The field of holistic medicine is in need of a scientific approach. We need holistic medicine--and we even need it to be spiritual to include the depths of human existence--but we need it to be a little less "cosmic" in order to encompass the whole human being. Many important research questions and challenges, empirical as well as theoretical, demand the attention from medical researchers. Like a number of other practitioners and researchers, our group at the Quality of Life Research Center in Denmark together with groups in Norway and Israel are trying to tackle the research challenge by using conceptual frameworks of quality of life. We have suggested that quality of life represents a third influence on health beyond the genetic and traumatic factors so far emphasized by mainstream medicine. In our clinical and research efforts, we attempt to specify what a clinician may do to help patients help themselves, by mobilizing the vast resources hidden in their subjective worlds and existence, in their hopes and dreams, and their will to live. The field of holistic medicine must be upgraded to fully integrate human consciousness, scientifically as well as philosophically. We therefore present a number of important research questions for a consciousness-based holistic medicine. New directions in healthcare are called for and we need a new vision of the future of the healthcare sector in the industrialized countries. Every person seems to have immense potentials for self-healing that we scarcely know how to mobilize. A new holistic medicine must find ways to tackle this key challenge. A healthcare system that could do that successfully would bring quality of life, health, and new ability of functioning to many people.
The intention of this study was to elucidate what the concept "quality of life" means to elderly women. A qualitative approach based on 282 women (age 75-93 years) showed that the participants were able to articulate what quality of life meant to them. Thinking about what makes for a good quality of life, 82.3% mentioned the importance of good social functioning, 68.8% mentioned good health, 22.3% mentioned good economic circumstances, and 14.9% mentioned the importance of living in their own flat or house. Six categories were identified based on the women's descriptions: holism, relationships, activity and participation, pragmatic approach to health, belonging and social environment, and personal values. The lay perspective on quality of life is characterized by three qualities: preservation of continuity-sameness within change, power-empowerment, and the quest for meaning.
Quality of life (QOL) has over the past decade become an important part of health science and also increased public awareness. It has become increasingly apparent that illness is closely related to the individual perception of a good life, and therefore the exploration of indicators related to quality of life appears to be of broad importance for the prevention and treatment of diseases. Identifying, which factors constitute a good life may reveal an understanding about what areas in life should be encouraged, in order to enhance the global quality of life, health, and ability. In this paper we present results from studies initiated in 1989 to examine quality of life in relation to disease. The purpose of this presentation was to assemble the results from the study carried out in the years between 1993 and 1997, examining a total of 11,500 Danes, to show the association between quality of life and a wide series of social indicators.
PURPOSE: The aim in the present study was to illustrate generalizability theory by exploring some psychometric aspects of the Norwegian version of KINDL (KINDL-N). This questionnaire is a measure of quality of life in adolescents. It consists of 24 items arranged in six subscales or aspects, corresponding to six domains of adolescents' health-related quality of life. METHOD: A total of 239 healthy adolescents completed the questionnaire. The analysis was performed in line with generalization theory, and this analysis yields among other things so-called generalizability and dependability coefficients, which are analogous to reliability coefficients in classical test theory. The preferred design was a mixed two-facet design, with the six aspects as a fixed facet and the items nested within aspects as a random facet. For comparison, a random two-facet design and a one-facet design were also analyzed. RESULTS: The generalizability and dependability coefficients for KINDL-N are satisfactory, but the coefficients can be markedly improved by increasing the length of the instrument while keeping it to a manageable size. The mixed two-facet design resulted in somewhat higher coefficients than a one-facet design and much higher coefficients than a random two-facet design. CONCLUSION: If the items within a questionnaire are arranged in distinct subscales, a two-facet design analyzed by generalizability theory gives more sophisticated results than classical test theory. Moreover, the results may depend considerably on whether a mixed or random two-facet design is chosen. Hence, the choice of an appropriate measurement design in line with the intended use of the questionnaire is essential.
To investigate changes in social network and quality of life of a substance use disorder cohort as they progressed through treatment.
Multi-site, prospective, observational study of 338 adults entering substance use disorder treatment.
Patients at 21 facilities across Norway contributed baseline data when they initiated treatment, and follow-up data was collected from them one year later.
The cohort was divided into those who completed, dropped out, and remained in treatment one year after treatment initiation. For each treatment status group, general linear models with repeated measures analyzed global and social quality of life with the generic QOL10 instrument over time. The between-group factor was a change in social network variable from the EuropASI.
Those who gained an abstinent network reported the largest quality of life improvements. Improvements were smallest or negligible for the socially isolated and those who were no longer in contact with the treatment system.
Developing an abstinent network is particularly important to improve the quality of life of those in substance use disorder treatment. Social isolation is a risk factor for impaired quality of life throughout the treatment course.
GOALS OF THE WORK: As part of a psychosocial intervention study, we wanted to prospectively assess the quality of life of colorectal cancer patients who were given a stoma at the time of their initial operation for cancer or later and those whose initial stoma was removed. MATERIALS AND METHODS: A total of 249 colorectal cancer patients were recruited and responded to a questionnaire 3, 6, 12 and 24 months after the initial operation (26-35% had a stoma during follow-up). MAIN RESULTS: Although most of the differences between stoma and non-stoma patients failed to reach significance, 22 out of 27 variables indicated a poorer quality of life for those with a stoma. Patients who currently had a stoma had significantly higher levels of depression (p = 0.013), poorer social functioning (p = 0.0085) and more problems with body image (p = 0.0001), future perspectives (p = 0.0058), micturition (p = 0.018) and side effects from chemotherapy (p = 0.008), but fewer problems with constipation (p = 0.034) than non-stoma patients. Male patients with a stoma had more sexual problems than males without a stoma (p = 0.015). Among those with a current stoma, quality of life seemed poorer among those whose stoma was made during follow-up compared with those with an initial stoma. CONCLUSIONS: Trends suggested that having a stoma led to poorer scores in most aspects of quality of life and that having a stoma made some time after the initial operation was more distressing than having a stoma made during the primary cancer operation.
The study is devoted to the problem of congenital disorder--cleft palate in elderly population. This theme is almost not investigated in the Russian Federation, whereas such studies are periodically made abroad and foreign investigations describe tasks of rehabilitation of this group of patients including their age features. Main characteristics of cleft palate syndrome and its influence on quality of life are described in the article.
Family caregivers are assuming growing responsibilities in providing care to dying family members. Supporting them is fundamental to ensure quality end-of-life care and to buffer potentially negative outcomes, although family caregivers frequently acknowledge a deficiency of information, knowledge, and skills necessary to assume the tasks involved in this care.
The aim of this inquiry was to explore how family caregivers describe learning to provide care to palliative patients.
Secondary analysis of data from four qualitative studies (n = 156) with family caregivers of dying people.
Data included qualitative interviews with 156 family caregivers of dying people.
Family caregivers learn through the following processes: trial and error, actively seeking needed information and guidance, applying knowledge and skills from previous experience, and reflecting on their current experiences. Caregivers generally preferred and appreciated a supported or guided learning process that involved being shown or told by others, usually learning reactively after a crisis.
Findings inform areas for future research to identify effective, individualized programs and interventions to support positive learning experiences for family caregivers of dying people.