nach oben

Quality of Life Research

Erschienen in:

08.05.2017

Impact of marital status and comorbid disorders on health-related quality of life after cardiac surgery

verfasst von: Ann Kristin Bjørnnes, Monica Parry, Ragnhild Falk, Judy Watt-Watson, Irene Lie, Marit Leegaard

Erschienen in: Quality of Life Research | Ausgabe 9/2017

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To explore associations between HRQL, marital status, and comorbid disorders in men and women following cardiac surgery.

Method

A secondary analysis was completed using data from a randomized controlled trial in which 416 individuals (23% women) scheduled for elective coronary artery bypass graft and/or valve surgery were recruited between March 2012 and September 2013. HRQL was assessed using the Health State Descriptive System (15D) preoperatively, then at 2 weeks, and at 3, 6, and 12 months following cardiac surgery. Linear mixed model analyses were performed to explore associations between HRQL, social support, and comorbid disorders.

Results

The overall 15D scores for the total sample improved significantly from 2 weeks to 3 months post surgery, with only a gradual change observed from 3 to 12 months. Thirty percent (n = 92) of the total sample reported a lower 15D total score at 12 months compared to preoperative status, of whom 78% (n = 71) had a negative minimum important differences (MID), indicating a worse HRQL status. When adjusted for age and marital status, women had statistically significant lower 15D total scores compared to men at 3, 6, and 12 months post surgery. Compared to pre-surgery, improvement was demonstrated in 4 out of 15 dimensions of HRQL for women, and in 6 out of 15 dimensions for men at 12 months post surgery. Both men and women associated back/neck problems, depression, and persistent pain intensity with lower HRQL; for women, not living with a partner/spouse was associated with lower HRQL up to 12 months.

Conclusion

Women experienced decreased HRQL and a slower first-year recovery following cardiac surgery compared to men. This study demonstrates a need for follow-up and support to help women manage their symptoms and improve their function within the first year after cardiac surgery. This was particularly pronounced for those women living alone.

Buth, K. J., Gainer, R. A., Legare, J. F., & Hirsch, G. M. (2014). The changing face of cardiac surgery: Practice patterns and outcomes 2001-2010. Canadian Journal of Cardiology, 30(2), 224–230.PubMed

Krishnaswami, A., Go, A. S., Forman, D. E., Leong, T. K., Lee, H., Maurer, M. S., et al. (2016). Multimorbidity is strongly associated with long-term but not short-term mortality after cardiac valve replacement. International Journal of Cardiology, 215, 417–421.PubMed

Mozaffarian, D., Benjamin, E. J., Go, A. S., Arnett, D. K., Blaha, M. J., Cushman, M., et al. (2016). Executive summary: Heart disease and stroke statistics-2016 update: A report from the American Heart Association. Circulation, 133(4), 447.PubMed

Mohr, F. W., Morice, M. C., Kappetein, A. P., Feldman, T. E., Ståhle, E., Colombo, A., et al. (2013). Coronary artery bypass graft surgery versus percutaneous coronary intervention in patients with three-vessel disease and left main coronary disease: 5-year follow-up of the randomised, clinical SYNTAX trial. The Lancet, 381(9867), 629–638.

Moazzami, K., Dolmatova, E., Maher, J., Gerula, C., Sambol, J., Klapholz, M., et al. (2016). In-hospital outcome and complications of coronary artery bypass grafting in the United States between 2008 and 2012. Journal of Cardiothoracic and Vascular Anesthesia, 31(1), 19–25.PubMed

Gaspar, M., & Călinescu, F. B. (2016). Long-term clinical outcome following CABG. Coronary graft failure (pp. 199–215). Cham: Springer.

Sabbag, A., Matetzky, S., Gottlieb, S., Fefer, P., Kohanov, O., Atar, S., et al. (2015). Recent temporal trends in the presentation, management, and outcome of women hospitalized with acute coronary syndromes. The American Journal of Medicine, 128(4), 380–388.PubMed

Kurfirst, V., Mokráček, A., Krupauerová, M., Čanádyová, J., Bulava, A., Pešl, L., et al. (2014). Health-related quality of life after cardiac surgery-the effects of age, preoperative conditions and postoperative complications. Journal of Cardiothoracic Surgery, 9(1), 46.PubMedPubMedCentral

Nugteren, L. B., & Sandau, K. E. (2010). Critical review of health-related quality of life studies of patients with aortic stenosis. Journal of Cardiovascular Nursing, 25(1), 25–39.PubMed

10.

Parry, M., Arthur, H., Brooks, D., Groll, D., & Pavlov, A. (2012). Measuring function in older adults with co-morbid illnesses who are undergoing coronary artery bypass graft (CABG) surgery. Archives of Gerontology and Geriatrics, 54(3), 477–483.PubMed

11.

Sibilitz, K. L., Berg, S. K., Thygesen, L. C., Hansen, T. B., Køber, L., Hassager, C., et al. (2015). High readmission rate after heart valve surgery: A nationwide cohort study. International Journal of Cardiology, 189, 96–104.PubMed

12.

Kloth, B., Schietsch, O., Sill, B., Schönebeck, J., Reichenspurner, H., & Gulbins, H. (2016). Does cardiac surgery affect quality of life? An update of more than 200 patients. The Thoracic and Cardiovascular Surgeon, 64(S01), ePP21.

13.

Grady, K. L., Lee, R., Subačius, H., Malaisrie, S. C., McGee, E. C., Kruse, J., et al. (2011). Improvements in health-related quality of life before and after isolated cardiac operations. The Annals of Thoracic Surgery, 91(3), 777–783. doi:10.1016/j.athoracsur.2010.11.015.CrossRefPubMed

14.

De Smedt, D., Clays, E., & De Bacquer, D. (2016). Measuring health-related quality of life in cardiac patients. European Heart Journal-Quality of Care and Clinical Outcomes. doi:10.1093/ehjqcco/qcw015.CrossRefPubMed

15.

Guimarães-Pereira, L., Farinha, F., Azevedo, L., Abelha, F., & Castro-Lopes, J. (2016). Persistent postoperative pain after cardiac surgery: Incidence, characterization, associated factors and its impact in quality of life. European Journal of Pain. doi:10.1002/ejp.866.CrossRefPubMed

16.

Middel, B., El Baz, N., Pedersen, S. S., Van Dijk, J. P., Wynia, K., & Reijneveld, S. A. (2014). Decline in health-related quality of life 6 months after coronary artery bypass graft surgery: The influence of anxiety, depression, and personality traits. Journal of Cardiovascular Nursing, 29(6), 544–554.PubMed

17.

De Smedt, D., Clays, E., Annemans, L., Pardaens, S., Kotseva, K., & De Bacquer, D. (2015). Self-reported health status in coronary heart disease patients: A comparison with the general population. European Journal of Cardiovascular Nursing, 14(2), 117–125.PubMed

18.

Rumsfeld, J. S., Alexander, K. P., Goff, D. C., Graham, M. M., Ho, P. M., Masoudi, F. A., et al. (2013). Cardiovascular health: The importance of measuring patient-reported health status. Circulation, 127(22), 2233–2249.PubMed

19.

Oterhals, K., Hanssen, T. A., Haaverstad, R., Nordrehaug, J. E., Eide, G. E., & Norekval, T. M. (2015). Factors associated with poor self-reported health status after aortic valve replacement with or without concomitant bypass surgery. European Journal of Cardio-Thoracic Surgery, 48(2), 283–292.PubMed

20.

Peric, V., Borzanovic, M., Stolic, R., Jovanovic, A., Sovtic, S., Djikic, D., et al. (2010). Quality of life in patients related to gender differences before and after coronary artery bypass surgery. Interactive CardioVascular and Thoracic Surgery, 10(2), 232–238.PubMed

21.

Martin, L. M., Holmes, S. D., Henry, L. L., Schlauch, K. A., Stone, L. E., Roots, A., et al. (2012). Health-related quality of life after coronary artery bypass grafting surgery and the role of gender. Cardiovascular Revascularization Medicine: Including Molecular Interventions, 13(6), 321–327.

22.

McSweeney, J. C., Rosenfeld, A. G., Abel, W. M., Braun, L. T., Burke, L. E., Daugherty, S. L., et al. (2016). Preventing and experiencing ischemic heart disease as a woman: State of the science a scientific statement from the American Heart Association. Circulation, 133(13), 1302–1331.PubMedPubMedCentral

23.

Westerman, S., & Wenger, N. K. (2016). Women and heart disease, the underrecognized burden: Sex differences, biases, and unmet clinical and research challenges. Clinical Science, 130(8), 551–563.PubMed

24.

Beckie, T. M. (2014). Biopsychosocial determinants of health and quality of life among young women with coronary heart disease. Current Cardiovascular Risk Reports, 8(1), 1–10.

25.

Peric, V., Jovanovic-Markovic, S., Peric, D., Rasic, D., Novakovic, T., Dejanovic, B., et al. (2015). Quality of life in patients of different age groups before and after coronary artery by-pass surgery. Annals of Thoracic and Cardiovascular Surgery, 21(5), 474–480.PubMedPubMedCentral

26.

Romero, P. S., Souza, E. N., Rodrigues, J., & Moraes, M. A. (2015). Changes in quality of life associated with surgical risk in elderly patients undergoing cardiac surgery. International Journal of Nursing Practice, 21(5), 592–597.PubMed

27.

Baig, K., Harling, L., Papanikitas, J., Attaran, S., Ashrafian, H., Casula, R., et al. (2013). Does coronary artery bypass grafting improve quality of life in elderly patients? Interactive Cardiovascular and Thoracic Surgery, 17(3), 542–553.PubMedPubMedCentral

28.

Shan, L., Saxena, A., McMahon, R., & Newcomb, A. (2013). Coronary artery bypass graft surgery in the elderly a review of postoperative quality of life. Circulation, 128(21), 2333–2343.PubMed

29.

Hokkanen, M., Järvinen, O., Huhtala, H., & Tarkka, M. R. (2014). A 12-year follow-up on the changes in health-related quality of life after coronary artery bypass graft surgery. European Journal of Cardio-Thoracic Surgery, 45(2), 329–334.PubMed

30.

Christiansen, J., Larsen, F. B., & Lasgaard, M. (2016). Do stress, health behavior, and sleep mediate the association between loneliness and adverse health conditions among older people? Social Science and Medicine. doi:10.1016/j.socscimed.2016.01.020.CrossRefPubMed

31.

Manfredini, R., De Giorgi, A., Tiseo, R., Boari, B., Cappadona, R., Salmi, R., et al. (2017). Marital status, cardiovascular diseases, and cardiovascular risk factors: A review of the evidence. Journal of Women’s Health. doi:10.1089/jwh.2016.6103.CrossRefPubMed

32.

Noyez, L. (2014). Is quality of life post cardiac surgery overestimated? Health and Quality of Life Outcomes, 12(1), 1.

33.

Horrocks, J., Closs, J., & Astin, F. (2014). Quality of life in older adults with aortic stenosis: A narrative review. International Journal of Older People Nursing, 9(3), 227–246.PubMed

34.

De Smedt, D., Clays, E., Höfer, S., Oldridge, N., Kotseva, K., Maggioni, A. P., et al. (2016). The use of HeartQoL in patients with coronary heart disease: Association with risk factors and European reference values. The EUROASPIRE IV study of the European Society of Cardiology. European Journal of Preventive Cardiology. doi:10.1177/2047487316631400.CrossRefPubMed

35.

Vartiainen, P., Heiskanen, T., Sintonen, H., Roine, R. P., & Kalso, E. (2016). Health-related quality of life and burden of disease in chronic pain measured with the 15D instrument. Pain, 157(10), 2269–2276.PubMed

36.

Heiskanen, J., Tolppanen, A.-M., Roine, R. P., Hartikainen, J., Hippeläinen, M., Miettinen, H., et al. (2016). Comparison of EQ-5D and 15D instruments for assessing the health-related quality of life in cardiac surgery patients. European Heart Journal-Quality of Care and Clinical Outcomes. doi:10.1093/ehjqcco/qcw002.CrossRefPubMed

37.

Vainiola, T., Roine, R. P., Suojaranta-Ylinen, R., Vento, A., & Sintonen, H. (2013). Can factors related to mortality be used to predict the follow-up health-related quality of life (HRQoL) in cardiac surgery patients? Intensive & Critical Care Nursing, 29(6), 337–343.

38.

Rantanen, A., Tarkka, M. T., Kaunonen, M., Tarkka, M., Sintonen, H., Koivisto, A. M., et al. (2009). Health-related quality of life after coronary artery bypass grafting. Journal of Advanced Nursing, 65(9), 1926–1936.PubMed

39.

Alanne, S., Roine, R. P., Räsänen, P., Vainiola, T., & Sintonen, H. (2014). Estimating the minimum important change in the 15D scores. Quality of Life Research, 24(3), 599–606.PubMed

40.

Kattainen, E., Merilainen, P., & Sintonen, H. (2006). Sense of coherence and health-related quality of life among patients undergoing coronary artery bypass grafting or angioplasty. European Journal of Cardiovascular Nursing, 5(1), 21–30.PubMed

41.

Stenvall, H., Tierala, I., Räsänen, P., Laine, M., Sintonen, H., & Roine, R. P. (2017). Long-term clinical outcomes, health-related quality of life and costs in different treatment modalities of stable coronary artery disease. European Heart Journal-Quality of Care and Clinical Outcomes, 3(1), 74–82. doi:10.1093/ehjqcco/qcw024.CrossRefPubMed

42.

Bjornnes, A. K., Parry, M., Lie, I., Fagerland, M. W., Watt-Watson, J., Rustoen, T., et al. (2017). The impact of an educational pain management booklet intervention on postoperative pain control after cardiac surgery. European Journal of Cardiovascular Nursing, 16(1), 18–27. doi:10.1177/1474515116631680.CrossRefPubMed

43.

Sintonen, H. (2001). The 15D instrument of health-related quality of life: Properties and applications. Annals of Medicine, 33(5), 328–336.PubMed

44.

Sangha, O., Stucki, G., Liang, M. H., Fossel, A. H., & Katz, J. N. (2003). The self-administered comorbidity questionnaire: A new method to assess comorbidity for clinical and health services research. Arthritis and Rheumatism, 49(2), 156–163.PubMed

45.

De-loyde, K. J., Harrison, J. D., Durcinoska, I., Shepherd, H. L., Solomon, M. J., & Young, J. M. (2015). Which information source is best? Concordance between patient report, clinician report and medical records of patient co-morbidity and adjuvant therapy health information. Journal of Evaluation in Clinical Practice, 21(2), 339–346.PubMed

46.

Cleeland, C. S., & Ryan, K. M. (1994). Pain assessment: Global use of the brief pain inventory. Annals of the Academy of Medicine, Singapore, 23(2), 129–138.PubMed

47.

Klepstad, P., Loge, J. H., Borchgrevink, P. C., Mendoza, T. R., Cleeland, C. S., & Kaasa, S. (2002). The Norwegian brief pain inventory questionnaire: Translation and validation in cancer pain patients. Journal of Pain Symptom Management, 24(5), 517–525.PubMed

48.

Gjeilo, K. H., Stenseth, R., Wahba, A., Lydersen, S., & Klepstad, P. (2007). Validation of the brief pain inventory in patients six months after cardiac surgery. Journal of Pain and Symptom Management, 34(6), 648–656.PubMed

49.

Stata, S. (2013). Release 13. Statistical software. College Station, Texas: StataCorp LP.

50.

Fitzmaurice, G. M., Laird, N. M., & Ware, J. H. (2011). Applied longitudinal analysis (2nd ed.). Chichester: Wiley.

51.

Bjornnes, A. K., Parry, M., Lie, I., Fagerland, M. W., Watt-Watson, J., Rustoen, T., et al. (2016). Pain experiences of men and women after cardiac surgery. Journal of Clinical Nursing, 25(19–20), 3058–3068.PubMed

52.

Choiniere, M., Watt-Watson, J., Victor, J. C., Baskett, R. J., Bussieres, J. S., Carrier, M., et al. (2014). Prevalence of and risk factors for persistent postoperative nonanginal pain after cardiac surgery: A 2-year prospective multicentre study. CMAJ: Canadian Medical Association Journal, 186(7), E213–E223.PubMedPubMedCentral

53.

Rantanen, A., Kaunonen, M., Tarkka, M., Sintonen, H., Koivisto, A.-M., Astedt-Kurki, P., et al. (2009). Patients’ and significant others’ health-related quality of life one month after coronary artery bypass grafting predicts later health-related quality of life. Heart and Lung, 38(4), 318–329.PubMed

54.

Saarni, S. I., Harkanen, T., Sintonen, H., Suvisaari, J., Koskinen, S., Aromaa, A., et al. (2006). The impact of 29 chronic conditions on health-related quality of life: A general population survey in Finland using 15D and EQ-5D. Quality of Life Research, 15(8), 1403–1414.PubMed

55.

Hu, Y., van Lenthe, F. J., Borsboom, G. J., Looman, C. W. N., Bopp, M., Burström, B., et al. (2016). Trends in socioeconomic inequalities in self-assessed health in 17 European countries between 1990 and 2010. Journal of Epidemiology and Community Health. doi:10.1136/jech-2015-206780.CrossRefPubMed

56.

Gunn, J. M., Lautamäki, A. K., Hirvonen, J., & Kuttila, K. T. (2014). The prognostic significance of declining health-related quality of life scores at 6 months after coronary artery bypass surgery. QJM: Monthly Journal of The Association of Physicians, 107(5), 369–374.PubMed

57.

Hansen, T. B., Thygesen, L. C., Zwisler, A. D., Helmark, L., Hoogwegt, M., Versteeg, H., et al. (2015). Self-reported health-related quality of life predicts 5-year mortality and hospital readmissions in patients with ischaemic heart disease. European Journal of Preventive Cardiology, 22(7), 882–889.PubMed

58.

Sethares, K. A., Chin, E., & Costa, I. (2013). Pain intensity, interference and patient pain management strategies the first 12 weeks after coronary artery bypass graft surgery. Applied Nursing Research, 26(4), 174–179.PubMed

59.

Parry, M., Watt-Watson, J., Hodnett, E., Tranmer, J., Dennis, C. L., & Brooks, D. (2010). Pain experiences of men and women after coronary artery bypass graft surgery. Journal of Cardiovascular Nursing, 25(3), E9–E15.PubMed

60.

Banack, H. R., Holly, C. D., Lowensteyn, I., Masse, L., Marchand, S., Grover, S. A., et al. (2014). The association between sleep disturbance, depressive symptoms, and health-related quality of life among cardiac rehabilitation participants. Journal of Cardiopulmonary Rehabilitation and Prevention, 34(3), 188–194.PubMed

61.

Bjornnes, A. K., Rustoen, T., Lie, I., Watt-Watson, J., & Leegaard, M. (2016). Pain characteristics and analgesic intake before and following cardiac surgery. European Journal of Cardiovascular Nursing, 15(1), 47–54.PubMed

62.

Katz, J., Weinrib, A., Fashler, S., Katznelzon, R., Shah, B., Ladak, S., et al. (2015). The Toronto General Hospital Transitional Pain Service: Development and implementation of a multidisciplinary program to prevent chronic postsurgical pain. Journal of Pain Research, 8, 695–702. doi:10.2147/JPR.S91924.CrossRefPubMedPubMedCentral

63.

Meissner, W., Coluzzi, F., Fletcher, D., Huygen, F., Morlion, B., Neugebauer, E., et al. (2015). Improving the management of post-operative acute pain: Priorities for change. Current Medical Research and Opinion, 31(11), 2131–2143. doi:10.1185/03007995.2015.1092122.CrossRefPubMed

64.

Valderas, J. M., Starfield, B., Sibbald, B., Salisbury, C., & Roland, M. (2009). Defining comorbidity: Implications for understanding health and health services. The Annals of Family Medicine, 7(4), 357–363.PubMed

65.

Gjeilo, K. H., Klepstad, P., Wahba, A., Lydersen, S., & Stenseth, R. (2010). Chronic pain after cardiac surgery: A prospective study. Acta Anaesthesiologica Scandinavica, 54(1), 70–78.PubMed

66.

Gijsberts, C. M., Agostoni, P., Hoefer, I. E., Asselbergs, F. W., Pasterkamp, G., Nathoe, H., et al. (2015). Gender differences in health-related quality of life in patients undergoing coronary angiography. Open Heart, 2(1), e000231.PubMedPubMedCentral

67.

Leegaard, M., & Fagermoen, M. S. (2008). Patients’ key experiences after coronary artery bypass grafting: A synthesis of qualitative studies. Scandinavian Journal of Caring Sciences, 22(4), 616–628.PubMed

68.

Choinière, M., Dion, D., Peng, P., Banner, R., Barton, P. M., Boulanger, A., et al. (2010). The Canadian STOP-PAIN project–Part 1: Who are the patients on the waitlists of multidisciplinary pain treatment facilities? Canadian Journal of Anesthesia, 57(6), 539–548.PubMed

69.

Bartley, E. J., & Fillingim, R. B. (2013). Sex differences in pain: A brief review of clinical and experimental findings. Brithish Journal of Anaesthesia, 111(1), 52–58.

70.

Idler, E. L., Boulifard, D. A., & Contrada, R. J. (2012). Mending broken hearts marriage and survival following cardiac surgery. Journal of Health and Social Behavior, 53(1), 33–49.PubMed

71.

Feeney, B. C., & Collins, N. L. (2015). A new look at social support: A theoretical perspective on thriving through relationships. Personality and Social Psychology Review, 19(2), 113–147.PubMed

72.

Staniute, M., Brozaitiene, J., & Bunevicius, R. (2013). Effects of social support and stressful life events on health-related quality of life in coronary artery disease patients. Journal of Cardiovascular Nursing, 28(1), 83–89.PubMed

73.

Zebhauser, A., Baumert, J., Emeny, R., Ronel, J., Peters, A., & Ladwig, K. (2015). What prevents old people living alone from feeling lonely? Findings from the KORA-Age-study. Aging & Mental Health, 19(9), 773–780.

74.

Parry, M., & Watt-Watson, J. (2010). Peer support intervention trials for individuals with heart disease: A systematic review. European Journal of Cardiovascular Nursing, 9(1), 57–67.PubMed

75.

Dear, B. F., Gandy, M., Karin, E., Staples, L. G., Johnston, L., Fogliati, V. J., et al. (2015). The pain course: A randomised controlled trial examining an internet-delivered pain management program when provided with different levels of clinician support. Pain, 156(10), 1920–1935.PubMedPubMedCentral

76.

Licskai, C., Sands, T., & Ferrone, M. (2013). Development and pilot testing of a mobile health solution for asthma self-management: Asthma action plan smartphone application pilot study. Canadian Respirology Journal, 20(4), 301–306.

77.

Bratt, E. L., & Moons, P. (2015). Forty years of quality-of-life research in congenital heart disease: Temporal trends in conceptual and methodological rigor. International Journal of Cardiology, 195, 1–6.PubMed

78.

De Smedt, D., Clays, E., Annemans, L., Doyle, F., Kotseva, K., Pająk, A., et al. (2013). Health related quality of life in coronary patients and its association with their cardiovascular risk profile: Results from the EUROASPIRE III survey. International Journal of Cardiology, 168(2), 898–903.PubMed

79.

Yang, K., & Victor, C. (2011). Age and loneliness in 25 European nations. Ageing & Society, 31(08), 1368–1388.

80.

Norris, C. M., Johnson, N. L., Hardwicke-Brown, E., McEwan, M., Pelletier, R., & Pilote, L. (2017). The contribution of gender to apparent sex differences in health status among patients with coronary artery disease. Journal of Women’s Health, 26(1), 50–57.PubMed

81.

Day, S., Mason, R., Lagosky, S., & Rochon, P. A. (2016). Integrating and evaluating sex and gender in health research. Health Research Policy and Systems, 14(1), 75.PubMedPubMedCentral

Titel: Impact of marital status and comorbid disorders on health-related quality of life after cardiac surgery
verfasst von: Ann Kristin Bjørnnes
Monica Parry
Ragnhild Falk
Judy Watt-Watson
Irene Lie
Marit Leegaard
Publikationsdatum: 08.05.2017
Verlag: Springer International Publishing
Erschienen in: Quality of Life Research / Ausgabe 9/2017
Print ISSN: 0962-9343
Elektronische ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-017-1589-2

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Impact of marital status and comorbid disorders on health-related quality of life after cardiac surgery

Abstract

Purpose

Method

Results

Conclusion

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Purpose

Method

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 9/2017

The association between fear of cancer recurrence and quality of life among Chinese cancer survivors: main effect hypothesis and buffering hypothesis

The patient’s experience of primary ciliary dyskinesia: a systematic review

Clinical setting-based smoking cessation programme and the quality of life in people living with HIV in Austria and Germany

Measurement invariance of the Satisfaction with Life Scale: reviewing three decades of research

Screening for depression in arthritis populations: an assessment of differential item functioning in three self-reported questionnaires

Quality of life among perinatally HIV-affected and HIV-unaffected school-aged and adolescent Ugandan children: a multi-dimensional assessment of wellbeing in the post-HAART era