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  • 1.
    Garvin, Peter
    et al.
    Linköping University, Department of Medical and Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care. Linköping University, Faculty of Medicine and Health Sciences.
    Nilsson, Evalill
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.
    Ernerudh, Jan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Immunology and Transfusion Medicine.
    Kristenson, Margareta
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    The joint subclinical elevation of CRP and IL-6 is associated with lower health-related quality of life in comparison with no elevation or elevation of only one of the biomarkers2016In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 25, no 1, p. 213-221Article in journal (Refereed)
    Abstract [en]

    Measures of health-related quality of life (HRQoL), like the Short Form (SF)-36, have been suggested to correlate with inflammatory biomarkers. It is, however, unclear whether a joint measure of two inflammatory biomarkers would bring additional information in comparison with evaluation of one inflammatory biomarker. To evaluate associations between SF-36 and low-grade inflammation in a Swedish population, with emphasis on a combined measure of C-reactive protein (CRP) and interleukin-6 (IL-6) as a proxy for low-grade inflammation. In a randomly selected sample of a middle-aged Swedish general population (n = 905; aged 45-69 years, 50 % women), relations between SF-36 parameters and the biomarkers were tested. Regression and correlation analyses were adjusted for sex, age, presence of disease, lifestyle, and psychological factors. After adjustment for sex and age, HRQoL was significantly lower in the group with a joint elevation of CRP and IL-6 in comparison with either the group with no elevation or the groups showing elevation of one of the two biomarkers. Also after full adjustments, the combined measure of elevated CRP and IL-6, with few exceptions, was associated with significantly lower HRQoL in comparison with elevations in one of them, difference ranging from 4 (Mental Health scale) to 18 scale steps (Role-Physical scale). This study confirms that there is a relationship between HRQoL and low-grade inflammation. In particular, SF-36 scores are significantly lower in a group with joint elevation of IL-6 and CRP, in comparison with elevation of either one of them.

  • 2.
    Nilsson, Evalill
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Aspects of health-related quality of life: Associations with psychological and biological factors, and use as patient reported outcome in routine health care2012Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background Health-related quality of life (HRQoL) is increasingly recognised as an important patient-reported outcome in health care research. However, the use is still restricted and several questions remain about the value and feasibility of using measures of HRQoL in routine health care. The general aims of the thesis were therefore to increase the understanding of these issues by studying 1) associations of HRQoL with psychological and biological factors, 2) comorbidity adjustments of HRQoL measurement results, and 3) the patient-perceived value and feasibility regarding the use of measures of HRQoL as patient-reported outcome in routine health care.

    Methods Three different data sets were used; baseline data (questionnaire, anthropometric, and biological) from the ongoing Life conditions, Stress, and Health Study (n=1007, papers I and II), data from a population survey from the County Council of Östergötland in combination with data from two national Swedish registries, the National Inpatient Register and the Causes of Death Register (n=6086, paper III), and data (questionnaire) from the multicentre Swedish Health Promoting Hospitals Network Health outcome assessment project (n=463, paper IV). The HRQoL measures used were the SF-36 and the EQ-5D. Statistical methods include variance, correlation and regression analyses.

    Results Psychological resources (Self-esteem, Sense of Coherence, and Perceived Control) as well as psychological risk factors (depressive mood) were found to relate independently to HRQoL (SF-36) in the expected directions (positive relations for resources and negative relations for risk factors), but with fewer sex differences than expected (Paper I). Low HRQoL (SF-36) was found to relate to higher levels of inflammatory biological factors (C-reactive protein, Interleukin-6, and MatrixMetalloProteinase-9), and, especially regarding Interleukin-6, many association remained significant, though attenuated, after adjustment for factors of known importance to HRQoL (age, sex, disease, lifestyle and psychological factors) (Paper II). A new comorbidity index, the Health-related Quality of Life Comorbidity Index (HRQL-CI), explicitly developed for use in HRQoL outcomes studies, showed higher explanatory power (higher R2 values) than the commonly used Charlson Comorbidity Index (CCI) regarding impact of comorbidity on HRQoL (SF-36 and EQ-5D). However, regarding mortality the CCI discriminated better between those who died within a year from answering the HRQoL questionnaires, died within ten years, or who were still alive after ten years. This result is in line with the CCI’s original purpose as a mortality predictor. Using morbidity data from mandatory, highly valid national health data bases was found to be useful in a large study of this kind, where using data from medical records might be impractical. (Paper III). Using measures of HRQoL as patient-reported outcome measures in routine health care was regarded as valuable by the majority of the patients in the Health outcome assessment project. A new concept was introduced, respondent satisfaction, and the respondent satisfaction summary score was in most cases equal, i.e. SF-36 and EQ-5D were found to be quite similar regarding the cognitive response process (understanding and responding to the items in the EQ-5D and the SF-36) and patient-perceived content validity (if EQ-5D and SF-36 gave patients the ability to describe their health in a comprehensive way) (Paper IV).

    Conclusions The four papers investigated different aspects of HRQoL that are important for the implementation of the use of measures of HRQoL within the health care system. In conclusion, 1) the use of measures of HRQoL to identify patients with low HRQoL for further health promoting interventions might be supported on a psychological (psychological resources are related to better HRQoL) and biological basis (low HRQoL being an important sign of increased biological vulnerability), 2) a comorbidity index specifically aimed to adjust for comorbidity in patient HRQoL outcomes studies was found to be valid in a normal population (that might serve as a reference population in future studies), and 3) patients perceived the use of measures of HRQoL to be valuable and feasible in routine health care, and questionnaire length and ease of response were not found to be crucial arguments in the choice between SF-36 and EQ-5D. Hence, in their own way, they all and together, contribute to removing obstacles in the implementation process of using patient-reported outcome measures in the health care system for quality improvement.

    List of papers
    1. Psychological factors related to physical, social,and mental dimensions of the SF-36: a populationbasedstudy of middle-aged women and men
    Open this publication in new window or tab >>Psychological factors related to physical, social,and mental dimensions of the SF-36: a populationbasedstudy of middle-aged women and men
    2010 (English)In: patient related outcome measures, Vol. 1, p. 153-162Article in journal (Refereed) Published
    Abstract [en]

    Background: Measures of health-related quality of life (HRQoL) are increasingly used as patient-reported outcome measures in routine health care. Research on determinants and correlates of HRQoL has, therefore, grown in importance. Earlier studies have generally been patient-based and few of them have examined differences between women and men. The aim of this study was to explore the relationship between psychological factors and physical, social, and mental dimensions of HRQoL, as measured by the Medical Outcome Study Short Form-36 Health Survey (SF-36), in a normal population and to see if observed relations were the same for women and men.

    Methods: Relations between scale scores for the eight scales of SF-36 and scale scores for Self-esteem, Sense of Coherence, Perceived Control, Depressed Mood (CES-D), and Cynicism were assessed through partial correlation and multiple linear regression analyses on a sample of 505 women and 502 men (aged 45–69 years), stratified for sex and adjusted for effects of age, presence of disease, back pain, lifestyle, and social support.

    Results: All psychological factors tested, except Cynicism, were significantly correlated to all scales of the SF-36 for women and men (Pearson product-moment partial correlation coefficient, |r| = 0.11–0.63 and |r| = 0.11–0.60, respectively). The addition of psychological factors into regression models resulted in significant total explained variance (R2) changes in all scales of the SF-36 for both sexes. Any discrepancies between women and men pertained more to the strength of relationships rather than the significance of different psychological factors.

    Conclusion: In this population-based study, psychological factors showed significant correlation, for women and men alike, with the physical and social scales of SF-36, as well as the mental scales. These findings suggest that assessments of HRQoL are not merely a measure of absolute function but are also dependent on people’s perception of their ability.

    Place, publisher, year, edition, pages
    Dove Medical Press Limited, 2010
    Keywords
    Health-related quality of life, patient-reported outcome measures, population
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology
    Identifiers
    urn:nbn:se:liu:diva-66496 (URN)10.2147/PROM.S13209 (DOI)
    Projects
    LSH-studien
    Available from: 2011-03-17 Created: 2011-03-17 Last updated: 2014-11-13Bibliographically approved
    2. Associations between SF-36 and inflammatory biomarkers CRP, CXCL8, IL-1β, IL-6, IL-10, and MMP-9 in a normal middle-aged Swedish population
    Open this publication in new window or tab >>Associations between SF-36 and inflammatory biomarkers CRP, CXCL8, IL-1β, IL-6, IL-10, and MMP-9 in a normal middle-aged Swedish population
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    Objective: To evaluate associations between health-related quality of life, HRQoL, and inflammatory biomarkers in a normal population, and investigate whether associations could be explained by the presence of disease, lifestyle and/or psychological factors.

    Methods: A randomly selected sample of a middle-aged Swedish population (n=961; aged 45-70 years, 50% women) was investigated. Self-reported data on HRQoL (SF-36), presence of disease, lifestyle and psychological factors, and plasma levels of biomarkers of inflammation: C-reactive protein (CRP), CXCL8, interleukin (IL)-1β, 6, and 10, and matrix metalloproteinase-9, were analyzed using correlation and regression analyses.

    Results: After adjustment for sex and age, significant negative associations were seen for all scales of the SF-36 to plasma levels of IL-6 and CRP (except the Mental Health scale for CRP), and to a lesser extent to MMP-9, while only a few significant associations were noted for the other biomarkers. Associations with IL-6 were attenuated but generally remained significant after full adjustment (for age, sex, presence of disease, lifestyle and psychological factors) in regression analyses, while associations with CRP for many scales became nonsignificant after control for lifestyle factors.

    Conclusions: Poor HRQoL was related to low grade inflammation in a normal population. The results suggest a possible pathway for earlier observed effects of HRQoL on mortality risk and indicate that low HRQoL is a sign of increased biological vulnerability. The data further indicate that IL-6, CRP, and MMP-9 are more informative markers than CXCL8, IL-1β, and IL-10 for these relationships, but also that they may not convey exactly the same information.

    Keywords
    CRP; health-related quality of life; interleukin; MMP-9; population; SF-36
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-75137 (URN)
    Available from: 2012-02-17 Created: 2012-02-17 Last updated: 2012-02-17Bibliographically approved
    3. Impact of comorbidity on health-related quality of life: a population-based study using the Charlson Comorbidity Index and the new Health-Related Quality of Life Comorbidity Index, with data from the Swedish National Inpatient Register
    Open this publication in new window or tab >>Impact of comorbidity on health-related quality of life: a population-based study using the Charlson Comorbidity Index and the new Health-Related Quality of Life Comorbidity Index, with data from the Swedish National Inpatient Register
    Show others...
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    Objectives: To investigate the impact of comorbidity on general health-related quality of life (HRQoL) in a Swedish normal population using the Charlson Comorbidity Index (CCI), designed for mortality outcomes, and the new Health-Related Quality of Life Comorbidity Index (HRQL-CI, with physical and psychosocial subindexes) designed for HRQoL outcomes, and comorbidity analyses based on data from the Swedish national inpatient register.

    Study design and setting:L In 1999, 6083 women (54%) and men aged 20-74 (mean 46, SD 15) responded to a public health survey in the county of Östergötland, Sweden, including measures of general HRQoL (the SF-36 and the EQ-5D).

    Results: During 1987-1999, 478 (15 %) and 664 (21 %)/418 (13 %) persons had been registered with ≥1 hospital admission ICD-code included in the CCI and the HRQL-CI physical/psychosocial dimensions, respectively. Both indices discriminated between persons with different degrees of comorbidity regarding their HRQoL. The HRQL-CI received somewhat higher R2 values (e.g. SF-36 scales Physical Functioning 0.161 vs 0.067 and Mental Health 0.026 vs 0.004).

    Conclusions: The new HRQL-CI, created on the basis of self-reports, proved to be a valid measure of comorbidity in a Swedish normal population using national register data.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-75138 (URN)
    Available from: 2012-02-17 Created: 2012-02-17 Last updated: 2012-02-17Bibliographically approved
    4. Respondent satisfaction regarding SF-36 and EQ-5D, and patients' perspectives concerning health outcome assessment within routine health care
    Open this publication in new window or tab >>Respondent satisfaction regarding SF-36 and EQ-5D, and patients' perspectives concerning health outcome assessment within routine health care
    2007 (English)In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 16, no 10, p. 1647-1654Article in journal (Refereed) Published
    Abstract [en]

    Objective: To investigate respondent satisfaction regarding SF-36 and EQ-5D and patients' perspectives concerning health outcome assessment within routine health care. Methods: Eighteen Swedish hospitals participated in the study which included 30 patient intervention groups (e.g. education groups for patients with ischemic heart disease or chronic obstructive pulmonary disease). Patients responded to SF-36 and EQ-5D before and after ordinary interventions (n = 463), and then completed an evaluation form. Results: Regarding respondent satisfaction, most patients found both questionnaires easy to understand (70% vs. 75% for SF-36 and EQ-5D respectively), easy to respond to (54% vs. 60%), and that they gave the ability of describing their health in a comprehensive way (68% for both). Health outcome assessment in routine health care was perceived as valuable by 57% of the patients, while 4% disapproved. Most patients (68%) considered both questionnaires equally suitable, 25% preferred SF-36 and 8% EQ-5D. Among those who were more satisfied with a short questionnaire (EQ-5D), several still preferred a longer and more comprehensive questionnaire (SF-36). Conclusion: Health outcome assessment within routine health care seems to be acceptable, and even appreciated, by patients. Questionnaire length and ease of response were not found to be crucial arguments in choosing between SF-36 and EQ-5D. © 2007 Springer Science+Business Media B.V.

    Keywords
    outcome assessment, SF-36, EQ-5D, patient perspective, respondent satisfaction
    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-39617 (URN)10.1007/s11136-007-9263-8 (DOI)50285 (Local ID)50285 (Archive number)50285 (OAI)
    Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
  • 3.
    Nilsson, Evalill
    Linköping University, Department of Neuroscience and Locomotion, Pathology. Linköping University, Faculty of Health Sciences.
    Lysosomal stability under the influence of oxidative stress and lipofuscin accumulation1998Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    The lysosome is the cellular organelle responsible for degradation and recycling of macromolecules through hetero- and autophagocytosis. It is generally considered a stable organelle that breaks down only late during cellular degeneration. This study is one in a series aiming to show that lysosomes, on the contrary, are quite vulnerable, especially to mtidative stress. Oxidative stress was applied as hydrogen peroxide or light irradiation.

    Three different cell types, known to differ considerably in their sensitivity to oxidative stress, were explored with respect to hydrogen peroxide-degradation capacity. The least sensitive comprised the highest degradation capacity, and vice versa. Furthermore, the importance of the iron content of lysosomes was investigated. Iron is known to induce Fenton reactions when reacting with hydrogen peroxide by homolytic cleavage. This creates the very reactive hydroxyl radical which can initiate lysosomal membrane damage. The result, if the oxidative stress is sufficiently pronounced, will be leakage of lysosomal enzymes to the cytosol, with ensuing cellular damage and, maybe, even death. We hypothesise that lysosomes containing the most redox-active iron also are the ones most vulnerable to oxidative stress. Lysosomes in all cell populations were shown to differ normally in iron content, and also in sensitivity to oxidative stress. Exposure to iron was shown to increase the sensitivity of cells to hydrogen peroxide, while the potent iron-chelator deferoxarnine decreased it. For photo-oxidation no such correlation was seen, indicating that the latter damage was mediated by singlet oxygen. However, a clear interlysosomal variation in stability was obvious here as well.

    As post-mitotic cells grow older, an indigestible material, known as lipofuscin or age pigment, accumulates in their lysosomes. This is commonly considered harmless to the cell, but we have for some time advocated the idea that the accumulation is detrimental. Here we have developed a new method to investigate lipofuscin's impact on cellular and especially lysosomal function. Artificial ceroid/lipofuscin was created through UV-irradiation of subcellular organelles and shown be endocytosed by cells, thereby transforming them to an aged phenotype.

  • 4.
    Nilsson, Evalill
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Borgstedt Risberg, Madeleine
    Public Health Centre, County Council of Östergötland, Linköping, Sweden.
    Orwelius, Lotti
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Unosson, Mitra
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Sjöberg, Folke
    Linköping University, Department of Clinical and Experimental Medicine, Burn Unit . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of Plastic Surgery, Hand surgery UHL.
    Kristenson, Margareta
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Impact of comorbidity on health-related quality of life: a population-based study using the Charlson Comorbidity Index and the new Health-Related Quality of Life Comorbidity Index, with data from the Swedish National Inpatient RegisterManuscript (preprint) (Other academic)
    Abstract [en]

    Objectives: To investigate the impact of comorbidity on general health-related quality of life (HRQoL) in a Swedish normal population using the Charlson Comorbidity Index (CCI), designed for mortality outcomes, and the new Health-Related Quality of Life Comorbidity Index (HRQL-CI, with physical and psychosocial subindexes) designed for HRQoL outcomes, and comorbidity analyses based on data from the Swedish national inpatient register.

    Study design and setting:L In 1999, 6083 women (54%) and men aged 20-74 (mean 46, SD 15) responded to a public health survey in the county of Östergötland, Sweden, including measures of general HRQoL (the SF-36 and the EQ-5D).

    Results: During 1987-1999, 478 (15 %) and 664 (21 %)/418 (13 %) persons had been registered with ≥1 hospital admission ICD-code included in the CCI and the HRQL-CI physical/psychosocial dimensions, respectively. Both indices discriminated between persons with different degrees of comorbidity regarding their HRQoL. The HRQL-CI received somewhat higher R2 values (e.g. SF-36 scales Physical Functioning 0.161 vs 0.067 and Mental Health 0.026 vs 0.004).

    Conclusions: The new HRQL-CI, created on the basis of self-reports, proved to be a valid measure of comorbidity in a Swedish normal population using national register data.

  • 5.
    Nilsson, Evalill
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Garvin, Peter
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Ernerudh, Jan
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Immunology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Diagnostics, Department of Clinical Immunology and Transfusion Medicine.
    Kristenson, Margareta
    Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Associations between SF-36 and inflammatory biomarkers CRP, CXCL8, IL-1β, IL-6, IL-10, and MMP-9 in a normal middle-aged Swedish populationManuscript (preprint) (Other academic)
    Abstract [en]

    Objective: To evaluate associations between health-related quality of life, HRQoL, and inflammatory biomarkers in a normal population, and investigate whether associations could be explained by the presence of disease, lifestyle and/or psychological factors.

    Methods: A randomly selected sample of a middle-aged Swedish population (n=961; aged 45-70 years, 50% women) was investigated. Self-reported data on HRQoL (SF-36), presence of disease, lifestyle and psychological factors, and plasma levels of biomarkers of inflammation: C-reactive protein (CRP), CXCL8, interleukin (IL)-1β, 6, and 10, and matrix metalloproteinase-9, were analyzed using correlation and regression analyses.

    Results: After adjustment for sex and age, significant negative associations were seen for all scales of the SF-36 to plasma levels of IL-6 and CRP (except the Mental Health scale for CRP), and to a lesser extent to MMP-9, while only a few significant associations were noted for the other biomarkers. Associations with IL-6 were attenuated but generally remained significant after full adjustment (for age, sex, presence of disease, lifestyle and psychological factors) in regression analyses, while associations with CRP for many scales became nonsignificant after control for lifestyle factors.

    Conclusions: Poor HRQoL was related to low grade inflammation in a normal population. The results suggest a possible pathway for earlier observed effects of HRQoL on mortality risk and indicate that low HRQoL is a sign of increased biological vulnerability. The data further indicate that IL-6, CRP, and MMP-9 are more informative markers than CXCL8, IL-1β, and IL-10 for these relationships, but also that they may not convey exactly the same information.

  • 6.
    Nilsson, Evalill
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Kristenson, Margareta
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Psychological factors related to physical, social,and mental dimensions of the SF-36: a populationbasedstudy of middle-aged women and men2010In: patient related outcome measures, Vol. 1, p. 153-162Article in journal (Refereed)
    Abstract [en]

    Background: Measures of health-related quality of life (HRQoL) are increasingly used as patient-reported outcome measures in routine health care. Research on determinants and correlates of HRQoL has, therefore, grown in importance. Earlier studies have generally been patient-based and few of them have examined differences between women and men. The aim of this study was to explore the relationship between psychological factors and physical, social, and mental dimensions of HRQoL, as measured by the Medical Outcome Study Short Form-36 Health Survey (SF-36), in a normal population and to see if observed relations were the same for women and men.

    Methods: Relations between scale scores for the eight scales of SF-36 and scale scores for Self-esteem, Sense of Coherence, Perceived Control, Depressed Mood (CES-D), and Cynicism were assessed through partial correlation and multiple linear regression analyses on a sample of 505 women and 502 men (aged 45–69 years), stratified for sex and adjusted for effects of age, presence of disease, back pain, lifestyle, and social support.

    Results: All psychological factors tested, except Cynicism, were significantly correlated to all scales of the SF-36 for women and men (Pearson product-moment partial correlation coefficient, |r| = 0.11–0.63 and |r| = 0.11–0.60, respectively). The addition of psychological factors into regression models resulted in significant total explained variance (R2) changes in all scales of the SF-36 for both sexes. Any discrepancies between women and men pertained more to the strength of relationships rather than the significance of different psychological factors.

    Conclusion: In this population-based study, psychological factors showed significant correlation, for women and men alike, with the physical and social scales of SF-36, as well as the mental scales. These findings suggest that assessments of HRQoL are not merely a measure of absolute function but are also dependent on people’s perception of their ability.

  • 7.
    Nilsson, Evalill
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV), Biomedicine.
    Raak, Ragnhild
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV), Biomedicine.
    Wahren, Lis Karin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Welfare and Care (IVV), Biomedicine.
    Kristenson, Margareta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Östergötlands Läns Landsting, Centre for Public Health Sciences, Centre for Public Health Sciences.
    Hälsorelaterad livskvalitet i relation till psykologiska förklaringsvariabler2004In: Svenska Läkarsällskapets Riksstämma,2004, 2004, p. 82-82Conference paper (Other academic)
  • 8.
    Nilsson, Evalill
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies, Natural Science - Medicine - Esthetics - Communication .
    Wenemark, Marika
    IMH Hälsouniversitetet, Linköpings Universitet.
    Bendtsen, Preben
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
    Kristenson, Margareta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Östergötlands Läns Landsting, Centre for Public Health Sciences, Centre for Public Health Sciences.
    Respondent satisfaction regarding SF-36 and EQ-5D, and patients' perspectives concerning health outcome assessment within routine health care2007In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 16, no 10, p. 1647-1654Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate respondent satisfaction regarding SF-36 and EQ-5D and patients' perspectives concerning health outcome assessment within routine health care. Methods: Eighteen Swedish hospitals participated in the study which included 30 patient intervention groups (e.g. education groups for patients with ischemic heart disease or chronic obstructive pulmonary disease). Patients responded to SF-36 and EQ-5D before and after ordinary interventions (n = 463), and then completed an evaluation form. Results: Regarding respondent satisfaction, most patients found both questionnaires easy to understand (70% vs. 75% for SF-36 and EQ-5D respectively), easy to respond to (54% vs. 60%), and that they gave the ability of describing their health in a comprehensive way (68% for both). Health outcome assessment in routine health care was perceived as valuable by 57% of the patients, while 4% disapproved. Most patients (68%) considered both questionnaires equally suitable, 25% preferred SF-36 and 8% EQ-5D. Among those who were more satisfied with a short questionnaire (EQ-5D), several still preferred a longer and more comprehensive questionnaire (SF-36). Conclusion: Health outcome assessment within routine health care seems to be acceptable, and even appreciated, by patients. Questionnaire length and ease of response were not found to be crucial arguments in choosing between SF-36 and EQ-5D. © 2007 Springer Science+Business Media B.V.

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