Health and Quality of Life Outcomes最新文献

{"title":"Cultural adaptation and psychometric evaluation of the CHU-9D in Hong Kong adolescents.","authors":"Richard Huan Xu, Yuanshuo Xu","doi":"10.1186/s12955-026-02549-1","DOIUrl":"10.1186/s12955-026-02549-1","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to perform a cultural adaptation of the Child Health Utility 9D (CHU-9D), a health-related quality of life (HRQoL) instrument, into Traditional Chinese specifically for use in Hong Kong, and evaluating its psychometric properties among a sample of local adolescents.</p><p><strong>Methods: </strong>A cross-sectional survey design was employed for data collection. Adolescents aged 13 to 17 years were recruited from diverse local community settings to complete a self-administered questionnaire that included the adapted CHU-9D and relevant demographic items. Psychometric evaluations encompassed assessments of ceiling and floor effects, factorial validity through confirmatory factor analysis, convergent validity via correlation analysis, and known-group validity to examine differences across predefined risk groups.</p><p><strong>Results: </strong>A total of 627 adolescents successfully completed the survey, providing a robust dataset for analysis. The unidimensionality of the CHU-9D was confirmed, demonstrating excellent model fit indices. A ceiling effect was observed, with 27% of participants reporting full health status on the CHU-9D descriptive system, indicating potential limitations in capturing variations at the upper end of health. Convergent validity was supported by significant correlations between CHU-9D and conceptually relevant items and subscales from another HRQoL instrument. The instrument exhibited strong known-group validity, effectively discriminating HRQoL differences across various risk groups with statistically significant results.</p><p><strong>Conclusion: </strong>The culturally adapted Traditional Chinese version of the CHU-9D demonstrates sound psychometric properties in Hong Kong adolescents, supporting it as a valid tool for measuring and valuing HRQoL in this population and cultural context.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13326470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the ICECAP-O for assessing wellbeing in people with mild dementia in Denmark.","authors":"Emma Kjær Pedersen, Laila Øksnebjerg, T Rune Nielsen","doi":"10.1186/s12955-026-02544-6","DOIUrl":"10.1186/s12955-026-02544-6","url":null,"abstract":"<p><strong>Background: </strong>Assessment of wellbeing is essential in the context of chronic diseases. The Investigating Choice Experiments for the Preferences of Older People-Capability Index (ICECAP-O) is a generic wellbeing measure beyond health. We aimed to assess whether ICECAP-O is a valid measure of capability-wellbeing in people with mild dementia by assessing its discriminative and convergent validity. Further, we assessed its feasibility, internal consistency, and test-retest reliability.</p><p><strong>Methods: </strong>Four quality-of-life (QoL) and wellbeing measures were completed by 123 community-dwelling people with mild dementia. Discriminative validity was assessed by the ability of ICECAP-O to distinguish between levels of QoL, wellbeing, and related variables. Convergent validity was assessed by correlations between ICECAP-O index and domain scores, and the 5-level EQ-5D version (EQ-5D-5L), European Quality of Life visual analog scale (EQ VAS), Engagement and Independence in Dementia Questionnaire (EID-Q), and the World Health Organization Wellbeing Index (WHO-5). The feasibility of ICECAP-O in people with mild dementia was evaluated by missing data analysis. Internal consistency was assessed with Cronbach's α, and test-retest reliability was assessed using intraclass correlation coefficient (ICC).</p><p><strong>Results: </strong>ICECAP-O significantly distinguished between different levels of QoL and wellbeing. Further, ICECAP-O was not affected by sociodemographic characteristics. ICECAP-O index scores were strongly correlated with EQ-5D-5L (ρ = 0.61) and EID-Q (ρ = 0.62), and moderately with WHO-5 (ρ = 0.58) and EQ-VAS (ρ = 0.58). Missing data on ICECAP-O dimensions, ranging from 2% to 3%, indicate good feasibility in people with mild dementia. ICECAP-O demonstrated acceptable internal consistency (α = 0.74) and good test-retest reliability (ICC = 0.86).</p><p><strong>Conclusion: </strong>The Danish version of ICECAP-O is a valid and reliable measure of wellbeing in people with mild dementia, and demonstrated acceptable psychometric properties, providing further evidence for its use in this population.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13371156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147928969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive functioning and nausea as stage-specific drivers of quality of life in breast cancer: a longitudinal network analysis.","authors":"Furong Chen, Jinxian Feng, Min Xu, Shaoxue Li, Yuen-Shan Ho, Naomi Takemura, Janelle Yorke, Jiaying Li, Zengjie Ye","doi":"10.1186/s12955-026-02525-9","DOIUrl":"10.1186/s12955-026-02525-9","url":null,"abstract":"<p><p>OBJECTIVE: To map the dynamic trajectory of quality of life (QoL) in newly diagnosed breast cancer patients and identify the central symptom drivers that precipitate global health decline during the peri-treatment period. METHODS: In this longitudinal study, patients newly diagnosed with breast cancer (n = 337) were recruited at a comprehensive cancer center in Guangzhou, China. The EORTC QLQ-C30 was administered at diagnosis (T1), discharge (T2), and one-month post-discharge (T3). We utilized Cross-Lagged Panel Network (CLPN) analysis to determine temporal relationships and identify influential “bridge” nodes between time points. RESULTS: Symptom burden shifted significantly over time; insomnia was dominant at diagnosis, whereas fatigue peaked post-discharge. Network analysis revealed two distinct driver mechanisms. During the transition from diagnosis to treatment (T1–T2), Cognitive Functioning emerged as the strongest predictor of subsequent symptom deterioration (Out-Expected Influence [EI] = 0.366). Conversely, in the acute recovery phase (T2–T3), Nausea/Vomiting replaced cognitive issues as the central driver (Out-EI = 0.517), acting as the primary gateway to global health decline. CONCLUSION: The drivers of QoL deterioration evolve rapidly during the peri-treatment phase. Cognitive dysfunction at diagnosis serves as an early temporal predictor for somatic symptoms, suggesting that clinical management must shift from reactive symptom control to proactive cognitive prehabilitation at the point of diagnosis. </p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":"24 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13151383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive analysis of health-related quality of life trajectories in older patients with chronic pain based on explainable machine learning models.","authors":"Xiaoang Zhang, Weichen Liu, Yaqing Hu, Daying Zhang, Yuping Liao, Ziqi Wu, Meijuan Huang, Jianmei Wei","doi":"10.1186/s12955-026-02543-7","DOIUrl":"10.1186/s12955-026-02543-7","url":null,"abstract":"<p><strong>Background: </strong>Health-related quality of life (HRQoL) is a vital indicator of evaluating care outcomes and prognosis, yet little is understood about its developmental trajectories in older patients with chronic pain. This study aimed to identify latent HRQoL trajectories and their predictors, and to develop explainable machine learning models for predicting HRQoL deterioration.</p><p><strong>Methods: </strong>This prospective cohort study assessed 608 older patients with chronic pain at admission and at 1, 3, and 6 months post-admission, collecting data on HRQoL, general characteristics, pain level, activities of daily living (ADL), depression, and perceived social support. Growth mixture modeling was applied to identify trajectories of physical and mental HRQoL. Predictors were selected using LASSO regression and SVM-RFE. Nine explainable machine learning models were developed for both components, and SHAP interpreted the outputs. An HRQoL decision-support dashboard was developed to facilitate potential clinical application.</p><p><strong>Results: </strong>Three physical HRQoL trajectories were identified: Stable High, Decline and Low Stability, alongside two mental HRQoL trajectories: Improvement and Decline. Key predictors included education level, pain duration, pain level, ADL, depression, and perceived social support, with ADL and pain level being the most influential for physical and mental HRQoL, respectively.</p><p><strong>Conclusions: </strong>This dual-trajectory study identified five distinct HRQoL patterns in older patients with chronic pain, elucidating key predictors via explainable machine learning. The proposed HRQoL decision-support dashboard may provide an interpretable tool to support understanding of predictive relationships and assist healthcare professionals in HRQoL assessment.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world comparative evaluation of quality of life and economic burden in patients with psoriatic arthritis and axial spondyloarthritis under different treatment strategies: a multicenter cross-sectional study.","authors":"Lin Zhang, Shuying Chang, Yumei Sun, Yongkang Chen, Dongmei Zhou, Kun Liu, Chichi Du, Guan Jiang","doi":"10.1186/s12955-026-02542-8","DOIUrl":"10.1186/s12955-026-02542-8","url":null,"abstract":"<p><p>BACKGROUND: Psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) are chronic inflammatory disorders that significantly impair patients’ quality of life and impose substantial economic burdens. The advent of Janus kinase (JAK) inhibitors and biologic therapies has diversified treatment options, prompting increased attention to the balance between clinical efficacy and economic impact. METHODS: This study analyzed 451 valid responses from a total of 508 collected questionnaires (validity rate: 88.78%), comprising 203 PsA and 248 axSpA patients. Participants were categorized based on treatment modality into three groups: conventional therapy, biologic agents, and JAK inhibitors. Economic burden was assessed using analysis of variance (ANOVA). Generic quality of life was evaluated via the Short Form-36 (SF-36) survey, while disease-specific quality of life was measured using the Dermatology Life Quality Index (DLQI) for PsA and the Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire for axSpA. Multiple linear regression models were constructed to identify factors influencing quality of life outcomes. RESULTS: Patients receiving JAK inhibitors or biologic therapies demonstrated significantly better DLQI and ASQoL scores compared to those undergoing conventional treatment, indicating superior efficacy of targeted therapies in enhancing disease-specific quality of life. While SF-36 scores also varied among treatment groups, the differences were less pronounced, suggesting limited sensitivity of this generic measure to disease-specific changes. Economically, the conventional therapy group incurred the lowest costs but also reported the poorest quality of life, reflecting a “low cost–low benefit” scenario. Conversely, JAK inhibitors and biologics, despite higher costs, substantially improved symptoms and quality of life, underscoring their greater clinical value. CONCLUSION: Treatment modality significantly influences both quality of life and economic burden in PsA and axSpA patients. Targeted therapies, including JAK inhibitors and biologics, offer marked improvements in disease-specific quality of life, as evidenced by DLQI and ASQoL scores, compared to conventional treatments. Although associated with higher direct costs, these therapies’ long-term benefits and potential to improve patient outcomes justify their broader clinical adoption, particularly in contexts with supportive health policies and expanding insurance coverage. </p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13270620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, social, and home-level factors associated with the quality of life of residents living with dementia in Canadian nursing homes: a cross-sectional, multi-province study.","authors":"Gabriel J Dusing, Kyle Corbett, Emily Dymchuk, Hannah M O'Rourke, Stephanie A Chamberlain, Malcolm B Doupe, Christine Kelly, Janice Keefe, Katie Aubrecht, Anna S Beeber, Amit Arya, Sube Banerjee, Pam Jarrett, Carole A Estabrooks, Shovana Shrestha, Rashmi Devkota, Melissa Ristau, Matthias Hoben","doi":"10.1186/s12955-026-02539-3","DOIUrl":"10.1186/s12955-026-02539-3","url":null,"abstract":"<p><p>BACKGROUND: Quality of life (QoL) is a central priority in dementia care, yet most nursing homes (NHs) in Canada rely on clinical indicators that do not capture the emotional and social dimensions of residents’ well-being. Little is known about how clinical, social, and NH factors jointly shape QoL for residents living with dementia. This study examined the associations of resident social characteristics, clinical conditions, and NH factors with resident QoL. METHODS: This cross-sectional study included publicly funded NHs in the Canadian provinces of Alberta, British Columbia, Manitoba, Nova Scotia, and Ontario. QoL was measured using staff-proxy interviews to complete the DEMQOL-CH. Staff also provided information about resident social characteristics. Clinical data were obtained from routinely collected, standardized resident assessments. NH characteristics were reported by administrators. We used linear regression with robust standard errors to assess associations of social, clinical, and NH variables with resident QoL. Multiple imputation addressed missing data, and model fit was compared using the Akaike Information Criterion. RESULTS: The final sample included 2,950 residents in 67 NHs. Older age was also associated with lower QoL (-0.009 per standard-deviation increase in age, 95%CI: −0.016; −0.002). Clinical factors that were significantly associated with lower QoL were: depressive symptoms (coefficient=-0.066, 95%CI: -0.082; -0.050), responsive behaviours (-0.034, 95%CI: -0.054; -0.015), and health instability (-0.027, 95%CI: -0.045; -0.010). More severe cognitive impairment was associated with higher staff-rated QoL (0.039, 95%CI: 0.023; 0.055). Compared with Ontario, residents in British Columbia (− 0.059, 95%CI: −0.079; −0.040) and Manitoba (− 0.039, 95%CI: −0.061; −0.017) had lower QoL. Living in a large NH was associated with lower quality-of-life scores relative to small homes (− 0.034, 95%CI: −0.051 to − 0.016). The combined model, which incorporated social, clinical, and facility factors, had the best fit. CONCLUSIONS: QoL in Canadian NHs appears to be shaped primarily by resident clinical conditions and facility environments rather than individual social characteristics. Interventions that address mental health, behavioural symptoms, and environmental stressors may yield the greatest improvements in resident well-being. </p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13224679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measurement properties of patient-reported outcome measures for sexual health in the general population: a systematic review following the COSMIN 2.0 guidelines.","authors":"Yihan Shang, Quan Yuan, Yihang Shen, Kang Xu, Gentao Zhang, Baojun Ju","doi":"10.1186/s12955-026-02535-7","DOIUrl":"10.1186/s12955-026-02535-7","url":null,"abstract":"<p><p>BACKGROUND: Sexual health plays a crucial role in the overall health and quality of life of adults. Currently, various Patient-Reported Outcome Measures (PROMs) exist globally to assess sexual health from different dimensions. However, the quality of these measurement tools has not been sufficiently evaluated. AIM: To conduct a systematic review of existing PROMs used to assess sexual health in the general population, evaluate their methodological quality and measurement properties, and provide corresponding recommendations. METHODS: The systematic review was conducted following the previously established research protocol in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches were conducted in five databases from database inception until March 14, 2025: PubMed, Embase, Web of Science, Cochrane, and China National Knowledge Infrastructure (CNKI). Two researchers independently identified literature eligible for inclusion based on predefined criteria and qualitatively summarized the characteristics of the Patient-Reported Outcome (PRO) scales. The methodological quality and measurement properties of the identified PROMs were evaluated using the COSMIN standard, and evidence was synthesized using the modified Grading of Recommendations, Assessment, Development and Evaluations (GRADE) method. RESULTS: A total of 27 PROMs for assessing sexual health in the general adult population were ultimately included. Among these, eleven instruments target both sexes, covering sexual function, sexual health, sexual pleasure, sexual violence, sexual addiction, sexual distress, sexual experience, and sexual satisfaction. Eight instruments are designed for men, assessing sexual health, sexual function, sexual satisfaction, sexual arousal, and genital appearance. Another eight instruments focus on women, evaluating sexual health, sexual function, sexual desire, and genital appearance. CONCLUSION: The International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI) demonstrated a relatively more rigorous development process and more comprehensive validation evidence, thus receiving a Grade A recommendation. Furthermore, this review highlights the prevalent insufficiency of evidence regarding the methodological quality and key measurement properties (such as content validity and responsiveness) of tools in this field. There is an urgent need for more high-quality methodological studies to enhance the scientific rigor and applicability of these instrument </p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13224438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of multimorbidity on change in quality of life in a multi-ethnic Asian population: a longitudinal study.","authors":"Fatima Zahoor, Hamimatunnisa Johar, Joanne Ryan, Devi Mohan, Sophia Zoungas, Tin Tin Su","doi":"10.1186/s12955-026-02528-6","DOIUrl":"10.1186/s12955-026-02528-6","url":null,"abstract":"<p><p>BACKGROUND: The increasing burden of multimorbidity is associated with a risk of poorer health outcomes and mortality; however, evidence on its long-term impact on quality of life (QoL) remains limited. This study aims to explore the association of multimorbidity and multimorbidity clusters with QoL over a five-year period in a multiethnic, semi-rural cohort across different age groups. METHODS: This study utilized two-wave data from 8280 participants aged 18 years and above, collected as part of health surveys in 2013 and 2018 at the South East Asia Community Observatory (SEACO) Health and Demographic Surveillance System (HDSS) site in Malaysia. Multimorbidity was defined as having two or more of the following eight self-reported chronic conditions: diabetes, hypertension, heart disease, stroke, kidney disease (chronic kidney disease, end-stage renal failure), arthritis, asthma, and obesity. QoL was assessed using the WHOQOL-BREF, a 26-item questionnaire comprising four domains (physical, psychological, social relationships, and environmental health). Multivariable linear regression models were used for both count and clusters of chronic conditions to evaluate the association between multimorbidity and change in QoL over 5 years. RESULTS: At baseline, multimorbidity was significantly associated with better QoL in the social relationships domain only. Multimorbidity at baseline was not significantly associated with the change in QoL over 5 years across any age group. Two clusters of multimorbidity were identified: [1] cardiometabolic and musculoskeletal conditions and [2] cardiorespiratory and renal conditions. Among younger adults (18–34 years), cluster 1 was associated with improvement in the psychological domain (ß: 4.54, SE: 2.25, p-value = 0.03), whereas among adults (35–59 years), cluster 2 was associated with a decline in social relationships (ß: -6.57, SE: 2.87, p-value = 0.01). CONCLUSIONS: The study findings highlight that clinicians and policymakers need to focus on developing age-tailored interventions. Moreover, a simple count of chronic conditions fails to fully capture whether a certain group of conditions is resulting in a decline in QoL. Therefore, a cluster-based approach could provide a more useful insight. </p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13196214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient- and provider-level determinants of self-assessed health and well-being among adults with chronic conditions in Slovenian primary care.","authors":"Nena Kopčavar Guček, Aleksander Stepanović, Nina Ružić Gorenjec, Zalika Klemenc-Ketiš","doi":"10.1186/s12955-026-02538-4","DOIUrl":"10.1186/s12955-026-02538-4","url":null,"abstract":"<p><p>BACKGROUND: Chronic diseases significantly impact patients’ quality of life and healthcare systems. In Slovenia, understanding the factors influencing self-assessed health and well-being can support more effective primary care policies. The purpose of this study was to identify patient- and provider-level factors associated with general health and well-being among Slovenian adults with chronic conditions. METHODS: This cross-sectional study was conducted as part of the OECD-led PaRIS initiative. Data were collected from 2133 patients aged ≥ 45 years with at least one chronic condition and 70 primary care providers. Well-being was measured via the WHO-5 Well-Being Index; general health was self-rated. Mixed-effects models were used to assess associations between well-being (linear mixed model for a continuous outcome) and general health (logistic mixed-effects model for a binary outcome) and sociodemographic, behavioural, and provider-level variables. RESULTS: General health was rated as excellent, very good, or good by 62.5% of the patients. The mean well-being score was 60.9 (SD = 20.9). The key patient-level predictors of better health and well-being were higher income (medium vs. low OR = 1.64, 95% CI [1.26, 2.15]; high vs. low OR = 2.28, 95% CI [1.62, 3.21]), regular physical activity (OR = 1.98, 95% CI [1.57, 2.50]), age and BMI. The last two were nonlinearly associated with optimal well-being near a BMI of 25 and peaking at approximately 65–69 years of age. Male sex was associated only with greater well-being, whereas employment (OR = 2.41, 95% CI [1.67, 3.50]) and higher education (OR = 1.52, 95% CI [1.17, 1.97]) were only associated with better health. Among the provider-level factors, only the public health care setting was positively associated with well-being. Surprisingly, receiving written self-management instructions more often was linked to slightly lower well-being. Observed differences in wellbeing reached clinical relevance (10 points) for age, BMI, and regular physical activity (b = 10.46, 95% CI [8.48, 12.43]). CONCLUSIONS: Patient-level factors were strongly associated with self-assessed health and well-being among patients with chronic conditions, whereas provider-level organisational features showed limited associations. Care in public health care settings was associated with higher well-being. These findings support the need for age- and BMI-sensitive interventions, behaviour-focused care, and socially equitable policies in chronic disease management. </p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13196154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of the Health Belief Scale for Sarcopenia Prevention and Management (HBSPM): a pilot study among older adults in Guangdong, China.","authors":"Jiamin Fang, Hao Liang, Jintao Zhong, Zhixia Jiang, Shilong Lu, Zhuyun Liu, Rui Chen, Ruotong Liao, Tao Zou, Qingyuan Su, Lin Wei","doi":"10.1186/s12955-026-02537-5","DOIUrl":"10.1186/s12955-026-02537-5","url":null,"abstract":"<p><p>BACKGROUND AND OBJECTIVES: The prevalence of sarcopenia among older adults is rising annually, highlighting the importance of enhancing awareness and self-management in sarcopenia prevention as a critical public health priority. This study aimed to develop and validate the Health Belief Scale for Sarcopenia Prevention and Management (HBSPM) in older adults and to assess its reliability and validity. METHODS: This study was conducted in two phases. Guided by the Health Belief Model (HBM), the HBSPM was developed through a comprehensive literature review, expert consultation, and cognitive interviews. In May 2024, 701 older adults were recruited through stratified convenience sampling across from cities classified into three tiers according to their 2023 GDP levels in Guangdong Province. The validity of the HBSPM was assessed using item analysis, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA). RESULTS: The scale consists of 30 items across six dimensions: Susceptibility (5 items), Seriousness (6 items), Benefits (4 items), Barriers (5 items), Cues for Action (5 items), and Self-Efficacy (5 items). EFA revealed that these six factors accounted for 60.42% of the total variance. Factor loadings for the 30 items ranged from 0.615 to 0.759. The scale demonstrated good validity (χ²/df = 1.466, RMSEA = 0.045, TLI = 0.965, IFI = 0.961, NFI = 0.897, CFI = 0.965, GFI = 0.852, I-CVI > 0.86, S-CVI = 0.989) and reliability (Cronbach’s alpha = 0.935). CONCLUSION: This study demonstrates that the HBSPM is an effective tool for measuring health belief regarding sarcopenia prevention and management among older adults and provides a robust foundation for targeted health education and behavioral interventions. </p>","PeriodicalId":12980,"journal":{"name":"Health and Quality of Life Outcomes","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13188640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}