OBJECTIVE: To conduct a randomized controlled trial and compare the effects on cancer survivors' quality of life in a 12-week group-based multidisciplinary self-management rehabilitation program, combining physical training (twice weekly) and cognitive-behavioral training (once weekly) with those of a 12-week group-based physical training (twice weekly). In addition, both interventions were compared with no intervention.METHODS: Participants (all cancer types, medical treatment completed > or = 3 months ago) were randomly assigned to multidisciplinary rehabilitation (n = 76) or physical training (n = 71). The nonintervention comparison group consisted of 62 patients on a waiting list. Quality of life was measured using the RAND-36. The rehabilitation groups were measured at baseline, after rehabilitation, and 3-month follow-up, and the nonintervention group was measured at baseline and 12 weeks later.RESULTS: The effects of multidisciplinary rehabilitation did not outperform those of physical training in role limitations due to emotional problem (primary outcome) or any other domains of quality of life (all p > .05). Compared with no intervention, participants in both rehabilitation groups showed significant and clinically relevant improvements in role limitations due to physical problem (primary outcome; effect size (ES) = 0.66), and in physical functioning (ES = 0.48), vitality (ES = 0.54), and health change (ES = 0.76) (all p < .01).CONCLUSIONS: Adding a cognitive-behavioral training to group-based self-management physical training did not have additional beneficial effects on cancer survivors' quality of life. Compared with the nonintervention group, the group-based self-management rehabilitation improved cancer survivors' quality of life.
Intra-ocular straylight can cause decreased visual functioning, and it may cause diminished vision-related quality of life (VRQOL). This cross-sectional population-based study investigates the association between straylight and VRQOL in middle-aged and elderly individuals. Multivariable linear regression analyses were used to assess the association between straylight modeled continuously and cutoff at the recommended fitness-to-drive value, straylight ≥ 1.4 log(s), and VRQOL. The study showed that participants with normal straylight values, straylight ≤ 1.4 log(s), rated their VRQOL slightly better than those with high straylight values (straylight ≥ 1.4 log(s)). Furthermore, multivariable regression analysis revealed a borderline statistical significant association (p = .06) between intra-ocular straylight and self-reported VRQOL in middle-aged and elderly individuals. The association between straylight and self-reported VRQOL was not influenced by the status of the intra-ocular lens (natural vs. artificial intra-ocular lens after cataract extraction) or the number of (instrumental) activities of daily living that were reported as difficult for the elderly individuals.
AimsKnowledge of patient preferences is vital for delivering optimal healthcare. This study uses utility measurement to assess the preferences of heart failure (HF) patients regarding quality of life or longevity. The utility approach represents the perspective of a patient; facilitates the combination of mortality, morbidity, and treatment regimen into a single score; and makes it possible to compare the effects of different interventions in healthcare.Methods and resultsPatient preferences of 100 patients with HF were assessed in interviews using the time trade-off (TTO) approach. Health-related quality of life (HR-QoL) was assessed with the EQ-5D and the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Patients' own estimation of life expectancy was assessed with a visual analogue scale (VAS). Of the 100 patients (mean age 70 ± 9 years; 71% male), 61% attach more weight to quality of life over longevity; while 9% and 14% were willing to trade 6 and 12 months, respectively, for perfect health and attach more weight to quality of life. Patients willing to trade time had a significantly higher level of NT-proBNP and reported significantly more dyspnoea during exertion. Predictors of willingness to trade time were higher NT-proBNP and lower EQ VAS.ConclusionThe majority of HF patients attach more weight to quality of life over longevity. There was no difference between both groups with respect to life expectancy described by the patients. These insights enable open and personalized discussions of patients' preferences in treatment and care decisions, and could guide the future development of more patient-centred care. © 2013 Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2013. For permissions please email: journals.permissions@oup.com.
The pressure on the European health care system is increasing considerably: more elderly people and patients with chronic diseases in need of (rehabilitation) care, a diminishing work force and health care costs continuing to rise. Several measures to counteract this are proposed, such as reduction of the length of stay in hospitals or rehabilitation centres by improving interprofessional and person-centred collaboration between health and social care professionals. Although there is a lot of attention for interprofessional education and collaborative practice (IPECP), the consortium senses a gap between competence levels of future professionals and the levels needed in rehabilitation practice. Therefore, the transfer from tertiary education to practice concerning IPECP in rehabilitation is the central theme of the project. Regional bonds between higher education institutions and rehabilitation centres will be strengthened in order to align IPECP. On the one hand we deliver a set of basic and advanced modules on functioning according to the WHO’s International Classification of Functioning, Disability and Health and a set of (assessment) tools on interprofessional skills training. Also, applications of this theory in promising approaches, both in education and in rehabilitation practice, are regionally being piloted and adapted for use in other regions. Field visits by professionals from practice to exchange experiences is included in this work package. We aim to deliver a range of learning materials, from modules on theory to guidelines on how to set up and run a student-run interprofessional learning ward in a rehabilitation centre. All tested outputs will be published on the INPRO-website and made available to be implemented in the core curricula in tertiary education and for lifelong learning in health care practice. This will ultimately contribute to improve functioning and health outcomes and quality of life of patients in rehabilitation centres and beyond.
Due to their diverse funding sources, theatres are under increasing pressure to demonstrate impact on society. The Raad voor Cultuur (2023) for example advised the secretary of state to include societal impact as an additional evaluation measure next to artistic value. Many theaters, such as the Chassé Theater and Parkstad Limburg Theaters, have reformulated their missions to focus on impact of performances on visitors. This is a profound transformation from merely selling tickets and filling seats, and requires new measurement instruments to monitor, manage, and improve impact. Currently available instruments are insufficient, and effective monitoring is crucial to larger future projects that theaters are currently planning to systematically broaden impacts of performances on their communities. The specific goal of this project is to empower theaters to monitor and improve impact by developing a brief experience impact questionnaire, taking existing data from student projects conducted at the Chassé Theater about performing arts experiences on one hand, and experience impact theory innovations on the other, as starting points. We will develop potential items to measure and benchmark against established measures of valued societal outcomes, such as subjective well-being and quality of life. These will be measured in questionnaires developed with project partners Chassé Theater and Parkstad Limburg Theaters and administered before and after performances across a wide range of genres. The resulting data will enable comparison of new questionnaire items with benchmarked measures of valued societal outcomes. The final product of the project will be a brief impact questionnaire, which within several brief self-report instruments and just a few minutes can effectively be used to quantify the impact of a performing arts experience. A workshop and practice-oriented article will make this questionnaire implementable, thereby mobilizing the key enabling methodology of monitoring and impact measurement in the performing arts sector.
Due to their diverse funding sources, theatres are under increasing pressure to demonstrate impact on society. The Raad voor Cultuur (2023) for example advised the secretary of state to include societal impact as an additional evaluation measure next to artistic value. Many theaters, such as the Chassé Theater and Parkstad Limburg Theaters, have reformulated their missions to focus on impact of performances on visitors. This is a profound transformation from merely selling tickets and filling seats, and requires new measurement instruments to monitor, manage, and improve impact. Currently available instruments are insufficient, and effective monitoring is crucial to larger future projects that theaters are currently planning to systematically broaden impacts of performances on their communities.The specific goal of this project is to empower theaters to monitor and improve impact by developing a brief experience impact questionnaire, taking existing data from student projects conducted at the Chassé Theater about performing arts experiences on one hand, and experience impact theory innovations on the other, as starting points. We will develop potential items to measure and benchmark against established measures of valued societal outcomes, such as subjective well-being and quality of life. These will be measured in questionnaires developed with project partners Chassé Theater and Parkstad Limburg Theaters and administered before and after performances across a wide range of genres. The resulting data will enable comparison of new questionnaire items with benchmarked measures of valued societal outcomes. The final product of the project will be a brief impact questionnaire, which within several brief self-report instruments and just a few minutes can effectively be used to quantify the impact of a performing arts experience. A workshop and practice-oriented article will make this questionnaire implementable, thereby mobilizing the key enabling methodology of monitoring and impact measurement in the performing arts sector.Societal issueThe specific goal of this project is to empower theaters to monitor and improve impact by developing a brief experience impact questionnaire, taking existing data about performing arts experiences on one hand, and experience impact theory innovations on the other, as starting points. Benefit to societyWe will develop potential items to measure and benchmark against established measures of valued societal outcomes, such as subjective well-being and quality of life. Collaborative partnersChassé Theater N.V., Parkstad Limburg Theaters N.V.
