ФГБУ «Федеральный научный центр трансплантологии и искусственных органов имени академика В.И. Шумакова» Минздрава России, Москва, Российская Федерация Изучение показателя качества жизни прижизненных органных доноров в трансплантологии с помощью опросников все чаще становится предметом клинических исследований. Однако не существует единых критериев и стандартных норм качества жизни. Каждый опросник имеет свои критерии и шкалу оценки. В настоящем обзоре представлены основные общие опросники, которые были применены в мировой практике для оценки качества жизни прижизненных доноров почки и фрагмента печени. Рассмотрены специальные опросники, применяемые для уточнения интересующих параметров качества жизни и их согласование с общими опросниками. Выявлен оптимальный опросник для проведения современных исследований качества жизни прижизненных органных доноров.Ключевые слова: прижизненный донор; качество жизни; опросник SF-36. aSSeSSMenT MeThODS Of QualiTY Of life Of liVinG OrGan DOnOrS S.V. Gautier, V.K. Konstantinov V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs of the Ministry of Healthcare of the Russian Federation, Moscow, Russian FederationThe study of quality of life of living organ donors in transplantation by questionnaires has increasingly become the subject of clinical studies. However, there are no unified criteria and standard norms of quality of life. Each questionnaire has its own criteria and evaluation scale. This review presents the main general questionnaires that have been applied worldwide for the quality of life assessment of living kidney and liver donors. Special questionnaires used to refine the parameters of quality of life and their coordination with common questionnaires are considered. Optimal questionnaire to detect quality of life in modern research for living organ donors is identified.

Summary In this paper the psychometric properties of the multidimensional fatigue inventory are established further in cancer patients. The MFI is a 20-item self-report instrument designed to measure fatigue. It covers the following dimensions: general fatigue, physical fatigue, reduced activity, reduced motivation and mental fatigue. The instrument was used in a Dutch and Scottish sample of cancer patients receiving radiotherapy. The dimensional structure was assessed using confirmatory factor analyses (Lisrel's unweighted least-squares method). The hypothesised five-factor model appeared to fit the data in both samples (adjusted goodness of fit; AGFI: 0.97 and 0.98). Internal consistency of the separate scales was good in both the Dutch and Scottish samples with Cronbach's alpha coefficients ranging from 0.79 to 0.93. Construct validity was assessed by correlating the MFI-20 to activities of daily living, anxiety and depression. Significant relations were assumed. Convergent validity was investigated by correlating the MFI scales with a visual analogue scale measuring fatigue and with a fatigue-scale derived from the Rotterdam Symptom Checklist. Results support the validity of the MFI-20. The highly similar results in the Dutch and Scottish sample suggest that the portrayal of fatigure using the MFI-20 is quite robust.

Spirituality is an important theme in health research, since a spiritual orientation can help people to cope with the consequences of a serious disease. Knowledge on the role of spirituality is, however, limited, as most research is based on measures of religiosity rather than spirituality. A questionnaire that transcends specific beliefs is a prerequisite for quantifying the importance of spirituality among people who adhere to a religion or none at all. In this review, we discuss ten questionnaires that address spirituality as a universal human experience. Questionnaires are evaluated with regard to psychometric properties, item formulation and confusion with well-being and distress. Although none of the questionnaires fulfilled all the criteria, the multidimensional Spiritual Well-Being Questionnaire is promising.

No abstract

Despite that the majority of the studies concluded that spirituality was associated with higher well-being, no definitive conclusions on this relationship can be drawn due to major methodological shortcomings of these studies. Longitudinal research utilizing spirituality and well-being measures that do not overlap in content is recommended.

(Cristensen, 1989).To date there are few studies which systematically register how many cancer patients experience fatigue, in which stage of the disease process and to what extent. To give an indication, a literature-search using MEDLINE with CD-ROM over the period 1980 to 1991 yielded nine references in which 'fatigue' was included in the title and 'cancer' was included in title, keyword or abstract. Eight of these references pertained to nursing research.An appraisal of the research literature concerning fatigue in cancer is presented in this paper to give an overview of what is currently known. Literature, other than obtained using the MEDLINE-procedure, was gathered either by searching for studies in which fatigue was assessed as part of patient functioning or through references of the papers obtained. This procedure does evidently not lead to an exhaustive list of all the studies which included fatigue as an outcome-variable. However, we think to have obtained a representative sample. Topics that will be discussed are: the conceptualisation of fatigue and its measurement, prevalence rates of fatigue during and after treatment and somatic and psychological correlates of fatigue. Finally, considerations with regard to research and interventions will be discussed.

The objective of this meta-analysis was to determine the longitudinal positive effect of religion or spirituality (R/S) on mental health. We summarized 48 longitudinal studies (59 independent samples) using a random effects model. Mental health was operationalized as a continuous and a dichotomous distress measure, life satisfaction, well-being, and quality of life. R/S included participation in public and private religious activities, support from church members, importance of religion, intrinsic religiousness, positive religious coping, meaningfulness, and composite measures. The meta-analysis yielded a significant, but small overall effect size of r = .08 (95% CI: 0.06 to 0.10). Of eight R/S predictors that were distinguished, only participation in public religious activities and importance of religion were significantly related to mental health (r = .08 and r = .09, respectively; 95% CI: 0.04 to 0.11 and 0.05 to 0.12, respectively). In conclusion, there is evidence for a positive effect of R/S on mental health, but this effect is small.

Summary Cancer patients undergoing radiotherapy frequently report fatigue. However, knowledge of the importance of fatigue for these patients and of the factors associated with their fatigue is limited. The aim of the current investigation was to gain more insight into fatigue as related to radiotherapy by answenng the following questions. First. how is the experience of fatigue best described? Secondly, to what extent is fatigue related to sociodemographic, medical (including treatment), physical and psychological factors? Finally, is it possible to predict which patients will suffer from fatigue after completion of radiotherapy? Patients with different types of cancer receiving radiotherapy with curative intent (n = 250) were interviewed before and within 2 weeks of completion of radiotherapy. During treatment, patients rated their fatigue at 2-weekly intervals. Results indicate a gradual increase in fatigue over the period of radiotherapy and a decrease after completion of treatment. Fatigue scores obtained after radiotherapy were onty slightly, although significantly, higher than pretreatment scores. After treatment, 46% of the patients reported fatigue among the three symptoms that caused them most distress. Significant associations were found between post-treatment fatigue and diagnosis, physical distress, functional disability, quality of sleep, psychological distress and depression. No association was found between fatigue and treatment or personality characteristics. Multivariate regression anatysis demonstrated that the intensity of pretreatment fatigue was the best predictor of fatigue after treatment. In view of this finding, a regression analysis was performed to gain more insight into the variables predicting pretreatment fatigue. The degree of functional disability and impaired quality of sleep were found to explain 38% of the variance in fatigue before starting radiotherapy. Fatigue in disease-free patients 9 months after treatment is described in paper (B) in this issue.