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Sampogna F.,Health Services Research Unit
Current Problems in Dermatology (Switzerland) | Year: 2013

The concepts of cumulative life course impairment (CLCI) and health-related quality of life (QoL) are analyzed, in order to find shared and divergent aspects. The concept of QoL includes the patients' perception of their health and their personal experiences concerning the psychosocial impact of the disease on their life. CLCI aims to investigate the impact of a chronic disease on the milestones of life, such as education, work, relationships, children, social life, (briefly - on the whole trajectory of life) and on how the disease influenced the possibility of patients of living their life up to its full potential. QoL is a cross-sectional measure, while CLCI takes into account the lifetime. However, it is clear that the possibility of reaching one's full life potential and QoL at a certain time are correlated. There are few studies in dermatology in this field; however, both in the case of atopic dermatitis and of vitiligo it has been shown that patients with a severe condition in childhood endured severe psychosocial and physical consequences in adulthood and experienced a profound negative impact of the disease on their current quality of life. It is thus important to take into account both CLCI and QoL when evaluating the impact of a chronic condition on a patient's life. Copyright © 2013 S. Karger AG, Basel. Source

Ammentorp J.,University of Southern Denmark | Jensen H.I.,University of Aarhus | Uhrenfeldt L.,Health Services Research Unit
Journal of Continuing Education in the Health Professions | Year: 2013

Introduction:: In recent years, coaching, as a supplement to professional development, has received increased attention, especially in nursing. Still, only little is known about how health professionals experience participating in coaching sessions. The purpose of this pilot study was to describe and analyze health professionals' experiences from coaching-what coaching meant to them and how it influenced different aspects of their lives. Methods:: The study was designed as a qualitative interview study including 5 health professionals working with quality improvement at the hospital. Depending on the individual's need, they participated in 2 to 4 coaching sessions. Afterwards, they were included in the study and interviewed. Data from the interviews was verbatim transcribed and analysed according to Paul Ricoeur's theory of interpretation. The findings and their importance are discussed in relation to results from research in positive psychology. Results:: By picturing their job in a new perspective, the participants experienced a raised potential for mutual prioritising, actions, and job satisfaction. Two dominant themes were identified: "progressive insight leading to actions" and "expressing needs for leadership aiming for self-realization." The results indicate that coaching can be effective in enhancing not only self-insight and core performance, but also increased positive feelings. Conclusion:: By looking at the experiences of coaching, we have elucidated why coaching in this instance could be a method used to strengthen the individual employee. The results indicate that coaching can improve the work attitude of the participants and pave the way for new and progressive insights. © 2013 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education. Source

Ottova V.,University of Hamburg | Erhart M.,University of Hamburg | Rajmil L.,Agency for Health Information | Rajmil L.,Health Services Research Unit | And 2 more authors.
Quality of Life Research | Year: 2012

Purpose To analyse the impact of overweight on HRQoL in a European sample of children and adolescents. Methods Analyses were conducted using data on 17,159 children and adolescents aged 8-18 from 10 European countries (Germany, Spain, France, Netherlands, Austria, United Kingdom, Switzerland, Hungary, Czech Republic and Poland) participating in the KIDSCREEN Health Interview Survey. In the studied sample (N = 13,041), there were slightly more girls (52.6%) than boys (47.4%). Gender- and age-specific cut-offs of Cole et al. (BMJ 320:1240, 2000) were used to define overweight and obesity. The two groups were collapsed into one 'overweight' category. HRQoL was assessed on 10 dimensions using the KIDSCREEN-52. Univariate analysis of covariance (ANCOVA) was performed for group comparisons (normal weight vs. overweight). Partial eta squared (ηp 2 ) was used as a measure of effect strength. Results Overall, 14.2% (N = 1,849) of the sample was overweight, with prevalence rates ranging between 9.4% in France and 17.6% in Spain. Across all countries, overweight children and adolescents had lower mean HRQoL scores than normal weight children and adolescents. The strongest HRQoL impairments emerged on the physical well-being (ηp 2 = 0.012) and self-perception dimensions (ηp 2 = 0.021), both P<0.001. Conclusions This is one of the first studies comparing the impact of HRQoL at European level using a generic and internationally valid HRQoL instrument, and the results show that, irrespective of national background, overweight children and adolescents are significantly impaired on their HRQoL, in particular on the physical well-being and the self-perception domain. © Springer Science+Business Media B.V. 2011. Source

Tabolli S.,Health Services Research Unit | Pagliarello C.,University of Parma | Paradisi A.,Health Services Research Unit | Cianchini G.,IDI IRCCS | And 2 more authors.
British Journal of Dermatology | Year: 2014

Background Studies conducted using different tools have invariably observed that physical and mental components of health status are seriously compromised in patients with pemphigus. An improvement in quality of life (QoL) has been commonly observed over the treatment period. Objectives The aim of the study is to verify whether the patients' wellbeing is affected by pemphigus also in absence of cutaneous and mucosal lesions. Materials and methods The clinical records of 203 patients were analysed. A total of 47 patients were without bullae/erosions and reported a score = 0 for both the Patient Global Assessment and the Ikeda index. In order to assess the QoL we used the Skindex-17 and the 12-item General Health Questionnaire (GHQ-12). Results Patients without bullae/erosions had a better QoL when compared with patients with active lesions. This difference, with a reduction of approximately 30% of the Skindex-17 scores in the patients without lesions, was statistically significant, for both the symptoms and the psychosocial scales. The proportion of patients at risk of anxiety/depression (GHQ-positive cases) was 44% lower in patients without lesions compared with patients with lesions. In a multiple linear regression model the presence of bullae/erosions negatively influences QoL with an average increase of Skindex-17 symptoms and psychosocial scale scores of 11·7 and 10·6 points, respectively. Female patients had a statistically significantly worse QoL than males on the symptoms but not on the psychosocial Skindex-17 scales. Conclusions While patients without lesions reported a better QoL than patients with bullae/erosions, their Skindex-17 scores remained elevated. Dermatologists should be aware that a clearing of the skin manifestations does not mean 'perfect health' for the patient. What's already known about this topic? Pemphigus has a severe impact on quality of life. Patients with pemphigus have an increased risk of anxiety and depression. Following treatment, pemphigus may have long periods of quiescence. What does this study add? Quality of life is significantly impacted also in patients without bullae/erosions, and in women it is worse than in men. High percentages of patients are at risk of anxiety and depression even when the disease is quiescent. The burden of disease continues to be present even during periods of relative wellness. © 2014 British Association of Dermatologists. Source

Paradisi A.,Health Services Research Unit | Abeni D.,Health Services Research Unit | Bergamo F.,IDI IRCCS | Ricci F.,Catholic University of the Sacred Heart | And 2 more authors.
Journal of the American Academy of Dermatology | Year: 2014

Background Toxic epidermal necrolysis (TEN) is a severe and potentially lethal drug reaction for which no standard treatment is available. Objective To describe a case series of patients with TEN treated with a single dose of etanercept. Methods We observed 10 consecutive patients with TEN. For each patient, we recorded the presence of comorbidities and all the drugs recently started (ie, in the last month). In all cases, 50 mg of etanercept was administered in a single subcutaneous injection. The clinical severity of disease was computed using the SCORe of Toxic Epidermal Necrosis (SCORTEN) scale. Using the probabilities of death linked to each level of SCORTEN score, we calculated the expected probability of death in our patients. Healing was defined as complete reepithelialization, and a time to healing curve was then obtained using the Kaplan-Meier method. Results All patients promptly responded to treatment, reaching complete reepithelialization without complications or side effects. The median time to healing was 8.5 days. Limitations This is a small, uncontrolled case series. Conclusion These preliminary results suggest the possibility that tumor necrosis factor-alfa may be an effective target for control of TEN, a dangerous skin condition for which no effective cure has yet been found. © 2014 by the American Academy of Dermatology, Inc. Source

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