no. 5 (December 11, 2014): 815–24. http://dx.doi.org/10.1017/s1041610214002609.
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ABSTRACTBackground:The evaluation of quality of life (QoL) among older adults has become increasingly important, and living arrangements play a pivotal role in determining the QoL of people with cognitive impairment (PWCI). Although informal care (home-based) is favored, transition to formal care (residential care) often becomes necessary, especially in the later stages of cognitive impairment. The primary objective was to compare the QoL of PWCI in the community and nursing homes. Additionally, factors differentiate the QoL of PWCI in these two settings were identified.Methods:This is a quasi-experimental study design involving 219 older adults with cognitive impairment, aged 60–89 years old from both nursing home and home care. Participants completed the EUROPE Health Interview Survey-QoL (WHO-8), the Short Mini-Mental State Examination (SMMSE), the Barthel Index (BI), the Geriatric Depression Scale (GDS-15), and the Friendship Scale (FS).Results:There were significant differences in QoL, depression, social connectedness (p < 0.01) and cognitive functions (p = 0.01) between home care recipients and nursing home participants. No significant differences were observed with regards to health condition, co morbidities and physical functions between study cohorts.Conclusions:Older adults with cognitive impairment living at home experienced higher QoL, had better cognitive function, were less depressed and reported higher social connectedness compared to those living in institutional care. Therefore, support should be provided in enabling home care and empowering caregivers to provide better care for PWCI.
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Hanrahan, Nancy P., Evan Wu, Deena Kelly, Linda H. Aiken, and Michael B. Blank. "Randomized Clinical Trial of the Effectiveness of a Home-Based Advanced Practice Psychiatric Nurse Intervention: Outcomes for Individuals with Serious Mental Illness and HIV." Nursing Research and Practice 2011 (2011): 1–10. http://dx.doi.org/10.1155/2011/840248.
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Individuals with serious mental illness have greater risk for contracting HIV, multiple morbidities, and die 25 years younger than the general population. This high need and high cost subgroup face unique barriers to accessing required health care in the current health care system. The effectiveness of an advanced practice nurse model of care management was assessed in a four-year random controlled trial. Results are reported in this paper. In a four-year random controlled trial, a total of 238 community-dwelling individuals with HIV and serious mental illness (SMI) were randomly assigned to an intervention group (n=128) or to a control group (n=110). Over 12 months, the intervention group received care management from advanced practice psychiatric nurse, and the control group received usual care. The intervention group showed significant improvement in depression (P=.012) and the physical component of health-related quality of life (P=.03) from baseline to 12 months. The advanced practice psychiatric nurse intervention is a model of care that holds promise for a higher quality of care and outcomes for this vulnerable population.
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Patra, Ramesh Chandra, Biswajit Kanungo, and Parul Bawa. "Mental health, sleep quality and quality of life in individuals with and without multiple health conditions during home quarantine in India due to the COVID-19 pandemic: a cross-sectional study." F1000Research 9 (July 17, 2020): 718. http://dx.doi.org/10.12688/f1000research.24321.1.
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Background: Since the World Health Organization declared the COVID-19 outbreak a global pandemic, global spread has created several challenges for the general public and health care workers across the world. The primary aim of this study was to assess the psychological stress, sleep quality, and health-related quality of life (QoL) of individuals with multiple health issues during home quarantine caused by the COVID-19 pandemic. Methods: 50 individuals were recruited between 28th March and 30th April 2020, who have a history of chronic health issues, and 50 individuals with no health issues for this cross-sectional study. Three questionnaires were used to evaluate the mental health [depression anxiety stress scale (DASS-21)], sleep quality [Pittsburgh sleep quality index (PSQI)], and QoL [short form of health-related questionnaire (SF-36)] of participants. Statistical analysis was carried out with Student’s t-test, using SPSS software v16. Results: Baseline demographic characteristics were homogenous for both groups of participants. Intergroup analysis revealed statistically significant differences in mental health (p<0.001), sleep quality (p<0.001), and QoL (p<0.001) between the two groups. Conclusion: Our findings indicate that individuals with chronic health issues exhibit higher mental health problems, lower quality of sleep and have a lower health-related QoL. More research needs to be done for this group of individuals and the Government should plan to care of these individuals.
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Scales, Kezia, and Kezia Scales. "THE HEALTH OF THE DIRECT CARE WORKFORCE: EVIDENCE AND IMPLICATIONS ACROSS LONG-TERM CARE." Innovation in Aging 6, Supplement_1 (November 1, 2022): 157. http://dx.doi.org/10.1093/geroni/igac059.624.
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Abstract Direct care workers play a key role in supporting the health and wellbeing of older adults and people with disabilities across care settings—yet their own health risks are largely overlooked. The four papers in this symposium address this critical knowledge gap. First, McCall and colleagues will present a comparative analysis of the health status, health insurance coverage, and healthcare experiences of direct care workers across long-term care using National Health Interview Survey data. Next, Lee et al. will present the trends and characteristics of occupational injuries and illnesses among California’s long-term care workers from 2019 to 2020 using California Workers’ Compensation data, assessing the impact of COVID-19 on their occupational health. Sterling will characterize the physical and mental health of the direct care workforce before and during COVID-19 using data from the CDC's Behavioral Risk Factor Surveillance Survey, as well as drawing on qualitative and survey-based studies of unionized, agency-employed home care workers in New York. Sterling will also present findings from a pilot feasibility study of an intervention aimed at improving home care workers’ well-being. Finally, Quinn et al. will synthesize findings on home care workers’ occupational hazards—including needlesticks, musculoskeletal strain, violence and infections—and examine how preventing these risks can improve safety for both workers and clients. The discussant will draw out themes and implications from across these complementary studies, highlighting the importance of safeguarding direct care workers’ health as a key step toward improving care quality and outcomes for older adults and people with disabilities.
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Landes, Scott, and Janet Wilmoth. "PHYSICAL AND MENTAL HEALTH OUTCOMES AMONG OLDER MILITARY VETERANS." Innovation in Aging 6, Supplement_1 (November 1, 2022): 149–50. http://dx.doi.org/10.1093/geroni/igac059.596.
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Abstract Older veterans are a unique health population, with physical and mental health outcomes impacted by the positive health aspects of military social capital as well as the negative aspects of military-related hazards. This symposium focuses on physical and mental health outcomes among older military veterans both before COVID-19, and during the COVID-19 pandemic. Three studies address veteran health outcomes pre-pandemic. Two of the pre-pandemic studies focus on veteran-only samples in order to determine whether aspects of marital quality predicted levels of loneliness, and risk factors for trauma re-engagement among those with medical illness. The third pre-pandemic study examines whether the increased mortality risk observed among older veterans compared to nonveterans varies by combat status. Two studies address veteran health outcomes during the COVID-19 pandemic. The first uses a sample of older veterans with PTSD who were surveyed pre-pandemic and during the pandemic in order to ascertain the mental and physical health impact of the pandemic. The second COVID-19 study uses data from a study of Veterans Affairs’ Home Based Primary Care (HBPC) providers to learn about the best practices discovered to ensure COVID-19 vaccination uptake by some of the most vulnerable older veterans. Results from each of these studies will shed light on policies and practices needed to ensure the best physical and mental health outcomes for older military veterans.
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Du, Jiayi, Ling Fu, Jiaxin Cui, Zifen An, Pei Fang, Lanhui Tan, Xianmei Meng, and Liping Yu. "Effects of the Heart to Heart Card Game for Patients with Advanced Cancer Receiving Home-Based Palliative Care: A Clinical Randomized Controlled Trial." International Journal of Environmental Research and Public Health 19, no. 10 (May 17, 2022): 6115. http://dx.doi.org/10.3390/ijerph19106115.
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The Heart to Heart Card Game improves psychological health outcomes in hospitalized patients with advanced cancer, but effectiveness studies for patients at home are rare. This randomized controlled study was conducted to determine the effectiveness of the Heart to Heart Card Game on patients with advanced cancer receiving home-based palliative care. Sixty-six participants were randomly assigned to the intervention group (n = 34) and control group (n = 32). The quality of life, dignity, and psychological distress were considered as outcomes, which were assessed pre-intervention and six weeks after the intervention. There was a statistical difference in the quality of life (global health statues) between the intervention group and the control group after intervention (z = 2.017, p < 0.05). A significant difference was found in the quality of life (emotional, social function), dignity (symptom distress dimension), and psychological distress in the intervention group through intragroup comparison before and after the intervention. This randomized trial showed that the Heart to Heart Card Game likely alleviates barriers to end-of-life conversations and helps patients with advanced cancer maintain a more stable mental state. This trial has been registered at the Chinese Clinical Trial Registry (registration number: ChiCTR2100049933).
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Chou, Yueh-Ching, Li-yeh Fu, Teppo Kröger, and Chiu Ru-yan. "Job satisfaction and quality of life among home care workers: a comparison of home care workers who are and who are not informal carers." International Psychogeriatrics 23, no. 5 (December 16, 2010): 814–25. http://dx.doi.org/10.1017/s104161021000219x.
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ABSTRACTBackground: Job satisfaction and quality of life among home care workers who serve simultaneously as informal carers for their own family members have seldom been explored. This study examined how this dual role influences job satisfaction and quality of life by comparing these dual carers with home care workers who do not provide informal care. The study also explored whether the factors related to job satisfaction and quality of life between these two groups were different.Method: Standardized self-administered questionnaires (Job Satisfaction Survey, the World Health Organization Quality of Life (WHOQOL) scales and various social demographic questions) were administered to the two groups of home care workers in Taiwan from March to April 2009. A total of 1,641 home care workers working in 119 non-government organizations sponsored by 23 local authorities completed and returned the questionnaires.Results: The two groups did not differ in individual characteristics, work characteristics or job satisfaction. Analysis results indicate that the lowest mean scores for all home care workers were the domains of promotion and pay within their job satisfaction and the domain of environment within their quality of life.Conclusions: Multiple regression analysis revealed a significant effect of unpaid caregiving in terms of quality of life but not in terms of job satisfaction. Moreover, job satisfaction and quality of life among home care workers were significantly determined by both their work conditions (e.g. travelling time, salary and length of work experience) and personal variables (e.g. age, family income and family support).
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Brandauer, A., S. Berger, N. Freywald, I. Gnass, J. Osterbrink, D. Seidenspinner, and P. Kutschar. "Quality of life in nursing home residents with pain: pain interference, depression and multiple pain-related diseases as important determinants." Quality of Life Research 29, no. 1 (September 21, 2019): 91–97. http://dx.doi.org/10.1007/s11136-019-02290-x.
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Abstract Aim Quality of life is an essential outcome parameter in geriatric research and presents an important indicator for the evaluation of care treatments. The present study analyses potential impact factors on health-related quality of life (HRQOL) of nursing home residents (NHR) who are in pain. Methods Data came from the cRCT ‘PIASMA’. Statistical analyses of 146 respondents were carried out by multiple linear regressions based on the EQ-5D index (Euroquol Quality of Life) as dependent variable. Potential impact factors were applied and categorised in five blocks: pain intensity and interference (according to the Brief Pain Inventory), intervention effect, sex and age, pain-related diagnoses, and scales regarding depressive symptoms and cognitive impairment (based on the Geriatric Depression Scale and the Mini-Mental State Examination). Results On average, residents showed a pain intensity of 18.49, a pain interference of 29.61, a MMSE score of 22.84, a GDS score of 5.65 and an EQ-5D index of 0.52. Residents with more diagnoses, more depressive symptoms, and a higher pain interference showed a significantly reduced HRQOL. Conclusion Findings underline the importance of identifying and applying treatment options for both pain (especially interference) and depressive disorders to maintain HRQOL of NHR.
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Harbottle, Lynn. "The effect of nutrition on older people's mental health." British Journal of Community Nursing 24, Sup7 (July 2019): S12—S16. http://dx.doi.org/10.12968/bjcn.2019.24.sup7.s12.
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In the context of a rapidly ageing population, with an increasing prevalence of mood disorders and a greater incidence of physical illness in older adults, it is imperative that their healthcare needs are effectively addressed. Nutritional vulnerability increases in later life for various reasons, related to the physiological impact of ageing as well as social and economic challenges. Specific nutrients and overall diet quality may impact on mood. Depression and anxiety in turn impact on interest in and ability to eat and may further distort intake and exacerbate symptoms. Whether working with older adults living at home or in the care setting, nurses need to be aware of and able to identify, refer and support those who need help. This article aims to raise awareness and provides some practical guidance for nurses working with older adults experiencing mood disorders.
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Bucy, Taylor, Kelly Moeller, John Bowblis, and Tetyana Shippee. "Meaningful Assessment or Minimum Compliance: PASRR for Nursing Home Residents with Mental Illness." Innovation in Aging 5, Supplement_1 (December 1, 2021): 841–42. http://dx.doi.org/10.1093/geroni/igab046.3080.
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Abstract The Omnibus Budget Reconciliation Act (OBRA) of 1987 included provisions for the Preadmission Screening and Resident Review (PASRR) program, which requires states to create and maintain systems to assess persons with serious mental illness (SMI) seeking NH care. The prevalence of SMI in NHs is increasing, and little is known about the effectiveness of the PASRR program intervention. We conducted 20 interviews with state and national PASRR stakeholders, including assessors, hospital discharge planners, mental health advocates, geriatricians and geriatric psychiatrists. Interview data were triangulated with state provided materials on PASRR collection and implementation. Based on these interviews, we identified four themes: 1) variation in the implementation of federal PASRR legislation across states and jurisdictions, 2) the need for investment in professional development and workforce capacity, 3) lack of usefulness of PASRR in ongoing care planning, and 4) the need to consider the role of age, race/ethnicity, and stigma on quality of care for NH residents with SMI. Stakeholders agree that PASRR legislation was well intentioned, but also expressed concern regarding the completion of PASRR as an issue of compliance versus meaningful assessment. More work is needed to determine how best to develop and support the care needs of people with SMI, while being mindful of the original goals of deinstitutionalization that prompted OBRA passage. In order to assess the impact of the PASRR program on quality of care and mental health outcomes, further research should take an evaluative approach through meaningful use of PASRR data.
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Kusmaul, Nancy, and Mercedes Bern-Klug. "INTEREST GROUP SESSION—RESEARCH IN QUALITY OF CARE: LIVING IN AND LEAVING NURSING HOMES: THE FACTORS THAT CONTRIBUTE TO QUALITY OF LIFE, HEALTH, AND SAFETY OUTCOMES." Innovation in Aging 3, Supplement_1 (November 2019): S359. http://dx.doi.org/10.1093/geroni/igz038.1307.
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Abstract Nursing homes house some of the most vulnerable older adults. They often have complex medical conditions and/or cognitive impairments that put them at risk for negative outcomes and poor quality of life. These outcomes can be altered through incorporating evidence-based practices aimed to improve care and residents’ life experiences. In this symposium we will explore factors that are shown to influence outcomes and quality of life for people that live in and are discharged from, long term care settings. Amy Roberts and colleagues will explore the influences of nursing home social service staff qualifications on residents’ discharge outcomes. Colleen Galambos and colleagues will present findings on advance directives and their impact on reducing potentially avoidable hospitalizations. Kelsey Simons and colleagues will discuss the potential for unmet needs for mental health services as part of nursing home care transitions, and will discuss a model of quality improvement that addresses this gap in care. Vivian Miller will present findings on the impact transportation access has on the ability of community-dwelling family members to visit and provide social support to their family member residents in long-term care. Finally, Nancy Kusmaul and Gretchen Tucker report the findings of their study comparing perceptions of nursing home residents, direct care staff, management, and families on the care practices that influence resident health and quality of life while they live in a long term care setting.
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Gaebel, W. "Value-based mental healthcare: The quality aspect." European Psychiatry 33, S1 (March 2016): S55. http://dx.doi.org/10.1016/j.eurpsy.2016.01.932.
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IntroductionThe goal of value-based healthcare is to improve the quality of care while also lowering healthcare costs. Values may also include societal or research benefits.ObjectivesTo outline the emergence and quality-related concepts of value-based healthcare.AimsTo give a comprehensive overview and critical discussion of quality aspects of value-based mental healthcare including aspects of personal, societal and scientific values.MethodsReview of quality aspects of value-based mental healthcare.ResultsThe quality aspect of value-based healthcare includes the implementation of patient-centered care and may include the assessment of societal values or values for research purposes. Current concepts focus on the reduction of disability-adjusted life years to measure the achievement of values, but may need to be broadened to include benefits to society as a whole or the progress of knowledge about mental disorders in research. Conceptually, addressing such broader value issues may lead to increased benefits and a better appraisal of the value of mental healthcare.ConclusionsThe trend towards value-based mental healthcare aims at creating an efficient care delivery model, that strongly focuses on achieving favorable patient outcomes and may in the future also include creating societal values. It includes the development and implementation of suitable mental health policies and comprehensive quality assessment, plus a broad conceptualization of the value-term and its assessment in value-based mental healthcare.Disclosure of interestThe author has not supplied his declaration of competing interest.
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Yang, Eunjin, and Sun Ju Chang. "STRUCTURAL EQUATION MODELING OF HEALTH-RELATED QUALITY OF LIFE AMONG PEOPLE WITH VISUAL IMPAIRMENT." Innovation in Aging 6, Supplement_1 (November 1, 2022): 667. http://dx.doi.org/10.1093/geroni/igac059.2458.
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Abstract Visual impairment can lead to limited accessibility and activities and a decreased quality of life. This study aimed to test a hypothetical model based on the International Classification of Functioning, Disability, and Health to predict the health-related quality of life (HRQOL) of people with visual impairment. Data from 202 people with visual impairment were collected from August 2020 to November 2020 via telephone or e-mail. The overall fitness indices of the model for physical HRQOL (Normed χ2=2.076, GFI=.878, TLI=.900, CFI=.928, RMSEA=.073) and the model for mental HRQOL (Normed χ2=2.232, GFI=.884, TLI=.904, CFI=.932, RMSEA=.078) complied with the recommended criteria of structural equation model fitness, indicating that the models were appropriate for predicting the HRQOL of people with visual impairment. The socioeconomic status, multimorbidity, perceived environmental barriers, and activity limitation/participation restriction directly affected the participants’ physical HRQOL. Moreover, depression, disability identity, and activity limitation/participation restriction directly affected participants’ mental HRQOL. Age, socioeconomic status, depression, social support, and perceived environmental barriers affected the participants’ physical and mental HRQOL by means of activity limitation/participation restriction. The findings of the study suggest that the strategies aimed at increasing the activity/participation of people with visual impairment will be helpful in improving their HRQOL. Based on the results of this study, nursing intervention programs and services for people with visual impairment should be developed and implemented to provide more comprehensive care for this group and expand nursing science.
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Nguyen, T. H. H., C. Seib, D. Anderson, and P. Yate. "Lifestyle Factors and Health Related Quality of Life in Vietnamese Women After Cancer." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 5s. http://dx.doi.org/10.1200/jgo.18.26200.
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Background: A range of lifestyle factors and health related quality of life (HRQoL) influence cancer survivors' health, wellbeing, and survival. Some women who have received treatment of breast and gynecologic cancer (BCG) report lifestyle practices and HRQoL at lower levels than the general community. However, the impacts of factors such as socio-demographic characteristics and health status on lifestyle factors and HRQoL, and the interactions between these variables in terms of their influence on HRQoL are not fully understood. Aim: This study aimed to provide a comprehensive understanding of the relationships between lifestyle factors and HRQoL and to identify the socio-demographic factors, health status, and behavioral determinants of these variables among Vietnamese women following treatment of BGC. Methods: A cross-sectional study design was used. Data were collected from 330 Vietnamese women who had received treatment of BCG using both online and paper-based methods. Descriptive statistics, bivariate and multivariate statistics were used to examine associations and structural equational modeling was used to identify the interactions between the study's variables. Results: Although the majority of the study participants had a normal range of BMI ( n=260, 81.2%) with the mean BMI was 22.02 ( SD=2.52), engagement in a range of healthy lifestyle behaviors was low at. More than 75% of the study participants had a deficit in physical health and mental health compared with the norms. Participants' cancer-specific HRQoL score was 80.61 ( SD= 15.81) which is lower than that of normal population (85.9). Sleep impairment had a significant indirect effect on mental health ( indirect effect= -.030, P < .05) and cancer-specific HRQoL ( indirect effect= -.017, P < .05). Exercise self-efficacy significantly and indirectly influenced mental health ( indirect effect= .022, P < .05). Conclusion: This study highlights that there are deficits in the HRQoL of Vietnamese women following BGC and they had lower than recommended levels of engagement in healthy lifestyle behaviors. Participants also had high levels of sleep impairment and low levels of self-efficacy to follow a healthy diet or exercise. The indirect effects identified in this study indicate that health care professionals should provide information and community support focused on improving HRQoL and improving sleep impairment and self-efficacy.
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Thorsen, Lene, Eva Skovlund, Sigmund B. Strømme, Kjersti Hornslien, Alv A. Dahl, and Sophie D. Fosså. "Effectiveness of Physical Activity on Cardiorespiratory Fitness and Health-Related Quality of Life in Young and Middle-Aged Cancer Patients Shortly After Chemotherapy." Journal of Clinical Oncology 23, no. 10 (April 1, 2005): 2378–88. http://dx.doi.org/10.1200/jco.2005.04.106.
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Purpose To evaluate the effectiveness of a supervised home-based flexible training program on cardiorespiratory fitness (CRF), mental distress, and health-related quality of life (HRQOL) parameters in young and middle-aged cancer patients shortly after curative chemotherapy. Patients and Methods One hundred eleven patients age 18 to 50 years who had received chemotherapy for lymphomas or breast, gynecologic, or testicular cancer completed the trial. These patients were randomly allocated to either an intervention group (n = 59), which underwent a 14-week training program, or a control group (n = 52) that received standard care. Primary outcome was change in CRF, as determined by Åstrand-Rhyming indirect bicycle ergometer test (maximum oxygen uptake [VO2max]), between baseline (T0) and follow-up (T1). Secondary outcomes were mental distress, as assessed by the Hospital Anxiety and Depression Scale, and HRQOL, as assessed by the European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire. Two-way analysis of covariance was used to analyze changes from T0 to T1. Results VO2max increased by 6.4 mL/kg–1/min–1 in patients in the intervention group and by 3.1 mL/kg–1/min–1 in patients in the control group (P < .01). The fatigue score decreased by 17.0 points in the control group compared with only 5.8 points in the intervention group (P < .01). There were no intergroup differences in mental distress or HRQOL. Conclusion A supervised, home-based, flexible training program has significant effect on CRF in young and middle-aged cancer patients shortly after curative chemotherapy, but it has no favorable effect on patients' experience of fatigue, mental distress, or HRQOL.
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Harenwall, Sari, Suzanne Heywood-Everett, Rebecca Henderson, Sherri Godsell, Sarah Jordan, Angela Moore, Ursula Philpot, Kirsty Shepherd, Joanne Smith, and Amy Rachel Bland. "Post-Covid-19 Syndrome: Improvements in Health-Related Quality of Life Following Psychology-Led Interdisciplinary Virtual Rehabilitation." Journal of Primary Care & Community Health 12 (January 2021): 215013192110676. http://dx.doi.org/10.1177/21501319211067674.
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Coronavirus disease 2019 (COVID-19) is increasingly recognized as having significant long-term impact on physical and mental health. The Primary Care Wellbeing Service (PCWBS) in Bradford District Care NHS Foundation Trust (BDCFT) is a psychology-led specialist interdisciplinary team of health professionals specializing in persistent physical symptoms (PPS) and Chronic Fatigue Syndrome (CFS)/Myalgic Encephalomyelitis (ME) with an emphasis on holistic integrated care. The PCWBS quickly recognized the risk of the long-term effects of COVID-19, particularly for social, health and care staff, and developed a 7-week virtual rehabilitation course which was piloted in October 2020. The “ Recovering from COVID” course takes a whole system, biopsychosocial approach to understanding COVID-19 and post-viral fatigue (PVF) and is delivered by an interdisciplinary team consisting of a clinical psychologist, physiotherapist, occupational therapist, dietitian, speech and language therapist, assistant psychologist, and a personal support navigator with support from a team administrator. The course focuses on understanding PVF, sleep optimization, nutrition, swallowing, activity management, energy conservation, stress management, breathing optimization, managing setbacks, and signposting to appropriate resources and services. Since the pilot, PCWBS has delivered 7 courses to support over 200 people suffering from post-COVID-19 syndrome. One hundred and forty-nine individuals that enrolled on the “ Recovering from COVID” course completed the EQ-5D-5L to assess Health-related quality of life (HRQoL) across 5 dimensions, including problems with mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Subsequently, 76 individuals completed these measures at the end of the rehabilitation course showing that patient ratings were significantly improved. In response to the NIHR recommendation for rapid evaluation of different service models for supporting people with post-COVID-19 syndrome, this data offers hope that rehabilitation is effective in reversing some of the problems faced by people living with the long-term effects of COVID-19.
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Jonsdottir, Thorbjörg, Helga Jonsdottir, Sigridur Gunnarsdottir, and Eirikur Lindal. "Health care utilization in chronic pain—A population based study." Scandinavian Journal of Pain 4, no. 4 (October 1, 2013): 255. http://dx.doi.org/10.1016/j.sjpain.2013.07.004.
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AbstractAimsTo investigate health care utilization in relation to chronic pain.MethodsIn this cross-sectional study postal questionnaires, measuring sociodemographic characteristics, pain, health related quality of life (HRQoL), attitudes to pain and health care utilization past six months, were sent to 4500 individuals aged 20–70 years, randomly drawn from the Icelandic National Registry.ResultsTotal response rate was 36.9% (n = 1589) and was higher among older individuals and women. Nearly one half of respondents (47.5%, n = 754) reported chronic pain (≥3 months) with mean duration of 9.3 years (median = 6.0 years, SD = 10.0) and 57.5% of them had consulted health care service for their pain past six months. Use of pain related health care was significantly related to attitudes towards pain and individuals with pain in chest, upper extremities, hips and lower extremities consulted health care for their pain significantly more often than people with other pain locations. Pain related health care utilization was not significantly related to sociodemographic characteristics. There was a significant difference in both Physical (PCS) and Mental (MCS) component HRQoL scales as well as nature of pain (severity, interference, spread and pattern), between individuals who had consulted health care for their pain and those who had not. However, when these relationships were tested by using logistic regression models, only PCS and pain interference remained significant in this relationship.ConclusionsChronic pain related health care utilization is related to several pain characteristics and its influence on daily life, where interference and physical components of HRQoL are most important.
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Samartzis, Lampros, and Michael A. Talias. "Assessing and Improving the Quality in Mental Health Services." International Journal of Environmental Research and Public Health 17, no. 1 (December 30, 2019): 249. http://dx.doi.org/10.3390/ijerph17010249.
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Background: The mental health of the population consists of the three essential pillars of quality of life, economy, and society. Mental health services take care of the prevention and treatment of mental disorders and through them maintain, improve, and restore the mental health of the population. The purpose of this study is to describe the methodology for qualitative and quantitative evaluation and improvement of the mental health service system. Methods: This is a narrative review study that searches the literature to provide criteria, indicators, and methodology for evaluating and improving the quality of mental health services and the related qualitative and quantitative indicators. The bibliography was searched in popular databases PubMed, Google Scholar, CINAHL, using the keywords “mental”, “health”, “quality”, “indicators”, alone or in combinations thereof. Results: Important quality indicators of mental health services have been collected and presented, and modified where appropriate. The definition of each indicator is presented here, alongside its method of calculation and importance. Each indicator belongs to one of the eight dimensions of quality assessment: (1) Suitability of services, (2) Accessibility of patients to services, (3) Acceptance of services by patients, (4) Ability of healthcare professionals to provide services, (5) Efficiency of health professionals and providers, (6) Continuity of service over time (ensuring therapeutic continuity), (7) Efficiency of health professionals and services, (8) Safety (for patients and for health professionals). Discussion/Conclusions: Accessibility and acceptability of service indicators are important for the attractiveness of services related to their use by the population. Profitability indicators are important economic indicators that affect the viability and sustainability of services, factors that are now taken into account in any health policy. All of the indicators mentioned are related to public health, affecting the quality of life, morbidity, mortality, and life expectancy, directly or indirectly. The systematic measurement and monitoring of indicators and the measurement and quantification of quality through them, are the basis for evidence-based health policy for improvement of the quality of mental health services.
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McKinley, Sharon, Mary Fien, Rosalind Elliott, and Doug Elliott. "Health-Related Quality of Life and Associated Factors in Intensive Care Unit Survivors 6 Months After Discharge." American Journal of Critical Care 25, no. 1 (January 1, 2016): 52–58. http://dx.doi.org/10.4037/ajcc2016995.
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Background Intensive care unit survivors often have diminished health-related quality of life. Objectives To describe health-related quality of life of former intensive care patients and identify associated factors 6 months after hospital discharge. Methods Six months after discharge, 193 patients from an intensive care unit completed the Short Form-36 Health Survey; measures of sleep; Intensive Care Experience Questionnaire; Depression, Anxiety and Stress Scales; and Posttraumatic Stress Disorder Checklist. Norm-based scores were calculated for the Short Form-36. Bivariate associations with Short Form-36 scores were tested by using the Pearson correlation. Multiple linear regression was used to identify independent associations with health-related quality of life. Results All scores on the Short Form-36 (physical component summary, 41.8; mental component summary, 48.2) were less than population norms. Bivariate associations with health-related quality of life (P < .05) were scores on the Acute Physiology and Chronic Health Evaluation II, hospital length of stay, awareness of surroundings and frightening experiences, depression, anxiety, stress, posttraumatic symptoms, and sleep quality at 2 and 6 months. In linear regression, scores on the Acute Physiology and Chronic Health Evaluation II, hospital length of stay, and sleep quality at 6 months were independently associated with Short Form-36 physical summary scores (P < .001); depression and stress were independently associated with mental summary scores (P < .001). Conclusion Sleep, depression, and stress are potential targets for interventions to improve health-related quality of life and improve recovery.
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Mainous, Arch G., Robert U. Wright, Mary M. Hulihan, Waleed O. Twal, Christine E. McLaren, Gordon D. McLaren, Vanessa A. Diaz, W. Scott Argraves, and Althea M. Grant. "Elevated Transferrin Saturation, Health-Related Quality Of Life and Telomere Length." Blood 122, no. 21 (November 15, 2013): 425. http://dx.doi.org/10.1182/blood.v122.21.425.425.
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Abstract Context Increased risk of heart disease, diabetes, dementia, cancer, and death has been found among individuals with elevated transferrin saturation (TS). Although TS has been linked to specific diseases, little research has focused on the relationship between elevated TS and current health status. Purpose This study examined the relationship between elevated TS and measures of health status (telomere length and patient-reported health-related quality of life) to assess whether elevated TS is associated with negative patient outcomes beyond increased risk for morbidity and mortality. Methods We conducted an analysis of the Hemochromatosis and Iron Overload Screening (HEIRS) Study supplemented with assays for leukocyte telomere length in adults (>25 years old). The HEIRS Study identified individuals through a multiethnic, multicenter sample of 101,168 US and Canadian adults. Screening was done with serum biochemical tests of iron status and hemochromatosis (HFE) gene mutation testing. Our sample was comprised of HEIRS subjects with responses on health-related quality of life (general health (GH) and mental health (MH) subscales of the SF-36 Health Survey), and known leukocyte telomere length (n=669). Leukocyte telomere length was assessed through a quantitative PCR-based technique (qPCR). Unadjusted mean values of the general health status subscale, the mental health status subscale and telomere length were compared between groups with elevated TS (>45% for women and >50% for men) versus non-elevated TS (<45% for women and <50% for men) using t-tests. Comparisons also were made between mean values for the general and mental health status subscales and telomere length for the group with TS >60% versus with non-elevated TS (<45% for women and <50% for men). For each of the quantitative outcomes of GH, MH, and telomere length, separate general linear regression models were formed with TS elevation as a dichotomous predictor, controlled for demographic characteristics as well as health conditions associated with iron overload. Results Among individuals with elevated TS (>45% for women and >50% for men), who also had a usual source of care, only 5.2% reported ever being told by a doctor that they had an elevated iron condition. Mean values for GH and MH, and telomere length were significantly lower in those with elevated TS (Table 1; p<0.01, p<0.001, and p<0.001, respectively), indicating worse general and mental health and shorter telomere length. In a fully adjusted model, elevated TS versus non-elevated TS was associated with worse general health status, mental health status and shorter telomere length. GH and MH status scores were progressively lower in individuals with increasing levels of TS (e.g., TS >60%) versus non-elevated TS. Conclusions Increased surveillance of elevated TS may be in order as elevated TS is associated with decreased health status and very few patients with elevated TS are aware of their condition. Disclosures: No relevant conflicts of interest to declare.
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Martens, Nicolaas, Marianne Destoop, and Geert Dom. "Physical Healthcare, Health-Related Quality of Life and Global Functioning of Persons with a Severe Mental Illness in Belgian Long-Term Mental Health Assertive Outreach Teams: A Cross-Sectional Self-Reported Survey." International Journal of Environmental Research and Public Health 19, no. 9 (May 2, 2022): 5522. http://dx.doi.org/10.3390/ijerph19095522.
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Research shows that care delivery regarding somatic health problems for patients with a severe mental illness (SMI) in community and mental health is difficult to establish. During the last decade, long term mental health outreach teams in Belgium were implemented to provide treatment and follow-up at home. This study aimed to map physical health status, care professionals, health related quality of life and global functioning in persons with SMI in Belgian long term outreach teams for mental health. Using a self-administered questionnaire, 173 persons, 58.1% female with a mean age of 48.3, were questioned. Our findings suggest an undertreatment of somatic comorbid conditions, with only half of physical health complaints being addressed. Although treatment rates for hypertension, when detected were high, treatment of respiratory complaints, pain and fatigue was lacking. Although the majority of respondents responded to have a GP or psychiatrist, contact rates were rather limited. Other disciplines, such as primary care nurses, when present, tend to have more contact with people with SMI. Notably, having regular contacts with GPs seems to improve physical health complaints and/or treatment. Being treated by an outreach team did not show significant correlations with physical health complaints and/or treatment suggesting a more proactive approach by outreach teams or primary care providers is desirable.
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Patra, Ramesh Chandra, Biswajit Kanungo, and Parul Bawa. "Mental health, sleep quality and quality of life in individuals with and without multiple health conditions during home quarantine in India due to the COVID-19 pandemic: a cross-sectional study." F1000Research 9 (June 30, 2022): 718. http://dx.doi.org/10.12688/f1000research.24321.2.
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Background: Since the World Health Organization (WHO) declared the COVID-19 outbreak a global pandemic and the global spread had created several challenges for the general public and the healthcare workers across the world, the primary aim of this study was to assess the psychological stress, sleep quality, and health-related quality of life (QoL) of individuals with multiple health issues during home quarantine caused by the COVID-19 pandemic. Methods: The study was conducted between 28th March to 30th April 2020. We recruited 50 individuals who have a history of chronic health issues, and 50 individuals with no health issues for this cross-sectional study. Three questionnaires were used to evaluate the mental health [depression anxiety stress scale (DASS-21)], sleep quality [Pittsburgh sleep quality index (PSQI)], and QoL [short form of health-related questionnaire (SF-36)] of the participants. Statistical analysis was carried out with Student’s t-test, using SPSS software v16. Results: Baseline demographic characteristics were homogenous for both groups of participants. Intergroup analysis revealed statistically significant differences in mental health (p<0.001), sleep quality (p<0.001), and QoL (p<0.001) between the two groups. The results showed high levels of depression, anxiety and stress; poor sleep quality and low health-related QoL in Group A as compared to Group B. Conclusion: Our findings indicate that individuals with chronic health issues exhibit higher mental health problems, lower quality of sleep and have a lower health-related QoL. More research is required and also government should plan on taking care of those patients.
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Hall, Allyson G., Jessica R. Schumacher, Babette Brumback, Jeffrey S. Harman, Barbara J. Lutz, Phyllis Hendry, and Donna Carden. "Health-related quality of life among older patients following an emergency department visit and emergency department-to-home coaching intervention: A randomized controlled trial." International Journal of Care Coordination 20, no. 4 (September 24, 2017): 162–70. http://dx.doi.org/10.1177/2053434517733263.
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Introduction Many older patients experience repeated emergency department visits and hospitalizations and inadequate links to primary care. This fragmented care can result in anxiety, uncertainty, and poor health outcomes. This study compares the impact of an emergency department-to-home coaching intervention to usual, post-emergency department care on patient-reported health-related quality of life measures: information support, anxiety, and physical function. Methods This was a randomized controlled trial. Seven hundred and forty-nine chronically ill older adults presenting to emergency departments were randomized into Intervention (emergency department-to-home coaching) or Usual Care groups. Participants completed baseline, in-person and follow-up, telephone surveys. Within- and between-group differences in health-related quality of life were assessed using unweighted linear regression and propensity-weighted difference-in-difference analyses. Three Patient Reported Outcomes Measurement System measures were assessed: social health (informational support), mental health (anxiety/emotional distress), and physical health (physical functioning). Results Usual Care participants experienced statistically significant declines in informational support in unweighted (−3.13) and weighted (−2.84) analyses not observed in the Intervention group (−0.91 and −1.45, respectively). Self-reported anxiety was lowest and physical function highest at the time of emergency department visit. Patient-reported anxiety increased and physical function declined statistically significantly in Intervention participants. Conclusion Among older emergency department patients, health-related quality of life was highest at the emergency department visit and declined following the encounter. The emergency department visit per se appears to provide needed information, and in the short term, reassurance about patients’ medical conditions. The coaching intervention blunts the fall in informational support observed after usual, post-emergency department care but may heighten patients’ anxiety and awareness of chronic health conditions.
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Tinker, Anthea, Elodie Haines, Laura Molloy, Imogen Monks, Evelina Russell, and Laura Pennells. "Is exercise helpful for women aged 50 and over with mental health problems and what are the barriers to exercise?" Quality in Ageing and Older Adults 18, no. 2 (June 12, 2017): 93–103. http://dx.doi.org/10.1108/qaoa-08-2016-0031.
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Purpose The purpose of this paper is to examine the influence of exercise on the mental health problems of older women. Design/methodology/approach The paper is based on information from academic literature, government publications and publications from other relevant bodies. It is a scoping study and is not a systematic review because of the constraints of the resources. Findings There is growing evidence about the value of exercise for the mental health of older women but few evaluated examples of how this can be achieved. Research limitations/implications There is a gap in the literature about this topic with few evaluated examples of how more older women can be encouraged to take more exercise. Practical implications Policy makers, practitioners and older people themselves would gain from a greater emphasis on exercise as a means of improving quality of life and for reducing healthcare budgets through fewer referrals to services. Social implications Greater emphasis on exercise for older women would increase their quality of life through a reduction in mental health problems. Originality/value There is limited research which links mental health, exercise and older women, especially regarding the barriers to exercise that older women with diagnosed mental health problems may face.
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Guo, Jeff J., Terrance J. Wade, and Kathryn N. Keller. "Impact of School-Based Health Centers on Students with Mental Health Problems." Public Health Reports 123, no. 6 (November 2008): 768–80. http://dx.doi.org/10.1177/003335490812300613.
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Objectives. School-based health centers (SBHCs) play an increasingly major role in providing mental health services for students. This study evaluated the impact of SBHCs on mental health-care services and psychosocial health-related quality of life (HRQOL). Methods. Four SBHC intervention and two matched non-SBHC school districts were examined from 1997 to 2003. The SBHC intervention began in 2000. Data included child and parent pediatric HRQOL and Ohio Medicaid claims. A longitudinal quasi-experimental time-series repeated measures design was used for this study, involving analysis of covariance to assess health costs and regression analyses for HRQOL scores. Results. After the SBHC program, proportions of students accessing mental health-care services for urban and rural SBHC intervention schools increased 5.6% (χ2=39.361, p<0.0001) and 5.9% (χ2=5.545, p<0.0001), respectively, compared with increases of 2.6% (χ2=2.670, p=0.1023) and 0.2% (χ2=0.006, p=0.9361) for urban and rural non-SBHC schools, respectively. Using data from 109 students with mental health problems based on Medicaid claims, the study found SBHC students had significantly lower total health-care costs (F=5.524, p=0.005) and lower costs of mental health services (F=4.820, p=0.010) compared with non-SBHC students. While improvements over time in HRQOL for SBHC students compared with non-SBHC students and students from non-SBHC schools were observed, only some were statistically significant. Conclusions. SBHC programs increase the proportion of students who receive mental health services and may improve pediatric HRQOL. SBHC students with mental health problems had lower total Medicaid reimbursements compared with non-SBHC students.
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Chorão, L., S. Martins, A. R. Ferreira, J. Fernandes, T. Vieira, L. Fontes, N. Reis, et al. "Delirium and health-related quality of life in severe COVID-19 survivors." European Psychiatry 65, S1 (June 2022): S311. http://dx.doi.org/10.1192/j.eurpsy.2022.794.
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Introduction Severe COVID-19 survivors experience long-term neuropsychiatric morbidity, particularly those who developed delirium, with a negative impact on health-related quality of life (HRQoL). Objectives To identify the cases of delirium in severe COVID-19 patients and to describe its association with post-hospital discharge HRQoL. Methods In the context of the longitudinal MAPA project, we included adult patients (≥ 18 years old) admitted with COVID-19 to the Intensive Care Medicine Department (ICMD) of a Portuguese University Hospital (October 2020-April 2021). Exclusion criteria were: ICMD length of stay ≤24h, terminal illness, major auditory loss, or inability to communicate at the time of assessment. Delirium during ICMD stay was ascertained based on patients’ clinical records. HRQoL was evaluated using the 5-Level EQ-5D questionnaire (EQ-5D-5L), at a scheduled telephone follow-up appointment on average 1-2 months after hospital discharge. Results Overall, 124 patients were included with a median age of 62 (range: 24-86) years, being mostly male (65%). About 19% had delirium, 42% were deeply sedated and 43% required invasive mechanical ventilation. Most survivors reported problems on the EQ-5D-5L domains: usual activities (85%), mobility (73%) and anxiety/depression (65%). Patients with delirium reported more pain/discomfort (75%vs46%; p=0.011) and considerably anxiety/depression (83%vs60%; p=0.032). Conclusions These findings pointed that COVID-19 patients who experienced delirium reported worse HRQoL, regarding pain/discomfort and anxiety/depression. This study highlights the importance of not only prevention but also early screening of delirium during hospital stay, as well as the crucial role of the timely interventions at discharge, in order to minimize delirium long-term impacts. Disclosure No significant relationships.
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Stephenson, Coryn, Chen Dai, Christian Harmon, Mackenzie Elisha Fowler, Smith Giri, Darryl Alan Outlaw, Robert Hollis, Smita Bhatia, and Grant Richard Williams. "The association of limited health literacy with frailty, health-related quality of life (HRQoL), and health care utilization among older adults with cancer: The CARE Registry." Journal of Clinical Oncology 40, no. 28_suppl (October 1, 2022): 157. http://dx.doi.org/10.1200/jco.2022.40.28_suppl.157.
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157 Background: Health literacy (HL) is a patient’s ability to obtain, process, and understand health information. Limited HL can act as a barrier to communication and access to medical treatment and lead to poor identification and management of comorbid conditions, resulting in frailty and impaired HRQoL; these issues remain unstudied in the geriatric oncology populations. We aimed to (1) describe the prevalence of limited HL; (2) examine the association between limited HL and frailty, HRQoL and healthcare utilization in older adults with cancer. Methods: The CARE registry prospectively enrolls older adults (≥60y) with cancer seen at UAB. Patients complete a patient-reported geriatric assessment. A single-item screening measure of HL (Stagliano et al. JABFM 2013) was also completed by the participants. Frailty was defined using the 44-item CARE frailty index (based on deficit accumulation). Multivariable analysis examined association of limited HL with CARE frailty index, HRQoL, and health care utilization, adjusting for age, race, sex, education, cancer type/stage and treatment phase. Results: The cohort included 475 participants with a mean age at enrollment of 69.4y; 61.9% were male; 18.9% were non-Hispanic Black. The most prevalent cancer types included colorectal (34.9%), pancreatic (17.5%) and hepatobiliary (11.4%) cancers. The prevalence of limited HL was 33.3%. Participants with limited HL were less educated (< HS: 23.4% vs. 4.7%, p= 0.01), older (71 vs. 68.5 years, p< 0.001), more likely to self-report as Black (26.6% vs. 15.1%, p= 0.009), and disabled (19.6% vs. 11.7%, p< 0.001). Patients with limited HL had a higher prevalence of frailty (57.6% vs 22.1%, p< 0.001) and hospitalizations (57.0% vs 45.4%, p= 0.036), as well as lower physical (39.5 vs. 46.4 p< 0.001) and mental (42.9 vs. 49.2 p< 0.001) HRQoL. In multivariable analysis, older patients with limited HL had 3.9 higher adjusted odds (aOR) of frailty (95% CI 2.4-6.3), worse physical (aOR 2.2, 95%CI 1.4-3.6) and mental (aOR 3.2 95%CI 2.0-5.2) HRQoL, and increased hospitalizations (aOR 1.8 95% CI 1.2-2.8), compared to those with adequate health literacy. Conclusions: Older cancer patients with limited HL had higher adjusted odds of frailty, lower physical and mental HRQoL scores, and higher odds of a recent hospitalization. Interventions to address limited HL should be explored in this vulnerable and growing cancer population.
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Black, Betty S., Deirdre Johnston, Jeannie Leoutsakos, Melissa Reuland, Jill Kelly, Halima Amjad, Karen Davis, et al. "Unmet needs in community-living persons with dementia are common, often non-medical and related to patient and caregiver characteristics." International Psychogeriatrics 31, no. 11 (February 4, 2019): 1643–54. http://dx.doi.org/10.1017/s1041610218002296.
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ABSTRACTObjective:Understanding which characteristics of persons with dementia (PWD) and their caregivers are associated with unmet needs can inform strategies to address those needs. Our purpose was to determine the percentage of PWD having unmet needs and significant correlates of unmet needs in PWD.Design:Cross-sectional data were analyzed using bivariate and hierarchical multiple linear regression analyses.Setting:Participants lived in the greater Baltimore, Maryland and Washington DC suburban area.Participants:A sample of 646 community-living PWD and their informal caregivers participated in an in-home assessment of dementia-related needs.Measurements:Unmet needs were identified using the Johns Hopkins Dementia Care Needs Assessment. Correlates of unmet needs were determined using demographic, socioeconomic, clinical, functional and quality of life characteristics of the PWD and their caregivers.Results:PWD had a mean of 10.6 (±4.8) unmet needs out of 43 items (24.8%). Unmet needs were most common in Home/Personal Safety (97.4%), General Health Care (83.1%), and Daily Activities (73.2%) domains. Higher unmet needs were significantly related to non-white race, lower education, higher cognitive function, more neuropsychiatric symptoms, lower quality of life in PWD, and having caregivers with lower education or who spent fewer hours/week with the PWD.Conclusions:Unmet needs are common in community-living PWD, and most are non-medical. Home-based dementia care can identify and address PWD’s unmet needs by focusing on care recipients and caregivers to enable PWD to remain safely at home.
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Hussein, Shereen, Ann-Marie Towers, Sinead Palmer, Nadia Brookes, Barbora Silarova, and Petra Mäkelä. "Developing a Scale of Care Work-Related Quality of Life (CWRQoL) for Long-Term Care Workers in England." International Journal of Environmental Research and Public Health 19, no. 2 (January 15, 2022): 945. http://dx.doi.org/10.3390/ijerph19020945.
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Background: Long-term care (LTC) workers are subjected to structural and inherent difficult conditions that are likely to impact their quality of life at work; however, no agreed scale measures it. This study aims to develop a scale to measure the work-related quality of life among LTC workers in England (CWRQoL). The study establishes the domains/sub-domains of CWRQoL, investigates the tool’s utility and collates information on existing supporting strategies for CWRQoL. Methods: We adopt a mixed-methods approach employing inductive/deductive processes at three stages: (1) a scoping review of the literature; (2) interviews and focus groups with frontline LTC workers, managers and LTC stakeholders; and (3) a content validity consensus survey. Results: CWRQoL is composed of seven domains (and 23 sub-domains). Additional domains to those in the literature include financial wellbeing, sufficient time for building relations, managing grief and emotions associated with client death and end of life care. Stakeholders identified several benefits and challenges related to the CWRQoL tool’s utility. COVID-19 significantly impacted LTC workers’ mental wellbeing and spillover between work and home. Conclusions: The study highlighted the complex nature of CWRQoL and provided a solid ground for developing and validating a CWRQoL scale.
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Perrin, Paul B., Ivan Panyavin, Alejandra Morlett Paredes, Adriana Aguayo, Miguel Angel Macias, Brenda Rabago, Sandra J. Fulton Picot, and Juan Carlos Arango-Lasprilla. "A Disproportionate Burden of Care: Gender Differences in Mental Health, Health-Related Quality of Life, and Social Support in Mexican Multiple Sclerosis Caregivers." Behavioural Neurology 2015 (2015): 1–9. http://dx.doi.org/10.1155/2015/283958.
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Background. Multiple sclerosis (MS) rates in Latin America are increasing, and caregivers there experience reduced mental and physical health. Based on rigid gender roles in Latin America, women more often assume caregiving duties, yet the differential impact on women of these duties is unknown.Methods. This study examined gender differences in mental health (Patient Health Questionnaire-9, Satisfaction with Life Scale, Rosenberg Self-Esteem Scale, State-Trait Anxiety Inventory, and Zarit Burden Inventory), health-related quality of life (HRQOL; Short Form-36), and social support (Interpersonal Support Evaluation List-12) in 81 (66.7% women) Mexican MS caregivers.Results. As compared to men caregivers, women had lower mental health (p=0.006), HRQOL (p<0.001), and social support (p<0.001). This was partially explained by women caregivers providing care for nearly twice as many hours/week as men (79.28 versus 48.48,p=0.018) and for nearly three times as many months (66.31 versus 24.30,p=0.002).Conclusions. Because gender roles in Latin America influence women to assume more substantial caregiving duties, MS caregiver interventions in Latin America—particularly for women caregivers—should address the influence of gender-role conformity on care and psychosocial functioning.
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Argimon, Josep M., Esther Limon, Joan Vila, and Carmen Cabezas. "Health-Related Quality-of-Life of Care-Givers as a Predictor of Nursing-Home Placement of Patients With Dementia." Alzheimer Disease & Associated Disorders 19, no. 1 (January 2005): 41–44. http://dx.doi.org/10.1097/01.wad.0000160343.96562.8e.
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Moore, Kirsten. "Quality of care for frail older adults." International Psychogeriatrics 30, no. 9 (September 2018): 1255–57. http://dx.doi.org/10.1017/s1041610218001321.
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Our successes in improving life expectancy has led to increased years of life lived with multimorbidity and dementia with increased support needs. Much of the support given to frail older people is provided by family and informal support networks with significant impact on their physical, psychological, and financial well-being. Demographic and societal changes are reducing the capacity of family to offer this care. Formal home-based, center-based, and long-term/residential/nursing home care services are predominately provided by untrained care staff working under supervision from nursing staff. Difficulties recruiting and retaining these staff is leading to major challenges to meeting the needs of older people (Chenoweth et al., 2010). This volume contains a number of studies focusing on ways to improve care provided by these services for frail older people. The approach underpinning these papers and many perspectives of good quality care for older people is the need to be person-centered where the older person identifies their own goals for care and assessment of need, employing a holistic and strength-based approach incorporating their interests, values, and capacities (Vernooij-Dassen and Moniz-Cook, 2016).
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Orgeta, Vasiliki, Phuong Leung, Lauren Yates, Sujin Kang, Zoe Hoare, Catherine Henderson, Chris Whitaker, et al. "Individual cognitive stimulation therapy for dementia: a clinical effectiveness and cost-effectiveness pragmatic, multicentre, randomised controlled trial." Health Technology Assessment 19, no. 64 (August 2015): 1–108. http://dx.doi.org/10.3310/hta19640.
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BackgroundGroup cognitive stimulation therapy programmes can benefit cognition and quality of life for people with dementia. Evidence for home-based, carer-led cognitive stimulation interventions is limited.ObjectivesTo evaluate the clinical effectiveness and cost-effectiveness of carer-delivered individual cognitive stimulation therapy (iCST) for people with dementia and their family carers, compared with treatment as usual (TAU).DesignA multicentre, single-blind, randomised controlled trial assessing clinical effectiveness and cost-effectiveness. Assessments were at baseline, 13 weeks and 26 weeks (primary end point).SettingParticipants were recruited through Memory Clinics and Community Mental Health Teams for older people.ParticipantsA total of 356 caregiving dyads were recruited and 273 completed the trial.InterventioniCST consisted of structured cognitive stimulation sessions for people with dementia, completed up to three times weekly over 25 weeks. Family carers were supported to deliver the sessions at home.Main outcome measuresPrimary outcomes for the person with dementia were cognition and quality of life. Secondary outcomes included behavioural and psychological symptoms, activities of daily living, depressive symptoms and relationship quality. The primary outcome for the family carers was mental/physical health (Short Form questionnaire-12 items). Health-related quality of life (European Quality of Life-5 Dimensions), mood symptoms, resilience and relationship quality comprised the secondary outcomes. Costs were estimated from health and social care and societal perspectives.ResultsThere were no differences in any of the primary outcomes for people with dementia between intervention and TAU [cognition: mean difference –0.55, 95% confidence interval (CI) –2.00 to 0.90;p-value = 0.45; self-reported quality of life: mean difference –0.02, 95% CI –1.22 to 0.82;p-value = 0.97 at the 6-month follow-up]. iCST did not improve mental/physical health for carers. People with dementia in the iCST group experienced better relationship quality with their carer, but there was no evidence that iCST improved their activities of daily living, depression or behavioural and psychological symptoms. iCST seemed to improve health-related quality of life for carers but did not benefit carers’ resilience or their relationship quality with their relative. Carers conducting more sessions had fewer depressive symptoms. Qualitative data suggested that people with dementia and their carers experienced better communication owing to iCST. Adjusted mean costs were not significantly different between the groups. From the societal perspective, both health gains and cost savings were observed.ConclusionsiCST did not improve cognition or quality of life for people with dementia, or carers’ physical and mental health. Costs of the intervention were offset by some reductions in social care and other services. Although there was some evidence of improvement in terms of the caregiving relationship and carers’ health-related quality of life, iCST does not appear to deliver clinical benefits for cognition and quality of life for people with dementia. Most people received fewer than the recommended number of iCST sessions. Further research is needed to ascertain the clinical effectiveness of carer-led cognitive stimulation interventions for people with dementia.Trial registrationCurrent Controlled Trials ISRCTN65945963.FundingThis project was funded by the National Institute of Health Research (NIHR) Health Technology Assessment (HTA) programme and will be published in full inHealth Technology Assessment; Vol. 19, No. 64. See the NIHR Journals Library website for further information.
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Gomutbutra, Patama, and Megan Brandeland. "Advance Care Plan and Factors Related to Disease Progression in Patients With Spinocerebellar Ataxia Type 1: A Cross-Sectional Study in Thailand." American Journal of Hospice and Palliative Medicine® 37, no. 1 (May 14, 2019): 46–51. http://dx.doi.org/10.1177/1049909119850797.
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Background: Spinocerebellar ataxia type 1 (SCA1) is an autosomal dominant progressive neurodegenerative disease. Few studies have been conducted regarding advance care planning in this population. Objective: This study explores advance care planning preferences of patients with SCA1 and their association with disease progression and quality of life. Methods: The study examined 12 Thai patients with SCA1 from 2 families living in Thailand. The advance care plan followed a Gold Standards Framework. The 12 patients were interviewed and recorded in video. The research team evaluated neurocognitive functions as measured by the following tests; Scale for the Assessment and Rating of Ataxia (SARA), Berg Balance Score, Mini-Mental Status Examination, and Digit Span and Category Fluency. The quality of life was measured by a Short-Form Health Survey-36 (SF-36). Results: Seven of 12 patients with SCA1 rated communication ability as most important for their quality of life. Patients identified becoming a burden on their family members and ventilator dependence as the most undesirable situations. Half of the patients preferred a hospital as their last place of care. Comparing patients prefer hospital to home has significantly high median SARA (23 vs 11.5; P = .03) and low SF-36 (41.4 vs 72.4; P = .02). Conclusions: Those patients preferring a hospital for end-of-life care exhibited more physical disability and lower quality of life than those who preferred home care. Making assisted living health-care services in the home more readily available and affordable may alleviate concerns of patients facing more severe physical challenges.
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Arnaert, Antonia, and Megan Wainwright. "Providing care and sharing expertise: Reflections of nurse-specialists in palliative home care." Palliative and Supportive Care 7, no. 3 (September 2009): 357–64. http://dx.doi.org/10.1017/s1478951509990290.
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AbstractObjective:This study explored the experiences, perspectives, and reflections of five nurse-specialists in palliative home care, whose dual role includes caring for patients in their daily practice as well as sharing their knowledge, skills, expertise, and experiences with other home care nurses in the community.Methods:A qualitative research design, incorporating face-to-face semistructured interviews, was used. Interviews were based on open-ended questions such as: “What is your experience in providing palliative home care to patients and their families? How do you feel about sharing your expertise and experiences with home care nurses?” Data were content analyzed using the constant comparative method.Results:Three major themes and a number of subthemes emerged: (1) acknowledging one's own limitations and humanness: (a) calling for backup, (b) learning as we go along, (c) coping with emotional demands, and (d) interacting with family members; (2) building a collaborative partnership: (a) working collaboratively, (b) sharing information, (c) guiding home care nurses, and (d) being nonjudgmental; and (3) teamwork and implementing palliative home care teams.Significance of results:Nurse-specialists play a key role in palliative home care as both carers and as resources of expert knowledge for other home care nurses caring for palliative patients. As the population ages, the health care system will be faced with increasing requests for high-quality palliative home care. The results of this study demonstrate that, from the perspective of the nurse-specialists of NOVA-Montréal (a nonprofit social and health service organization), nurse-specialists can work collaboratively with home care nurses to improve patients' quality of care and their quality of life. Moreover, patients and their families would benefit from the more widespread establishment of palliative care teams within community health organizations.
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Neill, Ruth D., Junko Wake, Mie Ohwa, Jill Manthorpe, Patricia Gillen, and Paula McFadden. "Comparing the Mental Wellbeing and Quality of Working Life among Nurses and Social Care Workers in the UK and Japan in Older Adults’ Care Services during the COVID-19 Pandemic." Psych 4, no. 4 (November 1, 2022): 843–55. http://dx.doi.org/10.3390/psych4040062.
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This study explored and compared the psychological wellbeing, burnout, coping strategies and work-related quality of life amongst health and social care workers in older adults’ care homes and community settings during the COVID-19 pandemic in the United Kingdom (UK) and Japan. A cross-sectional online survey was conducted in the UK (May–July 2021) and a postal survey conducted in Japan (September–October 2021). Participants recruited were health and social care professionals within nursing, social care and social work occupations working in care home or community settings in the UK and Japan during the pandemic. Data were analysed using SPSS. 1327 respondents across the UK and Japan completed the survey. Respondents’ psychological wellbeing was significantly lower in Japan compared to the UK (p ≤ 0.001). UK respondents had significantly higher personal burnout (p < 0.05) and work-related burnout (p < 0.05) while those in Japan had significantly higher client-related burnout (p < 0.001). The novelty of this study relates to exploring mental wellbeing and quality of working life in two culturally contrasting countries. The overall psychological wellbeing and work-related quality of life of staff who work with older adults in the UK and Japan during the COVID-19 pandemic were lower than the population norm. Greater support and flexible working conditions for this workforce are needed to reduce burnout by improving wellbeing and work-related quality of life.
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Leiße, M., and T. W. Kallert. "Social integration and the quality of life of schizophrenic patients in different types of complementary care." European Psychiatry 15, no. 8 (December 2000): 450–60. http://dx.doi.org/10.1016/s0924-9338(00)00521-6.
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Following reunification in Germany in 1990 the new states in the Federal Republic faced the task of restructuring and rebuilding the structures of complementary care for the chronically mentally ill. First and foremost, residential facilities had to be established that would correspond to and meet the currently high need for de-hospitalization by making different types of care and care concepts available. Five groups of patients with chronic schizophrenic psychoses (N = 245 patients) who live in different types of psychiatric care facilities (psychiatric nursing home, social therapeutic hostel, sheltered community residence) or at home, either with or without a family network, were studied. In addition to the sociodemographic data, the psychopathology and the extent of social disabilities were also surveyed, as well as data on the living situation and the subjective quality of life with an emphasis on ‘social relationships’, ‘recreation/leisure activities’, and ‘general independence’.The five groups differed with regard to various sociodemographic and disorder-related variables, particularly with regard to the extent of social disabilities. Especially relevant, however, are the differences among the patient groups in the extent of daily social life and recreational/leisure activities that are partially reflected in their statements on the subjective quality of life. Primarily for the two groups of home residents, but also in part for the patients living in sheltered community care, social contacts are more or less limited to the residential situation and patients are more or less otherwise socially isolated. This is due among other things to the fact that patients who have been hospitalized for long periods do not as a rule return to their prior area of residence; thus, the available compensatory mediation of relationships with the social environment does not suffice. Demands for the further development of complementary systems of psychiatric care derive from these findings.
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Hoon, E., D. A. González-Chica, A. Vakulin, D. McEvoy, N. Zwar, R. Grunstein, C. Chai-Coetzer, et al. "Population-based analysis of sociodemographic predictors, health-related quality of life and health service use associated with obstructive sleep apnoea and insomnia in Australia." Australian Journal of Primary Health 27, no. 4 (2021): 304. http://dx.doi.org/10.1071/py20216.
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Although there is growing recognition of the effects of living with sleep disorders and the important role of primary care in their identification and management, studies indicate that the detection of sleep apnoea (OSA) and insomnia may still be low. This large representative community-based study (n=2977 adults) used logistic regression models to examine predictors of self-reported OSA and current insomnia and linear regression models to examine the association of these sleep conditions with both mental and physical components of health-related quality of life (HRQoL) and health service use. Overall, 5.6% (95% confidence interval (CI) 4.6–6.7) and 6.8% (95% CI 5.7–7.9) of subjects self-reported OSA (using a single-item question) and current insomnia (using two single-item questions) respectively. Many sociodemographic and lifestyle predictors for OSA and insomnia acted in different directions or showed different magnitudes of association. Both disorders had a similar adverse relationship with physical HRQoL, whereas mental HRQoL was more impaired among those with insomnia. Frequent consultations with a doctor were associated with a lower physical HRQoL across these sleep conditions; however, lower mental HRQoL among those frequently visiting a doctor was observed only among individuals with insomnia. The adverse relationship between sleep disorders and physical and mental HRQoL was substantial and should not be underestimated.
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Turpin, K. V. L., L. J. Carroll, J. D. Cassidy, and W. J. Hader. "Deterioration in the health-related quality of life of persons with multiple sclerosis: the possible warning signs." Multiple Sclerosis Journal 13, no. 8 (July 10, 2007): 1038–45. http://dx.doi.org/10.1177/1352458507078393.
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Baseline data from a population-based study examining the health-related quality of life (HRQL) of MS patients about to begin disease modifying therapy was used to determine the factors associated with the HRQL of Saskatchewan adults with relapsing-remitting MS. Participants completed a self-report questionnaire regarding demographic and socioeconomic status, fatigue, comorbid medical conditions, disability level (EDSS), number of attacks in past 6 months, illness intrusiveness (Illness Intrusiveness Ratings Scale), depression (Beck Depression Inventory), and HRQL (SF-36 Health Status Survey). Multiple linear regression models were used to identify the factors associated with the physical and mental health summary scores of the SF-36. We found poorer physical HRQL in those who are female; older; not working; have musculoskeletal or respiratory problems; greater fatigue, higher disability scores, and more MS attacks. High illness intrusiveness; digestive system problems; genitourinary problems; and headaches were associated with poorer mental HRQL. Interestingly, we found an interaction between sex and age in mental HRQL, with worse mental health in older men but better mental health in older women. These findings may assist health care providers in identifying patients who may be at risk for decline in their HRQL, permitting appropriate and timely interventions. Multiple Sclerosis 2007; 13: 1038—1045. http://msj.sagepub.com
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O’Mahony, Julia, Ruth Ann Marrie, Audrey Laporte, and Adalsteinn Brown. "Addressing Health-Related Quality of Life Among Children With Multiple Sclerosis." International Journal of MS Care 25, no. 1 (January 1, 2023): 35–42. http://dx.doi.org/10.7224/1537-2073.2022-017.
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CE INFORMATION ACTIVITY AVAILABLE ONLINE: To access the article and evaluation online, go to https://www.highmarksce.com/mscare. TARGET AUDIENCE: The target audience for this activity is physicians, advanced practice clinicians, nursing professionals, mental health professionals, social workers, and other health care providers involved in the management of patients with multiple sclerosis (MS). LEARNING OBJECTIVES: Describe the three theories discussed and characterize their overlap with usual care in order to implement changes to improve health-related quality of life in children with MS. Describe how recommendations derived from these theories may improve the health-related quality of life of children with MS and their parents by strengthening self-concept, hope, and knowledge. ACCREDITATION: In support of improving patient care, this activity has been planned and implemented by the Consortium of Multiple Sclerosis Centers (CMSC) and Intellisphere, LLC. The CMSC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. This activity was planned by and for the healthcare team, and learners will receive .75 Interprofessional Continuing Education (IPCE) credit for learning and change. PHYSICIANS: The CMSC designates this journal-based activity for a maximum of .75 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. NURSES: The CMSC designates this enduring material for .75 contact hour of nursing continuing professional development (NCPD) (none in the area of pharmacology). PSYCHOLOGISTS: This activity is awarded .75 CE credits. SOCIAL WORKERS: As a Jointly Accredited Organization, the CMSC is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. The CMSC maintains responsibility for this course. Social workers completing this course receive .75 continuing education credits. DISCLOSURES: It is the policy of the Consortium of Multiple Sclerosis Centers to mitigate all relevant financial disclosures from planners, faculty, and other persons that can affect the content of this CE activity. For this activity, all relevant disclosures have been mitigated. Francois Bethoux, MD, editor in chief of the International Journal of MS Care (IJMSC), has served as physician planner for this activity. He has disclosed no relevant relationships. Alissa Mary Willis, MD, associate editor of IJMSC, has disclosed no relevant relationships. Authors Julia O’Mahony, PhD; Ruth Ann Marrie, MD, PhD; Audrey Laporte, PhD; and Adalsteinn Brown, DPhil, have disclosed no relevant financial relationships. The staff at IJMSC, CMSC, and Intellisphere, LLC who are in a position to influence content have disclosed no relevant financial relationships. Laurie Scudder, DNP, NP, continuing education director CMSC, has served as a planner and reviewer for this activity. She has disclosed no relevant financial relationships. METHOD OF PARTICIPATION: Release Date: January 1, 2023; Valid for Credit through: January 1, 2024. To receive CE credit, participants must: (1) Review the continuing education information, including learning objectives and author disclosures.(2) Study the educational content.(3) Complete the evaluation, which is available at https://www.highmarksce.com/mscare. Statements of Credit are awarded upon successful completion of the evaluation. There is no fee to participate in this activity. DISCLOSURE OF UNLABELED USE: This educational activity may contain discussion of published and/or investigational uses of agents that are not approved by the FDA. The CMSC and Intellisphere, LLC do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the CMSC or Intellisphere, LLC. DISCLAIMER: Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any medications, diagnostic procedures, or treatments discussed in this publication should not be used by clinicians or other health care professionals without first evaluating their patients’ conditions, considering possible contraindications or risks, reviewing any applicable manufacturer’s product information, and comparing any therapeutic approach with the recommendations of other authorities.