Psychosocial factors and health as determinants of quality of life in community-dwelling older adults.

PURPOSE: It is important to understand the determinants of differences in quality of life in old age and to include a wide range of possible predictors. The present study investigated the determinants of quality of life in two groups of older adults for whom there was an unusually informative set of possible predictor variables. METHOD: Participants were members of the Lothian Birth Cohorts of 1921 (n = 550) or 1936 (n = 1,091). Four facets of quality of life (QoL) and general QoL were measured using the WHOQOL-BREF. Possible determinants included personality traits, measured with the International Personality Item Pool (IPIP) scales; childhood and old age general cognitive ability, measured with the Moray House Test; minor psychological symptoms, measured with the Hospital Anxiety and Depression Scale (HADS); physical health, assessed by grip strength and cardiovascular disease history; and sociodemographic factors, assessed by interview. RESULTS: Linear regression analyses revealed that HADS depression had the greatest influence on quality of life. Personality traits, most notably Emotional Stability, also predicted quality of life to varying degrees, along with factors reflecting current life circumstances. There were differences between the two cohorts in the variables which predicted quality of life. There were different, conceptually relevant, contributions to the different QoL facets. CONCLUSIONS: Personality traits and minor depressive symptoms have an important influence on self-reported quality of life in old age. Quality of life may be influenced more by current than past circumstances, and this relationship may change with age

Perceived spirituality, mindfulness and quality of life in psychiatric patients

There is some evidence of the relationship between spirituality and quality of life, but there are few bibliographic references on these constructs for patients suffering from mental illness; thus, this study was aimed at revealing the possible role of spiritual outlooks as a protective factor in these individuals. The sample consisted of 96 Portuguese psychiatric patients, selected from a psychiatric hospital and assessed based on parameters for quality of life, spirituality and mindfulness. The data support some theories about the nature of the spirituality. Spiritual beliefs are poorly correlated with the quality of life index, and there is a moderate association between these beliefs and some aspects of mindfulness. It is suggested that a spiritual outlook of psychiatric patients should be taken into account in psychological interventions

Depression and quality of life of hemodialysis patients living in a poor region of Brazil Depressão e qualidade de vida entre pacientes em hemodiálise de uma região pobre do Brasil

OBJECTIVE: To determine the correlation between depression and quality of life (QOL) of patients in hemodialysis (HD). METHOD: One hundred and sixty six patients over 18 years of age who had been in HD for at least three months and had no history of transplant. QOL was assessed using the SF-36. To categorize depression, a score > 10 was used on the 10-item version of the Center for Epidemiologic Studies Depression Scale (CES-D). Comparisons between depressed and nondepressed patients were performed using the chi-square test, Student's t-test, and Mann-Whitney test. Multiple regression was performed to assess the predictive variables of patients' QOL. RESULTS: Symptoms of depression were found in 13 (7.8%) patients. The only variable that differed among depressed patients was QOL. Depressed patients presented lower scores in vitality (40.7 vs. 57.3; p = 0.010), role-emotional (25.6 vs. 62.5; p = 0.006), and mental health (50.1 vs. 65.4; p = 0.023). Regression analysis demonstrated that depression was a predictor of role-emotional (OR = 0.981, CI = 0.967-0.996; p = 0.010) and mental health (OR = 0.970, CI = 0.946-0.996; p = 0.022). CONCLUSION: Depressed patients experience a poor QOL because, in addition to their chronically affected physical aspects, they also feel limited in the mental dimensions, which usually have the highest score among non-depressed HD patients.<br>OBJETIVO: Determinar a correlação entre depressão e qualidade de vida (QV) de pacientes submetidos à hemodiálise (HD). MÉTODO: Foram estudados 166 pacientes com idade superior a 18 anos, em HD por pelo menos três meses e sem transplante prévio. O nível de QV foi medido pelo questionário SF-36. Para categorizar depressão foi utilizada a versão de 10 itens do Center for Epidemiologic Studies Depression Scale (CES-D; escore > 10). As comparações entre pacientes com e sem depressão foram realizadas pelos testes do qui-quadrado, t de Student e Mann-Whitney. Regressão múltipla foi realizada para testar variáveis preditivas de QV. RESULTADOS: Sintomas depressivos estavam presentes em 13 (7,8%) pacientes. A única variável que diferiu entre os pacientes com depressão foi QV. Pacientes depressivos apresentaram menor pontuação referente a vitalidade (40,7 vs. 57,3; p = 0,010), aspectos emocionais (25,6 vs. 62,5; p = 0,006) e saúde mental (50,1 vs. 65,4; p = 0,023). A análise de regressão demonstrou que depressão foi preditiva de aspectos emocionais (OR = 0,981, IC = 0,967-0,996; p = 0,010) e de saúde mental (OR = 0,970, CI = 0,946-0,996; p = 0,022). CONCLUSÃO: Pacientes com depressão vivenciam um nível baixo de QV porque, além dos aspectos físicos afetados cronicamente, esses pacientes são afetados nas dimensões mentais que costumam ser as dimensões com melhores pontuações entre os pacientes em HD sem depressão