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Assessment of Health-Related Quality of Life (HRQoL) in Public Health

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Public Health Statistics and Risk Assessment".

Deadline for manuscript submissions: closed (30 November 2020) | Viewed by 68935

Special Issue Editors


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Guest Editor
Area of Preventive Medicine and Public Health, Faculty of Health Sciences, University of León, 24071 León, Spain
Interests: dietary analysis; lifestyles; cancer; flu
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Universidad de León, Leon, Spain
Interests: Toxicology and public health

Special Issue Information

Dear Colleagues,

At present, it can be considered that the health-related quality of life (HRQoL) is a useful tool for measuring the impact that a disease has on the physical and mental aspects of an individual and to evaluate the efficacy/effectiveness of a treatment or health intervention. The trends of incidence in chronic diseases, the aging of the population, and the improvement of the treatments mean that the HRQoL has important repercussions on public health.

The aim is to create a Special Issue of the journal IJERPH in 2020, covering both general and specific aspects of quality of life assessment.

The issue is open to all researchers or research groups that analyze HRQoL, including papers related to methodological aspects of validation of general or specific HRQoL questionnaires, systematic reviews or original articles that evaluate this problem both in the general population and in a specific disease.

Dr. Tania Fernández-Villa
Prof. Vicente Martín
Guest Editors

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • health-related quality of life
  • methodology
  • validation
  • assessment
  • public health

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Published Papers (20 papers)

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13 pages, 352 KiB  
Article
Health-Related Quality of Life and Family Functioning of Primary Caregivers of Children with Cerebral Palsy in Malaysia
by Kelvin Ying, Hans Van Rostenberghe, Garry Kuan, Mohammad Haris Amirul Mohd Yusoff, Siti Hawa Ali and Nik Soriani Yaacob
Int. J. Environ. Res. Public Health 2021, 18(5), 2351; https://doi.org/10.3390/ijerph18052351 - 28 Feb 2021
Cited by 12 | Viewed by 4393
Abstract
Caregiving for children with cerebral palsy (CP) has proved to negatively impact on the physical and psychological well-being of their primary caregivers. The aim of the current study was to examine the overall impact of caregiving for children with CP on the primary [...] Read more.
Caregiving for children with cerebral palsy (CP) has proved to negatively impact on the physical and psychological well-being of their primary caregivers. The aim of the current study was to examine the overall impact of caregiving for children with CP on the primary caregivers’ health-related quality of life (HRQOL) and family functioning, and to identify potential factors associated with primary caregivers’ HRQOL and family functioning. The cross-sectional study involved a total of 159 primary caregivers of children with CP with a mean age of 42.8 ± 8.4 years. Demographic data and information on the physical and leisure activities of the primary caregivers were collected, and their quality of life (QOL) was measured based on the self-reported Pediatric Quality of Life Inventory Family Impact Module (PedsQL FIM). Primary caregivers in the current study have shown good HRQOL and family functioning, with scores of 82.4 and 85.3 out of 100, respectively. Through multiple linear regression analyses, the mother’s level of education, family monthly income, sleeping problems in children with CP, and the existence of children with other types of disability have been identified as factors contributing to HRQOL and family functioning. The findings help set out the course for stakeholders to establish action to enhance the QOL of primary caregivers. Full article
(This article belongs to the Special Issue Assessment of Health-Related Quality of Life (HRQoL) in Public Health)
13 pages, 2289 KiB  
Article
Changes in the Levels of Stress Perception, Experiencing Depressive Symptoms and Health-Related Quality of Life of Residents after the 2016 Gyeongju Earthquake
by Young Ran Han, Yeo Won Jeong, Sang Kyu Kim and Han Seok Jeong
Int. J. Environ. Res. Public Health 2021, 18(2), 540; https://doi.org/10.3390/ijerph18020540 - 11 Jan 2021
Cited by 3 | Viewed by 2039
Abstract
Background: The aim of this study was to evaluate the impact of the 2016 Gyeongju Earthquake on the stress perception, depressive symptoms, and health-related quality of life (HRQoL) among Gyeongju residents. Methods: This study was a secondary analysis of the 2015–2017 Korean Community [...] Read more.
Background: The aim of this study was to evaluate the impact of the 2016 Gyeongju Earthquake on the stress perception, depressive symptoms, and health-related quality of life (HRQoL) among Gyeongju residents. Methods: This study was a secondary analysis of the 2015–2017 Korean Community Health Survey undertaken in the disaster area, Gyeongju, and in controlled areas, Sangju and Yangju, which had varying seismic intensities. Pearson’s chi-square test, ANCOVA and two-way ANOVA were performed. Results: The stress perception rate and anxiety/depression in the 5th dimension of the EuroQul-five-dimensions three-level version (EQ-5D-3L) in Gyeongju was significantly higher in 2017 than in 2016. As for the HRQoL, the controlled regions showed a tendency to increase in 2017 rather than in 2016, while Gyeongju had no significant differences during 2015 and 2017. As a result, Gyeongju had the lowest HRQoL in 2017. Conclusion: Mental health in the disaster area after the 2016 earthquake was worse, and the HRQoL of Gyeongju residents was relatively lower than the control regions. Based on the results of the study, government agencies should remain interested in developing a post-disaster psychological support program for disaster survivors at a community level. Full article
(This article belongs to the Special Issue Assessment of Health-Related Quality of Life (HRQoL) in Public Health)
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14 pages, 1055 KiB  
Article
Drugs as Soulmates: The Construction and Validation of a 12-Item Soulmate Scale to Measure Substance Addiction and Loneliness
by T. Wing Lo, Jerf W. K. Yeung, Gabriel K. W. Lee, Cherry H. L. Tam and Gloria H. Y. Chan
Int. J. Environ. Res. Public Health 2020, 17(24), 9408; https://doi.org/10.3390/ijerph17249408 - 15 Dec 2020
Cited by 1 | Viewed by 2480
Abstract
Substance users use substances to tackle psychological stress, frustrations, poor social support and poor-quality relationships. Such experience resembles seeking a soulmate for receiving comfort, a sense of security and satisfaction to relieve feelings of loneliness. Against this backdrop, the study aims to develop [...] Read more.
Substance users use substances to tackle psychological stress, frustrations, poor social support and poor-quality relationships. Such experience resembles seeking a soulmate for receiving comfort, a sense of security and satisfaction to relieve feelings of loneliness. Against this backdrop, the study aims to develop a Soulmate Scale to measure substance use and loneliness. Data were collected from 507 drug abusers between 18–71 years of age who were receiving drug addiction treatment in Hong Kong. Both exploratory factor analysis and confirmatory factor analysis were conducted. Results show a valid and reliable scale with three factors: psychological release and shelter, staunch and supportive friendship, and spiritual solace and companionship. This study offers additional support for understanding the drug-taking experience of substance users from their perspective. The Scale provides a useful tool to assess the underlying reasons for substance users to persistently take drugs and formulate corresponding intervention plans to achieve drug abstinence. Full article
(This article belongs to the Special Issue Assessment of Health-Related Quality of Life (HRQoL) in Public Health)
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14 pages, 879 KiB  
Article
Predictors of Health-Related Quality of Life in Korean Adults with Diabetes Mellitus
by Mihyun Jeong
Int. J. Environ. Res. Public Health 2020, 17(23), 9058; https://doi.org/10.3390/ijerph17239058 - 04 Dec 2020
Cited by 14 | Viewed by 2139
Abstract
Diabetes mellitus (DM) as a chronic disease is a major public health problem worldwide. It is important to improve the quality of life of people with DM, especially health-related aspects, which should be monitored and managed as part of diabetes management. Accordingly, this [...] Read more.
Diabetes mellitus (DM) as a chronic disease is a major public health problem worldwide. It is important to improve the quality of life of people with DM, especially health-related aspects, which should be monitored and managed as part of diabetes management. Accordingly, this study investigated health-related quality of life (HRQoL) and identified predictors of HRQoL in Korean adults with DM using the Seventh Korea National Health and Nutrition Examination Survey (KNHANES VII) 2016–2018. This was a cross-sectional study with a stratified multistage probability sampling design that collected data from 1228 participants aged 30–80 years diagnosed with DM. HRQoL was measured using the Euro Quality of Life Five Dimension (EQ-5D) questionnaire. Analyses consisted of one-way analysis of variance, t-tests, chi-squared tests, and general linear regression analyses with complex sampling designs. Results demonstrated that low HRQoL was associated with older age (β = −0.002, 95% CI: −0.003 to −0.001), having elementary school education or less (β = −0.037, 95% CI: −0.061 to −0.014), being unmarried (β = −0.060, 95% CI: −0.078 to −0.040), poor subjective health status (β = −0.074, 95% CI: −0.094 to −0.055), perceived high stress (β = −0.047, 95% CI: −0.066 to −0.028), limited activity (β = −0.105, 95% CI: −0.131 to −0.079), being overweight (β = −0.021, 95% CI: −0.038 to −0.002), or obese (β = −0.016, 95% CI: −0.032 to −0.001), and three or more comorbidities (β = −0.044, 95% CI: −0.085 to −0.001). Comprehensive health care programs to manage these predictors should be provided to improve health-related quality of life of patients with DM. Full article
(This article belongs to the Special Issue Assessment of Health-Related Quality of Life (HRQoL) in Public Health)
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13 pages, 670 KiB  
Article
Lupus Erythematosus Quality of Life Questionnaire (LEQoL): Development and Psychometric Properties
by Elena Castellano-Rioja, María del Carmen Giménez-Espert and Ana Soto-Rubio
Int. J. Environ. Res. Public Health 2020, 17(22), 8642; https://doi.org/10.3390/ijerph17228642 - 20 Nov 2020
Cited by 4 | Viewed by 2588
Abstract
Lupus erythematosus (LE) affects patients’ quality of life. Nevertheless, no instrument has been developed to assess the quality of life in systemic lupus erythematosus (SLE) and cutaneous lupus erythematosus (CLE) patients. This study aims to develop and psychometrically test the “Quality of Life [...] Read more.
Lupus erythematosus (LE) affects patients’ quality of life. Nevertheless, no instrument has been developed to assess the quality of life in systemic lupus erythematosus (SLE) and cutaneous lupus erythematosus (CLE) patients. This study aims to develop and psychometrically test the “Quality of Life of Patients with Lupus Erythematosus Instrument” (LEQoL) and study the quality of life of these patients. Finally, percentiles for interpreting scores of LEQoL in patients with LE are provided. This study is cross-sectional, with a sample of 158 patients recruited from a lupus association for the psychometric evaluation of the final version of LEQoL. The scale’s reliability was assessed by Cronbach’s alpha, composite reliability (CR), and average variance extracted (AVE). Validity was examined through exploratory factorial analyses (EFA) and confirmatory factorial analyses (CFA). The definitive model, composed of 21 items grouped into five factors, presented good psychometric properties. Mean levels of quality of life were observed in patients with systemic LE, with higher values in patients with cutaneous LE. The LEQoL instrument is a useful tool for assessing the quality of life of patients with LE, allowing the evaluation of current clinical practices, the identification of educational needs, and the assessment of the effectiveness of interventions intended to improve the quality of life of patients with LE, SLE, and CLE. Full article
(This article belongs to the Special Issue Assessment of Health-Related Quality of Life (HRQoL) in Public Health)
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11 pages, 343 KiB  
Article
Repercussion of COVID-19 Pandemic on Brazilians’ Quality of Life: A Nationwide Cross-Sectional Study
by Isabella Teotônio, Mariana Hecht, Luiz Claudio Castro, Lenora Gandolfi, Riccardo Pratesi, Eduardo Y. Nakano, Renata Puppin Zandonadi and Claudia B. Pratesi
Int. J. Environ. Res. Public Health 2020, 17(22), 8554; https://doi.org/10.3390/ijerph17228554 - 18 Nov 2020
Cited by 20 | Viewed by 2853
Abstract
The COVID-19 outbreak, caused by Sars-Cov-2, was officially declared a global pandemic in February 2020, after an unexpected increase in hospitalization and mortality. When faced with this new disease, social and physical distancing and quarantine emerged as solutions to reduce virus transmission. This [...] Read more.
The COVID-19 outbreak, caused by Sars-Cov-2, was officially declared a global pandemic in February 2020, after an unexpected increase in hospitalization and mortality. When faced with this new disease, social and physical distancing and quarantine emerged as solutions to reduce virus transmission. This article examines the quality of life (QoL) of the Brazilian population’s during this period of isolation, due to the COVID-19 pandemic by analyzing; physical, psychological, social, and economic aspects. An online survey was distributed from 27 May to 14 August of 2020. A total of 1859 surveys were completed. Our results indicate that Brazilians were more affected by economic and social aspects than psychological and physical. Unemployed participants and individuals who tested positive for COVID-19 presented the lowest QoL. Females showed worst QoL scores than males, but having children did not influence the score. Higher educational level was associated with a better perception of QoL. Not following social distancing guidelines presented better scores in the psychological domain than the ones following restrict or partial social distancing rules. This study is the first to evaluate adults’ QoL related to the Sars-Cov-2 pandemic in Brazil at a national level. Our data may help health authorities identify the main factors affecting the QoL of the Brazilian population, thereby orientating them to recover after the pandemic. Full article
(This article belongs to the Special Issue Assessment of Health-Related Quality of Life (HRQoL) in Public Health)
16 pages, 1240 KiB  
Article
Quality of Life in a Cohort of 1078 Women Diagnosed with Breast Cancer in Spain: 7-Year Follow-Up Results in the MCC-Spain Study
by Jéssica Alonso-Molero, Trinidad Dierssen-Sotos, Ines Gomez-Acebo, Nerea Fernandez de Larrea Baz, Marcela Guevara, Pilar Amiano, Gemma Castaño-Vinyals, Tania Fernandez-Villa, Victor Moreno, Juan Bayo, Ana Molina-Barceloa, María Fernández-Ortíz, Claudia Suarez-Calleja, Rafael Marcos-Gragera, Xavier Castells, Leire Gil-Majuelo, Eva Ardanaz, Beatriz Pérez-Gómez, Manolis Kogevinas, Marina Pollán and Javier Llorcaadd Show full author list remove Hide full author list
Int. J. Environ. Res. Public Health 2020, 17(22), 8411; https://doi.org/10.3390/ijerph17228411 - 13 Nov 2020
Cited by 5 | Viewed by 2122
Abstract
Breast cancer is the most frequent cause of tumors and net survival is increasing. Achieving a higher survival probability reinforces the importance of studying health-related quality of life (HR-QoL). The main aim of this work is to test the relationship between different sociodemographic, [...] Read more.
Breast cancer is the most frequent cause of tumors and net survival is increasing. Achieving a higher survival probability reinforces the importance of studying health-related quality of life (HR-QoL). The main aim of this work is to test the relationship between different sociodemographic, clinical and tumor-intrinsic characteristics, and treatment received with HR-QoL measured using SF-12 and the FACT/NCCN (National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy) Breast Symptom Index (FBSI). Women with breast cancer recruited between 2008 and 2013 and followed-up until 2017–2018 in a prospective cohort answered two HR-QoL surveys: the SF-12 and FBSI. The scores obtained were related to woman and tumor characteristics using linear regression models. The telephone survey was answered by 1078 women out of 1685 with medical record follow-up (64%). Increases in all three HR-QoL scores were associated with higher educational level. The score differences between women with university qualifications and women with no schooling were 5.43 for PCS-12, 6.13 for MCS-12 and 4.29 for FBSI. Histological grade at diagnosis and recurrence in the follow-up displayed a significant association with mental and physical HR-QoL, respectively. First-line treatment received was not associated with HR-QoL scores. On the other hand, most tumor characteristics were not associated with HR-QoL. As breast cancer survival is improving, further studies are needed to ascertain if these differences still hold in the long run. Full article
(This article belongs to the Special Issue Assessment of Health-Related Quality of Life (HRQoL) in Public Health)
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10 pages, 623 KiB  
Article
Accuracy of Self-Reported Items for the Screening of Depression in the General Population
by Jorge Arias-de la Torre, Gemma Vilagut, Antoni Serrano-Blanco, Vicente Martín, Antonio José Molina, Jose M Valderas and Jordi Alonso
Int. J. Environ. Res. Public Health 2020, 17(21), 7955; https://doi.org/10.3390/ijerph17217955 - 29 Oct 2020
Cited by 8 | Viewed by 2435
Abstract
Introduction: Though self-reported items (SRD, self-reported depression) are commonly used in health surveys and cohort studies, their metric properties as a depression indicator remain unclear. The aims were to evaluate the measurement properties of SRD using the Patient Health Questionnaire-8 (PHQ-8) as reference [...] Read more.
Introduction: Though self-reported items (SRD, self-reported depression) are commonly used in health surveys and cohort studies, their metric properties as a depression indicator remain unclear. The aims were to evaluate the measurement properties of SRD using the Patient Health Questionnaire-8 (PHQ-8) as reference and to identify factors related to the agreement between both indicators. Methods: Data from the European Health Interview Survey in Spain in 2014/2015 (n = 22,065) were analyzed. Two indicators of depression were considered: SRD based on two items yes/no (positive: both yes), and the PHQ-8 (positive ≥ 10). Socioeconomic factors and use of health services were considered as independent variables. The prevalence of depression, sensitivity, specificity, global agreement, and positive and negative predictive values (PPV and NPV) of SRDs were evaluated using the PHQ-8 as a reference. Logistic regression models were fitted to determine factors associated with the agreement between indicators. Results: The prevalence of depression was lower when assessed with PHQ-8 (5.9%) than with SRD (7.7%). SRD sensitivity and PPV were moderate–low (52.9% and 40.4%, respectively) whereas global agreement, specificity, and NPV were high (92.7%, 95.1%, and 97.0%, respectively). Positive agreement was associated with marital status, country of birth, employment status, and social class. Negative agreement was related to all independent variables except country of birth. Conclusions: SRD items tend to overestimate the current prevalence of depression. While its use in health surveys and cohorts may be appropriate as a quick assessment of possible depression, due to their low sensitivity, its use in clinical contexts is questionable. Full article
(This article belongs to the Special Issue Assessment of Health-Related Quality of Life (HRQoL) in Public Health)
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13 pages, 371 KiB  
Article
Menstrual Problems and Lifestyle among Spanish University Women
by Elia Fernández-Martínez, Tania Fernández-Villa, Carmen Amezcua-Prieto, María Morales Suárez-Varela, Ramona Mateos-Campos, Carlos Ayán-Pérez, Antonio José Molina de la Torre, Rocío Ortíz-Moncada, Ana Almaraz, Gemma Blázquez Abellán, Miguel Delgado-Rodríguez, Jéssica Alonso-Molero, Virginia Martínez-Ruíz, Agustín Llopis-Morales, Luis Félix Valero Juan, José Mª Cancela Carral, Sandra Martín-Peláez and Juan Alguacil
Int. J. Environ. Res. Public Health 2020, 17(20), 7425; https://doi.org/10.3390/ijerph17207425 - 12 Oct 2020
Cited by 5 | Viewed by 3174
Abstract
Menstrual problems affect many young women worldwide, conditioning both their academic performance and quality of life. This study sought to analyse the prevalence of menstrual problems and their possible relationship with lifestyle among Spanish university women, as part of a research project (UniHcos [...] Read more.
Menstrual problems affect many young women worldwide, conditioning both their academic performance and quality of life. This study sought to analyse the prevalence of menstrual problems and their possible relationship with lifestyle among Spanish university women, as part of a research project (UniHcos Project) involving a cohort of 11 Spanish universities with 7208 university students. A descriptive analysis was performed using the bivariate chi-square test and the Student’s t-test together with a binary logistic regression, in which the dependent variable was ‘suffering from menstrual problems’. Menstrual problems were identified in 23.8% of the students, representing women who paid more visits to the doctor and to emergency rooms, and who consumed more painkillers and contraceptives. In relation to dietary preferences, menstrual problems were 1.39 (CI 95% 1.22–1.61; p = 0.000) times more likely among women classified as high-risk alcohol users according to the AUDIT questionnaire, and 1.187 (CI 95% 1.029–1.370; p = 0.019) times greater among those who consumed sweets daily, 1.592 (CI 95% 1.113–2.276; p = 0.011) times more frequent among those who eat fish daily, and 1.199 (CI 95% 1.004–1.432; p = 0.045) times greater among those who were dieting. Menstrual problems affect many college students and potentially modifiable lifestyle variables exist which may influence their prevalence. It would be interesting to develop programmes to promote women’s health in the university context. Full article
(This article belongs to the Special Issue Assessment of Health-Related Quality of Life (HRQoL) in Public Health)
11 pages, 378 KiB  
Article
Association between Lifestyle Behaviors and Health-Related Quality of Life in a Sample of Brazilian Adolescents
by Bruno Gonçalves Galdino da Costa, Jean-Philippe Chaput, Marcus Vinicius Veber Lopes, Rafael Martins da Costa, Luís Eduardo Argenta Malheiros and Kelly Samara Silva
Int. J. Environ. Res. Public Health 2020, 17(19), 7133; https://doi.org/10.3390/ijerph17197133 - 29 Sep 2020
Cited by 18 | Viewed by 3430
Abstract
This study aimed to analyze the association between lifestyle behaviors and health-related quality of life (HRQoL) among Brazilian adolescents. We evaluated 739 adolescents (51.0% girls; mean age, 16.4 ± 1.0 years) from the mesoregion Grande Florianópolis, Brazil. Participants were asked to complete an [...] Read more.
This study aimed to analyze the association between lifestyle behaviors and health-related quality of life (HRQoL) among Brazilian adolescents. We evaluated 739 adolescents (51.0% girls; mean age, 16.4 ± 1.0 years) from the mesoregion Grande Florianópolis, Brazil. Participants were asked to complete an online questionnaire and sex, age, mother’s education, health-related quality of life, physical activity, screen time indicators, sleep duration, diet, cigarette smoking, alcohol drinking, and drug experimentation were retrieved. Health-related quality of life was assessed using the Kidscreen-10 instrument. Measures of body mass and height were taken by trained researchers. Mixed-effects linear regression models were used. Self-reported health-related quality of life was higher in males (β = 3.68, 95%CI: 2.75; 4.61) compared to females, and no association was observed for age and mother’s education level. Practicing sports (β = 1.19, 95%CI: 0.29; 2.08) was associated with better HRQoL, while processed food score (β = −0.45, 95%CI: −0.78; −0.13), working using screen devices for more than 4 h/day (β = −2.38, 95%CI: −4.52; −0.25), having experimented illicit drugs (β = −2.05, 95%CI: −3.20; −0.90), and sleeping less than 8 h/night (β = −1.35, 95%CI: −2.27; −0.43) were unfavorably associated with HRQoL. Non-sport physical activities, unprocessed food, studying, watching videos, playing videogames, using social media, alcohol drinking, and smoking were not associated with health-related quality of life. These findings suggest that promoting sports and adequate sleep, and preventing excessive workloads and the use of drugs among adolescents may be effective strategies to improve HRQoL. Full article
(This article belongs to the Special Issue Assessment of Health-Related Quality of Life (HRQoL) in Public Health)
20 pages, 860 KiB  
Article
Evaluation of Quality of Life of Adult Patients with Celiac Disease in Argentina: From Questionnaire Validation to Assessment
by Nicole Selleski, Renata Puppin Zandonadi, Laura B. Milde, Lenora Gandolfi, Riccardo Pratesi, Winfred Häuser, Rosa Harumi Uenishi, Eduardo Yoshio Nakano and Claudia B. Pratesi
Int. J. Environ. Res. Public Health 2020, 17(19), 7051; https://doi.org/10.3390/ijerph17197051 - 26 Sep 2020
Cited by 8 | Viewed by 2855
Abstract
This cross-sectional study aimed to translate, culturally adapt, validate, and apply a Celiac Disease Quality of Life (CD-QoL) questionnaire to a representative sample of Argentina’s celiac population. A previously developed and validated questionnaire (Celiac Disease Questionnaire: CDQ) was chosen as a tool for [...] Read more.
This cross-sectional study aimed to translate, culturally adapt, validate, and apply a Celiac Disease Quality of Life (CD-QoL) questionnaire to a representative sample of Argentina’s celiac population. A previously developed and validated questionnaire (Celiac Disease Questionnaire: CDQ) was chosen as a tool for assessing the health-related quality of Life (HRQoL) of adult celiac patients in Argentina. Therefore, the study was performed in four stages: (a) translation and re-translation of the CDQ to Argentinian-Spanish language; (b) cultural adaptation and semantic evaluation; based on the Delphi method (c) validation of the CDQ by applying it to a representative sample of Argentinian celiac patients; (d) statistical analysis of the data. The result of stages (a) and (b) was a translated and culturally adapted an Argentinian-Spanish version of the CDQ, which was generated after reaching consensus between the corresponding four (phase a) and 10 (phase b) professionals involved in the different phases of this process. Among them, we can cite bilingual healthcare professionals with extensive experience in research and celiac disease, celiac patients, gastroenterologists, general practitioners, dieticians, and psychologists. The resulting CDQ proved to be an appropriate measuring tool to assess the HRQoL of Argentinian celiac patients confirmed by a good fit in the confirmatory factor validity analysis (RMSEA < 0.001 and χ2 = 267.325, df = 313, p = 0.971) and high values of internal consistency (Cronbach’s alpha > 0.7). A total of 191 participants accessed the questionnaire, and 171 individuals from 20 out of 23 Argentinian states completed the questionnaire. There was no correlation between higher educational level nor marital status with QoL. Individuals on a strict gluten-free diet (GFD) and those who do not take antidepressants showed higher QoL. Male gender also presented better HRQoL. There was no correlation between differences in HRQoL and age of the respondent, age at diagnosis, symptoms at diagnosis, or having other chronic diseases. However, a significantly higher score of HRQoL was reported among those individuals who disclosed having knowledge of CD related national regulations and benefits. This study highlights the importance of maintaining current public health regulations that support chronic disease patients, such as celiac patients. Full article
(This article belongs to the Special Issue Assessment of Health-Related Quality of Life (HRQoL) in Public Health)
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7 pages, 325 KiB  
Article
Improvement of the Quality of Life in Patients with Age-Related Macular Degeneration by Using Filters
by Daniel Caballe-Fontanet, Cristina Alvarez-Peregrina, Neus Busquet-Duran, Eduard Pedemonte-Sarrias and Miguel Angel Sanchez-Tena
Int. J. Environ. Res. Public Health 2020, 17(18), 6751; https://doi.org/10.3390/ijerph17186751 - 16 Sep 2020
Cited by 3 | Viewed by 2683
Abstract
Background: Age-related macular degeneration (AMD) is a disease with an increasing incidence due to the general aging of the population that decreases the patient’s quality of life. This work aims to study whether selective cut optical filters improve the AMD patient’s quality of [...] Read more.
Background: Age-related macular degeneration (AMD) is a disease with an increasing incidence due to the general aging of the population that decreases the patient’s quality of life. This work aims to study whether selective cut optical filters improve the AMD patient’s quality of life. Methods: Prospective and longitudinal study in 79 patients. Visual acuity, contrast sensitivity, and the line differences in the Colenbrander test were measured. Patients answered The National Eye Institute 25-Item Visual Function Questionnaire (NEI VFQ-25), which measures the quality of life related to vision before and after using cut optical filters. Results: There was an improvement of 5.99 points (3.7–8.3) in NEI VFQ-25 after wearing filters. This improvement was 4.0 points for 450-nm filters and 12.7 points for 511-nm filters. For patients with visual acuity (VA) < 0.25, results of NEI VFQ-25 increased by 10.11 points (1.19–19.02) and for patients with late AMDs, results increased by 5.33 points (1.31–9.35). Conclusions: Selective filters improve the quality of life of patients with AMD. The success rate in the fitting of filters is better for those with VA lower than 0.25 and those with late or advanced AMD. Full article
(This article belongs to the Special Issue Assessment of Health-Related Quality of Life (HRQoL) in Public Health)
13 pages, 338 KiB  
Article
Interference and Impact of Dysmenorrhea on the Life of Spanish Nursing Students
by Ana Abreu-Sánchez, Javier Ruiz-Castillo, María Dolores Onieva-Zafra, María Laura Parra-Fernández and Elia Fernández-Martínez
Int. J. Environ. Res. Public Health 2020, 17(18), 6473; https://doi.org/10.3390/ijerph17186473 - 05 Sep 2020
Cited by 18 | Viewed by 3898
Abstract
  1. Dysmenorrhea is a cause of absenteeism in universities which, in the context of nursing studies, may affect mandatory attendance. Moreover, presenteeism is associated with medication errors, patient falls, and a reduced quality of patient care. This study sought to identify the degree of
[...] Read more.
  1. Dysmenorrhea is a cause of absenteeism in universities which, in the context of nursing studies, may affect mandatory attendance. Moreover, presenteeism is associated with medication errors, patient falls, and a reduced quality of patient care. This study sought to identify the degree of interference of dysmenorrhea on daily life and its impact on academic performance among Spanish nursing students, and to explore the reasons for presenteeism. A cross-sectional descriptive study was conducted on 261 nursing students. Data were collected using a self-administered questionnaire. The chi square tests, chi-square linear trend, Student’s t-test, one-way analysis of variance of polynomial contrasts, and post hoc tests for the bi-variate analysis were used to compare the participants’ responses regarding their type of dysmenorrhea and pain intensity. In addition, a multivariate regression was performed to predict absenteeism. The answers to the open questions were analyzed using thematic content analysis techniques. We observed 62.8% of absenteeism and 92.7% of presenteeism due to dysmenorrhea. Absenteeism was observed to be 3.079 (confidence interval (CI): 95%1.724–5.499; p < 0.001) times more likely among women with severe menstrual pain, 2.513 (CI 95%1.314–4.807; p = 0.005) times more in those suffering from menstrual nausea and 1.936 (CI 95%1.098–3.411; p = 0.022) times more frequent in those suffering from diarrhea. The reasons for presenteeism were grouped into five categories: the pain was bearable, it is not a reason to be absent, others don’t consider it a reason to be absent, responsibility and guilt, and academic consequences. Dysmenorrhea can have a significant impact on academic performance. The concern among students about the academic repercussions and even feelings of guilt and incomprehension from others leads to high rates of presenteeism with potentially negative consequences for patient care.
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(This article belongs to the Special Issue Assessment of Health-Related Quality of Life (HRQoL) in Public Health)
21 pages, 4583 KiB  
Article
Ecological and Human Health Risk Assessment of Heavy Metal Pollution in the Soil of the Ger District in Ulaanbaatar, Mongolia
by Enkhchimeg Battsengel, Takehiko Murayama, Keisuke Fukushi, Shigeo Nishikizawa, Sonomdagva Chonokhuu, Altansukh Ochir, Solongo Tsetsgee and Davaadorj Davaasuren
Int. J. Environ. Res. Public Health 2020, 17(13), 4668; https://doi.org/10.3390/ijerph17134668 - 29 Jun 2020
Cited by 17 | Viewed by 5322
Abstract
The aim of the present study was to evaluate human health and potential ecological risk assessment in the ger district of Ulaanbaatar city, Mongolia. To perform these risk assessments, soil samples were collected based on reference studies that investigated heavy element distribution in [...] Read more.
The aim of the present study was to evaluate human health and potential ecological risk assessment in the ger district of Ulaanbaatar city, Mongolia. To perform these risk assessments, soil samples were collected based on reference studies that investigated heavy element distribution in soil samples near the ger area in Ulaanbaatar city. In total, 42 soil samples were collected and 26 heavy metals were identified by inductively coupled plasma optical emission spectrometry (ICP-OES) and inductively coupled plasma mass spectrometry (ICP-MS) methods. The measurement results were compared with the reference data in order to validate the soil contamination level. Although there was a large difference between the measurement results of the present and reference data, the general tendency was similar. Soil contamination was assessed by pollution indexes such as geoaccumulation index and enrichment factor. Mo and As were the most enriched elements compared with the other elements. The carcinogenic and noncarcinogenic risks to children exceeded the permissible limits, and for adults, only 12 out of 42 sampling points exceeded the permissible limit of noncarcinogenic effects. According to the results of the ecological risk assessment, Zn and Pb showed from moderate to considerable contamination indexes and high toxicity values for ecological risk of a single element. The Cr and As ranged as very high ecological risk than that of the other measured heavy metals. Full article
(This article belongs to the Special Issue Assessment of Health-Related Quality of Life (HRQoL) in Public Health)
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15 pages, 5238 KiB  
Article
Determination of Selenium in Common and Selenium-Rich Rice from Different Areas in China and Assessment of Their Dietary Intake
by Liuquan Zhang, Yanbin Guo, Kehong Liang, Zhongqiu Hu, Xiangdong Sun, Yong Fang, Xiaohong Mei, Hongqing Yin, Xianjin Liu and Baiyi Lu
Int. J. Environ. Res. Public Health 2020, 17(12), 4596; https://doi.org/10.3390/ijerph17124596 - 26 Jun 2020
Cited by 9 | Viewed by 2942
Abstract
In this study, 41 common rice varieties and 211 selenium-rich rice varieties from ten representative areas in China were collected in 2017–2019. The selenium contents of rice were analyzed with optimized inductively coupled plasma mass spectrometry (ICP-MS). Selenium concentrations of common rice and [...] Read more.
In this study, 41 common rice varieties and 211 selenium-rich rice varieties from ten representative areas in China were collected in 2017–2019. The selenium contents of rice were analyzed with optimized inductively coupled plasma mass spectrometry (ICP-MS). Selenium concentrations of common rice and selenium-rich rice ranges were 0.81–7.26 and 0.76–180.73 µg/100 g, respectively. The selenium contents in selenium-rich rice from different areas were significantly different (p < 0.001) while those in common rice from different areas were not. The selenium-rich rice in Harbin and Keshan showed the lowest selenium level and those from selenium-rich areas (Enshi and Ankang) were highest. Based on the estimation of the risk assessment software @risk7.0 (Palisade Corporation, New York, NY, USA), the consumption of selenium-rich rice can effectively increase dietary selenium intake for the population. However, the risk index of P95 (Percentile 95) selenium exposure at the tolerable upper intake level for children at 2–14 years old exceeded 100%, with potential risk currently. Therefore, the consumption of selenium-rich rice should be properly monitored for young children and adolescents. Full article
(This article belongs to the Special Issue Assessment of Health-Related Quality of Life (HRQoL) in Public Health)
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16 pages, 333 KiB  
Article
Quality of Life and Symptom Burden among Chronic Kidney Disease of Uncertain Etiology (CKDu) Patients in Girandurukotte, Sri Lanka
by Hansani Madushika Abeywickrama, Swarna Wimalasiri, Yu Koyama, Mieko Uchiyama, Utako Shimizu, Nahoko Kakihara, Rohana Chandrajith and Nishantha Nanayakkara
Int. J. Environ. Res. Public Health 2020, 17(11), 4041; https://doi.org/10.3390/ijerph17114041 - 05 Jun 2020
Cited by 14 | Viewed by 3486
Abstract
Symptom burden and health-related quality of life (HRQOL) are important predictors of how a disease affects patients’ lives, especially for endemic health problems such as chronic kidney disease of uncertain etiology (CKDu). Our study describes symptom burden, HRQOL, and associated demographic and clinical [...] Read more.
Symptom burden and health-related quality of life (HRQOL) are important predictors of how a disease affects patients’ lives, especially for endemic health problems such as chronic kidney disease of uncertain etiology (CKDu). Our study describes symptom burden, HRQOL, and associated demographic and clinical variables in CKDu patients in the Girandurukotte area, Sri Lanka. A cross-sectional study included 120 CKDu patients attending the renal clinic in the endemic area. The instruments applied were the Kidney Disease Quality of Life—Short Form (KDQOL-SFTM) version 1.3 and CKD Symptom Index—Sri Lanka. Socio-demographic, disease-related, and anthropometric variables were also investigated. The mean age of patients was 61.87 (SD 11.31), while 69.2% were male. The mean glomerular filtration rate was 28.17 (SD 14.03) mL/min/1.73 min2, and 70.8% were anemic. Bone/joint pain was the most experienced symptom while the median number of symptoms reported by patients was 5 (IQR 3–7). The mean symptom burden, physical component summary, mental component summary, and kidney-disease-specific component scores were 12.71 (SD 10.45), 68.63 (SD 19.58), 78.53 (SD 18.78), and 81.57 (SD 5.86), respectively. Age was found to be a significant predictor of HRQOL, while hemoglobin level and being a farmer were significant predictors of symptom burden. Our data indicate that CKDu patients in all stages experience at least one symptom affecting all aspects of HRQOL. Full article
(This article belongs to the Special Issue Assessment of Health-Related Quality of Life (HRQoL) in Public Health)
17 pages, 914 KiB  
Article
Nutritional Determinants of Quality of Life in a Mediterranean Cohort: The SUN Study
by Octavio Pano, Carmen Sayón-Orea, Alfredo Gea, Maira Bes-Rastrollo, Miguel Ángel Martínez-González and J. Alfredo Martínez
Int. J. Environ. Res. Public Health 2020, 17(11), 3897; https://doi.org/10.3390/ijerph17113897 - 31 May 2020
Cited by 13 | Viewed by 2736
Abstract
Health related quality of life (HRQoL) is a subjective appreciation of how personal characteristics and health influence well-being. This cross-sectional analysis aimed to quantitatively measure the influence of dietary, lifestyle, and demographic factors on HRQoL. A sub-sample of the Seguimiento Universidad de Navarra [...] Read more.
Health related quality of life (HRQoL) is a subjective appreciation of how personal characteristics and health influence well-being. This cross-sectional analysis aimed to quantitatively measure the influence of dietary, lifestyle, and demographic factors on HRQoL. A sub-sample of the Seguimiento Universidad de Navarra (SUN) Project, a Mediterranean cohort, was analyzed (n = 15,674). Through self-administered questionnaires the relationship between HRQoL and dietary patterns (Mediterranean-diet (MedDiet) and provegetarian food pattern (FP) assessment), lifestyles (sleeping hours, physical activity) and demographic characteristics were measured. Multivariate linear regression and flexible regression models were used to estimate the pondered effect of personal factors on Short Form-36 (SF-36) scores. Coefficients for MedDiet and provegetarian scores (β-coefficient for global SF-36 score: 0.32 (0.22, 0.42); 0.09 (0.06, 0.12) respectively for every unit increase), physical activity (β: 0.03 (0.02, 0.03) for every metabolic equivalent of task indexes (MET)-h/week) had a positive association to HRQoL. The female sex (β: −3.28 (−3.68, −2.89)), and pre-existing diseases (diabetes, β: −2.27 (−3.48, −1.06), hypertension β: −1.79 (−2.36, −1.22), hypercholesterolemia β: −1.04 (−1.48, −0.59)) account for lower SF-36 scores. Adherence to MedDiet or provegetarian FP, physical activity and sleep are associated with higher HRQoL, whereas the female sex, “other” (versus married status) and the presence of chronic diseases were associated with lower SF-36 scores in this sample. Full article
(This article belongs to the Special Issue Assessment of Health-Related Quality of Life (HRQoL) in Public Health)
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19 pages, 1291 KiB  
Article
The Effect of Physical Activity and High Body Mass Index on Health-Related Quality of Life in Individuals with Metabolic Syndrome
by Alba Marcos-Delgado, Tania Fernández-Villa, Miguel Ángel Martínez-González, Jordi Salas-Salvadó, Dolores Corella, Olga Castañer, J. Alfredo Martínez, Ángel M. Alonso-Gómez, Julia Wärnberg, Jesús Vioque, Dora Romaguera, José López-Miranda, Ramon Estruch, Francisco J Tinahones, José Lapetra, J. LLuís Serra-Majem, Laura García-Molina, Josep A. Tur, José Antonio de Paz, Xavier Pintó, Miguel Delgado-Rodríguez, Pilar Matía-Martín, Josep Vidal, Clotilde Vázquez, Lidia Daimiel, Emilio Ros, Nancy Babio, Ignacio M Gimenez-Alba, Estefanía Toledo, María Dolores Zomeño, M. A. Zulet, Jessica Vaquero-Luna, Jessica Pérez-López, Ana Pastor-Morel, Aina M Galmes-Panades, Antonio García-Rios, Rosa Casas, María Rosa Bernal-López, José Manuel Santos-Lozano, Nerea Becerra-Tomás, Carolina Ortega-Azorin, Zenaida Vázquez-Ruiz, Karla Alejandra Pérez-Vega, Itziar Abete, Carolina Sorto-Sánchez, Antoni Palau-Galindo, Iñigo Galilea-Zabalza, Júlia Muñoz-Martínez and Vicente Martínadd Show full author list remove Hide full author list
Int. J. Environ. Res. Public Health 2020, 17(10), 3728; https://doi.org/10.3390/ijerph17103728 - 25 May 2020
Cited by 7 | Viewed by 5062
Abstract
The main objective of this study was to examine the relationship between the level of physical activity (PA) and the degree of obesity with health-related quality of life (HRQoL) in individuals with metabolic syndrome (MetS) who participated in the Predimed-Plus study. A total [...] Read more.
The main objective of this study was to examine the relationship between the level of physical activity (PA) and the degree of obesity with health-related quality of life (HRQoL) in individuals with metabolic syndrome (MetS) who participated in the Predimed-Plus study. A total of 6875 subjects between 55 and 75 years of age with MetS were selected and randomized in 23 Spanish centers. Subjects were classified according to categories of body mass index (BMI). PA was measured with the validated Registre Gironí del Cor (REGICOR) questionnaire and subjects were classified according to their PA level (light, moderate, vigorous) and the HRQoL was measured with the validated short-form 36 (SF-36) questionnaire. By using the ANOVA model, we found a positive and statistically significant association between the level of PA and the HRQoL (aggregated physical and mental dimensions p < 0.001), but a negative association with higher BMI in aggregated physical dimensions p < 0.001. Furthermore, women obtained lower scores compared with men, more five points in all fields of SF-36. Therefore, it is essential to promote PA and body weight control from primary care consultations to improve HRQoL, paying special attention to the differences that sex incurs. Full article
(This article belongs to the Special Issue Assessment of Health-Related Quality of Life (HRQoL) in Public Health)
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Review

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14 pages, 1279 KiB  
Review
The Effect of Lifestyle Intervention on Health-Related Quality of Life in Adults with Metabolic Syndrome: A Meta-Analysis
by Alba Marcos-Delgado, Natalia Hernández-Segura, Tania Fernández-Villa, Antonio J. Molina and Vicente Martín
Int. J. Environ. Res. Public Health 2021, 18(3), 887; https://doi.org/10.3390/ijerph18030887 - 20 Jan 2021
Cited by 22 | Viewed by 3844
Abstract
The aim of this meta-analysis was to assess the effects of a lifestyle intervention through health education on nutrition, physical activity, and healthy habits on physical and mental health-related quality of life (HRQoL), in adults with metabolic syndrome (MetS). The databases used were [...] Read more.
The aim of this meta-analysis was to assess the effects of a lifestyle intervention through health education on nutrition, physical activity, and healthy habits on physical and mental health-related quality of life (HRQoL), in adults with metabolic syndrome (MetS). The databases used were PubMed, WOS, and Scopus. The inclusion criteria were: observational, longitudinal and randomized clinical trial (RCT) study designs, adults (both sexes), with at least two criteria of MetS, lifestyle intervention and comparison with a control group, and a measurement of HRQoL with a validated questionnaire. We analyzed the Hedges’ g and SF-36 score. I2 statistics were calculated and possible publication and small study biases were assessed using Egger’s test and funnel plots. Seven RCTs were selected for meta-analysis, based on 637 study participants. Significant improvements were found in the physical dimensions of the HRQoL scores for subjects in the active intervention compared to the group that received general lifestyle information (Hedges’ g 0.61, 95% confidence interval (CI) = 0.31–0.91). Mental health-related quality of life was also significantly improved in the intervention group compared with the control group (Hedges’ g 0.84, 95% CI = 0.64–1.03). In conclusion, our results suggest that, according to the RCTs selected for this meta-analysis, a lifestyle intervention significantly improves HRQoL in all its domains. Full article
(This article belongs to the Special Issue Assessment of Health-Related Quality of Life (HRQoL) in Public Health)
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15 pages, 2517 KiB  
Review
Incidence of Anorexia Nervosa in Women: A Systematic Review and Meta-Analysis
by Leticia Martínez-González, Tania Fernández-Villa, Antonio José Molina, Miguel Delgado-Rodríguez and Vicente Martín
Int. J. Environ. Res. Public Health 2020, 17(11), 3824; https://doi.org/10.3390/ijerph17113824 - 28 May 2020
Cited by 32 | Viewed by 6744
Abstract
Background: Anorexia nervosa (AN) among the general population is a rare but often fatal illness. Objective: To summarize the incidence of AN using a systematic review and meta-analysis. Methods: Four online databases (PubMed, Scopus, WoS and Embase) were consulted. The review [...] Read more.
Background: Anorexia nervosa (AN) among the general population is a rare but often fatal illness. Objective: To summarize the incidence of AN using a systematic review and meta-analysis. Methods: Four online databases (PubMed, Scopus, WoS and Embase) were consulted. The review was conducted according to with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was limited to women. The methodological quality of the studies was assessed by the Newcastle–Ottawa Scale (NOS). Results: A total of 31 articles were included in the study. The incidence rate of AN ranged from 0.5 to 318.0 cases per 100,000 women–years. The incidence in studies based on outpatient healthcare services (OHS) was higher than those based on hospital admissions (HA) (8.8 95% CI: 7.83–9.80 vs. 5.0 95% CI: 4.87–5.05). In young women, the incidence in OHS was higher than HA (63.7, 95% CI 61.21–66.12 vs. 8.1 95% CI 7.60–8.53). The linear trend in the incidence of AN was increasing in all ages of women and young women, both in studies with hospital admission records, and in those based on outpatient healthcare services. Conclusion: The incidence of AN depends on the methodology, the type of population and the diagnostic criteria used. Full article
(This article belongs to the Special Issue Assessment of Health-Related Quality of Life (HRQoL) in Public Health)
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