Health and Quality of Life Outcomes最新文献

Background: When the increasing prevalence of Smartphone Addiction (SA) and its potential negative effects on mental health among adolescents are taken into consideration, an in-depth investigation of the relationship between SA and Psychological Well-being (PW) is of critical importance. Therefore, using a three-wave longitudinal research design, this study aimed to examine the serial mediation role of Psychological Flexibility (PF) and Emotion Regulation (ER) in the relationship between SA and PW. To our knowledge, this is the first study to examine SA, PF, ER, and PW relationships and mediating mechanisms in an adolescent sample using a longitudinal design.

Methods: The study included 448 adolescents (49.8% female and 50.2% male; Range_age = 15-19, M_age = 16.76, SD_age = 1.12) who responded to the questionnaires in three waves. Participating adolescents responded to a 50-item questionnaire consisting of the Smartphone Addiction Scale-Short Version (SAS-SV), the Five-Dimensional Well-Being Scale for Adolescents (EPOCH), the Multidimensional Psychological Flexibility Inventory Short Form (MPFI-SF), and the Regulation of Emotions Questionnaire (REQ). The questionnaires were filled in using pen and paper in a classroom environment under the supervision of the teacher and the researcher.

Results: Compared to those who used their smartphones for 0-2 h and 2-4 h, adolescents who reported to use their smartphones for more than four hours daily were found to have higher SA scores and lower PW, ER, and PF scores across all three time points (T1, T2, and T3). The findings indicated that SA at T1 negatively predicted PW at T3 (β = -0.34, p < .001), PF at T2 (β = -0.39, p < .001), and ER at T2 (β = -0.23, p < .001). On the other hand, PF at T2 positively predicted ER at T2 (β = 0.17, p < .001) and PW at T3 (β = 0.40, p < .001), and ER at T2 positively predicted PW at T3 (β = 0.73, p < .001). Besides, PF at T2 (β = -0.15, SE = 0.03, 95% CI = [-0.2036, -0.1053]) and ER at T2 (β = -0.17, SE = 0.03, 95% CI = [-0.2288, -0.1054]) were found to fully mediate the longitudinal relationship between SA at T1 and PW at T3. The longitudinal serial mediation model accounted for 32% of the variance in PW (R² = .32).

Conclusions: This study shows that SA leads to a decrease in adolescents' PF skills and their capacity to effectively manage their emotional reactions over time, which in turn leads to lower PW levels. The findings emphasize the potential of interventions to improve PF and ER skills in alleviating SA-related mental health problems in adolescents. The findings also suggest that both strengthening PF and ER skills separately and addressing them simultaneously could significantly increase the effectiveness of treatment approaches.

Background: To comprehensively evaluate health care interventions in younger populations, outcome measurement in economic evaluation may need to be expanded beyond health-related quality of life to include well-being. However, whether appropriate well-being instruments exist for children remains uncertain. This study provides a systematic overview of multidimensional well-being instruments for children and assesses their potential applicability for economic evaluation.

Methods: This scoping review was reported following the PRISMA-ScR guidelines. The search strategy included terms related to "well-being," "child or adolescent," and "instrument", and was implemented in four electronic databases, yielding a total of 9622 articles. Two reviewers independently screened articles with ASReview, a machine-learning-based tool for expediting screening, and manually extracted information from relevant articles. Findings were synthesized narratively, highlighting consistency and discrepancies, as well as potential suitability for economic evaluation (using multiple criteria).

Results: Twentyfive studies were included, published between 1993 and 2024. On average, instruments assessed well-being with five dimensions and 38 questions. Common dimensions included physical, health, school, satisfaction, relationship(s), emotional and self. Dimensions that capture children's daily experiences, such as family, achievement, education and after-school activities were frequently considered.

Conclusion: The review highlights the variety of well-being instruments for children. Although many instruments measure well-being comprehensively, only ICECAP-CYP fit all criteria for suitability for economic evaluation. The small number of potentially suitable instruments highlights a growing yet still insufficient interest in moving beyond traditional HRQoL assessments in younger populations.

Background: The introduction of novel therapeutic agents has transformed the treatment landscape and significantly improved survival outcomes for patients with multiple myeloma (MM). However, the effects of these advancements on health-related quality of life (HRQoL) and financial toxicity in real-world settings remain insufficiently explored. The aim of this study was to investigate HRQoL and financial toxicity among Chinese patients with MM in the era of novel agents.

Methods: In this longitudinal, multicentre, real-world study, data from Chinese patients with MM were collected between March 2021 and July 2023. HRQoL was assessed using the EQ-5D-5 L, EQ-VAS and FACT-MM, while financial toxicity was measured using the Comprehensive Score for Financial Toxicity (COST). Patients were evaluated at baseline and at 3-, 6-, 12-, and 24-month follow-up visits. Mixed-effect models were employed to examine the factors associated with HRQoL and financial toxicity over time.

Results: A total of 441 patients were surveyed at baseline, with 412 (93.5%), 371 (84.1%), 335 (76.0%), and 253 (57.4%) completing the follow-up visits at 3, 6, 12, and 24 months, respectively. At baseline, the mean EQ-5D-5 L, EQ-VAS, FACT-MM, and COST scores were 0.79 (SD = 0.25), 81.96 (SD = 18.73), 117.46 (SD = 21.76), and 21.84 (SD = 5.78), respectively. The EQ-5D-5 L utility values and FACT-MM scores at follow-up visits were significantly higher than those at baseline, whereas the COST scores were significantly lower. Mixed-effect model analyses revealed that higher levels of financial toxicity were significantly associated with lower HRQoL (EQ-5D-5 L: β = 0.006, p < 0.001; FACT-MM: β = 1.60, p < 0.001). Moreover, significant interaction effects between socioeconomic status and COST were observed for both the EQ-5D-5 L (β = -0.001, p < 0.001) and the FACT-MM (β = -0.12, p < 0.001).

Conclusions: HRQoL improved moderately over the 24-month follow-up period, whereas financial toxicity progressively worsened. Greater financial toxicity was significantly associated with poorer HRQoL, particularly among patients with lower SES. These findings may inform future health policy development and economic evaluations aimed at improving the quality of care and financial well-being of patients with MM.

Background: Infertility is a global issue that significantly imposes physical and psychosocial burdens on both female and male patients, affecting their health-related quality of life (HRQoL) and family wellbeing. The aim of this study was to develop a de novo HRQoL instrument for male and female infertility patients in China, and describe the generation and selection of items for Infertility-QoL.

Methods: This study used a mixed methods design involving 4 steps. The items identified from the systematic review and qualitative interview analysis were used to construct draft candidate items (step 1). In order to ensure item relevance, comprehension, and acceptability, using cognitive interviews prior to quantifying psychometric testing (step 2). In the third step, we conducted a cross-sectional quantitative offline survey for item selection. Classical test theory (CTT) and item response theory (IRT) were used to assess dimensionality and performance of items. Finally, by conducting advisory committee consultations and thematic seminars, the items were further qualitatively evaluated, and developed a formal version of the Infertility-QoL (step 4).

Results: Step 1 resulted in the generation of 73 items. Based on CTT and IRT psychometric evidence, 36 items were deleted. Finally, according to the advisory committee consultations for qualitative evaluation, a formal version of the Infertility-QoL with 25 items was developed. The exploratory factor analysis results showed that the 6-factor model was appropriate. The newly developed instrument (Infertility-QoL) consisted of 25 items across six dimensions: physical health, sexual life, emotional status, self-efficacy, subjective wellbeing and social relations.

Conclusions: This study developed the new Infertility-QoL instrument for male and female infertility patients, and preliminarily verified its dimensions.

Background: Chronic Obstructive Pulmonary Disease (COPD) presents a significant health and economic challenge in low- and middle-income countries (LMICs) in Asia, where healthcare resources are often limited. Self-management programs (SMPs) offer a potential solution by empowering patients to manage their condition and reduce healthcare costs. However, there needs to be more consolidated evidence on the effectiveness of these programs in LMICs, and their success may depend on specific contextual factors.

Methods: This systematic review analyzed studies on COPD self-management interventions in Asian LMICs, focusing on outcomes such as health-related quality of life (HRQoL), exacerbation rates, healthcare utilization, and out-of-pocket (OOP) costs. Two databases- PubMed and Scopus were systematically searched following PRISMA guidelines, and data were extracted and analyzed to identify the effectiveness of these programs and the challenges encountered during implementation.

Results: The findings indicate that self-management programs in LMICs can improve HRQoL, reduce exacerbation rates, and lower OOP costs in specific contexts. However, the effectiveness of these programs is influenced by local healthcare infrastructure, digital and health literacy, and economic barriers. Digital interventions tended to be more beneficial in urban areas with better infrastructure, while programs led by community health workers were more effective in rural settings.

Conclusion: Self-management interventions show promise for managing COPD in resource-limited settings, but context-specific adaptations are essential. Flexible program designs tailored to local conditions and strengthened collaborations among healthcare providers and policymakers are crucial for sustainable implementation and scaling.

Background: Existing research has identified health‑related quality of life (HRQoL) is influenced by a multitude of factors among children and adolescents. However, there has been relatively limited exploration of the multidimensional predictive factors (individual characteristics, health risk behaviors, and negative life events) that contribute to HRQoL. This study aimed to develop a nomogram to predict the HRQoL in children and adolescents.

Methods: A total of 12,145 children and adolescents were surveyed using stratified cluster sampling method, randomly divided into a training set (n = 8503) and a validation set (n = 3642). Logistic regression, lasso regression, and random forest models were combined to identify the most significant predictors of HRQoL. A nomogram was constructed using multivariate logistic regression. The receiver operating characteristic curve, k-fold cross-validation, decision curve analysis (DCA), and internal validation were used to assess the accuracy, discrimination, and generalization of the nomogram.

Results: Non-suicidal self-injury, academic burnout, parental abuse, stress, bullying victimization, healthy diet, and sleep were found to be significant predictors of HRQoL. The area under the curve (AUC) of the training set was 0.765, whereas that of the validation data was 0.775. The k-fold cross-validation (k = 10) revealed good discrimination in internal validation (mean AUC = 0.771). The nomogram had good clinical use since the DCA covered a large threshold probability: 5%-89% (in the training set) and 4%-81% (in the validation set).

Conclusions: The nomogram prediction model constructed in this study can provide a reference for predicting HRQoL in children and adolescents.