Quality of life, health satisfaction and family impact on caregivers of children with developmental delays.

OBJECTIVE: To study the quality of life, health satisfaction and family impact on caregivers of children with developmental delays in Taiwan. DESIGN: Cross-sectional study. SUBJECTS: The caregivers of children with diagnoses of developmental delays recruited from a teaching hospital in northern Taiwan. METHODS: The main caregivers of 48 male and 22 female children with developmental delays were recruited. WHOQOL-BREF for health-related quality of life (HRQOL), PedsQL-Health Satisfaction for health satisfaction, PedsQL-Family Impact Module and Impact on Family Scale for family impact were evaluated. The correlation of caregivers' HRQOL, health satisfaction and family impact were also studied. RESULTS: Caregivers in nuclear families had higher health satisfaction scores (78.2 for nuclear families vs. 66.9 for extended families, P < 0.05) when assessed by the PedQL-Health Satisfaction questionnaire. Children's age was negatively correlated with family impact, including parent (-0.272, P = 0.023), family (-0.262, P = 0.029) and total scores (-0.281, P = 0.018) as assessed using the PedsQL-Family Impact Module. CONCLUSION: A negative relation between impact of burden and child's age suggests that family members gradually adapt to the delayed developmental status in their children as they grow. Caregivers in nuclear families having higher health satisfaction than those in extended families may be due to Chinese cultural effects.

Quality of life and its correlates in ambulatory hemodialysis patients.

BACKGROUND: In hemodialysis patients, quality of life (QOL) may vary across a range of individual conditions and social environments. In this study, we focused on ambulatory hemodialysis patients, examining their QOL compared with that of age-matched controls. Correlates of QOL in ambulatory hemodialysis patients were also examined. METHODS: QOL was evaluated by WHOQOL in ambulatory hemodialysis patients and age-matched controls. Correlations of QOL with age, sex, body mass index (BMI), functional performance, physical activity, cognitive function, psychiatric disorders, diabetes status, comorbidities, duration of dialysis therapy, adequacy of dialysis, biochemical variables and nutritional status were also examined in ambulatory hemodialysis patients. RESULTS: In WHOQOL, we found decreased psychological domain scores (19.8 vs. 21.6, p=0.012) and overall QOL (89.0 vs. 94.3, p=0.035) for ambulatory hemodialysis patients compared with age-matched controls, especially in the items: enjoying life (p=0.032), feeling life has meaning (p=0.023), having opportunity to take leisure time (p=0.003) and being satisfied with sexual life (p=0.044). Patients with male sex, BMI >24 and duration of dialysis shorter than 5 years had lower overall QOL than controls. Male dialysis patients also had lower QOL than female patients. As for correlates of QOL in ambulatory hemodialysis patients, age, BMI and psychiatric disorders were negatively correlated. By contrast, premorbid and current satisfaction with personal health were positively correlated. CONCLUSIONS: QOL in ambulatory hemodialysis patients was lower than in age-matched controls. QOL in ambulatory hemodialysis patients was positively correlated with personal health satisfaction and negatively correlated with age, BMI and psychiatric disorders.

Estimating life expectancy using an age-cohort model in Taiwan.

OBJECTIVES: Life expectation is a valuable summary index in public health and actuarial science. The life expectancies published in the vital statistics, however, are derived from the "current" rather than from the "cohort" life table. The former is based on a strong assumption of constant mortality in the population, whereas the latter calls for a recording of the mortality experience of a group of individuals, which is often an impossible task. Thus, a method of calculating cohort life expectancy without actual follow up is much needed. METHODS: Estimation of cohort life expectancy was based on an age-cohort model. Mortality data for the male population in Taiwan from 1951 to 1990 are used to illustrate the methodology. RESULTS: The increment of life expectancy over time in Taiwan is actually steeper than was previously thought using the current life table technique. CONCLUSIONS: The method is easy to implement and the data required are the usual age and period cross classified mortality data. It warrants further investigation.

Disability among the elderly of Taiwan.

A cross-sectional study on the correlates of elderly disability was conducted in Taiwan. A total of 400 subjects was randomly selected according to Barthel Index scores from among 2600 subjects, which was a sample of a previous community-based health survey of elderly aged 65 or over. After comprehensive interviews and examinations of the subjects, disability dimensions and its correlates were identified. Results showed elderly with lower Mini-Mental State Examination scores and chronic diseases (such as stroke, pressure sores, hypertension, fracture, etc.) were more physical-functionally and socially disabled. This suggests that prevention and treatment of chronic diseases should be pursued further and that further assessment of cognitive-mental status in the elderly is warranted. In addition, males were more disabled than females in a physical-functional aspect, which may be the consequence of the traditional Chinese cultural effect.