The main purpose of the study was to evaluate quality of life (QOL) among cancer patients using the WHOQOL-100 instrument and to see if any significant differences were seen in cancer stages, treatment status and prognosis. This study consisted of two parts; qualitative and quantitative. For the qualitative study, two focus groups were conducted by medical professionals to establish the applicability of the WHOQOL instrument in evaluating the QOL of cancer patients, but most participants were negative about using a generic instrument such as WHOQOL. For the quantitative study, 197 cancer patients (average age 55.86) from eight medical centers using the WHOQOL instrument, in addition to each patient's information sheet filled in by their own physicians, were analyzed. The average overall QOL score was 3.39. There was high reliability (Cronbach's alpha = 0.9685) and a high correlation between the psychological and the environmental domains (r = 0.7021), the physical domain and the level of independence (r = 0.6031) and social relations and the environment (r = 0.6856) and between health conditions perceived by patients and QOL scores. In addition, differences by gender, treatments and cancer sites were also found to be significantly different at the 5% significance level. The results indicated that the WHOQOL core instrument was sensitive enough to evaluate the QOL of cancer patients.
No abstract
The Japanese version of the World Health Organization Disability Assessment Schedule II (WHODAS II-J) was developed and its psychometric properties were evaluated, and then used to determine the influence of disability on quality of life among the elderly in Japan. The study included three phases: qualitative, preliminary and field. For the qualitative portion of the study, six key informants were interviewed before the translation/back-translation procedure. For the preliminary study, 17 healthy elderly individuals were interviewed using the 12-item interview version of the WHODAS II-J. For the field study, different versions of the WHODAS II-J and the Japanese version of the World Health Organization Quality of Life BREF (WHOQOL-BREF) were tested with different participants (the 36-item interview version with 30 participants living in a nursing home, the 36-item proxy version with 30 caregivers working in the nursing home, and the 12-item and 36-item self-report versions with 132 and 129 healthy elderly living in Kanto and Kinki regions, respectively). In total, 321 elderly individuals participated in the field study. Of these participants, physical or mental disabilities were present in 47. Cronbach's α scores calculated for each of six domains of the WHODAS II ranged from 0.67 to 0.98. A significant correlation was observed between the results of the WHODAS II-J and the degree of disability (P<0.01), and a negative correlation was observed between WHOQOL-BREF and WHODAS II-J scores (P<0.01). A significant difference was found between healthy elderly individuals and those with disabilities in three domains: getting around, self-care, and life activities (P<0.01). In conclusion, the WHODAS II-J is a reliable and valid instrument for assessment of function in the elderly population in Japan.
Due to the lack of adequate cure or medication for somatoform disorders, cognitive-behavioural intervention or cognitive-behavioural therapy (CBT) seems to be an optimal treatment resource for patients with these disorders, since the cause of the somatoform disorders cannot to be explained by medical illness, but can be analyzed in the process of both responding and operant conditioning. According to the reviews, randomized controlled trials are limited, but the efficacy of the intervention is quite impressive. Most of the studies use multiple treatment strategies, and no standardized treatment methods have been established. In general, the following steps are taken in CBT treatments: (1) assessment; (2) rationale of treatment choice; (3) course of treatment; (4) evaluation of treatment; and (5) reviewing treatment effects. In CBT, functional analysis in the assessment session is the key to success, to identify the relationship among discriminative stimuli and consequences, in order to reduce the undesirable behaviour, and the most effective approach of the treatment would be a combination of multiple techniques. However, as the efficacy of the treatments is established, expansion of accurate knowledge of functional analysis and training sessions for health care providers and patients should be provided. Further research should explore the effect of individual techniques, and comparison should be made to identify the relative benefits of the techniques using both individual, and group format.
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