Measuring Health-Related Quality of Life in Strabismus: A Modification of the Adult Strabismus-20 (AS-20) Questionnaire Using Rasch Analysis

PurposeTo evaluate the psychometric properties of the Adult Strabismus-20 (AS-20)- a health-related quality of life (HRQoL) questionnaire in adults with strabismus, and if flawed, to revise the AS-20 and its subscales creating valid measurement scales.Methods584 adults (meanage, 27.5 years) with strabismus were recruited from an outpatient clinic at a South Indian tertiary eye care centre and were administered the AS-20 questionnaire.The AS-20 was translated and back translated into two Indian languages. The AS-20 and its two 10-item subscales – ‘psychosocial’ and ‘function’were assessed separately for fit to the Rasch model, including an assessment of the rating scale, unidimensionality (by principal components analysis), measurement precision by person separation reliability, PSR, targeting, and differential item functioning (DIF; notable > 1.0 logits).ResultsResponse categories were not used as intended, thereby, required re-organization and reducing their number from 5 to 3. The AS-20 had adequate measurement precision (PSR = 0.87) but lacked unidimensionality; however, deletion of the six multi-dimensionality causing items and an additional three misfitting items resulted in 11-item unidimensional questionnaire (AS-11). Two items failed to satisfy the model expectations in the ‘psychosocial’ subscale and were deleted – resulting in an 8-item unidimensional scale with adequate PSR (0.81) and targeting (0.23 logits). One item misfit in the ‘function’ subscale and was deleted—resulting in a 9 item Rasch-revised unidimensional subscale with acceptable PSR (0.80) and targeting (0.97 logits).None of the items displayed notable DIF by age, gender and level of education.ConclusionsThe AS-11 and its two Rasch-revised subscales – 8-item psychosocial and 9-item function subscale may be more appropriate than the original AS-20 and its two 10-item subscales for use as unidimensional measures of HRQoL in adults with strabismus in India. Further work is required to establish the validity of the revised rating scale.     

Development and Validation of a New Questionnaire Assessing Quality of Life in Adults with Hypopituitarism: Adult Hypopituitarism Questionnaire (AHQ)

Objective

To develop and validate the Adult Hypopituitarism Questionnaire (AHQ) as a disease-specific, self-administered questionnaire for evaluation of quality of life (QOL) in adult patients with hypopituitarism.

Methods

We developed and validated this new questionnaire, using a standardized procedure which included item development, pilot-testing and psychometric validation. Of the patients who participated in psychometric validation, those whose clinical conditions were judged to be stable were asked to answer the survey questionnaire twice, in order to assess test-retest reliability.

Results

Content validity of the initial questionnaire was evaluated via two pilot tests. After these tests, we made minor revisions and finalized the initial version of the questionnaire. The questionnaire was constructed with two domains, one psycho-social and the other physical. For psychometric assessment, analyses were performed on the responses of 192 adult patients with various types of hypopituitarism. The intraclass correlations of the respective domains were 0.91 and 0.95, and the Cronbach’s alpha coefficients were 0.96 and 0.95, indicating adequate test-retest reliability and internal consistency for each domain. For known-group validity, patients with hypopituitarism due to hypothalamic disorder showed significantly lower scores in 11 out of 13 sub-domains compared to those who had hypopituitarism due to pituitary disorder. Regarding construct validity, the domain structure was found to be almost the same as that initially hypothesized. Exploratory factor analysis (n = 228) demonstrated that each domain consisted of six and seven sub-domains.

Conclusion

The AHQ showed good reliability and validity for evaluating QOL in adult patients with hypopituitarism.     

Trajectories of Quality of Life among Chinese Patients Diagnosed with Nasopharynegeal Cancer

Objective

This secondary longitudinal analysis describes distinct quality of life trajectories during eight months of radiation therapy (RT) among patients with nasopharyngeal cancer (NPC) and examines factors differentiating these trajectories.

Methods

253 Chinese patients with NPC scheduled for RT were assessed at pre-treatment, and 4 months and 8 months later on QoL (Chinese version of the FACT-G), optimism, pain, eating function, and patient satisfaction. Latent growth mixture modelling identified different trajectories within each of four QoL domains: Physical, Emotional, Social/family, and Functional well-being. Multinomial logistic regression compared optimism, pain, eating function, and patient satisfaction by trajectories adjusted for demographic and medical characteristics.

Results

We identified three distinct trajectories for physical and emotional QoL domains, four trajectories for social/family, and two trajectories for functional domains. Within each domain most patients (physical (77%), emotional (85%), social/family (55%) and functional (63%)) experienced relatively stable high levels of well-being over the 8-month period. Different Physical trajectory patterns were predicted by pain and optimism, whereas for Emotion-domain trajectories pain, optimism, eating enjoyment, patient satisfaction with information, and gender were predictive. Age, appetite, optimism, martial status, and household income predicted Social/family trajectories; household income, eating enjoyment, optimism, and patient satisfaction with information predicted Functional trajectories.

Conclusion

Most patients with NPC showed high stable QoL during radiotherapy. Optimism predicted good QoL. Symptom impacts varied by QoL domain. Information satisfaction was protective in emotional and functional well-being, reflecting the importance in helping patients to establish a realistic expectation of treatment impacts.     

Validation of Chinese Version of Polycystic Ovary Syndrome Health-Related Quality of Life Questionnaire (Chi-PCOSQ)

ObjectivesTo evaluate the responsiveness, longitudinal validity, and measurement invariance of the Chinese version of the Polycystic Ovary Syndrome Health-related Quality of Life Questionnaire (Chi-PCOSQ).ResultsWith improved 2-hour glucose and insulin levels, we also found significantly increased Chi-PCOSQ total and individual domain scores (total score: t (49) = 5.20; p < 0.001, domain scores: t (49) = 2.72 to 3.87; p < 0.01), except for hair growth. Half of the domains scores (3 of 6) and the total score of Chi-PCOSQ had a medium responsiveness, but WHOQOL-BREF was not sufficiently responsive to clinical changes of PCOS. Improved PCOS-specific health-related quality of life (HRQoL), as indicated by Chi-PCOSQ scores, was significantly associated with improved 2-hour glucose and insulin levels. All indices of the data-model fit of the Chi-PCOSQ structure were satisfactory, except for the slightly high standardized root mean square residual values (0.087 to 0.088). The measurement invariance of Chi-PCOSQ was supported across time.ConclusionChi-PCOSQ is sufficiently sensitive in detecting clinical changes and its measurement structure is suitable for Chinese women with PCOS. It is thus a promising tool for assessing the HRQoL of ethnic Chinese women with PCOS.     

青光眼患者生存质量量表的研究进展

青光眼是当今世界不可逆性致盲眼病的主要病因,同时也是导致视力丧失的第二主要病因.青光眼的症状、以及治疗方式、不良反应使患者的日常生活、心理、工作、社会活动等均受到不同程度的影响.随着医学模式的转变,单纯观察视功能的变化已不能够全面反映疾病对患者的影响,生存质量作为一种较全面的体现新的健康观和医学模式的评价体系已被引入眼科领域,是对传统视功能评价方法的有益补充.本文就国内外与青光眼相关的生存质量量表的研究进展作一综述.     

Development of Chinese Version of Polycystic Ovary Syndrome Health-Related Quality of Life Questionnaire (Chi-PCOSQ)

Objectives

To develop the Chinese version of the Polycystic Ovary Syndrome Health-related Quality of Life Questionnaire (Chi-PCOSQ).

Research Design and Method

This cross-sectional study was conducted in a medical center in Taiwan. Eighty women who met the criteria were enrolled: female, age range of 18–45 years, competent in the Chinese language, had been diagnosed with polycystic ovary syndrome (PCOS), and were regularly followed at outpatient clinics (defined as at least two outpatient visits before enrollment). The PCOSQ was translated and culturally adapted according to standard procedures. A semi-structured interview was applied to assess face validity. Exploratory factor analysis (EFA) was applied to determine scale constructs. Measurements of internal consistency via Cronbach’s α, test-retest reliability via intraclass correlation coefficient (ICC), construct validity, and discriminative validity were performed.

Results

Five additional items, representing the issues of acne, hair loss, and fear of getting diabetes, were incorporated into the original scale. A six-factor structure emerged as a result of the EFA, explaining 71.9% of the variance observed. The reliability analyses demonstrated satisfactory results for Cronbach’s α ranging from 0.78–0.96, and for ICC ranging from 0.73–0.86. Construct validity was confirmed by significant correlation between the domains of the Chi-PCOSQ and generic health-related quality of life (HRQoL) measures (WHOQOL-BREF, EQ-5D) and clinical parameters (body mass index, waist-hip ratio, blood pressure). The known-group analysis indicated that the Chi-PCOSQ is a discriminative tool that differentiates patients according to their HRQoL.

Conclusion

The Chi-PCOSQ seems internally consistent, culturally acceptable, and our preliminary evidence suggests that it may be reliable and valid. The Chi-PCOSQ is a promising assessment tool to address the HRQoL of women affected by PCOS in Chinese-speaking countries and to further identify ethnic/cultural differences in the HRQoL of women with PCOS.     

Factors Associated with Quality of Life among Hemodialysis Patients in Malaysia

Although hemodialysis treatment has greatly increased the life expectancy of end stage renal disease patients, low quality of life among hemodialysis patients is frequently reported. This cross-sectional study aimed to determine the relationship between medical history, hemodialysis treatment and nutritional status with the mental and physical components of quality of life in hemodialysis patients. Respondents (n=90) were recruited from Hospital Kuala Lumpur and dialysis centres of the National Kidney Foundation of Malaysia. Data obtained included socio-demography, medical history, hemodialysis treatment and nutritional status. Mental and physical quality of life were measured using the Mental Composite Summary (MCS) and Physical Composite Summary (PCS) of the Short-Form Health Survey 36-items, a generic core of the Kidney Disease Quality of Life Short Form. Two summary measures and total SF-36 was scored as 0–100, with a higher score indicating better quality of life. Approximately 26 (30%) of respondents achieved the body mass index (24 kg/m²) and more than 80% (n=77) achieved serum albumin level (>35.0 mg/dL) recommended for hemodialysis patients. The majority of respondents did not meet the energy (n=72, 80%) and protein (n=68,75%) recommendations. The total score of SF-36 was 54.1±19.2, while the score for the mental and physical components were 45.0±8.6 and 39.6±8.6, respectively. Factors associated with a higher MCS score were absence of diabetes mellitus (p=0.000) and lower serum calcium (p=0.004), while higher blood flow (p=0.000), higher serum creatinine (p=0.000) and lower protein intake (p=0.006) were associated with a higher PCS score. To improve the overall quality of life of hemodialysis patients, a multidisciplinary intervention that includes medical, dietetic and psychosocial strategies that address factors associated with mental and physical quality of life are warranted to reduce further health complications and to improve quality of life.     

SGRQ、CAT和CCQ问卷在COPD患者生活质量中的评估价值比较

目的:对比分析圣乔治呼吸问卷(SGRQ)、慢性阻塞性肺疾病评估测试(CAT)和临床慢性阻塞性肺疾患调查问卷(CCQ)在慢性阻塞性肺部疾病(COPD)患者生活质量中的评估价值。方法:收集我院呼吸内科2013年6月-2014年6月的门诊和住院治疗稳定期COPD患者60例,隔天应用SGRQ、CAT和CCQ问卷分别对60例患者生活质量进行评估,分析三种问卷以及与肺功能指标(FEV1%、FEVl/FVC、6MWD)的相关性。结果:SGRQ问卷完成时间及协助比例均大于CAT、CCQ问卷,比较均差异有统计学意义(P0.05);SGRQ问卷评分与肺功能指标呈现负相(r=-0.687、-0.587、-0.876,均P0.05);CCQ问卷评分与肺功能指标呈现负相关(r=-0.359、-0.338、-0.789,均P0.05);CAT问卷评分与肺功能指标呈现负相关(r=-0.455、-0.348、-0.877,均P0.05);三种问卷评分之间都具有高度相关性(P0.05)。结论:SGRQ、CAT和CCQ评分与COPD患者生活质量的相关性均较高,其中SGRQ的相关性最好,是评价COPD患者生活质量一个敏感、有效、可行的方法,值得临床上采纳使用。     

Validation of a Health-related Quality of Life (QoL) Questionnaire for Owners of Dogs with Heart Disease

ABSTRACT

In humans, heart disease is associated with high caregiver burden and stress, which can negatively affect the health-related quality of life (hrQoL) of both patient and caregiver. The effect of a dog’s heart disease on owners’ hrQoL has not been reported. Therefore, the objective of this study was to develop and validate a hrQoL questionnaire for owners of dogs with heart disease, with the hypothesis that heart disease would impact the hrQoL of owners. Owners of dogs with degenerative mitral valve disease, dilated cardiomyopathy, and arrhythmogenic right ventricular cardiomyopathy were eligible for the study. A 7-item questionnaire was developed, with a possible range of scores from 0–35 (higher scores indicated worse owner hrQoL). The questionnaire was self-administered by owners and results were analyzed to determine validity, test-retest reliability, and internal consistency. The Functional EvaluaTion of Cardiac Health (FETCH) questionnaire was used to assess dogs’ hrQoL. Two hundred and seventeen owners of dogs with heart disease were enrolled. Median owner hrQoL score was 6 (range, 0–31) and median FETCH hrQoL score was 7 (range, 0–70). The owner hrQoL score was correlated with the FETCH score (r = 0.76, p < 0.001) and severity of dogs’ disease (r = 0.53, p < 0.001). Test-retest reliability was high (r = 0.83, p < 0.001). These results suggest that the owner hrQoL questionnaire has good reliability and validity, and that further testing of this questionnaire is warranted to optimize communication with owners regarding the care of dogs with heart disease.     

终末期肾病透析患者的疲劳与生活质量的相关性研究

目的:评价终末期肾病行透析治疗患者的疲劳,探讨疲劳的影响因素及其与生活质量之间的相关性。方法:采用自行设计的患者一般情况调查问卷、多维疲劳量表MIF-20、健康状况问卷量表SF-36对204例ESRD进行血液透析与腹膜透析治疗的患者进行调查,分析治疗效果差异之间的相关因素。结果:204例透析患者的疲劳总分为60.47+11.75;经多元线性逐步回归分析透析患者疲劳的主要相关因素为年龄、文化程度、经济状况;除疲劳的活动减少与生活质量的躯体疼痛、情感职能无显著相关外,两者总分及各维度之间均呈显著性负相关。结论:终末期肾病透析患者存在重度疲劳;临床上重视患者的疲劳评估,进行有效干预,提高患者生活质量。     

Validity and Reliability of the Dutch Adaptation of the Psoriatic Arthritis Quality of Life (PsAQoL) Questionnaire

Objective

The Psoriatic Arthritis Quality of Life (PsAQoL) questionnaire is a disease- specific instrument developed to measure quality of life (QoL) in patients with psoriatic arthritis (PsA). The aim of this study was to translate the measure into Dutch and to determine its psychometric properties.

Method

Translation of the original English PsAQoL into Dutch was performed by bilingual and lay panel. Ten field-test interviews with PsA patients were performed to assess face and content validity. In total, 211 PsA patients were included in a test-retest postal survey to investigate the reliability and construct validity of the Dutch adaptation of the PsAQoL. The PsAQoL, Health Assessment Questionnaire (HAQ) and Skindex-17 were administered on two different occasions approximately two weeks apart.

Results

The Dutch version of the PsAQoL was found to be relevant, understandable and easy to complete in only a few minutes. It correlated as expected with the HAQ (Spearman’s ρ = 0.72) and the 2 subscales of the Skindex-17 (ρ = 0.40 for the psychosocial and ρ = 0.46 for the symptom scale). Furthermore, the measure had good internal consistency (Cronbach’s α = 0.92) and test-retest reliability (ρ = 0.89). The PsAQoL was able to define groups of patients based on self-reported general health status, self-reported severity of PsA and flare of arthritis. Duration of PsA did not influence PsAQoL scores.

Conclusions

The Dutch version of the PsAQoL is a valid and reliable questionnaire suitable for use in clinical or research settings to asses PsA-specific QoL.     

Impact of Influenza on Health-Related Quality of Life among Confirmed (H1N1)2009 Patients

Background

We aimed to assess the changes in health-related quality of life (HRQL) in patients with confirmed diagnosis of influenza (H1N1)2009, and to estimate the individual and societal loss of quality-adjusted life years (QALYs) caused by the pandemic.

Methods and Results

Longitudinal study of patients recruited at major hospitals and primary care centers in Spain. Patients reported their HRQL (EQ-5D) during their influenza episode and seven days prior to it. A subsample was monitored to evaluate HRQL after recovery. HRQL loss was estimated as the difference between EQ-5D prior to the influenza episode and during it. Individual QALY loss (disutility multiplied by the duration of the influenza episode in days) for confirmed cases was calculated and used to estimate the societal loss in Spain (with the official estimations). A total of 432 inpatients and 563 outpatients were included, of whom 145 and 184, respectively, were followed up. Baseline mean HRQL loss was 0.58 (95% CI, 0.53–0.63) for inpatients and 0.43 (95% CI, 0.40–0.46) for outpatients. The majority of the 145 inpatients and 184 outpatients who were followed up regained initial HRQL levels, presenting a mean difference of 0.01 between the EQ-5D score prior to and after the influenza episode. Individual QALY losses for inpatients (0.031, 95% CI, 0.025–0.037) were higher than for outpatients (0.009, 95% CI, 0.007–0.011), while societal QALY losses were reversed: 94 years for inpatients and 6,778 years for outpatients. For fatal cases (an official number of 318), we estimated a QALY loss of 11,981.

Conclusions

The influenza (H1N1)2009 pandemic had a significant but temporary impact on the HRQL of the majority of confirmed in- and outpatients. The societal impact of the influenza pandemic in Spain was estimated to be higher than other acute conditions. These results provide useful data for future cost-utility analyses.     

Health-Related Quality of Life in Chinese Patients with Mild and Moderately Active Ulcerative Colitis

Background

Ulcerative colitis (UC) impairs the health-related quality of life (HRQOL). The difference in HRQOL between patients with mild and moderately active UC is not well-defined. Few studies have been conducted to explore the factors that influence HRQOL in Chinese patients. Our study aims were to (1) compare HRQOL of mildly active UC patients with moderate patients; (2) explore the factors that influence HRQOL in Chinese patients with UC; and (3) analyze demographic and disease characteristics of UC in China.

Methods

A total of 110 mild and 114 moderate patients with UC were enrolled. The demographic and disease characteristics were recorded. HRQOL was measured by the Chinese version of the inflammatory bowel disease questionnaire (IBDQ) between mild and moderate patients, male and female patients, and different disease distributions. Stepwise regression analysis was used to assess factors influencing the IBDQ score.

Results

Patients with moderate UC had significantly lower IBDQ total scores compared to patients with mild UC (P=0.001). The IBDQ total score had a negative correlation with the Mayo score (r=–0.263, P<0.001). Stepwise regression analysis showed that the disease activity index and gender had an influence on the IBDQ total score (P<0.05). The female patients had a lower score than the male patients (P<0.05), especially in the emotional function domain (P=0.002). Different disease distributions were not statistically significant in the IBDQ total score (P=0.183).

Conclusions

UC has a negative influence on HRQOL. HRQOL in patients with moderate UC was lower than HRQOL in patients with mild UC, as measured by the IBDQ. UC disease activity has a negative correlation with HRQOL. Gender and the disease activity index are important factors involved in the impairment of HRQOL in Chinese patients with UC. Chinese females may benefit from increased psychological care as part of UC therapy.     

Construct Validity of the Impact of Weight on Quality of Life Questionnaire

KOLOTKIN, RONETTE L, SUSAN HEAD, ALAN BROOKHART. Construct validity of the Impact of Weight on Quality of Life questionnaire. The Impact of Weight on Quality of Life questionnaire (IWQOL) is a 74-item self-report, condition-specific instrument that (1) assesses the effect of weight on quality of life in eight key areas, and (2) may be used as a treatment outcome measure and/or an evaluation tool for healthcare policy makers and third-party payers. This study explores IWQOL construct validity and provides new information on internal consistency, treatment effects, and differences between men and women. IWQOL total scores correlated highly with other measures of overall quality of life, and subscale scores correlated well with counterparts in the assessment battery. Internal consistency estimates for the IWQOL scales generally were high. For the women, 4-week participants, and the total sample, pretreatment-posttreatment differences were significant for all IWQOL scales and total score. For men, treatment differences were significant for the total score and all subscales except for Work and Mobility. Treatment differences for 2-week participants were significant for all scales except for Work. Consistent with previous IWQOL study results, the Comfort With Food scale scores reflected more discomfort at posttreatment as compared with pretreatment. The IWQOL, already translated into French and Italian, currently is demonstrating clinical and research utility as a quality-of-life outcome measure for clinical trials of antiobesity drugs and surgical treatments for patients with obesity.     

Development and Validation of the Chinese Attitudes to Starting Insulin Questionnaire (Ch-ASIQ) for Primary Care Patients with Type 2 Diabetes

Objectives

To develop and evaluate the psychometric properties of a Chinese questionnaire which assesses the barriers and enablers to commencing insulin in primary care patients with poorly controlled Type 2 diabetes.

Research Design and Method

Questionnaire items were identified using literature review. Content validation was performed and items were further refined using an expert panel. Following translation, back translation and cognitive debriefing, the translated Chinese questionnaire was piloted on target patients. Exploratory factor analysis and item-scale correlations were performed to test the construct validity of the subscales and items. Internal reliability was tested by Cronbach’s alpha.

Results

Twenty-seven identified items underwent content validation, translation and cognitive debriefing. The translated questionnaire was piloted on 303 insulin naïve (never taken insulin) Type 2 diabetes patients recruited from 10 government-funded primary care clinics across Hong Kong. Sufficient variability in the dataset for factor analysis was confirmed by Bartlett’s Test of Sphericity (P<0.001). Using exploratory factor analysis with varimax rotation, 10 factors were generated onto which 26 items loaded with loading scores > 0.4 and Eigenvalues >1. Total variance for the 10 factors was 66.22%. Kaiser-Meyer-Olkin measure was 0.725. Cronbach’s alpha coefficients for the first four factors were ≥0.6 identifying four sub-scales to which 13 items correlated. Remaining sub-scales and items with poor internal reliability were deleted. The final 13-item instrument had a four scale structure addressing: ‘Self-image and stigmatization’; ‘Factors promoting self-efficacy; ‘Fear of pain or needles’; and ‘Time and family support’.

Conclusion

The Chinese Attitudes to Starting Insulin Questionnaire (Ch-ASIQ) appears to be a reliable and valid measure for assessing barriers to starting insulin. This short instrument is easy to administer and may be used by healthcare providers and researchers as an assessment tool for Chinese diabetic primary care patients, including the elderly, who are unwilling to start insulin.     

Development and Validation of the Chinese Version of the Multicultural Quality of Life Index (MQLI-Ch)

This study documents the validation study of the Multicultural Quality of Life Index, Chinese version (MQLI-Ch). This self-rated instrument is composed of ten items that correspond to multiple dimensions of the concept of quality of life. Each item is rated on a scale from 1 to 10, according to the subject’s culture-informed understanding of the concept. The MQLI-Ch was tested on 144 Chinese subjects (124 psychiatric patients and 20 professionals). It was found to be quite efficient (about 3 min to be completed) and easy to use. A Cronbach’s α of 0.94 demonstrated its internal consistency. The factor analysis of the ten items yielded one single factor, which accounted for 65.19% of the variance. The test–retest reliability correlation coefficient was 0.80. Its discriminant validity was documented by a highly significant difference (P < 0.001) between the mean scores of the two samples with presumed differences in quality of life. Thus, the MQLI-Ch showed high feasibility, internal structure, reliability and discriminant validity.     

Chronic Stable Angina Is Associated with Lower Health-Related Quality of Life: Evidence from Chinese Patients

Objectives

To compare health-related quality of life (HRQoL) between patients with stable angina and the general population in China and to examine factors associated with HRQoL among patients with stable angina.

Methods

A cross-sectional HRQoL survey of stable angina patients recruited from 4 hospitals (n = 411) and the general population recruited from 3 Physical Examination Centers (n = 549) was conducted from July to December, 2011 in two large cities, Tianjin and Chengdu. HRQoL was assessed using the EQ-5D, EQ-VAS, and SF-6D instruments. The health status specific to patients with stable angina was assessed using the Seattle Angina Questionnaire (SAQ). Information on socio-demographic, clinical, and lifestyle factors were also collected. Nested regressions were performed to explore how these factors were associated with HRQoL in patients with stable angina.

Results

Compared with the general population (44.2±10 years, 49.9% females), stable angina patients (68.1±12 years, 50.4% females) had significantly lower HRQoL scores in EQ-5D utility index (0.75±0.19 vs. 0.90±0.20, p<0.05), SF-6D utility index (0.68±0.12 vs. 0.85±0.11, p<0.05), and EQ-VAS (71.2±12.3 vs. 83.9±10.9, p<0.05). The differences remained (−0.05 for EQ-5D, −9.27 for EQ-VAS and −0.13 for SF-6D) after controlling for socio-economic characteristics. SAQ scores showed that stable angina patients experienced impaired disease-specific health status, especially in angina stability (40.5±34.6). Nested regressions indicated stable angina-specific health status explained most of the variation in HRQoL, among which disease perception, physical limitation, and angina stability were the strongest predictors. More physical exercise and better sleep were positively related with HRQoL.

Conclusions

Compared to the general population, stable angina patients were associated with lower HRQoL and lower health utility scores, which were largely impacted by clinical symptoms. Further studies are needed to characterize the influence of geographic and cultural factors on the variations of health-related utility in stable angina patients.     

Impact of Individual-Level Social Capital on Quality of Life among AIDS Patients in China

Background

With growing recognition of the social determinants of health, social capital is an increasingly important construct in international health. However, the application of social capital discourse in response to HIV infection remains preliminary. The aim of this study was to assess the impact of social capital on quality of life (QoL) among adult patients with acquired immune deficiency syndrome (AIDS).

Methods

A convenient sample of 283 patients receiving antiretroviral treatment (ART) was investigated in Anhui province, China. QoL data were collected using the Medical Outcomes Study HIV Survey (MOS-HIV) questionnaire. Social capital was measured using a self-developed questionnaire. Logistic regression models were used to explore associations between social capital and QoL.

Results

The study sample had a mean physical health summary (PHS) score of 50.13±9.90 and a mean mental health summary (MHS) score of 41.64±11.68. Cronbach''s α coefficients of the five multi-item scales of social capital ranged from 0.44 to 0.79. When other variables were controlled for, lower individual levels of reciprocity and trust were associated with a greater likelihood of having a poor PHS score (odds ratio [OR] = 2.02) or PHS score (OR = 6.90). Additionally, the factors of social support and social networks and ties were associated positively with MHS score (OR = 2.30, OR = 4.17, respectively).

Conclusions

This is the first report to explore the effects of social capital on QoL of AIDS patients in China. The results indicate that social capital is a promising avenue for developing strategies to improve the QoL of AIDS patients in China, suggesting that the contribution of social capital should be fully exploited, especially with enhancement of QoL through social participation. Social capital development policy may be worthy of consideration.     

Health-Related Quality of Life in Patients with Primary Cutaneous Amyloidosis

Background

Primary cutaneous amyloidosis (PCA) is a relatively rare and itchy skin disorder characterized by amyloid deposits in the superficial dermis. The cosmetic disfigurement and severe pruritus dramatically affects the patient’s quality of life. In spite of the prevalence of the disease in China, the quality of life (QoL) impact of the PCA has not been well defined and is the focus of this study.

Objective

To examine the HRQoL of patients with PCA and to evaluate the association between HRQoL scores, disease, and socio-demographic determinants.

Methods

A total of 104 PCA patients and 101 healthy participants completed the questionnaires. HRQoL was measured using dermatology life quality index (DLQI) and SF-36. The socio demographic and clinical data such as age, sex, duration of disease and distribution of lesion pattern were analyzed mainly by hierarchical multiple regression analyses.

Results

Patients with PCA experienced significantly impaired health-related quality of life. The mean DLQI score was 9.05. Younger age, female gender, more pruritus and distribution pattern were independent predictor correlates of the high DLQI scores. The PCA group showed significantly decreasing average scores in several aspects of psychological symptoms, including SF, RE and MH.

Conclusions

PCA disease has a negative impact on the HRQoL of patients, and the HRQoL is associated with various disease characteristics. In conjunction with medical interventions, psychological and sociocultural assessment and intervention should be an essential part of the management of these cases.