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      Survey on Quality Of Life related factors in patients with Peptic Ulcer based on PRECEDE Model in Yazd, Iran

      case-report

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          Abstract

          Background: Peptic ulcer is one of the most prevalent diseases. Its prevalence is estimated between 6-15% and, about 10% of the people, experience its symptom in a period of their life. Studies showed that quality of life and health status of peptic ulcer patients is affected by disease.

          Objectives: The aim of this study was to determine the Quality of life Related Factors in patients with peptic ulcer based on Precede Model.

          Context: A cross-sectional study with 120 subject patients, who were referred to Shahid Sadoghi Hospital of Yazd.

          Methods: The patients were selected by simple Random sampling and data were collected by researchers making questionnaire. The validity and reliability of the questionnaire was approved. The data collected were transferred directly into SPSS. For data analysis, correlations, T–test, One way – ANOVA were used.

          Results and Conclusion: Results showed that there was a significant difference between the Quality of Life and Self-Management (p=0.05) and Quality of Life with Health Status (p=0.01). Pearson correlation showed that there was a significant correlation between the Quality of Life and Reinforcing factors (P=0.01). Totally, it was found that the health status, Self–Management, Predisposing and Enabling factors predicted 0.64 of the quality of life variance, among which, the Health Status was the strongest predictor (β=0.575). What should be taken into account is the cultural situation of Iran and the fact that the PRECEDE model is a model for planning intervention. It can be used as a framework for planning intervention in order to promote the quality of life of ulcer peptic patients in Iran.

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          Depressive symptoms and health-related quality of life: the Heart and Soul Study.

          Bernice Ruo, M A Hlatky, John S Rumsfeld … (2003)
          Little is known regarding the extent to which patient-reported health status, including symptom burden, physical limitation, and quality of life, is determined by psychosocial vs physiological factors among patients with chronic disease. To compare the contributions of depressive symptoms and measures of cardiac function to the health status of patients with coronary artery disease. Cross-sectional study of 1024 adults with stable coronary artery disease recruited from outpatient clinics in the San Francisco Bay Area between September 2000 and December 2002. Main Measures Measurement of depressive symptoms using the Patient Health Questionnaire (PHQ); assessment of cardiac function by measuring left ventricular ejection fraction on echocardiography, exercise capacity on treadmill testing, and ischemia on stress echocardiography; and measurement of a range of health status outcomes, including symptom burden, physical limitation, and quality of life, using the Seattle Angina Questionnaire. Participants were also asked to rate their overall health as excellent, very good, good, fair, or poor. Of the 1024 participants, 201 (20%) had depressive symptoms (PHQ score > or =10). Participants with depressive symptoms were more likely than those without depressive symptoms to report at least mild symptom burden (60% vs 33%; P<.001), mild physical limitation (73% vs 40%; P<.001), mildly diminished quality of life (67% vs 31%; P<.001), and fair or poor overall health (66% vs 30%; P<.001). In multivariate analyses adjusting for measures of cardiac function and other patient characteristics, depressive symptoms were strongly associated with greater symptom burden (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.3-2.7; P =.002), greater physical limitation (OR, 3.1; 95% CI, 2.1-4.6; P<.001), worse quality of life (OR, 3.1; 95% CI, 2.2-4.6; P<.001), and worse overall health (OR, 2.0; 95% CI, 1.3-2.9; P<.001). Although decreased exercise capacity was associated with worse health status, left ventricular ejection fraction and ischemia were not. Among patients with coronary disease, depressive symptoms are strongly associated with patient-reported health status, including symptom burden, physical limitation, quality of life, and overall health. Conversely, 2 traditional measures of cardiac function-ejection fraction and ischemia-are not. Efforts to improve health status should include assessment and treatment of depressive symptoms.
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            Supporting self-management in patients with chronic illness.

            Mary Thoesen Coleman, Karen S. Newton (2005)
            Support of patient self-management is a key component of effective chronic illness care and improved patient outcomes. Self-management support goes beyond traditional knowledge-based patient education to include processes that develop patient problem-solving skills, improve self-efficacy, and support application of knowledge in real-life situations that matter to patients. This approach also encompasses system-focused changes in the primary care environment. Family physicians can support patient self-management by structuring patient-physician interactions to identify problems from the patient perspective, making office environment changes that remove self-management barriers, and providing education individually and through available community self-management resources. The emerging evidence supports the implementation of practice strategies that are conducive to patient self-management and improved patient outcomes among chronically ill patients.
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              Social conditions and self-management are more powerful determinants of health than access to care.

              Darren A DeWalt, T Pincus, Catherine Callahan … (1998)
              Professional organizations advocate universal access to medical care as a primary approach to improving health in the population. Access to medical services is critical to outcomes of acute processes managed in an inpatient hospital, the setting of most medical education, research, and training, but seems to be limited in its capacity to affect outcomes of outpatient care, the setting of most medical activities. Persistent and widening disparities in health according to socioeconomic status provide evidence of limitations of access to care. First, job classification, a measure of socioeconomic status, was a better predictor of cardiovascular death than cholesterol level, blood pressure, and smoking combined in employed London civil servants with universal access to the National Health Service. Second, disparities in health according to socioeconomic status widened between 1970 and 1980 in the United Kingdom despite universal access (similar trends were seen in the United States). Third, in the United States, noncompletion of high school is a greater risk factor than biological factors for development of many diseases, an association that is explained only in part by age, ethnicity, sex, or smoking status. Fourth, level of formal education predicted cardiovascular mortality better than random assignment to active drug or placebo over 3 years in a clinical trial that provides optimal access to care. Increased recognition of limitations of universal access by physicians and their professional societies may enhance efforts to improve the health of the population.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Med Life
                Journal ID (iso-abbrev): J Med Life
                Journal ID (publisher-id): JMedLife
                Title: Journal of Medicine and Life
                Publisher: Carol Davila University Press (Romania )
                ISSN (Print): 1844-122X
                ISSN (Electronic): 1844-3117
                Publication date (Print): 14 November 2011
                Publication date (Electronic): 24 November 2011
                Volume: 4
                Issue: 4
                Pages: 407-411
                Affiliations
                simpleShahid Sadoughi University of medical sciences,Yazd Iran
                Author notes
                Correspondence to:Maleknaz Baghianimoghadam, Student of Medicine Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences and Health Services. Ibn sina BLVD; Yazd, Iran Phone: 0351-6238626; Fax: 0351- 6238555 E- mail: maleknazbaghiany@yahoo.com
                Article
                Publisher ID: JMedLife-04-407
                PMC ID: 3227165
                PubMed ID: 22514574
                SO-VID: 9afc2844-ecc6-4a9a-8d49-e051e9750037
                Copyright © ©Carol Davila University Press
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 28 April 2011
                Date accepted : 25 September 2011
                Categories
                Subject: Case Presentation

                ScienceOpen disciplines: Medicine
                Keywords: precede model,peptic ulcer,quality of life
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: precede model, peptic ulcer, quality of life

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