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At least 19 recordsLinked to original sources

PubMedDate not supplied

[Life planning--consequences of a steadily growing life span 1650-2000. Considering the longer life span, do we need a life plan?].

Recent social historical studies on the development of life expectancy over the last 300-400 years have shown that the increasing certainty that the great majority of us will be able to live relatively healthy lives until the end is more decisive for most people than the lengthening of the life span itself. A premature death is no longer--as in previous generations--the rule. Today it is the exception. In an historical and worldwide context, we are the first who will--or could--be able to live our lives from the perspective of a relatively calculable, distant end. In order to do this to a greater degree and, above all, more consciously, a "life design" or "life plan" seems to be necessary. This means developing, as early in life as possible, the types of interests that will last a whole life long and will provide fulfillment, particularly in the "Fourth Age". The period of maturity (and waning activity) should not then be one of insufferable emptiness. "Maturity of life" can mean a chance and a goal for most of us today, provided that we structure this life appropriately ourselves. Contributions to discussions in this context in the USA and in two research-related seminars at the Free University of Berlin are presented.

Aged↗

PubMed2003

Quality of life philosophy I. Quality of life, happiness, and meaning in life.

In the Danish Quality of Life Survey, we asked 10,000 people about their quality of life with the validated SEQOL questionnaire with more than 300 questions on their quality of life. How did they feel? How content were they with their lives? How happy were they? Did they feel their needs were fulfilled? And many more questions. We asked the questions we believed to be important for their quality of life (QOL). The results were quite surprising and forced us to recontemplate the following philosophical questions: What is quality of life, happiness, and meaning in life? What is a human being? Do we need a new biology? Is the brain the seat of consciousness? How do we seize the meaning of life and by doing so, will we become well again? What are the key concepts of quality of life? The meaning of life is connectedness and development. It is about realizing every opportunity and potential in one"s existence. The opportunities must be found and acknowledged. What do you find when you find yourself deep down? You find your real self and your purpose in life. You realize that you are already a part of a larger totality. Antonovsky called it "coherence". Maslow called it "transcendence". Frankl called it "meaning of life". We call it simply "being". To test if these philosophical questions are actually relevant for medicine, we looked at the consequences for patients being taught the quality of life philosophy. Quite surprisingly we learned from our pilot studies with "quality of life as medicine" that just by assimilating the basic concepts of the quality of life philosophy presented in this series of papers, patients felt better and saw their lives as more meaningful. The improvement of the patient"s personal philosophy of life seems to be the essence of holistic medicine, helping the patient to assume more responsibility for his or her own existence.

Denmark↗

PubMed2006

What influence do major events in life have on our later quality of life? A retrospective study on life events and associated emotions.

BACKGROUND: To examine associations between global quality of life (QOL) and major life events. MATERIAL/METHODS: This was a retrospective study using the self-administrated expanded SEQOL questionnaire with questions on life events and connected emotions. Seven hundred forty-six people, 55-66 years old, from a representative sample of the Danish population participated. Global QOL was measured by SEQOL (self-evaluation of quality of life), containing eight global QOL measures: well-being, life-satisfaction, happiness, fulfillment of needs, experience of temporal and spatial domains, expression of life's potentials, and objective factors. RESULTS: Life events related to health such as restraints of movement or psychological illness showed a major association with the quality of life. Most other associations between quality of life and life events were intermediate or minor. CONCLUSIONS: Quality of life cannot simply be determined by life events. Actual quality of life is determined by how all the events of life have been processed and integrated in the consciousness. The results seem to support the idea that global QOL can be efficiently improved by integrating the painful events of the past. Since several studies have shown correlations between QOL and health, it is likely that such an improvement in QOL will also cause improved health and ability.

Aged↗

PubMed2003

Quality of life theory II. Quality of life as the realization of life potential: a biological theory of human being.

This review presents one of the eight theories of the quality of life (QOL) used for making the SEQOL (self-evaluation of quality of life) questionnaire or the quality of life as realizing life potential. This theory is strongly inspired by Maslow and the review furthermore serves as an example on how to fulfill the demand for an overall theory of life (or philosophy of life), which we believe is necessary for global and generic quality-of-life research. Whereas traditional medical science has often been inspired by mechanical models in its attempts to understand human beings, this theory takes an explicitly biological starting point. The purpose is to take a close view of life as a unique entity, which mechanical models are unable to do. This means that things considered to be beyond the individual's purely biological nature, notably the quality of life, meaning in life, and aspirations in life, are included under this wider, biological treatise. Our interpretation of the nature of all living matter is intended as an alternative to medical mechanism, which dates back to the beginning of the 20th century. New ideas such as the notions of the human being as nestled in an evolutionary and ecological context, the spontaneous tendency of self-organizing systems for realization and concord, and the central role of consciousness in interpreting, planning, and expressing human reality are unavoidable today in attempts to scientifically understand all living matter, including human life.

Human Development↗

PubMed2003

Measurement of quality of life VI. Quality-adjusted life years (QALY) is an unfortunate use of the quality-of-life concept.

The QALY (quality-adjusted life years) attempts to incorporate the dimension of quality of life into the evaluation by adjusting life years by a quality factor. In practice, this is based on discussing with people the progression of a number of hypothetical illnesses and their ensuing side effects. From this information, the person assesses how each state of health described compares with a theoretical maximum state of health. For example, 1 day with a certain condition might the equivalent of living only 0.5 days in good health. We believe that QALY value only represents a superficial impression of a person's quality of life. In short, the QALY does not express what it means for a person to live a life at reduced quality. We believe that if the patients were optimally informed and allowed to decide for themselves, they would more often reject high-tech expensive biomedical treatments that only serve to prolong life and do not increase its quality. The problem of priorities may then turn out to be far more simple and also more ethical: the focus will be on the quality of life, not on QALY, and the question of the meaning of life and death will achieve greater openness and respect.

Human Development↗

PubMedDate not supplied

[Quality of life at the end of life. Analysis of the quality of life of oncologic patients treated with palliative care. Results of a multicenter observational study (staging)].

Outcome in palliative care can be defined as patients' quality of life, quality of death and satisfaction with care. In an Italian multicentre prospectic study ('Staging') the quality of life of 571 palliative care patients with advanced cancer disease was assessed since the beginning of palliative care till the end of the study. We analyzed the tissue of quality of life missing data and the possibility to input the missing quality of life evaluation through the quality of life evaluation made by a proxy (doctor, nurse). The greatest functional impairment and an increasing level of some symptoms (fatigue, general malaise, emotional status) were observed during the last two weeks of life, whereas for other symptoms (gastro-intestinal, pain) some degree of control was possible. The quality of life analysis for palliative care patients should consider the different response of different quality of life components to the palliative care intervention.

Aged↗

PubMedDate not supplied

[Life events, quality of life and social support prior to acute cerebral vascular disease, as predictive factors of the quality of life and functional state following stroke].

INTRODUCTION: The repercussion of stroke on quality of life has been evaluated but not the possible relation between the quality of life before and months after an acute stroke. OBJECTIVE: To study the possible relation between quality of life, social support, stressful life events prior to the stroke and quality of life, social support and functional state months after. PATIENTS AND METHODS: A prospective study was made of 34 patients (71.7 +/- 8 years; 19 (56%) men; 15 (44%) women with stroke, by means of two evaluations: personal interview within the first 36 hours (quality of life--Nothingham health profile (NHP)-, perception of social support and stressful life events--Holmes and Rake inventory-) and an interview over the phone 16.5 +/- 5.3 months after the stroke (NHP, perception of social support and functional state--Rankin scale-). RESULTS: Following the stroke there was deterioration in perception of social support (19.8 +/- 3 vs 12.5 +/- 8; p = 0.000) and in the degree of social isolation of the NHP (9.4 +/- 20 vs 21.1 +/- 30; p = 0.03). The only relation found was between the following variables: pain at the first evaluation and pain (r = 0.45; p = 0.007) at the second evaluation; mobility at the first evaluation and emotional state (r = 0.39; p = 0.029) and social support (r = 0.37; p = 0.027) at the second evaluation; sleepiness at the first evaluation and energy (r = 0.55; p = 0.0006), pain (r = 0.39; p = 0.022), emotional state (r = 0.35; p = 0.038), mobility (r = 0.34, p = 0.048) and sleepiness (r = 0.51; p = 0.001) at the second evaluation. CONCLUSION: Our results indicate that there is little relationship between the previous state and that following stroke, and that the deterioration in perception of support and social isolation is due to the stroke itself.

Affect↗

PubMed1996

[Life change event--life history--life plant: psychopathologic and forensic aspects].

The life history approach-obsolete in biological psychiatry but given a new lease of life in psychology-embraces perspectives for the future. In clinical psychopathology it is advisable to limit consideration of the life history to past events and processes. Readiness for the future and development are more appropriately dealt with in the framework of the life plan, where life movement are concentrated and where most disturbances occur. The criminal life plan and the effect of life events are used to illustrate this point.

Adolescent↗

PubMed1995

The life attitudes schedule: a scale to assess adolescent life-enhancing and life-threatening behaviors.

The purpose of this study was to develop a questionnaire to measure suicidal and other risk-taking behaviors, the Life Attitudes Schedule (LAS), and to test a theoretical model that postulates a single domain of behaviors to which all life-threatening and life-enhancing behaviors belong. The LAS was developed and piloted on 1539 high school students and young adults. The schedule measures four different content categories: death related, health related, injury related, and self-related. Each content category includes an equal number of items designed to assess actions, thoughts, and feelings. Consistent with the theoretical model, the LAS includes positive (life-enhancing) and negative (life-threatening) behaviors. In this paper we present psychometric information for the LAS. The results are interpreted as providing support for a broad, bipolar conceptualization of suicidal and other risk-taking behavior that encompasses life-threatening and life-enhancing behaviors.

Adolescent↗

PubMed1998

[Successful coping with declining objective life style by institutionalized long-term patients. Results of a follow-up analysis of quality of life in long-term care institutions with the Zurich Quality of Life Inventory].

Measurement of quality of life in institutionalized frail patients is difficult considering the high prevalence of dementia. The Zurich quality of life inventory was developed specifically for this purpose and applied to describe longitudinally 103 institutionalized long-term care patients 3-12 months after entry: 11 slow-stream-rehabilitation patients (SSR), 16 severely dependent patients (ASL), 61 moderately dependent patients (ALL), and 15 young severely dependent patients, all of whom were assessed at least twice. The objective conditions of life deteriorated in all 4 groups, significantly in the SSR and ASL, and with high significance in the whole population from 121 +/- 54 to 139 +/- 58 (P < 0.001). Well-being did not change significantly in any of the groups or overall (from 122 +/- 59 to 117 +/- 54, p = 0.90). Deteriorating life conditions were due to a decline in clinical dementia rating, (p < 0.01) and living space diameter (p < 0.001), whereas the remaining subscores of life condition, i.e., number of falls, days of sickness, life style rating, and all subscores of well-being, i.e., number of medicines, valuation of handicap and of suffering, visual self-rating of well-being and caregivers' stress did not change significantly.

Activities of Daily Living↗

PubMed2003

Life at the end of life: beliefs about individual life after death and "good death" models - a qualitative study.

BACKGROUND: Different ideas of "good death" may influence the effectiveness of end-of-life care in patients with different ethos. This study aimed to identify the influence of believing in individual life after death on "good death" models. METHODS: Semi structured-interview to 8 persons, 4 believers and 4 non-believers in individual life after death from the general Italian population. Analysis of the transcribed text according to the method suggested by Mc Cracken. RESULTS: The analysis has shown a diverse and coherent conceptualization of death according to whether the subjects believe or not in individual life after death. Believers, for whom death marks the passage to a new dimension, prefer to be unaware of dying, while non-believers, for whom death is the end of the individual, prefer to be conscious until the very end of life. However some important aspects in common have been identified, i.e. having close people nearby, receiving assistance from experts, or the preference for a soft atmosphere around the dying person. CONCLUSION: There are aspects in common and aspects in contrast between believers and non-believers in individual life after death: while sharing many aspects of what a "good death" ought to be, they have opposite stands on being aware of dying. A plurality of models should be foreseen, accepting, in this case, their practical and theoretical implications.

Awareness↗

PubMed1998

The relationship between objective life status and subjective life satisfaction with quality of life.

A locally developed quality of life inventory was used to examine the relationship between objective life status and subjective satisfaction with quality of life in 8,550 participants from Hunan, China. The inventory included 112 items in 4 dimensions-physical health, psychological health, social functional status, and living conditions. Objective life status was the principal factor affecting subjective satisfaction, but discrepancies were found in some participants, especially when objective status was at the extremes of the distribution. Young, urban, or more educated participants with higher scores on objective status often had lower subjective satisfaction scores in spite of comparatively high objective status scores. Participants who ranked lower on objective status (old, rural, or less educated people) sometimes ranked higher in subjective satisfaction. Scores for subjective satisfaction always showed a normal distribution, whatever the objective satisfaction of the population. Divergence between individual objective status and subjective satisfaction was associated with hierarchy of life needs and the reference standards used for the comparison.

Adult↗

PubMed1999

Quality of life in patients with vertebral fractures: validation of the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO). Working Party for Quality of Life of the European Foundation for Osteoporosis.

Vertebral fractures may be minor or lead to pain, decreased physical function, immobility, social isolation and depression, which together contribute to quality of life. A Working Party of the European Foundation for Osteoporosis has developed a specific questionnaire for patients with vertebral fractures. This questionnaire, QUALEFFO, includes questions in the domains pain, physical function, social function, general health perception and mental function. QUALEFFO was validated in a multicenter study in seven countries. The study was done in 159 patients aged 55-80 years with clinical osteoporosis, i.e., back pain and other complaints with at least one vertebral fracture and lumbar bone mineral density T-score <-1. Patients with a recent vertebral fracture were excluded because of unstable disease. Controls were age- and sex-matched, and did not have chronic back pain or vertebral fractures. Subjects with conditions exerting a major influence on quality of life were excluded. The QUALEFFO was administered twice within 4 weeks and compared with a generic questionnaire, the Short Form 36 of the Medical Outcomes Study (SF-36). Standard spinal radiographs were made for assessment of vertebral height. Seven questions were removed from the analysis because of low response rate, linguistic ambiguities or redundancy. The 41 remaining questions were analyzed for repeatability, internal consistency and the capacity to discriminate between patients with vertebral fractures and controls. Comparison with the SF-36 was performed within similar domains by conditional logistic regression and by receiver operating characteristic (ROC) curves. The repeatability of QUALEFFO was good (kappa statistics 0.54-0.90) and 26 of 41 questions had a kappa score >/=0.70. The internal consistency of the five domains was adequate, with Crohnbach alpha around 0.80. All except five questions discriminated significantly between patients and controls. The median scores of QUALEFFO were significantly higher in patients with vertebral fractures than in controls in all five domain (p<0. 001), which is consistent with decreased quality of life in patients with osteoporosis. Spinal radiographs were assessed using the McCloskey-Kanis algorithm. According to this, 124 patients (78%) had vertebral fractures of >/=3 SD severity, in contrast with 7 controls (4%). Significant correlations existed between scores of similar domains of QUALEFFO and the SF-36, especially for pain, physical function and mental function. All five domains within each questionnaire discriminated significantly between fracture cases and controls. The odds ratios for pain and social function were greater for QUALEFFO, while general health perception was more discriminating using the SF-36. The ROC curve analysis of QUALEFFO indicated that all five domains were significantly predictive of vertebral fractures. When comparing similar domains of the two questionnaires, QUALEFFO domains demonstrated significantly better performance for pain, physical function and social function. The QUALEFFO total score and SF-36 physical composite score showed similar performance. In conclusion, QUALEFFO is repeatable, coherent and discriminates well between patients with vertebral fractures and control subjects. The results of this study confirm the decreased quality of life in patients with vertebral fractures.

Aged↗

PubMed2001

Comparison of three generic questionnaires measuring quality of life in adolescents and adults with cystic fibrosis: the 36-item short form health survey, the quality of life profile for chronic diseases, and the questions on life satisfaction.

OBJECTIVE: To compare different generic instruments in measuring quality of life and to demonstrate dimensions of quality of life (QL) in patients with cystic fibrosis (CF). METHODS: The short-form-36 health survey (SF-36), the quality of life profile for chronic diseases (PLC), and the questions on life satisfaction (FLZ(M)) were simultaneously employed in a cross-sectional study with 70 adolescents and adults with CF. The different concepts of the measures were compared. Internal consistency (Cronbach's alpha), convergent and construct validity (correlation patterns, common factor analysis), and external validity (correlations with symptom and pulmonary function scores, with intensity of therapy; comparisons with healthy peers) of the three instruments were investigated. RESULTS: Similar reliability, but different validity of the questionnaires are demonstrated. Seventy-three percent of the total variance across the three measures could be explained with a seven-factor-solution: (1) physical functioning (19.3% of total variance), (2) mental health (19.3%), (3) social integration (7.5%), (4) role function/pain (7.5%), (5) economic/material living conditions (7.5%), (6) partnership/family (6.7%) and (7) anxiety (5.2%). DISCUSSION: The different validity of the instruments has to be considered in chosing a questionnaire appropriate to the purpose of measuring. Shortcomings of each instrument can be overcome by multimethod designs and by developing disease-specific scales.

Adolescent↗

PubMed2002

Rock surfaces as life indicators: new ways to demonstrate life and traces of former life.

Life and its former traces can only be detected from space when they are abundant and exposed to the planetary atmosphere at the moment of investigation by orbiters. Exposed rock surfaces present a multifractal labyrinth of niches for microbial life. Based upon our studies of highly stress-resistant microcolonial fungi of stone monument and desert rock surfaces, we propose that microbial biofilms that develop and become preserved on rock surfaces can be identified remotely by the following characteristics: (1) the existence of spectroscopically identifiable compounds that display unique adsorption, diffraction, and reflection patterns characteristic of biogenerated organic compounds (e.g., chlorophylls, carotenes, melanins, and possibly mycosporines), (2) demonstrably biogenic geomorphological features (e.g., biopitting, biochipping, and bioexfoliation), and (3) biominerals produced in association with biofilms that occupy rock surfaces (e.g., oxalates, forsterite, and special types of carbonates, sulfides, and silicates). Such traces or biosignatures of former life could provide macroscopically visible morphotypes and chemically identifiable products uniquely indicative of life.

Australia↗

PubMed2000

Life quality vs the 'quality of life': assumptions underlying prospective quality of life instruments in health care planning.

Quality of Life is a broad construct used in health planning, health economics, and medical decision-making. It is also a term that has a long currency in social and sociological literatures. This paper considers the assumptions underlying prospective QL instruments in an historical and contemporary context. It argues that as a tool in health planning and in clinical decision making life quality as a measurement has its origins in the early eugenics literature and the social policies that derived from it in first North America, the primary focus of this paper, and later in Europe. Reference to narrative and social literatures, as well as those involving coping and adaptation, are then used to critique the assumptions underlying this class of QL instruments. It concludes that to the degree now current prospective instruments reflect a purely physical perspective of "disease burden" irrespective of social conditions they create a context that works against life quality, and in some cases, the continuance of persons with physical differences.

Chronic Disease↗

PubMed2004

[Quality of life and occupational dermatoses--development and evaluation of a questionnaire assessing quality of life with in patients with occupational dermatoses (LIOD--Life Quality Index Occupational Dermatoses)].

BACKGROUND: Quality of life (QOL) is an established parameter in dermatology; it is known that skin diseases can affect QOL adversely. There are no specific questionnaires that consider the consider the effect of occupational factors as triggers for work-related diseases, even though such a questionnaire could link QOL specifically with the work situation. PATIENTS AND METHODS: Based on a literature search and the analysis of existing study instruments, a questionnaire reflecting "Life Quality Index Occupational Dermatoses (LIOD)" was developed and studied in four different groups of persons (N = 228) with and without dermatological diseases. RESULTS: Using the "Guidelines for QOL-assessment in dermatological studies", a test comparing LIOD to established instruments showed a reliability quotient of 0.804. Cronsbach's alpha was 0.898. The logical and discriminate validity were tested and found to be significant. Hypotheses that had been devised while developing the test were confirmed. CONCLUSIONS: The validated LIOD questionnaire is a valuable addition to existing instruments in dermatology. LIOD may be used to gain data reflecting the efficacy of therapeutic strategies comparable to medical data.

Data Collection↗

PubMed2003

Life satisfaction across the life course: evaluations of the most and least satisfying decades of life.

In a recent American study, the decades from ages 20 to 59 were most frequently chosen to be the most satisfying. However, one third of the elderly evaluated a decade in old age to be the most satisfying (Field, 1996). The present study was undertaken to investigate whether this finding could be replicated in a larger, representative sample of elderly Danes. Four cohorts born with an interval of five years, 62 to 77 years old (N = 3207) were asked to point out the most and the least satisfying decades of life. The years from 30 to 39 were most frequently chosen as the most satisfying decade, followed by the adjoining decades. A decade in old age was chosen as the least satisfying by 24% of the participants, while only 8.5% of the participants evaluated old age as the most satisfying period of life. Further analyses were made to examine conditions related to evaluating the present decade as the most or the least satisfying.

Activities of Daily Living↗