Integration of health services improves multiple healthcare outcomes among HIV-infected people who inject drugs in Ukraine. Quality of life in Brazil: normative values for the Whoqol-bref in a southern general population sample A comparison of the WHOQOL-100 and the WHOQOL-BREF in detecting change in quality of life following liver transplantation Correlation between changes in quality of life and symptomatic improvement in Chinese patients switched from typical antipsychotics to olanzapine Exercise is associated with better quality of life in patients on TSH-suppressive therapy with levothyroxine for differentiated thyroid carcinoma. Community-based treatment for opioid dependent offenders: a pilot study. A randomized, controlled trial of fall prevention programs and quality of life in older fallers. Changes in quality of life in chronic psychiatric patients: A comparison between EuroQol (EQ-5D) and WHOQoL Metformin improved health-related quality of life in ethnic Chinese women with polycystic ovary syndrome Acceptance and Commitment Therapy and yoga for drug-refractory epilepsy: A randomized controlled trial Determinants of objective and subjective quality of life in first-time-admission schizophrenic patients in Poland: a longitudinal study
BACKGROUND People who inject drugs ( PWID ) experience poor outcomes and fuel HIV epidemics in middle-income countries in Eastern Europe and Central Asia . We assess integrated/co-located ( ICL ) healthcare for HIV-infected PWID , which despite international recommendations , is neither widely available nor empirically examined . METHODS A 2010 cross-sectional study r and omly sample d 296 HIV-infected opioid-dependent PWID from two representative HIV-endemic regions in Ukraine where ICL , non-co-located ( NCL ) and harm reduction/outreach ( HRO ) setting s are available .  ICL setting s provide onsite HIV , addiction , and tuberculosis services , NCLs only treat addiction , and HROs provide counseling , needles/syringes , and referrals , but no opioid substitution therapy ( OST ) . The primary outcome was receipt of quality healthcare , measured using a quality healthcare indicator ( QHI ) composite score representing percentage of eight guidelines -based recommended indicators met for HIV , addiction and tuberculosis treatment . The secondary outcomes were individual QHIs and health-related quality -of-life ( HRQoL ) . RESULTS On average , ICL- participants had significantly higher QHI composite scores compared to NCL- and HRO- participants ( 71.9 % versus 54.8 % versus 37.0 % , p<0.001 ) even after controlling for potential confounders . Compared to NCL- participants , ICL- participants were significantly more likely to receive antiretroviral therapy ( 49.5 % versus 19.2 % , p<0.001 ) , especially if CD4 ≤ 200 ( 93.8 % versus 62.5 % p<0.05 ) ; guideline -recommended OST dosage ( 57.3 % versus 41.4 % , p<0.05 ) ; and isoniazid preventive therapy ( 42.3 % versus 11.2 % , p<0.001 ) . Subjects receiving OST had significantly higher HRQoL than those not receiving it ( p<0.001 ) ; however , HRQoL did not differ significantly between ICL- and NCL- participants . CONCLUSIONS These findings suggest that OST alone improves quality -of-life , while receiving care in integrated setting s collectively and individually improves healthcare quality indicators for PWID Purpose Normative data for WHOQOL-bref are scarce in the literature and unavailable in Latin American countries . The main objective of this study was to provide normative scores of WHOQOL-bref in a general population sample in Brazil and to describe differences in mean scores according to some socio-demographic characteristics . Methods WHOQOL-bref was applied to a r and omly selected sample of the general population of Porto Alegre . Participants were literate people aged 20 to 64 years . The question naires were self-administered in the presence of an interviewer in the respondent ’s home . Results The response rate was 68 % , and the final sample contained 751 respondents ( 38 % men , 62 % women ) .  Low quality of life was observed in the following subgroups : female gender , lower economic class , lower educational level , and the subgroup reporting a chronic medical condition . The mean scores of the WHOQOL-bref and percentiles of scores are reported as normative data for the general population . Conclusion Our results can be useful to research ers using the WHOQOL-bref to compare their results with normative data from a r and omly selected sample of general population . Additionally , the ability of WHOQOL-bref to discriminate different population subgroups makes it an important tool to identify vulnerable groups in epidemiological surveys The World Health Organization has recently produced a generic quality of life measure – the WHOQOL-100 , together with an abbreviated version , the WHOQOL-BREF . Preliminary data suggest that the WHOQOL BREF provides a valid and reliable alternative to the lengthier WHOQOL-100 . In the present study , the sensitivity to change of both versions was tested pre- and 3 months post liver transplantation in fifty patients and also in twenty-one non-transplanted liver disease controls .  Quality of Life domains on both measures were highly correlated , and were sensitive to change following transplant and remained stable on repeat assessment in non-transplanted control patients . However , the sensitivity to change was significantly reduced for the Social domain in the WHOQOL BREF . It is concluded that the WHO-QOL-BREF is a useful alternative to the WHOQOL-100 in evaluating quality of life improvement following major therapeutic interventions for Physical , Psychological and Environmental domains of life quality . However , research ers interested in measuring the Social aspects of life quality may be best advised to use the lengthier WHOQOL-100 Purpose The aim of this study was to investigate the correlation between changes in symptoms and changes in self-reported quality of life among Chinese patients with schizophrenia who were switched from a typical antipsychotic to olanzapine during usual outpatient care . Patients and methods This post hoc analysis was conducted using data from the Chinese subgroup ( n=475 ) of a multicountry , 12-month , prospect i ve , noninterventional , observational study . The primary publication previously reported the efficacy , safety , and quality of life among patients who switched from a  typical antipsychotic to olanzapine . Patients with schizophrenia were included if their symptoms were inadequately controlled with a typical antipsychotic and they were switched to olanzapine .  Symptom severity was measured using the Brief Psychiatric Rating Scale ( BPRS ) and the Clinical Global Impressions-Severity scale ( CGI-S ) . Health-Related Quality of Life ( HRQOL ) was assessed using the World Health Organization Quality of Life – Abbreviated ( WHOQOL-BREF ) . Paired t-tests were performed to assess changes from baseline to endpoint . Pearson ’s correlation coefficients ( r ) were used to assess the correlations between change in symptoms ( BPRS and CGI-S scores ) and change in HRQOL ( WHOQOL-BREF scores ) . Results Symptoms and HRQOL both improved significantly over the 12 months of treatment ( P<0.001 ) . Significant correlations were observed between changes from baseline to end of study on the BPRS and the CGI-S and each of the WHOQOL-BREF four domain scores and two overall quality -of-life questions . The correlation coefficients ranged from r=−0.45 to r=−0.53 for the BPRS and WHOQOL-BREF . The correlation coefficients were slightly smaller between the CGI-S and WHOQOL-BREF , ranging from r=−0.33 to r=−0.40 . Conclusion For patients with schizophrenia , assessing quality of life has the potential to add valuable information to the clinical assessment that takes into account the patient ’s own perspective of well-being OBJECTIVE To evaluate if a supervised exercise training program improves the quality of life ( QoL ) of differentiated thyroid carcinoma ( DTC ) patients on TSH-suppressive therapy with levothyroxine ( L-T4 ) . SUBJECTS AND METHODS Initially , a cross-sectional study was performed to compare the QoL and the health-related quality of life ( HRQoL ) between sub clinical hyperthyroidism ( SCH ) patients ( n = 33 ) and euthyroid subjects ( EU ; n = 49 ) . In the prospect i ve phase of the study , SCH patients were r and omized in a non-blinded fashion to either participate ( SCH-Tr = trained patients ; n = 16 ) or not ( SCH-Sed = untrained patients ; n = 17 ) in a supervised exercise training program . The exercise program consisted of 60 minutes of aerobic and stretching exercises , twice a week , during twelve weeks . The QoL was assessed by the application of the WHOQOL-Bref , and the SF-36 was used to assess the HRQoL. RESULTS SCH patients had statistically lower scores than EU on the " physical " domain of WHOQOL-Bref , besides " physical function " , " role-physical " , " bodily pain " , " general health " , " vitality " , " role-emotional " , and " mental-health " domains of SF-36 . After three months , SCH-Tr patients showed improvement in the " physical " and " psychological " domains of WHOQOL-Bref ( p < 0.05 ) , and in the " physical function " , " role-physical " , " bodily pain " , " vitality " and " mental health " domains of SF-36 . CONCLUSION Patients on TSH-suppressive therapy with L-T4 for DTC had impaired QoL and HRQoL compared to EU , but it was improved after 3-months of an exercise training program . Exercise seems to play an important role in the follow-up of DTC patients , since it seems to minimize the adverse effects of the treatment on QoL and BACKGROUND Primary care opioid substitution treatment ( OST ) has not been compared to program-based OST for community-supervised offenders . OBJECTIVE The purpose of this project was to compare primary care to specialist supervised OST for opioid dependent offenders in terms of substance use and HIV risk outcomes . METHODS This project r and omly assigned 15 jail diversion participants to either : ( i ) primary care buprenorphine OST , ( ii ) specialist facility buprenorphine OST , or ( iii ) specialist facility methadone OST . Participation lasted 13.5 months ( 12-month active treatment plus a post-participation visit ) . RESULTS All subjects endorsed 0 days of opioid use in the previous 14 at follow-up . Specialty care reduced HIV risk ( Risk Assessment Battery composite score ) over 6 months ( -.24 ± .17 ) compared to primary care ( .02 ± .14 ; p = .032 ) . CONCLUSION Findings support primary care OST feasibility for a community-supervised offender sample . Specialist care may facilitate improvements in secondary outcomes , such as HIV risk behaviors . SCIENTIFIC SIGNIFICANCE Further research is needed to clarify ( i ) the role of primary care in addicted offender management , and ( ii ) the matching of offenders , based upon history and co-morbidity , to care coordination conditions OBJECTIVES To compare the effects of three fall-prevention programs ( education ( ED ) , home safety assessment and modification ( HSAM ) , and exercise training ( ET ) ) on quality of life ( QOL ) , functional balance and gait , activities of daily living ( ADLs ) , fear of falling , and depression in adults aged 65 and older . DESIGN A 4-month r and omized trial . SETTING R and omized , controlled trial . PARTICIPANTS One hundred fifty participants who had experienced a recent fall . MEASUREMENTS QOL was assessed according to the brief version of the World Health Organization Quality of Life instrument ( WHOQOL-BREF ) , functional balance and gait according to functional reach and Tinetti balance and gait , ADLs according to the Older Americans Re sources and Services question naire , fear of falling according to a visual analog scale , and depression level according to the Geriatric Depression Scale . RESULTS The score changes for the ET group were 2.1 points greater on the physical domain ( 95 % confidence interval (CI)=-1.2 - 5.3 ) , 3.8 points greater on the psychological domain ( 95 % CI=0.7 - 7.0 ) , and for the WHOQOL-BREF , 3.4 points greater on the social domain ( 95 % CI=0.7 - 6.1 ) and 3.2 points greater on the environmental domain ( 95 % CI=0.6 - 5.7 ) than for the ED group . The score change for each domain of the WHOQOL-BREF for the HSAM group was greater than that for the ED group , although these results were not statistically significant . The ET group also had greater improvements in functional reach , Tinetti balance and gait , and fear of falling than the ED group . CONCLUSION The QOL outcome supports the superiority of ET over the other two interventions in older people who have recently fallen . This finding also parallels those gathered from the functional measures It has often been postulated that simple , short question naires are unable to reflect complex changes in well-being of individuals with chronic psychiatric disorders . To investigate these assumptions we included two recently developed instruments to measure quality of life  ( the WHOQoL-Bref and the EuroQoL EQ-5D ) in a r and omised control trial ( RCT ) in which two treatment conditions were compared . Aims of the study were to assess the sensitivity and validity of these  quality of life (QoL)-instruments  , to establish their relationship and to examine the predictors of changes in QoL. Subjective changes in QoL were measured on three assessment s waves in a period of 18 months and compared to objective changes in psychopathology and social functioning in a sample of 76 chronic schizophrenic patients who participated in the RCT . Results indicated that both WHOQoL-Bref and EuroQoL EQ-5D are capable of detecting changes in QoL over time in physical and psychological well-being . The instruments partly measure the same aspects of QoL , indicated by 50 % common variance on total scores . Reduction of positive psychotic symptoms appeared to be the most important factor in improving QoL. The weighted TTO-score of EuroQoL-5D , which is often used as an index in economic evaluations of health care , did however not correspond with these changes , which indicates that it is less sensitive to changes in social and psychological well-being . It ’s use as the core measure in ( economic ) health evaluation in the field of psychiatry therefore seems less appropriate Background Few studies have assessed whether the amelioration of the clinical signs of polycystic ovary syndrome ( PCOS ) achieved by treatment leads to improvement in the health-related quality of life ( HRQoL ) of patients . This study was aim ed to examine the HRQoL of ethnic Chinese women with PCOS who received metformin treatment .  Methods This prospect i ve study was conducted at a medical center in Taiwan . Study participants aged 18–45 years were diagnosed as having PCOS according to the Rotterdam criteria , and all received metformin treatment .  Their HRQoL was assessed using generic ( WHOQOL-Bref ) and PCOS-specific ( Chi-PCOSQ ) instruments . Mixed effect models were used to examine the effects of metformin on repeatedly measured HRQoL. Additional analyses using stratified patients characteristics ( overweight vs. normal ; hyper and rogenism vs. non-hyper and rogenism ) were done . Results We recruited 109 participants ( 56 % were overweight , 80 % had hyper and rogenism ) . Among the domain scores of WHOQOL-Bref , the psychological domain score was the lowest one ( 12.64 ± 2.2 , range 4–20 ) . Weight ( 3.25 ± 1.59 , range 1–7 ) and infertility ( 3.38 ± 1.93 , range 1–7 ) domain scores were relatively low among the domain scores of Chi-PCOSQ . Overweight and hyper and rogenic patients had significantly lower HRQoL as compared with those of normal weight and non-hyper and rogenic patients , respectively . Metformin significantly improved the physical domain of WHOQOL-Bref ( p = 0.01 ) , and the infertility ( p = 0.043 ) and acne and hair loss aspects ( p = 0.008 ) of PCOS-specific HRQoL. In the subgroup analysis , significantly improved HRQoL  following metformin treatment appeared for only overweight and hyper and rogenism subgroups . Conclusions Metformin might improve health-related quality of life of polycystic ovary syndrome women  by ameliorating psychological disturbances due to acne , hair loss and infertility problems , especially for overweight and hyper and rogenic patients OBJECTIVE There is a need for controlled outcome studies on behavioral treatment of epilepsy . The purpose of this study was to evaluate Acceptance and Commitment Therapy ( ACT ) and yoga in the treatment of epilepsy . METHODS The design consisted of a r and omized controlled trial with repeated measures ( N=18 ) . All participants had an EEG-verified epilepsy diagnosis with drug-refractory seizures . Participants were r and omized into one of two groups : ACT or yoga . Therapeutic effects were measured using seizure index ( frequency x duration ) and quality of life ( Satisfaction with Life Scale , WHOQOL-BREF ) . The treatment protocol s consisted of 12 hours of professional therapy distributed in two individual sessions , two group sessions during a 5-week period , and booster sessions at 6 and 12 months posttreatment . Seizure index was continuously assessed during the 3-month baseline and 12-month follow-up . Quality of life was measured after treatment and at the 6-month and 1-year follow-ups . RESULTS The results indicate that both ACT and yoga significantly reduce seizure index and increase quality of life over time . ACT reduced seizure index significantly more as compared with yoga . Participants in both the ACT and yoga groups improved their quality of life significantly as measured by one of two quality -of-life instruments . The ACT group increased their quality of life significantly as compared with the yoga group as measured by the WHOQOL-BREF , and the yoga group increased their quality of life significantly as compared with the ACT group as measured by the SWLS . CONCLUSIONS The results of this study suggest that complementary treatments , such as ACT and yoga , decrease seizure index and increase quality of life Objectives This study involved a naturalistic , prospect i ve project assessing objective and subjective dimensions of quality of life ( QoL ) and the range of its putative determinants in first-episode schizophrenia . Methods Seventy-four patients , mean age 24.7 years , participated in the study . The patients were assessed 1 month following the first hospitalisation ( Time 1 ) , 12 months later ( Time 2 ) , and 4–6 years after Time 1 ( Time 3 ) . The Social Functioning Scale and World Health Organisation Quality of Life-BREF ( WHOQOL-BREF ) were applied to evaluate objective and subjective QoL , respectively . The Positive and Negative Syndrome Scale was used to examine psychopathological status , and the Global Assessment Scale was applied to evaluate social adjustment prior to hospitalisation . Results The objective and subjective QoL was relatively low at Time 1 . Over time , the objective QoL improved in three domains , decreased in one domain , and remained stable in three domains . The subjective QoL did not change . The most important predictors of both dimensions of QoL were psychopathology and duration of untreated psychosis . Conclusions Because psychopathology seems to have the greatest impact on the QoL , there is a need to develop community psychosocial treatment to reduce these symptoms and to support patients in the early phase of the disease
Dosage of pharmacologic medication and length of follow-up did not affect changes in domain scores .
WHOQOL-BREF and ASI domain scoring is a useful tool in measuring overall quality of life and levels of addiction among OST participants .
BACKGROUND Opioid substitution treatment ( OST ) can increase quality of life ( WHOQOL-BREF ) and reduce addiction severity index ( ASI ) scores among participants over time .
OST program participants have noted that improvement in quality of life is one of the most important variables to their reduction in drug use .
However , there is little systematic underst and ing of WHOQOL-BREF and ASI domain changes among OST participants in low and middle-income countries ( LMIC ) .