HRQL 2 Flashcards
Mastery
1
Q
SF - 36
what is it?
- Assesses patients’ perceptions of…
- With regard to the following dimensions of HRQL:
- … health
- … functioning
- … functioning
- …. health
- …. pain
- …..
- Example: How much pain have you experienced in the past 4 weeks? What degree has pain
interfered with normal daily activities?
A
Most widely used measure of HRQL is 36-item Short Form Health Survey (SF-36). Is also a shorter version, SF-12
- Assesses patients’ perceptions of symptoms and the extent to which symptoms impact daily functioning
- With regard to the following dimensions of HRQL:
- General health
- Physical functioning
- Social functioning
- Mental health
- Bodily pain
- Vitality
- Example: How much pain have you experienced in the past 4 weeks? What degree has pain
interfered with normal daily activities?
2
Q
SF-36
* SF-36 ???? measure of HRQL
* Designed to assess….
- Two components –
- Other subjective measures considered….
- Designed to measure HRQL only among people with…..
- E.g., in cancer – FACT measures
- E.g., in children – PEDS-QL
A
SF-36
* SF-36 GENERIC measure of HRQL
- Designed to assess multiple aspects of HRQL across wide range of patient populations
- Two components – Physical Component Scale (PCS) and Mental Component Scale (MCS)
- Other subjective measures considered DISEASE SPECIFIC
- Designed to measure HRQL only among people with specific disease or disability such as cancer, asthma, arthritis, etc.
- E.g., in cancer – FACT measures
- E.g., in children – PEDS-QL
2
Q
- Exercise has …. impact overall on SF36 scores – enhances HRQL
- Effects of exercise on various dimensions measured by the SF-36 varies across populations
- Cardiac rehab patient changes vs breast cancer patient changes from exercise
- Should not expect exercise-induced improvements on …. in all patient populations
A
- Exercise has positive impact overall on SF36 scores – enhances HRQL
- Effects of exercise on various dimensions measured by the SF-36 varies across populations
- Cardiac rehab patient changes vs breast cancer patient changes from exercise
- Should not expect exercise-induced improvements on all dimensions in all patient populations
3
Q
“We need to ask ourselves what is more
important – how we as researchers and healthcare
professionals rate HRQL, or how they perceive their
own HRQL ”
A
4
Q
*Exercise is associated with ???? in HRQL in general populations, as well as potentially in those who have …
Such as :
- Effects of exercise are ???? among people who already have high HRQL scores
how can increase in these people
A
- **Exercise is associated with IMPROVEMENT in HRQL in general populations, as well as potentially in those who have “more to gain”:
- Older adults, those with chronic health conditions, mental illness
- Effects of exercise are less dramatic among people who already have high HRQL scores
- Difficult to increase HRQL further among these people
- How does exercise impact your HRQL?
5
Q
- For many people with chronic disease and disability, goal of exercise is to help them ….
ADL?
- Programs might include:
* - What does this have implications for??
A
- For many people with chronic disease and disability, goal of exercise is to help them regain or maintain capacity to perform activities of daily living (ADL)
- Programs might include:
- PA performed at sufficient intensity to increase physical fitness
- PA at lower levels
- Moderate and low intensity PA not necessarily intense enough to increase fitness, but can help person attain or maintain ability to perform ADL
- What does this have implications for??
6
Q
Increasing awareness of movement benefits HRQL
TO THINK ABOUT, how would you design a PA intervention to target HRQL
A
- consider the population
- social factors
- envn barrier
- self-efficacy
7
Q
Physical Functioning
* Exercise results in significant improvements in ????
- Demonstrated in healthy populations and across wide range of patient populations
- Large improvements in perceptions of physical functioning compared to a control group
- Physical self-concept**
- How individual feels…
- Included under domain….
- Not studied….
- Believed that people with chronic disease or disability can improve….
A
Physical Functioning
* Exercise results in significant improvements in perception of physical functioning
- Physical self-concept**
- How individual feels about physical abilities and appearance
- Included under domain of physical function
- Not studied as thoroughly
- Believed that people with chronic disease or disability can improve physical self-concept through exercise
- SEE SELF AS AN EXERCISER
8
Q
Cognitive Functioning
* Exercise has been shown to improve objective indices of ???? :
- Processing…
- Example – cerebral palsy
- Example – cancer
- Taken together….exercise can improve perceptions of cognitive functioning among….
A
- Exercise has been shown to improve objective indices of COGNITIVE PERFORMANCE
- Processing and sorting information, planning and initiating behaviors
- Example – among children with cerebral palsy, those who participated in exercise class had greater perceived cognitive functioning (reported by patients and parents)
- Example – among cancer survivors, those in exercise condition had larger improvements in perceived cognitive functioning (i.e., less brain fog).
- Taken together….exercise can improve perceptions of cognitive functioning among children and adults who may have cognitive impairments as a result of injury or disease
9
Q
Emotional Well-Being
* Exercise associated with improvements in numerous aspects of ???? among general population and special populations
- Decreased….
- Majority of exercise and HRQL studies have focused on changes in…
- Many studies have also shown exercise can also increase…
- People who reported….s in PA experienced …. in level of happiness
A
Emotional Well-Being
* Exercise associated with improvements in numerous aspects of EMOTIONAL WELL BEING among general population and special populations
- Decreased depression & anxiety among the elderly, MI
patients, cancer patients, others - Majority of exercise and HRQL studies have focused on changes in negative affect
- Many studies have also shown exercise can also increase feelings of positive affect
- People who reported greatest increases in PA experienced greatest improvements in level of happiness
10
Q
Social Functioning
- Evidence suggests exercise can positively affect patient perceptions…
- This is NOT necessarily a … thing
- Patients who exercise … can experience improvements in social function equal to those who exercise in…. – may reflect broader social life/context
- Exercise may enhance social ….
- Physical gains made during exercise gives them more
…. in social situations
A
- Evidence suggests exercise can positively affect patient perceptions of their social lives
- This is NOT necessarily a “group” thing
- Patients who exercise alone can experience improvements in social function equal to those who exercise in group settings – may reflect broader social life/context
- Exercise may enhance social confidence of people with disease and disability by reducing concerns about being perceived by others as “disabled”
- Physical gains made during exercise gives them more
confidence in social situations
11
Q
Health Status
* Exercise shown to improve perceptions of physical health and …
- Exercise can help alleviate …. symptoms
and might provide patients with a strategy for
…. symptoms - ENHANCED SENSE OF CONTROL – SELF-EFFICACY
- Exercise can help alleviate …. of certain disease treatments.
- E.g.,
A
Health Status
* Exercise shown to improve perceptions of physical health and symptom severity across wide range of populations
- Exercise can help alleviate disease-related symptoms
and might provide patients with a strategy for
managing or controlling symptoms - ENHANCED SENSE OF CONTROL – SELF-EFFICACY
- Exercise can help alleviate uncomfortable side-effects of certain disease treatments.
- E.g., chemotherapy – nausea, fatigue
