"In public health and in medicine, the concept of health-related quality of life refers to a person or group's perceived physical and mental health over time. Physicians have often used health-related quality of life (HRQOL) to measure the effects of chronic illness in their patients to better understand how an illness interferes with a person's day-to-day life. Similarly, public health professionals use health-related quality of life to measure the effects of numerous disorders, short- and long-term disabilities, and diseases in different populations. Tracking health-related quality of life in different populations can identify subgroups with poor physical or mental health and can help guide policies or interventions to improve their health. Most conceptualizations of HRQL emphasize the effects of disease on physical, social/role, psychological/emotional, and cognitive functioning. This important book gathers the latest research from around the world in this field."--Publisher's description.

This volume's purpose is to describe concepts and methods concerning assessment of health-related quality of life (HRQOL) in children and adolescents with a special focus on chronic health conditions. The impetus for this book came from a recognition of the increasing importance of HRQOL assessments in the evaluation of treatment outcomes and the need to increase the utilization of HRQOL assessments in research and clinical applications with a range of pediatric populations. The need to develop a volume that describes new research and clinical applications concerning this topic stemmed from several recent developments. There is a continuing need for evaluations of the efficacy of medical treatments for children and adolescents, including those with chronic health conditions. To address these critical unmet needs in the field of HRQOL assessment, and to advance scientific methods and clinical applications in this field, a conference was held at Case Western Reserve University. The conference set out to summarize current information concerning the development and implementation of measures of HRQOL assessment, to identify and consider key conceptual and methodological issues in research concerning the measurement of HRQOL, and to recommend priorities to advance the state-of-the-art in research and clinical applications of QOL assessment in children and adolescents with chronic health conditions. This volume summarizes and synthesizes the information that was presented by the conference participants in a series of lively discussions and chapters that were based on the presentations.

The concept of health-related quality of life (HRQoL) has evolved since the 1980s, with broad-based applications for clinical care, research, and health policy, as well as for individual and patient use. This book, Health-Related Quality of Life - Measurement Tools, Predictors and Modifiers, highlights measurement tools for HRQoL, as well as predictors and modifiers, examining HRQoL in various disease states, including psychological health. It also discusses ethical issues in the use of HRQoL measurements. The book is a compendium of original research, sharing perspectives from across developing and developed world settings. It is a useful text for researchers and students of academic disciplines in public health and clinical studies, extending to healthcare administrators and policymakers.

A modern definition of health goes beyond the biological dimension to encompass human functionality and well-being. Quality of life is one of the most popular health-related concepts and simultaneously reflects several dimensions of individual health. Health-related quality of life (HRQoL) is taken to include physical, psychological, and social aspects of positive well-being as well as negative effects of illness, treatment, and infirmity. Quality of life outcomes are now considered an important indicator of the success of both diagnostic and therapeutic procedures. In this book, recognized experts discuss the findings of various studies, including their own, regarding HRQoL in patients with cardiovascular diseases. The impact of the newest forms of medical treatment on well-being is considered in patients with arterial hypertension, coronary artery disease, heart failure, arrhythmias, and stroke as well as in patients who have undergone interventional procedures or have implantable cardiac devices. By summarizing established facts and presenting new data, this book will be an invaluable source of information for all practitioners in the field.

This book discusses HRQoL in patients with cardiovascular disease including arterial hypertension, coronary artery disease, heart failure, arrhythmias and stroke, and patients who have undergone interventional procedures or have implantable cardiac devices.

Healthcare workers, clinicians and/or researchers require information on the consequences of illness on their patients, as well as on the effects associated with treatments, when making decisions on recommended treatments and for follow-up evaluations of the same. Identifying health indicators which provide necessary and appropriate data for the evaluation of clinical outcomes in terms of Health-Related Quality of Life (HRQoL), as established by the WHO Biopsychosocial Model, and which provide appropriate and pertinent information on physical, mental and social factors in patients, can improve decision-making in relation to a comprehensive and global perspective of clinical outcomes of the various treatments and procedures given to patients. This chapter aims to provide an overview of the various tools for assessing Health-Related Quality of Life, as a growing number of clinicians, researchers and patient groups wish for comprehensive and not merely biological measures of health. This may be explained by the growing number of self-administered or interview questionnaires which have the aim of measuring changes in health as well as the consequences of the various treatments used mainly on chronicity and chronic health conditions. During recent decades, numerous tools have been developed and applied to the measurement of the effects of Health-Related Quality of Life in patients based on biological or physical aspects, psychological or mental aspects, and social aspects. This chapter will review the most frequently-used tools for the measurement of Health-Related Quality of Life, and recommendations are made for their use in medical care according to psychometric characteristics and quality criteria, as a guide for use in the field of healthcare, in public health, or in outcomes research.

This monograph provides an overview of HRQL measurement to facilitate an understanding of HRQL measures to be used in both clinical practice and research. Clinicians of all disciplines may find this monograph useful in guiding their selection of HRQL measures for use in their clinical practice and research programs. The monograph also provides a brief summary of HRQL studies conducted at the Institute of Health Economics.

Atrial fibrillation (AF) is the most common cardiac arrhythmia, affecting at least 2.9 % of the Swedish population. Although AF is associated with increased risk of ischaemic stroke, there have been many reports on the underuse of oral anticoagulants (OAC) and non-adherence to guidelines in other areas as well. AF is also associated with disabling symptoms and decreased health-related quality of life (HRQoL), but some patients are asymptomatic. The reasons for the great variation of symptoms remain unclear. Furthermore, although research on AF has increased, studies have mainly focused on treatment, while studies on risk factors, such as alcohol consumption, have only recently gained attention. The aim of this thesis was to investigate whether structured care of patients with AF could improve guideline adherence and HRQoL compared to standard care, and to determine which factors affect symptoms and HRQoL prior to treatment with radiofrequency catheter ablation (RFA), as well as improvement after RFA. Furthermore, we aimed to examine the associations of alcohol consumption with cardiac biomarkers, the size of the left atrium (LA), and re-ablation. This thesis is based on two studies. In the ‘Structured Management and Coaching – Patients with Atrial Fibrillation’ (SMaC-PAF) study, 176 patients were recruited to the intervention group, receiving a structured follow-up programme, and 146 patients were recruited to the control group, receiving standard care. The two groups were compared in regard to adherence to guidelines and patient-reported outcome measures (PROMs) assessing symptoms and HRQoL. In the ‘Symptom burden, Metabolic profile, Ultrasound findings, Rhythm, neurohormonal activation, haemodynamics and health-related quality of life in patients with atrial Fibrillation’ (SMURF) study, 192 patients referred for their first RFA of AF were included. PROMs questionnaires were filled out, echocardiography was performed, and cardiac biomarkers were analysed. Alcohol consumption was assessed through interview and through analysis of ethyl glucuronide in hair (hEtG). AF recurrence and re-ablation within 12 months were examined. In the first study, after one year, 94% (n=112) and 74% (n=87) of patients with indication for OAC in the intervention and the control groups, respectively, actually received treatment with OAC (p <0.01). Both groups improved in anxiety and HRQoL scores over the year, but in the intervention group, arrhythmia-specific symptoms were less frequently experienced and the SF-36 scores were more similar to the norm population. In the second study, the most important predictors of arrhythmia-related symptoms and HRQoL prior to RFA were anxiety, depression and low-grade inflammation, while frequent AF attacks prior to RFA, freedom from AF recurrence after RFA, female gender, no enlarged LA, absence of diabetes, and the presence of heart failure were significant predictors of improvement in symptoms and HRQoL after RFA. Men with hEtG ≥7 pg/mg had higher levels of cardiac biomarkers, larger LA volumes and a higher re-ablation rate than men with hEtG <7 pg/mg, while no such findings were present in women. In conclusion, structured management was superior to standard care in patients with AF, emphasising the importance of structured care, adjusted to local requirements, in order to improve the care and well-being of patients with AF. Although the reasons for the great variety of symptoms in patients with AF still are not yet fully understood, it seems that psychological factors and inflammation play a role, and that improvement in symptoms and HRQoL after RFA is influenced by gender, diabetes, heart failure, LA size and the frequency of attacks before, as well as freedom from AF after, RFA. Finally, alcohol consumption corresponding to hEtG ≥7 pg/mg was associated with higher levels of cardiac biomarkers, larger LA size and a higher rate of re-ablation in men, implying that men with an hEtG-value ≥7 pg/mg have a higher risk for LA remodelling that could potentially lead to a deterioration of the AF situation.