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Book part

Gül Seçkin, Susan Hughes, Cassie Hudson, David Laljer and Dale Yeatts

Purpose: The aim of the study is to consider the use of the Internet as a potential facilitator of positive health-related perceptions. Specifically, we propose that

Abstract

Purpose: The aim of the study is to consider the use of the Internet as a potential facilitator of positive health-related perceptions. Specifically, we propose that online health information seeking fosters positive perceptions of health. Using path modeling, we theorized several mechanisms through which information seeking could be conducive to positive health perceptions, which we conceptualized into the following four dimensions: (1) sense of empowerment in managing health, (2) self-reported ability to take better care of health, (3) sense of improved health-related quality of life, and (4) self-reported improvement of health.

Methodology: Our sample consisted of respondents who have used the Internet as a resource for health information (n = 710), drawn from the largest national probability-based online research panel. Our comparison subsample consisted of older respondents (age ≥ 60; n = 194). We used Internet-specific measures and employed structural equation models (SEM) to estimate the direct, indirect, and total effects of health-related use of the Internet on subjective health perceptions. Based on our review of the literature, competent health communication with healthcare providers and sense of empowerment in managing personal health were modeled as mediator variables. We assessed whether the proposed mediational relationships, if significant, differed across our indicators of positive health perceptions and whether any differential associations were observed among older adults. We run parallel models for each indicator of positive health perception.

Findings: Provider-patient communication informed by the Internet resources were perceived to impart a greater sense of empowerment to manage health among our respondents, which in turn, was associated with perceived contributions to better self-reported ability to provide self-care, increased health-related quality of life, and improvement in self-reported health. The SEM results revealed a good fit with our full sample and subsample.

Research Implications: Conceptualization of the multidimensional aspects of online health information seeking with separate multi-indicator analyses of the outcome variable is important to further our understanding of how technology may impact the pathways involved in influencing health perceptions and as a result health outcomes.

Details

eHealth: Current Evidence, Promises, Perils and Future Directions
Type: Book
ISBN: 978-1-78754-322-5

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Article

Gillian Windle, Rhiannon Edwards and Vanessa Burholt

Researchers have a wide range of tools for health assessments to choose from, some of which can be lengthy and time consuming. The purpose of this paper is to examine a…

Abstract

Researchers have a wide range of tools for health assessments to choose from, some of which can be lengthy and time consuming. The purpose of this paper is to examine a potentially shorter alternative, the EQ‐5D instrument, with a community dwelling population sample of older people. Data was obtained using trained interviewers from a randomly sampled crosssectional survey of community dwelling older people. 423 people aged 70‐99 were interviewed. Information was obtained relating to activities of daily living, the EQ‐5D, the EQ‐VAS, the SF‐36, use of health and social care services and the presence or absence of a limiting illness, disability or infirmity. In terms of construct validity, the EQ‐5D was able to distinguish between hypoThesised differences in the sample that could be expected to reflect differences in health‐related quality of life. The EQ‐5D items correlated well with conceptually similar items. Completion rates for the EQ‐5D items were good, ranging from 98.3‐98.8%. Completion rates for the EQ‐VAS were 98.1%. The results suggest that the EQ‐ 5D may provide a valid measure of health‐related quality of life in a cross‐sectional population sample of older adults, although the emphasis of the scale is very much on physical health and functioning. The results for the depression/anxiety item suggest that additional information may be needed if mental health is of concern.

Details

Quality in Ageing and Older Adults, vol. 5 no. 3
Type: Research Article
ISSN: 1471-7794

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Article

M.S. Sajid, A. Tonsi and M.K. Baig

The purpose of this article is to discuss the value of health‐related quality of life (HR‐QOL) measurement and describe its development with a few examples.

Abstract

Purpose

The purpose of this article is to discuss the value of health‐related quality of life (HR‐QOL) measurement and describe its development with a few examples.

Design/methodology/approach

The methodology is a literature review of various articles published in the last 25 years on health‐related quality of life.

Findings

HR‐QOL tools are health status instruments, which are utilized to assess the changes in the health status of patients. These surveys are of increasingly importance as healthcare providers are challenged to justify treatment approaches and rationale for any intervention. Objective criteria can be used to determine whether there is clinical evidence of disease. However, the impact of disease on the individual's life is not included in such a clinical assessment. The use of validated and reliable health instruments is directed at measuring this impact in a reproducible and valid fashion. In patient‐centred research, “experimental” conditions are constantly changing because human beings with values, feelings, perspectives and social relationships are being treated. It is especially important to use valid measurement tools when assessing these impacts.

Originality/value

This article is written from the authors' own experience and knowledge and adds those benefits to the literature already available.

Details

International Journal of Health Care Quality Assurance, vol. 21 no. 4
Type: Research Article
ISSN: 0952-6862

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Article

Johanna Buchcik, Joachim Westenhoefer and Colin R. Martin

Definition-problems concerning the terms “migrant” and “Health-Related Quality of Life” (HRQoL) have a negative impact on the operationalization and measurement of the…

Abstract

Purpose

Definition-problems concerning the terms “migrant” and “Health-Related Quality of Life” (HRQoL) have a negative impact on the operationalization and measurement of the multidimensional and subjective construct of HRQoL. The aims of this systematic literature review are to address the following questions: How can the instruments used within the research field “migration and HRQoL” be described or categorized? Which dimensions (psychological, physical and social) and associated sub-dimensions have been used concerning measuring HRQoL when measures are applied to migrants?

Design/methodology/approach

A systematic review was conducted. Three databases (Medline, Embase and Cinahl) were systematically searched for the investigation on HRQoL of migrants. Articles written in English, German and Polish, published since 2003 and meeting other inclusion criteria, were included in the final analysis.

Findings

In the first stage a total of 4,062 studies were identified. However, very few studies were found to focus on HRQoL among migrants. Finally, 28 studies were included in the analysis. The results confirm that the terms “migrant” and “Quality of Life” and “Health-Related Quality of Life” are neither congruently used nor defined, respectively, within these studies, which consequently impacts deleteriously on the application and measurement of the concept in these groups. The majority of the studies reported to measure HRQoL with a well-known and validated HRQoL instrument. The physical dimensions (symptoms/pain/vitality, energy/vitality/sleep and the objective/subjective health status) are predominantly represented in the reviewed literature. The psychological dimension mostly includes sub-dimensions such as psychological stress and depressive symptoms; the social dimension was predominantly considered as the sub-dimension social relationships/networking.

Originality/value

This paper highlights profound issues in the accurate assessment of HRQoL in migrants. This may have a significant impact on delivery of appropriate evidenced-based care for migrants in need of healthcare intervention.

Details

International Journal of Migration, Health and Social Care, vol. 9 no. 4
Type: Research Article
ISSN: 1747-9894

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Content available
Article

Dominik Michalski, Stefanie Liebig, Eva Thomae, Susanne Singer, Andreas Hinz and Florian Then Berg

Anxiety, depression and impaired health-related quality of life (HRQoL) are commonly reported in patients with multiple sclerosis (MS) and are of great interest for…

Abstract

Anxiety, depression and impaired health-related quality of life (HRQoL) are commonly reported in patients with multiple sclerosis (MS) and are of great interest for therapeutic approaches. Based on regional differences a quantitative assessment of these factors in comparison to the general population, and the consideration of demographic cofactors, would be useful when designing specific interventions. We adopted such an approach in a German cohort of MS patients. Anxiety, depression (HADS) and HRQoL (SF-36) were measured in 49 consecutive outpatients with MS and compared to age- and gender-adjusted control groups (n=1330 for HADS; n=5087 for SF-36) extracted from German National Health Surveys. Patients with MS showed significantly increased levels of anxiety and depression as well as decreased HRQoL with the exception of mental health; the effect sizes ranged from 0.39 (depression) to 1.06 (physical functioning). As could be expected, MS patients with relapsing-remitting clinical course had better physical functioning than patients with secondary progressive MS. There were strong relations between anxiety and depression (r=0.54; P<0.01), and between neurological impairment (EDSS) and physical functioning (r=-0.80; P<0.001) as well as depression (r=0.48; P<0.05). This investigation of MS patients confirms the prevalence and impact of anxiety, depression and most of the HRQoL dimensions in MS patients and provides evidence for the usefulness of a quantitative comparison to a region-specific general population as a starting point for therapeutic approaches.

Details

Mental Illness, vol. 2 no. 1
Type: Research Article
ISSN: 2036-7465

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Book part

Sara LeGrand, Teresa L. Scheid and Kathryn Whetten

This chapter examines the associations between gender, social support, and health outcomes for individuals living with HIV disease. We include social integration and…

Abstract

Purpose

This chapter examines the associations between gender, social support, and health outcomes for individuals living with HIV disease. We include social integration and social isolation as structural measures of social support as well as perceived social support and social conflict as functional measures of social support. We include both mental health and physical health outcomes, which are too often studied in isolation of each other.

Methodology/approach

Data are from the Coping with HIV/AIDS in the Southeast (CHASE) study; this study reports on baseline data from 611 participants collected from 2001 to 2002. We first examined differences by gender and race, and then used blocked linear regression to determine the additive effects of the social support variables on both mental and physical health outcomes while controlling for potential confounders.

Findings

There were notable differences in the significance and strength of social support variables in health outcome models for men and women. Unlike men, social conflict was the strongest predictor of greater psychological distress and poorer physical health-related quality of life among women.

Research limitations/implications

While the results from this study contribute to a greater understanding of gender differences in the relationships between social support and health outcomes, the data used for this study are limited to those living with HIV/AIDS in the Southeast.

Originality/value

Our findings suggest that social conflict may be more detrimental for the health of women than men.

Details

Special Social Groups, Social Factors and Disparities in Health and Health Care
Type: Book
ISBN: 978-1-78635-467-9

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Content available
Article

Carolin Gall, Iris Mueller, Gabriele H. Franke and Bernhard A. Sabel

Considerably diminished quality of life (QoL) is observed in patients with visual field defects after lesions affecting the visual pathway. But little is known to what…

Abstract

Considerably diminished quality of life (QoL) is observed in patients with visual field defects after lesions affecting the visual pathway. But little is known to what extent vision-and health-related QoL impairments are associated with psychological distress. In 24 patients with chronic visual field defects (mean age=56.17±12.36) the National Eye Institute-visual functioning questionnaire (NEI-VFQ) for vision-related QoL, the Short Form Health Survey-36 (SF-36) for generic QoL and the revised Symptom-Checklist (SCL-90-R) were administered. Cases with clinically relevant SCL-90-R symptoms were defined. Demographic, QoL and visual field parameters were correlated with SCL-90-R scales. About 40% of the investigated patients met the criteria for the definition of psychiatric caseness. 8/12 NEI-VFQ scales correlated significantly with SCL-90-R phobic anxiety (r-range -0.41 to -0.64, P<0.05), 5/12 NEI-VFQ scales correlated with SCL-90-R interpersonal sensitivity (-0.43 to -0.50), and 3/12 with SCL-90-R depression (-0.51 to -0.57) and obsessive-compulsiveness (-0.41 to -0.43). In contrast, only 1/8 SF-36 scales correlated significantly with SCL-90-R depression, phobic anxiety and interpersonal sensitivity (-0.41 to -0.54). No substantial correlations were observed between visual field parameters and SCL-90-R scales. Significant correlations of SCL-90-R with NEI-VFQ but not with SF-36 suggest that self-rated psychological distress is the result of diminished vision-related QoL as a consequence of visual field loss. The extent of visual field loss itself did not influence the rating of psychological distress directly, since SCL-90-R symptoms were only reported when diminished vision-related QoL was present. Patients with reduced vision-related QoL due to persisting visual field defects should therefore be offered additional neuropsychological rehabilitation and supportive psychotherapeutic interventions even years after the lesion.

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Article

Roger Beech and Michael Murray

Social engagement is important for healthy ageing but may be challenging for residents of disadvantaged urban communities. For older residents of one such community, this…

Abstract

Purpose

Social engagement is important for healthy ageing but may be challenging for residents of disadvantaged urban communities. For older residents of one such community, this project aimed to examine levels of social engagement and its link with wellbeing and community attachment.

Design/methodology/approach

The project introduced activities to promote social engagement and used a survey to assess participants' wider involvement in local activities and their feelings of wellbeing and community attachment.

Findings

Sixty five people completed the survey: most lived alone (over 69 per cent) but had contact at least monthly with family, friends and neighbours (over 70 per cent) and made regular use of local amenities (over 79 per cent). Only 34.7 per cent were classified as “not lonely” and participants' mean health related quality of life score was lower than the national average. However, over 65 per cent of participants rated their generic quality of life as good or better and over 67 per cent had a positive sense of community attachment. Statistically significant associations were identified between a person's feelings of loneliness and generic quality of life and their level of contact with relatives, neighbours and friends and their sense of community attachment.

Originality/value

Results confirm the need for strategies to promote the social engagement of older people. The link between community attachment and wellbeing also demonstrates that community wide strategies are required. The importance of maintaining the “corner shop” was evident.

Content available
Article

Helge H.O. Müller, Caroline Lücke, Matthias Englbrecht, Michael S. Wiesener, Teresa Siller, Kai Uwe Eckardt, Johannes Kornhuber and J. Manuel Maler

Kidney transplantation (KT) is the treatment of choice for end-stage chronic kidney disease (CKD) and is well known to improve the clinical outcome of patients. However…

Abstract

Purpose

Kidney transplantation (KT) is the treatment of choice for end-stage chronic kidney disease (CKD) and is well known to improve the clinical outcome of patients. However, the impact of KT on comorbid psychological symptoms, particularly depression and anxiety, is less clear, and recipients of living-donor (LD) organs may have a different psychological outcome from recipients of dead-donor (DD) organs.

Design/methodology/approach

In total, 152 patients were included and analyzed using a cross-sectional design. Of these patients, 25 were pre-KT, 13 were post-KT with a LD transplant and 114 were post-KT with a DD transplant. The patients were tested for a variety of psychometric outcomes using the Hospital Anxiety and Depression Scale, the 12-Item Short Form Health Survey (assessing physical and mental health-related quality of life), the Resilience Scale, the Coping Self-Questionnaire and the Social Support Questionnaire.

Findings

The mean age of the patients was 51.25 years and 40 per cent of the patients were female. As expected, the post-KT patients had significantly better scores on the physical component of the Short Form Health Survey than the pre-KT patients, and there were no significant differences between the two post-KT groups. There were no significant differences among the groups in any of the other psychometric outcome parameters tested, including anxiety, depression and the mental component of health-related quality of life.

Research limitations/implications

KT and the origin of the donor organ do not appear to have a significant impact on the psychological well-being of transplant patients with CKD. Although the diagnosis and early treatment of psychological symptoms, such as depression and anxiety, remain important for these patients, decisions regarding KT, including the mode of transplantation, should not be fundamentally influenced by concerns about psychological impairments at the population level.

Originality/value

CKD is a serious condition involving profound impairment of the physical and psychological well-being of patients. KT is considered the treatment of choice for most of these patients. KT has notable advantages over dialysis with regard to the long-term physical functioning of the renal and cardiovascular system and increases the life expectancy of patients. However, the data on the improvement of psychological impairments after KT are less conclusive.

Details

Mental Illness, vol. 12 no. 1
Type: Research Article
ISSN:

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Article

Ali Kazemi Karyani, Satar Rezaei, Behzad Karami Matin and Saeed Amini

Poor health-related quality of life (HRQoL) is one of the important issues in the health sector. The purpose of this paper is to investigate the prevalence and…

Abstract

Purpose

Poor health-related quality of life (HRQoL) is one of the important issues in the health sector. The purpose of this paper is to investigate the prevalence and socio-economic inequality in poor HRQoL in Tehran city, Iran.

Design/methodology/approach

In total, 562 adults were included in this cross-sectional study. The cluster sampling method was used for data collection from May to June, 2016 in Tehran city, Iran. Data on HRQoL, using EuroQol 5-dimensions questionnaire, and data on socio-economic and demographic variables were gathered. Convenience regression method was performed to measure the concentration index (CI). Decomposition analysis was performed to determine the contribution of variables on socio-economic inequality in poor HRQoL. All analyses were performed by Stata v.14.

Findings

The prevalence of poor HRQoL was 28.3 percent. The value of CI for “poor HRQoL” was −0.299 (95% confidence interval: −0.402 to −0.195). Socio-economic status (SES) was the largest contributor to socio-economic inequality in poor HRQoL (69.44 percent of inequality was explained by SES). Age, obesity and race had a positive contribution to socio-economic inequality in poor HRQoL among the participants. Nonetheless, sex and smoking intensity had a negative contribution to inequality in poor HRQoL.

Originality/value

There is little evidence about the prevalence of poor HRQoL in insured people. This study provided new evidence in this area through the investigation of socio-economic inequality in poor HRQoL and its determinants among people with health insurance in Iran using decomposition analysis.

Details

International Journal of Human Rights in Healthcare, vol. 12 no. 1
Type: Research Article
ISSN: 2056-4902

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