Browsing by Subject "Health-Related Quality of Life"
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Item At what age can children reliably and validly self-report their health-related quality of life? An investigation using the PedsQL(tm) 4.0 Generic Core Scales Database(2009-05-15) Limbers, Christine A.Health-related quality of life (HRQOL) assessment has emerged as a vital health outcome measure in clinical trials, healthcare services and evaluation, and population health outcomes research. Reliability, validity, and parent-child agreement of the PedsQL? 4.0 Generic Core Scales were examined using child self-report and parent proxy-report age subgroup data on over 8,000 children ages 5-16 years from the PedsQL 4.0 Generic Core Scales DatabaseSM. The PedsQL? 4.0 Generic Core Scales demonstrated good internal consistency reliability for children as young as 5 years; healthy children across the age subgroups demonstrated a statistically significant difference in HRQOL (better HRQOL) than children with a known chronic health condition. Confirmatory factor analysis demonstrated that a 5-factor model fit almost identically across the age subgroups, providing further evidence that children as young as 5 years are reliable and valid self-reporters of their HRQOL. Parent-child agreement was in the moderate-to-good range, with parents reporting significantly higher PedsQL? 4.0 scores across the age subgroups. In conclusion, the analyses support the reliability and validity of child self-report in children as young as 5 years old.Item Disease-Specific Symptoms and Health-Related Quality of Life in Children and Adolescents with Inflammatory Bowel Disease(2013-07-17) Vaughan-Dark, Chelsea AnnThis study assesses generic and disease-specific Health-Related Quality of Life (HRQOL) in children and adolescents with Inflammatory Bowel Disease (IBD). More specifically, the purpose of the study is to address the relationship between disease- specific indicators, both on a symptom-by-symptom basis and as a whole, to overall HRQOL. Self- and proxy-report versions of the Pediatric Quality of Life Inventory? (PedsQL?) Generic Core Scales and the newly developed Pediatric Quality of Life Inventory? Gastrointestinal Symptoms Module were administered to 187 parent-child dyads at ten study sites across the United States. Disease-specific indicators included: stomach pain, stomach upset, trouble swallowing, heartburn and reflux, gas and bloating, constipation, and diarrhea. It was hypothesized that caregiver- and child-reported disease-specific HRQOL would be positively correlated with generic HRQOL, and that physical disease-specific indicators would contribute the greatest variance in total generic HRQOL scores, for both self and proxy report. Results confirmed the hypothesis that disease-specific HRQOL would be positively correlated with generic HRQOL for children and caregivers. Multivariate regression results revealed that the Stomach Pain and Hurt, Worry, Medicines, and Communication scales contributed the most variance to overall HRQOL scores for children. The same analysis performed for parent ratings yielded one statistically significant scale: Worry. In essence, intervention efforts aimed at reducing the influence of worry and anxiety may prove more effective in improving HRQOL outcomes than interventions targeting reduction of physical symptoms.Item Evaluation of the relationship between Body Mass Index (BMI) and healthcare cost, utilization and health-related quality of life in adult diabetic patients(2014-05) Adeyemi, Ayoade Olayemi; Rascati, Karen L.The present study assessed the relationship between Body Mass Index (BMI) and healthcare cost, utilization and health-related quality of life (HRQoL) of type 2 diabetes patients using the Medical Expenditure Panel Survey (MEPS) database. Study subjects were at least 18 years of age, diagnosed with diabetes and taking ≥1 oral antidiabetic medication. Data were extracted over a 5-year period (01/01/2006-12/31/2010). The main study outcomes were healthcare costs and utilization and HRQoL. The study covariates were age, gender, race, smoking status, census region of residence, marital status, insurance status, Charlson comorbidity index score and additional bed days. Study objectives were addressed using generalized linear model, negative binomial and multivariate regression analyses. A final un-weighted sample size of 7,003 patients was obtained. Mean age (±SE) was 61.2 (±0.24) years, mean BMI (±SE) was 32.2 (±0.12), and 50.4% were males. The majority was white (77.4%), did not smoke (84.5%), and were married (60.4%). Based on BMI categories, 12.6% had normal weight (BMI: 18.0-24.9); 29.2% were overweight (BMI: 25.0-29.9); 45.6% were obese (BMI: 30.0-39.9), and 12.6% were morbidly obese (BMI≥ 40.0). Compared to normal-weight patients; overweight, obese or morbidly obese patients had significantly higher (p<0.05) diabetes-related direct medical costs. However, overweight patients had significantly lower (p=0.021) all-cause direct medical costs. Furthermore, compared to normal weight patients, obese patients had a significantly higher (p=0.009) number of ambulatory care visits, while overweight patients had a significantly lower (p=0.035) number of emergency department visits. In addition, being obese or morbidly obese was associated with a significantly higher (p<0.0001) number of prescribed medicines compared to normal-weight patients. Compared to normal-weight patients; being obese or morbidly obese was also significantly (p<0.0001) associated with lower physical component summary (PCS-12) scores (i.e., worse quality of life) while being overweight was significantly (p=0.038) associated with higher mental component summary (MCS-12) scores (i.e., better quality of life). In conclusion, the present study suggests that among type 2 diabetes patients, being obese may be associated with negative consequences (in terms of healthcare costs, utilization and outcomes). Hence, there is the need to address obesity among type 2 diabetes patients in order to improve their health outcomes and significantly reduce healthcare costs and resource utilization.